Drugs in Sports
I KEEP WAITING FOR DR. DON CATLIN TO SOUND THRILLED, or at least mildly pleased, about the mushrooming furor over the use of performance-enhancing drugs in sports. Catlin, after all, helped break the now-infamous BALCO doping scandal from this very office, a small, dark, paper-strewn space inside the UCLA Olympic Analytical Laboratory. The lab is one of the world's top facilities for analyzing biological samples from athletes to detect the use of banned substances like anabolic steroids, the blood-oxygen booster erythropoetin (EPO), and scores of other prohibited drugs that aid performance.
But Catlina tall, balding, 67-year-old M.D. with a handsomely craggy facejust frowns when I prod him. He sips from an old coffee mug and says the current media blitz reminds him of every other time doping has hit the news: There's a lot of noise, and yet doping persists. He thinks about this a moment and then issues a bleak verdict on the drug-policing system in which he's toiled for the past 25 years.
"People are following this old modelrun 'em down, chase 'em, find 'em, assume they are guilty, drag them into testing," he says. "And athletes still get away with stuff, and I maintain you can get away with stuff with everybody looking right at you."
This realization has left Catlin profoundly frustrated. A few hours after we first meet, we sit in his lab chatting about doping politics and watching a young woman scan a computer readout from a testing machine. Suddenly, Catlin blurts out, "I don't want to do it anymore. I am 67 years old. I can walk out of this lab, turn the key, chuck it out, and say, 'That's the end. I'm going skiing.' "
Millions of dollars' worth of high-tech gear is whirring all around him. Beyond these walls there's an entire international bureaucracy devoted to catching cheaters. If Catlin is right, and all that won't stop doping, the sports world has an even bigger credibility problem than most of us realize.
And sports definitely has a problem, what with the recent congressional hearings about Major League Baseball's steroid scandal and lingering suspicions that many eventsfrom the Olympics to the Tour de Franceare tainted by cheating. In the past two years alone, U.S. anti-doping authorities have uncovered 77 violations. Most recently, homegrown cycling fans suffered a major blow when Tour stalwart Tyler Hamilton was hit with a two-year suspension after allegedly transfusing another person's blood into his body in an effort to boost endurance.
In response, sports and legislative leaders are piling on bigger punishments for doping offenders and demanding ramped-up testing. But Catlin is convinced more of the same won't help, and his voice can't be ignored: He's an insider who knows all about what science can and can't do to stop doping. He ran the drug testing for the 1984 Los Angeles Summer Olympics, the 1996 Atlanta Summer Olympics, and the 2002 Salt Lake Winter Games. These days, his lab conducts tests for the United States Anti-Doping Agency (USADA), the body that oversees drug testing for American athletes in all Olympic sports. He performs testing for the NFL, the NCAA, and minor league baseball. That's a tidal wave of tests, about 35,000 urine (and, occasionally, blood) samples per year, making his the busiest lab of its kind in the world.
Catlin also helps develop new tests, with help from the 40-some researchers and technicians in his labincluding six Ph.D.'s. In 2000 the lab figured out how to differentiate natural testosterone from an artificial drug form made from yams. Just before the Salt Lake Games, Catlin and his team came up with a way to test for darbepoetin, a long-acting form of EPO, a drug that athletes inject to increase endurance. That test was used to bust cross-country-skiing gold medalists Johann Muehlegg, of Spain, and Larissa Lazutina, of Russia.
More recently, Catlin has played a starring role in the BALCO case, the biggest scandal of them all and a strong indicator that, as Catlin has long argued, there are labs out there secretly working to help cheaters outfox the doping police. In a sprawling affair that's still under grand-jury investigation in California, the Bay Area Laboratory Co-Operative, a Burlingame-based company run by a musician-turned-businessman named Victor Conte, allegedly sold potions called "the Clear" and "the Cream." According to illegally leaked grand-jury testimony described in the San Francisco Chronicle, these turned out to be steroids used by big-name athletes like baseball's Barry Bonds and Jason Giambi, plus a slew of track-and-field stars. (Giambi has admitted to taking THG; Bonds maintains that he had no idea the substances he was provided by BALCO were steroids.)
