Editor's Note: This book excerpt is used with permission of VeloPress from Spitting in the Soup: Inside the Dirty Game of Doping in Sports by Mark Johnson. In Spitting in the Soup, Johnson explores how the deals made behind closed doors keep drugs in sports. Johnson unwinds the doping culture from the early days, when pills meant progress, and uncovers the complex relationships that underlie elite sports culture. Spitting in the Soup offers a bitingly honest, clear-eyed look at why that's so, and what it will take to kick pills out of the locker room once and for all. Learn more at www.spittinginthesoup.com and www.velopress.com.
While few within organized sports expressed concern about the use of performance-enhancing drugs until the 1960s, there was some early unease. A December 1, 1895, New York Times editorial, "The Use of Stimulants by Athletes: Drugs Designed for This Purpose Not Favored," took drug manufacturers to task for marketing their products to athletes. Appealing to notions of athletic purity, the piece argued that while "the alert mind of the modern drug manufacturer" had taken note of the growing popularity of sports like cycling and football, "all true athletes would disdain any such injurious and adventitious aids." The Times opinion writer disapproved of performance-enhancingdrugs on two grounds: one, they could be injurious to health; and two, they gave athletes an advantage "true" sportsmen would frown upon. Perhaps influenced by the same aristocratic, class-preserving "trueness" Coubertin admired, the editorial concluded that innocent amateurs should stay away from the pros' methods because drugs are somehow inherently wrong: "The general effect of drug taking, and especially of the use of drugs belonging to the caffeine and cocaine class, is distinctly bad. We believe that the medical profession ought seriously to warn those with whom they come in contact professionally against the use of such things."
In 1928, 33 years after the Times warned readers of the undefined dangers of adventitious substances, the first whisper of anti-doping made its way into an official sporting regulation when an anti-drug statement appeared in the regulations of the International Amateur Athletics Federation (IAAF). Founded in 1912 by Sigfrid Edström, a Swedish industrialist who made his fortune in tramlines and electric motor manufacturing, the IAAF was born the same year that Edström's influence helped bring the Olympics to Stockholm. A talented runner in his youth, Edström's wealth and starched-shirted belief in amateurism helped him become an IOC member in 1920 and IOC president in 1942.
Edström clamped down on amateurs who collected race appearance fees. During its annual convention in 1928, the IAAF executive council passed strict rules outlawing athlete compensation. At the same time, the IAAF wrote what may be the sport's first anti-drug regulation. Roughly a quarter century after drugs were prohibited in horse racing, the rule defined doping as "the use of any stimulant not normally employed to increase the power of action in athletic competition above the average."1 As vague as it was obscure, the new IAAF regulation targeted those who administered drugs, not athletes. Its passing stirred barely a ripple of press coverage, although a July 28, 1928, article on the opening of the Amsterdam Olympic Games in the New York Times did briefly mention the new doping ban. A sentence in the piece explained that a recent IAAF congress had debated a "proposal to suspend from amateur athletics any person involved in giving competitors 'drugs or stimulants internally by hypodermic or other methods.'"2
This information, however, was but one sentence buried in a long piece on an ongoing controversy over whether University of Southern California track star Charley Paddock would be allowed to compete in Amsterdam. Paddock had angered the high priests of amateurism by insisting that his work as a sports columnist for the Los Angeles Times and as a Hollywood actor did not violate Olympic values. As Paddock saw it, the critical difference that preserved amateur status was that he was paid to write about sports but received no compensation for the act of playing in sports. In the eyes of the U.S. Amateur Athletic Union (AAU), the writing earnings polluted Paddock's amateur purity and threatened the social bulwark separating the working pro from the sportsman of leisure. As historians John Gleaves and Matthew Llewellyn explain in a 2013 study of this early IAAF drug rule, amateurs were expected to maintain an ideal: "The Olympic amateur played the game for the game's sake, disavowing gambling and professionalism, and competed in a composed dignified manner fitting of a 'gentleman.'" By working in sports-related roles, Paddock failed his obligation to uphold these patrician standards.3
The New York Times mentioned the new doping regulation to put a fine point on its larger exploration of amateurism, specifically the fear that professional sporting practices-and lower-class habits-were infiltrating amateur games. For Olympic organizations, the incursion of the trappings of professionalism into amateur sports-whether by making money commenting on sports or using professional sports medicine practices-was scandalous. At least on paper, the new IAAF rule seemed to come down hard on the trainers and doctors who administered performance-enhancing drugs because they were symptomatic of the professional practices that amateur governing bodies wanted to keep out of their sports. Paddock's hassles with the IAAF and AAU made a public display of efforts to wall off amateur sports from the "corrupting" influence of money and professional drug practices. As Gleaves and Llewellyn write, for those worried about protecting upper-class ease through amateur sports, the doping habits of working-class cyclists, boxers, and runners "only served to reinforce their belief that their place in the social order was well deserved."4 Paddock's work caused alarm because it was close to his actual sport and thus threatened to puncture the wall separating doped pros from chivalric and pure amateurs.*
