In a valuable column reviewing the scant statistical evidence of performance-enhancement resulting from the use of allegedly performance-enhancing drugs on Thursday, ESPN columnist David Schoenfield comes to one judgment that has been commonly associated with the reflexive condemnation of athletes who use: that use in itself may constitute evidence of efficacy. "I do believe steroids can help," Schoenfield says. "Why do athletes continue to take them -- in all sports -- if they don't believe in some benefits, however small?"
The answer is that human beings have a long history of dosing themselves with anything if someone says it will help. We like to believe in miracle cures and secret knowledge that will erase our wrinkles, heal our cancers, or allow us to perform feats that others cannot. Little concerns about the laws of science or medicine tend to fall by the wayside.
Just one example: Today, the toxicity of mercury is well understood, but 100 years ago that metal was an ingredient in dozens of medicines. In the days before antibiotics, the liquid metal was used to treat diseases such a syphilis. Abraham Lincoln, who suffered from chronic constipation, attempted to ease his symptoms with a patent medicine called Blue Mass which was mercury mixed with licorice and honey. That and the Civil War are thought to have really ruined his mood.
If you've taken anything like a high school-level history course, you've heard about Upton Sinclair's 1906 novel The Jungle, or perhaps were even required to read it. Sinclair's book is really an advertisement for socialism with a plot, but its most vivid descriptions are reserved for the disgusting practices of the Chicago meat packers. The book was treated as a sensational exposé, and the resultant public outcry led to the passage of the Pure Food and Drug Act. "I aimed at the public's heart," Sinclair said, "and by accident I hit it in the stomach."
The "and Drug" part of the story is often overlooked, but at the same time Sinclair was dishing on the unsanitary condition of the food supply, reporters like Samuel Hopkins Adams were investigating the patent medicine industry, an unregulated cesspool in which manufacturers felt free to offer any substance without regard to safety and to make any claim on its behalf. For example, Pond's Cream, invented in 1846 with witch hazel as its main ingredient, may very well have been useful in treating the skin, but when there was a meningitis scare in New York at the turn of the 20th century, the company felt free to advertise its product as "the oldest, best known and most effective remedy for all diseased conditions of the mucus membranes." This despite witch hazel being "about as effective as molasses," as Hopkins put it, in the treatment of meningitis. God help anyone who treated their infection solely with facial cream, because they undoubtedly went to meet Him in short order.
You know who (Anthony Gruppuso-USA TODAY Sport)
Similarly, Peruna, a mix of "half a pint of cologne spirits, 190 proof, with a pint and a half of water... a little cubebs for flavor and a little burned sugar for color," was marketed as a cure for Yellow Fever and "catarrh." What is catarrh? Hopkins asked. "Whatever ails you. No matter what you've got, you will be not only enabled, but compelled [by those shilling for Peruna] to diagnose your illness as catarrh and to realize that Peruna alone will save you. Pneumonia is catarrh of the lungs; so is consumption. Dyspepsia is catarrh of the stomach... Appendicitis -- surgeons, please note before operating -- is catarrh of the appendix... Heart disease is catarrh of the heart."
And hell, maybe in a sense Peruna might have cured some of these things in the same way that a dose of random pharmaceutical goodies from Tony Bosch's magical wonder-closet enabled close to 20 players to hit balls the length of several city blocks. That is to say that it didn't, but since the placebo effect is (oxymoronically) real, perhaps people believed in its efficacy enough that they were given an emotional and physiological boost over whatever ailed them -- at least until the "catarrh of the heart" backed up again and the delayed-but-still-inevitable climactic coronary laid them on a slab.
The best expression of human gullibility when it comes to wonder medicines is the literally thousands of people, men and women both, who spent the 1920s and 30s walking around with goat testicles surgically implanted in their bodies. A quack doctor with an MD from "Eclectic Medical Univeristy" named John R. Brinkley became a national celebrity by supposedly curing impotence, prostate disease, and other problems with a generous helping of bovid gonads. Brinkley didn't have science on his side -- shove some bits o' goat into your scrotum and all you'll have is a really grotesque conversation piece -- and given that he frequently operated with dirty hands and instruments while drunk, the real winner of his procedure was septicemia, which offed a decent number of his patients (additional losers no doubt included multiple generations of goats who spent their blighted lives grunting in an unnaturally high voice). The survivors frequently expressed an unhealthy interest in the pan flute but otherwise were in the same shape as before.
Brinkley founded one of the first Mexican border radio stations, blasting its signal at up to 1 million watts -- strong enough for it to be picked up on dental fillings -- dedicated 24-7 to advertising the medical benefits of putting a little goat in your tank, as well as other questionable medicines like (here it comes again) mercurochrome injections. Eventually, his medical license was revoked, Congress passed a law targeted specifically at shutting down his radio station, and wrongful death and fraud suits destroyed his practice. Shades of Oscar Wilde: Brinkley was undone in part by suing a debunking doctor who called him a charlatan for libel; the jury found that he was, in fact, a charlatan.
Do baseball's performance-enhancing drugs fall under the same heading as goat-gland transplants and Peruna? Like Schoenfield, I'm inclined to think there's something more to steroids and the rest, but it is far from clear that there is much more than that to them -- "something" in this case being an amorphous benefit that might be equivalent to "a general feeling of well-being" rather than "a sudden ability to launch balls into low orbit." I don't know the literal answer, and we probably never will. However, I do feel confident of the answer to the question, "Why would players use if it doesn't necessarily work?" It's just like the felt frog sang in The Muppet Movie: "Somebody thought of that/ and someone believed it."
People believe in all kinds of things -- invisible omnipotent cloud beings, massive JFK-killing conspiracies, the existence of Big Foot, and the promises of politicians of either party. Given that, it seems unremarkable that a group of athletes would believe someone who says, "Psst! Inject this and you'll hit like Babe Ruth on, well, on steroids." The data is the data, and the data says that PEDs haven't had much of an effect on power production. Belief is belief, and never the twain shall meet.