NCU Hosting Taylor Hooton Foundation Event

NCU Hosting Taylor Hooton Foundation Event HERE.

News Bits-Metrodome "Last Lap"

Metrodome running, which has been a Minnesota winter refuge for over three decades will, hopefully, just be taking a break during the construction of the new facility.  The "Last Lap" will be held at 7:55 PM on the day after Christmas at the Dome.  One last chance this winter to run on dry pavement this Winter.  Rick Recker, USATF president and administrator of the Metrodome running program since its inception, reports that talks are being held to continue the runs in the Dome when the new facility is built.  Stay tuned.

Three time Grandma's Marathon champion and 2006 Medtronic Twin Cities Marathon champ Mary Akor banned for positive test for clenbuterol is HERE.  TC Running's Jenna Boren, who was second in the March 2 Woodlands Marathon, gains the title vacated by Akor's ban.

Sun Sailor article on Wayzata girls win at NXN is HERE.

MIAC Student Athlete Spotlight on Bethel's Alex Hintz is HERE, on St. Mary's Shauna Stephens is HERE.  MIAC feature on Macalester's Gretchen Greene's "cross training" via log rolling is HERE  NCAA feature on St. Thomas alum and former coach Mark Dienhart is HERE.

NSIC indoor track has begun, first weekly review is HERE.  NSIC coaches polls are HERE.

Gopher men's throws coach Lynden Reder's presentation at the USTFCCCA convention is HERE.

UMAC Indoor Track Athletes of the Week are HERE.

Boise State College newspaper story on Emma Bates is HERE.

Fitger's 5K Run & Walk registration opens HERE.

Dyestat final boy's HS individual rankings HERE. Girl's rankings HERE.

"Houston, We Have A Problem"

By Jim Ferstle
In the Fall of 1988, Ben Johnson had just been busted in Seoul for steroid use.  A short time afterward a pediatrician in St. Paul had an appointment with a mother and her young son.  The son was a high school wrestler.  "I'd like you to prescribe some stanozolol for my son," the mother said to the doctor, who refused the request.

Not long ago, in another doctor's office in Illinois, a young athlete was also visiting his physician.  "You need to get bigger," the doctor told the boy and his parents.  "I should give your son some Human Growth Hormone."

Yesterday a study in the medical journal Pediatrics concluded that use of steroids, human growth hormone, protein shakes, and other methods advertised as being able to enhance muscularity in individuals were used by more than a third of the middle and high school students who were part of the study done in the Twin Cities.  The number of steroid users in the study was  higher than previously reported in similar surveys such of the self reported use of steroids by both boys and girls, athletes and non-athletes.

"This study did not find significant clustering of muscle enhancing behaviors within schools," the atuthors conluded.  "Rather than being driven by a particular school sports team coach or other features of a school’s social landscape, this diffusion suggests that muscle enhancing behaviors are widespread and influenced by factors beyond school, likely encompassing social and cultural variables such as media messages and social norms of behavior."

While the rate of steroid use was higher among athletes, it was not limited to them.  These conclusions are not unique, nor startling.  They've been reported before in lower numbers, and have the limitation of being from one area of the country and a self reporting survey that relies on the truthfulness and accuracy of the information provided by the subjects, but one would have to have the proverbial "head in the sand" not to understand that athletics and society in general has a drug/"enhancing substances" problem.

The major unanswered question of this latest survey is where are these middle and high school kids getting what are controlled substances, such as steroids, that are illegal to possess or sell without a prescription.  The answer may be in the second example cited of the doctor willing to prescribe HGH to a child that has no growth problem other than to "get bigger" to improve his chances in a sport where size matters. The other most common answer is "on the internet."

One level below the illegal activity, however, is the unregulated "supplement" industry where "prohormones," testosterone boosters, or other products that are advertised as "legal steroids" that may contain actual steroids.  These supplements are a category of substances that the researchers noted as being frequently used by the school kids in an attempt to enhance their muscularity.

In a space mission, whenever something  went wrong the catch phrase: "Houston, we have a problem," became associated with impending disaster or at least imminent danger.  Athletics, we have a problem.  It's not a new one.  As the recent USADA dossier on the systemic doping in cycling illustrated at the highest level of sport an industry has grown up to support doping in sport.

It appears to not yet have filtered down to the middle and high school level, and hopefully never will, but other countries, such as South Africa, have fears about the infiltration of doping into their school sports and are initiating programs to combat it.  The alarm bells are ringing, and hopefully it won't take a disaster the size and scope revealed by the USADA case against Lance Armstrong to stimulate a response.  Prevention is a more effective deterrent in this sort of situation than attempting to find a "cure" after the "disease" has already infected the "patient."

Pediatrics article is available HERE.

Lance's Legacy

By Jim Ferstle
Lance Armstrong is a survivor.  He survived a broken home, essentially growing up without a father.  He survived cancer.  Now he has to survive a test of his own making.  The USADA's  "reasoned decision" as the file on the investigation of doping on the US Postal/Discovery teams documents has been labelled, documents in detail what has been known in the cycling community for years.  Doping was part of the culture.  It was perceived as the only way to the top of the sport and was part of the mantra: "Everybody is doing it."

Everybody wasn't doing it, but enough were to transform the sport of cycling.  The same could be said during this era about other sports, including track and field, and with the introduction of blood doping and use of rhuEPO, distance running.  At a conference on the topic of doping in sport in the late 1990s at Duke University, Alberto Salazar was one of the speakers.  He told the group that he was reluctant to encourage his own kids or anybody else's to get into the sport because it was perceived that doping was necessary to rise to the top.

In 1984, John Treacy, an Irish runner who later that year won a silver medal in the Olympic marathon and already twice won the World XC Championships, walked into a bathroom at the Meadowlands prior to the start of that year's IAAF World XC championships.  There he saw members of the Spanish team injecting themselves with a red substance in syringes.  Years later, I was at the table in a restaurant in the New York Hilton during New York City Marathon weekend with John, Minnesotans Mark Nenow and  Steve Plasencia, Steve Scott, and other top runners of the era.

Talk got around to doping, and John reiterated his own vehement opposition to the notion that you had to do it to succeed.  He knew others were doping.  He knew it was a big problem in the sport that wasn't being properly addressed by the sports governing bodies.  But that didn't make him believe he had to dope.  He derived great satisfaction, he said, by beating the runners he believed were doping.  Today John is the head of the Irish Sports Council, whose anti-doping unit polices the doping issue in Ireland.

Running has always had the advantage of being an individual sport where you won or lost based on your own talent and ability to perform.  It wasn't the sort of team effort or culture where others could be pressured to give in to the temptation to dope just to keep one's "job" or stay at that level of the sport.  The pressure to dope just to survive wasn't as intense, yet, as the recent case of California runner Christian Hesch  illustrates, doping can be a strong temptation not only for Olympic level athletes, but for others as well.

