Michael Watson, the British boxer, received critical head injuries during his fateful bout against Chris Eubank, over two decades ago. Watson went into coma. For days his life hung by a slender thread of hope. He miraculously survived to make a painfully slow and long road to ‘complete’ recovery. He was lucky. In January three years ago, Indonesia’s Tubagus Sakti, a 17-year-old amateur boxer, was not so fortunate. He died of brain hemorrhage — the result of lethal punches from his opponent.
As the groundswell of moral opinion expands as to whether men or women should be licensed to punch someone else in public, subtle camouflage of belief is never too insidious to appear at the hospital ward of a seriously battered or injured boxer. More importantly, such a plausibility graph does nothing to absolve the obscured irrationality and well-orchestrated entreaties promoted by defenders of the ‘bloody’ sport, who bask in the grandeur of megabucks without having ever stepped into the professional ring.
Controversy surrounding the safety of boxing dates far back — 1928, to be precise — when the first medical report on brain injury in pugilists appeared in The Journal of the American Medical Association (JAMA). The researcher described a clinical syndrome in veteran professional boxers. The set of symptoms, akin to Parkinson’s disease, covered such signs as tremors of hands, unsteady gait, and mask-like facial expression — of tremors, most powerful in the quiet, sitting posture. The list also included muscular rigidity, general slowing down of movement, poor balance, wobbly head and legs, difficulty in walking and an ungainly stoop, juxtaposed by a dull and relatively immobile face, not to speak of the possibility of mental and emotional descent with slurred diction.
For the next 30 years, over 30 cases of neurological illness in boxers were reported by medical experts. While a cogent, dissenting voice, in unison, first resulted following British neurologist MacDonald Critchley’s study, in 1957, on 69 cases of chronic brain damage in boxers, who the doctor had personally examined, the much-respected British medical journal, The Lancet, asked for nothing short of a blanket ban on the ‘violent’ sport. However, eyebrows were raised as US medical researchers found no major electroencephalogram (EEG) abnormalities in pugilists, and also concluded, at approximately the same time, that there was no definitive evidence in the anatomy of brain damage and its inherent sequel in pugilists exposed to innumerable blows — even in the long run.
Be that as it may, medical researchers, using the best of scientific techniques, have, for long, persistently pursued their work. They assert that rigid, or stringent, measures, in the form of preventative, therapeutic and safety protocols, need to be promoted to protect boxers, while not infringing upon their participation in the tough vocation — where whopping sponsorship money and fortune are involved.
While professional boxing was banned in Sweden in 1969 and Norway in 1982, the irony also is boxing returned to the former in 2007, after a gap of 38 years. Picture this — the British Medical Association (BMA) declared its tacit opposition, not symbolic antipathy of the 1970s, to the sport, only in the recent past — especially urging parents and others to keeping kids away from the sport. The BMA has since been joined, with the same gusto, by the American Medical Association (AMA), and, more recently, by medical bodies in Australia and elsewhere.
When physicians of ‘The Greatest’ Muhammad Ali, who passed away into sunset, recently, candidly confirmed rumors that the former world heavyweight champion, “who (once) floated like a butterfly and stung like a bee”, was, in fact, suffering from Parkinson’s disease, possibly connected to his long, grand career in the ring, it served much to arouse medical and popular streams’ potent opposition to boxing. Yet, one fact remains — the theme-song of a ‘veto’ on the sport has only been symbolic, sans any worthwhile substance in it. Agreed that knock-outs (‘KO’) have become somewhat rare in modern boxing, by virtue of ‘augmented’ rules and technological and scientifically derived protective gear made available to boxers, unlike the 1950s where the resultant injury — hemorrhage into the space between the skull and the brain — was the most common mechanism of death in over 400 boxers in the ring. All the same, it must be emphasized that not all blows cause palpable brain damage or injury. May be, a ‘KO’ could still be less damaging than the cumulative effects of repeated, less intense blows. The reason is simple — a ‘KO’ often leads to unconsciousness. The ‘victim’ is automatically past the worst from receiving dreadful blows in the so-called groggy state. Ask your friendly neighborhood boxer, and s/he will tell you why.
