The rise in Simpson’s body temperature would have led to heat exhaustion. It is actually possible that he was already suffering from this when he arrived at the mountain. He could have been showing the symptoms when he asked Vin Denson for water and told Colin Lewis that his ‘guts were feeling queer’.
If heat exhaustion is not treated, heatstroke sets in: an uncontrollable rise in body temperature which causes damage to the body’s organs as the cells die off owing to the heat. The medical term for the condition is hyperthermia: when the body cooks slowly from within. Usually, heatstroke patients have to be treated in an intensive care unit.
Heatstroke can result in irrational behaviour: the bizarre conduct which Lucien Aimar observed when he overtook Simpson and his refusal to ride up the mountain at a sensible pace would be typical, as was Simpson’s obsessive desire to continue. The lack of sweat on Simpson’s skin ties in as well: it is common in the acute stages of the condition.
Simpson’s heart would have felt the strain first. The heart of a top cyclist going up a mountain beats between 160 and 200 times per minute, but Simpson’s pulse rate would have increased drastically above this. It would have entered a state known as ‘tachycardia’, where the heart beats very rapidly and less efficiently: the contractions are so brief that less blood than is needed is pumped around the system. From the British team car, Harry Hall filmed Simpson zigzagging up the mountain. It ties in with tachycardia: the reduction in the supply of oxygen to the brain would result in confusion and a lack of coordination, similar to that seen in climbers at extremely high altitudes.
It is possible for the heart to revert naturally to a normal rhythm following a brief spell of tachycardia, but Simpson’s heart had no chance to do so. He had been climbing the mountain for almost an hour, and his internal temperature would have been too high, even though he had slowed down and by now he was in the cooler part of the climb. He would then enter a state known as ‘ventricular fibrillation’, where the heartbeat becomes completely uncoordinated and there is no blood flow through the body. This is not a heart attack, which is when the heart actually stops beating owing to a blocked cardiac artery. Heart attacks are virtually unknown in athletes with no history of heart disease in their family. In a state of fibrillation, on the other hand, the heart is still moving but the muscles are merely twitching and pumping no blood. Once this has begun, death usually follows between two and three minutes afterwards. The brain is starved of oxygen, and is irreversibly damaged.
The waxy nature of Simpson’s skin, and his yellowish colour, both described by Harry Hall, would suggest that there was no oxygen in Simpson’s blood when he fell for the second time. The way in which Simpson’s fingers gripped on his handlebars is typical of the muscular spasm which happens as a result of the sudden severe chest pain caused by heart failure. I asked a retired Home Office pathologist about Simpson’s fingers, and he gave me a chilling answer: ‘He would have had a violent cardiac cramp and would have hung on like grim death.’
Nowadays, these are well-known syndromes; many large public buildings in the United States have defibrillators, which apply an electric shock to an abnormally beating heart to jolt it back into a normal rhythm. The machines are carried in the ambulances at most major cycle races. If a modern-day Simpson were to collapse on the Ventoux in a similar state in the 2002 Tour de France, he might be kept alive, if a doctor were on the spot immediately, which is of course by no means likely. It would, however, take the best of modern resuscitation aids: the defibrillator, plus an electrocardiograph (ECG). Pure oxygen might be administered via a tube down the throat, with a bag used to pump air into the lungs. At the same time, he would have to be treated for the heatstroke.
In 1967, however, Dr Dumas did not arrive on the scene immediately. The Tour caravan would have been spread over at least six miles of mountain road, so it would have taken a fluke for him to be in the right place at the right time. The doctor had a primitive oxygen mask and cylinders; but Simpson’s heart needed to be functioning for the equipment to have any effect. There is virtually no chance that he could have been saved, unless he had happened to fall off in front of a hospital with an intensive care unit. This is worth bearing in mind, given the claims directed at Harry Hall and the late Alec Taylor, who obeyed Simpson’s final order to put him back on his bike. Hall has been accused to his face of failing to prevent Simpson’s death, and there have been comments such as this from Simpson’s teammate Roger Pingeon: ‘Tom was unlucky that the Tour was being contested by national teams. His [trade team] manager would never have put him back on his bike.’
