Sep. 20, 2018

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Blood Sport

Our rigid understanding of doping is incompatible with shifting scientific and ethical understanding of our bodies

1. Sir Roger Bannister died this spring, at home in Oxford. In interviews, Bannister said he was prouder of his half-century of work in neurology than he was of being the runner who broke the four-minute mile. At his physical peak, though, in the early 1950s, running and theoretical medicine seemed to converge. While he and his athletic contemporaries were chasing the elusive mark, there were doctors, scientists, and newspaper columnists who thought the four-minute barrier was a hard wall for the human body, that 1,609 metres in 3:59.99 was simply unapproachable by flesh and bone and sinew. It wasn’t, of course: on May 6, 1954, Bannister, a student who trained mostly on his lunch hour, stepped on a dirt track and ran 3:59.4. His skin didn’t melt, and his heart didn’t explode. By the end of June, the world record belonged to an Australian named John Landy. Bannister held it for just seven weeks. He did get revenge, beating Landy head-to-head at the British Empire Games in Vancouver that August. But he never got the record back.

2. In the forty-five years following Bannister’s run in 1954, no mile world record stood for more than eight years. In the first thirteen years the record was broken eight times, the last of which brought the time to 3:51.1. Then, in July of 1999 a Moroccan named Hicham El Guerrouj ran 3:43.13. In the nineteen years since that race, no one has come within two seconds of his time.

3. Oxygen is fussy. It doesn’t dissolve cleanly into the veins. It needs to be carried from lungs to muscles by hemoglobin, which is itself tucked inside red blood cells. During periods of intense exercise, a human body can require more than twenty times the oxygen it would need at rest. The more red blood cells in your bloodstream, the more oxygen carried to your muscles, the better your peak athletic performance. This is why an unprepared runner might have trouble competing at high altitude: the further up you get from sea level, the less oxygen there is in the air you breathe. You run slower, and it’s harder to catch your breath. In 1968, the summer Olympics were in Mexico City (elev. 7,382’). The results in most endurance sports were bitterly disappointing, which led to increased scientific interest in the effects thinner air. Runners and coaches began to purposefully train at high altitude; after a few weeks, they found, the scarcity of oxygen forced the body to find efficiencies in the athlete’s bloodstream and reorient it to produce more red cells. Today, endurance athletes—especially runners—often live and train at high-altitude locations. Others use pressurized tents to mimic the effects of living “high” while training in oxygen-rich sea-level locales. In the weeks leading up to the professional track season, shoe-brand sponsored athletes retreat to Flagstaff (6,910’) or Mammoth Lakes (7,880’) or Iten, Kenya (7,874’).

4. In 2012 Tim Noakes, an exercise physiologist and altitude expert at the University of Cape Town, told the New York Times that benefits from altitude training could be largely chalked up to placebo: “If you look at the literature, some people benefit and some get worse, and the general result is no effect.”

5. Samuel “Sammy” Wanjiru was born in Kenya in November of 1986. His hometown, Nyahururu (7,556’), is a thirty-five-thousand-person transport hub in central Kenya sitting almost exactly on the equator. He and his brother were raised by their mother with virtually no money. At twelve, Wanjiru couldn't afford school fees, and was forced to drop out. When he was fifteen he moved to Sendai, Japan, to continue his education and become a star on the Japanese and international cross-country circuits. At eighteen, he attempted to best the particularly stubborn world record in the half marathon; in the twelve years leading up to it, only three men had bettered the standing record. Wanjiru became the fourth. Over the next eighteen months it was broken five times, including twice by Wanjiru. At the 2008 Olympics in Beijing he won gold in the marathon, finishing in 2:06:32 and shattering the Olympic record. That year Wanjiru set for himself a Bannisterian task, telling reporters that, within five years, he could run a marathon in under two hours. Nike began pouring money into a project to capture the barrier-breaking race, first in unsanctioned conditions, and then in a way that could be ratified. It recruited a cadre of the fastest runners in the world to set outlandish paces for its impossibly talented guinea pigs. Wanjiru wouldn’t live to see his proclamation through. In May of 2011, three years after Beijing, he plunged to his death from a balcony at his home in Nyahururu. At the time of his death, he was awaiting trial for illegal possession of an AK-47, which he’d allegedly brandished at his wife and at a security guard. The details of his death were salacious and disputed—there was his wife, another woman, supposed screaming matches, and that leap off the balcony. Some police spokespeople ruled it a suicide; virtually everyone in his life disputes that. The case is still, officially, unsolved.