BALCO came complete with a B-movie mystery plot. In June 2003, a syringe was mailed by an anonymous source to USADA. (The source turned out to be Trevor Graham, a former coach of track star Marion Jones, who is under investigation by USADA but has not been formally accused of anything.) USADA sent it to Catlin, and his lab deciphered the syringe's contents as a previously undetectable, custom-made steroid that he called THG. Because doping authorities are allowed to hold on to urine samples for up to eight years, Catlin's lab was able to test urine taken from athletes who participated in the U.S. Outdoor Track and Field Championships in June 2003.
When the results came in, four stars of U.S. track and field, among them U.S. shot-put champion Kevin Toth, tested positive. The current world-record holder in the men's 100 meters, Tim Montgomery, reportedly admitted to the BALCO grand jury that he had used THG, too. Montgomery, who denies using any performance enhancers, has since been charged with doping by USADA. At press time, a hearing was scheduled for early June.
At first, Catlin was encouraged by the busts, but now he believes BALCO only proved what he already suspected: Doping has gone big-time, and the current anti-doping regime can't hope to stop it. "The system has failed to deal with the problem," he declares. "And it will fail now."
THE STATE OF THE ART
Catlin has no intention of giving up, though. Instead, he's decided to mount a campaign to radically change the way sports go about fighting drugsan idea that he's revealing publicly for the first time in Outside. Catlin's vision is to replace the current law-enforcement modelin which all athletes are treated as suspects who are monitored and tested to find evidence of specific drug usewith a reward model, one driven by a new voluntary system that, he hopes, would enable officialdom to actually prove that the athletes who take part in it are clean.
As we'll see, there are serious questions about this scheme's practicality, and Catlin knows that, for his idea to gain traction, sports leaders and drug testing's entrenched power structure will have to accept that the current system is fatally flawed. That's a tall order, but whatever the outcome, Catlin's pending crusade is a notable attempt to debate and reform what has become a complex, expensive, and inefficient system for detecting performance boosters. A startling figure shows just how costly the current system really is. Last year, USADA charged 38 athletes with doping violations, including some from the BALCO scandal; based on its 2004 expenses for testing, legal costs, research, education, and administration, each violation it discovered cost USADA $320,404a huge per-person tab.
The World Anti-Doping Agency (WADA) sits at the top of this pyramid. It was created in the wake of a famous 1998 scandal that dramatically exposed the warts of the old system, in which various sports federations, as well as the Olympics, ran their own anti-doping operations. During that year's Tour de France, French customs officials stopped a car driven by Willy Voet, a masseur for the Festina team, and found a stockpile of EPO. Festina director Bruno Roussel admitted to doping riders, and he, Voet, and a team doctor were charged with drug-law violations and briefly jailed. Festina star Richard Virenque later confessed and was suspended from competition for nine months.
While the scandal threatened to collapse the Tour, it also frightened officials at the International Olympic Committee (IOC). They had long known doping was rampant, but aside from the occasional high-profile enforcement action, like sprinter Ben Johnson's expulsion from the 1988 Seoul Olympics for steroid use, they'd failed to institute a rigorous protocol for catching cheaters.
The following February, thenIOC president Juan Antonio Samaranch convened a meeting at the IOC headquarters, in Lausanne, Switzerland. Two days later, officials emerged with a plan to create WADA as an independent anti-doping agency. WADA's 2005 budget is $23 million, half of which comes from the IOC. The rest comes from governments around the world.
Not all sports fall under WADA's jurisdiction, of course. Major League Baseball and the National Football League set their own drug policies, and these leagues have to negotiate terms with their players' unions. But the dozens of sports federations that have signed on to WADAthe Union Cycliste Internationale (UCI), for examplemust abide by its decisions.
WADA establishes banned methods (such as blood infusion) and the roster of prohibited substances, a list of nearly 200 steroids, stimulants, beta-blockers, diuretics, narcotics, and human hormones that can be dispensed as drugs. All active, elite-level WADA athletes are considered to be part of the "testing pool," and at any time they may be required to provide a urine or blood sampleeither during competitions or by surprise while they're traveling, training, or at home.
