Category Archives: Health


Maracana Stadium

Q: A contagious disease, the threat of violence, insanitary conditions, a constitutional crisis,  and now … a doping crisis! All in a day’s work for the organizers of the Rio de Janeiro Olympics, eh?

A: Yes: every summer Olympics has its share of problems in the lead-up to the tournament, but they’re usually about getting the stadiums built in time, or completing the transport links. For Rio, these are minor problems: they have much more serious crises to avert. Do you want me to go through them?

Q: Sure. Start with the public health cataclysm.

A: Cataclysm might be overstating it a bit, but the Zika virus certainly has the potential to develop into a global pandemic. Zika is the virus spread by mosquitoes — those pesky little long-legged flies with a taste for human blood. Aedes aegypti is the name of a species of mozzie that carries this Zika virus and if they bite a pregnant woman her baby could develop a devastating birth defect. This has already happened in Rio. The danger is that, if some of the expected 500,000 visitors to the Olympics get bitten, then return home, then the virus goes with them. The European Centre for Disease Prevention and Control says the mosquito type has been recently reported in Madeira, the Netherlands and the north-eastern Black Sea coast. You can bet that, after the Olympics, it will be many, many other places too.

Q: So this is potentially a huge public health risk. Who in their right mind would go to a part of the world where this kind of mosquito thrives?

A: The Olympics has a great pulling power and not only for audiences. Athletes train for four years and, when they finally get the chance to compete in the most prestigious tournament in the world, they will run a cost-benefit calculation through their mind and decide it’s a risk worth taking.

Q: Professor Amir Attaran of the University of Ottawa has recently written a warning in of the Harvard Public Health Review in which he calls for a complete postponement or even cancellation of the Olympics. He thinks it’s that serious.

A: And I find his arguments compelling. I was in a discussion with him recently and agree with his findings. But I don’t think the Olympic organizers will listen. As always, money overpowers everything, including public health considerations.

Q: How much money are we talking about?

A: Well let’s start with the sponsors’ money. The International Olympic Committee , or just IOC for short, has about 30 global corporations in its team of commercial “partners,” as it likes to call them. These include Samsung, Visa, Omega as well as the ever-present pair, Coca-Cola and McDonalds.They pay for the rights to use the Olympic rings logo, advertise themselves as Olympic sponsors and generally associate themselves with the Olympic brand. Because of the different levels and lengths of contracts, I can only estimate the value of sponsorships for this particular tournament, but I don’t think $1 billion would be wide of the mark. And I know we tend to use the word billion as we used million a decade ago. But remember: a billion is a thousand times more than a million.

Q: A thousand million American dollars? That’s £691,488,810. Serious money!

A: Actually, it gets more serious. The media deals are enormously complex because they’re often structured over several Olympic cycles and there are subcontractors who buy the broadcast rights to whole territories and then sell on to individual broadcasters. The IOC has one particularly lucrative contract with NBC television worth $7.5 billion and which stretches to 2032. But for this single Olympic games, the overall value of media contracts is, I’d say, slightly north of $4.1 billion.

Q: Why so much?

A: Advertising. The 2012 London Olympics was broadcast to 115 different countries, reaching an audience of 3.8 billion homes. That’s a formidable reach and very, very few televised events can claim such a fantastic demographic. Football’s World Cup is one of them, of course. So, if you’re an advertiser and you want to show your products to the biggest possible consumer market, then you advertise during the Olympics. And tv and radio companies charge you more. So they make money. The IOC charge a lot in the confident expectation that broadcasters will cough up, secure in the knowledge that they can charge advertisers a premium. The USA’s NBC charges about $100,000 per 30-seconds and has already taken $1 billion in advertising spots. The rate is dwarfed by those attached to some sporting events, like the Super Bowl, but, of course the Olympics lasts over two weeks. So a cancellation at this late stage would create pandemonium for both sponsors and broadcaster.

Q: But surely the huge corporations tied up with the Olympics are insured against a cancellation or some other kind of catastrophe.

