Expert-Free Zone

Where Were the Doctors to Testify at Roger Clemens’s Perjury Trial?

Why did the prosecution doom their case by relying on a ‘star witness’ who kept his evidence in a Miller Lite can instead of expert medical testimony? The science of intentional drug use for enhanced athletic performance is a boutique business, says Kent Sepkowitz.

06.20.12 8:45 AM ET

The world of professional sports never fails to break the hearts of its fans. No, not because your team never wins the championship, though that’s bad enough, but rather because of the 100-year war that organized sports has waged on our desire to worship. Not a season goes by without some star in some sport disgracing himself by “showing poor judgment.”

Against this depressing backdrop comes the news that baseball pitcher Roger Clemens, accused of lying about using performance-enhancing drugs, was cleared by a jury in Washington, D.C. Clemens was someone who, in his early 30s, hit the predictable moment of physical decline familiar to athletes and non-athletes alike. Yet unlike us and almost everyone else, rather than decline further, he mysteriously, unnaturally, and miraculously started to get better and better and better. By age 40, he was just about the best pitcher ever. He was so good, in fact, that it was not believable.

Despite the fishiness of his second youth, the prosecution’s case was doomed from the start. It relied on “star witness”  Brian McNamee, a personal trainer and strength and conditioning coach who claimed to have supplied Clemens with anabolic steroids, then human growth hormone. Well, as it turned out, he kept his most important evidence, some used syringes, “stored in and around a Miller Lite beer can inside a FedEx box for some six years.” And the other not-such-a-star witness was a convicted drug dealer who from jail apparently growled revenge at Big Rog.

Which raises the question—where were the doctors at the trial? The scientists? The urine samples and the head measurement and testicle measurements and all the facts? You remember facts, those Jeopardy-like nuggets that veteran CSI and House and Bones watchers know to be integral to a properly conducted trial. Why did the entire case rely on two people of extremely shady character who predictably were going to lose any he-says, she-says battle?

Well, in turns out that the science of intentional drug use for enhanced athletic performance is not a course they teach in medical school. It’s not an NIH-funded discipline. It’s not a field that the brightest minds have swarmed toward. Rather it is in the intellectual halfway house with Dr. Phil and Miss Cleo, that place where possibly not incorrect worldviews faintly related to science go. The experts who people this turf have a boutique business that caters only to those using the drugs—a few thousand people, tops—and the lawyers trying to convict them. That’s no way to make a living. But it’s a very safe place to break the law.

Illustration by The Daily Beast

Roger Clemens at Houston Spring Training on February 27, 2008 in Kissimmee, Florida

The basics are simple enough: there are three types of performance-enhancing drugs (PEDs) out there. Two common PEDs are technically and chemically steroids, though their sibling status creates a great deal of confusion, as they chare nothing beyond chemical lineage. The benign one, given above board and never kept in cans of Miller Lite, is corticosteroids. This group includes familiar medicines like hydrocortisone, cortisone, prednisone, and Decadron. Corticosteroids are helpful to the jock because they decrease inflammation. Have a sore shoulder and need to pitch tomorrow? Let’s inject steroids into that joint and get you back on the mound. It works and it’s 100 percent legal and accepted. It also creates its own boundary. It can’t be used too often. Pain and inflammation are nature’s way of shrieking, “Don’t pitch tomorrow!” Disguising the pain with a shot of steroids doesn’t prevent the destruction of the joint created by snapping off a curve ball, it just makes the ouch go away. Too many injections of this type of steroid will destroy a joint and lead to early retirement. Just ask Sandy Koufax.

Anabolic steroids, hailing from the world of male sex hormones—androgens like testosterone—are the second PED. (Sex hormones, like people, come in two models: for males there are androgens and for females, estrogens.) Androgens are what make a guy a guy: muscles, zits, the urge to go pound the crap out of someone, horniness and hairiness, shitty moods, rudeness, megalomania, the whole package. But it’s the muscle bulk that Roger and the gang were after. The world of competitive bodybuilding, and Gov. Schwarzenegger, owed its waxy life to androgens. So did many successful male athletes—and if we are to believe the old propaganda, so did many female athletes from behind the Iron Curtain. When you need to bulk up fast, only androgens will do.

The last of the big three is HGH, the drug McNamee said Roger’s wife used to tone up for a Sports Illustrated shoot. HGH is a hormone normally made in tiny amounts by the pituitary gland in all of us. As its name suggests, it promotes growth, including more muscle and more bone. It has a medical role in the treatment of short stature and a few other rare conditions. At the other end, a tumor of the pituitary can over-produce growth hormone and cause acromegaly. People with acromegaly can grow to more than 7 feet tall, making them prime fodder for either the circus or the NBA.

HGH was the darling of the PED crowd for a long while because it could not be detected. All you had to do was inject it and go about your business. Unlike anabolic steroids, no blood test or urine test around could trip you up. Now, though, there is a test, and its inclusion (or exclusion) for routine use was a major sticking point in the resolution of the recent NBA strike.

For athletes like Clemens and Lance Armstrong, Barry Bonds, and so many others, HGH may have provided a brief window into PED-induced athletic excellence that now has closed. And only those, like Armstrong, whose urine samples are stored somewhere have reason to worry. When a used needle in a Miller Lite can kept in a FedEx box is the loudest J’accuse coming at you, you’re in pretty good shape.

The urgencies of competitive sports have created this expert-free zone where the supply chain, from dealer to user, is completely ignorant of any nettlesome specifics. They only know that the shots make the muscles bigger. And with bigger muscles come bigger contracts. But the entire boring circus of lawyers and athletes wearing Brooks Brothers suits that don’t quite fit right raises a basic question about PEDs: who cares? Who is the victim here? Babe Ruth is slightly victimized, and so is Walter Johnson, but their achievements already are immortal, at least to sports fans. And surely the victim is not Joe Fan, who though in high dudgeon right now—how could these athletes betray my trust!—is itching to watch the highlights tonight not of the important single that plops in the outfield but the meaningless but mighty home run. Or the fastball at 100 miles an hour. Or the splattering collision in football. Despite our claims otherwise, we love this stuff. We prefer the PED NFL and the PED MLB and the PED NBA.

No, the victims here are the stupid athletes who are going to suffer from this someday, sooner or later. In the NFL, the post-concussion syndrome has already shown the start of the damage. But surely many of those who took gobs of HGH eventually will pay something to the piper. To read the side effects of HGH is to read a pathophysiology textbook: diabetes, big weird-looking jaws, swollen heads, cardiovascular disease from elevated cholesterol. Whatever syndromes we may see in 20 years, I predict that we the fans will be heartbroken once again.