Another point should be made regarding Hall’s and Taylor’s action. Simpson was the boss, in charge of the team. Hall makes it clear that Simpson had the final say on virtually everything that went on, down to which of the two mechanics would travel alongside Taylor in the team car on which day. All of Taylor’s orders were prefaced with ‘Tom wants this’. Simpson’s status and experience were vastly superior to that of either the mechanic or the manager. It was not their job to deny him.
Dr Dumas has also been blamed for Simpson’s death. Albert Beurick’s theory is that, when Dumas put Simpson in the helicopter to transport him to hospital, the doctor killed his patient by taking him to a higher altitude and depriving him of oxygen. This view does not stand up: Simpson was already being given oxygen, to no effect, and was put in the helicopter at least 40 minutes after his collapse. Dr Dumas maintained that he was dead ‘a long time’ before then – ‘you could see it: his blood pressure was not rising’.
Both Jacques Anquetil and his manager, the former cyclist Raphael Geminiani, claimed for many years after Simpson’s death that Dumas was to blame. In an interview with the magazine Velo in 1984, Geminiani claimed: ‘Pierre Dumas made Simpson die. Simpson died of a cardiac arrest which can happen to anyone. You have to immobilize the sick man, keep his head lower than his feet [to ensure some oxygen reaches the brain] and inject adrenaline or Maxiton to reanimate the heart.’ The same claim is still there on Geminiani’s website today, quoting its source, a newspaper article written shortly after Simpson’s death by one Dr Philippe Decourt.
But Simpson was immobilized. Keeping his head lower than his feet would have been pointless if his heart was not beating, and could not deliver the oxygen. Today, an adrenaline injection might indeed be given, but it would be just one of a wider panoply of measures. Whether on its own it would have had an effect on an athlete suffering advanced heatstroke is debatable.
There are other, less pernicious, Simpson myths which are worth dealing with briefly. His death has been blamed on the fact that he came from a mining family and had inherited undersized lungs from his father. No medical doctor I have spoken to feels this is worthy of consideration. Had Simpson had damaged lungs, he would have been unable to win the toughest cycle races in the world, with or without drugs. Then there is the claim from Jacques Anquetil at the time that Simpson’s death was due to the newly instituted drug controls, because he would not have used his usual drugs and might have tried something more dangerous. This has to be put in the context of Anquetil’s war on drug testing. Great cyclist he may have been, but he was hardly objective when that topic came up.
Decourt could not claim to be writing from an objective standpoint either, although his allegations, now also on Geminiani’s website, were widely quoted in the press after Simpson’s death. A former employee of the Rhône-Poulenc drug company, Decourt claimed to have been responsible for inventing the amphetamine marketed as Ortedrine. It could be argued that he had a personal agenda: blaming Dumas meant that the drugs were cleared of any responsibility. He makes the link explicitly in his article: ‘Amphetamine did not cause Simpson’s death. He did not receive appropriate care.’
Geminiani and Anquetil belong to the same school of thought. On his website, over 30 years since the publication of the autopsy report, Geminiani maintained that Simpson died ‘of cardiac collapse due to hypoglycaemia’. Anquetil, for his part, t
old Velo magazine in 1979: ‘As far as I know, Simpson died due to a cardiac collapse which was not caused by the use of amphetamines.’ The five-times Tour winner and icon of cycling, and the popular ‘Big Gun’, as Geminiani is known, are in prestigious company. The late Robert Chapatte, former Tour cyclist and head of sport at French national television Antenne 2, wrote this in his autobiography When the Doors Slam: ‘The tragedy of the Tour de France 1967 calls for a definitive answer about the use of stimulants by certain sportsmen. In Simpson’s case, the answer was no he did not.’
Even Simpson’s great friend the journalist David Saunders, who ghosted his autobiography Cycling is My Life falls into the same trap. In his book Cycling in the Sixties, Saunders wrote: ‘I think the drug played a very small part in his [Simpson’s] death . . . It relieved him of much of the pain and suffering.’
