by Dr. Conor McGrane, co-author of The Pat McQuaid File
I’ve been a doctor for almost 20 years but a cyclist since childhood. Over the years I’ve seen huge changes.
I started cycling as a kid but the 1982/83 TDF’s really sparked my interest.
Ireland is a small country but to see Kelly and then Roche do so well brought a generation of us into the sport.
Back in the day golf was seen as the sport for docs…
Now I see my classmates from medical school comparing rides on strava the way previous generations compared handicaps.
Conversations at conferences and meeting now revolve around new bikes, events or even the pro scene.
Sports medicine is also becoming more formalised and training more streamlined. It has made me look at the whole issue of Doctors in cycling. How did they get involved and why do they do it?
I see then likes of Ferrari (who is a bright and intelligent physician) and see what damage he has done.
The overriding principle for physicians dating back to the Greeks was “First do no harm”
At some point we as a profession threw this principle away.
Gert Jan Theunisse has just has a pace maker fitted at the age of 50 after a series of heart attacks. There is no way this could not be connected to his use of testosterone (at the very least) while a pro. Almost certainly someone prescribed and maybe even administered this to him.
The introduction of EPO (again prescribed most of the time by doctors) was heralded by a series of deaths, often while sleeping.
When you read of what Armstrong, Hamilton, Landis et al were taking under the supervision of a series of doctors I fully expect to see ill health and premature deaths in a large number of ex pros from that era.
Yet for all the cyclists (and other athletes) banned it’s rare to see those who admistered or facilitated the doping get a similar sanction.
It’s time for WADA and indeed the UCI to do more.
Fuentes was a trained gynaecologist yet was allowed become the team doctor for male pro teams without anyone batting an eyelid as recently as 2005.
Agents and DS’s now need to be certified and surely it’s time for team doctors to be similarly accredited.
If we are serious about eradicating doping then we need to do much more than simply ban those who get caught.
We need to be more thorough in checking out those who work behind the scenes.
There are relatively few Pro Continental teams and even fewer ProTour ones. At this level I feel it would be relatively easy to enforce standard rules and limits as to who was allowed act as team doctors. It would be a start and set an example not just to cyclists but to other sports as well.
Would the likes of Fuentes have been able to pass the scrutiny of a proper check of their past training and actions?
Not only did these guys help cyclists cheat, they also endangered their lives at the time and increased their risks of all sorts of illness in the future.
The UCI is now under new management and in my opinion the time has come to properly regulate those who provide medical care to the top echelons of the sport.
There are plenty of examples of doctors working across different countries jurisdictions who make dreadful mistakes largely because they were given positions they were not properly trained for.
At present it falls back on the medical regulatory body of the doctor’s country of practice to certify them.
I have yet to see a doctor be disciplined for doping athletes by these bodies.
If the UCI introduced a relatively simple system of registration with a thorough background check we could at the very least keep tabs on who is doing what.
Considering the risks involved to the sport I think it’s the least we should be doing.
Fine piece.
Excellent overview of the challenge with doping in cycling. It will be interesting to see the early deaths in the near future since the doping era had some of the widest use of testosterone, epo, and HGH. For those that have ill feelings against Armstrong, he may find that there are health repercussions to his actions sooner than later. However, it also says something about our society which is so focused on drugs. I’m a workers’ compensation attorney in Georgia, and I am seeing prescribed drugs as a major part of today’s injury rehab. In other words, some of what we are seeing in cycling is a mirror to the trends in treating people outside sport.
“Do no harm”……I’ve heard most graduating med students choose not to take the Hypocratic oath, an established trend for a while now. Also thanks for offering a solution, keeping track of doctors is a great idea!
Gert Jan’s problem might be he still trains about 5 hours a day, usually on a mountain bike in very small shorts. To make matters worse he’s bald and covered in ink.
I questioned the issue of team doctors direct with the UCI back in the days of ONCE when they had 9 doctors and 2
mechanics.
Q I asked if they were actually Doctors, qualified like a GP ?
A. No idea.
Q Do they have UCI Licences like Dir Sportifs and race organisers
A No.
Q Why not…. how can the be allowed in the pro peloton if they do not have a UCI Licence.
A From the next year on they all had to have a UCI Licence (So I was informed)
Q I also asked if my GP gets £ 35 for a 10min session with a patient so generally Doctors are very highly paid, so how can they prefer to work for a team – unless they have already been struck off.
A. No idea.
Also in the cases where a Doctor is required at any of the races, for a child, media or spectator whatever they always call one locally – NEVER does a team doctor assist and also in a race it is ONLY the race doctor that attends NEVER the team Doctor.
It has always seemed to me that “harm” can be, and is, interpreted in wildly different ways by various members of the medical profession.
History is littered with many examples of the bending of medical ethics for idealogical and or religious reasons. I suppose the most extreme example being Dr Mengele, who, while carrying out his horrific experiments, probably felt he was working for the good of his people. And there’s been no shortage of religiously motivated medical decisions made in this country.
In modern times, the threshold of what constitutes “harm” seems to be inversely proportionate to the amount of money to be made. From celebrity cosmetic surgery to doping, there seems to be a plentiful supply of doctors ready to pander to peoples vanity should the money be right.
Or maybe, like the surgeon hacking at a beautiful woman’s face to “help her feel better about herself”, the likes of Ferrari genuinely felt they were helping. Isn’t that a scary thought.