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The Modified Man

[Quotes CGS's Richard Hayes]
by Carl T. HallCalifornia
July 3rd, 2008

Nobody's perfect. Not even Tim McNeill. A three-time All-American gymnast and team co-captain at Berkeley, in April McNeill won two NCAA individual championships competing at Stanford's Maples Pavilion. He keeps up a 3.5 grade point average despite a rigorous training schedule. He's even managed to maintain a yearlong relationship with a nonathlete (a high-achieving sociology major). His latest titles, on both pommel horse and parallel bars, bring his career total to five-more
than any other Cal athlete. At the Stanford meet he was "just lights-out better than his competition," says Ryan Cobb, head athletic trainer. This spring, the 22-year-old earned himself a spot on the U.S. Senior National Team, giving him a shot at the biggest prize of all this summer: a ticket to Beijing and a chance for Olympic gold.

"This is what I love to do," he says. "I love going to practice and competing. If I could do this the rest my life, I would."

If only he could.

Like some high-performance two-seater sports car in human form, McNeill's 5-foot-6, 135-pound body seems ideally suited for its purpose: light and fast, strong and supple, arms a little long for extra elevation on the pommel horse. But even the most expensive Ferrari-or elite gymnast-can break down when pushed too hard.

McNeill has had severe knee problems ever since he tore a frayed patella tendon in a stiff-legged landing on Halloween of his freshman year. He's had more than his share of shoulder troubles from his punishing routines on the rings. He takes strong pain pills daily, and gets spinal injections when the pills aren't enough to cope with a back injury he suffered at 16. The pain was so intense he couldn't finish a Conference meet in April-the first time in his career that had happened-and he could barely walk, let alone practice, leading up to the all-important nationals. At Stanford, he had to sit out the first day of the grueling three-day competition, saving himself for his best events.

After this year's collegiate season ended, he strolled into Haas Pavilion to talk to me between classes and looked relaxed enough in loose jeans and untucked T-shirt. But even then, his pain level was barely tolerable, at least a 3, he says, on a scale of 1 to 10. "The pain is pretty constant. I'd say 90 percent of the time I am performing I am not healthy, or even close to healthy."

So it wasn't too surprising to find McNeill intrigued to hear about some potential new ways of tuning up the human machine-enhancing its potential, let's say, to stick a dismount without tearing out a tendon. It's speculation, of course, but clearly possible given enough advances in areas such as gene therapy, stem cells, and tissue engineering. Bioethicist Ronald Green, author of the 2007 book Babies by Design, presents the case for modification, arguing that although gene manipulation can be dangerous and lines must be drawn to guide its use, it can wisely be incorporated "into the ongoing human adventure."

Green, during an interview, brought up Hall of Fame hitter Wade Boggs, whose superior eyesight must have contributed to his lifetime .328 batting average. Maybe a safe and effective gene swap can give virtually any child 20/15 vision. Such techniques almost surely will be developed sooner or later, Green says, though for reasons that have little to do with picking up the seams on 100 mph fastballs (or maybe 150 mph fastballs, if pitchers also are genetically enhanced by then). And we will almost inevitably be pushed beyond current performance limits in a new era of "directed evolution." In this scenario, future Berkeley gymnasts might compete using fundamentally better components than those so prone to breakdown in McNeill and his peers.

The idea of bioengineered superjoints and high-tech performance muscles, perhaps even built into children before they're born, has long been fodder for science fiction writers. And like time travel and androids, messing with the human genome is to many people a disturbing notion. "There is something unsettling about the specter of genetically altered athletes lifting SUVs or hitting 650-foot home runs," notes Michael Sandel, a professor of government at Harvard and author of The Case against Perfection: Ethics in the Age of Genetic Engineering. It pushes right up against some of our basic ideas of human value. We accept that we have defects, and that our humanity has something to do with our drive to overcome what limits us.

But a little tinkering with what's inside us doesn't sound immediately off-putting if you happen to be an elite athlete struggling to stay healthy. "I would have to think about the ethical issues around that, but at first thought it sounds like a pretty good idea," McNeill says. "With every injury I've had, I've just prayed and hoped there was a quick fix to it. There hardly ever is. In terms of biologically altering joints and muscles to prevent injuries, I think that could be a step in the right direction for gymnastics, because a lot of the time at big competitions it's not the best gymnast that wins. It's the healthiest gymnast that wins."

At the northern edge of San Francisco, where the Golden Gate Bridge and the Marin Headlands dominate about as perfect a view as anyone could engineer, people who have served this country in uniform now arrive at the San Francisco Veterans Administration Medical Center to get treatment for their wounds. Dr. Hubert Kim, director of a cartilage repair and regeneration project at UCSF and the San Francisco VAMC, has no lack of clients for his studies.

Kim and his colleagues are among the pioneers of a new era of gene-based medicine. They are studying the mechanisms of muscle atrophy-how genes and their regulatory molecules kick in and degrade the muscles after an injury or surgery. "Say you're laid up, you're in a cast, or you're an athlete who's had an ACL reconstruction. Almost immediately your muscles undergo atrophy, and it takes a long time to build up those muscles again," he says.

