Professionalism/Lance Armstrong, the Tour de France, and a Culture of Cheating

Introduction
In 2012, the United States Anti-Doping Agency (USADA) classified Lance Armstrong's performance-enhancing drug use as "the most sophisticated, professionalized and successful doping program that sport has ever seen." Armstrong was a professional in cycling, doping, and keeping the silence. But his blatant dishonesty and disrespect of competition regulations greatly challenge his classification as a true professional. While Armstrong received the fame, recognition, and victories, he did not work alone. He relied on a large network including his teammates, coaches, medical staff, family, and friends to help achieve this scandal. Yet the secrets did not last forever, and the gradual collapse of this network revealed the truth.

Early Life
Lance Armstrong was born on September 18, 1971 in Plano, Texas. He was raised by his single mom for most of his childhood and showed early signs of athleticism. Armstrong became a professional triathlete at 16 years old and then turned his focus to cycling. By 21, he achieved second place in the US Olympic time trials. In 1993, Armstrong won the World Road Race Championship, becoming the youngest person and the second American to ever win this contest. That same year, he won the Triple Crown, which consists of the Thrift Drug Classic, the Kmart West Virginia Classic, and the CoreStates Race (also known as the U.S. Professional Championship). By 1996, Armstrong was the 7th ranked cyclist in the world.

Cancer and the LIVESTRONG Foundation
In October of 1996, Armstrong was diagnosed with testicular cancer, which had spread to his abdomen, brain and lungs. Doctors determined he had less than a 40% chance of survival. He was extremely adamant during his sickness that he would beat cancer and return to cycling. After brain surgery, successful tumor removal, and aggressive chemotherapy, Armstrong was announced cancer-free the following year.

He became a renowned celebrity, philanthropist, and the face of Nike with his LIVESTRONG campaign, which raised over 500 million dollars for cancer patients and survivors. In 2000, Armstrong published an autobiography titled It's Not About the Bike: My Journey Back to Life. Armstrong's story became a symbol of hope and inspiration to cancer patients all over the world.

Background
The Tour de France is a grueling race. It takes place over 21 days, called stages. The race is approximately 3,500 kms and travels through France and nearby countries. 198 cyclists compete in the tour; each rider is part of a team of nine members. Each team has a leader, and the remaining eight are called domestiques," which translates to "servants." The domestiques' responsibility is to protect the team leader by leading the peloton, chasing down attacks, and setting pace. While the Tour is a team competition, there is only one champion. The overall victor has the shortest cumulative time over all 21 stages and is typically a team leader.

Armstrong's Performances
Armstrong first won the Tour de France in 1999. He went on to win seven consecutive titles and retired on July 24, 2005. He returned to the Tour in 2009 until his second retirement in 2011. Armstrong served as team leader for the United States Postal Service Team (USPS) since 1999, later changing to the Discovery Channel Pro Cycling Team in 2004. After returning from retirement, he raced for the Astana Cycling Team and Team RadioShack.

Technology of Doping
The purpose of doping in professional cycling is to improve the oxygen-carrying capacity of the blood and help cyclists recover faster from fatigue. This is achieved in a number of ways, all of which are illegal and result in disqualification. National and worldwide anti-doping agencies are responsible for testing cyclists both in-competition and out-of-competition. The testing is complex, though. Since the abused substances are produced naturally in the body, riders need not remove all the traces - they just have to make levels appear normal at the time of the test.

Blood Doping
Erythropoietin (EPO) is a natural glycoprotein that stimulates red blood cell production. Direct infusion of synthetic EPO was used extensively prior to 2000, when there was no laboratory test for EPO. Even after a test was developed, blood samples would not raise any red flags if timed right because EPO's half life is only 5 hours.

As EPO injections became riskier, cyclists turned to a more natural form of blood doping: autologous transfusion. Half a liter of blood is removed from the body several weeks before a competition and refrigerated. Directly before or during the race, the blood is reinfused, giving the rider an extra boost of red blood cells to enhance performance. Blood transfusions were performed with great care and in secret, often in hotel rooms along the route of the Tour de France where all syringes, blood bags, and medical equipment could be flushed or disposed of without trace. The USPS team allegedly received transfusions on the back of the team bus while the driver dealt with "engine trouble" on a hidden mountain road.

