Then the conversation turns to Mara Howell and her treatment. As the psychedelic community is small, Doblin has heard about Mara’s story. “I wish it was legal,” he says, “but I like the fact they’re doing it in the home, that it’s integrated into her hospice care, that they have co-therapists and are not limited by treatment protocols to one substance at one specific dose. They’re using the entire psychedelic tool kit at the levels the situation demands. That’s the future.”
How long until we get to the future is another open question. The majority of current research is Phase II trials, but to actually legalize these drugs, Phase III trials are required. These are multicentered trials with large patient populations and will take some time to set up and more time to run. The main reason trials take so much time to set up has nothing to do with the government. “The greatest problem,” says Grof, “has always been recruiting patients.” Doblin points out that while a few scientists may be aware that there has been a psychedelic sea change, that information has yet to trickle down to mainstream doctors. But it will, and soon.
Doblin finishes his dinner in a hurry. He needs to go pack. Tomorrow he leaves for Israel, where he’s consulting on a PTSD/MDMA study, and then to Jordan, where — “Talk about peace in the Middle East,” he jokes — they’re doing more of the same. On his way out of the kitchen, he tells a quick story about an aerobics class he used to attend, where the teacher always showed up stoned and encouraged her students to do the same. His eleven-year old interrupts him.
“But Daddy,” she shouts, “I don’t want to do stoned aerobics.”
Doblin shakes his head and smiles.
“Story of my life,” he says.
11.
An hour after Marilyn and David dance with their daughter, the Ecstasy begins to wear off and Mara’s symptoms return. Everyone in the green room tries to figure out what to do next. MDMA’s effects can be prolonged, so some psychedelic therapists will administer ongoing low doses during life’s final stages both for pain relief and lucidity. Marilyn and Allan go a different route. They decide to alternate sedation days with drug days, for what they believe is the maximum physical, emotional, and spiritual benefit. On his way out the door, Allan leaves enough MDMA for another session.
Mara spends the next day asleep. She can no longer eat or drink. The following morning, Marilyn can’t wake her, but her daughter’s pain is obvious. At noon, Mara becomes slightly alert. Marilyn asks her if she wants to try more MDMA. It takes Mara a long time to answer.
“Yes,” is all she says.
Marilyn puts a tablet under her tongue. Mara falls back asleep. An hour later her breathing steadies and her muscle spasms cease, but Mara still isn’t awake. Marilyn calls Allan for advice and he suggests giving her a second tablet. Marilyn takes his advice, but two more hours pass and Mara remains comatose. Marilyn calls David and tells him to come over. When he arrives, she says, “I don’t think she’s going to wake up again.”
They spend the next few hours holding their daughter’s hands, telling her stories, not knowing what else to do. Then Marilyn is seized by a peculiar notion. On his deathbed, Aldous Huxley had himself injected with LSD, believing the drug would facilitate a “good death.” His wife, Laura, administered the dose. A few weeks back, Allan had dropped off a copy of Laura Huxley’s This Timeless Moment, her posthumous biography about Aldous’s life and his passing. Marilyn picks up the book and begins to read aloud.
All too often, unconscious or dying people are treated as if they were “things,” as though they were not there. But often they are very much there. Although a dying person has fewer and fewer means of expressing what he feels, he is still open to receiving communication. In this sense the very sick or the dying person is much like a child: he cannot tell us how he feels, but he is absorbing our feeling, our voice, and most of all our touch. . . . To the “nobly born” as to the “nobly dying” skin and voice and communication may make an immeasurable difference.
Later Marilyn learns that nobly born is a phrase from the Tibetan Buddhist tradition. She now holds onto the fact that this tradition “places the greatest importance on one’s state of consciousness at the time of death.” Back then, Marilyn didn’t know what to think. She was in the green room, beneath “those fucking angels,” beside her dying daughter. “And for reasons I still can’t fathom,” she says, “I’m reading to her from Laura Huxley.”
