Dr John M

cardiac electrophysiologist, cyclist, learner

Why didn’t anybody listen to Lemond? Why don’t we learn from history?

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I began cycling for real in the 1990s. This was in no small part due to Greg Lemond. He was an American sporting hero. And, as history teaches us, he still is, now more than ever. History reveals so much. Darn hindsight is crystal clear.

In the late 1990s through 2005, when Lance Armstrong’s unbelievable exploits captivated a nation, Greg Lemond dared to suggest it might all be: not so believable. He broke the silence–the code of honor. And he paid dearly.

Lance Armstrong and his backers threatened and slandered him. This ruined his business. The irony is striking: the perpetrators of perhaps the greatest sporting fraud of all time trampled over something beautiful and real. Lemond wasn’t the only victim.

The doping culture ran talented sportsmen out of the sport, like local masters champion, Dr. Greg Strock, then a promising young rider who refused to submit to the doping culture.

When Mr. Lemond retired prematurely from the sport, I remember him saying something about a mysterious mitochondrial muscle disease. It turns out his muscle cells were fine; it was that his competitors’ cells were enhanced. He knew; and when he tried to open the eyes of Americans to something too good to be true–a cancer survivor who came back against all odds to “win” seven Tours–no one listened.

I thought I was done with Lance and the fraud. Expunged. I swore off reading about it. I needn’t explain the fraud to non-believers anymore. Oprah and others had done that. My imaginary friend chastised me for wasting valuable reading time on doping books and articles. I could have been reading more literary fiction.

But this 30-minute interview with Greg Lemond brought it all back.

His description of Lance’s extortion, deceit, slander, threats, bring it back. It’s a bad story. I don’t want it to make me cynical. Cynical is not heart-healthy. Yet this story is worth noting. It can teach. It informs. It underscores something I’ve grown more interested in: the value of history. I’m surprised how little we learn from history, in medicine, in politics, and in human nature.

Gosh, were we duped. “What am I on? I’m on my bike 6 hours a day.”

JMM

CW: An inflamed day for cycling

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You have watched the videos.

Heard the testimonials.

Read the books. Floyd’s was a little sketchy, but the frankness and details of Tyler’s connected the dots.

You re-watched the videos. How could he ride those guys off his wheel so easily?

You still aren’t convinced. You want to believe, which of course is a normal human instinct.

Something clicks in your brain and you recall that speech Lance gave on the podium in Paris after one of his seven Tour wins. It was something along the lines of shame on you non-believers.

You search around for more data. The PhD types speak of impossible average watt outputs and vertical ascent rates.

The damn videos are so incriminating. While you watch Lance demolish the world’s best climbers, you hear Phil and Paul speculate that the cancer made him stronger and lighter. That’s pretty amazing. They’ve obviously not been on too many oncology units.

Today’s news shredded the remaining 0.01% chance that Lance and the US Postal Service cycling team were not guilty of doping. The chance of his innocence in my mind is now zero.

But yet the vehement denials continue. Check out this sentence for descriptive details:

[Armstrong] attorney, Tim Herman, called the report “a one-sided hatchet job — a taxpayer funded tabloid piece rehashing old, disproved, unreliable allegations based largely on axe-grinders, serial perjurers, coerced testimony, sweetheart deals and threat-induced stories.”

What angle am I taking on this matter?

It’s not that systematic doping has dogged professional cycling for years. I knew this all along. All bike racers knew. It’s because we know normal.

It’s not that professional cyclists are human and flawed. I like my athletes to be human. It’s more interesting this way.

And it’s not that other sports, like baseball and football, are equally (or more) infiltrated with performance enhancing chemicals.

My angle here? The common denominator of a heart disease blog:

Inflammation.

Lance’s approach to this debacle exudes excess inflammation. The truth here would be like a salve. It would burn a little once applied, but then it would sooth the festering irritation.

I hate to witness inflammation. For a heart rhythm doctor, it’s akin to watching patients succumb to a preventable disease. ‘Come on,’ you think to yourself.

I see it everyday in the office. Constant worry, anxiety, pessimism and vitriol wreak havoc on the human heart.

Cycling is going to be okay. It’s a resilient and beautiful sport that will surely survive this scandal. Plus, we’ve already seen evidence that riders are cleaner. My friends and I enjoy the sport more than ever.

It’s the inflammation inherent in the scandal that’s so hard to watch. My heart aches for these guys. I really do try to look away.

For the truth-tellers, the sting will soon subside. For the deniers, the inflammation continues.

That’s hard to watch. It almost causes my heart to palpitate.

JMM

CW: The Secret Race — The end of magical thinking in pro cycling?

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Here’s what I was learning: secrets are poison. They suck the life out of you, they steal your ability to live in the present, they build walls between you and the people you love.
Tyler Hamilton, The Secret Race

It seems frivolous at times: to be so rabid a fan that I would actually take vacation days just to watch the big mountain stages.

It’s true; when Lance was dominating the Tour de France, we would gather at a local bike shop to watch the drama unfold live. It’s hard to put into words how ‘attached’ we bike racers were to Lance’s triumphs. At least I was.

When Outdoor Life Network first televised the Tour live, regular people saw an American sportsman doing what American sportsmen often do. Bike racers, however, saw something more. Words like ‘unbelievable’ got tossed around. Phrases like, “how’s that possible?” were heard frequently. When the entire US Postal team dominated day in and day out, some of us harbored doubts. We looked askance at the TV. Hmm?

