The use of performance enhancing drugs in competitive sports is an enormous problem.  Many professional sports are addressing the problem by identifying banned substances, instituting testing procedures for those substances and legislating penalties to be applied to athletes who are found to have used the banned drugs.  From professional leagues that are reluctant to grapple with the problem, to drug tests that are often not conclusive, to athletes that lie about their drug use or insist they didn’t know they were taking a banned substance the problem of performance enhancing drugs in sport seems almost impossible to solve.  And this is only the tip of a much larger iceberg.  I think consideration of this issue opens up a world of deeper questions about what constitues performance enhancement, whether some types of enhancement might be acceptable or even desirable at some levels of sporting competition, and what functions we want different levels of sporting competition to fulfill in our culture.  Consider the following.

One of the desired ideals for sporting competition is that the competitors should begin from a level playing field, that none of the athletes be given an unfair advantage over the others.  The competition begins on a level playing field and the athlete who has trained harder, who understands the game better, who is more skilled, who is better able to maintain focus during the heat of the battle wins out in the end.  At least that’s the way it should be.  A fundamental objection to the use of performance enhancing drugs is that they upset this level playing field by giving the drug user an advantage that is not due to his training, knowledge or skill.  Is this always true?  It depends on how you look at it.

The amount of oxygen carried by the blood is an essential determinant of performance in sports.  Oxygen is used to both carry energy to the muscles so that they can perform the work the sport requires and to carry waste products away from the muscles.  Oxygen carrying capacity is especially important in long term endurance events such as marathon running, triathlons and road racing in cycling where athletes must sustain very high levels of performance for hours without a break.  Many world-class athletes in high endurance sports have used artifical means to increase their oxygen carrying capacity in order to gain what can be a substantial competitive advantage.

Oxygen is carried in the blood by red blood cells (RBCs) and an increase in the density of RBCs in the blood can greatly improve performance in endurance sports.  The two methods most commonly used to do this are blood doping and the the injection of EPO (erythropoietin).  Blood doping involves extracting blood from a donor, concentrating the blood so that it has an extremely high proportion of RBCs, freezing the concentrate and then thawing it and injecting it into the athlete before the competion or during the competition in the case of multi-day events such as the Tour de France.  The donor can be either the athlete himself (autologous blood doping) or someone else with a compatible blood type (homologous blood doping).  EPO is a hormone that is naturally produced by the kidneys and that stimulates the production of RBCs in the bone marrow.  EPO can also be made in the laboratory and this type of pharmaceutical EPO can be injected under the skin to increase the body’s RBC production.

The use of EPO or blood doping can be difficult to detect.  Subcutaneously injected EPO typically cannot be detected 3 to 4 days after injection yet it has its maximum effect stimulating high levels of RBC production approximately 3 weeks later.  For that reason, banning an athlete for EPO use usually depends on catching him with EPO paraphanalia in his possession.  Homologous blood doping (using someone else’s blood) can be detected by DNA differences between the donor and the athlete’s RBCs.  Autologous blood doping (using your own blood) is extremely difficult to detect and no tests are currently available that are considered reliable enough to use in competitive sports.

In addition to relying on blood tests that are specific for EPO use or doping many professional sports use hematocrit as an indicator of illegal performance enhancement.  Hematocrit measures the proportion of the blood volume that is composed of RBCs.  Hematocrits above a certain level are taken to be abnormal and are officially used as indicators of doping or EPO use.  The UCI (Union Cycliste Internationale), the organizing body of professional cycling, has set 50% as the upper allowable hematocrit level.  If a rider tests with a hematocrit above 50, he is banned from competition.  It is often cited that the “normal” hematocrit range in adult males is between 41 and 50.  This is the two standard deviation range which encompasses approximately two thirds of the general population.  The upper level of the three standard deviation range for hematocrit is 54.  Approximately one third of the general population falls outside the two standard deviation range that is cited as “normal”.  More to the point, approximately one sixth of the general population (about 16.6%)  will have naturally occurring hematocrit levels above 50.  We can also expect that those individuals with higher than normal hematocrit levels will be disproportionately represented in the population of endurance athletes because the increased oxygen carrying capacity of their blood gives them a natural advantage in endurance sports.  The UCI recognizes this problem by allowing exceptions to the 50 hematocrit rule for cyclists who have a long and consistent history of hematocrit measures above 50 as indicative of a naturally occuring high hematocrit level.