Based in Montreal, WADA is run by a foundation board and its chairman, Canadian lawyer Richard Pound. It does no testing on its own. Rather, it has accredited a global chain of 33 laboratories like Catlin's to conduct doping tests. National anti-doping agencies, like USADA, are responsible for actually collecting samples, requesting tests from labs, and charging and prosecuting athletes. USADA is financed by American taxpayers, who pay about two-thirds of its $11 million annual budget, and the United States Olympic Committee, which pays about a third.
As it goes about its business, USADA often performs surprise sampling, with names chosen by an automated draw. So, for example, an American cyclist training in this country might hear a knock on his door from a USADA doping-control officer. In a typical procedure for male athletes, the officer follows the cyclist into a bathroom, then asks him to raise his shirt and drop his pants so he can get a close look at the athlete's penis. (Cheaters have used bizarre tricks to fake out control officers, including hiding containers of clean urine up their rectums and releasing it through a hidden tube.) The cyclist then urinates into a bottle and divides that sample between two more bottles, labeled A and B. USADA sends these samples to Catlin. The A sample will be tested, the B used to confirm any positive results.
When the same rider shows up for events like the Tour de France, the UCI takes over. It will choose which riders to testtypically the stage winner, the overall leader, and two chosen at randomand what to test for. It then ships the samples to a WADA-approved lab.
Athletes accused of doping can fight the charges by contesting them before a panel of three arbitrators from the Lausanne-based Court of Arbitration for Sport (CAS), the Supreme Court of sports doping. Should a test turn up positive and be confirmed, punishment can range from a warning or suspension to a lifetime ban, depending on the drug, the circumstances, and the athlete's past record.
INSIDE A DRUG LAB
Catlin's lab is the business end of this system, and his team is exquisitely good at finding drugs on the WADA list. The facility has handled about 300,000 tests over the past 21 years, and it has never produced a false positive. If Catlin says you've doped, you've doped.
Approaching the lab from the outside, you wouldn't know to be impressed. It's housed in a drab off-campus building that looks like a converted Quonset hut, and it sits next door to an auto-repair shop. Just inside the front door, there's a tiny reception foyer where I wait for Caroline Hatton, a forty-something Ph.D. chemist who helped organize the lab and who will escort me through the complete cycle of a drug test. While I wait, a UPS man arrives with a load of boxes. A Huggies carton sits right on top, so mundane as to be incongruously funnyinside are several of that morning's urine samples.
Hatton appears and we walk back to the large, equipment-jammed lab, where we watch technician Yvonne Chambers heft the Huggies carton onto her work table, slice it open, remove several smaller boxes, unseal them, and lift out two bottles marked A and B. They come with a form identifying the sample by gender and sport, with a list of tests to be performed. The sample belongs to a male weight lifter who falls under the jurisdiction of USADA. There's no name; he's just a number. During A-stage tests, Catlin's lab never knows the identity of the athlete.
Chambers labels each bottle for tracking purposes. Using a hand pipette, she places some of the A sample in smaller glass tubes, each for use in a separate test. While Chambers works, Hatton explains that the B sample will be stored, to be opened only if the A is positive. For a doping charge to stick, both A and B must be positive. Under the rules, an athlete has the right to observe B-sample testing or send a representative. When this happens, the athlete is first ushered into a waiting room across the hall from Catlin's office and shown the B sample.
Hatton, a small, thin woman, tells me she once met with a male athlete in that room. When she handed him the B sample, she recalls, "he dropped his bottle accidentally on purpose, but it failed to break. After a few seconds of stunned silence from both of us, he picked it up, then smashed it on the floor." Incidents like that explain the taped line on the lab floor around every workstation. Witnesses to B-sample testing are forbidden to cross it.
The lab offers a package of tests for the most commonly abused steroids, like nandrolone and stanozolol. Since the lab's decoding of THG, the standard workup has included it as well. USADA also wants this sample tested for such things as human chorionic gonadotropin, a hormone women generate when pregnant. Dopers sometimes use it to prevent their testicles from shrivelinga side effect of taking steroids.