Recovery Drugs
Like EPO, drugs that shorten recovery and healing time are all produced naturally by the body. This allowed the riders to "microdose," or take just the right amount of a performance enhancing drug at just the right time to avoid showing spiked levels on a test. During training and competition, cyclists wore testosterone patches overnight and ingested drops of testosterone mixed with olive oil. Synthetic human growth hormone (HGH) and cortisone injections were also commonly abused recovery drugs.

A Culture of Cheating
What began as scientific research in the 1980s became a systematic culture of cheating during Armstrong's reign as champion of the professional cycling world. Much of the science behind blood doping technology is attributed to Dr. Francesco Conconi, who led a Biomedical Research Institute at an Italian university. Conconi and his student, Michele Ferrari were avid cyclists themselves, and used their own bodies to conduct blood doping experiments to further the limits of the human body. When Ferrari became Armstrong's doping consultant, developed the olive oil/testosterone mixture, and discovered that injecting EPO directly into the vein rather than subcutaneously avoided positive EPO test results, it became clear that his "research" had taken on a latent function.

For cyclists participating in a doping program, avoiding a positive test result was of utmost importance. Riders found that by simply not answering the door or creating travel plans at the last minute, out-of-competition testing was easily avoided without penalty. During competition, each rider was expected to know his "glowtime," or how long his previous dose would be detected if tested. Teammates and staff were in constant communication to alert riders of surprise tests. In desperate moments, riders infused a liter of saline solution to quickly dilute the blood enough to pass a test. Taking illegal substances and avoiding drug testers became part of routine life in professional cycling. A quote by USPS teammate Tyler Hamilton demonstrates just how casual doping became:

Lance pointed casually to the fridge. I opened it and there, on the door, next to a carton of milk, was a carton of EPO.

After former teammate Floyd Landis left USPS, he joined the Phonak cycling team, which did not have a doping program. In 2005, Landis coordinated a doping regime on his own, which was costly and time-consuming. By the 2006 Tour de France, Landis had convinced the Phonak team owner to allocate money and resources to managing a doping program similar to that of the USPS team. The sport had nearly become a competition to determine who was the best at cheating, rather than who was the best cyclist.

The Network
Lance Armstrong was part of a complex network that made the USPS team scandal possible. In order for each step of the process to be executed properly, all involved in the network were required to keep a strict code of silence.

This network began with Armstrong's medical staff, particularly Dr. Michele Ferrari who provided his performance enhancing drug expertise through handwritten doping plans. Johan Bruyneel, the team director for all seven of Armstrong's Tour de France wins, further promoted the culture of doping by "looking the other way" when his cyclists engaged in the act. But the most heavily affected in this network were Armstrong's own teammates. Floyd Landis, Tyler Hamilton, George Hincapie, and the many other athletes who rode alongside Armstrong during his career felt direct pressure not only to engage in doping, but to suppress the truth at any cost. The team believed participation in doping was an absolute necessity to competing.

If I wanted to be a professional cyclist, I had to do this.

The members of Armstrong's personal life were also required to keep silent. Armstrong's former wife, Kristin Richard, was both aware of the happenings and a direct aid in the doping operations. USADA claimed that before competition she had distributed cortisone tablets wrapped in foil to members of the USPS team. Armstrong relied on individuals in both his professional and personal circles and he could not have carried out his doping regime alone.

Allegations
Lance Armstrong was accused of doping many times throughout his career, which eventually culminated in the condemning 2012 USADA investigation. Greg Lemond, a successful American cyclist and winner of the Tour de France before Armstrong’s time, was skeptical of Armstrong’s success from very early on. As someone who knew the demands of professional cycling, Lemond thought that Armstrong’s success was not physically possible without performance enhancing drugs. Emma O’Reilly, a masseuse for the USPS team, claimed to have witnessed Armstrong doping. Betsy Andreu, wife of cyclist Frankie Andreu, said that she heard Armstrong admit to doping when he was in the hospital for cancer treatment. She also claimed that her husband was cut from Armstrong’s team because he refused to follow Armstrong’s intense doping standards.