All professional endurance sports ban both EPO and blood doping as illegal forms of performance enhancement.  Should they do this?  If we consider them as a means of gaining an unfair advantage over the opponent, which is the way they are currently used, the answer is clearly “yes”.  However, I think another perspective is possible.  Everyone has a naturally occuring hematocrit level that is genetically determined.  This natural hematocrit is not subject to training, it is what it is.  Natural factors such as training at high altitude or anemia, and artificial factors such as the use of EPO and blood doping can temporarily increase or decrease hematocrit but they do not affect the base hematocrit that each of us is born with.  This means that independently of any steps the competitor may take to increase hematocrit, some endurance athletes have a competitive advantage because of their genetics.  In other words, with all other things such as training regimen, skill level, knowledge of the sport, strength of will and competitive focus held equal, the endurance athlete with a naturally high hematocrit will have an advantage over the athlete who was born with a low hematocrit.  With regard to hematocrit, a critically important factor in endurance sports, the playing field is not level.  The low hematocrit athlete starts at a disadvantage that has nothing whatsoever to do with anything that is relevant to the sport.  It’s not about training regimen or intensity, it’s not about knowledge of the sport, the competition or the opponent, it’s not about trained skills and it’s not about heart, will or desire.  It’s about which sperm happened to fertilize which egg when the athlete was conceived.

Suppose we shift the common perspective on the use of EPO and blood doping.  Rather than think of them as a means to unbalance the competition by giving an athlete an unfair advantage, suppose we think of them as medical technologies we can use to level the playing field so that some athletes don’t begin the competition at a marked disadvantage because of their genetic inheritance?  Viewed from this different perspective, EPO and blood doping could be used to bring all of the athletes up to the same hematocrit level so that the competition could be decided on the basis of factors the athlete can control such as training, knowledge and desire.  Under the current system EPO and blood doping are used surreptitiously by some athletes to give them an unfair advantage over their opponents.  These techniques unbalance the playing field.  However, if we make EPO and blood doping available to any athlete who wants to use them, these technologies can eliminate a naturally occurring advantage that benefits some athletes but not others.  The technologies level the playing field.

How might EPO or blood doping be used in this way?  Set a hematocrit level as a cut off point such as the level of 50 currently used by the UCI.  Competitors may use any means they wish such as training at altitude or using EPO to bring their hematocrit up to this level.  The athelete is tested before every competition, or in multi-day events such as the Tour de France before every stage, and they must have a hematocrit level below the cut off.  Under this system hematocrit level would function like weight levels in wrestling or boxing.  If you don’t make level, you can’t compete in the event.  You’re not labled as a cheater, fined and banned from the sport.  You simply cannot compete in the current event because your hematocrit level gives you an unfair advantage. 

This approach to the problem has several advantages.  By reorienting our thinking away from the view that these medical technologies are a means of introducing unfair advantage to the view that they are a means of eliminating unfair advantage we reorient the relationship between the athlete and his sport.  The athlete is no longer a cheater who is afraid of discovery and the organizing body of the sport is no longer treating its athletes like criminals to be caught.  Medical technologies that currently are used in secret and not in the best and safest of ways would be used in the open and in much safer conditions.  As athletes strained to get as close to the cut off point as possible without going over and being eliminated from competition, our knowledge of how to use technologies like EPO and blood doping would increase and the conditions under which these technologies can be safely used would become better understood. And perhaps most important of all, a playing field unbalanced by genetic factors is leveled so that competitions are less likely to be determined by the DNA of the athlete’s parents and more likely to depend on what the athlete has done to prepare for the event.

Is this the right way to think about EPO and blood doping?  I don’t know but it’s worth considering.

I was in the Post Office mailing in my 2007 taxes when I noticed a poster they had up from the US Department of Justice advertising National Crime Victim’s Rights Week.  What attracted my attention was their slogan which is plastered across the poster.  In large type on the top it says “Justice for VICTIMS”,  on the bottom, in even larger type, it says “Justice for ALL”.  The more I looked at the poster, the more disgusted I became.  The US Department of Justice, the branch of government tasked with overseeing law and justice at the national level in an administration that has imprisoned over 700 people in Cuba without recourse to any legal or human rights, that holds secret military courts where none of the rules of law apply, that grabs people off the street and ships them off to secret prisons in countries that do not abide by the Geneva Conventions so that they can be tortured without interference, prints up posters proudly proclaiming “Justice for ALL”.  These people have no shame.

September 11, 2001 was a bleak and terrible day in the history of the United States.  We were assaulted by a terrorist act that was of a scale and a level of savagery that would have been incomprehensible to most Americans beforehand.  It was horrendous.  But it was not the first such day in our history and it was not the worst. 