As the sample moves through various stations, the urine is processed, or "derivatized," so it can be put through a gas-chromatography/mass-spectrometry machine, known as a GC/MS. The steps include several refining and filtering procedures that reduce the sample's volume to a tiny amount of liquid at the bottom of a bullet-shaped vial.
This vial is loaded onto the carousel of a GC/MS, which is about the size of a large microwave oven. The machine heats the sample to between 284 and 356 degrees Fahrenheit, turning it into a gas. The gas is driven through a column, a coiled silica tube a quarter of a millimeter in diameter. As the gas moves through the coil, the various ingredients in urine physically separate like school kids marching single file.
Next, the urine's components enter the mass-spectrometer portion of the machine. This device measures the atomic weight, or mass, as well as the prevalence of various atoms or molecules, and it scans the components one at a time. Since every molecule has a signature molecular weight, the machine can create a personal snapshot of each, depicted as peaks on a computer readout. Years of experimentation have yielded a collection of telltale peaks for drugs of interest and their by-products.
Notably, the procedure I'm watching wouldn't work for THG. By luck or intent, the steroid's designerwhose presumed identity is widely known but who hasn't been publicly named by investigatorscreated a molecule that disintegrates when heated, so using a GC/MS destroys it, making it undetectable. Instead, the lab has to use a related technique, liquid chromatography/mass spectrometry, which analyzes the material in a liquid state. Both GC/MS and LC/MS are accurate to within one part per billion.
Seeing Catlin's team at work is impressive, but the experience also raises a question. The people here clearly know how to find drugs. A complex international network has been set up to collect samples from athletes. The whole operation looks like a pretty tight net. So why can't it work?
HOW ATHLETES CHEAT
I pose that question to Hatton, who laughs at the idea that athletes can't beat these tests. "People always say, 'I have always tested clean,' not 'I do not dope,' " she says. "We hear that and giggle." Her reaction confirms what other experts have told me: Dopers evade detection all the time.
Take the case of Tim Montgomery. According to press reports, Montgomery told the BALCO grand jury he used THG. But he has never tested positive, even though he was tested four times in 2001, three in 2002, and five in 2003. Another example is British cyclist David Millar. Though he never failed a drug test in eight years of riding, he admitted in 2004 that he'd used EPO.
THG itself was invisible to testers until Graham mailed the infamous syringe. Making such a designer steroid isn't even difficult. The UCLA lab reverse-engineered its THG sample and determined that its manufacturer had probably taken an existing steroid and bubbled hydrogen gas through it to slightly alter its structure. The ease of such tinkering matters, because Catlin's machines are tuned only to watch for known drugs. Introduce an unknown and the machines can go blind.
Thousands of such combinations are possible, and in a globalized world, these drugs can be made anywhere. In fact, long before BALCO, Catlin argued that clandestine chemists were busily supplying designer steroids to jocks and bodybuilders. Notmany people listened. But all they needed to do was scan the Web, where the underground experts talked about exactly what they were doing. As if to further prove Catlin's argument, another designer steroid, dubbed DMT, was discovered at the U.S.-Canada border in December 2003. Like THG, it was found only because of a tip.
As difficult as finding steroids can be, they're a snap compared with the class of drugs based on natural human proteins. The most famous of these is EPO. Because EPO stimulates the body to make more red blood cells, which carry oxygen, athletes who use it get an endurance boost. This makes it especially popular in cycling, cross-country skiing, and distance running.
Another drug based on a natural human protein, human growth hormone (HGH), joined EPO as a doping agent about ten years ago. As its name implies, HGH helps athletes build muscle and bone, adding strength and power. HGH accomplishes this by stimulating the release of yet another protein, insulin growth factor 1 (IGF-1).
These protein drugs are a challenge because they occur naturally in all of us. For more than a decade, testers have been researching ways to tell the difference between natural and artificially introduced proteins. EPO was knocked off first, thanks to a 2000 test developed by scientist Françoise Lasne, of France's National Anti-Doping Laboratory.
