By Andrew Blecher, MD

I am a fan of the Olympic Games and look forward to them every four years.   I was an All-American sprinter myself, having competed against some Olympic medalists, and have a special interest in Track and Field. This is the perfect example of a sport that doesn’t get so much exposure outside of the Summer Olympics, so the events become a stage for athletes in these fields to shine in the rarer-than-usual limelight. The 2012 Olympic Games are underway and as a former athlete and fan, I am looking forward to some amazing performances.

But I am also a sports medicine physician and have treated many elite level athletes, including Olympic Champions. This adds an additional perspective for me as an onlooker- layered within a former athlete, fan, and doctor-and one that I have a hard time coming to grips with. The 2012 Olympic Games are underway and I am looking forward to some amazing performances. The question is, will I believe them?

It seems that every Olympic Games is defined by displays of incredible athleticism. In Beijing, for example, there was Jamaican sprinter Usain Bolt’s effortless destruction of Olympic records and acquisition of multiple gold medals. There was also Michael Phelps’ complete domination of men’s swimming and simultaneous record-setting. We see these athletic accomplishments and ask ourselves, “Oh my God, how did he do that? Is he just THAT much better than everyone else?” To answer these questions we look at their training, their determination, their genetics and their God-given abilities. But we can’t help but ask ourselves if there is something more. Why do they have such an edge over everyone else? Could performance enhancing drugs be involved?

It’s not that this question is something new that is borne out of some naiveté. It comes from our own experience. It comes from having been burned before with amazing past performances. In Track and Field, Ben Johnson and Marion Jones come to mind. We are initially awed and inspired by their accomplishments, only to be deflated later on when we find out that they were cheating by using performance enhancing drugs. And it’s not just the Olympics. This thinking permeates all sports, whether it is Bonds and Clemens in MLB, Armstrong in cycling, Merriman in the NFL, the list goes on and on to include drug cheats and those simply suspected of it. Whenever someone significantly outperforms their peers, we always wonder how they did it.

The athletes themselves don’t do much to help ease our conscience either. They all admit that they are looking for every single performance advantage that they can utilize. It might be the newest training methods, the newest equipment and technology, sports supplements or hyperbaric treatments, anything else which gives the athlete a sense of advantage, whether this advantage is proven or not. There was one anonymous study that asked whether Olympic athletes would take a performance enhancing drug if they were guaranteed to win a gold medal and never get caught. Over 80% said yes. When the question was asked again but this time the drug had a side effect that would kill them in five years, surprisingly the majority still said yes. This is how strong the desire to win is for these athletes. They are literally willing to risk their lives for it. With this mentality, how can we not believe that many choose the route of performance enhancing drugs, especially when they believe that they need to use them just to compete with everyone else who is?

The IOC banned the use of performance enhancing drugs in 1967. Since that time, there have been over 100 athletes that have been caught and disqualified. Medals have been returned and world records have been erased. The London Olympics will now perform more drug tests than ever before. With over 10,000 Olympic athletes at these games, more than 6000 samples will be tested, including medalists and those randomly selected. Not only is this a large number of athletes but there will also be new tests administered that have not been administered at any previous Olympics. Blood and urine samples will be tested for anabolic steroids, HGH, stimulants and over 240 prohibited substances. Samples will be collected, tested and also saved. “Biological passports” will be created. The hope is that even if we can’t test for something today, we can save the sample to test in the future when we have the technology to test for something new.

This is the threat that is supposed to be the deterrent for the athletes from trying to take something new. But does it really work? There have already been 9 Olympians that have tested positive in the last few days and this Olympics has barely even begun. Therefore it’s safe to say that the deterrent probably doesn’t work, but the testing does. In fact some athletes from previous Olympic games are currently under investigation for new test results just completed with new technology. So as a scientist, I have to believe that eventually we will have the technology and the will to catch those that are cheating. The question is, how long will we have to wait to catch them?

When I see an amazing Olympic performance in the next week, can I cheer after they cross the finish line or should I wait until their drug testing is complete before I give them praise? Or maybe I should wait four years just to make sure they don’t get caught. Or maybe I have to wait until long after they retire to make sure we don’t have another Marion Jones situation on our hands. What are we to do?

The answer is this. When I go to see an action movie I enjoy the movie for what it is. I know that some of the story line and stunts are unbelievable and are just created on a Hollywood set. It’s not real, but during the movie, a good movie, I get caught up and suspend my disbelief. I enjoy the film and when I am walking out of the theatre I am adrenalized. It may only be later on that I realize that what I saw was fictional, but it doesn’t take away from my enjoyment of the film. So let’s see what kind of action and drama these Olympics create. Will it suspend my disbelief? We will know in the coming days. How long will it last? I guess only time will tell.

Dr Andrew Blecher is a Board Certified Sports Medicine physician at the Southern California Orthopedic Institute. He provides care for both amateur and professional athletes including youth sports, high school and college, and he also has experience as a team physician in the NFL and NBA as well as for the Los Angeles X-Games and USTA. You can follow him on Twitter for the latest sports medicine news and performance enhancing drug information: @the_jockdoc.