*Bribery Covers Up Doping Positives
While 1928 image management meant keeping pros and their ways out, in the early 2000s, damage control took the form of massive bribes to let embarrassingly doped podium placers off the hook. In 2015, it came to light that IAAF officials hid systematic athlete doping in Russia. A January 2016 World Anti-Doping Agency (WADA) independent commission report revealed that Russian runner and 2010 London Marathon winner Liliya Shobukhova paid €450,000 to IAAF officials to keep a 2011 suspicious blood test result under wraps and preserve her place in the 2012 London Olympics. The same report explained that out of 7,177 EPO tests performed on IAAF athletes between 2001 and 2009, nearly 9 percent returned atypical blood samples. Three hundred and nine of those suspicious samples came from medal winners, yet only 67 were sanctioned. While an atypical blood sample does not automatically equate to doping, 88 years after the IAAF first took steps to keep professionals' doping from tainting its amateur sheen, IAAF officials still seemed set on protecting their public image. A separate November 2015 WADA report concluded that IAAF corruption was pervasive and that drug maleficence in its Russian member federation "was an embedded and institutionalized process designed to secure winning at any cost." As a result of the scandal, IAAF sponsor Adidas severed its sponsorship relationship with the IAAF with four years remaining on its 11-year contract. See "The Independent Commission Report #1," WADA, November 9, 2015; "The Independent Commission Report #2," WADA, January 14, 2016.
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Thirteen years after the IAAF published its first stricture against drugs as a symptom of professionalism, the problem of how to be competitive on international sporting fields without pro-level support came to a head at the 1936 Berlin Games. After Hitler's Olympic extravaganza, the IOC fielded complaints that German teams were amateurs in name only. While they technically were not paid to train and compete, they had all the support of professional athletes, but without the obligations that came with holding an outside job. The neologism "shamateurism" came to describe a system in which government or private support allows an athlete to train full time, without having to hold a job to pay the rent and grocery bills. Critics claimed the Nazi athletes were sham amateurs.
Responding to the complaints, IOC president Henri de Baillet-Latour, a wealthy Belgian horse racing aficionado and past president of the Brussels Jockey Club, wrote an essay expressing the opinion that doping was contrary to amateurism. "Amateur sport is meant to improve the soul and the body," the IOC boss wrote. "No stone must be left unturned as long as the use of doping has not been stamped out. Doping ruins the health and very likely implies an early death." According to Gleaves and Llewellyn, this 1937 opinion is the first-ever IOC proclamation regarding drugs in Olympic sports. Like the 1928 IAAF note, the first-recorded IOC comment on drugs in sports was not so much a declaration against doping as against the creeping inroads of professionalism and a threat to social stratifications. It is also likely that Baillet-Latour's background in horse racing, where doping had long been a problem, inspired his special interest in human performance-enhancing drugs, since drug taking could threaten the Olympics' identity as a place where sports were practiced for the sake of goodwill among men, not financial gain.5
In advance of the IOC's 1938 annual meeting in Cairo, Egypt, the organization commissioned several reports on the state of doping in sports. The Belgian Medical Society for Physical Education and Sport wrote one of these papers. Titled "Rapport sur le doping" (Doping report), it matter-of-factly pointed out what everyone knew but saw little reason to condemn: "In professional sports, in cycling above all, doping is practiced on a grand scale." The report argued that in Olympic sports, doping should be condemned because "it creates a mentality contradictory to the true spirit of sports."6 That true spirit, of course, was the class-order-preserving ethos venerated by grandees calling the shots at the British-dominated IAAF. As Coubertin reflected in 1925, "the fundamental condition" of the British sports club is one of social exclusion; "members are gentlemen of the same station."7
The reports pointed to a level of doping that most certainly threatened to infect gentlemen with the workingman's chemicals. After reviewing these reports and acknowledging that drugs in pro sports were as common as water, on March 17, 1938, the IOC adopted its first formal statement against drugs in Olympic sports. However, in 1938, protecting sporting amateurism was beginning to seem like a small and self-indulgent problem relative to the unhinging taking place as the world's nations girded for war. With London, Dresden, and Tokyo burning, the IOC's official statement on doping gathered dust. It was not until after the defeat of Germany and Japan in 1945 that the IOC got back to business and published a new official Olympic charter in 1946. But even then, the IOC's updated delineation of its official functions and obligations treated doping as a minor subset of the organization's crowning challenge-maintaining the sanctity of amateurism.
