Performance Enhancing Drugs and Baseball – A Surgeon’s Perspective


As a baseball fan and a surgeon with a practice partially consisting of wound healing clients, my perspective on the Performance Enhancing Drugs (PEDs) controversy is unusual. While I understand the legitimate desire of Major League Baseball (MLB) to maintain a level playing field, efforts to suppress the use of PEDs to date have been erratic and perhaps fail to take into account entirely the “bigger picture.” The issue as I see it breaks into two main topics:

PEDs as an “Unfair Advantage”

The public at large as well as those within the sport have seen the near superhuman gains realized by the well publicized users of PEDS. The recent suspension and disgrace of Ryan Braun moved toward a more extreme punishment, but is still short in the eyes of many. Looking at December of 2011 when a confidential urine test conducted in October was leaked to ESPN the public became aware of Braun’s potential “cheat.” With this taken into account, the MLB decision to allow his participation in the 2011 National League post season was to say the least unfair. A pressing question regarding Braun as well as other uncovered PED users is how can this obvious unfair advantage be tabulated in a sport the keeps statistics as the “Bible of Glory?” Secondly, the fact that Braun like many of the “Steroid offenders” has been allowed to keep the lion’s share of his contract money is the carrot on the end of the proverbial stick, is it not? Ryan Braun may not be honorable, but he is obscenely rich. Should the sport so richly really reward those who blatantly violate fairness and are so offensively dishonest about it? The players and the fans alike seem to say: No.

PEDS as Wound Healing Aids

Some (but not all) of the compounds identified as PEDs have substantial wound healing properties. As the potential career of some players on occasion may be threatened due to injuries, it seems reasonable to have a mechanism to allow the use of medications determined to be helpful. In the MLB, players come on and of the Disabled List (DL) for injuries not infrequently. Perhaps a portion of the players on the list for the more severe injuries could obtain the benefits of a circumscribed list of medications. This could be done under appropriate supervision for a specified period of time without penalty.

An inquiry into what exactly is allowed and under what circumstances would be required. Looking at the plethora of medications, vitamins and nutritional aids players already consume in their training, such action by the MLB seems prudent anyway.

So to summarize there are a few issues for the MLB organization to consider:

(1) Players are using a multitude of nutritional as well as illicit aids in order to perform and prosper. The whole lot should be examined and ground rules established to define what may be used by the players and under what circumstances. Allowing players to utilize certain otherwise “off-limits” aids while injured seems reasonable as evidence indicating their effectiveness is available.

(2) For those who violate these rules, establish a penalty structure with stiff fiduciary consequences to make it likely that players, the teams and associated staff members will comply.

Best Regards,

John Di Saia MD

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