NEW YORK -- The New York Yankees' dirty little secret is out: Unless the reliever is named Dellin Betances, Andrew Miller or Aroldis Chapman, Joe Girardi has little use for him and even less trust.

That may not come as much of a surprise, but rarely does something so indicative of the state of a team become as obvious as it did in the seventh inning of Thursday's game against the Baltimore Orioles: With CC Sabathia in a jam and nearing 100 pitches, Girardi left him in to pitch to Jonathan Schoop, one of the O's best hitters, despite having Chad Green and Anthony Swarzak warming in the bullpen.

And after Schoop inside-outed a two-run double to right field, Girardi went not to Swarzak, who had thrown 5 1/3 scoreless, hitless innings in his previous two appearances, but to Green, a Triple-A starter who many thought might get the ball Friday night when the Yankees open a weekend series against the San Francisco Giants.

The damage had already been done for this day, of course -- Schoop's double extended the Orioles' lead from 2-1 to 4-1, which became the final -- but in the process, Girardi may have damaged his team's chances over the weekend as well. Now, with Green unavailable, the Yankees must throw Masahiro Tanaka on Friday night on four days' rest -- when he is far less effective this year -- and against Madison Bumgarner, who is likely to beat the Yankees anyway.

For a team -- and a manager -- that had called Thursday's game all but a must-win, it was a puzzling strategic choice, and it all came down to one essential truth: With Betances unavailable, Girardi really had no reliable Plan B to get his team through the seventh inning of a still-winnable game.

Asked if he had considered bringing in Swarzak to face Schoop, or even to get the final out of the inning after Schoop's double, if only to preserve the option of starting Green on Friday night, Girardi grew testy.

"And then do what? Save Green for the eighth and ninth?" he asked.

When it was pointed out that he did, in fact, have other pitchers in his bullpen, Girardi could only name three. "I can't kill Miller, I can't kill Chapman, and I can't kill Betances," he said. "If Dellin was available for us, maybe Dellin comes in in that situation, but he wasn't available."

Which raised the next question -- namely, what is the point of having seven relief pitchers on your staff if you're going to use and trust only three of them? True, Betances, Miller and Chapman have been a cut above any similar troika in any bullpen in baseball, but there's got to be at least one other arm in the pen a manager can trust to get a key out. And the bullpen's scoreless streak, which stretched to 31 innings after Green's 2 1/3 on Thursday, was not solely the work of the three-headed monster at the back end. The Yankees sent Nick Goody down Thursday to clear a spot for Green, but still Girardi had Chasen Shreve, Richard Bleier and Swarzak available, even if Swarzak's usefulness was limited after going 2 2/3 in Tuesday's 7-1 Yankees win.

Surely those three could have cobbled together the rest of the game and saved Green for Friday, and who knows, maybe you get lucky? Now, the Yankees will have to go ace vs. ace in the series opener Friday, and in this one, the Giants have the better ace.

"You have to get yourself back up tomorrow and know you're facing a really good pitcher again tomorrow," Girardi said. "You have to find a way to scratch some runs across, and Tanaka needs to perform well."

This is not to say the Yankees would have won, and swept the Orioles, had Girardi handled his bullpen differently. Certainly, had Betances been available, perhaps Sabathia -- who had pitched well for six innings, allowing just two runs on four hits -- would never have gone out for the seventh, and the Yankees could at least have kept it close for a possible late-inning rally. (By the way, part of the reason Betances was not available was because Girardi warmed him up but didn't use him in Tuesday's 7-1 win, just another bit of evidence that he trusts no one in his bullpen other than the big three.)

And without a middle reliever he could trust, Girardi sent Sabathia back out for the seventh, and although none of the three hits he allowed was particularly hard, neither did he have the kind of swing-and-miss stuff on this day that would allow him to easily wriggle out of a jam. For the third straight start, he struck out only two.

"I liked the way CC was still throwing the ball," Girardi said. "You look at Schoop, left-handers have gotten him out a lot more than right-handers this year and in his career, and he's done a good job on Jonathan. Everything tells you to leave him in."

Especially since, to paraphrase the manager's own words, who else was he going to go to?

And just like that, what could have been a pivotal four-game sweep against a tottering first-place team ended with a two-game swing in the standings the Yankees can hardly afford at this point in their season.

"I think today is extremely important because you have a chance to make up ground on teams that you're chasing," Girardi had said before the game. "We're five and a half behind them. Four and a half sounds a whole lot better than six and a half, so I think it's really important that we win today."

Afterward, of course, the spin was that three out of four was good enough. "I think you have to look at it as we took three of four from a good team, and you move on," Girardi said. "You can't have a letdown because you lost today."

Headley's son has medical scare

Chase Headley returned to the Yankees following a one-day excused absence to attend to a personal matter. After the game, Headley revealed it was a medical emergency involving his 4-year-old son, Colt. "Over the All-Star break, my son had a small operation and he's been dealing with some complications the last few days," Headley said. "It got pretty serious yesterday, and we had to take him to the hospital. He had to have another procedure, but he's doing a lot better."

Headley, who was not in the starting lineup but grounded out pinch hitting for Ronald Torreyes in the eighth, looked exhausted and red-eyed speaking to reporters in front of his locker. "I don't remember a whole lot of days in my life that were worse," he said. "But I'm thankful that he's got the care that he needed and that he's doing a lot better. He's in great condition right now."