Hesch only came forward with a confession of his guilt for using rhuEPO after he was caught by teammates who threatened to turn him in to USADA.  Armstrong missed his first opportunity to join the other cyclists who admitted their use of drugs and accept a more lenient punishment by helping the agency attempt to get at the roots of the problem, the suppliers, enablers of doping that make the practice possible.  Thomas Bach, and IOC VP, has urged Armstrong not to miss another, to "come clean,"  to essentially be part of the solution to the doping in sports cycle instead of part of the problem.

When Armstrong got cancer he devoted his considerable energy and determination toward dealing with his illness.  Then he took one step further by trying to be part of the solution to the curse of cancer.  Nobody expects him to confess.  To tell all he knows about the dark underbelly of sports. But it would be, perhaps, a greater achievement than finishing first in the Tour de France seven times.  If Lance Armstrong wants to be remembered for what he did for sport, he has a chance to step up and be remembered not as what Greg LeMond has called the sport's greatest fraud, but rather as someone who contributed to changing the course of modern sport.  If he wants to be remembered for the good he has done or forgiveness for the damage he's caused, now is the time to earn it.

Dr. Ferrari's Closing Arguments

Dr. Michele Ferrari's final response to Robin Parisotto is HERE.

It's Not About the Dopes: Why the US Postal Case Matters

By Jim Ferstle
If you think the much publicized USADA prosecution of the doping conspiracy case against the US Postal cycling team is all about Lance Armstrong and the US Anti Doping Agency, you're wrong.  It is much more than that.  At it's core it is the attempt by USADA to tackle their greatest challenge, exposing and punishing what can generically be called "the sophisticated doper," athletes who not only use performance enhancing substances(PEDs), but also resort to extraordinary means to prevent people from exposing what they are doing.

For as long as I've written about this topic(since 1987) the frustration of those who operate the drug testing labs, and those charged with uncovering and prosecuting doping offenders has been that the vast majority of the people they caught breaking the rules were what you could call "low hanging fruit,"  the athletes who often accidentally ingested a contaminated supplement or "inadvertently" were caught with a banned substance in their urine.  These were not hard core cheaters who bought into the win at all costs mentality, but rather careless individuals who made mistakes.

But the current prosecution takes direct aim at the US Postal Six, the alleged ringleaders of "the most sophisticated, professionalized and successful doping program that the sport has ever seen," according to USADA.  The aim is to expose the lengths to which some will go to achieve success in sport.  As I've often told those who ask why I'm still interested in this topic after a quarter of a century I say that it encapsulates the best--athletes striving to be the best they can be in their chosen hobby/profession--with the depths to which they will go to achieve those goals.  It is a fascinating study of human nature.

It's a topic that involves psychology, physiology, pharmacology, ethics, morality, and a host of other fields.  In literary terms it is Shakespeare in spikes, a fascinating journey through shades of gray, as well as black and white.  The technological and social changes of the last 50 years has transformed society and this is reflected in our views on sports.  They have been transformed from the games we played for fitness and recreation or watched to be amazed by the exhibition of physical talent, to entertainment and recreation businesses that generate billions of dollars in revenue.

This has an impact not only in economic terms, but in social ones as well.  Sports "stars" become celebrities with influence rivaling, if not surpassing, those in other professions and an income to match that status.  College scholarships are almost the equivalent of a four-year salaried career and as much a sought after goal as a short term professional sports contract for those not gifted enough to make the "big leagues."  All this leads to a "trickle down" effect. The pressure to perform is not only on the small minority of the greatly athletically gifted, but also to the families of those who want their children to get a good college education, but can't afford it any other way.

A graphic example of the temptations of this reality hit home for me in 1988.  After Ben Johnson tested positive at the Seoul Olympics and the surrounding publicity delivered the unintended message that: "Hey, steroids work."  A mother took her son to an in law of mine who was a Twin Cities pediatrician.  The mother  said to her: "I want you to prescribe some stanozolol(the banned steroid Johnson took) for my son(a wrestler) because he needs to get better."  Or a similar story told to me recently by a high school coach at a private school in Illinois where the doctor of the one of the school's football players  told the parents that he should give some growth hormone to the teenager because "he needs to get bigger."

Doping is not just for Olympians or professional athletes anymore.  Masters cyclists are getting busted for using recombinant erythropoietin(EPO), the blood boosting drug that is one of the most potent performance enhancers used by athletes.  This reality of modern sport is only getting more advanced as another coach told me recently that research into genes, receptor cells, and the mysteries of how the body does what it does is unlocking a whole new territory/definition of doping.  Instead of injecting oneself with pharmaceuticals, the next generation of performance enhancers will be manipulating one's cellular functions and capabilities to do what PEDs do today without the potential negative side effects.

Why all this matters is that the "culture" of top level and elite level high school sport has changed.  People have always cheated, but it was usually a singular, individual indiscretion.  Now it's an industry.  It's not merely one off doping, it's a sophisticated system of manufacture, delivery, and consumption of products and services provided to give an athlete "the edge" on the competition.  To break that culture, the most potent battleground is on the level of the sophisticated cheaters.  They are the "role models,"  the engine driving the doping train.

When the BALCO case broke, many of the athletes who were caught were not the big name stars, but those striving to reach that status.  Many of them struggled with the decision to dope and, when caught, ultimately confessed to their "sins."  But when asked to go the "extra mile,"  to give up their suppliers, to tell the full story of the network that was set up to service this industry, they balked.  Marion Jones, who had not and ultimately was not convicted of a doping offense, was frequently cited by these individuals who said: "Why aren't you going after her?  Why haven't you busted her?"

To kill the beast, you have to cut off its head.  The head of the doping beast is the sophisticated doper and the enablers around him or her.  That is why the US Postal case matters.  To change the doping culture, you have to demonstrate that no matter who you are or when you did it, there is a price to pay.  A price commensurate with the crime.  For the US Postal Six this is not a "witch hunt" or an unfair targeting of individuals.  It is an attempt to change the culture. To return sport to the best athletes.  This case will not accomplish that in one fell swoop, but it is a step in the right direction.

For details of the USADA/US Postal case go HERE.

Scientists' Debate: Parisotto's Closing Arguments

After a break for our Medtronic TCM Marathon coverage, we have reached the point of "closing arguments" in the scientific debate between Robin Parisotto and Dr. Michele Ferrari regarding what may be a small piece of the file USADA will soon send to WADA and UCI regarding the doping conspiracy case they pursued on cyclist Lance Armstrong.  The debate began with Parisotto's original analysis of some of the data (HERE) Armstrong had published on his website during his comeback to cycling in 2009 and an invitation to readers to "peak behind the curtain" of  the process of deciding guilt or innocence in a doping case HERE and HERE.

That was followed by a debate between Parisotto and Dr. Ferrari in several installments  beginning  HERE,  and proceeding with the point/counterpoint  HERE,  HERE, HERE, and HERE. Below are Parisotto's "closing arguments."  Dr. Ferrari may post his after reading the remarks below and we'll post a link to them if and when he does.  

