Domhnall MacAuley on Lance Armstrong

Domhnall MacauleyLance Armstrong in the news again. The world is divided. Those who read his book are struck by his bravery coping with illness and the incredible drama of his surgery for metastatic testicular cancer and return to fitness. Unbelievable. But, unfortunately, the same word is sometimes used to describe his cycling career. To win the Tour de France seven times is remarkable but, for some reason, he never really captured the hearts of European cycling aficionados. There seemed a reluctance to unreservedly applaud his victories. Was it, perhaps, an anti American sentiment, a reaction against his professionalism, jealousy, or doubt?  Could it be they thought it was too good to be true?  In a sense, it doesn’t matter because what he achieved was extraordinary; overcoming illness, conquering the mountains and winning against adversaries since shown to have been doping. And, from a health perspective, the Lance Armstrong Foundation and his Livestrong campaign have contributed greatly to raising cancer awareness and generating funds for research, education and community action. His wrist bands are seen everywhere. He has inspired hope far beyond the world of cycling.

Tour de France 2010 and his performance was slipping. Crossing the line in Morzine on July 11th almost 12 minutes behind the leader, bloodied and jersey torn after three crashes and 117 miles in the saddle, his cycling career was visibly in decline. So too was his credibility, as headlines citing doping allegations competed with those on cycling. At 39, age was taking its toll. He competed well in 2009 but this year was a challenge too great as the new generation of cycling heroes climbed away from him on the mountains,  He still attracted support; television showed his fans on the roadside and he too courted publicity in trying to wear  a Livestrong jersey rather than team colours on the final stage into Paris. But, in the background, the doubters asked questions. Former teammates have admitted to doping and allege a systematic programme of performance enhancing drugs and blood transfusions. He has been called to give evidence in US federal investigations. More stories emerge daily and the most recent in the New York Times further sullies his image. Like many, I still want to believe in the fairytale story of sporting glory, courage in the face of adversity, triumph over illness, making a lasting contribution to the health of others. Tell me it’s not true.

Domhnall MacAuley is primary care editor, BMJ