Item six in an Olympic charter section titled "Resolutions Regarding the Amateur Status" proclaimed: "The use of drugs or artificial stimulants of any kind must be condemned most strongly, and everyone who accepts or offers dope, no matter in what form, should not be allowed to participate in amateur meetings or in the Olympic Games."8 And that was all the IOC needed to say about doping, because the meaning was clear to everyone affiliated with the Games: If you use drugs or supply drugs to amateurs, you have crossed the threshold to professionalism and are therefore no longer welcome in the Olympic family. After all, as the 1938 Cairo report acknowledged, in vocational sports like cycling, doping was "practiced on a grand scale." The IOC's raison d'être was to tack constantly away from professionalism, not pass judgment on what professional athletes did.
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The 1946 Olympic charter's single condemnation of doping was submerged among nine other entries detailing how athletes should not be paid, housed, fed, and otherwise financially supported in a way that would lead them into the moral perdition of professionalism. The 1946 charter included zero guidance on which chemical substances were unacceptable, how to go about identifying dopers, the consequences of ignoring the recommendation, or how enforcement would be organized and funded. The rule was therefore not so much a law equipped with implementation mechanisms as a signpost warning Olympic athletes to not go down the chemical road to professionalism. The IOC's commitment to building a wall between amateurs and pros was so fierce that matters of drug use kept their position in the charter as a subset of amateur protection rules all the way until 1975. That was the year the first IOC Medical Commission was created, and with it, drug use moved from the protection-focused general charter to the IOC medical code.
So what finally pushed the IOC to look at doping as an issue separate from protecting amateurism? One reason was that as pro sports grew in popularity, it became difficult to find amateur athletes who did not emulate their professional heroes' sports medicine and racing techniques. At some point, the IOC could not continue to pretend that its amateurs were not embracing professional doping habits. A 1964 report commissioned by the Council of Europe (CoE) cited an Italian survey of amateur cyclists conducted during the 1962 and 1963 race seasons. The organization reported that at the 1962 Italian amateur road championships, 14 of the top 30 finishers tested positive for drugs-46.6 percent positive among a group of non-pro riders who had been told in advance of the race that they would take part in a drug survey. Prior to that, in 1955, the Federazione Medico Sportiva Italiana tested the urine of 25 cyclists during an Italian stage race, and 20 percent were positive for amphetamines.9
But while the pervasiveness of doping in amateur sports was becoming too obvious for the IOC to ignore, it was a death at the 1960 Rome Olympics that forced the organization to pay sharper attention to the anti-doping rule that had been sitting quietly ignored on its books since 1938.
The 100-kilometer cycling team time trial was held on Friday, August 26, 1960, a day that saw thermometers passing the 100-degree mark along Rome's Viale dell'Oceano Pacifico. Rolling out between the Portuguese and Moroccan squads, the four-man Danish team was 33rd to start. At 9:33 a.m., the Roman sun was already punishing the softening blacktop. Falling quickly into a tempo, the Danish squad finished the first of three 32.2-kilometer laps with the fourth-best time of the day.
Then things went wrong. After passing the first time check in front of the Rome velodrome, Dane Jørgen Jørgensen dropped out; the heat was too much. Then one of the remaining three riders, Knud Enemark Jensen, began complaining of dizziness. His teammates, Vagn Bangsborg and Niels Baunsøe, rode next to the 23-year-old from Ärhus. A Danish news photographer's photo shows Bangsborg and Baunsøe riding on either side of Jensen with their hands pulling him forward by the back of his jersey. With race number 127 crinkling on Jensen's hip, the two teammates suspended the collapsing Jensen like a bicycle marionette. Their efforts were for naught. Jensen had succumbed to heatstroke. A photo in Denmark's Ekstra Bladet newspaper caught Jensen spilling from his bike and landing on his head.