Thanks to both Parisotto and Dr. Ferrari for allowing us to be spectators in the debate and get that "peak behind the curtain" of the biological passport process and the spirited exchange of information that transpires in these cases.---Jim Ferstle

Response to Dr. Ferrari from Robin Parisotto

First, it must be asked how a member of the public (as Armstrong has stated, Dr. Ferrari is merely a friend and their conversations during his comeback in 2008-2010 were not  about matters of training or physiological analysis such as this) has such intimate knowledge of times, places, and conditions surrounding the blood tests. 

By posting the results on the web it could be argued that Armstrong had invited speculation and perhaps should have provided other relevant information (which Ferrari appears to have at hand) for others to consider as well. Much of this debate Dr Ferrari and I have engaged in only involves the initial phase of a case brought using the biological passport. 

For example none of the data and the information that Ferrari claims to have or know about is verifiable at this point. Meaning that a higher standard of proof applies in making decisions in a biological passport case.  Any action that is taken has to be the result of the analysis of  all the relevant data available to the panel studying the case and creating an official Biological Passport profile. 

While Ferrari may be intimately aware of the Passport guidelines/rules etc.,  it cannot be assumed that everyone else is also. This is critical if readers are to understand both his position and mine. For example, as Dr. Ferrari argues, whether an athlete’s values lie within the predictive value (for upper and lower levels) is irrelevant in the context of the passport. 

It is the variability of measures, the magnitude of the changes, and the timing of the changes that are key to forming an opinion. When an athlete's data shows wide variation in blood values breaching the upper and lower limits, however, this does raise a "red flag," and influences the recommendation made using that data.

When an individual athlete's Biological Passport is assessed, it is classified into one of four categories; normal, target, pathology and doping suspicion.  (Normal means there are no suspicious values.  Target means there are suspicious values, but more data is needed so the athlete is "targeted" for further testing.  Pathology means there may be other indicators that a disease or other medical issue may be responsible for the abnormal blood values.  Doping suspicion is a case where the values are consistent with known physiological responses to using doping substances or methods.)   

It is not uncommon that an initial evaluation of the data received to result in a classification as a doping suspicion. But the case doesn't end there, it has to survive much more analysis before it moves from being a suspicion to the recommendation that it be adjudicated as a doping violation.

Following the initial evaluation, full documentation packages are provided in order for experts to assess the influences of competition status, environmental conditions, time and place of collection, transport and storage conditions, and analytical techniques/controls. 

So in responding to Ferrari’s claim of pre-emptory accusation "subjectivity," it is "subjective" in the sense it is being done by people who will form opinions on the data, but in order to get beyond the initial stage of "suspicion" to "possible/probable" doping violation, that conclusion must be supported by the data, not a subjective belief that the initial data might be evidence of doping. 

The real test of any conclusion is a second and third opinion followed by a teleconference review and report, and then a full evaluation of documentation packages by three separate experts who must all agree and sign off the findings/conclusions in a comprehensive report. The athlete is then afforded the opportunity to counter –argue the panel members evaluation(s) before a final recommendation for sanctioning (or not) is made.

It is evident therefore that a final recommendation to proceed to sanctioning is made on the ‘balance of probability’ that the evidence suggests/supports a suspicion of doping. This is made following considerations given to any influence of competition, altitude exposure, illness/injury etc as I have previously stated. The decisions are not made lightly nor without due diligence and due process.

With regards to Hemoglobin levels during competitive racing,  it is a well known that the body responds by increasing plasma volume during long racing events, such as cycling stage races(Tour de France, etc). An increase in blood volume is one of the basic physiological adjustments which the human body makes in response to endurance training/performance.  This helps the body to dissipate heat by shifting fluid from the tissues into the circulation passing through the capillary blood vessels into the skin for cooling. 

This response also decreases blood viscosity and improves blood flow resulting in reduced heart rates and more efficient delivery of oxygen to the muscles, all of which are beneficial attributes for endurance performance. In doing so, the formed or cellular elements in the circulation like red blood cells will therefore be artificially reduced and this scenario continues until physical activities have ceased. 

So when the cellular elements(Hemoglobin, etc.) in the circulation increase rather than decrease as expected (which is well documented in the literature) during the course of a long race, it may be a sign of manipulation; the infusion of ‘extra’ blood comes to mind. This can be corroborated by what’s happening with the young red blood cells (reticulocytes).  If Hemoglobin is truly increasing,  then it follows that the reticulocyte levels will also increase. 

With regards to the reticulocytes Ferrari states;

The reduction in reticulocytes (around 0.2%) evoked by Parisotto is not significant: the average value of the six tests during the TdF 2009 is 0.61%, which is perfectly compatible with a previous period of 26 days at altitude.  ‘Just as the reticulocytes in the tests dated 16th and 17th of June (0.64 and 0.74), collected after 16 days of altitude-induced hypoxic stimulus, correspond to a slowdown in the hematopoietic response subsequent to the increase in the concentration of Hb (16.0)’

I will let readers ponder the following..  What are the causes of decreased red blood cell production and why would this persist long after return from altitude? Does the reduction in reticulocyte values during the 2009 Tour reflect a continued slowdown in the hemopoietic response(the natural response of the body to try and maintain homeostasis or equilibrium)?  Following return from altitude exposure the body would be busily restoring hemopoietic balance by producing more reticulocyes so that  the body is not deprived of much needed red blood cells to support extreme physiological efforts. 

Thus if you see high hemoglobin levels combined with low reiticulocytes in a person's blood, you have to ask: If hemodilution does not affect the reticulocyte levels what may be the reason(s) for the prolonged shutdown of red blood cell production?

There are a number of causes which result in the shutdown and/or decrease in red blood cell production:

1.    Due to diseases such as Aplastic Anaemia, congenital red blood cell disorders such as Diamond Blackfan syndrome etc

2.       Travel into outer space – gravity inhibits the release of new red blood cells and/or destroys new red blood cells entering into the circulation in a process known as neocytolysis, or more simply the death of new blood cells (for those with a propensity to laugh at this suggestion see PubMed article by Alfrey C and Rice L 2000)

3.       Micro-doping with EPO/CERA etc

4.       Previous doping with EPO/CERA etc

5.       Previous blood transfusion  

If the first two causes are eliminated by the thorough evaluation of athlete medical records and ‘travel history,’ then we are left with the possibility of doping.  The only remaining question then is by what means (3, 4 or 5 above).  

While Ferrari contends that Hemoglobin concentration may be affected by training, fatigue, rest, stress, nutrition, hydration, and altitude, this cannot be said of the percentage value for reticulocytes. In a situation where Hemoglobin is increasing despite an expected physiological response to decrease due to plasma volume expansion and the reticulocytes are decreasing (or have remained static) this just does not "compute." It is a physiological oxymoron in a normal healthy athlete, especially one who has been able to place third in arguably the world’s toughest endurance event.

