It's Not About the Bike: My Journey Back to Life [NOOK Book]

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Before and After

I want to die at a hundred years old with an American flag on my back and the star of Texas on my helmet, after screaming down an Alpine descent on a bicycle at 75 miles per hour. I want to cross one last finish line as my stud wife and my ten children applaud, and then I want to lie down in a field of those famous French sunflowers and gracefully expire, the perfect contradiction to my once-anticipated poignant early demise.

A slow death is not for me. I don’t do anything slow, not even breathe. I do everything at a fast cadence: eat fast, sleep fast. It makes me crazy when my wife, Kristin, drives our car, because she brakes at all the yellow caution lights, while I squirm impatiently in the passenger seat.

“Come on, don’t be a skirt,” I tell her.

“Lance,” she says, “marry a man.”

I’ve spent my life racing my bike, from the back roads of Austin, Texas to the Champs-Elysées, and I always figured if I died an untimely death, it would be because some rancher in his Dodge 4x4 ran me headfirst into a ditch. Believe me, it could happen. Cyclists fight an ongoing war with guys in big trucks, and so many vehicles have hit me, so many times, in so many countries, I’ve lost count. I’ve learned how to take out my own stitches: all you need is a pair of fingernail clippers and a strong stomach.

If you saw my body underneath my racing jersey, you’d know what I’m talking about. I’ve got marbled scars on both arms and discolored marks up and down my legs, which I keep clean-shaven. Maybe that’s why trucks are always trying to run me over; they see my sissy-boy calves and decide not to brake. But cyclists have to shave, because when the gravel gets into your skin, it’s easier to clean and bandage if you have no hair.

One minute you’re pedaling along a highway, and the next minute, boom, you’re facedown in the dirt. A blast of hot air hits you, you taste the acrid, oily exhaust in the roof of your mouth, and all you can do is wave a fist at the disappearing taillights.

Cancer was like that. It was like being run off the road by a truck, and I’ve got the scars to prove it. There’s a puckered wound in my upper chest just above my heart, which is where the catheter was implanted. A surgical line runs from the right side of my groin into my upper thigh, where they cut out my testicle. But the real prizes are two deep half-moons in my scalp, as if I was kicked twice in the head by a horse. Those are the leftovers from brain surgery.

When I was 25, I got testicular cancer and nearly died. I was given less than a 40 percent chance of surviving, and frankly, some of my doctors were just being kind when they gave me those odds. Death is not exactly cocktail-party conversation, I know, and neither is cancer, or brain surgery, or matters below the waist. But I’m not here to make polite conversation. I want to tell the truth. I’m sure you’d like to hear about how Lance Armstrong became a Great American and an Inspiration To Us All, how he won the Tour de France, the 2,290-mile road race that’s considered the single most grueling sporting event on the face of the earth. You want to hear about faith and mystery, and my miraculous comeback, and how I joined towering figures like Greg LeMond and Miguel Indurain in the record book. You want to hear about my lyrical climb through the Alps and my heroic conquering of the Pyrenees, and how it felt. But the Tour was the least of the story.

Some of it is not easy to tell or comfortable to hear. I’m asking you now, at the outset, to put aside your ideas about heroes and miracles, because I’m not storybook material. This is not Disneyland, or Hollywood. I’ll give you an example: I’ve read that I flew up the hills and mountains of France. But you don’t fly up a hill. You struggle slowly and painfully up a hill, and maybe, if you work very hard, you get to the top ahead of everybody else.

Cancer is like that, too. Good, strong people get cancer, and they do all the right things to beat it, and they still die. That is the essential truth that you learn. People die. And after you learn it, all other matters seem irrelevant. They just seem small.

I don’t know why I’m still alive. I can only guess. I have a tough constitution, and my profession taught me how to compete against long odds and big obstacles. I like to train hard and I like to race hard. That helped, it was a good start, but it certainly wasn’t the determining factor. I can’t help feeling that my survival was more a matter of blind luck.

When I was 16, I was invited to undergo testing at a place in Dallas called the Cooper Clinic, a prestigious research lab and birthplace of the aerobic exercise revolution. A doctor there measured my VO2 max, which is a gauge of how much oxygen you can take in and use, and he says that my numbers are still the highest they’ve ever come across. Also, I produced less lactic acid than most people. Lactic acid is the chemical your body generates when it’s winded and fatigued—it’s what makes your lungs burn and your legs ache.