An ambulance rushed Jensen to a medical tent. Lacking air conditioning, the dark canvas military tent was like a sauna. Interior temperatures reached an estimated 120 to 130˚F. Today we know that proper treatment for the heat-stricken Jensen would have been to submerge him in an ice bath to lower his core body temperature. Instead, he got the opposite. Jensen broiled in the canvas oven for two hours. Then he died.10
Though Italian authorities will not release it to this day, the official autopsy reportedly attributed the first death in modern Olympic history to heatstroke, which was probably not helped by Jensen's head injury and the fact that he was severely dehydrated on a day that saw 31 other riders suffer from the same debilitating condition. The Danish riders did not carry water on their bikes; the coaches thought bottles would be too heavy. Of course, racing 62 miles in 100-degree temperatures without fluids is a recipe for physical collapse.11
From a physiological perspective, placing Jensen in an oven rather than an ice bath was tantamount to putting him in a coffin and nailing the lid shut when he still had a chance of survival. Properly treated heatstroke victims can be back on their feet within an hour of collapse. But left untreated, heatstroke leads to a catastrophic chain of events that includes organ failure, cardiac arrest, and cardiac stroke as the body shuts down in an effort to cope with severe physiological imbalances. As one sports medicine textbook explains, "Delay in initiating cooling makes heatstroke a potentially fatal condition."12
Had the press reports of the day stuck to the autopsy, Jensen's death by heat probably would have remained a somber Olympic footnote. However, the Dane's demise took on sinister overtones when the team trainer, Oluf Jørgensen, told Jensen's attending doctors that he had given his riders a vascular dilation drug called Roniacol before the race. Jørgensen had no reason to hide this fact. Although anti-doping rules were technically on the books, it was common knowledge that athletes took drugs to compete, that no one was tested, and that as long as an athlete was not openly flaunting race earnings at the Olympics, he had little to worry about concerning drug use in the Games. The chairman of the Dutch cycling federation, Piet van Dijk, reportedly said athletes were using "cartloads" of dope that year in Rome-"in royal quantities."13
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After Jørgensen mentioned drugs, the press gathered in Rome lost interest in reporting the obvious and medically documented cause of Jensen's death-dehydration, heatstroke, a head injury, and emergency services that raised his core temperature at exactly the time when it needed to be lowered. Even though Jensen's autopsy did not mention the presence of drugs in his blood, a myth took hold that Jensen had amphetamines in his system. Drugs-not the rise in core temperature and subsequent catastrophic organ failure-became the popularly reported killer. Drugs gave Jensen's death a darkly dramatic angle that made it irresistible to the press. The Olympic scribes tailored their reports of this tragic turn of Olympic events for ominous effect.
In response to Jensen's death and the subsequent media eruption, in 1962 the IOC created a medical commission to examine doping in Olympic sports. In 1967, it assigned Prince Alexandre de Mérode, a Belgian with no medical experience, to lead the drug study group. The commission oversaw the first Olympic drug tests. They were rolled out at the 1968 Winter Games in Grenoble, France, and that year's Summer Games in Mexico City, where Swedish pentathlete Hans-Gunnar Liljenwall became the first Olympic competitor to be suspended for doping. For decades, anti-doping sentiments had remained a quiet subset of the IOC's obsession with amateurism; it was not until Jensen's death that the IOC made its first timid exhortations against doping, early protests that eventually inflated the 1946 anti-doping statement into a full-blown anti-doping industry with its own policies, procedures, and global bureaucracies, along with a tractable fleet of reporters channeling fresh winds of anti-doping moral outrage.
Short on facts but packed with speculative projections, media reports on Jensen's death became so ingrained in the public consciousness that they turned up in U.S. congressional testimony, used wrongly as evidence of the lethal effect of performance-enhancing drugs. During hearings held in 1973 on drug abuse in America, University of Oklahoma athletics physician Donald Cooper referred to Jensen's death as evidence that mixing doping and sports can kill. Jensen's death entered the congressional record when Senator Birch Bayh asked Cooper for cases in which amphetamines were "linked with serious injury or fatalities." Cooper responded, "There are reports in the literature; yes, in fact I think you will find in the 1960 Olympics there was a cyclist, a Belgian cyclist, where it happened."14 Illustrating the secondhand nature of his testimony, Cooper got Jensen's nationality wrong. His citation of a death that had little, if anything, to do with drugs and much to do with bad trauma care illustrates the degree to which the Danish cyclist's demise took on a sinister life of its own. What was truly ominous-the lack of proper emergency care that could have saved Jensen's life-was not the story American lawmakers heard. Instead, it was the mangled parroting of a media fabrication-granted credibility by dint of the Oklahoma physician's medical training and athletic authority-that resonated with politicians, journalists, and the public. Jensen's death became one of the earliest examples in the American historical record of the dangers of doping in sport, even though it should have been evidence of the danger of practicing endurance sports in extreme heat without properly trained medical technicians on hand.
As Paul Dimeo put it in A History of Drug Use in Sport, 1876-1976, Jensen's reputation continued "to be sullied by those eager to use his body as proof of the health risks of doping" long after his death.15 In his painstakingly researched account of Jensen's death and its manipulation, Verner Møller points out that because Jensen's demise "became a symbol of unethical behavior," journalists and doping researchers alike were more interested in the mythology that served their growing prohibitionary impulses than in locating facts.16 The drug fabrication served political, economic, and social interests that heatstroke did not.
