Do we put too much pressure on athletes?
Gary I. Wadler, M.D., FACP, FACSM, FACPM, FCP, is an internist with special expertise in the field of drug use in sports. He is the lead author of the internationally acclaimed textbook, Drugs and the Athlete. Dr. Wadler currently serves as the Chairman of the World Anti-Doping Agency's (WADA) Prohibited List and Methods Sub-Committee and serves as an ex-officio member of WADA’s Health, Medicine, and Research Committee. Additionally, he has served as a Medical Advisor to the White House Office of National Drug Control Policy, a Trustee of the Board of the American College of Sports Medicine and of the Women’s Sports Foundation. Among his other sports medicine activities, he has served as Tournament Physician of the U.S. Open Tennis Championships.
For his groundbreaking work in the field of drug abuse in sports, Dr Wadler received the International Olympic Committee's President's Prize in 1993. He is a frequent lecturer on the subject and his opinions are widely sought by the print and electronic media nationally and internationally. In 2007, he was selected by the Institute for International Sport as “One of the 100 Most Influential Sports Educators in America” and serves Chairman of the Communications and Information Committee of the American College of Sports Medicine. In addition, he is Chairman of the American Ballet Theatre's Medical Advisory Board where he oversees the development of medical guidelines for the healthy and sound training of dancers in the United States. Dr. Wadler is the Chairman of the College Council of the State University of New York at Old Westbury. Dr. Wadler maintains a private practice in Internal Medicine and Sports Medicine in Manhasset, New York and is a Clinical Associate Professor of Medicine at the NYU School of Medicine.
Question: Do we put too much pressure on athletes?
Gary Wadler: Well, you know, yeah. And there’s no question it’s another form of drug abuse. And what drives the drug trade is money. Now, what’s unique about this form of drug abuse is a form of other drug abuse. In the other form of drug abuse, tremendous amount of money, people grow crop, market it, sell it, whatever. But the end user you can find nonfunctional,without a job, disheveled, whatever it might be. In the sports aspect of drug abuse, we still have the guy making money, importing it, developing it, packaging it and all that stuff, but the user not only is not not functional, he’s making more money than ever before. He has now become a national hero. So it’s an interesting dynamic. So you really have in the doping end that people who are providing the product are making money and the people who are using the product are making money. That’s a very hard act to break up.
Question: Do you still watch baseball?
Gary Wadler: Ask my wife. I go home. If I had a rough day, I put on the baseball game. I love to watch the game of baseball. I love it. I grew up in Brooklyn. I grew up with the Brooklyn Dodgers. I met Jackie Robinson twice. And people have used that argument, you know? Free will. Let them do what they want to do. You have to recognize, and although it’s a lot better now than it was four or five years ago, we have had as many as four percent of high school seniors have used anabolic steroids. We had as many as two and a half percent of eighth graders have used anabolic steroids at least once. Those are staggering figures. And so ultimately, we got to look at the implications for our society. Are we condoning the abuse of dangerous drugs to achieve some goal? Is that an acceptable form of behavior in our society? I submit most people would say no, it’s unacceptable, but they still like to watch their professional sports.
Recorded on: 04/25/2008
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A new method promises to capture an elusive dark world particle.
- Scientists working on the Large Hadron Collider (LHC) devised a method for trapping dark matter particles.
- Dark matter is estimated to take up 26.8% of all matter in the Universe.
- The researchers will be able to try their approach in 2021, when the LHC goes back online.
Researchers hope the technology will further our understanding of the brain, but lawmakers may not be ready for the ethical challenges.
- Researchers at the Yale School of Medicine successfully restored some functions to pig brains that had been dead for hours.
- They hope the technology will advance our understanding of the brain, potentially developing new treatments for debilitating diseases and disorders.
- The research raises many ethical questions and puts to the test our current understanding of death.
The image of an undead brain coming back to live again is the stuff of science fiction. Not just any science fiction, specifically B-grade sci fi. What instantly springs to mind is the black-and-white horrors of films like Fiend Without a Face. Bad acting. Plastic monstrosities. Visible strings. And a spinal cord that, for some reason, is also a tentacle?
But like any good science fiction, it's only a matter of time before some manner of it seeps into our reality. This week's Nature published the findings of researchers who managed to restore function to pigs' brains that were clinically dead. At least, what we once thought of as dead.