Basically, I can endure more physical stress than most people can, and I don’t get as tired while I’m doing it. So I figure maybe that helped me live. I was lucky—I was born with an above-average capacity for breathing. But even so, I was in a desperate, sick fog much of the time.

My illness was humbling and starkly revealing, and it forced me to survey my life with an unforgiving eye. There are some shameful episodes in it: instances of meanness, unfinished tasks, weakness, and regrets. I had to ask myself, “If I live, who is it that I intend to be?” I found that I had a lot of growing to do as a man.

I won’t kid you. There are two Lance Armstrongs, pre-cancer, and post. Everybody’s favorite question is “How did cancer change you?” The real question is how didn’t it change me? I left my house on October 2, 1996, as one person and came home another. I was a world-class athlete with a mansion on a riverbank, keys to a Porsche, and a self-made fortune in the bank. I was one of the top riders in the world and my career was moving along a perfect arc of success. I returned a different person, literally. In a way, the old me did die, and I was given a second life. Even my body is different, because during the chemotherapy I lost all the muscle I had ever built up, and when I recovered, it didn’t come back in the same way.

The truth is that cancer was the best thing that ever happened to me. I don’t know why I got the illness, but it did wonders for me, and I wouldn’t want to walk away from it. Why would I want to change, even for a day, the most important and shaping event in my life?

People die. That truth is so disheartening that at times I can’t bear to articulate it. Why should we go on, you might ask? Why don’t we all just stop and lie down where we are? But there is another truth, too. People live. It’s an equal and opposing truth. People live, and in the most remarkable ways. When I was sick, I saw more beauty and triumph and truth in a single day than I ever did in a bike race—but they were human moments, not miraculous ones. I met a guy in a fraying sweatsuit who turned out to be a brilliant surgeon. I became friends with a harassed and overscheduled nurse named LaTrice, who gave me such care that it could only be the result of the deepest sympathetic affinity. I saw children with no eyelashes or eyebrows, their hair burned away by chemo, who fought with the hearts of Indurains.

I still don’t completely understand it.

All I can do is tell you what happened.

Of course I should have known that something was wrong with me. But athletes, especially cyclists, are in the business of denial. You deny all the aches and pains because you have to in order to finish the race. It’s a sport of self-abuse. You’re on your bike for the whole day, six and seven hours, in all kinds of weather and conditions, over cobblestones and gravel, in mud and wind and rain, and even hail, and you do not give in to pain.

Everything hurts. Your back hurts, your feet hurt, your hands hurt, your neck hurts, your legs hurt, and of course, your butt hurts.

So no, I didn’t pay attention to the fact that I didn’t feel well in 1996. When my right testicle became slightly swollen that winter, I told myself to live with it, because I assumed it was something I had done to myself on the bike, or that my system was compensating for some physiological male thing. I was riding strong, as well as I ever had, actually, and there was no reason to stop.

Cycling is a sport that rewards mature champions. It takes a physical endurance built up over years, and a head for strategy that comes only with experience. By 1996 I felt I was finally coming into my prime. That spring, I won a race called the Flèche-Wallonne, a grueling test through the Ardennes that no American had ever conquered before. I finished second in Liège-Bastogne-Liège, a classic race of 167 miles in a single punishing day. And I won the Tour Du Pont, 1,225 miles over 12 days through the Carolina mountains. I added five more second-place finishes to those results, and I was about to break into the top five in the international rankings for the first time in my career.

But cycling fans noted something odd when I won the Tour Du Pont: usually, when I won a race, I pumped my fists like pistons as I crossed the finish line. But on that day, I was too exhausted to celebrate on the bike. My eyes were bloodshot and my face was flushed.

I should have been confident and energized by my spring performances. Instead, I was just tired. My nipples were sore. If I had known better, I would have realized it was a sign of illness. It meant I had an elevated level of HCG, which is a hormone normally produced by pregnant women. Men don’t have but a tiny amount of it, unless their testes are acting up.

I thought I was just run down. Suck it up, I said to myself, you can’t afford to be tired. Ahead of me I still had the two most important races of the season: the Tour de France and the Olympic Games in Atlanta, and they were everything I had been training and racing for.

I dropped out of the Tour de France after just five days. I rode through a rainstorm, and developed a sore throat and bronchitis. I was coughing and had lower-back pain, and I was simply unable to get back on the bike. “I couldn’t breathe,” I told the press. Looking back, they were ominous words.

In Atlanta, my body gave out again. I was 6th in the time trial and 12th in the road race, respectable performances overall, but disappointing given my high expectations.