The Lasne test is an extremely complex procedure involving a biology lab full of ingredients. It requires nearly three days and dozens of steps, most done by hand. The time factor is one reason why the Tour de France relies more heavily on a simpler hematocrit test, a measure of the volume percentage of red cells in the bloodstream. If a rider's hematocrit exceeds 50, the cyclist will be banned from starting that day.
The Lasne test exploits the difference between natural and exogenous ("out of the body") EPO. When drug companies make EPO, the sugar molecules in it are subtly altered from the natural form. The test measures this difference by using a technique called isoelectric focusing, in which an electric charge sends the EPO scooting through a gelatin slab. Exogenous EPO will stop in a slightly different position than natural EPO. The slab is then blotted, and the blotting material is "developed"not unlike a photograph. This creates an image of small black blobs aligned in rows. If blobs appear in the range where exogenous EPO is known to stop, that means the athlete doped.
Sounds good, but the test can detect exogenous EPO for only three days after the last time an athlete injected it. Unfortunately for the testers, the performance boost can last several weeks, and new red blood cells can survive for about 120 days. So a cyclist could use EPO, stop four days before a test, and still reap benefits.
This brief window also helps defeat surprise sampling. A doping-control officer has to physically find an athlete to collect a sample. Though athletes are supposed to tell anti-doping authorities where they live and where they'll be, Catlin argues that "any good athlete can wriggle out of that and be somewhere the tester isn't. We are chasing the cheaters around." USADA statistics support Catlin: In 2004, the agency recorded 507 missed tests.
Still, as the case of Tyler Hamilton seems to indicate, some athletes have already decided to shift away from EPO. Hamilton is accused of boosting his red-cell count by transfusing somebody else's blood. Such cheating is detectable because, even if you transfuse blood matched by typeA positive, AB negative, and so onthe blood will have slightly different immune properties from person to person. The test uses a machine called a flow cytometer to sort cells according to these differing properties. But this test has a weakness, too: It can't be used to tell if an athlete has blood-boosted by extracting his own cells during training, storing them, and then injecting them before competitions.
Because there are so many complexities, architects of the anti-doping system may be hurting their cause by trying to keep up with every new technology. For example, in 2003, Kenyan runner Bernard Lagatlater the silver medalist in the 1,500 meters at the 2004 Athens Olympicswas refused entry into the track-and-field world championships after a urine sample from him tested positive for EPO. He denied doping, and his attorney asked German cell biologist Hans Heid to observe his B-sample testing. Lagat's B sample was negative, which didn't surprise Heid. He declared the EPO test "error-prone" and told WADA that "the development of totally new urinary EPO tests should be encouraged and funded."
Heid says WADA authorities told him they knew the test was flawed but were happy to have a test at all. Catlin believes the EPO test was introduced prematurely. WADA clearly saw the need for refinements, too: Last year, four years after the test was first used, WADA issued a refined protocol for performing it.
CHASING THE FUTURE
WADA's rules demand abundant caution before declaring a test positive, and during my visit to Catlin's lab, I see why. When Allison Evans, who runs many of the EPO tests for Catlin, shows me the results of one test, I think it looks positive. But after applying a statistical analysis, she declares it negative. Catlin says he thinks his lab, owing to caution, exonerates ten guilty EPO users for every one it declares positive. He says he's so fed up with the politics of the test that he's decided not to reapply for a USADA grant that supports the EPO research in his lab.
Heid says the whole idea of routine testing for proteins is worrisome. "Analyzing tiny amounts of samples belonging to the protein field gets really complicated," he says. "Most of these methods for [proteins] are still in development, in a research state, and not even useful in practical work."
This bodes ill for WADA's ongoing effort to develop a test for HGH and IGF-1. After a decade of research, experts don't even agree on whether or not a validated, usable HGH test exists. WADA says it does. Catlin and other sources say it doesn't.
The test in question may prove useful one day, but Catlin says "there is a big gap between having a test and having a bulletproof test," adding that, as of now, the proposed HGH test results would never withstand a legal appeal. Even if the test did hold up, it suffers from the same flaw as the EPO testa short time frame of detectability. The next big challenge will be gene dopinga theoretical procedure that's probably years or decades away, whereby genes would be transferred into muscle or bone marrowwhich might be impossible to test for.
