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Authors: Jeremy Whittle

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Even though medical supervision was still required, EPO made blood manipulation generally accessible for the first time. And with it, a new generation of sports doctors emerged who openly refused to condemn its use in sport. At the forefront of these was Michele Ferrari, an Italian whose name was to become inextricably linked to that of Lance Armstrong.

There’s no doubt that Ferrari – nicknamed ‘Schumi’ after Formula 1 legend Michael Schumacher – helps his clients go faster. But he is expensive and only the best-paid riders can afford him. Ferrari, who is still actively working with several leading riders, maintains that all his advice is ethical, but in 1994, challenged by French newspaper
L’Equipe
about EPO use, he scoffed at concerns over blood doping, in an exchange which has passed into the folklore of the sport. (It is worth remembering that at this time EPO was not banned, nor was there a test to detect it.)

L’EQUIPE:
Do your riders use EPO?

FERRARI:
I don’t prescribe this stuff, but you can buy EPO in Switzerland without a prescription. If a rider does that, it doesn’t scandalise me.

L’EQUIPE:
But EPO is dangerous – ten Dutch riders have died in the last few years.

FERRARI:
EPO is not dangerous: it’s the abuse of EPO that is. It’s also dangerous to drink ten litres of orange juice …

After saying that, Ferrari became something of a pariah. The team he advised at the time, Gewiss, soon dispensed with his services. As concerns over EPO abuse grew, riders became discreet over their contact with him. He stayed clear of the major races yet hovered unseen in the background of the sport, maintaining his big-name clients.

But despite the warnings of the European press, EPO use in cycling became rampant. It was, and remains, a wonder drug. It is easily available, portable and user-friendly. It achieves results. But there are dangers.

The tales of riders, haematocrit levels soaring, blood thick as sludge, being woken during the night by panicking team staff to prevent cardiac arrests, have become cycling’s urban myths. Most journalists have a story of the night they stayed in the Team X hotel and were disturbed in the early hours by slamming doors, panicked voices and the steady whirr of riders
training
on stationary bikes in their bedrooms, battling to speed their circulation.

They were the lucky ones; some of the others didn’t wake up in time.

To state the obvious, blood is fluid. Thickening it beyond the heart’s tolerance, through overuse of artificial EPO, can prove fatal. It remains impossible to put an exact figure on the number of athletes who have suffered heart failure through their blood being thickened to deadly extremes. But these days, only the most blinkered dispute that EPO use in cycling became endemic and in some cases led to fatalities.

Some European media reports estimate that between 1987 and 1990, up to seventeen Dutch and Belgian cyclists may have died due to their ill-fated dalliance with EPO. It is certain that many more have since experimented and then become regular users. Those riders were the hapless guinea pigs of a doping revolution.

Twenty years on, the use of EPO has become more sophisticated. Now smaller and more regular doses – known as ‘micro-dosing’ – are in vogue. ‘Artificial boosting of haematocrit levels a week or more before a race can be maintained by micro-dosing with EPO three times a week – and still go undetected,’ says Michel Audran, a Montpellier-based doping expert.

Faced with this tidal wave of blood doping, with Ferrari’s ambivalence over the dangers of EPO, and with growing fears over the riders’ health, what did the UCI do?

Until the 1998 Festina Affair provided irrefutable evidence of widespread EPO use, the UCI remained in denial. Cycling, like other sports, had been desperately in need of a definitive EPO test. But at the same time, the development of a successful test could have proved a commercial disaster for a sport that was enjoying a global boom in popularity. If most riders had mastered the use of EPO, a flurry of high-profile positives would have been a public relations nightmare.

How many riders would be caught and how well known would they be? What would be the repercussions legally? What
would
this do both to corporate and public support of cycling? Would the sponsors cut and run? Faced with this dilemma, the UCI froze in the headlights and opted for a fudge.

In 1997, the UCI introduced blood ‘health checks’. In an attempt to end the rampant abuse of EPO, a fifty per cent haematocrit level was imposed and early morning blood testing introduced. For most observers, there was a palpable sense of relief. But the riders, supposedly behind the test’s introduction, were more ambivalent: the UCI’s visiting medical team was quickly nicknamed ‘the vampires’.

