Triathlon and the CIRC Report

We have been mentioning about the lack of supervision on Human Rights on the part of the International Triathlon Union.  “The Right to Compete” has been violated by the FMTRI when they have the “Marcas Mínimas” as a requirement to represent Mexico in international competitions.  Similar problems encounter the International Cycling Union now that the CIRC REPORT was published:

An independent report has heavily criticized the International Cycling Union (UCI) for its handling of the Lance Armstrong doping scandal. The 227-page report also said doping remains an ongoing problem in the sport.

Cycling continues to struggle with widespread doping, that's the bottom line of a new report from the Cycling Independent Reform Commission.

In a bid to investigate how the sport was lost due to doping scandals through the 1990s and 2000s, the CIRC was set up last January, and has now heavily criticized the sport's leadership throughout that era.

Former UCI presidents, Hein Verbruggen and Pat McQuaid, were condemned for their behaviour towards cycling's most famous doper, Lance Armstrong. However the pair were cleared of the allegation that the former seven-time Tour de France winner paid bribes to cover up any positive testing, or independed reports.

"The UCI exempted Lance Armstrong from rules, failed to target test him despite the suspicions, and publicly supported him against allegations of doping," the report said.

Pat McQuaid was president of the UCI from 2006 to 2013

US Anti-Doping Agency chief Travis Tygart says he is ready to assist in pursuing prosecution of the former cycling chiefs accused in the new report.

"USADA will work with the current UCI leadership to obtain the evidence of this sordid incident to ensure that all anti-doping rule violations related to this conduct are fully investigated and prosecuted, where possible," said Tygart.

Opened up to scrutiny

A total of 174 anti-doping experts, officials, riders and other interested parties were interviewed in the 3 million euro ($3.3 million) report. CIRC Chairman Dr Dick Marty, a former Swiss prosecutor and two vice-chairs, German anti-doping expert Professor Ulrich Haas and expert investigator Peter Nicholson, compiled the document.

"Very few, if any sports, have opened themselves up to this level of independent scrutiny and while the CIRC report on the past is hard to read for those of us who love our sport, I do believe that cycling will emerge better and stronger from it," current UCI president Brian Cookson said Monday.

However, as well as damning the sport's past, the report also uncovered ongoing issues with doping in the sport. "The CIRC considers that a culture of doping in cycling continues to exist, albeit attitudes have started to change," it said.

One "respected" witness estimated that around 90 percent of riders are doping, while "three to four" top teams have a widespread reputation for cheating. Many are apparently using micro doses to avoid detection, giving small performance gains. Under that method, riders can take a micro drug dose in the evening and expect to test negative again by 6 am the next morning, the report said.

apc/al (AFP, dpa, Reuters)

But, what is the person involved says about it?:

Verbruggen’s full statement is below.

I have studied the CIRC report and I am satisfied that it confirms what I have always said: that there have never been any cover-ups, complicity or corruption in the Lance Armstrong case (or, indeed, in any other doping cases), nor did Armstrong make any payments relating to the Vrijman Report. The wild conspiracy theories and accusations have all been properly debunked once and for all. I am pleased that this report confirms my complete innocence concerning these accusations which have been levelled [sic] at me in the past.

Where the report becomes more subjective, however, it also becomes more contradictory. The CIRC’s main criticism in its analysis of the UCI’s anti-doping policy is that the “policies put in place to combat doping during my presidency were inadequate”. That is a rather cheap shot from people who today have the benefit of 25 years of hindsight.

The CIRC omits to mention that I took over the UCI presidency in November 1991, when the UCI was virtually non-existent and had no financial means whatsoever. This meant the whole federation had to be started from scratch, including its anti-doping activities. As a result, the necessary professionalization of the UCI’s anti-doping work could only be started as of 1992 – and we had to work with the technology that existed at the time. For the CIRC to pronounce judgment concerning the “adequacy” or otherwise of the start of our battle against doping, without taking these prevailing circumstances into account, is, I believe, unfair.

Looking back, I am still firmly of the conviction that, given the financial and staff constraints the UCI had at the time, we couldn’t have done anything much differently. Indeed the CIRC acknowledges that, at the time, the UCI was one of the best federations in terms of its anti-doping policy. Also the anti-doping policy was reported, discussed and approved regularly at the meetings of the UCI management committee and also at the UCI congress where also the current UCI president was a delegate for many years.