A rational assessment of Jensen's death would lead one to believe that the incident should have encouraged the IOC authorities to pass rules demanding better medical care and better monitoring of life-endangering weather conditions during competition. Instead, Jensen's death by heatstroke became the foundational event for today's anti-doping organizations. Indeed, as late as 2015, the World Anti-Doping Agency's website referred to an autopsy that revealed "traces of amphetamines" in Jensen's blood, even though no evidence exists for this claim, since the actual final autopsy report was never seen. Møller speculates that the report may stay under lock and key to this day because revealing it might be embarrassing to Italian medical authorities.
In keeping with the moral import of Coubertin's original quasi-theological project, Jensen's death helped give doping a menacing social weight greater than mere athlete health. The pan-European CoE bureaucracy was one of the first to embrace the notion that sports doping represented a social evil that, if left unchecked, would rend the fabric of society. With Jensen's death hanging in the public consciousness, in 1963, the CoE held its early anti-doping conferences in Strasbourg and Madrid. A 1964 report on the meetings described medical experts from 14 European countries (Russia and East Germany were noticeably absent) joining to discuss "the gravity of the problem and the value attached to combatting this menace by means of a joint European approach."17 Meeting resolutions described doping as "a social evil having ramifications far beyond the realm of sport." Seeing which way the social and bureaucratic winds were blowing, the IOC agreed at its annual congress in 1964 to formally condemn drug use and instruct its national Olympic organizing bodies to let their athletes know they might be tested.
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Jensen's death and these early meetings of European bureaucracies marked a change in the paradigm of drugs as substances that helped realize the optimistic vision of science at the service of human potential. Instead, doping was being redefined as an evil. Dimeo writes that these early 1960s events "set in place the modernization of anti-doping; a system that rigidly enforced moral values through scientific testing, legal restrictions, and bureaucratic procedures."18
Jensen's death created pressure on sports federations in places like Belgium, Holland, and Spain to take a harder look at the drug use that had always been present in bike racing, a sport that had long had an important role in those countries. The federations looked to the CoE to bring together scientific and legal experts to help them figure out how to manage a practice that after decades of being accepted as a pro trade tool was now being characterized as a threat to national moral hygiene.
In cycling, the 1964 CoE report concluded that doping had "already begun to undermine the whole structure of the sport." And since sports were understood to be both a mirror of life and preparation for it, "If doping is allowed to grow unchecked, the time will come when all the benefits accruing to the individual and to the community from the practice of sport will be lost."19 The CoE did not provide evidence why the doping that had been an accepted part of cycling since the 1870s had suddenly become morally corrosive. Indeed, only 21 years earlier, American College of Sports Medicine founder Peter Karpovich had argued that "ergogenic aids" that improve performance without harm "can hardly be called unethical." After Jensen's death, such an opinion was out of joint with the changing spirit of the times.20 Arguing against the position that doping is evil would soon be tantamount to defending a murder or rape; all were indefensible, a priori sins.
The CoE report dictated who held the bureaucratic capacity and paternalistic weight to build an anti-doping infrastructure. "The European community is particularly well endowed with the specialized technological, judicial, and medical savoir-faire to abolish the practice of doping and thus protect its own peoples and give a lead to the world," it concluded. The European sports doctors and administrators that the CoE had brought together in Strasbourg and Madrid were charged with an obligation to protect young athletes from doping pressures outside their control.
Historians like Dimeo and Møller have shown that just as athletes dared not spit in the doping soup that fed them, anti-doping authorities were reluctant to admit evidence that would reveal weaknesses in the nurturing fable of pure sports. By the mid-1970s, attitudes toward doping, which first celebrated the union of man and technology, and then began to worry about the potential health risks of overtaxing the human machine with stimulants, fell into two opposing camps. Dimeo describes them as "morality-driven pedagogues and scientists" on one side and athletes, drug suppliers, and innovative pharmacologists on the other.21 The good-versus-evil frame of reference being constructed around doping was woven into the tone of the CoE report's language. "Doping is a dangerous form of moral deception," the conference attendees concluded. Because the consequences go beyond sports, "apathy on the part of those morally responsible is a crime against humanity."22
The CoE's approach to doping in the early 1960s set the stage for the doping battles that continue today. Rather than defining and managing drugs in sports as a health risk alongside more prevalent dangers like heatstroke, heart attacks, and head injuries, the CoE conferences helped turn a previously unremarkable practice into a moral panic that played on broader social worries. As we'll see, those anxieties had to do with the larger youth and social revolutions roiling Europe and the United States in the 1960s. The solutions that came out of those first conferences in Strasbourg and Madrid helped build the foundation for heavily bureaucratic and self-protecting anti-doping institutions that were unique to Europe, and that did not take root in the pharmaceutically laissez-faire United States until the creation of the U.S. Anti-Doping Agency in 2000.
