BALTIMORE -- Cole Ragans did not know whether he would ever play baseball again.

It was 2019, and Ragans was in the midst of another season rehabbing from his second Tommy John surgery in as many years, long days spent in the training room while not picking up a baseball and taking slow steps to get back on the mound.

This was back when Ragans was a top prospect in the Rangers system. He underwent his first elbow surgery in March 2018. It was a setback, but many pitchers make it back to the mound 12-14 months after a Tommy John procedure. One year later, Ragans was nearing a return to affiliate ball when he felt a similar pain in his elbow.

Imaging showed that the ligament had torn. Another surgery, another lost season, and a much bigger setback than the first surgery.

“You go through one and it’s all right,” Ragans said. “But back to back, the second one, there were days where I was like, ‘I don’t know if I’ll ever be healthy again. Who knows?’”

On Tuesday, Ragans will take the mound as the Royals’ Game 1 starter for their first playoff game in nine years. He’ll face Orioles ace Corbin Burnes at Camden Yards to kick off a best-of-three Wild Card Series.

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Ragans’ journey to get here has not been linear. It includes first-round Draft pick status and a two-time Tommy John designation. It features up-and-down performance in the Minors and trying to make it in the big leagues with the Rangers. It includes a trade that sent Ragans to Kansas City for Aroldis Chapman.

In 2023, Ragans joined the Royals as a young pitcher with a high ceiling.

Now he’s an ace.

“The way he’s super calm on the mound, the way he prepares himself every time he’s going to pitch,” catcher Salvador Perez said, “He’s young, but he [acts] like a veteran guy.”

Ragans became a target for the Royals in June 2023 when it became clear the Rangers wanted to move aggressively to bolster their bullpen. Light discussion turned intense over three or four weeks, with the Royals eyeing young starters and zeroing in on Ragans.

“Good teams are built around starting pitching,” general manager J.J. Picollo said. “... And it’s really expensive to go get starting pitching. We were able to do things this offseason, but at the time, we needed to get better fast to maximize our years with Bobby [Witt Jr.], not knowing we’d be able to extend him.”

Officials saw Ragans pitch live in Triple-A and were blown away by the increase in velocity -- the result of an offseason spent with Tread Athletics -- a consistent delivery and command trending in the right direction.

What they saw with their eyes matched the data and scouting reports they had on the lefty.

“We knew the makeup was good from the background work we did,” Picollo said. “But it was the velocity and the command improving that really stuck out to us.”

The trade was not without risk, especially with Ragans’ injury history. But the Royals medical team signed off on it because the surgeries were back to back. That meant the procedure had failed the first time, and Ragans was not likely dealing with a genetic or reoccurring issue.

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“That was probably the most interesting part of it,” Picollo said. “I fully expected our medical staff to come back and say it was too high of a risk. But it was the opposite.”

The day Ragans was traded was “chaos,” he said, but he flew to Triple-A Omaha to get acclimated. He told the pitching coaches there that he was working on a slider, and they agreed it would help his repertoire. That became the main focus until there was a need for Ragans in the Kansas City rotation.

He never left after his start on Aug. 2. He was the AL Pitcher of the Month in August. He finished the 2023 season with a 2.64 ERA, and he opened the ’24 season as the Opening Day starter. Even with the additions of veterans Seth Lugo and Michael Wacha, the Royals were and still are building their rotation around Ragans.

This season, Ragans posted a 3.14 ERA across 32 starts. He became the fifth Royals pitcher to record 200-plus strikeouts and first since Zack Greinke in 2009.

A lot has changed since Ragans worried baseball was over for him. He wouldn’t trade a second of the journey, especially since joining Kansas City.

“I love it here,” Ragans said. “This team is special, I love the city of Kansas City, I love the fans. Everything about it.

“I’ve enjoyed every fricken’ second I’ve been here.”