With regard to Joop Zoetemelk’s transfusions in 1976, and his decision not to transfuse in 1977. The former first. What does that story tell us?
1) We know the where and the when of it. Paris, Divonne-les-Bains and (possibly) Port Bacares. That’s just ahead of the start of the race, on the first rest day (between stages 8 and 9), and (possibly) on the second rest day (between stages 11 and 12). That’s pretty much in line with the c21st practice: ahead of the race and on the rest days. It also raises yet another question mark over why Felice Gimondi was doing his (alleged) transfusion before the end of the first week of the race, if the ‘75 Tour story is to be believed (and not the ‘73 Worlds one).
2) We can (I think) deduce that it wasn’t Zoetemelk’s own blood, that it must have been someone else’s. I’ve only watched occasional episodes of House so I’m no expert but I don’t think it would be normal to treat anaemia by extracting the patient’s own blood and then reinfusing it (please correct me) and Zoetemelk has said he was using transfusions to treat anaemia, which arose as a consequence of a 1974 crash. (With regard to the suggestion he was using transfusions to treat a saddle sore, I’ve no idea what to make of that – was that a full transfusion or an injection of red cells into the area of the wound, a treatment that is still en vogue today?)
3) We can – if we can believe the athlete himself and there is much debate as to whether we can ever believe the athlete, for some it’s a case of only believe when it suits your position – say that, for Zoetemelk, the transfusion was effective. He won more stages in the ‘76 Tour that he normally did – three, stages 9 and 10 (immediately after the second transfusion) and stage 20 (the pre-penultimate days’ assault on the Puy de Dôme) – and said himself that he felt the treatment was effective. Can we conclude that for other Tour riders – Freddy Maertens, Giovanni Battaglin, Hennie Kuiper, Miguel-Maria Lasa, Aldo Parecchini, Jacques Eclassan, José-Luis Viejo, Raymond Delisle, Willy Teirlinck, Wladimiro Panizza, Michel Pollentier, Ferdinand Bracke, Gerben Karstens, Hubert Mathis, to name just the 1976 Tour’s stage winners – this we equally be true? The scientific papers of the period disagree. And Zoetemelk was being treated for anaemia, while we don’t know if any of those others had similar underlying medical problems. So we can not conclude that Zoetemelk’s treatment would have resulted in a performance gain for others.
4) The scientific papers of the time indicate differences of opinion over the correct amount of blood to transfuse. We don’t know how much blood Zoetemelk transfused. Nor do we know what he actually used: the cheap and cheerful wholeblood package or the deluxe red cells treatment.
5) We know that transfusions today are a lot easier than they were 40 years ago but tend to forget just how complicated the logistics then would have been. Did Zoetemelk have to visit hospitals in Paris, Divonne-les-Bains and Port Bacares or was it, like the apocryphal Felice Gimondi story and our modern perception of the practice, all done in a hotel room? Where did the blood come from, was it legitimately sourced by the doctor, Fucs, or was it acquired less legally? If legit, was it sourced locally or did it have to be flown in from the Netherlands? This leads into the next point.
6) How expensive was the whole procedure? Those stage wins would have helped Zoetemelk’s earning power on the critérium circuit (as would Felice Gimondi winning the rainbow jersey in ‘73 but probably not one measly stage win in ‘75, whichever of the two you want to believe, if you want to believe either). But would that have been enough to offset Zoetemelk’s costs? We know nothing about the expense of the procedure. And we have to remember that, as the ‘70s wore on and the Oil Crisis bit - and the Cannibal bit - cycling was squeezed more and more. You have a situation in ‘76 where other teams collaborated to allow one team to win a Tour stage in order to try and keep the sponsor in the game. You have the Vuelta and the Tour struggling to find a full field. The riders weren’t exactly coining it in. We assume Zoetemelk stopped transfusing because he was morto over the Virén story, but he might just as easily have stopped because he couldn’t afford it in ‘77.