Finally, with regards to concerns that the Biological Passport is too subjective to differentiate doping from physiological disturbances, to date 25 cyclists have been sanctioned as a result of ‘targeting’ due to evidence gleaned from the passport which subsequently led to positive tests for exogenous stimulating agents such as EPO and CERA.   Another four athletes were sanctioned simply on the basis of suspicious profiles. A further eight track and field athletes have also been sanctioned on evidence from the passport alone, and the number of cases decided through use of Biological Passport data will continue to mount.

The Biological Profile and this "data mining" approach to uncovering "sophisticated dopers" was not being used effectively by all federations back in 2008-2009.  While it is natural to question whether or not a new system is "robust" enough to handle the burden of providing conclusive proof to back up the rampant suspicions of doping, the ability to successfully investigate and adjudicate doping cases, as noted above, indicates that is a valuable tool in detecting and sanctioning the more sophisticated dopers, not a tool for targeting specific athletes in overzealous attempts to spend time, money, and resources on "witch hunts." 

My judgment on the data we have been presented with remains that, upon initial evaluation in the Biological Passport process, this case would be classified as a Doping Suspicion.  Irrespective of this debate though the file in the Armstrong case that will include the evidence collected and used to bring it to prosecution will be handed over to WADA and the UCI by USADA.  The evaluation of the file data by these organizations will determine the outcome of the next step in the process.  Hopefully that file will be made public as well and readers can then make up their own minds.  

Scientists Debate--Parisotto's Response to Ferrari

Point 1 
Michele Ferrari: The article "It is all about blood" of September 20, 2012 makes no reference to the Tour de France 2009: it proposes two graphs for Hemoglobin values ​​and reticulocytes, without any historical (dates), logistical (altitude), and competitive context, comparing values ​​obtained in different situations, which interfere with the values ​​themselves. 

In particular, You cannot compare the results collected at the end of a three-week stage race with tests done out of competition, furthermore at altitude. Yet you decline to answer to such a serious FLAW. 

Robin Parisotto: The data which was initially reviewed (HERE) does not contain any reference to altitude exposure. Where or what evidence is there that these two samples were collected/tested at altitude? 

In a normal Biological Passport review such data is only made available when a full documentation package is requested to confirm/exclude any suspicions. The documentation package will include chain of custody details, time and place of collection, storage conditions,  time of transport, time of testing, testing laboratory, any relevant illnesses/injuries, exposure to altitude and any other relevant information such as blood donations.  

Until such time, a passport may be described (and communicated to an anti-doping authority) as being consistent with manipulation and deemed to be in breach of anti-doping rule violation (ADRV) until factors such as hemodilution, altitude exposure, illnesses or underlying medical conditions have been considered which suggest otherwise. As indicated previously, the analysis was posted in the context of an initial biological passport evaluation.

To address the "flaw, " the values in the graphs can be linked/viewed/confirmed by comparison with the results listed at the above website.  See the response to Point 3 and the chart for further clarification..

Point 2 
MF: Armstrong stayed at altitude (Aspen) from June 1, 2009 to June 26, 2009: therefore the tests on the 16th and 17th of June 2009 were taken at an altitude of 2400m a.s.l. 

So was the test dated August 12, 2009 (always Aspen, Armstrong raced in Leadville a few days later). 

RP: As this was data that was not evident in the website described above and also in the chart HERE:    which would ordinarily only become available to Passport members on request to the UCI through the Biological Passport process.   It is curious how a member of the public(As Armstrong has stated, Dr. Ferrari is merely a friend and their conversations have not been about matters of training or physiological analysis such as this) has such intimate knowledge of times, places, and conditions surrounding these blood tests.

Point 3 
MF: Since You are not informed enough about the discussed facts: the tests mentioned above are official values from USADA - UCI and each corresponds to a sample code. 

The correction factors are NOT applied in the COMMUNICATION of the result, but in any possible further EVALUATION: therefore Hemoglobin=16.0 is the measured value.

RP: The UCI is listed at the testing agency at this WEBSITE , so what is the point here? With regard to recorded vs corrected Hemoglobin values, to infer that a value of 16.0 equates to a value of 15.2 is making a simplistic interpretation of the biological passport evaluation process.

It is true that at altitude of between 2000 and 2500 metres a correction factor of eight is applied to the passport profile. However the correction factor is not automatically deducted from the recorded test value but rather applied to a predictive formula which adjusts the predictive distribution for low and high Hemoglobin values at that particular time of testing (see graphic below with upper and lower red lines indicating predictive values and blue line indicating the recorded values for each of the four passport parameters). 

In other words, if the predictive value was X but there was a confounding factor of altitude present, then this predictive value of X would rise to accommodate the influence of altitude (for those inclined, see WADA Athlete Biological Passport Guidelines for a full explanation HERE ) . The recorded value is not changed but the predictive value is, and if the recorded value is still increased above the adjusted high predictive value (or below the low predictive value) then this would be flagged as being an abnormal result. 

As previously posted though when evaluating a biological passport it is not about identifying or singling out any one abnormal result but rather about making a subjective assessment of the pattern of test results, magnitude of changes, and the times at which these changes may be occurring over a whole sequence of results (the profile). 

Point 4 
MF: Z-score is a number that expresses the probability that the test can not be the result of natural physiological changes (not necessarily doping, in any case). 
Z-score is used in the Biological Passport (Haematologica 2006,91:356-363 and UCI Technical Document 2.09), even though, as you say, often it takes a SUBJECTIVE assessment of a "picture of pattern, magnitude of changes and what time they are occurring", which sometimes lends itself to biased interpretations. 

RP: The four parameters used in the Biological Passport, as of today, are: Hemoglobin, %reticulocytes, OFF-score and ABPS-score. The passport is not a static tool or threshold based test but rather a continuous assessment of blood parameters that when assessed as a 'whole' can give very clear and objective patterns which may be reflective of blood manipulation. Factors such as competition, altitude, illness/injury, and pathology are always considered, however, before making final recommendations or conclusions about any suspicious profile.

Point 5 

MF: See comment to Point 3. 
I find it very surprising that such an Expert Scientist as Yourself has expressed an "absolute certainty of blood manipulation" in the evaluation of data of which You had only partial knowledge. 

RP: Two points that have not been explained by Ferrari and which would be pivotal in an evaluation of such a profile are:

1.      1) Why had the Hemoglobin and Hematocrit increased during the 2009 Tour race when in just the previous race they had dramatically decreased (by almost 15%). The point here is not the decrease in Hemoglobin during the Giro as this probably reflects  hemodilution as pointed out by Ferrari (and was not suggested by me that this was due to blood withdrawal) but rather why the same phenomenom did not occur during the Tour de France.

      

         2)Why were reticulocyte levels decreased when Hemoglobin was increased in the two tests allegedly collected/performed at altitude prior to the 2009 tour. This scenario is consistent with previous administration of stimulating agents such as EPO and or previous blood re-infusion. In the original post “…. from October 16, 2008 the average reticulocyte levels are 1.1 but from May 18, 2009 the average reticulocyte levels are 0.6.’ This change/reduction in reticulocyte production during competition is not due to hemodilution however as percentage values for reticulocytes are not affected by this physiological response. This reduction reflects a blunted response to normal red blood cell production and can be achieved by micro-doping over an extended period of time or blood doping over shorter periods.