A: Definitely. But imagine the brand damage: the Olympics is a popular portal for advertising and marketing because of its connotations: health, wholesomeness, purity, virtue — squeaky-cleanliness. Public health disasters are not part of the brand profile.

Q: Which brings me to the other potential problems. I was reading the Brazilian footballer Rivaldo had warned prospective travellers to stay away from Rio. He thinks they will be exposing themselves to violence.

A: I’m always skeptical about these kinds of warnings. Every big city in the world carries its own menace: cities are, almost by definition, places where rich and poor live side-by-side. Well, perhaps not side-by-side: there are affluent and impoverished areas of most cities. Rio is no different. Of course, there are dangerous parts and most clued-up travellers will give them a wide berth. All the same, when someone like Rivaldo reckons Brazil is getting “more ugly,” I guess we should take notice. You might expect Brazilian athletes to support the Games and encourage fans from everywhere to flock to Rio. He’s warning them off. Add to this the report that Rio’s Olympic waterways are rife with pathogens — bacteria that can cause disease — and that corruption is rife and you come up with the picture of a country that is not quite fit-for-purpose as an Olympic host. Matter of fact, Rio and the Olympics makes Quatar and football’s World Cup look like a match made in heaven!

Q: Almost inevitably there’s been an ominous doping scandal, the difference this time being that this one has arrived before rather than during or after the Games.

A: Let me recap: Russia is already suspended from the Olympics and it will petition to have its suspension lifted before the start. It’s case is now being considered. Kenya has also been mentioned, though nothing has materialized thus far. Russia is known to have had a state-sponsored doping programme. Kenya was recently declared “non-compliant” with the World Anti-Doping Agency’s rules. It would be a major blow if either or both nations were excluded from the Games for drugs violations. Russia was fourth in the 2012 medals table and Kenya is the preeminent force in middle and longdistance running. And it gets worse: dozens of athletes expecting to compete in Rio de Janeiro could be barred from the Games. The International Olympic Committee announced that it had retested urine samples taken at the Beijing Olympics of 2008 and would retest more from the 2012 tournament. The intention is presumably to strip those who tested positive of their medals and, if they planned to compete in Brazil, ban them.

Q: Hang on, I’m not quite getting this. The athletes at Beijing and London were tested in 2008 and 2012 respectively and, we presume, came out clean and so kept their medals. How can they testers change their minds now and declare them “cheats”? It seems to go against the entire ethos of sports. I mean, there’s a contest, an outcome and winners are declared. OK, we know dopetesting can take a few days. But eight years? This means that every single medallist at Rio keeps the medal conditionally and, if at some future unspecified time, their sample shows up a banned substance, their medal could be annulled.

A: That’s it. Every result at Rio will be provisional. And it will remain provisional for ever. The testing equipment available now will detect some substances. But athletes are intelligent enough to realize that, if they intend to enhance their athletic performance, they don’t want to use substances that will be detected. That’s why they use designer drugs, these being drugs that are synthetically made to escape detection. It’s possible that at some point in the future, the testers will catch up — as they apparently have with some of the substances used in 2008 and 2012 — but, there’s also a better-than-even chance that they’ll never devise tests sophisticated enough to catch them.

Q: All the same, this has to be an unsatisfactory state of affairs. It means that the 78,838 fans at the Estádio do Maracanã (pictured above) plus the 3 billion+ tv audiences will be watching events in which the results will be inconclusive and always subject to change.

A: Correct. But try to think of the Olympic Games less as a sporting tournament and more of a spectacular exhibition — a showcase for the world’s seventh biggest economy. Between August 5-21, there will be plenty of competition, but there’ll also be the grand opening and closing ceremonies and two-and-a-half weeks of the most intensive marketing imaginable. The Chariots of Fire bolted long ago.



Pearl Izumi Tour Series - Kirkcaldy (4)

Q: Is cheating fair?