Transgenic mice have been developed that lack some of the gene products implicated in muscle atrophy. When these mice are experimentally given the equivalent of an Achilles' tendon blowout, they recover muscle strength in half the time as ordinary mice. The goal now is to find some way to knock out these genes in humans without doing more harm than good. Kim's focus is on helping patients recover normal function, not on helping star athletes get an edge. But the implications for sports seem pretty obvious. "The goal is to identify therapeutic targets to delay the progression of atrophy after an injury. So maybe an athlete could lose half as much muscle and therefore get back in the game sooner, just because he hasn't lost as much," Kim says. This could be done rather simply, without much controversy, if it turns out that a safe and effective treatment is found and used solely to limit harm and to speed recovery from an injury.

Some tricky questions arise, however, when such interventions cross over from treatment into performance enhancement. It's entirely possible that a method to limit muscle atrophy after an injury could be beneficial to a healthy athlete trying to get stronger in a hurry. "The injury recovery piece is one thing, and how to enhance performance is another," says Dr. Tom Vail, chief of orthopedics at UCSF. "It's such a gray area. Altering physiology-that is essentially what elite training does, in the most positive sense."

In top-ranked collegiate and professional athletic programs, expert trainers and sports medicine practitioners tailor programs for each competitor, so that particular muscle groups and other physical components get better, thereby enhancing performance. That's no more controversial than running up flights of stairs or lifting weights.

Says Vail, "Where it becomes almost uncomfortable to talk about is when you wonder, 'Well, where does it go from there?'"

At UCSF, Dr. Cynthia Kenyon is pursuing the genetics of aging. She and her colleagues have bred long-lived mutant laboratory animals that would be the equivalent of 90-year-old humans who physically resemble 45-year-olds. If similar results can be had in humans, Kenyon says, the payoff would go beyond mere longevity, or some drawn-out twilight years. "You're basically staying young longer."

It doesn't seem much of a leap to imagine 50- or 60-year-old superstars still competing at the highest level of sports, rather than coaching as happens nowadays. A bigger leap takes us into the realm of tweaking the genes of embryos in order to pass along these new and improved traits to a future generation. Very quickly, scenarios spring up of enhanced trans-humanist superathletes whacking 1,000-foot home runs or throwing 100-yard passes with pinpoint accuracy.

Even setting aside the idea of germ-line alterations, the mere idea of genetically enhancing adult athletes strikes many on the front lines of sport as absurd, if not truly dangerous. At Berkeley, it's filed under the general header of cheating, and it's rightly banned by international sports authorities. "Some of the lines are drawn very clearly for us," noted Cobb, the Berkeley athletic trainer. "The NCAA draws the line on anything that changes someone's chemical makeup, anything changing the body's physiology by putting a chemical in. What we are allowed [are] the technology and planning and thought-through processes for training somebody." Mike Blasquez, head strength and conditioning coach, just shook his head at the idea of genetic enhancements. "You're talking about changing athletics as we know it," he says one afternoon in an office inside Haas Pavilion. "As a performance person, I believe in training. I believe in preparation and work. I just have a really hard time looking in that direction for the answer to better performance."

He's hardly alone. Even the bioethicist Green, who argues for a thoughtful approach to gene technology, says it would be unethical to use it merely to gain a competitive advantage in sports. Others go further and argue against virtually all uses of the new technologies that exceed treating injuries and illness to enhance what is normal. Drawing such a line may be tricky, as researchers already realize, but it must be done anyway.

"We want to use genetic research for medical reasons," says Richard Hayes, head of the Center for Genetics and Society in Oakland, a liberal research and advocacy group. "But we don't want to go down the road of creating genetically enhanced superathletes." The reason, he says, goes to the heart of sports and "what it means to be human." Hayes worries about the loss of "a common human community with a common human future," which in turn can threaten basic principles of democracy. "If people feel their futures are no longer a function of what we decide as a community, but of what genes we insert in our children, that can undermine the very foundations for our commitment to democratic institutions."

And yet the debate may not easily be settled. For some, at least, getting a handle on the course of human evolution may be the ultimate expression of our human ingenuity. After all, aren't we defined as a species by our ability to adapt? We may never make ourselves perfect. But is it wrong to consider new ways to make ourselves better?It's hard to say where Tim McNeill's passion for gymnastics might have originated. Some of it may run in the family. His younger brother Robbie is also a standout athlete, a diver finishing his freshman year at the University of North Carolina. And Robbie has had to persevere through back injuries just as Tim has.

To succeed, it takes the kind of single-mindedness that has kept the Cal gymnast working six days a week since age 15, competing through pain, and not once joining his college friends for a skiing or snowboarding trip to the mountains, for fear of risking injury. "Certainly there's a part of me that would want a normal life," McNeill says. "Especially right after an injury. I get so frustrated when I can't practice. But I've been in it so long, I know that giving up is not an option.

"It's been what I've done with my entire life," he adds. "To give up something like that, something that I've worked at for so long, would just be ridiculous."

Carl T. Hall is a science writer for the San Francisco Chronicle. He has been on a leave of absence since fall 2007 helping newsroom employees organize a new unit of the Newspaper Guild at the Contra Costa Times, Oakland Tribune, and affiliates in the Bay Area News Group-East Bay.


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