What's dead may never die, it seems
The researchers did not hail from House Greyjoy — "What is dead may never die" — but came largely from the Yale School of Medicine. They connected 32 pig brains to a system called BrainEx. BrainEx is an artificial perfusion system — that is, a system that takes over the functions normally regulated by the organ. The pigs had been killed four hours earlier at a U.S. Department of Agriculture slaughterhouse; their brains completely removed from the skulls.
BrainEx pumped an experiment solution into the brain that essentially mimic blood flow. It brought oxygen and nutrients to the tissues, giving brain cells the resources to begin many normal functions. The cells began consuming and metabolizing sugars. The brains' immune systems kicked in. Neuron samples could carry an electrical signal. Some brain cells even responded to drugs.
The researchers have managed to keep some brains alive for up to 36 hours, and currently do not know if BrainEx can have sustained the brains longer. "It is conceivable we are just preventing the inevitable, and the brain won't be able to recover," said Nenad Sestan, Yale neuroscientist and the lead researcher.
As a control, other brains received either a fake solution or no solution at all. None revived brain activity and deteriorated as normal.
The researchers hope the technology can enhance our ability to study the brain and its cellular functions. One of the main avenues of such studies would be brain disorders and diseases. This could point the way to developing new of treatments for the likes of brain injuries, Alzheimer's, Huntington's, and neurodegenerative conditions.
"This is an extraordinary and very promising breakthrough for neuroscience. It immediately offers a much better model for studying the human brain, which is extraordinarily important, given the vast amount of human suffering from diseases of the mind [and] brain," Nita Farahany, the bioethicists at the Duke University School of Law who wrote the study's commentary, told National Geographic.
An ethical gray matter
Before anyone gets an Island of Dr. Moreau vibe, it's worth noting that the brains did not approach neural activity anywhere near consciousness.
The BrainEx solution contained chemicals that prevented neurons from firing. To be extra cautious, the researchers also monitored the brains for any such activity and were prepared to administer an anesthetic should they have seen signs of consciousness.
Even so, the research signals a massive debate to come regarding medical ethics and our definition of death.
Most countries define death, clinically speaking, as the irreversible loss of brain or circulatory function. This definition was already at odds with some folk- and value-centric understandings, but where do we go if it becomes possible to reverse clinical death with artificial perfusion?
"This is wild," Jonathan Moreno, a bioethicist at the University of Pennsylvania, told the New York Times. "If ever there was an issue that merited big public deliberation on the ethics of science and medicine, this is one."
One possible consequence involves organ donations. Some European countries require emergency responders to use a process that preserves organs when they cannot resuscitate a person. They continue to pump blood throughout the body, but use a "thoracic aortic occlusion balloon" to prevent that blood from reaching the brain.
The system is already controversial because it raises concerns about what caused the patient's death. But what happens when brain death becomes readily reversible? Stuart Younger, a bioethicist at Case Western Reserve University, told Nature that if BrainEx were to become widely available, it could shrink the pool of eligible donors.
"There's a potential conflict here between the interests of potential donors — who might not even be donors — and people who are waiting for organs," he said.
It will be a while before such experiments go anywhere near human subjects. A more immediate ethical question relates to how such experiments harm animal subjects.
Ethical review boards evaluate research protocols and can reject any that causes undue pain, suffering, or distress. Since dead animals feel no pain, suffer no trauma, they are typically approved as subjects. But how do such boards make a judgement regarding the suffering of a "cellularly active" brain? The distress of a partially alive brain?
The dilemma is unprecedented.
Setting new boundaries
Another science fiction story that comes to mind when discussing this story is, of course, Frankenstein. As Farahany told National Geographic: "It is definitely has [sic] a good science-fiction element to it, and it is restoring cellular function where we previously thought impossible. But to have Frankenstein, you need some degree of consciousness, some 'there' there. [The researchers] did not recover any form of consciousness in this study, and it is still unclear if we ever could. But we are one step closer to that possibility."
She's right. The researchers undertook their research for the betterment of humanity, and we may one day reap some unimaginable medical benefits from it. The ethical questions, however, remain as unsettling as the stories they remind us of.
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