And then her dying daughter starts to move.
Mara slides her right hand out from beneath the covers and places it directly inside her father’s palm. Then she lifts her chin and opens her eyes and turns straight toward him. In the past year, she’s lost so much weight that her skeletal aspects have been showing through, but in that moment they vanish. David watches the transformation and can’t believe what he’s seeing.
“She became angelic,” he says later. “She looked radiant.” He also said: “I knew exactly what was going on. She held my hand for about fifteen seconds, and then this look of absolute relief came over her face. Absolute peace. And then she died.”
David had experimented with drugs in his younger days and was never too keen about Mara’s decision to try psychedelic therapy. “I’ll be honest, I had a lot of misgivings about the whole thing.”
But not anymore.
“It was a gift,” he says, “to get to spend that little bit of time with her.”
And her death?
“I don’t know what to say about that. I think her death was a miracle.”
Sympathy for the Devil
THE TROUBLED SCIENCE OF LIFE EXTENSION
In 2006, an editor called to ask if I would investigate a strange claim made by baseball player Jose Canseco — that steroids were the wonder drug of the future. But baseball bored me; everyone knew that steroids were cancer-causing, testicle-shrinking horrors; and anti-aging medicine — which is what Canseco meant by “the wonder drug of the future” — was somewhere between sci-fi fantasy and crackpot city. I wanted nothing to do with the story. But my editor could be very convincing.
“I’ll pay you to do the research,” he said.
“I’ll take one for the team,” I replied.
My plan was not Woodward and Bernstein. This wasn’t about following the money. All I needed to do was convince my editor that these drugs were deadly. In the midst of the biggest steroid scandal in history, I mean, how hard could that be? So I read a few articles in medical journals. And then I read a few more. Next I started talking to experts. And kept talking. Damn if this wasn’t turning into Woodward and Bernstein.
When I started, I was certain that everything I uncovered would be negative. The articles would be thick with warnings about the dangers of these substances and the experts would toe the same line. But that’s not what happened. Not even close. After poring through the literature and speaking to the experts and, well, following the money, I discovered that just about everything I knew about steroids was wrong. Instead of bad drugs, I’d encountered big lies — one of the greatest misinformation campaigns in history, a stealth war of propaganda and politics, and one that has cost millions of lives.
Even stranger, as it turns out, Jose Canseco might actually be right. Steroids appear to be a cure for some of our most intractable diseases and an actual first step toward legitimate anti-aging medicine. They are the wonder drug of tomorrow, and, like everything else in this book, they are here today.
1.
The road to the future is paved in blood — my own. Not too long ago, a nurse went a little crazy with my hemoglobin. Somewhere in the middle of the second vial, I got too dizzy to pay attention, but it felt like she took pints, quarts, gallons, whatever comes after gallons, gleefully mining my veins for any secrets they might conceal. The blood was sent to a medical lab that ran a battery of tests and then, the results were shipped to a doctor named Ron Rothenberg. Besides the blood work, getting in to see Dr. Rothenberg also required signing a ten-page waiver, filling out a twenty-page health and lifestyle que
stionnaire, and the profound willingness to look my medical future square in the eye.
Rothenberg is of medium size, smooth-skinned and strong-shouldered. With sandy brown hair, dark eyes, and darker eyebrows, he looks like a Jewish version of a Latin American soap star, which is to say he looks nothing like his fifty-nine years. He is open about his age, just as he is open about the fact that he feels twenty-five, but unlike most who brag of their youthful virility, because of the way Ron Rothenberg now makes a living, his virility is perhaps no idle claim.
Rothenberg runs the California Health Span Institute in Encinitas, California, and to the limited number of people who know of him and understand the world of anti-aging medicine, he is considered something of a pioneer — which is saying something when you consider that the Western tradition of anti-aging medicine dates back to the 1500s, when Ponce de León accidentally discovered Florida while looking for the Fountain of Youth.