Without a satisfactory explanation of these two key points, my suspicion of blood manipulation would remain as my conclusion in the initial biological passport evaluation.

2.      

Behind the Curtain

By Jim Ferstle
Welcome "behind the curtain" of the sports drug testing process. As sports doping has become more sophisticated, the methods used to catch someone who is doping have had to become better as well.  In endurance sports, such as distance running and cycling, blood doping, enhancing the blood for a performance gain, has become the "battleground."

How do you tell the difference between when someone is merely training hard, getting proper recovery and diet, or doping?  Tests have been developed to detect the use of recombinant erythropoietin(EPO), the use of which had replaced blood doping(removing and reinfusing blood to enhance the oxygen carrying capacity of one's blood.) as the method of choice for endurance athletes.

But those using rhuEPO have discovered a "work around" to minimize the danger of being detected of taking what is called "micro doses," small amounts of rhuEPO.  They combine use of the rhuEPO in micro doses with "old fashioned" blood doping--removing one's blood and reinfusing it close to a competition in order to increase your red blood cells/oxygen carrying capacity of the blood.

The reason for going back to "old fashioned" blood doping is that it is much harder to detect, especially when   the individual uses his or her own blood.  How can you tell if somebody has done a "vampire transfusion"(sucking out one's own blood and putting it back in again)?  The answer has been a protocol known as the biological passport.  Simply stated the biological passport is a comparative analysis of various blood parameters over time,  tracking and the changes and .interpreting what those changes mean.

Detecting use of rhuEPO is a simpler process.  Scientists developing the test discovered that the recombinant(synthetic) EPO was different than the EPO produced by one's body.  (EPO is the body's natural "trigger" for stimulating the production of new red blood cells--reticulocytes.) Thus, using a process called electrophoresis, synthetic EPO could be differentiated from the EPO everyone produces normally.

So, the "sophisticated dopers," those who didn't merely take a PED(performance enhancing drug/substance), but used every means at their disposal to make sure the substance or method they were using had minimal danger of being detected by the current drug testing protocols.  It's been called the "cat and mouse" game, the mouse being that doper and the cat being the anti-doping corps attempting to catch them.

If you've ever watched a cat hunt its prey, you'll notice the cat patiently watching a mouse, a bird, whatever it  is after, and studying the patterns, movements of the prey.  The anti-doping scientists, to some extent, do the same thing.  They compare the physiological profiles of "normal" athletes with that of those who are doped.  Patterns emerge.  Abnormalities are discovered that allow the scientists to determine whether the individual is doping or not.

For example, the reticulocytes, mentioned above, are more plentiful in the blood of a person who is stressed in such a way that the body compensates by attempting to increase red blood cell production.  If you travel to a high altitude, for example, oxygen is less available so the body adapts by producing more red blood cells.  You can artificially attempt to do this by getting an injection of rhuEPO, which will quickly increase your red blood cells, but the body also has a feedback mechanism, a governor, that recognizes that this sudden increase in EPO is not part of the regular process.

It is an artificial, short term enhancement that, if continued, will overload the blood with red cells, creating thick blood and potential negative health effects.  So the body shuts down its production of reticulocytes to slow the increase in red cells.  So, injecting rhuEPO into an otherwise healthy individual leaves a tell-tale indicator of artificial enhancement, a lower retiuculocyte count, fewer young red blood cells.  Since red cells stick around in your body for months, you get a mixture of "old" and "new" red cells.  This mixture is one of the indicators that someone has artificially attempted to produce more red cells instead of a natural body adaptation of producing a "normal" level of red cells.

This analysis of biological fluids and changes is complex, an interconnected cascade of reactions and substances.  Each individual can be different.  Thus the data required to differentiate between those who are cheating and those who aren't is not as simple as merely finding a substance, such as rhuEPO, in an athlete's body.  What the discussion between the two sports scientists--Robin Parisotto and Michele Ferrari--that we've had here over the last few days is about is the interpretation of biological passport data.

It gives you a peak behind that "curtain" of discussions that go on every time an abnormal profile shows up on doping tests/athletes' biological passports.  Recently Mario Zorzoli and his colleagues at UCI(Cyclings world governing body) published a paper that did a similar analysis of some of the cases that UCI has seen using the biological passport.  Some athletes were found guilty, others not.  The paper illustrated the complexity of the "cat and mouse game," of determining who doped and who didn't.

And none of this addresses the legal issues that come after a scientific panel has ruled that a case they have examined should be prosecuted as a doping violation.  This peak behind the curtain is not the final word in this sort of situation, it's merely a peak at how these decisions are made, the arguments that both sides engage in during this process.  Why is this important?  Because doping is a problem for modern sport.  Not just at the elite level, but if you follow news reports of doping, you know that Masters cyclists are using rhuEPO, high school kids are using steroids.  A symposium was just held this past weekend in Stockholm tilted: "Doping as a Public Health Issue."

There is a growing number of scientists, ethicists, and sports trend watchers who believe that doping will be the norm for sports in the future.  That technology is advancing at such a rapid pace and the will to spend the money necessary to police doping is seemingly not very strong, so sports, especially at the professional level, will be more about entertainment than the games.  In the future, they believe, genetically gifted, maybe even engineered, athletes will display their talents for the public's amusement.

Whatever the future, what we can learn from the past is that doping has been largely ignored until recently and has grown as an industry and as a means of achieving success for aspiring athletes.  We can sit by and watch as that trend continues or learn about the issue.  Peak behind the curtain and see what is happening and learn more about what needs to be done about it.  The choice, as always, is yours.

A Scientific Debate

Earlier this week we posted an article by sports scientist Robin Parisotto of his analysis of biological data provided by the cyclist Lance Armstrong during his comeback for the 2009 Tour de France.  Because the subject of his analysis was Armstrong, the article generated a lot of interest, such is the nature of the news business these days that when a "celebrity" is involved readership figures go up.

It also generated a rebuttal from Dr. Michele Ferrari, an advisor and friend of Armstrong and a target of the USADA charges of being a part of a doping conspiracy involving Armstrong and his teammates.  Both Armstrong and Ferrari refused to contest the charges before sports arbitration panels.  Ferrari saying that he was never informed of the charges.  USADA responding that copies of the charges were presented to his lawyers and delivered to his home.  In response to Parisotto's conclusions, Ferrari wrote a detailed response on his website that you can find HERE.

This back and forth between sports scientists demonstrates the intricacies of the process of of attempting to prove guilt or innocence in a doping case.  It features the often uncomfortable relationship of the scientific and legal community.  Lawyers gravitate toward arguments, "proofs" that are convincing and short on ambiguity.  Scientists start with a theory and try and prove it right or wrong.  They deal in more probabilities than seeming certainty.