A: “The rules of fair play do not apply in love and war.” This isn’t an answer: it’s a quote from John Lily’s Euphues (1578). A contemporary of Shakespeare, Lily could have had no clue how his phrase would become so widely used as a mitigation of cheating. Of the many modifications, one stands out: “All’s fair in war, I believe,” claims the central character John Pendleton Kennedy’s 1954 novel of the American Revolution, Horse-shoe Robinson. “But it don’t signify a man is good.” OK, this is hardly a definitive statement, but it does highlight how the rules of fair play might be acceptably broken in some circumstances, though without necessarily making the violation morally right, or exculpating the offender (i.e. signifying he or she “is good”).

Q: That’s actually a better answer than I’d expected. I was hinting at the recent case of “mechanical doping,” as they’re calling it. A motor concealed in a bike at the world cyclo-cross championships suggests competitors are prepared to try any means, fair or foul, to gain an advantage. It is banned in competitive cycling and the UCI, cycling’s governing body, has acknowledged it is a problem. Cycling is still trying to come to terms with performance enhancing drugs, of course. This is another form of cheating, isn’t it? After all, to cheat is to deceive, trick, swindle or flout the rules designed to maintain conditions of impartiality. So how can this be fair in any situation?

A: To answer this we need to establish the circumstances in which cheating takes place, and the conditions under which cheating is practiced – the context of cheating. Prior to professionalism, the aim of sporting competition was to perform at the highest level our bodies and minds permitted. Rules were designed as guiding principles, directions regarding appropriate behavior. Participants played on their honor: they trusted each other to be fair and honest. In a sense, the rules were superfluous. Later, when winning became the ultimate goal, rules became limits – boundaries of permissible behavior; they were supposed to govern conduct and specify what we could and couldn’t do. Rules not players governed acceptable conduct. It’s impossible to be precise about the time of the change in ethos. Sports such as association football and baseball were both professional in the nineteenth century, whereas rugby union didn’t go open until 1995. The Olympics were amateur for much of the IOC’s history; but, during 1986-92, it introduced amendments in its charter that effectively permitted professionals to compete. Even allowing for this unevenness, we can surmise that, while competitors in all sports were committed to doing their utmost to win, those who competed for money rather than glory alone had to deal with temptation.

Q: We’re always hearing phrases like, “Winning isn’t everything; it’s the only thing” and “Football is a matter of life or death? … It’s more important than that.” Competitors are encouraged to adopt a professional win-at-all-costs attitude. So, it could be argued that the athlete who is prepared to risk disqualification and the defeat, shame and sometimes humiliation in order to win embodies the very qualities that define competitive sports in the 21st century, right?

A: I’d say so. Cheating is an undesirable but inevitable consequence of professionalism. You could say it’s an admirable characteristic of determined competitors who are prepared to do whatever it takes to win.

Q: So how does cheating manifest today?

A: I’d say in three main ways:

(1) An intentional infraction designed and executed to gain an unfair advantage. Perhaps the most notorious unpunished instance of disguised cheating was Diego Maradona’s “Hand of God” goal, when he palmed the ball into the goal of the England football team in a 1986 World Cup game. Video evidence showed that the Argentinean player used his hand illegally and probably intentionally. The referee didn’t see it and awarded a goal amid much protest. Maradona didn’t confess his sin to the referee. For that matter, he’s never openly acknowledged it. There are too many cases of this kind to chart here. But let me just give one more, this time from boxing. In 1983, the unbeaten Billy Collins, then 21, took a terrible pounding from the normally light-hitting Luis Resto, who was 20-7-2 at the time. Collins’ injuries were so bad that he didn’t fight again and was killed in a car accident nine months later. It was found that padding had been removed from Resto’s gloves. Resto was banned from boxing and, later, convicted of assault, conspiracy and criminal possession of a deadly weapon (his fists). His cornerman, Panama Al Lewis was convicted of assault, conspiracy, tampering with a sports contest and criminal possession of a deadly weapon. They both served 2 years in prison.

2) An unintentional infraction that goes unnoticed by game officials and which the offending player fails to report. It’s difficult to imagine an instance when a coach would not condone cheating if there was a guarantee that it would go undetected and an advantage to be gained. In a 1997 game of football, Liverpool player Robbie Fowler was awarded a penalty after the referee ruled that Arsenal’s goalkeeper David Seaman had fouled him. Fowler informed the referee that Seaman had not fouled him, but the referee was adamant that the penalty stood and Fowler duly took it. While Fowler’s spotkick was saved and driven home on the rebound, one wonders what might have happened had the player remained true to his original confession and deliberately sliced the ball wide of the goal. Even if the original intention of the athlete was not to cheat, the structure of the game actually inhibits him or her from doing much else.

