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20 DECEMBER 2014

 

The importance of being honest


By Margaret Goodman, MD

The word “honesty” or the lack thereof can be life-threatening in the sport of boxing. The term “omission” often caries a less onerous tone than dishonesty. Whichever way you choose to put it, not coming forward to a boxing commission, your cornermen, trainers, or family can cost a boxer more than a title. Sure, there are forms that have to be completed, but there can be plenty of excuses for not writing something down. Nevertheless, these forms and the questions they hold, and the questions asked by the ring doctor are there to protect the boxers, not to hurt them.

When I first began as a ringside physician I was astounded by how many times a boxer or his/her trainer would sit there and fib how the boxer lost his/her last fight or make light of an injury or cut he/she sustained. Even if it had been televised for the world to see, they would still say, “Oh that TKO, it was just political.” Perhaps it is a failure to see the truth, fear their fight might be canceled, or disregard for the system in place to guard them. Whatever the reason, and there are many … I have heard them all, the boxer is taking a gigantic risk by not being completely honest.

FORMS

Pre-fight forms, on the surface, can appear a seemingly perfunctory, meaningless task each commission requires of the boxer. This includes his/her signature on a waiver to obtain medical records, and responses to a series of questions surrounding his/ her medical history in and outside the sport. They are also asked about medications, allergies and weight loss. THIS IS A LEGAL DOCUMENT.

Post-fight forms. After every fight a fighter gets a “head sheet” in Spanish/English. This includes the signs and symptoms to look for that could represent a potentially serious head injury and where to seek medical attention. This is why fighters have medical insurance. The state requires the promoter to carry health insurance for every boxer to include any trauma surrounding his or her bout (be it to the head or the hand).

STORIES I HAVE HEARD/STORIES A FIGHTERS “FORGETS” TO MENTION

As I mentioned above, we hear time and time again excuses as to why a boxer lost or was stopped. It is easy to muddy the waters. However, it is crucial for the ring doctor to know if the boxer was injured after his/her last fight so we better tell what things might affect the boxer during his/her upcoming bout. This knowledge doesn’t mean we will not let the bout go. It just means it helps cut down on the element of surprise.

Example 1. I worked a fight at the Orleans a couple of years ago. The fighter told me he had broken his nose during his last bout 2 months earlier. It didn’t really bother him until he began sparring again. He then had it checked, it was diagnosed as a fracture, and he had been okay since. This meant he was one month out from a nasal fracture. His nose actually felt pretty good, but we checked the medical records. We allowed the fight to go with the fighter’s knowledge that he could easily re-break his nose, and he would most likely exhibit excessive swelling, but we would try to let the fight go as long as safely possible. Low and behold, by round 4 of a six-rounder the guy’s face was very swollen. He could see, and he could breathe okay, but he was a mess. If I hadn’t the knowledge before about his nose fracture, there is no way I would have let it go and it probably would have scared an unprepared fighter and his cornermen into quitting. This way, the fighter completed the six rounds, ended up winning a decision, and then got the needed rest required to let a broken nose heal.

Example 2: I worked a Stevie Johnston WBC Lightweight title fight a few years back. Stevie is a fighter I greatly admire. I remember the weigh-in like it was yesterday.

“Okay Stevie, any problems in training, other injuries….”

“No, Maam.”

Second, or was it the third round, his right eye began to close rapidly. My first thought was, “Orbital fracture,” a potentially dangerous injury that can cause double vision and require surgery. The orbit felt good upon examination between rounds. The eye closed after I had had a good chance to check his vision. He fought better than any one-eyed boxer I had ever seen. In the back, we were told that he had been in a car accident one week before. I know knew why every round he would look up at me and say, “Is my eye going to be okay?”

Now they are many types of accidents. As a Neurologist, I see accident patients all too often. Most of the time there are no complications except for a neck strain and maybe soft tissue swelling. But in this case, Stevie had bumped that right eye. His coming forward would have made it much less likely for me to have stopped that fight and we would have discussed what eventually happened to his eye after a few rounds. This would have allayed his fears as well as my own.