Why does all this matter?  While philosophers and ethics experts have a grand time debating the need  or efficacy of them, sports are defined by rules.  One of those rules is that athletes are not supposed to be able to impact the outcome of a sporting event by cheating, breaking the rules.  Using biological and/or pharmacological means to attempt to enhance one's performance is one of those rules.

So when an athlete, such as Armstrong, is charged with a doping offense sports scientists are often on different sides arguing if, in fact, a doping violation was committed.  As doping techniques have become increasingly sophisticated, the science for detected what is being done has become more complicated.  Thus we have debates like the one here where one scientist takes issue with another over what the data collected means.  The fate of the athlete depends on the outcome of that debate.

It's All About Blood

By Robin Parisotto

Robin Parisotto is a sports scientist based in Australia.  He was part of a group of Australian scientists who helped develop the first blood tests for detecting use of "blood doping" by athletes for the Sydney Olympics in 2000.  Currently his input is sought by sports federations on cases of suspected blood manipulation, biological passport abnormalities that, if confirmed, lead to the sanction of athletes for doping violations.  

The USADA(United States Anti-Doping Agency) case, where charges were brought against Lance Armstrong, his team manager, and team doctors and advisors has received a lot of attention.  Even more since Armstrong decided not to contest those charges before an arbitration panel, stating that he could not get a fair hearing in that forum.  The result being that USADA has levied sanctions commensurate with the violations listed in the charge letter.

UCI(cycling's governing body) are waiting for the details of the case file to be submitted to them before any action can be taken on the sanctions proposed by USADA, which include stripping Armstrong of his race results including his seven Tour de France victories from 1999-2005.

The following is an analysis Parisotto did recently using the blood  values cyclist Lance Armstrong posted on his website back in 2008-2009 during his comeback to competitive cycling for the 2009 Giro and Tour de France. This was not part of any official investigation into the data, but more as a matter of curiosity about available information on the case and what it can tell us.

Part of USADA’s charge letter that led to the sanctioning of Lance Armstrong(LA) and other "co-conspirators" was that there was strong evidence of blood manipulation(blood doping) in data examined by USADA. I can only presume that some/all of this data included information that Lance Armstrong had posted on a website some time ago where the UCI and USADA were referenced as the testing agencies. 

To better understand the basis for charges against Armstrong, it is worth remarking on some of this data.  The figures referenced in this article are from Armstrong's published blood values for 2008-2009.

The following graphic indicates a fairly regular and normal pattern of Hemoglobin (Hb) values until a significant drop on May 5, 2009, four days before the start of the Giro d'Italia(the Tour of Italy which was contested from May 9-31, 2009 and where Armstrong placed 12th). This is followed by a quite staggering increase on June 16, 2009 (further explained below), shortly before the Tour de France(which went from July 4, 2009 to July 25, 2009 and Armstrong placed third).

Fig.1 Hemoglobin values for LA October 2008 to July 2009

The graphic below is significant because while Hemoglobin appears to have been significantly disrupted, the reticulocytes (young red blood cells) have suddenly diminished and stabilized just before the Tour de France. This change is counter-intuitive (for reasons stated below).

Fig.1 Reticulocyte values for LA October 2008 to July 2009

The charts show a halving of the reticulocyte values in circumstances when the Hemoglobin has risen dramatically, which is not consistent with normal physiology. If one is making more red blood cells and increasing Hemoglobin then it is inconceivable to not have more immature red blood cells (reticulocytes) in the body of a normal healthy person.

The decrease in Hemoglobin  from April 30, 2009 to May 31, 2009 (149 – 130) in samples 10 to 13 is 15% however there is no expected increase in reticulocytes. In fact from October 16, 2008 the average reticulocyte levels are 1.1 but from May 18, 2009 the average reticulocyte levels are 0.6.

The sudden increase in Hb from sample May 31, 2009 to June 16, 2009 (130 – 160) in samples 13 to 15 is 23%, however the response in reticulocytes is again not consistent with normal physiology. Such a scenario is consistent with a deceleration in red blood cell production following auto-bleed and re-infusion(i.e. removal of blood to store for later re-infusion, otherwise know as blood doping). 

The subsequent low reticulocyte values are consistent with re-infusion of blood and continued micro-doses of rhuEPO(recombinant erythropoietin) to ‘stabilize’ and therefore mask the expected response in reticulocytes.

A Cycling News article of July 13, 2012 noted that if USADA were to present evidence such as this during a legal hearing of the charges, this evidence of doping would be challenged by Armstrong lawyers “by summoning medical experts who would say that a person's hematocrit score could conceivably jump 7.5 percentage points in 16 days because of external influences like changes in altitude and heavy perspiration.” Reportedly Armstrong was in Aspen, Colorado at nearly 8000 feet above sea level between the two above-mentioned tests. 

There any number of studies that refute the hypothesis that such a large increase in Hemoglobin is merely a response to altitude exposure.  To suggest that a 23% increase in Hemoglobin and a 50% decrease in reticulocytes was the result of time spent at altitude is stretching the bounds of the known and documented physiological responses to altitude exposure. For example, the Ashenden et al study in 2003 demonstrated that in no less than 7 study groups either at natural or simulated altitudes (above 2600 metres – about 8500 feet) that even after 4 weeks of exposure the increase in Hb was, at best, muted.

The largest increase in Hemoglobin was 9.5% in a group of elite cyclists returning from living and training in Toluca (Mexico) after 4 weeks. The Hemoglobin measures were taken 7 days after returning to sea level conditions. In all other study groups there was no increase or at best a 1-2% increase in Hemoglobin. Similar responses were noted with reticulocyte levels. Whatever way you cut it, Armstrong's blood values are undoubtedly indicative of blood manipulation. 

This is hard empirical evidence lending support to the charges filed by USADA.  If this profile had been submitted to me for review by me as a member of the Passport Panel(biological passports which are used by the UCI, cycling's governing body, and the IAAF),  it would have been assessed as an anti-doping rule violation particularly in view of the timing of the disturbances leading into the 2009 Tour.

Redemption Song

By Jim Ferstle
Last month New York's Carnegie Hall Notables series hosted a program named Redemption Song featuring musicians who were or had recovered from substance abuse issues. Those looking at sports books, magazine articles, or cable television sports documentaries might be inclined to think the same message is being sold about once star athletes attempting to rehabilitate their images after being tarnished by doping convictions or admissions.

2003 Twin Cities Marathon champion, Eddy Hellebuyck, an Olympian for Belgium back in 1996, admitted in a Runner's World story that he took the blood booster erythropoietin(EPO)and was using the drug when he won the TC race. Hellebuyck had been convicted of EPO use in 2004, but had steadfastly denied using EPO until now. In the article he said his confession was inspired by guilt and that he now regretted using the drug.

Marion Jones tearfully admitted that she had made mistakes by not asking what she was given by her coaches during her career, and acknowledging that what she was given was doping products. Her mistake, she says now, was not that she "knowingly" took drugs, but that she lied about the fact that she knew what she was taking was a banned substance. Testimony given by some of those people she "trusted" contradict Jones' statements. They say she knew what she was doing.

