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Swart recalls a specific day, July 17, 1995, that his hematocrit level was 48. "Lance was at 54 or 56," he says. Swart also remembers Italian cyclists joking about their high hematocrit levels as they rushed to hotel ice machines to fill EPO-carrying thermoses. (Once cycling introduced a test for EPO, in 2001, a reading higher than 50 resulted in a 15-day ban.) Swart says he never saw Armstrong or any other rider inject EPO, nor did Armstrong provide him with it.
By the mid-1990s, according to Armstrong's deposition in the SCA case, he had begun a relationship with Michele Ferrari, the Italian physician who publicly defended EPO use. Ferrari, an omnipresent figure on the Tour de France, told L'Equipe in 1994, "EPO is not dangerous, it's the abuse that is. It's also dangerous to drink 10 liters of orange juice." Nonetheless the doctor, who did not respond to SI's requests for comment, has always denied allegations that he doped riders, once telling USA Today, "I'm totally against administration of any kind of medicines with the intent of artificially enhancing performance."
According to Landis, however, "[Ferrari] was matter-of-fact about [doping]." Landis, who was a client of Ferrari's, says the doctor helped him transfuse his own blood to boost his performance. "It was like, This is what we have to do to win," Landis says. "He wasn't a thrill-seeker about it. He got satisfaction from winning the Tour de France, but he wasn't flamboyant or boastful. He was very calculated about what he did."
Two cyclists say Ferrari used coded language and symbols to detail doping regimens. A dot, for example, represented EPO. Sources with knowledge of the federal investigation say agents have been provided with cyclists' training logs and alleged doping programs handwritten by Ferrari. These notes could be relevant to the government's inquiry if the details match records about Armstrong's last three teams—Radio Shack, Astana and Discovery—found in the raid in Italy.
Once the press discovered Armstrong's relationship with Ferrari, in 2001, the Texan described his visits to the doctor as routine checkups. Three years later Armstrong announced that he had instructed U.S. Postal team members to cut ties with Ferrari after he was found guilty in an Italian court of "sports fraud."
Armstrong said in a statement, "Dr. Ferrari has been a long-time friend and trusted adviser to me and the USPS team, during which time he never suggested, prescribed or provided me with any performance-enhancing drugs. I have always said that I have zero tolerance for anyone convicted of using or facilitating the use of performance-enhancing drugs."
The verdict against Ferrari was overturned two years later on a technicality—it was discovered that the statute of limitations had expired before his trial—but the view of the doctor as a doping specialist remained. People close to the investigation believe that the raid on Popovych's house links Armstrong's teams to Ferrari as recently as 2009, the year Armstrong returned from retirement to bring attention to the war on cancer.
After Armstrong's cancer diagnosis, former teammates say, even Ferrari questioned his methods. "I remember when we were on a training ride in 2002, Lance told me that Ferrari had been paranoid that he had helped cause the cancer and became more conservative after that," says Landis. (Ferrari, again, declined to talk to SI for this story.)
A few years earlier, according to a source familiar with the government's investigation of Armstrong, the Texan became interested in Baxter Healthcare Corp., a company based in Deerfield, Ill., that focuses in part on developing drugs to treat hemophilia. According to that source, the FDA has information that Armstrong gained access to a Baxter-made drug in clinical trial in the U.S. and Europe in the late 1990s. According to public records, a study on a drug called Diaspirin Cross-Linked Hemoglobin (DCLHb) began in early 1997 and ended in 1998. Baxter developed the drug, whose trade name is HemAssist, for use in cases of extreme blood loss, such as by shock and trauma victims; in animal studies it was shown to boost the blood's oxygen-carrying capacity without the thickening caused by EPO. The human trials were ended, however, after a number of patients died—though not necessarily from the drug's effects; some of the trauma victims were likely to have died anyway.
Armstrong's lawyers say that he denies ever having taken HemAssist, and they claim it was impossible for him to have had access to the drug after the clinical trials ended and Baxter abandoned development in September 1998. Still, stockpiles of the drug may have remained, says Dr. Robert Przybelski, an associate professor at Wisconsin who was the director of hemoglobin therapeutics at Baxter in the late '90s, although he adds that he doesn't know of any missing quantities. What would a cyclist want with the drug? "If somebody was going to design something better than EPO, this would be the ideal product," says Przybelski. DCLHb would certainly give the endurance-starved cyclist a push in the Pyrenees. "[Hemoglobin-based oxygen carriers] do everything they want EPO to do without the potential side effects of increased blood viscosity and strokes," says Przybelski. "And it doesn't last long [in the body], 12 to 24 hours, which is ideal for an event."