The ‘health checks’ were not a doping test – EPO itself was still undetectable – although it was clear that those with haematocrit levels beyond that magic and seemingly arbitrary figure of fifty per cent would be under intense suspicion. There was no punishment for a failed test; merely a two-week suspension from racing, to ‘protect the rider’s health’. Once back under the fifty per cent threshold, riders were allowed to resume their careers.

But the suspicion grew that the fifty per cent limit was in fact a tacit legalisation of EPO use, although this suggestion has been vehemently denied by UCI presidents Hein Verbruggen and his successor, Pat McQuaid. It’s clear that those with naturally high haematocrit, say of forty-six or forty-seven per cent, have a significant natural advantage over athletes with lower haematocrit. With the fifty per cent limit in place, those with naturally lower haematocrit levels – sometimes as little as thirty-six per cent – now had free rein to top up their red blood cell count and to overcome their natural inferiority. Thus donkeys became thoroughbreds. Everybody could be champion for a day. Unwittingly a level playing field was created, though perhaps not of the kind that the UCI intended. Verbruggen, however, considers this analysis to be ‘bullshit’.

In fact, the UCI went to court to defend their reputation after the Festina Affair. They were awarded one euro in damages, but, McQuaid says, the ruling ‘stated that the UCI couldn’t have done any more to inform the riders of the dangers of doping’.
Yet
many experts disagree. Mario Cazzola, of the University of Pavia School of Medicine’s Haematology Division, believes that the UCI’s ‘health check’ was inherently flawed. The UCI had based their fifty per cent limit on the results of tests carried out in competition during the Tour of Romandie. However, Cazzola suggests that the baseline for the ‘health check’ should have been established through out-of-competition testing. Out-of-competition haematocrit – when athletes are not suffering the strain of intense competition – should be
higher
than in-competition haematocrit, when fatigue takes its toll on the red blood cell level. The results of the in-competition ‘health checks’ revealed that many of the riders seemed to have a surprisingly high haematocrit level of forty-nine per cent – some three per cent higher than the figure the UCI itself deemed ‘average’. Even so, the UCI’s suspicions were not aroused and they held to the planned fifty per cent limit. Perhaps, given the commercial growth of the sport and the pressure from teams and riders to not undermine them, this limit was no surprise. At fifty per cent, everybody was a winner; the UCI showed that it was getting tough – and the riders could still dose up on EPO.

Cazzola believes that the fifty per cent limit is an inducement for athletes to ‘top up’ their blood through micro-dosing without risk of detection: ‘This is the only explanation I can provide for the elevated haematocrit values frequently found in some professional athletes. Haematocrit levels greater than forty-seven per cent are found in only one or two out of a hundred elite soccer players.

‘Upper limits generate aberrant beliefs in athletes: doping is no longer taking rEPO but instead having haematocrit levels greater than the upper limit. Abusing rEPO and having haematocrit values below fifty per cent is felt by some athletes to be fully normal behaviour.’

For Cazzola, blood doping is ‘a betrayal of the Hippocratic oath for the physicians who are involved in it. Sport is intended to improve people’s health – doping worsens it.’ But as the money kept coming in and the Tour’s global audience grew, nobody in cycling seemed to be listening.

THE BOTTOM LINE

AUGUST 1993, LEEDS,
Yorkshire. Nearly six months after shattering my knee in Battersea.

My big break. The Leeds Hilton hotel. My first interview, my first ‘sold’ story. I hobbled through the lobby.

‘I am here to see Lance Armstrong,’ I announced grandly to the receptionist, leaning on my stick. Her expression was blank.

‘Who?’ she said.

‘Armstrong, Lance Armstrong. He’s a cyclist – the Motorola team. Can you, erm, give me his room number … please?’

This was my first mistake.

You don’t prowl the hotel corridors, you wait in reception. You don’t knock, uninvited, on a professional cyclist’s bedroom door. You don’t disturb their afternoon nap after a hard morning’s training.

But, back then, I didn’t know that. I went up in the lift. I prowled the corridors, hobbling through the shadows until I found the right door. I took a deep breath, and knocked once, firmly.

No response. I knocked again, harder. And that was how I woke him up. The door was snatched open.