Both athletes said they sought "redemption." As image consultants or spin doctors would say, these athletes want to reconstruct their image, reinvent themselves in political lingo. Until today, Jones had pretty clear sailing. The interviewers on her book tour didn't ask the tough questions. Jones stuck to her script of "making mistakes" and attempting to be a role model and advocate for those who had paid for their sins and wanted to regain respect.

Hellebuyck wants to continue coaching. Jones wants to play basketball and regain some of her athletic fame. Many athletes who competed against them aren't so forgiving. They cheated us out of medals and money, they say, what about that? Jones returned her Olympic medals, but has no plans to return her prize or endorsement money. The Twin Cities Marathon folks are contemplating what they should do about the title and prize money Hellebuyck won in their event. Should they strip Eddy of his "title?" Should they demand he return his prize money?

Another conundrum in all this is the desire of anti-doping officials to not only catch those who dope, but also find and punish their suppliers, the "pushers" and enablers that make doping possible. Should there be "plea bargaining" for doping "criminals?" Or should we just go after them with the full power of the law, recognizing of course that proving one assisted or enabled doping without an admission from the "enabler" or athlete is a very difficult, if not impossible task in the legal system.

Hellebuyck named a fellow marathoner and doctor, Russian Leonid Shvetsov, as his enabler, his supplier. Would he have done that if he knew that people would go after him for past prize money? Would anybody confess, unless they were, like Jones faced with a plea deal to bargain down prison time? Is it a "fairness issue?" A justice issue? One thing it is not is a universally agreed upon solution. Do those who "cheat" deserve "redemption?"

How do we know when seeking redemption is a legitimate attempt to right a past wrong or make up for one's sins? How do we know when it's simply just another con? Is attempted rehabilitation, draconian sanctions, or neither of these options part of the "right" solution to the doping problem in sports? Athletes know that image campaigns, like those mastered by the most successful politicians, built their fame, so it's only natural that they turn to the same delivery method to rehabilitate their images.

Lance Armstrong is arguably as impressive an image creator and protector as he was an elite cyclist. But will he survive the latest assault of another athlete seeking "redemption" of sorts, Floyd Landis? Used to be that athletes only needed a good coach and a great work ethic, plus the right parents to bequeath on them the correct genetic profile, as a pathway to sports success. Now, like politicians, they need the cash of donors(sponsors for athletes), and a crackerjack staff of image consultants.

As the camera commercial with Andre Agassi as pitchman claimed: "Image is everything." Especially if you're seeking redemption.

FLASH: 2003 TCM Champ Admits to Doping

In an exclusive Runners World story by John Brant, 2003 Twin Cities Marathon champion Eddy Hellebuyck admits he used EPO to prepare for that race and others late in his career.

The Belgian-born naturalized American citizen tested positive for EPO in 2004 at age 43, but denied using the drug at the time, going as far as appealing his case to the Court for Arbitration in Sports.

Read the full, interesting story HERE.

Photo of Hellebuyck by Paul Phillips, Competitive Image.

Funeral for a Friend

By Jim Ferstle

Funeral services were today for Canadian sprinter and coach, Charlie Francis, who died last Wednesday after a five year battle with cancer. We met nearly two decades ago when I was working on a television documentary for the BBC. During those 20 years we had many long conversations—you didn’t have short chats with Charlie—about everything from family to his fight with cancer to his latest theory on sprint training.

Mostly we talked about the topic that had brought us together, drugs in sports. He was a Shakespearean figure. Triumph and tragedy, great ambiguity, comic relief, lessons learned, and great stories. We made a strange pair, two men who viewed the world, ethics, and sport from opposite poles when we met, but probably came closer together as the years past and we became friends. His was a tale of great ambition, a thirst for knowledge, great hubris, and harsh reality.

As a young man, Charlie wanted to be the best sprinter in the world. He earned a college scholarship to Stanford where he was tutored to be both an athlete and a coach by Payton Jordan. He made it to the second round in the 100 in the Munich Olympic Games in 1972, but had already made a discovery that would change his life. In discussions with an American hurdler he was introduced to steroids and said he felt like an idiot for not figuring out sooner what was happening. While steroids were banned, the tests to detect their use would not be used to sanction athletes until the 1976 Games in Montreal.

Both Charlie and I grew up in a generation of idealists who saw the Olympics as the Camelot of athletics where the best in the world were crowned and recognized for their achievements. Where you were taught to play by the rules and not take “short cuts.” Sometimes. The lesson Charlie took away from Munich was that steroids weren’t “short cuts,” they were part of the program if you wanted to be the best. One reason for this was that there was very little deterrence to their use.

In the GDR, as we would all discover later, there was a government sponsored program to exploit these doping products in sports. But the real escalation of doping in sports was another byproduct of the Cold War between the Soviet Union and the US. American sports officials became aware in the 1950s that the Soviets were using testosterone to help their athletes, so, like the nuclear arms race, a US doctor, John Ziegler, who had worked with US teams, used the wealth and scientific technology of the US to “invent” designer testosterone—anabolic steroids. The US wanted a better steroid to use in the “war” with the Soviets.

Francis picked up information like a sponge from everyone he could. As a coach on the international circuit, he made friends with some of the GDR coaches, who observed what he had done with Canadian sprinters and had heard of Francis’ technical expertise. They shared information on workouts, drills, spotting talent, and, ultimately, doping. Contrary to popular belief, not everyone was seeking an “edge” from doping, many just wanted it to be a “fair fight” where each side came into the battle with similar tools.

There is the famous story of a US and an Iron Curtain country athlete who competed against one another in the ‘70s. They were friends off the playing field, but on it they would do whatever was necessary to win. They talked openly about their drug regimens. Compared notes on substances and doses, concluding that they were on similar programs. Then they went out and beat the rest of the opposition.

For them, that was a “level playing field.” At that time, doping was not the “Scarlet Letter” that it is today. The IOC and the sport governing bodies just wanted to make sure athletes didn’t die during events, and the testing was done primarily on stimulants. The medical community kept debating whether or not steroids really “worked,” aided performance. The athletes figured out that they did through trial and error and sharing information.

In the early 1980s two American coaches took a trip to a US military research facility to meet with one of the “steroid gurus” of the day. He gave them a lesson in proper, “safe,” steroid administration. One coach left the session troubled by what he had witnessed. The other said the reason for it was that the team knew the athletes were going to experiment with drugs, thus it was his duty to educate them on how to do it properly. Papers were prepared, sort of a CliffsNotes version of the infamous Underground Steroids Handbook that outlined how to take the drugs, and handed out to athletes. I still have copies of some of them.