The CIRC, in saying that I was too close to Armstrong when there was strong reasons to suspect him of doping and that “UCI failed to target test him despite the suspicions”, is being rather blinkered and one-sided in its condemnation. It pointedly fails to mention that WADA only tested Armstrong three times in 10 years and that USADA performed far worse than the UCI in its testing of Armstrong. This was all information that the CIRC had in its possession.

In this respect, I am grateful that the CIRC report vindicates what I have said from the very beginning: “the CIRC is not suggesting that UCI leadership knowingly or deliberately allowed doping and high-profile dopers to continue within the sport knowing or suspecting them still to be doping.” This was one of the main allegations against me and the UCI.

The CIRC’s description of my presidency as “autocratic without appropriate checks and balances” is a caricature based on the opinions of five people who, for a variety of reasons, had personal grudges against me. I would gladly have provided the CIRC with a list of 50 to 100 people who have worked with me as President of their Boards, Commissions, etc. and who would definitely not recognize the extremely one-sided picture that has been painted of me.

Finally, I am happy to note that, at the end of the chapter about the Vrijman report, on pages 189-191, the Commission’s President Dick Marty expresses an ‘additional opinion’ concerning the breaches of medical confidentiality at the request of WADA; the targeting of Armstrong in a context of conflicts with WADA, the French NADO and ASO; targeted leaks to the media; etc. He concludes that “the affair gave rise to genuine feelings of unease especially when taking into account the serious conflicts that at that time existed between UCI and WADA (at least at executive level)”. My concern is why the two other members of the CIRC did not wish to join President Marty in signing off this part of the report concerning WADA in particular.

Read more at http://velonews.competitor.com/2015/03/news/circ-report-statement-hein-verbruggen_362509#1YArUX1112QGZ58B.99

This is an old matter:  If John F Kennedy would be the USA president in today´s ethics, he would be in a lot of trouble.  It is not that ethics is different, but we take into account many other things.  Human rights for females, children, gays and lesbians are not the same for good of bad in today’s ethics.  As a doctor, I was trained not to make jokes in general, because I could get into multiple problems.  Europeans are more liberal about human rights and ethics as well as Canadians, but the WASP ethics governs over the International Unions and sooner or later “justice” will come; Armstrong was caught by the USADA, not the WADA or the UCI.  ARMSTRONG WAS RIGHT: HE WAS THE BEST OF THE CHEATERS.  And, as the report says, the doping culture still exists in cycling and it contaminated triathlon as well.  ITU!  Are you doing enough for keeping the sport clean as well as watching after Human Rights from National Federations?  Nope.  Don’t cry baby in the future!

Triathlon and the Ultimate Fight

I was reading Obama´s health care plan and the creation of a databank:

Mr. Obama announced last month that his new budget included $215 million toward the creation of a national databank of medical information, intended to associate specific gene patterns with various diseases and to predict what genetic, lifestyle and environmental factors correlate with successful treatment. Once all those relationships are clarified, the path will open to drugs or other interventions that firm up the good links and interrupt the bad ones.

http://well.blogs.nytimes.com/2015/02/16/genes-tell-only-part-of-story/?emc=eta1

Skeptics point out that genetic medicine, for all its promise, has delivered relatively few clinical benefits. And straightforward analyses of lifestyle and environment effects on health may occasionally lead to clear-cut advice (don’t smoke), but more often sow confusion, as anyone curious about the best way to lose weight or the optimal quantity of dietary salt knows… Barbara has obvious genetic predispositions, like most patients, but not inherited diseases like cystic fibrosis or genetic signatures on tumor cells. Those alcoholism genes are unquestionably going to turn out to be subtle troublemakers, the kind that nudge people in the wrong direction, raising risk but not sealing doom.

The relationship between medical problems like the one of Barbara and triathlon performance are quite similar.  We have seen this phenomenon with the kids that left the team:

Which chapter came first? Was it the genetic predilection for alcohol that created her lifestyle (pure chaos) and environment (streets, shelters, hotels)? Or did the story start at another point in the cycle, with alcohol selected as a comforting longtime companion, then taking over?... Either way, Barbara’s medical problems are predictable spokes on the wheel: bad heart, terrible liver, crumbling hips, gummed up lungs, AIDS from a brief foray into injectable drugs.