Four US Presidents have been assassinated while in office:  Abraham Lincoln in 1865, James Garfield in 1881, William McKinley in 1901 and John F. Kennedy in 1963. 

During the War of 1812 the United States was invaded by Great Britain, Washington DC was captured and the White House, the buildings that housed the Senate and the House of Representatives, the US Treasury Building, the Navy Yards and the Library of Congress were burned.  Tornadoes and a torrential downpour put out most of the fires but not before the buildings had been gutted and only a few exterior walls remained.  What was left of the White House had to be torn down and rebuilt.

On Christmas Eve 1860 South Carolina seceeded from the United States and the next year the American Civil War began.  The war lasted from 1861 until 1865 and came within a hair’s breadth of destroying the United States.  Approximately 620,000 soldiers died, the number of civilian deaths is impossible to estimate.

On December 7, 1941 the Japanese attacked and largely destroyed the American naval fleet in the Pacific at the US naval base at Pearl Harbor.  Five ships, including two battleships were completely destroyed.  Ten additional ships were badly damaged including two battleships which were sunk at their berths, raised, repaired and put back into service.  In addition, 188 airplanes were destroyed.  There were 2388 men and women killed and another 1178 wounded.

The United States was hurt and hurt badly by all of these events.  Our country was invaded, our people died, our ability to fight back was severely damaged, some of our most cherished institutions were attacked and the living symbols of those institutions were destroyed.  In every case, save one, the United States responded the way we would want our country to respond.  We stood resolute and strong, we fought back.  And we did so without abandoning the great principles of freedom for all and justice for all on which this country was built.  We did not cave in to fear although we were afraid, we did not abandon justice although justice had abandoned us.  We stood behind our principles and we came through victorious.  We showed the world that even under the utmost adversity we would not abandon the goal of striving to realize the ideals on which our country was founded, that all men are created equal, that all men are endowed with certain and unalienable rights, that there was to be justice for all.

Then came the tragedy of 9/11 and in response George Bush, Dick Cheney and their band of cowards abandoned many of the ideals and principles that made our country great.  At the time, we were frightened, confused and disoriented.  We didn’t know what to do.  Now we can see that what Bush and Cheney did represents more of a threat to the heart and soul of our country than anything Al Qaeda could ever hope to accomplish.  They talked the big talk and ran away and hid like craven little girls.  Their fear was so great that they believed anything they did was justified as long as it made them feel safe in bed at night.  Their cowardice was so great that they implemented a program that has systematically undermined many of the fundamental principles on which our country was built so they could feel safe from the enemies that terrified them. 

When did our country, the United States, become the place that held political prisoners in jails without being charged with a specific crime, for unspecified and open ended periods of time, without trial and without recourse to the rights and responsibilities of the US justice system?  Since Bush and Cheney turned us from a government of the fearless to a government of the terrified.  When did our United States become the country that openly practiced torture, torture!, and tried to hide behind arguments made by mealy-mouthed lawyers that torture was okay when we did it?  When Bush and Cheney were running the show.  When did our United States sink to the shameful depths of spiriting political prisoners away to secret prisons in countries that refused to abide by the Geneva Conventions so those prisoners could be tortured at will without fear of legal sanction?  When Bush and Cheney’s cowardice overrode our history and our principles.

The other night I watched the first episode of HBO’s miniseries on John Adams and saw Adams portrayed as a lawyer who courageously defended the British troops who fired on and killed the people of Boston in the Boston Massacre.  Adams had every expectation that defending these men would destroy his business and turn he and his family into social outcasts but he did it anyway because he believed that doing what was right was more important than doing what was wrong because you are afraid. 

In the classic American film “High Noon” Gary Cooper portrays a western sheriff who walks out to face a gang of outlaws alone because the entire town has abandoned him in fear and cowardice.  He doesn’t do this because he is fearless, in fact he’s terrified, he does it because he knows it’s the right thing to do. 

John Adams, Gary Cooper’s sheriff and countless others have been held up as epitomizing the American ideal of taking an unwavering stance behind the principles of equality, freedom and justice on which this country was founded.  No matter how great the threat, how terrifying the enemy, when the test came, the United States held firm.  When they faced their test, Bush and Cheney abandoned the ideals that made us great to fear and cowardice.  They are craven, shameful men.  They have shamed themselves, they have shamed our country and they have shamed each one of us because they have done this in our name.

