By David Epstein
January 12, 2010

"I still think even today that we labor under the burden of this well-intentioned but incorrect stance where people question or downright deny that these drugs work so well."

That quote is from a conversation I had over a year ago with Charles Yesalis, a professor emeritus at Penn State and one of the country's foremost experts on steroid abuse.

Steroids are "an illusion."

That's how Mark McGwire told Bob Costas on Monday that he would reply to Cardinals players who ask their new hitting coach about the impact of steroids. For Yesalis, that's a rather troubling tack. In 2008 Yesalis spoke with SI for a story in which he emphasized how denying the effectiveness of steroids on performance had cost the medical community decades of credibility with athletes. On Tuesday, Yesalis recounted for SI a time in the early 1990s when he attended a meeting of the Federation of American Societies for Experimental Biology and brought along as a panel guest his friend Steve Courson, the late Steelers guard who wrote a book about his own steroid use. When a doctor on the panel hemmed and hawed over whether steroid abuse builds muscle, Courson stood up and said: "Doctor, with all due respect, steroids work like rocket fuel." Yesalis says that had he polled the room of doctors after that on whom they believed, Courson would have won the voting over the more-educated doctor on the panel. Not only do steroids work in building muscle, there is some evidence from a small study in Sweden that the muscles of steroid users remain enhanced even years after steroids are no longer used. In light of McGwire's contention that steroids did not help his performance, SI checked in with Yesalis for his take on the slugger's confession.

SI: What do you make of McGwire's contention that steroids did not help his performance?

Yesalis: To me, he's lost any credibility he might have had in regard to his sincerity. It appears he's trying to have his cake and eat it too, to still have his stature as a player and do a mea culpa at the same time. You can look at how his body morphed from post collegiate to early major league play, to the point where his arms are as big as the thighs of most men.

SI: What about his suggestion that steroids didn't improve his performance because they don't help hand-eye coordination.

Yesalis: Some players have made the argument that you can't make some guy a big behemoth and he's going to be in the majors. But if you have that rare, God-given skill of hitting 100 mph fastballs, and curveballs, and then you make that person bigger, the notion that being bigger after that skill doesn't help you, I can't even take seriously. You take Bambi and Godzilla with the same skill level, who's going to hit the ball better?

SI: So what about McGwire's saying that he will tell players who ask him about steroids that they are "an illusion?"

Yesalis: If I were in charge of a group of young people or in charge of some program where he were going to say something like that, I would say, "No you're not; you're either going to tell the truth, or don't say anything." For example, the reason drug intervention programs might not work on young people is if you lose your credibility, you have the potential to do more harm than good. Young people are aware that these drugs work and that they work remarkably well. I think [saying that steroids are an illusion] would be a very bad strategy if Mr. McGwire were to use that in any type of education.

SI: What are some specific ways in which steroids might help a hitter, beyond just making a ball that he would've hit anyway go farther?

Yesalis: As your forearms become stronger, you can react late to a pitch and still hit it out. You have a certain amount of weight in the bat, and that 35-ounce bat now becomes more like a toothpick, so you can snap it more and go through the ball. It's not only what happens when you contact the ball; you can take a bigger bat. And if you're behind on the pitch and swat at it, what would've been a ground ball or fly-out is now an opposite-field home run. That's why these big guys hit opposite-field homers. The line drive to the warning track will now carry to the fence, and the grounder is faster and might get through two infielders. I could never hit a curveball, so steroids won't make me a major leaguer, but when used by people who have that God-given skill, to say they have no impact has no credibility.

SI: I've heard anecdotally from a few people who have used human growth hormone that their eyesight improves, which would certainly be a benefit to a hitter. Not that contact lenses or laser eye surgery should be banned, but McGwire said that he dabbled in HGH, so do you know anything about that alleged impact of HGH?

Yesalis: I've heard that over the last five years. I'm not keeping up with the literature on that, but I've not seen any clinical empirical evidence, but I have also heard that claim. On the other hand, you have to keep in mind the potential for a placebo effect.

SI: Of course, we know that the effects of anabolic steroids are not an illusion for sick patients, so can you just talk briefly about some of the impact they have in people who need them for medical purposes?

Yesalis: Both HGH and anabolic steroids have been used in wasting associated with AIDS for 10-15 years minimum. They were given to concentration camp victims at the end of World War II to help them rebuild their decimated bodies, and to burn victims. The positive feedback information from the wasting of AIDS is beyond discussion -- they work. They help AIDS patients to regain their strength and sense of well-being and appetite and the like. That's long ago established. And really the notion that these drugs might not help an athlete, the notion that if increased strength doesn't help ... then why do the teams strength-train?

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