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Recent Newspaper & Online Columns by Kate Scannell MD

Armstrong doping scandals reveals much about society as a whole

By Dr. Kate Scannell
First published in print: 10/28/2012

I'm going to ask my nephew to read the 202-page report issued last week by the United States Anti-Doping Agency that summarizes the doping allegations against cyclist Lance Armstrong by his own teammates and entourage. It's a powerful document that stimulates critical thinking about sportsmanship and athletic competition, and it raises important ethical issues about athletes' pervasive use of performance-enhancing drugs.

Because the report cobbles together stories from professional athletes who broke a code of silence that had tethered them to a troubling team secret, it also offers insights about these issues from the experiences of intimate insiders. No aunt or school health counselor can compete with that for the prized attention of a serious young man trying to imagine what life might be like as a professional athlete.

At times, the USADA report reads like William Golding's classic novel, "Lord of the Flies." On a literal level, we learn what happens when a group of (mostly) men are sequestered on an island (team) of their own making and self-governance, without effective supervision by oversight agencies that are supposed to enforce publicly agreed-upon rules of conduct.

In short order, leaders emerge within the team and regularly break those rules. A new regime supplants the old order and, ultimately, everyone comes to fear retaliation if they don't comply with the new norm. So they take the secret handshake -- or the blood doping, the growth hormone, the steroids.

The USADA report also evokes a potent analogy between Armstrong and Golding's character, Jack -- the instigator of anarchy on the island who rejects societal norms and feels no remorse for breaking them. For example, the USADA asserts that —... Armstrong had ultimate control over not only his own personal drug use, which was extensive, but also over the doping culture of his team ... . His goal led him to depend on EPO, testosterone and blood transfusions but also, more ruthlessly, to expect and to require that his teammates would likewise use drugs to support his goals if not their own."

On a more symbolic level, the USADA report -- like "Lord of the Flies" -- poses what might happen to "civilized people" when the structures of civilization disappear. Public reactions to doping allegations against Armstrong and his teammates have included diatribes against eroding societal norms for professional sports that have fostered moral corruption among athletes. Where, some demand, were the doping police, the team physicians and employees who should have helped the athletes to stay a moral course?

Actually, the USADA report alleges that many of these "civilizing influences" were also ... well, under the influence. That, along with Armstrong and his teammates, they had "employed a wide variety of techniques to attempt to avoid a positive drug test." That (well-paid) doctors supplied illicit performance-enhancing drugs. That the team was able to avoid testers because its "staff was good at being able to predict when riders would be tested and seemed to have inside information about the testing."

These civilizing enforcers are reminiscent of the adults who finally appear at the end of "Lord of the Flies," ostensibly to rescue the lost boys on the island. But, as Golding once explained in his own words, the adults arrive: —... dignified and capable, but in reality enmeshed in the same evil as the symbolic life of the children on the island."

The point is that, as John Donne claimed, "No man is an island." What may have become of professional cycling as regards to the use of illicit performance-enhancing drugs is no one man's doing, let alone one sport's dubious claim. And -- whether using drugs to boost our kid's classroom achievements or undergoing cosmetic surgery to enhance success in the workplace -- using performance-enhancing technologies has become an increasing acceptable societal norm to gain "a sporting chance" in life.

Clearly, the Armstrong case raises questions about where we draw the line -- if we draw one at all -- between "acceptable" and "objectionable" body modification in sports as well as in medical practice. It stimulates thinking about what constitutes fair play and competition, both on the field and off. It casts a dim gray light on our attempts to distinguish when prescriptions for some drugs and medical technologies should serve "therapeutic" versus "enhancement" goals. It raises the question about whether people -- athletes or not -- should have unfettered lawful access to those drugs and technologies in their quests for personal flourishing.

Persuasive arguments support all sides of those debates, and it is doubtful that we will arrive at a societal consensus about them any time soon. So, in the meantime, awaiting more substantive philosophical agreements about how we "ought" to play sports or govern ourselves, we make up rules. Some rules may seem arbitrary or arcane or even goofy, but, still, we agree to them as teammates and competitors. Then we hop on our bikes or pick up the ball and play for loyal fans who expect that those same rules will govern the game they watch and love.

In the end, whether or not the USADA's allegations are accurate, the central Armstrong controversy is "not about the bike" -- or blood-doping or steroids. It's about having your faith broken and your reality manipulated by someone you trusted and supported.

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Kate Scannell is a Bay Area physician and syndicated columnist. She is the author of "Flood Stage" and "Death of the Good Doctor."
Copyright 2012, Kate Scannell