In addition to the GDR coaches, Francis had compared notes with Chuck DeBus, a US coach who would become the first to be sanctioned by the sport’s governing body for aiding his athletes in the use of performance enhancing drugs(PEDs). Francis became known in the Canadian athletics community as “Charlie the chemist.” He had absorbed everything he could about the technical aspects of sprinting, probed the best minds, but knew from his own experience and what he would encounter on the world track circuit that the use of PEDs was common at the upper levels of competitive sport. From this Francis concluded that success at the pinnacle of sport not only took knowledge and application of training, recovery, and performance, but PEDs as well.

Not everybody in our generation made that choice. John Treacy was World Cross Country Champion and later a silver medalist at the 1984 Olympics in the marathon. In the spring of that year he had walked into the bathroom at the Meadowlands race track where the World Cross Country Championships were held and observed the Spanish team injecting themselves. Blood doping was believed to be the PED of choice for distance runners at that time. But Treacy didn’t conclude from his experience that he had to dope to be the best. He would say that his satisfaction came from beating people he knew were cheating, but had never been caught.

Mark Nenow, who ran for Anoka in high school and later became the US recordholder at 10,000 meters, was a member of the US track team at the Pan American Games in Caracas, Venezuela in 1983. That competition had the first major steroid scandal in sports when many athletes flunked drug tests and over a dozen of the US track team members left the Games before the competition after the entire team had been warned by US officials that they might also get caught if they had been using PEDs. Prior to the 1984 LA Olympic Games the USOC instituted a pre-Olympic non-punitive drug testing that, in effect, provided those using PEDs with information on how to avoid testing positive on Olympic drug tests. Sessions were held with Olympians prior to the 1984 Games where “experts” gave information similar to that given to the US coaches on how to use PEDs and how to use them to beat doping tests. I still have copies of those.

Francis testified at the Dubin hearings that Canadian officials told him in prior to the 1988 Olympics that out of competition testing that was beginning to be implemented in selected countries would not target his athletes. Francis also said that meet promoters would also “protect” certain athletes by either manipulating who would be tested or tipping off the athletes to what places in each race would be tested. Most athletes didn’t need a lot of help to beat the testing system.

As one lab director admitted in 1984 the labs could not detect stanozolol, the steroid found in Ben Johnson’s urine in Seoul. That wasn’t the only “loophole” in the testing. There are countless stories of athletes who tested positive only to be exonerated by appeals panels that were intentionally stacked with people predisposed to let off the athletes. The testimony given in those hearings would be laughed at today for the rationale given to not impose a sanction.I have copies of some of the decisions in these cases as well.

All this illustrates the “environment” back then. Not to condone the choices Francis and others like him made, but to provide an understanding of what he was thinking. Why he chose that path. If he wanted to be the best, Francis believed, he had to “level the playing field.” Don Kardong, who would finish fourth in the marathon at the Montreal Games in 1976, was a teammate of Charlie’s at Stanford. I asked him once for his impressions of Francis. He responded that it did not surprise him that Charlie made the choice to encourage his athletes to use drugs, but it also didn’t surprise him that when he was caught in 1988 in Seoul and when the Dubin Inquiry convened that Francis didn’t try to do what nearly every other person who has faced that situation did and deny any wrongdoing.

Instead Francis decided to attempt to blow the lid off of what he saw as the hypocrisy in the sport where athletes, coaches, administrators, and the like who publicly denounced doping while either engaging in the practice themselves or aiding it. He had been part of that hypocrisy before Ben got caught. Yes, one motivation in his confession was to expose others he either knew or believed were “dirty,” but the other was that old idealism. The hope that by coming clean on all this it would force the Olympic sports world to finally address the problem, not sweep it under the rug and hope that nobody noticed.

Charlie was no angel. He could be profane and vitriolic toward those who he considered to be the greatest hypocrites. He could be stubborn. He could be arrogant and displayed plenty of hubris. As the years rolled by he often found himself caught between two worlds, the present where he now had a young son, who was the light of his life, and advised a bevy of eager clients who wanted his knowledge on the finer art of training, and the past where he had worked with the top of the pyramid in the athletic world.

He told me during one conversation in the early 2000s about a job he’d been asked to do in California. They wanted his technical expertise on training and sprinting. I didn’t ask for specifics. Later I found out that the project he was talking about was Victor Conte’s Project World Record that resulted in Tim Montgomery’s short lived 9.78 world best. Montgomery, in turn, would recommend to his then wife, Marion Jones, that the pair train with Francis. Marion paid for Charlie’s trip to Hawaii to work with her and Tim. The arrangement was kept undercover until Tim and Marion showed up in Toronto to train, and a media firestorm erupted.

Francis tried desperately to salvage the project. He insisted that the goal was to prove that an athlete with Marion’s talent could accomplish what she had clean. He knew that he could not afford to be associated with them if they could not buy into that goal. Marion was pregnant when they were working together in Toronto. Charlie had filmed them, worked with them, and was firmly convinced that they could improve on what they had already done, and do it without drugs. While Francis would insist that he was happier being out of top level coaching, he also really wanted to get another shot at working with the best.

He had Tim and Marion come to Toronto knowing that this would be the make or break point in his quest. Prior to this he had always insisted that he could have gotten back into top level coaching if he had been willing to grovel and declare that he was wrong in giving his athletes steroids, sort of do his public penance for another shot at the big time. The fallout from the discovery that he was working with Marion and Tim killed that notion. In athletics circles he would always be the “disgraced coach,” the pariah. It was a hurtful revelation.

He admitted in our conversations that until he’d worked with Marion he hadn’t believed it was possible to compete clean at the highest level. He believed that she could. But the harsh reality was that nobody in the athletics world was going to let him try. Before his belief was that the key to ridding the sport of drugs, if it could indeed be done, was to give the athletes an alternative to PEDs. Demonstrate that it can be done without “short cuts.” Instead there was a market flooded with unregulated supplements that promised to deliver the same benefits as steroids.

Supplement makers got rich and athletes suffered. There was a period of bitterness and remorse. If he knew then what he knew now, Charlie said, he never would have come clean at the Dubin hearings. What good did it do? Why would anyone confess when it did no good? While those sentiments reflected more the anger of the moment than the true impact of his testimony and continued efforts to expose what was happening in sports, his confessions were a key element in the attempts at reforming and improving the drug testing system.

It may well be his enduring legacy. Soon after the collapse of his working with Marion and Tim, the BALCO scandal erupted, he found out he had cancer, and the trivial things of the past became not all that important anymore. Just as he had in athletics, Charlie plunged into cancer research, sought out the best information he could find, the best treatments. He was able to get five pretty full years. Years to continue to work and help others realize their dreams. Years to watch his son grow up. Years to spend with his family and friends.

He didn’t totally separate from track as there were many conversations about the present environment, Usain Bolt, and a snippet of the past. He finally answered questions he’d had about Seoul in 1988 and what really happened. Some day the full story may yet emerge. But the last sprint for Charlie Francis was perhaps best expressed in a Dylan Thomas poem that his wife Angie recited during the visitation services on Monday. “Do not go gentle into that good night. Rage, rage against the dying of the light.”