Lance Armstrong Never One to Be Halted by Pain

Lance Armstrong, by the numbers: seven Tour de France crowns, a five-inch metal plate and 12 screws in his broken collarbone.
Lance Armstrong, by the numbers: seven Tour de France crowns, a five-inch metal plate and 12 screws in his broken collarbone. (By Victor R. Caivano -- Associated Press)
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By Sally Jenkins
Thursday, March 26, 2009

Lying in a ditch in Spain, Lance Armstrong tried to decide whether to touch his crumpled shoulder, or not. "I knew it hurt like hell, and whenever you have a big pain like that, your mind says you better go feel it and make sure nothing is sticking out," he said. "And at same time I was afraid to feel it."

He hesitantly passed a hand over his jersey, and hoped the uneven bumps he felt were the cables from his radio. They weren't. They were the jigsaw pieces of his collarbone. "I knew then it was broken pretty good," he said during a teleconference on Tuesday night.

Yesterday morning, an Austin orthopedic surgeon played pick-up sticks with Armstrong's clavicle, trying to "put the puzzle back together," as he described it. A five-inch metal plate with 12 screws was inserted over the angulated, uneven breaks in the bone. Armstrong emerged from the surgery with his shoulder heavily wrapped, and under orders from his surgeon, Doug Elenz, not to move for at least 72 hours. Elenz says Armstrong's comeback will be "day-to-day, week-to-week, month-to-month."

Good luck with that. Armstrong has no intention of abandoning or even delaying his cycling comeback because of his busted collarbone. Armstrong says the issue is not whether he will ride in the two headline events he has entered this season, the Giro d'Italia and the Tour de France. The only issue is how much it will hurt when he does.

Armstrong is reunited with his old friend, Pain, and you get the distinct impression that he's happy to be keeping company with it again. Most people's natural reaction is to avoid pain, to anesthetize it, dull it, or kill it. But Armstrong frankly welcomes it. His relationship with pain, his ability to tolerate it, cope with it, and even use it, is the single most interesting aspect of his character, and one thing no one can doubt about him.

It emerges from the tabloid reports of his playboy habits, and the accusations of doping, as a defining characteristic like his cast-iron cheekbones. It's what allowed him to whip cancer in a fair fight, and it's what provoked him to launch a comeback attempt at the age of 37, after a three-year layoff. "Pain is temporary," he told me once. "Quitting lasts forever." The statement is the ruling imperative of his life, and it was the cornerstone to the autobiography we collaborated on, "It's Not About the Bike."

On Monday, Armstrong catapulted over the handlebars of his bike in a massive pileup on a rugged little goat path of a road, near the end of the first stage of the Vuelta a Castilla y Leon, a five-day race in northern Spain. He landed on his head, cracking his helmet open, and then struggled to a sitting position, stunned, as the hurt set in. It felt like being hit with a club, followed by scalding water. "You're laying there, and you sort of ask yourself, 'What the hell am I doing here?' " he said during the teleconference, which took place shortly after he returned to Austin for a battery of X-rays and CT scans.

As hospital scenes go, it was a mere sketch compared to the one that Armstrong experienced a few years ago. The last time he went under the knife he was fighting for his life against testicular cancer and had surgery to remove two brain tumors. Armstrong's reaction upon regaining consciousness on that occasion tells you something about how he deals with both pain, and the capriciousness of accident, whether a bike wreck or a random cellular disease. As his friend and trainer Chris Carmichael bent over him to comfort him, Armstrong said, "Hey, listen. I like it this way. I've never known it any other way." The next time he awoke, a couple of hours later, he fought to get out of bed. The nurses had to push him back down.

None of this is meant to over-dramatize Armstrong's broken collarbone, merely to explain how he is likely to deal with it. It's a common injury in cycling -- he's the fourth big-name rider with one this spring -- and tends to be a fast-healing one. Ask cyclists which bone they would prefer to break, and they would unanimously pick the collarbone, because it's the easiest to recover from quickly. Riders have been known to get back on the bike as quickly as two weeks after suffering the injury; in this masochistic culture, Armstrong is hardly alone. As soon as his doctor will permit him to move, Armstrong plans to start riding a stationary bike mounted on rollers in his living room. "The bike to nowhere," he calls it.

That said, it will still hurt, and Armstrong is probably better equipped to tolerate that fact than any rider in the world. The clavicle will especially complain on the uphill. That's when he'll rise up out of his seat to pump at the pedals, and lean all of his weight forward on his handlebars.

There are two reasons why Armstrong is so good at dealing with pain. One is his extraordinary physique: According to the results of a study by Austin-based researcher Edward F. Coyle, who tested Armstrong over a seven-year period, his body is genetically fortunate; it simply responds well to severe duress and deprivation. In training he was able to annually lower his weight and body fat by 7 percent, and to improve his power output by a stunning 18 percent. As Coyle wrote in the conclusion of his paper, "Improved Muscular Efficiency Displayed as Tour de France Champion Matures," Journal of Applied Physiology, March 2005, "Clearly, this champion embodies a phenomenon of both genetic natural selection and the extreme to which the human can adapt to endurance training. "

But Coyle's conclusion could be summed up in one word: will.

Armstrong's approach to pain is as much a matter of fundamental state of mind as of fortunate physiology. He views pain as corrective, and cleansing. At a time when so many people seek shortcuts to wealth, and crave indulgences and exquisite personal comfort, he voluntarily seeks out severe discomfort because he likes what it does for him. He wants things the hard way -- in the cold, and rain, with his backside on a bike for six hours at a time -- because he finds it clarifying. He knows exactly who he is: He's the guy who can take it. He returned to cycling precisely because he found the slackness of retirement soul-wearying. Even in his most dissolute periods over the last three years, between sipping good red wines in Miami or New York, he goaded himself through training for the New York and Boston marathons. "I have the will to suffer," he says. "I do have that."

People can debate the wisdom of his latest comeback, whether he should have left well enough alone. All I know, as his friend and former co-writer, is that he's at his most pure when he's in pain. He believes it has a basic purpose: It's supposed to improve us. His fatalistic, laconic, uncomplaining acceptance of it, his treatment of it as not just inevitable, but useful, is his most instructive quality.

"Quite honestly it's a part of racing and to go as long as I've gone without having something like this is basically a miracle," he said of his crash. "So while I was sitting there in a hell of lot of pain, you also think, it was bound to happen at some point. It's not good timing, but again it could be worse. And I look at it from the different perspective of the curve of my life, lying in that ditch with a busted collarbone is a lot better than other health scares I've had."


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