A Canadian doctor who has treated many N.F.L. players as well as Olympic medalists like Donovan Bailey and the world’s top golfer, Tiger Woods, is under criminal investigation in the United States. He is suspected of providing athletes with performance-enhancing drugs, according to several people who have been briefed on the investigation.
From NY Times, Dec 15, 2009
The headline reads: “Doctor Who Treated Top Athletes Is Subject of Doping Inquiry”. Doctor … Athlete … Doping – those words linked together are so mundane nowadays. But as someone who is both a doctor and an athlete, they carry some resonance with me.
“Dope” as applied to drugs enhancing athletic performance is a mysterious term, possibly linked to “dop”, an alcohol-based stimulant used in southeast Africa. Or “doop”, a Dutch word meaning “thick dipping sauce”, which in American slang referred to a concoction of tobacco and jimsonweed seeds used by robbers to stupify their victims. By 1889, “doping” first appeared in a dictionary as a thick viscous preparation of opium. Simultaneously, both human and equine athletes were using laudanum and other agents to enhance performance. By 1900, “dope” and “performance enhancing substance” were becoming synonyms.
As long as there have been athletic contests, participants have sought ways to gain an edge on competitors. Greasing a baseball, tripping in soccer, starting before the gun goes off – rulemakers have always had their hands full trying to sort out what is permitted from what is not. Sometimes the choices seem arbitrary – why should basketball players not be allowed to wear calf-length uniforms? Sometimes the choices are clearly for safety, like many rules in American football. But most of the rules are designed to create an equitable set of circumstances for competition.
Because athletic competition is at its heart a test of physical prowess, the enhancement of the body’s strength and skills is paramount. Refining and training that strength and skill comes first. But as many at the highest levels have both equal genetic gifts and access to the same training concepts and programs, other means are often sought to enhance the chance of victory.
Runners switch from floppy shorts and tops to skin tight lycra. Cyclists, fighting the relentless headwind, adopt more and more aerodynamic bikes. Swimmers shave their heads and legs. Sports psychologists, nutritionists, massage therapists and countless other specialists are enlisted to refine every aspect of the athlete’s mental and physical capabilities.
In such an environment everything and anything is seen through the filter of how it may help performance. The list of possible aids is almost endless. People blow into devices used by asthmatics to improve their breathing muscles. They adopt diets which some of us would find intolerable (nuts, raw grains, and vegetables fresh from the ground?). Baseball players stare at computer screens, trying to improve their ability to detect rotation of a ball traveling 100 mph. To say nothing of the standard weight lifting, practicing single skills for hours at a time, or sitting in tubs of ice.
The Olympic sports over the past several decades have gradually moved to a uniform anti-doping system. Anyone who participates in the Olympics must follow the same rules. And those athletic federations which funnel athletes to that level of competition must ensure those rules are followed in all the competitions they sanction.
The World Anti-Doping Authority was created to: develop a list of prohibited substances; determine how to test for them; establish and oversee processes for that testing; and oversee the sanctions used against those who break the rules.
While there is a strain of logic to some of the choices of approved and banned substances, in the end, it seems somewhat arbitrary. Caffeine, a legal, non-prescription performance enhancing drug, is allowed. DHEA, a legal, non-prescription performance enhancing agent, is not allowed. One of the treatments highlighted in the NY Times article was the use of platelets to enhance injury healing. (It should be noted that this is the use of the patient’s own platelets.) Finally, the list of banned substances and processes is filled with phrases like “and other substances with similar chemical structure or similar biological effect”, making it almost impossible to determine with any assurance what might or might no be allowed.
Some people argue that the athlete, not the sports governing body, should determine what is and isn’t allowed. After all, athletes are constantly doing legal things which put them at risk, such as training past the point of exhaustion, exercising to the point of bodily injury, and starving themselves to an unhealthy state. So clearly, the goal of “health protection” is not the primary reason for banning dangerous drugs.
Athletes are allowed to spend unlimited sums on their plethora of trainers and gurus, which some can afford and some can not. Witness Dara Torres, age 44, in the last Olympics. She is married to a wealthy physician, and could afford the luxury of TWO full time masseuses, each for specific stretching protocols, along with her nutritionist, psychologist, coach, etc. And some national federations or even countries are willing and/or able to spend far greater sums on support, equipment, and facilities than others. The Jamaican bob sled team loses, not because it’s athletes are less skilled (come on, they have the fastest runners in the world!), but because their country chooses to support track and field, not winter sports. Why not require limits on spending for sports, like limits on campaign contributions?
In the end, it seems, it is all arbitrary, exactly like the rules for, say, the size of the basketball court, diameter and height of the rim, and what constitutes traveling or an offensive foul. In my sport, triathlon, there are also specific rules like this. For example, in Ironman racing, one is not allowed to be closer than 7 meters to the bike in front, with other specifics about how to pass and be passed. Marshals on motorcycles follow the racers, and hand out 4 minute “stand-down” penalties for infractions. They don’t see all the violators, and in the end it is a judgment call anyway. But a key point: many Ironman races have been won by someone who incurred a penalty, and probably others were won by those who broke the rules, but were not caught, just as every NBA basketball game is filled with instances in which the rules are broken, only some of which are penalized by foul shots (or, more rarely, ejection).
So in a world in which the rules are arbitrary, enforcement is almost random, and no moral hazard is associated with breaking the rules, what is an athlete to think of the anti-doping code?
(To Be Continued)