Anti-doping policy and implementation became the domain of scientists and administrators, people who looked for solutions in rationalist, bureaucratic ways; in their view, more testing, more research, and better science would solve doping in sports. Yet these solutions were difficult to apply to a tradition with causes rooted in a century of social and economic history, not biological pathologies that could be eliminated if only science could find the right antidote. As Dimeo puts it, under the gaze of the growing pack of government-supported anti-doping organizations in Europe, "Athletes were either clean or they were guilty, they were good or evil, there was no middle ground and no scope for ethical dilemmas."23
According to Møller's research, Jensen's rumor-driven death-by-amphetamine story ossified into accepted fact because journalists and historians handed the story from one to the other without bothering to check primary sources. It was a house of cards that hardened into an unassailable edifice of "truth." One example of this rewriting of history to forward a preferred bureaucratic agenda can be found in the 2002 cautionary book on sports doping, Dying to Win. A Council of Europe publication, the book claims "Jensen collapsed and died at the Rome Olympic Games during the 175 km team time trials following his use of amphetamines and nicotine acid."24 Apart from the fact that the time trial was 100 kilometers, not 175, author Barrie Houlihan pushes the unsubstantiated claim that not only Jensen but also two of his teammates had amphetamines in their systems.
Born of good intentions, Dying to Win forwarded the CoE's paternalistic agenda. Houlihan, a respected sports science professor, did not mention the 31 other cyclists who suffered heatstroke during the 1960 Rome time trial. Instead he focused on Jensen's death by a drug that was never proven to be in his system. The CoE effort to warn athletes of the dangers of drugs-dying to win-promulgated the false terms of Jensen's death tale and illustrates how both journalists and historians could write history in a way that fit a preconceived moral narrative.
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Even Robert Voy, the U.S. Olympic Committee's chief medical officer during the 1988 Seoul Olympics, fell back on a manufactured version of Jensen's story. Voy is no canting acolyte, yet in his well-researched 1991 book Drugs, Sport, and Politics, he wrote that Jensen died "during the 175.38-km road race" while riding under the influence of "a combination of nicotynal alchol and amphetamine, sarcastically nicknamed by his competitors the 'Knud Jensen diet.'"25 Besides confusing the road race distance with the team time trial distance, Voy's account shows that even well-intentioned physicians could easily turn to a rough assemblage of rumor to support the post-1960s received wisdom that sports doping is fatal to moral and physical health.
Austrian doctor and sports scientist Ludwig Prokop also helped foster the seedling notion that doping represented a significant moral risk to society at large. A prominent member of the European sports medicine community and a leader of early anti-doping efforts, Prokop led the University of Vienna's Institute for Sports Science for three decades and was an IOC Medical Commission member who served in 26 Olympic Games. Seeing syringes in locker rooms at the 1954 Innsbruck Winter Olympics triggered Prokop's lifelong interest in drugs in sports. Even though there was only circumstantial evidence that drugs played a role, Jensen's 1960 death compounded the Austrian's fear that performance-enhancing drugs were getting out of control. Prokop had conducted experiments with performance-enhancing drugs in 1956 and concluded that any benefit came from a placebo effect rather than the pharmaceuticals. His conclusion that drugs did not make athletes stronger or faster added to his sense that using them was a risk not balanced by any quantitative return other than potential physical harm. He felt that sports governing bodies should act.
Prokop's physician's duty to look out for the health of his patients fused with an impulse to protect athletes from their darker human and social selves and protect the Coubertinian notion of sports as character builder. As Prokop put it in the proceedings of a 1964 sports science conference in Tokyo, sports must shield athletes from drugs to "prevent sporting ideals and values from becoming falsified." Even when doping was not dangerous to the athlete's health, Prokop argued that it "must be regarded primarily as a sporting and not a medical problem." Doping, he concluded, could be regarded "as a dangerous fraud."26 Like the conclusions of many members of the growing anti-doping establishment, Prokop's scientific judgments were clouded by a quest for social purity that was driven as much by emotion as rationality. As Møller writes, Prokop's desire to get doping out of sports "led him to make unsubstantiated claims" in the service of his cause.27 Because of Prokop's stature in the scientific community, his statements that drugs killed Jensen became accepted as fact, even though the amphetamine claims are based on hearsay.28 In the years following Jensen's death, this was a new phenomenon-a physician's concern for athletes' health becoming intertwined with an evangelical desire to protect sports and society from moral corruption. The fudging of the truth about Jensen's death is important in the history of doping in sports not so much because he became known as the first to die from drugs, but rather because of the way his death was unmoored from fact to serve a moral cause. In many respects, the early 1960s marks an irreversible turn of scientists, bureaucratic functionaries, historians, and journalists from proscience and prohealth researchers into moral evangelists.
