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Steroids in Sports
Are Drugs the Only Ones Being Used?


Given the nature of the testimony at the Congressional hearings on anabolic steroids in baseball in March, I continue to harbor concerns over drug use and other harmful trends in sports (see my editorials in the January through March issues). But now I'm worried that current sports ethics, already impaired by drugs, have also tainted those who care for the athletes.

The Congressional hearings provided us with both spectacle and insight. The ire of the officials asking questions at the hearings was piqued, even before proceedings began, by commissioner Bud Selig's public statements that Major League Baseball (MLB) would not launch an investigation into Jose Canseco's allegations of widespread steroid abuse in baseball. (This was before Selig proposed a tougher drug-testing policy in late April.) Their anger surfaced again in questions posed to Elliott Pellman, MD, Selig's medical adviser, who exhibited a lack of knowledge of key components of MLB's proposed drug-testing program. Dr Pellman's weak performance likely prompted The New York Times to investigate his credentials, and Times reporters discovered that the bio he submitted to Congress misstated where he received his medical training, as well as his current membership in professional organizations.

Now, this misrepresentation of Pellman's information could have been carelessness. But I suspect that the impetus for the Times' investigation was a desire to expose, through whatever route available, this less-than-forthright testimony about a still sorely lacking drug policy.

Taylor Hooton, the high school student who died as a result of depression attributed to steroid use, was asked by his father, before he died, "Why do you take steroids?" Taylor's answer was, "Why not? Barry Bonds does." With this tragedy and the spectacle of all-but-certain illicit drug use in sports as background, the hearings began. Then, an anemic response by MLB and its less-than-credible medical witness all but did in the lingering hope any of us had in the integrity afforded this professional sport. In its April 3, 2005, issue, The New York Times published an article titled "Seeking Heroes, Finding Humans: Athlete as Role Model Is a Dubious Notion." Many athletes and sports governing bodies no longer can lay claim to integrity.

But, while this spectacle brewed, an unasked question lay in the back of the minds of many, particularly physicians. Doesn't MLB have a host of physicians and other medical people associated with its teams? What do those people think?

A good question. How could it be that we have smothered professional sports with some of the best physicians, yet there has been no organized outcry? And I'm not hearing many solitary outcries, either.

Two decades ago, I remember giving a talk about injury prevention. One method was to improve protective equipment, and another was to advance training techniques for fitness and strength. The third area was involvement in rules and legislation. This currently represents medicine's best hopes for making athletics safe and for creating models of sports that can be viewed by children and their parents without cringing.

I think the message is quite clear. Physicians should not be involved in professional sports that compromise ethics, have anemic policies on drug use or injury prevention, and do not make attempts to ensure short- and long-term health for athletes. It is not in the physician's best interests to serve as a team doctor in these instances. Nor does it send the right message to our colleagues in other branches of medicine.

Most important, it doesn't promote our intended function: to promote health and safety, to understand the balance point between risk of injury and gain of participation, and to make recommendations that ensure patients' health.

Now, I'm ready for the outcry.

Gordon O. Matheson, MD, PhD