Back home in Austin, I told myself it was the flu. I was sleeping a lot, with a low-grade achy drowsy feeling. I ignored it. I wrote it off to a long hard season.

I celebrated my 25th birthday on September 18, and a couple of nights later I invited a houseful of friends over for a party before a Jimmy Buffett concert, and we rented a margarita machine. My mother Linda came over to visit from Plano, and in the midst of the party that night, I said to her, “I’m the happiest man in the world.” I loved my life. I was dating a beautiful co-ed from the University of Texas named Lisa Shiels. I had just signed a new two-year contract with a prestigious French racing team, Cofidis, for $2.5 million. I had a great new house that I had spent months building, and every detail of the architectural and interior designs was exactly what I wanted. It was a Mediterranean-style home on the banks of Lake Austin, with soaring glass windows that looked out on a swimming pool and a piazza-style patio that ran down to the dock, where I had my own jet ski and powerboat moored.

Only one thing spoiled the evening: in the middle of the concert, I felt a headache coming on. It started as a dull pounding. I popped some aspirin. It didn’t help. In fact, the pain got worse.

I tried ibuprofen. Now I had four tablets in me, but the headache only spread. I decided it was a case of way too many margaritas, and told myself I would never, ever drink another one. My friend and agent attorney, Bill Stapleton, bummed some migraine medication from his wife, Laura, who had a bottle in her purse. I took three. That didn’t work either.

By now it was the kind of headache you see in movies, a knee-buckling, head-between-your-hands, brain-crusher.

Finally, I gave up and went home. I turned out all the lights and lay on the sofa, perfectly still. The pain never subsided, but I was so exhausted by it, and by all the tequila, that I eventually fell asleep.

When I woke up the next morning, the headache was gone. As I moved around the kitchen making coffee, I realized that my vision was a little blurry. The edges of things seemed soft. I must be getting old, I thought. Maybe I need glasses.

I had an excuse for everything.

A couple of days later, I was in my living room on the phone with Bill Stapleton when I had a bad coughing attack. I gagged, and tasted something metallic and brackish in the back of my throat. “Hang on a minute,” I said. “Something’s not right here.” I rushed into the bathroom. I coughed into the sink.

It splattered with blood. I stared into the sink. I coughed again, and spit up another stream of red. I couldn’t believe that the mass of blood and clotted matter had come from my own body.

Frightened, I went back into the living room and picked up the phone. “Bill, I have to call you back,” I said. I clicked off, and immediately dialed my neighbor, Dr. Rick Parker, a good friend who was my personal physician in Austin. Rick lived just down the hill from me.

“Could you come over?” I said. “I’m coughing up blood.”

While Rick was on his way, I went back into the bathroom and eyed the bloody residue in the sink. Suddenly, I turned on the faucet. I wanted to rinse it out. Sometimes I do things without knowing my own motives. I didn’t want Rick to see it. I was embarrassed by it. I wanted it to go away.

Rick arrived, and checked my nose and mouth. He shined a light down my throat, and asked to see the blood. I showed him the little bit that was left in the sink. Oh, God, I thought, I can’t tell him how much it was, it’s too disgusting. What was left didn’t look like very much.

Rick was used to hearing me complain about my sinuses and allergies. Austin has a lot of ragweed and pollen, and no matter how tortured I am, I can’t take medication because of the strict doping regulations in cycling. I have to suffer through it.

“You could be bleeding from your sinuses,” Rick said. “You may have cracked one.”

“Great,” I said. “So it’s no big deal.”

I was so relieved, I jumped at the first suggestion that it wasn’t serious, and left it at that. Rick clicked off his flashlight, and on his way out the door he invited me to have dinner with him and his wife, Jenny, the following week.

A few nights later, I cruised down the hill to the Parkers’ on a motor scooter. I have a thing for motorized toys, and the scooter was one of my favorites. But that night, I was so sore in my right testicle that it killed me to sit on the scooter. I couldn’t get comfortable at the dinner table, either. I had to situate myself just right, and I didn’t dare move, it was so painful.

I almost told Rick how I felt, but I was too self-conscious. It hardly seemed like something to bring up over dinner, and I had already bothered him once about the blood. This guy is going to think I’m some kind of complainer, I thought. I kept it to myself.