Talent identification for triathlon has to do more with lifestyle and environment than genetics, as we have mentioned multiple times in this blog.  But, are the environmental and lifestyle teachable?  We come back to same problem: EDUCATION.  We struggle to teach a healthy lifestyle and the environment we live in sucks.  Obama is fighting the ultimate fight already with a handicap:

Furthermore, the influence of Barbara’s lifestyle and environment on her medical conditions doesn’t require a giant database or a powerful computer to interpret. Mr. Obama’s data crunching and Barbara’s own analysis are bound to concur: “Gotta find a place to live, gotta make new friends, gotta take my meds.”

Triathlon and Winners’ Psychology

Nothing can substitute real life experiences.  I was called in by my sister who told me that my mother was vomiting a “black stuff.”  She is a 94 years old.  I said: “It is an emergency…there is a gastroenterologist next door, call him while I get there.”  She got an endoscopy next day, she had a gastric ulcer but it does not appear that it was the cause of how bad she looked, it was a consequence to me.  IF YOU DO NOT BELIEVE WHAT YOU SEE THE PATIENT IS DEAD.  The same things for winning in triathlon, if you do no clock you progress you are lying to yourself, and the chances of winning are null.  Believing what we see is the first step.

Planning after believing what we see is the following step.  Here, we can have a good plan or a bad plan but either one of them could be useful if we describe and follow step by step how to achieve goals.  I decided to go with the gastroenterologist who told me to contact the doctor in certain hospital where he was going to do the endoscopy.  In Mexico, most of the doctors are useless, not just from the point of view of what they do; they are unable to play in a team.  In our town, we do not have transplants because we are unable to put together, in a team, a bunch of doctor who could do it (renal transplants have been around for decades in the world). When we decided to do a surgery, the gastroenterologist decided to move out of the care and I was left with an internist and a surgeon who said he was busy to do the surgery in the next 24 hrs.  I contacted, in a hurry, a surgeon who could have the privileges in the hospital.  I was not able to take mom someplace else at this time and I was left with supervising what they were doing the best I could.  In a strange move, I was left out of the surgery; I did not make waves because I put the surgeon in and I was desperately trying to make a team work.  I ACCEPTED WHAT THEY TOLD ME.  It was a nightmare.  Planning training in triathlon means to practice cadence vs low cadence while training cycling; reps at high speed vs long pacings that last more than five minutes when running, as well as high cadence vs low cadence jumping while running; decreasing strokes when swimming vs poor technique but speed for the moment to get certain speed to be in the second or third pack.  In triathlon, there is a chance to plan what follows, very different from a medical emergency.

The decision of which road to take depends on the state of knowledge of the individual.  I knew I was just supervising, something I did with residents as a Chief Resident but this was different; my mom was dying.  I played as a Chief Resident overviewing what they were doing.  My mom came back home but three days later she started to deteriorate -they did not put a drainage after surgery assuming they resolved the problem by liberating gut (it was trapped because of the edema).  I changed the game at this time.  I needed a team to be able to do our best this time, only chance.  I called a friend (surgeon) who went to Medical School with me; I presented the case to him.  He said: “I need to see the patient before making a decision.”  He came home (my mother´s) and reviewed the case:  “I need a team all the way to do something.”  Then I knew we were in the game.  He said: “I’ll call a few doctors (it was Sunday), she needs surgery and we will do it in two hour:  We need to do an abdominal surgery again.” 94-years-old, with mild heart failure and problems to keep a good oxygen saturation, adding sepsis to it.  The last chance for Rachel.  I asked to her about it and she said: “Go for it.”  The surgeon and I were left after the surgery, in addition to one nurse; the only medical team committed to Rachel.  Commitment to improve is the requirement in triathlon; athletes need to be students of their sport, experts in physiology, nutrition and administration.  This is the way to avoid falling into a trap.  Little knowledge is dangerous, just like the doctors in Mexico.

The surgeon who performed the last surgery wanted Rachel to improve because he likes winning; the other were just playing medicine.  The decision made changed the outcome of Rachel. It was made on solid basis of how life works, something that every athlete should know. Do we want to win or just “play triathlon?”