As revisionism goes, it is hardly Stalinist, but, like Beurick’s ‘helicopter’ theory, it all serves to muddy the waters and steer attention away from the amphetamines. In Saunders’ and Beurick’s case, it can be explained as blind loyalty: they do not want to admit that what their friend ingested may have helped kill him. Anquetil and Decourt also have their own agendas.
Part of the confusion arises because it is perfectly possible to die of exertional heatstroke without taking ‘speed’. Heatstroke kills a small number of participants in long-distance runs every year, and it also claims a few US army recruits. In these cases, it is excessive motivation, extreme weather conditions and possibly a lack of fitness which are to blame. There is no drug link.
In Simpson’s case, the drug was present. Amphetamines did not directly cause his death, in the same way that alcohol does not directly lead to the death of a driver who has a few beers, then goes off the road and crashes into a tree. But they would have caused his body temperature to rise, they would have hindered his body from dealing with that situation, and they would have prevented his mind from being aware of what was going on. The background to his death and his symptoms point to exertional heatstroke as the cause: amphetamines would have played their part along with the other factors.
The question which follows immediately is this: if amphetamines did play a part in Simpson’s death, and given that they were being widely used by cyclists at the time, why was Simpson the only cyclist to drop dead on the Ventoux on that day? My search for the answer took me a long way from Mont Ventoux. Surfing the Internet using the search terms ‘hyperthermia’ and ‘amphetamines’, I came across the best modern parallel: the deaths of nightclubbers who have used Ecstasy, which is itself a form of amphetamine. Deaths are extremely rare in relation to the volume of drugs being taken.
In Britain in 2001, 500,000 Ecstasy tablets were estimated to be downed in one weekend. Exactly as in Simpson’s case, there is no apparent explanation why one particular person takes the same pill as another under the same conditions and survives while the other dies. The available evidence from the 1960s is that a lot of amphetamines were being used in cycling. And, as is the case for Ecstasy-popping clubbers of today, the mortality figures imply that the game was probably worth the candle.
So was it plain bad luck that Simpson died when others did not? Not for nothing do the French refer to the force which drives cyclists on as rage à vaincre, or ‘rage to win’. But ‘rage’ also refers to the madness of rabies. Simpson’s friends, contemporaries and family all comment on his ability to drive himself further than most people could manage, from an early age. Simpson said himself that he could ride ‘into such a state of fatigue that you don’t know what you’re doing’. ‘He would fire off and explode and we would all pass him lying in the gutter,’ says his professional mentor, Brian Robinson, who gives the impression that the sight of Simpson lying by the roadside surprised no one. Indeed, at the top of the Ventoux, when Vin Denson, Colin Lewis and Barry Hoban saw him being treated by Dr Dumas, they assumed he had just tried too hard – as usual.
Indeed, Simpson made a habit of continuing to race far beyond the point where common sense would dictate withdrawal in the interests of damage limitation. Simpson summed up his philosophy thus: ‘I find it hard to think a rider is ever justified in retiring from a major race.’ The 1965 Tour de France was a good example: the poorly treated hand injury left Simpson with severe blood poisoning, bronchitis, a kidney infection and one abscess after another, but he did not quit until he was made to by the race’s doctor. In his first Tour, 1960, he lost two stones in weight, finished in a state of exhaustion, and then raced himself to a standstill afterwards in appearance events.
Given cyclists’ minimal understanding of physiology at the time, it was normal for them to go over the limit in races: they did not know whether or not they were harming themselves. Barry Hoban says now: ‘We had no idea how often we were pushing ourselves into the red.’ In his autobiography, Watching the Wheels Go Round, Hoban describes an incident in 1963, in the Paris–Luxembourg race. ‘Edouard Delberghe and I were so smashed that we were zigzagging along the road. Delberghe went off the road completely. He was suffering from heatstroke and was taken to hospital, delirious. I managed to struggle on . . . I crumpled like a piece of jelly . . . There was no strength left in my legs. They carried me to the team car. I was so smashed I couldn’t go downstairs for dinner [in the hotel].’
