“It was one of those instances I should have been dead,” Hesch said.

He picked himself off the road and received only six stitches to his left elbow, a few deep bruises, minor road rash and a dislocated shoulder. He was able to walk away from the accident but was not able to train adequately for nearly five months.

For the fall racing season, he decided he deserved some extra help to get back on track.

“My justification was that if I used it for three weeks, was running three weeks after that, then I’ll race in another two to three weeks, and, theoretically, I’ll have all the benefits out of my system,” he said.

EPO is a hormone that stimulates red blood cell production and, thus, oxygen-carrying capacity. Quietly obtaining it in Southern California was easy, Hesch said, and cheap.

He made the two-hour drive to Tijuana three times. On this first visit, another runner recommended pharmacies that other Southern Californian runners preferred. But since then he has chosen to find his own.

He bought a month’s supply: 18 vials holding 1 cubic centimeter of concentrated EPO for $400. Athletes say they feel dramatic effects after six doses, or six vials, said Dr. Michael Ashenden, director of the Science and Industry Against Blood doping research organization.

In the privacy of a bathroom stall, Hesch held the vials against his inner thigh, secured them under his shorts with plastic wrap and walked back across the border. On the next two trips he simply stuffed the vials into his pockets.

“You get a little nervous when you just brought it back into the country,” he said, recalling the first trip. “You just want to start driving and get away from the border because you feel the dirtiness of what you just did. Yet you have the EPO in the seat next to you, and you can’t escape it.”