Beginning in 2010, Armstrong's former teammates began to expose him. Floyd Landis was stripped of his 2006 Tour title for doping. After years of denial, Landis used the press to admit guilt and accuse Armstrong of doping. On September 5, 2012, The Secret Race, a book written by former cyclist Tyler Hamilton, was published. In it, Hamilton described the hidden world of doping in professional cycling and how it led to Armstrong’s success. This book was damning evidence that led some of the general public to strongly question Armstrong’s legitimacy. He also partook in a 60 Minutes interview, where he admitted that he, Armstrong, and his teammates had doped during all seven of Armstrong's Tour victories.

In response to these criticisms, Armstrong defended himself, but he also attempted to ruin the reputations of his criticizers. Greg Lemond was labeled an alcoholic and was ostracized by the cycling community. Emma O’Reilly was called a whore. Landis was said to be past his prime and envious of Armstrong’s Tour victories. Betsy Andreu was “portrayed as an ugly, obese, jealous, obsessed, hateful, crazed bitch.” Upon learning of Hamilton's 60 Minutes interview, Armstrong threatened him, saying, "we are going to f---ing tear you apart. You are going to look like a f---ing idiot.  I'm going to make your life a living f---ing hell." Armstrong's personal attacks in response to these allegations successfully quelled most of his challengers until the allegations culminated in the USADA trial.



The Truth
The USADA case involved "sworn testimony from 26 people, including 15 riders... [and] direct documentary evidence including financial payments, emails, scientific data and laboratory test results". Armstrong was stripped of all seven of his titles and banned from professional cycling.

Following the USADA case, Armstrong decided to admit the truth that so many had already told. In his famous interview with Oprah Winfrey, Armstrong confessed to using a variety of performance enhancing drugs during his reign as Tour champion. He also acknowledged his bullying tactics when dealing with those who accused him of cheating. Armstrong claimed that it was not possible to win the Tour de France without doping. Doping was part of the cycling culture and was necessary if a cyclist merely wanted to keep up with the peloton. Seven of the top eight finishers in the 2003 Tour de France eventually admitted to some form of doping. From 1998 to 2010, only one of the Tour de France winners has not been involved in a doping scandal. These statistics indicate that doping was as pervasive in professional cycling as Armstrong claimed.

Armstrong supposedly resorted the culture of cheating as a way to even the playing field. He even said that he would dope again if he were placed in a similar situation. Others, however, chose to go against the norm. In The Secret Race, Tyler Hamilton talks about the few cyclists who rode paniagua. Paniagua, or “pan y agua”, literally means “bread and water” in Spanish and is a slang term to describe riding without the use of performance enhancing drugs. In a culture where cheating is so prevalent and easily accomplished, paniagua riders display true professional integrity.

Conclusion
There are many parallels from this case to the Milgram Experiments. In these experiments, participants were instructed to perform unethical actions and inflict pain. While they knew it was wrong and could have refused, most participants complied. Many of Armstrong's teammates testified that they felt that doping was wrong, and some were initially reluctant to do so. The members of Armstrong's network did not have to dope or assist in doping, yet they did it anyway. In a way, they lost autonomy and became components of the Armstrong machine. The case also provides evidence of the status quo bias. The practice of doping became so commonplace that competitors began to view it as the new "normal". Akin to the status quo bias, many athletes found it easier to engage in the doping culture than to actively work against it. Since 1998, more than one-third of the top finishers of the Tour de France have admitted to using performance-enhancing drugs in their careers or have been officially linked to doping.

In order to maintain integrity in a culture of cheating, one must not be afraid to go "paniagua," to borrow Hamilton's term. But for cyclists, competing paniagua would also mean losing the support of large doping rings that both protected their own and tried to discredit outsiders. Although Lance Armstrong was at the center of the doping scandal, he only succeeded because of the many others who actively assisted him or maintained the code of silence. Those that revealed the truth stood up against Armstrong's pressure and assisted investigators in bringing the scandal to light. However, it is difficult to determine if the 11 teammates who testified against Armstrong can be considered true professionals. They knowingly participated in illegal, unethical behavior, and they let the idea of victory and fame cloud their search for the greater good, or eudaimonia.