There he stood, all Texan testosterone. Jaw jutting, barrel-chested, frowning, narrowed eyes, clad in white T-shirt and jogging pants, unsmiling – pissed at me already. And I hadn’t even opened my mouth.

I stammered through an introduction. He stared at me.


Yeah
…?’ he growled. ‘I’m sleeping. Wait downstairs …’ And the door slammed shut before I could apologise.

I hobbled back through the shadows to the lift, muttering,
‘Idiot
.
Git
. Blown it,
blown it –
first chance and you’ve blown it.’ I sat in the lobby, despondent, wondering whether it was actually worth waiting, checking my watch and the Leeds to London train times, over and over.

An hour or so later, he strolled out of the lift, chewing gum, wearing a baseball cap, clutching his phone. He even smiled when we shook hands. Everything I’d read about him said he was brash, outspoken, arrogant; very much from the wrong side of the tracks. But it was the softer, more charming Lance who I met that day.

We sat down and talked for about forty-five minutes. He listened thoughtfully to each question. He was dry, funny and sharp. This, in brief, is what he said.

‘I don’t study cycling, like some people study art.’

‘I don’t like Europe at all. I really miss the States. When I go home to Italy, life sucks. I miss Texas.’

‘I’m not frightened of anybody or their reputations. I grew up on the ropes and I don’t have to take anything from anyone. I don’t like being told what to do …’

‘People always think Texans are tough, but there are a lot of wimpy Texans too – it’s a big place …’

‘I don’t let the media pressure or the fans’ expectations get to me – I mean we’re not U2 and I’m not Bono!’

‘Last year in the Tour, I found the Alps just incredibly difficult, harder than I’d expected. After that I realised that it will take me a while to become a Tour contender.’

And …

‘The bottom line is that I expect to win.’

I thanked him and former British professional Paul Sherwen, then working as Motorola’s PR officer. We stood up and shook hands. A photographer took Lance outside to pose for pictures with his bike.

‘How do you like your bike to be set up?’ asked a journalist.

‘Man – I just get on it and
ride
,’ Lance said. We all laughed.

Two weeks later, arrogantly, brashly, decisively, Lance won the World Championship road race in Oslo. By a street.


The bottom line is that I expect to win
.’

JEEPS AND SHOTGUNS

NOVEMBER 1996. THREE
years on from the Leeds Hilton.

The taxi swept me away from the airport terminal, picked up speed and joined the freeway heading downtown.

Flatbeds, limousines and jeeps slid past, bumper to bumper, in the outside lane. Alongside the slab of elevated road, football stadiums towered over shopping malls and parking lots.

Through the cab’s windscreen I saw shotguns stacked against the rear windows of passing trucks, and read bumper stickers with the ominous warning: ‘Don’t Mess With Texas’.

This was Austin, Texas. Lance Armstrong’s home town.

I checked in to the motel, dropped my bags on the bed, downed a bottle of water, and thumbed through my contact book. Lance in Como, Lance in Santa Barbara, Lance in Nice, Lance in Austin, and finally, Lance at Bill’s – his agent Bill Stapleton’s office. I called the number and scribbled down the address they gave me. I would have to wait. Then I took a shower, switched on the TV, shut my eyes and slept.

Across town, off another exit from another freeway, somewhere on the edge of the Texas hill country, and very much on the right side of the tracks, Lance Armstrong, pale, bald and scarred, was moving slowly through his luxury home on a gated estate. He had been diagnosed with testicular cancer and had undergone surgery and chemotherapy. He’d agreed to be interviewed. At the time, he had seen only a few journalists, mostly American. French sports paper
L’Equipe
, later to become his nemesis, had already been and gone. I was the only other European presence.

The last time I had seen him had been that summer, first at
the
Tour de France and then, in August, at the start of the San Sebastian Classic in northern Spain. He’d quit the Tour with a shrug and a wry grin, as a dark thunderstorm swept over Aixles-Bains. The news broke over race radio as we arrived at the press room. I turned the car around and headed across country to his team’s hotel, anxious to find out what was wrong.

I parked up and waited until he arrived. Eventually a Motorola team car swept up to the front door and he hopped out. I walked with him to his room. After he had showered and changed out of his racing kit, we chatted.

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