Simpson, however, is the only cyclist I have come across to drive himself so hard that he managed a near-death or out-of-body experience. It happened in a two-man team time trial in Italy in 1964, the Baracchi trophy, when he was partnered with Rudi Altig. He would beat the German a year later to win his world championship, but on that day Altig was far stronger and pushed Simpson to a point where he could barely keep up. The day after, Simpson went out training with Vin Denson, and told him about it. It clearly made a huge impression on Denson.
‘He said “Christ, I died.” He said everything seemed to be coming and going. It was a sensational feeling, you could see things totally clearly, then it all closed up and you could see nothing. Then it came back again, it went and came back like being in a tunnel. He said he felt peace of mind and wasn’t afraid to die. He said, “I’m sure I died and came back again.” He said he would have been happy dying.’
This sounds like the sense of detachment from the body and from physical discomfort which athletes describe when they enter ‘the zone’. In Simpson’s case it may have been caused by a shortage of oxygen in the brain due to the effort of trying to stay with Altig, or by endorphins, the body’s natural painkillers. It could have been both of these, with or without the effects of ‘speed’. Nonetheless, it is an eerie premonition.
Acceptance of mortal danger is integral to cycle racing. Just as a top Formula One driver can find an extra 10 mph over the rest on a given bend, on the road the best cyclists will perfectly calculate their descending speed and the expert sprinter will spot a minute gap between the wheels of a group sprinting for the finish at 40 mph. Even in a sport where every participant has a mass of scars from ‘road rash’ on elbow and thigh, Simpson fell more often than most other riders. His wife Helen wrote to George Shaw on July 18, 1963: ‘Tom fell off yesterday and cut his head rather badly, not bad enough though to prevent him from riding today. That’s the second fall in two days.’
Injuries were not something he took seriously. On September 1, 1960, he wrote to George and Marlene Shaw from a Paris hospital: ‘Raced almost every day since the Tour (the money’s OK). I’m in hospital – it’s nothing serious, just a leg I can’t walk on. I don’t like me bike, it’s to’ard [sic].’
Many of Simpson’s contemporaries felt that he did not merely flirt with disaster, but warmly embraced it. When racing on a banked indoor velodrome, Simpson would sometimes ride up the vertical advertising boards at the top of the bankings, Wall of Death-style, to please the crowds. ‘We admired it, but we said “the guy’s a bloody idiot. He will kill himself one day”,’ says Norman Sheil. Racing with Simpson in France, Sheil saw him crash twice, once sliding down the road on his back for 100 ya
rds, another time piling into a heap of gravel at full speed. ‘I told him to his face: “one of these days you will kill yourself”.’
To the outsider, cycle racing can look suicidal – descending mountains at 60 mph, sprinting into the finish elbow-to-elbow in a group of a hundred riders travelling at 40 mph. But, to the cyclist on the inside, the risks are part of the business, in the same way that a jockey accepts sitting on a horse galloping at 30 mph or so, or one rugby player flings himself at another. I have enjoyed the constant flirtation with danger myself. It’s a game of courage, instinct and adrenaline, where the man who gets closest to the line that says ‘disaster’ without stepping over it is most likely to win. Understand this, and you understand something of why Simpson died, why it is possible for a man to leave part of himself behind when he gets on a bike.
There is an element in the best bike racers, amateur and professional, which is beyond the bounds of rational behaviour. They have times when the inner need to win overrides any sense of danger, and the physical effort becomes almost irrelevant. There is a kind of split in the personality involved. On two wheels, I have seen the friendliest, most level-headed people become possessed with a will power which turns them into a human machine with tunnel vision.
Simpson should be remembered as an impulsive, intelligent, articulate and supremely charismatic man who had a single blind spot: his need to win at any cost. He was not a bad man, nor a foolish one, nor was he unprofessional in his approach to his sport, but he chose to join others in cheating and got caught out in the most dramatic manner imaginable. He transgressed no more than many others did, and still do. Unlike Richard Virenque, who lied for two and a half years, and then confessed, served his drug ban and returned to stir the hearts of cycling fans once again, there is no way back for Simpson. That is his enduring tragedy.
Put Me Back on My Bike Page 19