(3) When rules are observed, but the spirit of competition is compromised. During her losing match against Steffi Graf in the French Open final of 1999, Martina Hingis (a) demanded that the umpire inspect a mark on the clay surface after her forehand landed adjacent to the baseline, (b) went for a 5-minute toilet break at the start of the third set and (c) served underarm when facing match point on two occasions. While the actions did contravene the rules, they prompted Graf to ask the umpire: “We play tennis, OK?” A dramatic fall by Arsenal player Eduardo in 2009 was the subject of intense, yet ultimately inconclusive scrutiny. Playing against Celtic in the European Champions League, the player tumbled after what appeared to be minimal contact with an opponent, and was awarded a penalty, from which his team scored. A retrospective charge of diving, or “simulation,” yielded a two-match ban from Uefa; this was subsequently overturned when governing organization failed to prove its case. Whether the player deliberately deceived the referee remains a talking point, though the absence of sanction suggests that the official view was that Eduardo was fouled and simply exaggerated his fall. Soccer players are so notorious for this that Fifa introduced rules that forced all injured (or pseudo-injured) players to be stretchered off the field of play before they could resume playing. Boxers employ a comparable strategem, exaggerating the effects of low blows to gain time to recover when under pressure.

Q: From what you’re saying, it seems instrumental qualities, such as prudence and calculation, are now parts of the character of professional sport. So were there no cheats before money became a factor?

A: There were, but perhaps not so many as today. Earlier this week, Lawrence Donegan, author of Four Iron in the Soul, who called me about a story he was writing on cheating in sport for the New York Times. I emphasized the importance of the filthy lucre, but added that we should guard against assuming amateurs were pure and virtuous. In 1976, for example, when the Olympics were amateur, Boris Onischenko, in a desperate bid for gold in his last Olympics, wired a switch under his leather grip, which triggered a hit when pressed during the fencing event of the modern pentathlon. He was disqualified after officials noticed that hits were registering even though his foil wasn’t even touching his opponent. Money is the primary variable in motivational mixture behind cheating, but prestige, distinction and the status winning brings to the victor are also ingredients.

Depression in sport


Ian Thorpe ‘in rehab for depression’, says managerThe five-times Olympic swimming champion, Ian Thorpe, has been admitted to rehab after suffering from depression, local media said on Monday.

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The recent news about Ian Thorpe  would have been stunning ten years ago. Today, we are used to hearing about former Olympic champions, football greats, rugby legends and stars from many other sports who quickly fall from grace once their competitive career ends. Depression is prevalent among athletes across the whole spectrum of sports. Why? After all, these are people who have achieved more than most of us and enjoy the adulation of sports fans. Perhaps the very factors that drove their success also contribute towards their depression. One of the chapters of my book Making Sense of Sports examines the specific causes of depression in sport. I include it here: Sinking Under Pressure

Jonathan Trott’s stress-related illness

Jonathan Trott - England

The news that cricketer Jonathan Trott is returning from England’s tour of Australia, suffering from what’s been described as a “stress-related illness,” reminds us of how depression can unexpectedly descend on the most unlikely people. In recent years, athletes from across the whole spectrum of sports, have seemed particularly prone to depression. Perhaps there is something peculiar about the intense, competitive environments in which they operate. The 32-year-old Trott endured a torrid time during the first test in Brisbane as he was twice dismissed cheaply by Mitchell Johnson. He was also the victim of insults from David Warner, who accused England of being “scared” of fast bowling and Trott of being “weak”.  A few months ago, Ellis Cashmore wrote a blog on depression. Here we repeat that blog.

Is depression really an illness?

It sounds a ridiculous question today. Ten years ago, we would have discussed it. Twenty years ago, we would have been suspicious. And thirty years ago, we wouldn’t have heard of the word depression, at least not in the way we use it today to describe a prolonged feeling of despondency and hopelessness. The way we conceptualize depression is largely a result of medicine.