The advance of technology places WADA and USADA in an impossible situation. Both take heat from legislators, for failing to get ahead of the cheaters, and from athletes and their lawyers, who say the rules are burdensome and unfair. Yet they're armed with dime-store budgets and asked to defeat doping even while science creates new avenues for it.
Catlin is almost militant in his view that the system is grossly underfinanced. The testing program in his lab runs on about $2 million per year, supported by fees. (The standard steroid panel I watched cost USADA about $82.) Catlin can reinvest some of these proceeds back into the lab, but the rest is turned over to UCLA, which owns the facility. If Catlin wants to do research or buy new machines, he's dependent on grants, mainly from USADA or WADA.
He estimates the worldwide research budget at somewhere between $20 million and $25 million per year, about what Barry Bonds will make this year ($22 million) and a pittance compared with the billion-dollar TV deals for major sports. The IOC may be a huge multinational business, but WADA still has to beg money from it, and, Pound says, outside agencies that could kick in, like government health institutes and philanthropists, "are far more interested in finding a cure for cancer or diabetes rather than analyzing urine of perfectly healthy athletes."
No wonder Catlin says there's no way to win.
So why persist? Partly because Catlin, a man who can seem cranky even on a good day, refuses to give in. "I just can't turn in my badge," he tells me. But there's a deeper answer. Beneath a gruff exterior softened by a dry sense of humor, Catlin really believes that sports are a vital part of the human experience, and he wants that experience to be honest.
Other than his two sons, whom he raised alone after his wife died of cancer, this work has been Catlin's greatest passion for 25 years. To him, sports doping is a "grubby, dirty, nasty, filthy business." Catlin's view of his mission is consistent with his character, which combines a serious sense of justice with a dash of Yankee pragmatism.
He was raised a New Englander, graduated from Yale University, and received his medical education at the University of Rochester, graduating in 1965. As a freshly minted doctor specializing in internal medicine, he entered the Army at the height of the Vietnam War and was stationed at Walter Reed Army Medical Center, in Washington, D.C.
One day, Catlin read a newspaper account of a D.C. storefront drug campaigner, a guy who dressed up in old Army fatigues and went around snatching addicts off the streets, hauling them to his "treatment" center, and reforming them. The government was planning to close him down because he had no staff doctor. Catlin went to his headquarters and volunteered.
Meanwhile, in Vietnam, soldiers were dealing with the danger and drudgery by shooting up heroin. Catlin, now considered a drug-addiction expert by the Army, got the nod to head up a treatment program. He fought with generals over their plan to jail addicts, insisting that punishment wouldn't solve the problem. Instead, he focused on getting addicted soldiers out of Vietnam, then treating the addiction.
In 1972, UCLA recruited him to its med-school faculty; he was still teaching when Los Angeles was selected to host the 1984Olympics. Though a few academic labs, primarily in Europe, had researched sports doping, and the IOC had started using limited doping tests at the 1968 Summer Olympics in Mexico City, there hadn't been much work done in the U.S. Catlin was asked to set up a lab for the L.A. Games, a job he thought would be nothing more than an interesting diversion. He's been at it ever since.
Catlin loves pure athleticism, and he's upset that drugs have made the very fact of greatness a cause for suspicion. He first encountered this reality soon after he started the lab. One day, track coach Pat Connolly stormed into his office. At the time, Connolly was coaching sprinter Evelyn Ashford, who would go on to win four gold medals and a silver in three Olympics. Back then there were whispers that Ashford's success was due to drugs. But Connolly knew Ashford was the best natural athlete she'd ever coached, and there was no way she would allow innuendo to mar her accomplishments. She wanted Catlin to help quash the rumors.
"I went in and said, 'Come out to practice anytime,' " Connolly remembers. " 'Do not tell us when. Come every day. Whenever. Get samples, test blood, whatever, so we can document. Then, once fingers start to point, we have this record.'"
Catlin watched Ashford work out and came away in awe. She didn't look like she was on drugsshe was lean, not bulkyand she had a natural grace that convinced him her talents were pure. "Don said, 'Evelyn will never need this. She will not have that problem,' " Connolly recalls. "I did not like his answer."