Prokop wrote the official IOC report on Jensen's death. In it, he claimed amphetamines and Roniacol (pyridylcarbinol) caused the death. Prokop cited an official Italian postmortem from 1960 as the source for the report's claim that Jensen died with amphetamines in his system. However, in 1961, Italian authorities produced a report that indicated that drugs did not play a role in Jensen's death. As Møller puts it, the amphetamines in Prokop's IOC report seem to be based on a "haphazard guess" rather than any observed evidence.29 The doctor had circumstantial evidence for the Roniacol, since the team trainer stated he administered that drug to his riders. However, the trainers did not mention amphetamines. As neither drug was illegal at the time, there would have been no punishment for telling the whole truth. It seems odd that the trainers would only reveal part of their sports medicine regime when trying to help doctors understand what happened to Jensen and his teammates-two of whom also collapsed in the heat.
Twelve years after Jensen's death, Prokop was sticking to his interpretation of Jensen's death, writing in 1972 that Jensen "broke down and died during the Olympics in Rome as a result of an overdose of amphetamine and Roniacol."30 In 2001, however, Prokop admitted that he had never seen an autopsy linking Jensen's death to drugs. "Perhaps it was wrong of me to draw it out in the report," Prokop told Danish journalist Lars Bøgeskov, who was investigating the Jensen story. Prokop also asserted to Bøgeskov that while it might have been wrong of him to draw conclusions without evidence, in the long run, it was worth it because Jensen's "death initiated the fight against doping."31
Ironically, the Roniacol element of Jensen's death did support Prokop's general claim that drugs and sports can be lethal. However, with their attention diverted by nonexistent amphetamines, media and medical researchers never accurately followed up on the Roniacol angle. A vascular dilator, pyridylcarbinol was thought to improve performance by increasing blood flow to muscles. However, by expanding blood vessels, the drug also lowers blood pressure, which can accelerate dehydration and lead to the sort of dizziness, disorientation, and even organ failure that Jensen suffered in Rome. Given Jensen's overheated core temperature, a scientific argument could be made that Roniacol could have contributed to death by heatstroke. When combined with the Olympic first responders baking Jensen for the last two hours of his life, drugs may indeed have contributed to Jensen's death-only evidence does not point to the demon stimulant that spawned today's anti-doping organizations as the culprit.
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In fact, an argument can be made that had he taken them before the race, amphetamines might have saved Jensen's life. Møller points out that one of Jensen's teammates, Niels Baunsøe, suffered no ill effects. If Baunsøe had used amphetamines along with Roniacol, the effect of the amphetamines could have countered the performance-degradingeffects of Roniacol. While Roniacol causes vascular expansion, amphetamine sparks release of noradrenaline, a hormone that triggers vascular contraction. If it were the case that Jensen took only Roniacol while Baunsøe took that drug plus amphetamines, Møller suggests that it "seems more likely that the use of amphetamine helped or even saved Baunsøe than it is that it killed Jensen."32 Absolute proof exists that the riders raced in extreme heat and without water. Their trainer's word provides evidence that they were all on Roniacol. The combination of these three factors can cause lethal dehydration. No evidence exists to suggest that the riders also used amphetamines. However, at the physiological level, the first three factors plus amphetamines would be less lethal than those three alone-an inconvenient possibility that undermines the simple narrative that any and all performance-enhancingdrugs are bad. Growing hysteria about drugs in sports was getting in the way of a measured analysis of their actual risks and benefits-even precluding the possibility that drugs could be helpful at all. More importantly, in the interest of promoting an anti-doping agenda, the posthumous focus on amphetamines permanently turned public attention away from what was a mountain of evidence pointing to the likely cause of Jensen's death: bad emergency medical care.
As for Jensen's autopsy report, it is still inaccessible. After Jensen died, his body was spirited off to the Istituto di Medicina Legale for an autopsy by three Italian doctors. After four days, the Italians shipped his body to Copenhagen for burial-and then radio silence from Italy. The IOC sent repeated letters to Italian and Danish officials asking for the results of the autopsy, but they got nothing. It was not until seven months after Jensen's death that the IOC received official word from Italy: Jensen died of heatstroke, and there were no drugs in his system. The actual autopsy report never saw the light of day.
