When Oprah Winfrey spoke with the United State’s most feted and reviled cyclist, it was billed as one of the biggest interviews the talk show host had ever conducted. This was the moment when Lance Armstrong confessed to using performance-enhancing drugs to help him win the world’s most prestigious bike race, the Tour de France, an unprecedented seven consecutive times.
He had broken the sport’s most stringent rules and deepest moral codes. But he was not the only one. He cited the “EPO generation” in cycling. (EPO, or erythropoietin, increases the blood’s oxygen-carrying capacity and is banned in cycling). “I didn’t have access to anything else that nobody else did,” he said.
“You didn’t think it was possible to win without doping?” asked Winfrey.
“Not in that generation,” said Armstrong.
Sports can be seen as a microcosm of what is happening in society at large. The pressure to compete and outperform personal goals, mixed with a highly technologized culture, is blurring the boundaries between humans and artificial enhancement and calling into question the traditional idea of fairness.
Students, for example, are misusing drugs that are usually prescribed for psychiatric disorders to boost exam grades. As many as 16% of U.S. students and 10% of UK students admit to using performance-enhancing drugs to improve their academic results, according to work by professor Barbara Sahakian, a psychiatrist at Cambridge University. Limited evidence shows that these techniques can work. But such students are not doing anything that their supervisors do not do themselves. An online poll by the journal Nature found that out of 1,400 academics, one in five claimed they had used cognitive enhancers, such as the sleep-disorder drug modafinil, to improve performance or cope with jet lag.
Silicon Valley start-up executives have also been tampering with their nervous systems in the hope of boosting productivity. Provigil, which is manufactured by the Frazer, Pennsylvania-based drugmaker Cephalon, is designed to improve wakefulness and has been approved for prescription by the Food and Drug Administrator as a treatment for narcolepsy, obstructive sleep disorders and those who cannot sleep because of shift-work patterns.
But executives, who boast of increased concentration and mental stamina while on the drug, use it to put in 20-hour days. It is non-addictive, and its only apparent side effect is weight loss. Huffington Post journalist Johann Hari, who took Provigil for an article he wrote on the subject, said he became more productive—but also more withdrawn. Ultimately, he worried about the long-term effects of the drug; the impact on people who take it recreationally is unknown.
Workers are also using marijuana, which is available in California and 17 other states for medical purposes. Doctors can recommend—not formally prescribe—the drug for those seeking relief from migraines, arthritis or “any other illness for which marijuana provides relief.” San Jose has 106 marijuana dispensaries clustered around such tech giants as Adobe Systems, eBay and Netflix. The Palliative Health Center, which is based in the area, has its own professional cannabis pastry chef, and users can phone-in edible requests to order. It said that 40% of its clients were tech workers. The drug is often used to alleviate the pain caused by long hours sitting at desks writing code, which can lead to back and wrist injuries. And while area companies forbid the use of illegal drugs on their premises, almost none actively test for it.
Benefits and Controversy
The most obvious beneficiaries for such enhancement have been those with physical or cognitive impairments, or those growing old and wanting to stay in the workplace. In these areas, relatively moderate enhancements can lead to big gains in productivity and performance. In many cases, they can make the difference between being able to work or not.
“Something as simple as having the right kind of lighting at work for people suffering from some degree of sight loss can make all the difference,” said Malcolm Fisk at the Age Research Centre at Coventry University in the UK. In fact, he said, academic studies have shown that those exposed to certain types of light enjoy enhanced subjective alertness, well-being and visual comfort. Prosthetic limbs, devices to improve hearing and sight, and online communications have also helped people get back into work.
Even though restorative environments and technologies have been creeping into the workplace, some interventions have proven more controversial. Helen Mayberg, professor of psychiatry, neurology and radiology at Emory University School of Medicine, has been working on procedures that restore normal life patterns among people suffering from acute depression.
She is the inventor of a deep-brain stimulation technique that can snap patients out of recurring episodes of treatment-resistant varieties of the illness. During lengthy surgery, her team implants electrodes into those brain areas thought to be associated with depression and effectively “unblock” the region, allowing the brain to return to more normal patterns of activity. The results are immediate and, where successful, lasting.
“We return the brain to the person,” said Mayberg. Some who underwent the procedure were able to return to their old jobs while other, severe sufferers were able to begin caring for their children again after surgery.
Mayberg is working at the cutting edge of science and is not without her detractors. She accepts that the metrics on the level of success need improvement—not least to take account of the way that families often resist the change in the patient and can affect the direction of recovery. Her work demonstrates that enhancements are not a quick fix and that any accurate assessment of their effectiveness and potential risks needs to account for a wide range of factors.
But neither society nor technology is willing to wait. A cursory glance at YouTube reveals a thriving sub-culture of self-experimenters documenting their non-scientific adventures in cognitive and physical enhancement. By turns funny, sad and baffling, they indicate a shift in attitudes to such techniques. And they suggest that the issues raised by Lance Armstrong’s fall from grace are likely to move center stage in both work and play in the 21st century.
The feature first appeared in Risk management magazine in the US.