"She was mad at me," Catlin says. "But she wanted me to test Evelyn and declare her drug-free," and he could not think of any scientific way to give an athlete a formal stamp of approval. He sympathized with Connolly, though. It seemed unfair to be accused just because you were good.
"Though I could not do anything then, the thought was indelibly stamped in my mind," Catlin says. He assumed that, in time, a system would emerge that could exonerate pure athletes like Ashford.
"Something had to give," Catlin says. "It's been 20 years, and nothing gave."
A MODEST PROPOSAL
So now, at 67, with his career winding down, Catlin has decided it's time to act. He believes a major upheaval in the anti-doping system is the last best hope for making drugs in sports nothing more than an insignificant irritation. He thinks he's come up with just such an approach, and he's decided to push hard for it in hopes of capitalizing on the recent surge of interest in the issue.
He calls his idea the Volunteer Program. It's driven by the concept of using science, testing, and free-will participation to prove that athletes who sign up are clean, based on thorough biological profiles of their bodies. Catlin would use these profiles to create a set of "biomarkers" that show what is and isn't normal for each athlete. Armed with these indicators, he would institute ongoing, voluntary checkups for any athlete who chooses to participate. In return for entering the Volunteer Program, athletes would receive recognition as members. The public, press, sponsors, and governing bodies would be assured that members of the program were not doping.
In this, the idea resembles one floated in the early nineties by Pat Connolly and Charles Yesalis, a Penn State health-policy professor and scathing critic of the current drug-testing system. They suggested creating a Team Clean. But Catlin would bolster the concept by deploying the latest research and technology to make clean a meaningful word.
First he wants to mount a research project using ordinary weekend athletes, such as college students. A number of biomarkersblood pressure, cholesterol, total testosterone, hemoglobin, IGF levels, and many otherswould be monitored and plotted over time to see how they vary between people and within each person's body. What happens, for example, during a long trip? How does having the flu affect biomarkers? Or doing a workout? The idea is to create a fixed portrait of each athlete so each can serve as his or her own standard.
Then, in a move sure to be controversial, the test subjects would be given safe doses of performance-enhancing drugs for a limited time. Their biomarkers would be monitored to see how the physiological portrait changed.
Using this data, Catlin wants to try the Volunteer Program with one sport, like weight lifting, which has the advantage of a small population that's tested frequently. If it works there, he wants to expand it. Athletes who volunteered would establish a pattern of historical data on their own physiology through frequent biomarker testing. Samples from that testing would be stored and used as reference materials.
For instance, if the monitoring shows a spike in a weight lifter's IGF-1, that probably means he's doping with growth hormone. At that point, Catlin says, a doctor would call the lifter in and say, " 'Joe, we've been following you for six months and suddenly your IGF is way up. I'm worried. Let's talk.'
"You'd approach it as a physician does a patient," Catlin continues. " 'Is something going on in your life? I am worried you are taking growth hormone, and you know we do not have a bulletproof HGH test, but we do have these blood markers, so I want you in here every week. We are going to track you, and I want to see that go down, and if it doesn't go down, a committee of your peers, other athletes, is goingto want to talk to you.' "
That's it. No punishment. If Joe doesn't agree, or his levels stay high, he would revert to the old system and take his chances. But he'd also lose the built-in absolution of the Volunteer Program.
Catlin's explanation reveals two critical ingredients of the program. First, he hopes to rejuvenate the role of the sports physician, to make doctors the system's eyes and ears. (Currently, some athletes avoid physicians for fear of being discovered; this endangers their health.) Second, Catlin believes the enforcement of the program's rules must be left to a panel of athletes. His plan makes athletes the judges, not USADA or WADA.
Under the program, there's no need to prove an athlete is shooting up HGH, so you don't need a complicated test for it. Because athletes booted out of the program won't be banned from competing, there will be no subsequent legal battles. Authorities will never again have to worry about unknown steroids floating around the sports netherworld, because Catlin isn't looking for specific causesdrugsbut instead for their effects. Yet another advantage, Catlin argues, is that fewer legal battles and complex drug tests should mean the Volunteer Program will be much cheaper to operate once the initial research is finished. And an athlete like Lance Armstrongdogged by doping whispers throughout much of his careerwould have the opportunity to trumpet a definitively clean bill of health.
