Chemicals don’t care what you call them.
Performance-enhancing drugs are great. They enhance performance, and isn’t enhanced performance good?
Look: today I felt grumpy. So Partner grabbed me a pearl tea: sugar, plus a substance the Olympics banned until 2004. Twenty minutes later I was up and rolling, knocking out work I’d been avoiding for three weeks. It got me thinking.
The classifications we give – food vs supplement vs medication vs drug vs illegal drug – are not chemically meaningful. If you eat the vitamin C that’s in an orange, that’s called eating an orange. If you take the same amount of vitamin C in pill form, that’s called taking a supplement. Yet we think about these very differently. The exact same chemical process that ten years ago was called doing drugs is now called “doctor-prescribed medication for sleep” (cannabis).
Why does our society (all societies?) have these classifications? We want to restrict some behaviors: for the safety of others, for the safety of the individual, or for reasons that aren’t about safety at all.
The biggest not-about-safety category is purity: questions of what a human is, and what appropriate human behavior looks like. So what’s with the obsession with purity?
I’m reminded of a lawyer who built a Supreme Court practice by soliciting: He would identify cases the Court might take, contact the potential plaintiffs to inform them of their potential case, and end up arguing before the Justices. Chief Justice John Roberst pooh-poohed this: “If I’m going to have heart-bypass surgery, I wouldn’t go to the surgeon who calls me up.”
But actually, wouldn’t you? Let’s run the thought experiment. A surgeon approaches you out of nowhere: “Based on the shape of your face, I know that you have obstructive sleep apnea. I’m a medical doctor. I studied at this school. I’m not some quack making things up: here are the rigorous scientific tests you can take to verify what I’m telling you. And get a second opinion, if you like.” I would think: that’s excellent.
In fact, this is roughly what happened to me before my jaw surgery. After six doctors’ worth of searching, I found Dr. Christian Guilleminault – one of the founders of the field of obstructive sleep apnea, since passed. While he hadn’t found me on the street, his diagnosis was as unsolicited as they come. He looked at my face and said: “I can tell by the shape of your face that you were a rambunctious child.”
What a funny thing to say!
He followed it up with, “We will send you in for the lab tests, of course, but I already know what they will say.” He then predicted the results, which aligned perfectly when the tests came back a few months later. That’s the doctor I want to hire!
So much of our restriction runs on purity. But purity is not itself good for the individual. Purity puts the individual into a particular game — a game they can win only by behaving in one specific way, and a game they never asked to play.
The purity game is about packaging. Take virginity, the archetype of purity: a woman who is chaste, who follows the virginal pathway, receives adulation for it. There are other pathways to adulation. Purity just happens to be the lowest common denominator (for women in a specific slice of society).
I drastically prefer informed consent. The biggest danger with performance-enhancing drugs — with drugs, period — is the unknown unknowns. You have to know and understand not only the limitations of the drug itself, but the limitations of our knowledge about the drug. We do this poorly as a society, because much of a doctor’s job is to demonstrate confidence and instill calm. They act, one could fairly say, like a con man. The onus is therefore on you the patient to work out the actual epistemology of your circumstance. It is frequently much less certain than any doctor, drug manufacturer, or therapist would have you believe.
External games like purity are other people’s scoreboard. Informed consent is your own: you, the substance, and an honest approximation of uncertainty. To enhance performance, choose the right substances. To choose the substance, know the limits of what’s known.
Today I consented, informed, to one highly-caffeinated pearl tea. Three weeks of avoidance, cleared. Enhanced performance. Fundamentally good.
Julian Wise 