About 54 million people around the world habitually take Prozac, which is just one of several prescription drugs known collectively as antidepressants. Between 1991 – i.e. four years after the introduction of Prozac – and 2001, depression in the USA more than doubled. It seemed more than a coincidence. Before 1986, people were nervous, glum, moody or felt continually down in the dumps. Depression didn’t begin in the early 1990s, but its official recognition as a sickness that could be clinically diagnosed and treated with medication marked the start its medicalization. This refers to the treatment of something – potentially anything – as a medical problem, even if there is little justification. That little justification is: we can treat it. If we have the ability to address any behaviour pattern or unwelcome emotional state with a medical intervention, it becomes a medical condition. Problem gambling and sex addiction, for example, are accepted as medical conditions. Treating them as such precludes any analysis of the underlying cultural conditions that give rise to complex patterns of behaviour that become, in some senses, unwelcome.

So when I hear the likes of Clarke Carlisle, the ex-pro footballer, chairman of the PFA, and Staffordshire University alumnus – and with whom I align myself in his campaigns against racism in sport – talking about depression in football, I have mixed feelings. On the one hand I appreciate that labelling mental states that interfere with normal functioning as illnesses helps remove the stigma once attached to mood disorders. If you manage the symptoms with therapy and drugs, then it serves to de-stigmatize it. On the other hand, it masks the origins or sources of the condition and painlessly negates its social dimensions. Symptoms are treated; causes are identified as within the individual, not his or her surroundings. Medicalization is a dominant force: today, more people are diagnosed with mental disorders than at any time in history. Are we getting sicker, or less “normal”? Or are we just inventing new kinds of mental disorder? The “bible” of psychiatric disorder is a US manual, The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, which is used worldwide as a basis for diagnosis, research and medical education. The 2013 edition contains diagnoses of conditions such as mixed anxiety depression, psychosis risk syndrome and temper dysregulation disorder, as well as the more familiar binge eating. Accepting depression as a sickness means subscribing to what’s called a disease model.

Three particularly influential critiques of the disease model emerged in the 1960s and 1970s. They were those of Thomas S. Szasz (1920- ), R.D.Laing (1927-89) and Thomas J. Scheff (1929- ). In his The Myth of Mental Illness (1974), Szasz critiqued both the concept of mental disorder as a disease, or even illness, and the psychiatric profession that perpetrated it. In a different, though complementary way, Laing (1965) located the causes of behaviours that are seen as symptoms of mental disorders in the family, where he saw destructive conflicts disguised as “love” and “care.”

Scheff’s Being Mentally Ill (1966) proposed that mental disorders are the product of social responses to certain kinds of deviant behaviour. Being normal means conforming to an expected standard. Normalcy is a convention: a customary set of protocols and guidelines as to how we should think and act. Deviations are labelled and those who get stuck with a label find themselves unable to shrug them.

In all these and many related arguments, the complexities and diversity of character and content of what is popularly recognized as mental illness meant that it could not be reduced to the status of a disease or straightforward illness. Mental disorder is experienced in the mind, but the implied arena is larger: private conditions are indexed to social processes.

The terms that come under the rubric of mental disorder are, from this perspective, convenient labels. Once someone gets labelled as suffering from a mental disorder and in need of treatment, whether pharmaceutical or psychiatric (or both) the stigma sticks. This makes it difficult for them to be anything but someone who suffers or who has once suffered from a mental disorder and, in this sense, isn’t totally no

While it may serve the purposes of sport to liken, equate or make mental disorders synonymous with physical illness, we should guard against seeing this as the only way to understand mental disorders. According to many scholars, disordered people are often coping with exceptional social predicaments and their symptoms are more reflections of what goes on outside them than inside them.

Depression and associated mental disorders, even those of the most serious nature, have diverse origins and divergent paths of development. Mental disorders should always be understood in context and conceptualizing them as diseases does not necessarily advance this understanding. Even if it does embolden footballers and other athletes to talk about their problems in public.