When I woke up the next morning, my testicle was horrendously swollen, almost to the size of an orange. I pulled on my clothes, got my bike from the rack in the garage, and started off on my usual training ride, but I found I couldn’t even sit on the seat. I rode the whole way standing up on the pedals. When I got back home in the early afternoon, I reluctantly dialed the Parkers again.

“Rick, I’ve got something wrong with my testicle,” I said. “It’s real swollen and I had to stand up on the ride.”

Rick said, sternly, “You need to get that checked out right away.”

He insisted that he would get me in to see a specialist that afternoon. We hung up, and he called Dr. Jim Reeves, a prominent Austin urologist. As soon as Rick explained my symptoms, Reeves said I should come in immediately. He would hold an appointment open. Rick told me that Reeves suspected I merely had a torsion of the testicle, but that I should go in and get checked. If I ignored it, I could lose the testicle.

I showered and dressed, and grabbed my keys and got into my Porsche, and it’s funny, but I can remember exactly what I wore: khaki pants and a green dress shirt. Reeves’ office was in the heart of downtown, near the University of Texas campus in a plain-looking brown brick medical building.

Reeves turned out to be an older gentleman with a deep, resonating voice that sounded like it came from the bottom of a well, and a doctorly way of making everything seem routine—despite the fact that he was seriously alarmed by what he found as he examined me.

My testicle was enlarged to three times its normal size, and it was hard and painful to the touch. Reeves made some notes, and then he said, “This looks a little suspicious. Just to be safe, I’m going to send you across the street for an ultrasound.”

I got my clothes back on and walked to my car. The lab was across an avenue in another institutional-looking brown brick building, and I decided to drive over. Inside was a small warren of offices and rooms filled with complicated medical equipment. I lay down on another examining table.

A female technician came in and went over me with the ultrasound equipment, a wand-like instrument that fed an image onto a screen. I figured I’d be out of there in a few minutes. Just a routine check so the doctor could be on the safe side.

An hour later, I was still on the table.

The technician seemed to be surveying every inch of me. I lay there, wordlessly, trying not to be self-conscious. Why was this taking so long? Had she found something?

Finally, she laid down the wand. Without a word, she left the room.

“Wait a minute,” I said. “Hey.”

I thought, It’s supposed to be a lousy formality. After a while, she returned with a man I had seen in the office earlier. He was the chief radiologist. He picked up the wand and began to examine my parts himself. I lay there silently as he went over me for another 15 minutes. Why is this taking so long?

“Okay, you can get dressed and come back out,” he said.

I hustled into my clothes and met him in the hallway.

“We need to take a chest X ray,” he said.

I stared at him. “Why?” I said.

“Dr. Reeves asked for one,” he said.

Why would they look at my chest? Nothing hurt there. I went into another examining room and took off my clothes again, and a new technician went through the X-ray process.

I was getting angry now, and scared. I dressed again, and stalked back into the main office. Down the hallway, I saw the chief radiologist.

“Hey,” I said, cornering the guy. “What’s going on here? This isn’t normal.”

“Dr. Reeves should talk to you,” he said.

“No. I want to know what’s going on.”

“Well, I don’t want to step on Dr. Reeves’ toes, but it looks like perhaps he’s checking you for some cancer-related activity.”

I stood perfectly still.

“Oh, fuck,” I said.

“You need to take the X rays back to Dr. Reeves; he’s waiting for you in his office.”

There was an icy feeling in the pit of my stomach, and it was growing. I took out my cell phone and dialed Rick’s number.

“Rick, something’s going on here, and they aren’t telling me everything.”

“Lance, I don’t know exactly what’s happening, but I’d like to go with you to see Dr. Reeves. Why don’t I meet you there?”

I said, “Okay.”

I waited in radiology while they prepared my X rays, and the radiologist finally came out and handed me a large brown envelope. He told me Reeves would see me in his office. I stared at the envelope. My chest was in there, I realized.

This is bad. I climbed into my car and glanced down at the envelope containing my chest X rays. Reeves’ office was just 200 yards away, but it felt longer than that. It felt like two miles. Or 20.

I drove the short distance and parked. By now it was dark and well past normal office hours. If Dr. Reeves had waited for me all this time, there must be a good reason, I thought. And the reason is that the shit is about to hit the fan.

As I walked into Dr. Reeves’ office, I noticed that the building was empty. Everyone was gone. It was dark outside.

Rick arrived, looking grim. I hunched down in a chair while Dr. Reeves opened the envelope and pulled out my X rays. An X ray is something like a photo negative: abnormalities come out white. A black image is actually good, because it means your organs are clear. Black is good. White is bad.

