DMacA_3Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK


Sport, the focus of so many dreams, hopes and ambitions is a part of life where we were encouraged to believe that ability, dedication and commitment would triumph over all adversity. Who hasn’t imagined a winning performance, making that critical score or crossing the finish line to the applause of the crowd: Daydreams of the young and not so young.

We could dismiss the occasional cheat, vilify the greed of a professional team, criticise the incompetence of a governing body but the systematic, structured and organised doping, bribery and cover up associated with recent scandals in athletics is staggering. First it was the Kenyans who betrayed our beliefs. Their distance runners, world leaders and role models, whose easy loping style, lightness of foot, and incredible pace suggested an awesome natural ability, winning almost all the major city marathons. Allegations of doping, while persuasive, seemed to suggest small scale, ad hoc involvement. Until the recent story of doping by Russian athletes, that is. This evolving story is much more dramatic than what we’ve come to expect as the norm; doping in Russian athletics is widespread, structured and systematic. Every day reveals another layer. And doctors were complicit.

The World Anti-Doping Agency (WADA) commission report, released on Monday (Nov 9th), reported, in point 4 of 5, the involvement by doctors, coaches and laboratory personnel. It stated explicitly that some Russian doctors and/or laboratory personnel acted as enablers for systematic cheating. The report also points to the “intentional and malicious destruction of more than 1,400 samples by Moscow laboratory officials after receiving written notification from WADA to preserve target samples.” Grigory Rodchenko, the Director of the Anti Doping laboratory was identified in particular and he has since resigned. The commission also found there was a second laboratory in Moscow, whose purpose was unknown. It was directed by Dr. Giorgi Bezhanishvili, a forensic toxicologist. Dr. Sergey Portugalov Chief of the ARAF Medical Commission was severely criticized for committing offenses in his position as a medical professional, and with complete disregard for the health and well-being of the athletes. The full WADA commission report, available online, makes for sobering reading.

There was considerable Canadian involvement in this investigation. Dick Pound, a former president of WADA chaired the three man commission and he was joined by fellow Canadian lawyer, Richard McLaren.

Dr Gabriel Dollé, a French doctor who had been at the centre of the IAAF anti doping campaign until the end of last year is suspected and reported to have received at least €190 000 to turn a blind eye to certain positive test results. The Guardian reported in December 2014 that Dr Dollé, whose job was to oversee all doping-related aspects of IAAF events, athletes and related matters, left after being interviewed by the world governing body’s ethics commission.

Yet, even knowing the scandals of the past, we still try to believe in the purity of sport. Every new doping scandal takes something away from those childhood dreams, colours our perception of the honour and glory of sporting achievement, and shows, again, our heroes with feet of clay. How can we continue to believe? And the involvement and exposure of sports doctors is sad for the profession. Many doctors involved in sport have contributed greatly to the health and well-being of athletes, motivated primarily by their love of sport and a willingness to share their knowledge and expertise. In recent years, sports medicine has developed as an independent specialist discipline with its own faculties and professional organizations, attaining specialist recognition in some countries. Unfortunately, in the eyes of the public and some of our colleagues, doping has become inextricably linked with sports medicine, and judging by media speculation we can expect even more revelations from other countries. Each doping scandal not only sullies sport and damages the reputation of athletes but, sadly, casts a shadow, however unjustified, on all of us involved in sports medicine.