You remember the ad: “What am I on?”

“I’m on my bike 6 hours a day; what are you on?”

Oh how sharp hindsight is.

To the book…

Like a good cycling fan, I wasted away almost an entire weekend reading Tyler Hamilton’s The Secret Race.

Superbly written and exquisitely researched by Dan Coyle, author of Lance Armstrong’s War, Tyler’s tell-all story had me entranced.

From a racer’s standpoint: The accurate descriptions of cycling life gave the book credibility. From not wanting to walk with his wife (so as to save energy), to ‘half-wheeling’ Lance in training and obsessing over everything he ate, Tyler’s account of life as a bike racer rings as true as true can be. The other thing about believability: the details seemed…well…just to detailed to be made-up. Tyler’s account was consistent and corroborated. You will feel what I mean after reading the book. Think aggregate.

From a medical point of view: The science behind the doping methods were astounding. I wished they had gone into more detail. One thing that surprised me: Why didn’t they use EPO to get their hematocrit to above 50 immediately before they ‘donated’ blood? This way, the donation would have brought them down to normal and they wouldn’t have suffered so badly in the days after the donation.

From a human perspective: I am a fan of humans. We are so dang interesting–and flawed. For instance, why is it that we think sportsmen (or doctors or lawyers or clergy or anyone) aren’t governed by the laws of human nature? I may be in the minority here, but I like my sports contested by humans, not cyborgs.

The bottom line:

I’m glad I read the story. I came away liking Tyler even more than I did when I watched him race.

Call me gullible; I believe Tyler.

But this doesn’t sour me on the sport. On the contrary, the drama of it all only enhances my interest.

Do I think cycling should strive to clean itself up? Of course it should.

I think of doping in cycling as if it were an abscess. You can’t expect to treat a walled off infection with painless therapies like antibiotics. To get rid of an abscess, one must break down the wall between the infection and the body. And that hurts–but then it feels good. Accounts like Tyler’s, and Johan Museeuw’s, and Jonathan Vaughter’s and yes, even Floyd Landis’ act to lance the boil. It’s a start.

I think you will like the book.

JMM

Cycling Wed: Be wrong Sports Illustrated

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Every morning I rest my coat on a chair in a shared office that has this picture on the wall.

My son and I were glued to the TV that day.  We cheered loudly and hugged each other after Lance rose up from the pavement and stomped away from his rivals.  (Rivals that have subsequently been either implicated in, convicted of, or admitted to doping.)

The picture of Lance belongs to my partner. We are both avid cyclists, we both trained at Indiana University in the 1990s (when Lance was there), and we both hope that Lance’s “miracle was not a mirage,” as David Epstein describes in his recent seven-page Sports Illustrated piece.

For me, deciding about Lance can be likened to medical decision-making.

In medicine, a diagnosis is not always completely confirmable. Sometimes doctors are forced to decide on treatment without absolute proof they are right.  In these cases, like grand juries do, we make judgements based on the evidence.  At the same time, though, good doctors also make a measure of their own degree of certainty—leaving an open mind to alternative, far less likely etiologies, which we call ‘zebras.’  The zebra reference stems from the ancient diagnostic adage that says if there are hoofbeats outside your door, it is more likely a horse than a zebra.

The problem for Lance-believers is that when one considers the details of Mr Epstein’s piece the hoofbeats are loud, and we are not on a safari.

JMM

Could this be the most interesting Tour yet…

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He is a liar.  A really profound one at that.  He took donated money for his legal defense, which was a lie.  Then he wrote a book filled with lies. How do we know this for sure?

Because now he says he lied, and this time it’s the truth.

As reported in an opportunistically timed WSJ report, Floyd Landis, disgraced winner of the 2006 Tour de France, having admitted to both doping and lying, is now accusing most of his former cycling colleagues of systematic cheating.  Blood transfusions and testosterone patches (not for lowT) were the performance-enhancing agents du jour. As said in the WSJ…

Doping is a scourge in professional athletics, and pro cycling has seen numerous scandals and suspensions over the past decade. The picture painted by Mr. Landis in the interviews, and in a series of emails he wrote to cycling sponsors in May, provides the most detailed view yet of what may be one of the biggest and most intricately coordinated cheating conspiracies in sports history. It involves blood transfusions taken in a bus on a remote alpine road, riders wearing testosterone patches to bed, and an operative posing as an autograph-seeking fan to deliver a bag of blood to a rider after a race.”

Is a liar now telling the truth?  Is a liar capable of ever telling the truth?

Tonight, I watched a few Tour highlight shows in which Lance rode away from his rivals as if they were overweight golfers–but in reality they were the second through fifth best cyclists in the world.  Even more interesting is that said rivals have subsequently all been either busted for doping, admitted to doping, or mysteriously left the sport.

Regular people–outside the bike racing cult–who know I ride, often ask me, is Lance clean?  

I don’t know for sure.  But a truism from the inside world of bike racing is that competitive cyclists do not believe the unbelievable.

It is a drug in a way.  The amazing sensation of when the pedals turn effortlessly, for forever, it seems.  Competitors squirm with discomfort as you pedal harder. And as if this sensation was not a high enough high, remember that the heavy load of an athlete’s self-worth is hung on a single peg.  Validation of a winning performance surely strengthens the peg, albeit only transiently, as impermanence is truth.

What is the truth?

It is hard to know with absolute certainty, but this dramatic his-word against-our-word story only adds to the intrigue of the next three weeks.

JMM