A moral flaw or neurophysiologic deficit?

In part one of a two part interview with Oprah Winfrey aired on January 17, 2013, Lance Armstrong admitted to using performance enhancing drugs throughout much of his career, including all seven Tour de France wins…. In part two of the interview, aired the following day, Armstrong said that while doping, he neither felt that it was wrong nor felt bad about what he was doing.

Many who watched Oprah Winfrey’s two-part interview with Lance Armstrong have commented that they didn’t feel that Armstrong’s apology for having doped was sincere. During the course of those interviews Armstrong certainly admitted that he had doped repeatedly in order to maximize his cycling performances to win. What he didn’t do was pass value judgment on his actions. In short, he failed to demonstrate sincere remorse for the actions themselves. Listening to the interviews, you get the feeling that Armstrong’s agenda was to orchestrate whatever would be necessary to allow him to be reinstated as a bona fide competitor in the world of sport.

On October 2, 1996, then aged 25, Armstrong was diagnosed as having stage three (advanced) testicular cancer. His brain tumors were surgically removed by Scott A. Shapiro, MD, Professor of Neurosurgery at Indiana University and Resident Director, and were found to contain extensive necrosis. In February of 1997, he was declared cancer-free.

Armstrong’s testicular cancer had metastasized to the orbitofrontal regions of the brain, the same regions which we now know are largely responsible for the development of our moral sense. These were the regions that were destroyed by an iron tamping rod in the case of Phineas Gage, the 19th century railroad worker. According to eye-witness accounts, Gage underwent marked changes in his personality after the accident.

His contractors, who regarded him as the most efficient and capable foreman in their employ previous to his injury, considered the change in his mind so marked that they could not give him his place again. He is fitful, irreverent, indulging at times in the grossest profanity (which was not previously his custom), manifesting but little deference for his fellows, impatient of restraint or advice when it conflicts with his desires, at times pertinaciously obstinate, yet capricious and vacillating, devising many plans of future operation, which are no sooner arranged than they are abandoned in turn for others appearing more feasible. In this regard, his mind was radically changed, so decidedly that his friends and acquaintances said he was “no longer Gage.”

Could it be that part of Lance Armstrong’s narcissistic and sociopathic behaviors are the direct result of insults to orbitofrontal regions of the brain? If so, to what extent might he be neurophysiologically incapable of demonstrating remorse for lying about doping?

I do not raise this question to justify Armstrong’s actions, which were illegal; but rather to pose the possibility that he might be incapable of showing sincere remorse for those actions.

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3 comments on “A moral flaw or neurophysiologic deficit?

  1. Michael Kincaid says:

    Very interesting post! I have been a big fan of Lance Armstrong for many years. I even won a bid on a framed photo of him at a fund-raiser for the Tx Academy of PAs several years ago—it’s on the wall in my front room; I haven’t taken it down yet, but I keep thinking about it. Thanks for giving me something new to think about.

  2. Alexander Bayne says:

    Interesting. Never thought of that. A

  3. djelpern says:

    Yes. Interesting question. I read a bk recently, “Brain on Fire” by a young woman (also ~ age 25) who developed autoimmune encephalitis of the frontal lobe and lived to tell of the ordeal. Who knows what permanent changes she may have suffered. I suppose in the final analysis we are what we are — does that excuse him? I’d need to think about that. If he has a “defect” like that — can it be cured? Does he have insight?

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