Even in family medicine, a specialty that prides itself on knowing a little about almost everything in medicine, there are things that fall outside our scope.

Some time ago, someone picked up my email address, presumably from this newspaper, and sent me an unusual request. Her younger brother was a footballer who had just been signed by a European club. The family was understandably ecstatic, but his older sister had her reservations. She suspected he was using performance-enhancing drugs (PEDs) and worried that he might fail the club’s doping tests and be sent home before his promising career had even begun.

Could I see him, she asked, or refer them to a laboratory where he could be tested?

What in the world of Diego Maradona was this?

Firstly, I had absolutely no knowledge of performance enhancing drugs as sports medicine isn’t a subject taught in medical school. And not only did I know next to nothing about drugs in sports, I also had no idea where to send him for a proper doping test. The routine urine drug screens we do in hospitals are designed to detect illegal substances such as cannabis, cocaine and certain opioids or sedatives. They aren’t the same as the specialised tests used to detect the wide range of substances prohibited in competitive sport.

I told her the truth. This was beyond my expertise; E pass my level; but I would help her look for an appropriate laboratory.

She was grateful, then came the follow-up question. If her brother tested positive, did I know a doctor who could prescribe something to mask the banned substances in his urine?

See me see wahala. Clearly, this woman had done her homework and knew more than she was letting on.

My answer was a firm no!

I knew no such doctor and wouldn’t have recommended one even if I did. I would, however, keep my promise to look for a laboratory, if only to satisfy my own curiosity.

That was how I fell down the rabbit hole of sports doping, spending much of the day reading about the lengths some athletes and their associates go to gain an advantage.

Doping isn’t new. From anabolic steroids to blood doping and newer performance-enhancing substances, the methods have evolved alongside the systems designed to catch them.

Apparently, some athletes have been able to beat the urine test through ‘micro dosing’. Instead of taking large amounts of performance-enhancing drugs, some athletes take tiny doses that clear their system before testing. Another method is through using masking agents; these drugs help hide traces of banned substances, making it nearly impossible to detect them. This is what the woman was referring to. Masking agents are popular in Asian countries and Russia, especially Russia, apparently that is why they were banned from the Olympics. I had no idea.

Another way to beat the drug test is by using designer drugs. These are custom-made substances that evade standard drug tests because they aren’t officially listed as banned. Of course, these are reserved for the ultra-rich athletes.

In Nigeria, our sophistication no to reach like dat. The way our athletes beat the test, is through good old-fashioned corruption. We simply bribe someone to look away when the test results come out and then pretend to be surprised and embarrassed when we are caught at the Olympics.

Remember in the last Olympics when boxer Cynthia Ogunsemilore was provisionally suspended and removed from the 60kg lightweight division after testing positive for the banned diuretic furosemide? Remember Blessing Okagbare, the runner who received a 10-year ban from the Athletics Integrity Unit (AIU) for an organized doping regimen (testing positive for EPO and human growth hormone)? Do you remember that this came shortly after 10 Nigerian athletes were barred from competing due to out-of-competition testing non-compliance?

I may not agree with the woman’s email, but I understand and maybe even admire the way she was looking out for her younger brother and the lengths she was willing to cover up for him.

The obvious reasons are money, fame and the pressure to win. For a young footballer from a modest background, a contract with a European club may represent a way out of financial hardship for an entire family. The pressure to seize that opportunity can be enormous.

While reading about doping in sports, I came across an argument that many athletes believe everyone else is cheating. If your competitors are allegedly using substances to become stronger, faster or recover more quickly, you may begin to see doping not as cheating but as a way to level the playing field. It is a dangerous logic, but one that helps explain why the problem persists.

Injuries add another layer. A player who is desperate to return before an important tournament may be tempted by substances that promise faster recovery or improved physical performance. And with coaches demanding results, sponsors expecting victories and fans who worship winners but quickly abandon losers, the environment becomes ripe for poor decisions.

Apart from the embarrassment from cheating, some performance-enhancing substances can increase the risk of cardiovascular complications, hormonal disturbances, liver damage and psychiatric effects, depending on the substance, dose and duration of use. These athletes are gambling with their long-term health for a few extra goals, seconds or kilograms lifted.

I don’t think we can ever eliminate doping in sports; but we can make it harder to get away with and less attractive to attempt.

Testing remains important, but it must be sophisticated, independent and unpredictable. Biological passports, which monitor changes in an athlete’s blood or other biological markers over time, can help investigators identify patterns that a single test might miss. Education is equally important, particularly for young athletes who may not fully understand the health risks or may be persuaded to take substances by coaches and other trusted figures.

I never did establish whether that young footballer was using performance-enhancing drugs, or whether his sister’s suspicions were justified. I suspect she was angry after my firm ‘No’.

I have since learnt a very important life lesson: You cannot save everybody. You cannot help everyone. You do your best and move on.

That woman’s email, apart from making me read voraciously on the subject of doping, also made me apprehensive. So, you mean all these football lessons I have been registering my son for- will they all be in vain? Should I abandon my project Mbappe altogether? Who is then supposed to spring us into generational wealth?? Who???