WASHINGTON, DC – On Wednesday afternoon, Washington Nationals pitcher Shawn Hill had some time to kill, a curse only when your mind is burdened with concern. While his teammates took batting practice or jogged in loose rows along the outfield perimeter, the Canadian-born Hill sat in the dugout next to a Gatorade cooler. His latest injury prevented him from anything but waiting, watching and worrying. “Not having a great day today,” Hill said. “Just tough, you know? It's just day after day – pain. Yesterday I was [ticked] off. Today I'm [ticked] off.”

Had Hill's arm felt pain-free, or even pained but usable, he – not Matt Chico – would have started the game this particular evening as Washington's pitcher.

In six starts spanning the previous month, that's how it worked: Hill took painkillers to silence the throbbing in his right forearm and battled just long enough, just well enough, to persuade himself to try it again five days later.

To preserve himself between starts, Hill never threw. He fine-tuned mechanics only by watching video. The approach downgraded his pitching ability, removing the bite from his curve and the grace from his change-up, but reality left him with little choice. Pitching, baseball’s most precarious job, turns potential into disappointment with cruel regularity. Across the sport, injuries burn careers.

Rarer, though, are cases such as Hill's, whose forearm pain inhibits pitching but doesn't prohibit it. His present goal – to prove he can still be a commodity, even when he can't pitch his best – indicates both baseball's demand for pitching and Hill's demands for himself. Still, Hill, 27, often worries about his circumstances.

No doctor has identified the source of his forearm pain, which resurfaced in February. A series of MRI exams, bone scans, X-rays and nerve studies have offered no clues.

His trip to a specialist at Duke University Hospital had ended with these words, according to Hill: “I wish I could help you.”

While in the dugout, talking about his season – so far, an 0-1 record and a 4.08 ERA in six starts – Hill interrupted a question about his chance for a potential-fulfilling career.

“If I can get healthy, yes,” he said. “If I can get past the point of not dealing with this. But right now, nobody really knows [what's wrong]. If you could tell me, ‘You've got to take three months off, one week, even two years,’ whatever it is, and you’d be 100 percent, I could at least live with that.”

“With this pain, I could still make a living; I could be an above-average pitcher. But the hardest part is knowing what I'm capable of. It's just frustrating that the body won't let me get to that point.”

Baseball, from the beginning, has found a way to test Hill's willingness to fight injuries.

In second or third grade, right before T-ball season in Ontario, Hill broke his leg while playing in his grandmother's yard.

He decided to play the entire season in a cast, batting last and playing first base. So his baseline for toughing it out ? Hill was willing to play while entirely immobilized.

Since becoming a pro, injuries have become more orthodox – and more persistent. He had ligament replacement surgery in 2003 and left shoulder surgery last season; never has Hill, who entered the minor leagues in 2000, managed more than 25 starts in a year.

The forearm injury developed last season, too, and offseason surgery designed to remove the pain actually worsened it. Now, Hill said he is conscious of the pain 99 percent of the time. It prevents typical upper-body weight training. It hinders his sleep. It spikes when he twists his arm or moves it forward. He drives with his left hand on the steering wheel. He grimaces when he picks up a bottle of water.

“This part,” Hill said, pointing to a spot in the middle of his forearm, “it’s basically like somebody stabbed me. I've never had somebody stab me, obviously, but the feeling is a sharp, sharp pain. I basically modify everything I do so I'm not feeling anything”.

“Pitching, I'm nowhere near 100 percent of what I'm capable of. I go out there, and the team expects a certain outcome – fans, reporters, coaches, [General Manager] Jim [Bowden], whoever – and then you go out there and you're not doing what they expect you to do. The performances I've put out I'm not happy with at all."

Because of Hill’s predicament, team management faces a delicate question, one that weighs Hill’s ability as an aching pitcher opposite the ability of a healthy substitute. Hill only received the opportunity to pitch this season, after starting the year on the disabled list, because Washington received assurances that doing so would risk no long-term damage.

“If there was risk we’d shut him down completely, because we always lean on the side of conservatism when it comes to our pitchers," Bowden said. "When the medical reports come back and say there's no risk for him to pitch, based on that, we give him the ball. We give him the ball and make him pitch through the pain.”

Some pitchers quietly spend every fifth day, over years, doing the exact thing their body doesn't want. And a mistreated pitching arm can find complicated ways to protest. In Hill's case, forearm problems likely shifted more pressure during his delivery to the back of the elbow. Because extending his arm caused pain, the elbow and triceps felt compelled to counteract that motion -- or apply the brakes, as Hill said.

Now, Hill has elbow pain, too.

Saturday, doctors pumped his elbow with cortisone and drained it of fluid.

Shortly after, the Nationals determined Hill would miss his start, though Manager Manny Acta expects Hill to return for his next appearance.

Hill, too, thinks he can do it. If he must, he can tolerate an entire season of handicapped preparation; he can get by with a sinkerball that's good instead of great, with a curve that's whimsical instead of reliable. Complete health, if and when it comes, might enable a great career, but the key – the dilemma, too – requires learning what to do while waiting.

“Exactly,” Hill said. “Can I give the team six innings, maybe [allow] two runs – a quality start, maybe not what I want, but I keep the team in it to possibly win the ballgame? Or will I go out there and give up seven runs in four innings ? Even if I can suck it up and deal with the pain, will I get shelled ?”

SPECIAL TO WWW.CANADIANBASEBALLNEWS.COM – 23 May 2008