In April 2010, Yankee pitcher, Bartolo Colon, received experimental stem cell therapy to mend torn ligaments in his elbow and shoulder and a torn rotator cuff. The procedure involved taking some of his stem cells from bone marrow and fat tissues and injecting them in the elbow and the shoulder. Since then, he has been back in the game again pitching as he did pre-injuries. The therapy was experimental and was done in the Dominican Republic. And while the Dominican Republic has dragged its heels on releasing Colon’s medical records, things seem to be on the up-and-up regarding this procedure. The MLB commission is investigating whether Colon received any banned substances along with the stem cell procedure as well as whether this procedure is within regulation. (See this New York Times article and this New York Daily News article for background.)
Here are the ethical issues that seem to be presented here:
Human growth hormone (HGH) is a banned substance that is touted as a wonder drug for the veteran athlete. See this Mayo Clinic article for a brief description on myths and facts about HGH. In short, we all make HGH until we are about forty years old. If a teen or twenty-something were to take HGH, there would be no effect because they are already making the hormone. If a middle-aged person takes HGH, they will notice some slight changes, like firmer skin, scars that disappear, and bones and injuries that heal faster. Their bones and bodies are healing faster, like when they were young – think about the little boy who wears a cast for four weeks versus the middle-aged man who wears a cast for six-to-nine weeks to heal the same type of fracture. The doctor who did the stem cell therapy on Colon is known to use HGH which is illegal for professional athletes. Is Colon covering up the use of HGH by saying that he received experimental stem cell therapy? Maybe he actually did receive stem cell therapy, but did he also use HGH? This is still under investigation.
It is worth noting that since adult stem cells are being used in this procedure, the stem cell source is not morally objectionable. As far as the procedure itself, obtaining bone marrow can be painful, but this procedure is technically minimally invasive. However, it is an experimental procedure, so not all risks are known.
- Therapeutic vs. Enhancement
This seems to be a therapeutic procedure. I do not follow the Yankees or their stats nearly as much as my Texas teams, but from what I understand, Colon is throwing well, but not necessarily better than ever. He isn’t breaking his own personal record or other pitcher’s records at age 38, including oldest pitcher. He is, apparently, back to his pre-injury skill level. To me this seems to be a therapeutic procedure more than an enhancement procedure, but this is not a clear-cut, black-and-white issue. I wrote an article on the use of anabolic steroids several years ago when the Mitchell Report was out. The steroids make a player’s body do what it was never designed to do. Not everyone was designed to build that much muscle, and the consequences of stressing your joints and ligaments with loads they were never meant to take can cause permanent damage.
The reason why this is not a clear issue is because the therapy is to correct injuries are the result of age and use, but not every pitcher has the same problems as they age. The question is: Is this part of the natural consequences of aging or is it fixing an injury? Is Colon getting an unfair advantage over other players? Certainly, I am less likely to injure ligaments in my elbow and shoulders because it’s not part of my job to use them to their full potential every day. By way of example, however, I am a runner. Not a professional runner, by any means, but does this mean that if I am dealing with a nagging knee injury 20 years from now I should chalk it up to old age? Good-bye track; l hello pool? I do preventative things now for my knees, liking icing and stretching in hopes that I will not have to make that decision later, but some people have bad ligaments and some don’t. As one orthopedist I know said, “Some people have forty year knees, some have eighty year knees.” If there is a therapy out there to fix a knee injury, is it fair for runners with this therapy available to them to use it and compete in races in their age range?
The last issue is what I believe gets people a little uneasy about this procedure. It’s the athletes’ attitude. Whether we’re talking about Brett Farve or Michael Jordon or Lance Armstrong or some of the less famous, athletes are who they are because they are not quitters. They will push themselves to the limit and do what it takes to win. But the one foe that they will never beat, no matter how hard they try, is old age. Eventually they are going to get too old to play the sport professionally, and no amount of physical therapy, green tea, and weight lifting is going to stop it. But, they will most certainly try. I am not a professional athlete (so this might be me stretching), but here’s what might be going through my mind: Is it fair that Colon at thirty-eight years old gets some experimental procedure and now gets to live even one more year in the spot light while I had to go through the difficult transition of retiring at a ripe old age of thirty-five? Is it fair that he gets to wipe away the wear and tear while I never had that opportunity? After all, at 38, your mind is sharper than ever, even if your body is “slowing down” a bit. How much better can an athlete be with experience and maturity under his belt?