6. Not everyone wants to waste time in Flagstaff. After Mexico City, while some athletes climbed in elevation, others began taking blood transfusions to increase their concentration of red blood cells. Sometimes an athlete would flood their veins with the blood of another; others withdrew their own, stored it for months, then re-infused it into their veins when a competition was nearer. This was legal, for a while, before it was banned in 1986. By the 1990s, though, transfusions had fallen out of vogue. In its place, athletes began injecting a drug called EPO, a synthetic version of a hormone which is produced naturally by the kidneys. It stimulates bone marrow to produce more red blood cells. It’s often given to dialysis patients and to people with anemia. EPO as a performance enhancer has been banned since the early 1990s, but there was no effective test for it until 2000.


7. “You ask me, clean? No technology, no help? That is what Abebe Bikila ran in 1960. That was barefoot. The cleanest.” —Haile Gebrselassie, perhaps the greatest distance runner to ever live, when asked by Wired how fast a “clean” runner could run a marathon.

8. Last year, the International Olympic Committee stripped a gold medal from the 2012 games in London. The initial champion of the women’s eight-hundred-metre run was Mariya Savinova, a Russian, who eventually admitted to using an anabolic steroid. The gold was instead given to Caster Semenya of South Africa.


9. Semenya is dominant in every sense, holding her country’s record in the four-hundred-metre, six-hundred-metre, eight-hundred-metre, one-thousand-metre, and fifteen-hundred-metre. But the eight-hundred-metre is her race—she won gold outright at the 2016 Olympics and is the fourth fastest woman in the history of the distance. She’s also been the subject of an invasive and dehumanizing controversy in both the press and at the highest levels of track’s governing bodies. You might be at least vaguely familiar: in 2009, it was leaked that the International Association of Athletics Federations had forced the then eighteen year old to undergo a sex determination test. This was, officially, due to the rapid (though not unprecedented) improvements in her performance. It was widely speculated that the test had more to do with Semenya’s physical appearance, with whispered accusations she was not adequately female. Semenya was suspended from international competition for about a year, but none of her results were wiped away. The IAAF has tried, in the years since, to eliminate or limit the careers of women with supposedly abnormal, though natural, levels of testosterone. In 2011 it instituted a rule requiring hormone treatment for such women, which Semenya underwent. Her times slowed, but she still won that gold medal from London. In 2015, the Swiss-based Court of Arbitration for Sport struck down the rule, determining that the IAAF had not sufficiently quantified the naturally elevated testosterone as a competitive advantage. The Times summarizes:

“Many factors affect performance, and the I.A.A.F. has struggled to show conclusively that elevated testosterone provided women with more of a significant competitive edge than factors like nutrition, age, height, weight, access to coaching and training facilities, and other genetic and biological variations like oxygen-carrying capacity.”

This November, the IAAF will try to institute another version of the testosterone rules, which has already been decried by scientists and ethicists.

10. Blood doping—through synthetic drugs like EPO or through conventional transfusions—thickens the blood and increases the risk of stroke, heart attack, and pulmonary and cerebral embolism. The precise risks among world-class athletes are unknowable because, well, which world-class athlete is going to volunteer for this study?

11. It’s possible that none of the times mentioned in this article mean anything to you. Many non-runners have at least a frame of reference for the mile—gym class, hotel treadmills—but 2:01:39 might be painfully abstract. For some reference: that’s the new world record in the marathon, set by Eliud Kipchoge this past Sunday in Berlin. It works out to a 4:38 pace per mile. Next time you’re near a high school, find its track and try to keep that pace for a half mile. Two laps in 2:19. Then imagine doing the same thing fifty-one more times, without stopping, without allowing so much as a critical thought to drift across your mind, while a half-dozen of the fastest humans to ever evolve on Earth breathe down your neck and your sponsors watch skeptically from portable TV monitors. Or watch Ethiopia’s Kenenisa Bekele run the five-thousand-metre in 12:37, a record that’s stood since 2004. That’s 4:03 per mile. Bekele routinely finished his runs with faster-than-four-minute miles. He ran faster than Bannister’s once-unbreakable barrier after already running basically that fast for more than two miles.

12. Galen Rupp—who is, by most measures, the greatest American-born distance runner of his generation—is able to stay healthy despite running remarkable volume by, among other things, doing workouts on an underwater treadmill manufactured by HydroWorx, which helpfully notes on its website that it has partnered with Ascentium Capital to offer financing up to USD$250,000.  

13. In 2016, Kenya's GDP per capita was USD$1,455.36.

14. Last summer, a leaked report revealed Mo Farah, the defending Olympic gold medalist in both the five-thousand-metre and ten-thousand-metre had been flagged in 2015 as “likely doping.” A British reporter called Farah “cowardly” for refusing to respond to it. Farah sued the reporter, banking on the United Kingdom’s notoriously stringent libel laws, and received a cash settlement as well as a public apology.  