Rothenberg was not trained in anti-aging medicine, because, at the time he was trained, anti-aging medicine was not something one could get trained in. Instead, he graduated from Columbia Medical School in 1970, moved out West, learned to surf, and completed his residency at Los Angeles County–USC Medical Center. He received an academic appointment to teach emergency medicine at the University of California, San Diego in 1977, and became a full professor in 1989. Throughout, Rothenberg kept surfing.
Back in 1975, he was one of the first Americans to venture to Bali to try his hand at those now-legendary Indonesian waves. He has a house down deep in Baja, right in front of one of the better breaks in Mexico. Surfboards hang on his office walls, as do pictures of him riding overhead waves with a charging stance akin to that of Greg “The Bull” Noll. These pictures were taken in 2006, when Rothenberg was fifty-eight, but it was a few years before this — around the time he turned fifty — when his interest in surfing pointed him toward the then-emerging field of anti-aging medicine.
“Around the half-century mark, I saw all these changes in my body,” says Rothenberg. “I felt fuzzy — like I was losing my edge. My energy was low, my libido was low, things didn’t look as good as they used to. When I went surfing, I got winded on the paddle-out. I wasn’t used to getting winded. I read a Newsweek article about the anti-aging properties of DHEA and started to wonder if there was something I could do about the way I was feeling and the changes my body was undergoing.”
Rothenberg got in touch with the then nascent American Academy of Anti-Aging Medicine and began reeducating himself. “Most doctors are frozen in time,” he says. “They stop learning when they get out of medical school. Unfortunately, one of the first things they teach you in medical school is that nearly half of what you’ll learn there is wrong — only no one is exactly certain which half.” One of the things Rothenberg learned in medical school was that time marches on and aging is an unstoppable process — turns out, this was part of the half that was wrong.
How wrong is still a matter of debate, but few disagree that the version of anti-aging medicine as practiced by Rothenberg and his cohorts represents one of the more radical departures in Western medical thought to surface in centuries. “Traditional medicine is reactive, disease-based medicine,” says Dr. Robert Goldman, chairman of the American Academy for Anti-Aging Medicine. “Anti-aging medicine is the opposite. It’s about finding the problem and fixing the problem before it occurs. If sports medicine is about optimizing the body for maximum athletic performance, then anti-aging medicine is about optimizing the body for living in general.”
Goldman believes that anti-aging is the future of medicine. And Ron Rothenberg was one of the first to venture into that future. He became the tenth doctor in the world board-certified in anti-aging medicine and, in 1998, among the earliest to begin seeing patients. Truthfully, he had been self-medicating for a little while before then, and his earliest patients were fellow doctors who noticed that Rothenberg seemed younger, faster, and stronger, and wanted some of that magic for themselves. His prescription for them was very similar to his prescription for me — and this is where the road to the future takes a sharp left turn — because the basis for both prescriptions was hormones. Though, as Rothenberg likes to point out, “There’s a joke in the medical community: When someone has something nice to say about the work we’re doing, they use the word hormones. When they don’t have something nice to say, they call them steroids.”
And these days, plenty of people have plenty of not nice things to say about steroids.
2.
Oh, the trouble started a long time ago — and we’ll get to that story — but its more recent incarnation arrived in 2006, when former baseball star Jose Canseco published Juiced, his book about “wild times, rampant ’roids, smash hits, and how baseball got big.” In Juiced, Canseco claimed that 80 percent of ballplayers were using steroids, and then proceeded to name names. It was also in Juiced where Canseco argued that steroids are the wonder drug of tomorrow. “[Soon] everyone will be doing it,” he writes. “Steroid use will be more common than Botox is now. Every baseball player and pro athlete will be using at least low levels of steroids. As a result, baseball and other sports will be more exciting and entertaining. Human life will be improved, too. We will live longer and better. And maybe we’ll love longer and better, too.”