Signs of brain dysfunction, abnormal reflexes, impaired motor function, personality and cognitive aberrations, apart from other neuropathological anomalies, may all be a gloomy part of a boxer’s life after their active career in the ring. The paradox also is — most of them go unnoticed, because it sometimes takes a boxer 16-20 years to develop clinical symptoms, by which time their health status may be far too gone for a malfunction to actually get resolved, or rendered treatable. Worse still, the boxer may not even be remotely aware of any change in the initial period. While it is established that high-tech diagnostic tools, like magnetic resonance imaging (MRI), are a boon in detecting early signs and correcting health snags much before the onset of actual symptoms in boxers exposed to injuries, the inherent dilemma vis-à-vis the hazardous side of the sport remains partially addressed.
To cull a case in point — CAT scans have, in the recent past, revealed abnormalities in 50 per cent of former and current pugilists. Inference? A large number of blows to the head sustained for a long period of time can lead to a high percentage of chronic injuries, not to mention other minute, microscopic damage to nerve cells and the white matter deep in the brain. The damage caused by such minute injuries is cumulative and they may result in subclinical and obvious clinical brain malfunction later.
A recent study by medical researchers, McCrory P, Zazryn T, and Cameron P, published in Sports Medicine, suggests, that, “The sport of boxing has been the source of much debate, with concerns about the neurological risks of participating having led to several calls to ban it.” Their study sought to establish the evidence base for the development of boxing-related chronic traumatic encephalopathy (CTE) and determine the relevance of such information to modern-day boxing. The clinical features of CTE include various symptoms affecting the pyramidal and extrapyramidal systems, in the brain, which manifest most often as disturbed gait and lack of co-ordination, slurred speech and tremors, as well as cerebral dysfunction, leading to cognitive impairment and neurobehavioral turbulence.
Both amateur and professional boxers, as the study observed, are potentially at risk of developing CTE, although no current epidemiological evidence exists to determine the prevalence of the condition in contemporary boxing, despite 17 per cent of professional boxers in Britain alone with careers in the 1930-50s having clinical evidence of CTE. The researchers, however, conclude that as medical advance within the sport expands, and with modern boxers likely to have shorter careers, a reduced exposure to repetitive head trauma and improved treatment and understanding of the development of CTE will come about. This, they aver, could lead to the incidence of CTE declining in boxers.
Hold your breath. There is a lurking, diabolical ‘edge’ too to boxing — the threat of AIDS through open wounds caused by boxing blows, especially through contamination, if one of the pugilists happens to be a ‘carrier’ of the much dreaded virus. It is, therefore, imperative, as some experts point out, that the exciting, albeit ‘ruthless’ sport is made to look at itself and its ‘motives’ part — more thoroughly and dispassionately, especially in the wake of updated medical and scientific knowledge and for its continued existence in tune with the demands of our time.
This is simply because banning the sport isn’t going to help — the idea would also be tantamount to unjustifiable intrusion with individual freedom. What’s more, the canon would be brusquely lopsided, or coerced, and even applicable to martial arts. Recent medical studies suggest that brain injury could be more prevalent in martial arts than boxing. The protagonists’ riposte is, not surprisingly, logical. The American Automobile Association, as they emphasize, reports that over 20,000 people die, every year, as a result of drunken driving. Besides, medical laxity, in the US alone kills over 40,000 people a year and over one million people succumb to cardiovascular disease (CVD), each year, notwithstanding medical and surgical advance. Just think of it — on an average, as they argue, no more than four people die in professional boxing, every year, across the globe.
The big question is simple, with no easy answers: “Who is going to ‘tame’ our warped ambivalence towards boxing?” Go figure.
José María Gatica and Luis Federico Thompson during a boxing match, circa 1952 – Wikimedia Public Domain
Boxers – pixabay Public Domain
This article was first published in Financial Chronicle.
It is reprinted here with full permission of the publisher. © Financial Chronicle.