15. Also last year, the Times published an expose about the Oregon Project, a Nike-funded group of elite runners, including Rupp and Farah, who live and train in and around Portland. The piece centers on a 269-page report from the U.S. Anti-Doping Agency, which confirmed what the running community had known for years: the Oregon Project’s runners were using legal drugs in legally questionable ways and possibly dabbling in less-than-legal enhancers as well. But there was new, more sinister information as well. The piece described how star-runner Dathan Ritzenhein, whose Nike salary was being slashed during a slump in performance, was coerced into receiving infusions of a substance called L-carnitine. The amino acid derivative occurs naturally in the body and helps convert fat to energy. This is the problem with any discussion about doping as an acute or systemic problem in the sport: not everything is EPO; some substances are fine in certain doses and provided your body chemistry is a certain way but not at larger doses or if your body chemistry is another way; sometimes pressure to dope is obvious, like a coach with military backing injecting you with drugs, but other times a smiling shoe rep asks you how much your mortgage is; sometimes the prize money from one Diamond League race could build a school in your town; sometimes the records you’re breaking were set by barefoot runners with day jobs; sometimes people have pulmonary embolisms. The science behind chemical doping moves far too fast for any scold or drug-testing body to truly keep up with, and so for decades we’ve taken to wagging our fingers at a broad array of (usually) drug-related behaviors as “doping,” in a way that’s rigid and moralistic. The truth is that the line between a technically legal L-carnitine infusion and a technically illegal EPO injection is a lot murkier than any of us understand. And yet, more permissive attitudes toward performance-enhancing substances risk putting athletes’ autonomy and health in jeopardy, because they fail to account for situations where athletes who might be hesitant to take drugs or undergo procedures with unknowable side effects are forced to take those drugs or undergo those procedures anyway. Of course, this happens already.


16. Ritzenhein left the Oregon Project in 2014, Farah left last October. Another Oregon Project runner, Tara Welling, also recalled the L-carnitine procedure. When USADA interviewed her about the experience, she reportedly began to cry, and said “I don’t know if Alberto did something to me.”

17. Alberto is Alberto Salazar, a former world-class marathoner who is the coach and overlord of the Oregon Project. Salazar was born in Havana to a Cuban revolutionary father who turned on Fidel Castro and moved his family to Wayland, Massachusetts. Salazar was a fantastic high school runner and was even better in college at Oregon, winning the NCAA team cross country title in 1977, the individual title in 1978, and losing a still-legendary final a year later. Salazar pushed his physical limits until, at a road race one summer, when he should have been preparing for the cross-country season, he collapsed. His body temperature was 107 degrees Fahrenheit. He was rushed to the hospital in critical condition and read his last rites. He recovered and, after college, won marathons: one Boston, three New Yorks. He made the 1980 Olympic team, but Jimmy Carter boycotted; he made it in 1984, too, but withered in the Los Angeles sun. When he missed out on Seoul in 1988, he opened a restaurant near his old college. At this point, Salazar could barely run, limping through four-mile trots. He tried cardiologists, surgeries, and sleep studies. He went to Kenya. What eventually worked was Prozac, which he claimed alleviated both his depression and his exercise-induced asthma. At thirty-four, he made a brief comeback to win an ultra-marathon in South Africa before retiring to start coaching. One of his first star pupils was Mary Decker, who in the 1980s had been the world’s best three-thousand-metre runner and, in 1985 had set the women’s world record in the mile. It’s only been broken twice. After missing the 1986 and 1987 seasons to have her first child and later because of injury, Decker ran disappointingly at the 1988 Olympics and failed to qualify in 1992. Then, after hiring Salazar, Decker qualified, at thirty-seven years old, for the 1996 Games in Atlanta. A urine test taken during the trials showed elevated levels of testosterone, and the IAAF banned her. The case dragged on for years. Decker and her lawyers argued that the specific test was not reliable for women in their late thirties who were taking birth control pills. When she finally accepted her legal fate, in 1999, she had an interminable string of orthopedic surgeries to repair stress fractures; they didn’t work, and she ended up competing instead in elliptical bike races. Her coach moved on to the Oregon Project. In 2007, Salazar had a heart attack at the Nike campus; he was dead for thirteen minutes and then shocked back to life.


Paul Thompson is a Los Angeles-based writer and critic, originally from Winnipeg.

Alex Mathers is an artist and designer based in Toronto.

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