Still, some criticisms of the program are obvious. For starters, the plan seems to rely too much on voluntary actions, and you wonder how it would work with a superstar athlete who says, "I'm clean, but I decline to take part."
This is a risk, of course, but imagine a future peloton of cyclists. Some wear a logo showing they're part of the Volunteer Program; some do not. The press, sponsors, and public would surely question any athletes who did not sign up. What are those riders hiding? Why wouldn't they want to be declared clean? Catlin believes social pressure would lead athletes to volunteer. Another area of concern is the reliance on doctors. After all, it was the Festina doctor who supervised the team's EPO use in 1998. But while Catlin hopes to make physicians the front line, their patients will still be checked by independent biomarker testing.
That testing will be rigorous and frequent at first, then will become more sporadic over time. Athletes would have to be available for sampling to the point that Catlin would hand each one a cell phone that he or she would be obliged to answer. Early on, there would still be drug testing, too, to ensure every athlete entering the program wasn't using. Over time, though, the drug testing would diminish in favor of the biomarkers.
"Cheaters just aren't going to join this," Catlin says. "They'd be crazy to."
NOW OR NEVER
Catlin has a long way to go before this idea becomes more than a dream, but in recent months he's been preparing for his push by sounding out trusted friends among sports administrators. Next, he'll present a formal case to the powers that beUSADA, UCLA, perhaps the USOC, maybe even the federal government through the National Institutes of Healthto seek the necessary research funds.
Meanwhile, the plan has already received a few endorsements. One prominent backer is Thomas Murray, a well-known bioethicist who serves as the chairman of the Ethical Issues Review Panel for WADA. "Don's idea is fascinating," he says. "I would like to see it discussed much more thoroughly as a way to break out of this cops-and-robbers cycle we've been in."
Dr. Robert Wolfe, a human-metabolism expert at the University of Texas Medical Branch in Galveston, says Catlin's plan "could overcome some of these problems with one new drug after another. I think this is a great idea, a fantastic idea, really, and I hope he is successful."
And Evelyn Ashford, who inspired Catlin and now sits on USADA's board, says the plan sounds "great... more logical, like a better way of doing things. I could get behind this, because it is a more positive approach to the problem."
But Catlin will certainly face resistance. Lawyers for some prominent athletes are vocally skeptical. Edward G. Williams, a New York attorney whose clients include accused dopers like Regina Jacobswho set the 1,500-meter indoor world record in 2003 only to later test positive for THGsays Catlin's idea "sounds hokey." After hearing the basics of the plan, he notes that if an athlete's biomarkers were changed for any reason, not just drugs, he or she might flunk out of the Volunteer Program.
Howard Jacobs (no relation to Regina), a Los Angeles attorney who represents Tim Montgomery and Tyler Hamilton, praises Catlin's objectivity but says the plan sounds too subjective to risk damaging an athlete's reputation for not taking part in it. He wants solid proof of drug use. "It troubles me to have a system where it's OK to say, 'Something looks funny.' You should have to show more than 'Something doesn't seem right, but we do not know what it is.' "
USADA reacts with lukewarm caution; spokespeople for the organization declare their respect for Catlin but issue caveats and polite boilerplate about the need to explore new solutions.
WADA officials pooh-pooh the idea outright, arguing that they're already on the case. "We call what he's talking about the 'longitudinal approach,' " says WADA's chief scientist, Olivier Rabin. "We are well aware of it and have some projects in that direction," he says, referring to WADA's now-defunct Athlete's Passport, which kept track of some biological parameters. But the Athlete's Passport, a voluntary program that had a stop-and-start history at WADA, was mainly a record of drug-test results. Catlin dismisses any comparison.
Nobody, not even Catlin, believes his idea is a sure thing. But he feels obliged to fight. If he can't live with the current system, he says, "it is time to pass the baton. But I'm not ready. I need to give the Volunteer Program a go... I gotta get the damn thing off the ground."
For Catlin, and for sports as a whole, time is short.