Dr. Ferrari Was Right, a chapter from Spitting in the Soup

Exploring how the deals made behind closed doors keep drugs in sports

Race Coverage Tour de France


Even the Sporting News, a magazine that usually keeps its nose pointed firmly in the direction of stick-and-ball sports, got on the EPO-kills bandwagon, writing in a 2004 piece titled “Cycling’s Deadly Downward Spiral” that “death is yet the unseen rider in world-class cycling.” The story cited the death of nine riders due to heart failure between January 11, 2003, and June 30, 2004, including “one in a den­tist’s chair.” The piece also referred its readers to the death of Italian superstar cyclist Marco Pantani in 2004. Though Pantani’s autopsy sin­gled out a cocaine overdose as the cause of death, that did not stop the Sporting News from attaching its amplifier to the common speculation: “Some cyclists believe he died as the other eight did—of heart failure prompted by use of EPO.”

On January 29, 2004, the Sydney Morning Herald described soccer players who had mysteriously died on the pitch. Although none of the players’ autopsies indicated EPO as a cause of death, the Australian paper did not let medical records get in the way of a growing fiction. It promptly made the EPO connections that coroners did not. Citing a French investigation into doping by the Cofidis cycling team, the paper wrote, “Perhaps the soccer authorities should start an inquiry into these supposed unrelated deaths.”

Marathoners also got their moment in the EPO-kills glare. “Fear on the Marathon Starting Line,” blared an April 22, 2001, piece in Scotland’s Sunday Herald. It asserted that the top runners in that year’s London Mar­athon were wondering whether their days on Earth were so numbered that they would not have time to spend their appearance fees. The reason? EPO. Spanish marathoner Sergio García had died earlier that year at the age of 39, and coaches and runners were abuzz with speculation that his death was related to EPO. “Garcia’s spectre has been stalking the corridors of the London Marathon race headquarters this week,” the paper whis­pered. The connection between García’s death and EPO was hypothetical, and yet by 2001, the EPO-kills myth was so hardened that newspapers could get away with publishing gossip in the guise of reporting.

Unlike the press, EPO-using athletes separated the true risks of EPO from myth. U.S. Postal Service team rider Tyler Hamilton started using the synthetic hormone in 1997. In his 2012 book The Secret Race, the American compared the risk of taking EPO to the damages he suffered while racing—a catalogue of smashed bones from nose to back to ribs. “Bike racing is not a healthy sport in any sense of the word,” Hamilton wrote, “so when it comes to the risks of EPO, they tend to feel pretty small.”20 In light of the actual clinical facts available in the 1990s that EPO and hypertension were “not related” in healthy patients and that the drug’s causation of blood clots was “quite sporadic” if not “nonexistent,” Hamilton’s response to the public perception of EPO danger was rational. As Erslev and the European and American drug regulators who approved Epogen and its variants indicated, under a doctor’s supervision, EPO was safe. And as Hamilton pointed out, the risk of doctor-supervised EPO use was especially slight compared to the nearly 100 percent statistical chance that a rider would suffer multiple, and sometimes life-threatening, injuries while racing on Europe’s narrow roads.

Spanish scholar Bernat López researched how EPO was transformed from a life-saving miracle hormone into what he calls a “drug of mass destruction.”21 Although no evidence exists to support the claim that EPO caused any of the cyclists’ deaths in the early 1990s, López’s research led him to conclude that the rumor had ossified into received wisdom through media repetition. The fiction served as propaganda that made it professionally and personally suicidal to challenge the morality and righteousness of the antidrug movement.

As López sees it, the story of EPO killing loads of cyclists became a “flagship myth” for anti-doping interests. It was a story manufactured and spread by the press with the intent of scaring athletes. López, a professor at the Universitat Rovira i Virgili in Catalonia, also argues that because the general public is largely indifferent to the drug-regulating policies that are the bedrock of anti-doping organizations, anti-doping missionaries played up the deadly EPO myth as a way to gain sympathy from a public that has an otherwise insatiable appetite for legal and ille­gal performance- and lifestyle-enhancing drugs.

When López ran a meta-analysis of 36 academic texts that referenced the EPO deaths as evidence of the danger of EPO, he discovered a schol­arly train wreck. All the articles either referred to no source for their EPO-deaths claims or noted secondary resources that cited no source. As a result of this evidence-free conclusion making, academics came up with a shambolic number of EPO deaths, ranging from 5 to 20. The victims’ nationalities were also wildly inconsistent. While newspapers like the New York Times reported that the dead riders were Dutch, the academic researchers indicated that they hailed from Spain, Holland, Belgium, and Scandinavia. The deaths also took place during variable time frames ranging from “the 1980s and early 1990s” to “between 1997 and 2000,” to “1987 to 1991.”

López also looked at 20 academic texts that offered evidence against the claim that EPO killed a bunch of cyclists in the late 1980s and early 1990s. The articles commonly pointed to genetic heart defects as the most likely cause of the deaths. None of these studies cited EPO as a potential or actual cause. If the researchers behind the 20 papers came up with any one Grim Reaper haunting bike races and marathons around the world, it was the damaging effect of extreme and prolonged training. In sum, López concluded, the 20 studies he investigated “sug­gest that EPO is extremely unlikely to have had the effects that have been claimed in the speculation of anti-doping sports doctors, academ­ics, and journalists.”

Continue to page 5 for more from Spitting in the Soup »
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