The man making the case for steroids
As controversy swirls, medical ethicist remains a center of calm and certainty
By Charles Leroux | Tribune senior correspondent
January 15, 2008
How can the accomplishments of Bonds, McGwire, Sosa and others of the "steroid era" of baseball be compared to those of Aaron or Ruth? Can Major League Baseball and the National Football League and the others ever get drugs out of their systems? Will the athletes named as users in the Mitchell report face futures threatened by cancer, heart attack, stroke? What will come of the House committee hearings, now postponed until February? Is there any tarnish remover strong enough to put the shine back on sports in America?
As the controversy over use of anabolic steroids by athletes swirls like a wind-whipped snowstorm, Norman Fost, professor of pediatric medicine and director of the Program in Bioethics at the University of Wisconsin, is a center of calm and certainty. He says, as he has for many years and virtually alone, that the maelstrom is nothing more than "the hypocrisy, bad facts, inconsistency and moral incoherence of anti-drug hysteria."
To him, athletes who take banned performance-enhancing drugs are as morally and ethically blameless as the pole vaulters who quickly converted from bamboo poles to fiberglass when they saw a competitive edge. Rather than being banned, he insists, steroids should be available, under a doctor's supervision, to any pro or amateur adult athlete who wants them.
For his contrarian stance, the soft-spoken, 68-year-old tennis- and basketball-playing sports junkie who will, he said, "watch anything that moves," has been roundly vilified.
"NPR called me 'the loneliest man in America,'" he said. "The president of the university has forwarded letters from alumni saying they are withdrawing their financial support because of me. I've had sportswriters tell me to wake up to the modern world. I've been called 'the wacko in Wisconsin.'"
If Fost is a wacko, he likely has the most stellar resume in the wacko world. His bachelor's degree is from Princeton, his M.D. from Yale. His residency was at Johns Hopkins and his master's in public health came from Harvard. At Wisconsin in 1973, he founded one of the earliest and most highly regarded and copied bioethics programs in the nation.
"Norm has always been provocative and controversial," said Dr. Mark Siegler, director of MacLean Center for Clinical Medical Ethics at the University of Chicago and a friend and colleague of Fost's since the '70s. "But his views are always presented in a careful, thoughtful way, and come from a depth of insight and clear thinking."
New Jersey-born Fost recalled that his father, also a pediatrician, was "skeptical when it came to conventional wisdom. He was smart, funny and a pit bull about honesty."
Those genes kicked in vis-a-vis sports for Fost when, in the 1972 Munich summer Olympics, an American swimmer, Rick DuMont, was stripped of a gold medal for taking a banned substance, ephedrine. It was contained in an over-the-counter cold medicine that he took, with the permission of his team doctor, to relieve asthma symptoms.
"I started thinking about the line between treatment and enhancement," recalled Fost, who takes even aspirin reluctantly. "As time went by, I kept reading more and more superficial reporting about how taking enhancing drugs was immoral."
In 1983, he wrote an editorial for The New York Times titled "Let 'em Take Steroids," an attack on the growing body of conventional and, he thought, bogus wisdom.
At the 1988 Seoul Olympics, Canadian sprinter Ben Johnson would leave in disgrace, portrayed as, Fost said, "a combination of Charles Manson and Adolph Hitler. But the American swimmer Janet Evans was hailed as representing everything good and great."
The difference was that Johnson tested positive for the use of an anabolic steroid while Evans, after her 5,000-meter gold medal win, was lauded for keeping secret from other teams the newly developed, high-tech fabric swimsuit she said helped her to victory.
Watching this morality play of good and evil on his TV, Fost wondered, "Why was Johnson condemned for taking a performance-enhancing drug while Evans' use of a performance-enhancing suit was praised?"
Fost then wrote another New York Times op-ed piece, this one titled "Ben Johnson: World's Fastest Scapegoat."
Just as he found hypocrisy in the stance that one form of enhancement is immoral while another is OK, he found it as well in the hue and cry concerning the health horrors associated with steroid use. He read medical journals from around the world and found no deaths tied to anabolic steroid use, no side effects for adults beyond acne, hair loss, infertility, lowered voices in women -- mostly cosmetic and reversible effects. He allows that, during use, bad lipids in the blood rise while the good decline but said: "This gets translated by the press into statements that there is an increased incidence of heart disease or stroke. I don't know of any evidence of that."
As to so-called "'roid rage," out-of-control anger associated with steroid use, he says there are statistically so few cases that conclusions about cause and effect are hard to make. Fost is more interested in controlling the behavior than the steroids. "If people are worried about physical or sexual assault by athletes on steroids, they should be equally worried about them by athletes who are not on steroids."
Charles Yesalis, a steroids expert and epidemiologist at Penn State, has expressed doubts about "'roid rage" as well and has been quoted in media reports as saying, "You take a state college on any given weekend and you will see as many cases of alcohol-induced rage as you will see in a hundred years with anabolic steroids."
Last February's issue of Behavioral Neuroscience reported on research conducted at Northeastern University by a group headed by Richard Melloni Jr., associate professor of psychology. The group injected a cocktail of various steroids into adolescent hamsters and found the animals becoming aggressive and remaining that way weeks after their last injection.
"After tearing apart thousands upon thousands of animal brains," Melloni said in a telephone interview, "I've concluded that these [anabolic steroids] are dangerous substances and should continue to be banned. They produce dramatic effects on developing systems in adolescents and on already developed systems. Some of the effects seem to reverse when the steroids are no longer used. Some don't."
Melloni's is one of the few labs doing such research and has looked only at animals, though he says research on human brains may become possible with improved neuro-imaging technology.
Fost absolutely opposes giving steroids to adolescents because steroid use can stunt growth. He urges stringent testing of young athletes, and, for those distributing steroids to children: "Hanging followed by a fair trial."
In all the health and morality questions about steroids, Fost said: "It's as though the drug hysteria serves as a distraction from more serious issues. You'd be hard-pressed to find a single death associated with steroid use, yet the TV cameras keep showing [Red Sox manager] Terry Francona drooling disgusting spit from something [chewing tobacco] that has a very high cancer rate associated with it.
"You have 400,000 deaths a year due to tobacco and tens of thousands of alcohol-related deaths, a substance heavily promoted by Major League Baseball, yet the president and Congress and the press have virtually nothing to say about tobacco and alcohol in athletics, but lots to say about steroids. A football player spending more than three years in the NFL has an 80 to 90 percent chance, according to one study, of some permanent disability, but the NFL produces films focusing on the most vicious hits.