First-round draft choice Kenny Clark, a nose tackle from UCLA, stretches during Green Bay Packers rookie orientation minicamp Friday. Credit: Mark Hoffman

Green Bay — The Green Bay Packers' decision to bypass UCLA linebacker Myles Jack underscores the oftentimes hidden dimension of medical tolerance and the importance it plays in who is drafted when.

As much as the Packers loved Jack as a player, the condition of his right knee carried too much risk for general manager Ted Thompson at the 27th pick of the first round of the NFL draft last week.

Loquacious Sam Seale, the team's valued west regional scout since the mid-1990s, urged Thompson to make Jack a Packer.

"Sam told Ted, 'Take him. He is a Pro Bowl player. Take him,'" said one of Seale's many NFL friends after they had a conversation in the last 10 days.

"But the doctors were the issue," the friend continued. "They didn't feel comfortable taking him there with the questions about the knee. That was the only reason."

One team with a top-20 pick cleared Jack and planned to take him.

When other players fell, that club took someone else and Jack crashed to No. 36, where Jacksonville traded a fifth-round choice to Baltimore for the right to move up two slots and select him.

On the other hand, a top executive in personnel for a team with one of the final 11 selections in the first rounds expressed the view that was commonplace throughout the league.

"We didn't get the OK to take him," the executive said this week. "Too big a risk. How do you waste a first-round pick? We didn't have enough picks to be throwing them around. Even if he can play, it's not going to be for long."

Under the 2011 collective bargaining agreement, only players taken in the first round have base salaries guaranteed for the first three years. Since the draft began in 1936, no team wants egg on its face from a disastrous selection in the first round.

A vocal segment of fans have emailed insisting Thompson should have gambled on Jack at No. 27. Now they'll use Seale's words for more attacks.

Just remember that as an area scout Seale wasn't privy to Jack's voluminous medical file. Also, he isn't responsible for spending millions of dollars on a first-round pick just as he wouldn't be held accountable for his opinions within an organization that demands he be opinionated.

They say it's lonely at the top, and it must have been for Thompson that night in late April.

Thompson showed his aggressiveness the next day, trading up in the second round to draft tackle Jason Spriggs with the 48th choice. As wrenching as I'm guessing it was to let Jack go, Thompson displayed wisdom taking the never-been-injured nose tackle, Kenny Clark.

Jack fit no greater need at inside linebacker than Clark did at nose tackle.

Of the two, there's no doubt Jack was the superior prospect. When the Journal Sentinel polled 19 national-oriented scouts on the best player in the draft, Jack finished third.

"People told me he (Jack) was the best player in the draft," Ron Wolf, the Packers' general manager from late 1991 to early 2001, said Friday.

Wolf quickly added that he knew nothing about Jack as a player other than what he had picked up from others.

However, Wolf certainly can relate to what might have been the keen disappointment felt by Thompson as he let a potential superstar slip away.

"Yeah, but it doesn't do you any good," said Wolf. "If the guy is medically unable to play, then you have to control your emotions. You're the person that established what the criteria is.

"If the criteria is the guy has this or has that, then one has a decision to make. If in the opinion of the doctors and trainers the guy can't play medically, what's the use beating your head against the wall?"

Patrick McKenzie, an orthopedic surgeon and the team's physician since 1993, was primarily responsible for informing Thompson of the risks associated with Jack's right knee.

In a late September practice, Jack suffered meniscus cartilage damage. After being unable to run a 40 at the combine or pro day, he told reporters in New York two days before the draft that microfracture surgery might be necessary.

Microfracture is about the reddest of red flags when it comes to knees. There's little doubt some teams were petrified after hearing that coming from the player's lips.

Coach Mike McCarthy, who has worked with McKenzie for 11 years, has called him conservative in his prognoses several times. Wolf demurred, citing the trade for Brett Favre in 1992.

Clarence Novotny, a general practitioner in Green Bay, replaced Eugene Brusky as team physician in January 1991. Novotny then examined Favre at the combine a month later.

When Wolf traded for Favre in February 1992, Novotny was in charge of Favre's physical examination before the deal could be consummated. He didn't like the look of Favre's hip.

"When he came in here Novotny failed him," recalled Wolf. "He didn't have all the facts."

McKenzie had been treating Packers players on a referral basis as early as 1991. Acting as a consultant on Favre, it was McKenzie who signed off on the hip, according to Wolf.

"Obviously, I did trust him," said Wolf, who appointed McKenzie to team physician in 1993 after firing Novotny. "People (fans) don't know. That's why you have those people (doctors). They help you get out of trouble. They do a great job of that."

During Wolf's tenure, players received a medical grade of 1, 2, 3 or 4. A 4 meant do not take.

When McKenzie and the rest of the medical/training staff would return from the combine medical recheck in Indianapolis a few weeks before the draft, everything would be cut and dried under Wolf.

"It was who failed, who didn't fail and go from there," said Wolf, adding that any players with a 4 were off his board.

It was the 3-graded players that led to heavy discussion.

"You establish with the doctor your criteria," Wolf said. "Now you interview the doctor. The doctor tells you what he thinks. The doctor doesn't make the decision. You make the decision."

Let's assume Thompson still uses Wolf's grading, and Jack was a 3.

Wolf said he never drafted a 4. When Wolf took 3s, he said those players usually didn't work out.

In Wolf's last full-fledged draft (2000), he remembered using two of his three fourth-round choices on wide receiver Anthony Lucas and safety Gary Berry.

Lucas, who had three arthroscopic surgeries on his right knee at Arkansas, showed up at the post-draft minicamp and couldn't run. Eventually, he had ACL surgery before being released in August 2001 without having played a down.

Berry's career was ended by a spinal injury in his only game. The season before at Ohio State, he had suffered a neck strain and concussion.

"I tried a couple times to take guys to hit a home run, and they failed," said Wolf. "They both had injuries, and stayed injured. You learn lessons that way, you know?"

My best guess, based on discussing Jack with half a dozen teams, is that his career will be short-lived, at least as an elite performer.

Fans are blind to the X-rays and scans, forget about the money at stake and the pressure to reinforce a vulnerable defense with reliable parts.

They want Jack today, a Super Bowl tomorrow and happy ever after. Too bad it's never quite that easy.

Play the odds, just the way Ted Thompson did.