Dr. Reeves snapped my X rays onto a light tray in the wall.

My chest looked like a snowstorm.

“Well, this is a serious situation,” Dr. Reeves said. “It looks like testicular cancer with large metastasis to the lungs.”

I have cancer.

“Are you sure?” I said.

“I’m fairly sure,” Dr. Reeves said.

I’m 25. Why would I have cancer?

“Shouldn’t I get a second opinion?” I said.

“Of course,” Dr. Reeves said. “You have every right to do that. But I should tell you I’m confident of the diagnosis. I’ve scheduled you for surgery tomorrow morning at 7 a.m., to remove the testicle.”

I have cancer and it’s in my lungs.

Dr. Reeves elaborated on his diagnosis: testicular cancer was a rare disease—only about 7,000 cases occur annually in the U.S. It tended to strike men between the ages of 18 and 25 and was considered very treatable as cancers go, thanks to advances in chemotherapy, but early diagnosis and intervention were key. Dr. Reeves was certain I had the cancer. The question was, exactly how far had it spread? He recommended that I see Dr. Dudley Youman, a renowned Austin-based oncologist. Speed was essential; every day would count. Finally, Dr. Reeves finished.

I didn’t say anything.

“Why don’t I leave the two of you together for a minute,” Dr. Reeves said.

Alone with Rick, I laid my head down on the desk. “I just can’t believe this,” I said.

But I had to admit it, I was sick. The headaches, the coughing blood, the septic throat, passing out on the couch and sleeping forever. I’d had a real sick feeling, and I’d had it for a while.

“Lance, listen to me, there’s been so much improvement in the treatment of cancer. It’s curable. Whatever it takes, we’ll get it whipped. We’ll get it done.”

“Okay,” I said. “Okay.”

Rick called Dr. Reeves back in.

“What do I have to do?” I asked. “Let’s get on with it. Let’s kill this stuff. Whatever it takes, let’s do it.”

I wanted to cure it instantly. Right away. I would have undergone surgery that night. I would have used a radiation gun on myself, if it would help. But Reeves patiently explained the procedure for the next morning: I would have to report to the hospital early for a battery of tests and blood work so the oncologist could determine the extent of the cancer, and then I would have surgery to remove my testicle.

I got up to leave. I had a lot of calls to make, and one of them was to my mother; somehow, I’d have to tell her that her only child had cancer.

I climbed into my car and made my way along the winding, tree-lined streets toward my home on the riverbank, and for the first time in my life, I drove slowly. I was in shock. Oh, my God, I’ll never be able to race again. Not, Oh, my God, I’ll die. Not, Oh, my God, I’ll never have a family. Those thoughts were buried somewhere down in the confusion. But the first thing was, Oh, my God, I’ll never race again. I picked up my car phone and called Bill Stapleton.

“Bill, I have some really bad news,” I said.

“What?” he said, preoccupied.

“I’m sick. My career’s over.”

“What?”

“It’s all over. I’m sick, I’m never going to race again, and I’m going to lose everything.”

I hung up.

I drifted through the streets in first gear, without even the energy to press the gas pedal. As I puttered along, I questioned everything: my world, my profession, my self. I had left the house an indestructible 25-year-old, bulletproof. Cancer would change everything for me, I realized; it wouldn’t just derail my career, it would deprive me of my entire definition of who I was. I had started with nothing. My mother was a secretary in Plano, Texas, but on my bike, I had become something. When other kids were swimming at the country club, I was biking for miles after school, because it was my chance. There were gallons of sweat all over every trophy and dollar I had ever earned, and now what would I do? Who would I be if I wasn’t Lance Armstrong, world-class cyclist?

A sick person.

I pulled into the driveway of my house. Inside, the phone was ringing. I walked through the door and tossed my keys on the counter. The phone kept ringing. I picked it up. It was my friend Scott MacEachern, a representative from Nike assigned to work with me.

“Hey, Lance, what’s going on?”

“Well, a lot,” I said, angrily. “A lot is going on.”

“What do you mean?”

“I, uh . . .”

I hadn’t said it aloud yet.

“What?” Scott said.

I opened my mouth, and closed it, and opened it again. “I have cancer,” I said.

I started to cry.

And then, in that moment, it occurred to me: I might lose my life, too. Not just my sport.

I could lose my life.

IT’S NOT ABOUT THE BIKE

By Lance Armstrong

Copyright © 2000, 2001 by Lance Armstrong.