Example 3. This last week Eric Morales fought Marco Antonio Barrera. Unfortunately, like most athletes, and boxers are not an exception, they develop little aches and pains. There are other things predisposing a fighter to an early stoppage other than direct trauma.

ASPIRIN/MOTRIN/NAPROSYN/VOLTAREN are all anti-inflammatories. These types of medications, and there are many others under this category, can decrease your ability to clot your blood, increase your threshold for facial swelling, and potentially even increase the brain’s susceptibility to bleeding. TYLENOL is the only acceptable drug for a fighter if they are sparring or have an upcoming fight.

Yes, some fighters bruise and swell more than others. To Eric’s credit and value in his health he disclosed the use of an anti-inflammatory. We talked about the possibility of increased bruising and swelling. Less (than more) surprises are what a ring doctor wants and what a fighter needs for confidence.

EVERYONE IS AN INDIVIDUAL

In Nevada, we have a different system in place than other states because it is what works best for us. We require different tests depending on which stage of a fighter’s career he is in. The fighter’s record (via FightFax), opponent history, and prior suspensions are carefully examined. I have given careful consideration in the last few days to what additional tests would be helpful.

The more information you have the better, but there has to be a limit. In Great Britain, with socialized medicine, fighters see a neurologist to undergo MRI’s/MRA’s every year. This is wonderful, but will it cut down on ring death? In truth, the statistics are no less available over there. You can do the scan yearly, but if during that year the fighter is fighting, and is sparring in the gym, you could miss something. The other day, someone raised a point about doing an MRI before every fight. Okay, that sounds nice, too. However, some boxers fight more than 6 times a year…that’s a lot of scans. An MRI often will not show blood, a CT will often not show cortical (brain tissue) loss/injury. So what do you get? You could do a CT scan right after every fight, or right after every tough fight. But, it can sometimes takes 48/72 hours for a real injury to show up. This leaves out training. Headgear will not protect the fighter from head injury. The fighters spend so much time in the gym, that they can set themselves up for injury. So does a fighter get a scan after every tough sparring session/or after they get dropped in the gym? It is an interesting point of contention, but not one with an easy answer or solution.

WHAT IS THE ANSWER?

HONESTY, the disclosure of any potential injuries in or outside the ring would be a huge start. Fighter education and education of their cornermen on what symptoms to look for after a fight and after sparring that could easily represent a potentially life-threatening head injury. These things are not as costly as an MRI/CT, don’t involve medical exams, but do take a bit of common sense. And, that is something we can all use a bit more of in the sport we hold so dear.

***

Dr. Margaret Goodman is a Ringside Physician and Chairman of the Medical Advisory Board of the Nevada State Athletic Commission.

Dr. Margaret Goodman practices in Las Vegas, Nevada, where she is a licensed ringside physician since 1994. Her medical specialty is in the field of Neurology. Dr. Goodman was appointed by Nevada’s Governor, Kenny C. Guinn, in September of 2001, to serve as Chairman of the Medical Advisory Board to the Nevada State Athletic Commission. Although she is Chairman of the Commission’s Medical Advisory Board, all of the views, opinions, and/or recommendations contained herein are solely her own and do not necessarily reflect those of Nevada’s Commission. All readers are strongly cautioned that the information contained herein is not intended to, and never should, substitute for the necessity of seeking the advice of a qualified medical professional whenever a boxer or his/her representatives have specific questions regarding the best course of action that a boxer should take. Furthermore, since it is possible that general information herein may pertain only to a law, regulation, rule or acceptable standard of practice for a particular jurisdiction, a boxer or his/her representatives must always inquire with the appropriate licensing jurisdiction to determine the applicable laws, regulations, rules, and acceptable standards of practice for each jurisdiction.

All readers are advised that the information herein is intended solely as a general reference source, and to the fullest extent permitted by law, the information is provided “AS IS” without any warranties of any kind, whether express or implied, including without limitation, warranties of merchantability, fitness for a particular purpose and non-infringement. No one may rely on the accuracy, integrity, quality or completeness of the general information herein. Accordingly, neither the authors, editors nor anyone else affiliated with this website may be held liable for damages of any kind whatsoever allegedly caused or resulting from any such claimed reliance.



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