A Nike commercial in 2001that is a prophecy for Lance’s future 2013

Two things scare me. The first is getting hurt. But that’s not nearly as scary as the second, which is losing.
Lance Armstrong

We are still in the orbit of planet Lance. He is a weighty fellow and, for better or worse, he still attracts us.  Recently the International Swimming Federation banned him from masters’ competition, US Postal is suing him for $40 million, and Hollywood has at least 3 movies about him in the works, with lurid titles such as The Cycle of Lies, Seven Deadly Sins and The Secret Race. The spectacle of his fall from grace is irresistible.

As many know, it all started when the US Antidoping Agency (USADA) website posted its 202 page report. The document was a damning indictment against Armstrong and his legacy. It methodically interviewed everyone in Lance’s circle, and eventually breached Lance’s wall of secrecy. And that, in itself, was not enough. The USADA did not simply dismantle Lance’s wall, they needed an exhausting inventory of each and every brick. Who at USADA did Lance piss off (as only he can), because there is vindictiveness in the report that goes beyond accountability? USADA’s report wasn’t about cleaning up sport, it was a vendetta.

I have to ask – Did hard-core cycling fans deny that performance-enhancing drugs fuelled Lance’s 7 Tour victories, or did they suspect cheating and watch the spectacle anyway?  Professional cycling is a drug culture and the Tour de France, since its inception, has been rife with drugs. Back in the beginning amphetamines and opioids were the drugs du jour.  Anabolics had their day, only to be supplemented by EPO in the 90’s. Now noninvasive tDCS, (trans cranial direct current simulation where you electrically zap the part of the brain that tells the body to slow down, and bypass the redline puke and die stage every racer experiences), is on the horizon. Who knows what the future holds? As long as there is fame and money to be had, as long as races are grueling events that millions watch, there will be cheats and there will be drugs. Almost every top contender in the Tour has been busted. Did anyone think that Lance would be spared?

Whether you love him or hate him there is only one Lance. He has never deviated from whom he is to gain public approval. There was an appetite for a superhero and Lance was glad to oblige. It was a win-win situation – he got to win, we got a hero. We ignored the personality traits he revealed because they were incongruous in the man we wanted to see. Now the winds of public opinion have shifted. Everyone is furious that our Lance Armstrong, (the mythical, super human, heroic version) never existed. USADA has forced us to look at all of Lance and see him as he is, and what we see, unfortunately, has made us unhappy.

Early on, I questioned, Who is Lance Armstrong?  I read his books to find some answers (My conclusion: What a jerk!). Since the start of his meteoric rise, I was at first, awed by his raw talent and his laser- like drive to succeed. These are qualities that I admire.  And, I confess, I stood for hours on the shoulders of Mt Ventoux during the 2009 Tour, just to see him pass. I envied his quick wit and quirky language, his ability to spar with the press, deal with the naysayers, and say something definitive after every Tour stage. He was smart, charismatic and Lance was good TV. I was bewitched, but as time went by, I was no longer fooled. Lance simply could not be that good for that long, because, well, no one is. This is a fact that every cyclist knows. As a doctor, I tend to look for a diagnosis, a pattern of behavior to explain what I see. I paid attention to what Lance revealed in his actions and behavior. In short, I tried to see the whole man and he was quick to reveal his coldness, fury towards those in his crosshairs, strict control of all of those in his service and above all, his monstrous ego. He does what he needs to do, to remain the top dog no matter the price. There has never been room for anyone else in the rarefied atmosphere of planet Lance.

Martha Stout in her book The Sociopath Next Door states that 1 in 25 ordinary Americans are sociopaths with an antisocial personality disorder and what qualifies these individuals is a lack of conscience. She defines a lack of conscience as a state where the individual experiences no feelings of guilt or remorse no matter what they do, no limiting sense of concern. This state leaves the sociopath free to participate in society without being hampered by the fussy concept of right and wrong. If morality is absent and conscience does not come into play, then whatever decision is right for you, is the right solution.  There is a tendency for the public to think sociopaths are criminals but the vast majority is nothing of the sort.  They are ordinary citizens. When they possess great talent, strength or intellect they are our heroes and idols.

In my career I have interacted with many patients who were sociopaths. When an MD is presented with a patient, the Diagnostic and Statistical Manual of Mental Disorders (or DSM: fifth revision) helps to classify the difficult personality. The DSM-5 lists 5 personality types and gives criteria for each. For example, the antisocial personality type requires the individual to display a trait from each of the ABCD categories below.

• A Criteria is defined as either; Egocentrism, (self esteem derived from personal gain, power or pleasure) OR goal setting based on personal gratification, absence of internal standards associated with culturally normal ethical behavior

 

AND

• B Criteria is either a lack of remorse OR exploitation as a primary means of relating to others, including by deceit or coercion, the use of dominance or intimidation to control others

 

AND

• C Criteria is a personality showing antagonism either by;

 

1. 1.     Manipulation (frequent use of subterfuge to influence or control others, use of seduction, charm or glibness or ingratiation to achieve ones ends) or
2. 2.     Deceitfulness –dishonesty and fraudulence, misrepresentation of oneself,
3. 3.     Callousness –lack of guilt or remorse about the negative effects of ones actions on others, aggression or
4. 4.     Hostility –persistent or frequent angry feelings, anger or irritability in response to minor slights and insults; mean, nasty or vengeful behavior

 

AND

D Criteria includes irresponsibility, impulsivity or risk taking behaviors

 Robert Hare, at the University of British Columbia, concurs that the Antisocial personality may be valued for audacious leadership, and that these individuals are adaptive to a highly competitive environment because they gets results for the individual or/ and the corporations who employ them. Often these individuals will cause long term harm, both to their co workers and the organization as a whole, due to their manipulative, deceitful, abusive and fraudulent behavior. Hare describes this personality as intra- species predators who use charm, manipulation, and intimidation among other things, to satisfy their personal needs. Because they lack conscience and empathy, there is no guilt or remorse. Further, Martha Stout states that the best way to identify such a person is that they will always seek our sympathy and often unwittingly, we forgive.

 Lance has the criteria for this diagnosis. He has never hidden from us. He was always in full view. We just did not want to see him. The characteristics of his personality that made the USADA want to vilify him, to make him pay, are also the ones that have made him iconic. Lance Armstrong is one of the most fascinating figures in modern sport. He is the guy who beat the odds with cancer only to comeback from near death to win the most difficult sporting event in the world, not once, but seven times. He never quits, gives in, or admits defeat. He put flesh on the American dream.  We like that. He dominated his sport utterly, completely, and ruthlessly because that is his personality. We pretend to like that, but now, not so much.

Some may ask: What happens for Lance now? He will do as he has always done. He will keep his yellow jerseys because, as he will justify, everyone else on the podium with him and beyond has been caught doping at some time or other. Victory sustains him, and he will perform and beat everyone for as long as he can, even if it is just in a pool training session. He will reinvent himself, write another book and do personal appearances. Now we will come for his notoriety, or our curiosity. Others will come because he is charismatic, smart, a good speaker and he came back from cancer to win seven Tours. Although he won’t ask for sympathy, time will be the balm that leads us to forget and perhaps, forgive.