The government, of course, has been delivering the exact opposite message for years — with the website for the National Institute of Drug Abuse (NIDA) being one example: “Steroid abuse may lead to serious, even irreversible, health problems. Some of the most dangerous consequences that have been linked to steroid abuse include kidney impairment or failure; damage to the liver; and cardiovascular problems including enlargement of the heart, high blood pressure, and changes in blood cholesterol leading to an increased risk of stroke and heart attack (even in young people).”
Unfortunately, as has often been the case with drug policy, the gap between politics and science is considerable. “As used by most people, including athletes, the adverse effects of anabolic steroids appear to be minimal,” says Dr. Mauro Di Pasquale. “Steroids do not cause cancer. They don’t cause kidney failure. There have been thousands of steroid studies and about a hundred of those point out bad side effects. But if you look at those studies carefully, there’s no one-to-one correlation, and a one-to-one correlation is the hallmark of good science.”
And Di Pasquale would know. A former world champion power-lifter, he is also a medical doctor — a family practitioner for over twenty-five years — and one of our foremost authorities on performance-enhancing drugs. In the early 1990s, when World Wrestling Federation founder Vince McMahon decided it was time to get his empire off the juice, Di Pasquale was the one who got the job. He later became the medical director to the World Bodybuilding Federation and the acting medical review officer for NASCAR, helping both sports develop their stringent drug-testing policies.
With steroids, Di Pasquale points out, it can be hard to wade through the propaganda. “Consider the apocryphal idea that steroids produce ’roid rage,” he said. “What we know is that steroids produce an incredible amount of energy — but you need to think about the kind of people taking steroids. If really competitive and aggressive people start taking drugs that give them more energy, then common sense says that sooner or later you’re going to have problems. But are steroids the problem, or the fact that this person didn’t know how to control their anger long before the steroids came along?”
Which is not to say steroids aren’t without complications. When teenagers take them, because their bodies are still producing significant amounts of natural hormones, the results can be disastrous. In adults, there are also issues — especially at higher doses. Weightlifters, for example, ingesting ten times the normal amount will see excessive hair growth in unwanted places, premature baldness, development of breasts (in men), and an enlarged clitoris (in women). Men are also at risk for testicular atrophy. It is also worth pointing out that these conditions tend to go away once they stop u
sing steroids. As far as long-term effects — negative or positive — until very recently, almost nobody had studied them.
One of the first such investigations was undertaken by UCLA orthopedic surgeon and sports medicine specialist Nick Evans. In the early 1990s, when the original Steroid Control Act was passed (an updated version was re-passed in 2004), much was said about the dire consequences of sustained abuse, but there was little science backing up such claims. So Evans got curious. He figured if anyone knew anything about the long-term consequences of steroids, it would be weightlifters. Evans discovered that nobody had ever bothered to ask them. “It’s the craziest thing you’ve ever seen,” he says. “It was like scientists bought into all the negative hype and propaganda and never bothered to walk into a gym and talk to a bodybuilder.”
Evans had no problem talking to bodybuilders. He talked to plenty. In 1996, in the British Journal of Sports Medicine, he published the results of those conversations: “Gym and Tonic: A Profile of 100 Steroid Users.” This was followed by an even more rigorous look at 500 long-time juicers. In both studies, Evans’s findings agree with Di Pasquale’s conclusions. Even in long-term abusers, he found no concrete links between these drugs and the dangerous side effects — like those listed on the NIDA website — with which they’re often associated. In fact, the only real concern he has is for those people taking super-high doses for years at a time. “The issue is the heart,” he explains. “The heart is a muscle, and steroids increase muscle size. If the heart starts getting bigger, it becomes less efficient at doing its job, and, over time, that can cause big problems.”
But Evans also feels that if steroid users had access to proper medical advice, many of these problems could be avoided. Though, because of America’s current drug stance, very few have access to such advice. This is also among the reasons that Evans finds America’s steroid policy slightly ridiculous — not because he believes that people should be taking steroids, rather because of the reasons most people are taking steroids.
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