Today, Møller is a professor in the Faculty of Health at Aarhus University, where his research focuses on teasing out the truth from a sports doping history that is muddied with political and moral ambitions and economic incentives. From his office in Denmark, Møller told me the anti-doping campaigners who were inspired by Jensen's death are like early Amazon missionaries. Before the arrival of the Christians, Møller said, cyclists were like indigenous peoples living "with completely different notions and ideas and values." The missionaries showed up and pronounced, "We need to do something to save these people from themselves and their beliefs, and we want to christen them." Missionaries were not anthropologists interested in suspending their own prejudices in the interest of understanding foreign ways. They, like the early generations of anti-doping evangelists, were there to impose an ideology on people who never asked to be saved. In Møller's opinion, the ride-clean rhetoric some riders began to proclaim was a self-preserving feint. "Like Indians who said, 'Well, we don't want to be shot here, so we'll start saying that we are Christians,'" he thinks cyclists talked pure sports and then, once the anti-doping evangelists turned away, went "back to praying to their previous gods, or their real gods. They tried to say what the missionaries wanted to hear because they were in a disadvantaged position." Møller's research leads him to conclude that the messianic zeal of many anti-doping researchers and sports functionaries impeded their ability to get to the facts of Jensen's death, in part because those facts did not serve the needs of the growing anti-doping mission. A rider who died from heatstroke is not a useful symbolic foundation for an anti-doping campaign.
Møller's analogy of Christian missionaries imposing alien values on an isolated tribe is apt. During the first hundred or so years of cycling, society took it for granted that science at the service of higher human performance-including pharmaceutical science-was a moral good. From tuberculosis to penicillin to polio, drugs had improved human life in astonishingly positive ways. This link between science and goodness also held true for cycling, since it was the first sport truly born of a technological invention. "Man is extremely innovative," Møller told me. "Cycling is the first genuine, modern sport, in that it is related to the invention of a machine which expanded mankind's ability to travel the world by his own powers." Science was beneficial, and chemicals were part of science. "We could create a brave new world which was fantastic because of science," Møller said. And, of course, this technical virtuousness could also be applied to sports other than cycling.
The same year Jensen died, society's optimism about pharmaceutical science and faith in the motives of drug makers began to crack under the weight of a catastrophe-thalidomide. Photographs began appearing in newspapers showing babies born with severe birth defects-no limbs, no eyes, extra appendages growing from shoulders. Sold over the counter to pregnant mothers as an anti-nausea treatment, the drug developed by West German pharmaceutical company Chemie Grünenthal was causing thousands of birth defects and stillbirths in the more than 40 countries where the product had been sold since 1957. Thalidomide was eventually blamed for severe abnormalities in more than 10,000 newborns. However, it wasn't until 1961 that the chemical's full horrors would be disclosed. Until then, the public bobbed along on a bright current of faith in science and misplaced trust that pharmaceutical companies would put human safety first.
The horrors of the thalidomide disaster profoundly complicated our attitude toward the role drugs play in society. The miraculous pharmaceutical inventions that ended the nightmare of polio could also create appalling new disfigurements. And as society at large was forced to reexamine its celebratory attitudes toward drugs, inside the world of sports, bureaucracies were born that forced a similar reanalysis of the wisdom of the everyday nature of drugs for improved performance. Although thalidomide caused quantifiable death and harm that led to the establishment of stricter drug safety approval procedures, in sports, newly emerging anti-doping systems were based more on emotion than evidence.
About the Author
Mark Johnson is a sportswriter and sports photographer. He has covered cycling and endurance sports as a writer and photographer since the 1980s. His work often focuses on the business of pro cycling-a topic that frequently intersects with the sport's long history of doping. Along with U.S. publications like VeloNews and Road, his work is published in Cycling Weekly in the UK, Velo in France, Ride Cycling Review and CyclingNews in Australia as well as general-interest publications including the Wall Street Journal.
VeloPress published Johnson's first book, Argyle Armada: Behind the Scenes of the Pro Cycling Life, in which Johnson was embedded for a year with the Garmin-Cervélo professional cycling team. A category II road cyclist, Mark has also bicycled across the United States twice and completed an Ironman triathlon. A graduate of the University of California, San Diego, the author also has an MA and PhD in English Literature from Boston University. His other passion is surfing, which he does frequently from the home he shares with his wife and two sons in Del Mar, California. Learn more at www.ironstring.com, and follow Johnson on Twitter, Facebook, Instagram.