Franklin D. Roosevelt told us “The only thing we have to fear is fear itself.”  Bush and Cheney have shown us Roosevelt was wrong.  We also have to fear cowardly men who cannot overcome their fear.  Soon Bush and Cheney will be gone and we can begin the difficult task of dismantling the government of fear they built and repairing the damage they have done to our country.  If we face the mistakes we made under their leadership, if we recognize the way they have betrayed so many of the principles on which our country was built, we can once again have a Department of Justice where “Justice for ALL” isn’t an empty, shameless slogan that reminds the world how far from our ideals we have strayed but is a principle that defines who we are.  A principle that we will stand behind and never again abandon.  Come what may.

Are these people so comfortable with lying whenever it suits their self interest that they can’t tell the difference anymore between honesty and dishonesty?  Are they so arrogant that they know the difference but think they can say or do whatever serves their needs as long as they don’t get caught?  What’s going on with these people?

On March 17 in Washington DC Hillary Clinton gave a public speech in which she talked about how she and her daughter had to run for cover when they came under sniper fire after landing at the airport in Tuzla Bosnia in 1996.  As is well known by now, nothing remotely like the story Clinton told actually happened.  The news media jumped all over her story producing reports from other people who were there along with film of the event.  Clinton’s story was a complete fabrication.

At the time I thought you would expect the wife of Bill I-did-not-have-sex-with-that-woman Clinton to be the last politician on earth who would think it was a good idea to tell blatant lies in an attempt to bolster her political ambitions.  The story she told was striking, dramatic and easily shown to be false. What was she thinking? 

Now along comes Bill Clinton, ex-President of the United States, Hillary’s husband, and the man who left cum stains on Monica Lewinsky’s dress while insisting he never had sex with her.  As reported in the Washington Post on Saturday April 12, Bill Clinton said the following while he was campaigning for Hillary in Indiana.

There was a lot of fulminating because Hillary, one time late at night when she was exhausted, misstated and immediately apologized for it, what happened to her in Bosnia in 1995. 

The Post went on to point out just how false this statement is.  Hillary didn’t tell the sniper-fire lie once, she told it several times in several speeches.  While there may have been times when she told the made-up story late at night, the speech she gave which drew the media’s attention to her fabrication was given in the middle of the morning.  Neither Hillary Clinton nor her campaign organization immediately apologized for getting caught telling a fabricated story.  At first they refused to answer any questions about it and then insisted her story was true for a week after the lie was exposed.  Hillary didn’t go to Bosnia in 1995 when war was raging in the country, she went in 1996 when the situation was much more peaceful. 

One simple sentence from Bill Clinton that turns out to be one long string of pure unadulterated horseshit.  He got his wife’s name right and he had the right country.  Everything else he said was false.  One of the most striking things about Clinton’s statement is that he could pack so much untruth into a single sentence.

Do these people never learn?  Bill Clinton is hardly the first politician who used his position of power to get laid but he is the only President who suffered impeachment proceedings because of his continued lies about his tawdry sexual activities.  You would think that on the basis of their recent history he and his wife would have at least figured out that telling lies that are easily shown to be lies is not such a good idea if you’re running for public office.  You would think that Bill and Hillary Clinton, of all people, would be especially careful to make sure that what they say is true.  Apparently, not.

You listen to the two of them, “sniper fire!”, “I did not have sex with . . .”,  “one time late at night when she was exhausted”, and you ask yourself “how stupid can people be?”  But we know Bill and Hillary Clinton aren’t stupid; no matter how dumb it looks, stupidity can’t be the answer. 

In fact, maybe they tell these lies because they’re not stupid.  Consider this.  Driving a car is extremely dangerous.  There are about 43,000 traffic fatalities a year in the US.  That’s just under 118 per day or one every 12 minutes 15 seconds, 24 / 7 – 365 days a year.  And yet people still drive all the time.  Why?  Because the number of car trips that end in death is a very small percentage of the number of car trips overall.  People drive because their experience driving tells them they have a very small chance of dying in a traffic accident.  Now, suppose lying was as common in your life as driving.  You lie all the time about anything and everything whenever it’s convenient for you to do so.  You’ve been doing this for years and you rarely get caught.  When you get caught you lie some more and, more often than not, you get away with it.  Maybe the Clintons tell lies for the same reason the rest of us drive cars.  We know bad things can result from what we do but they happen so infrequently that we keep on doing it.

If this is what’s going on, you have to wonder.  What else are Bill and Hillary Clinton lying about?