It's a popular sport with the goal of disabling the opponent's central nervous system. Now one neurosurgeon says there has to be a way to prevent boxing fatalities. This ScienCentral News video has more.
Limit the Damage?
West Virginia University neurosurgeon Vince Miele says it's rare for a boxer to be carried out of the ring on a stretcher. More often, by the time a contender who's suffered an acute brain injury seeks treatment, it's become life threatening. That's what happened to his patient, Jennifer Heater, now 28, who in 2002 went to the emergency room the day after leaving a match with a headache that turned out to be a blood clot in her brain.
"The size of her clot could have easily been fatal," says Miele. Heater spent a year in the hospital having multiple brain surgeries. "I was so drugged up and just out of my mind, I cannot recall a lot about being in the hospital other than the neurosurgeons coming in at 4:30 in the morning with the flashlights," says Heater. "But afterwards, being so sick, I couldn't eat, it took me a really long time to eat food just regular food and just to be able to walk, and to get my speech back."
Miele, who's served as a ringside physician, says it's not easy to protect athletes without any objective way to know when to stop a match. "Right now it's very subjective. You observe the fighters, you examine them before and after the matches, and that's it, really," he says. "You can't go get a CT scan, an MRI scan, you can't do a formal neuro exam during a match. So everything that we use right now to stop a fight or to protect the fighter is subjective."
After analyzing recordings of thousands of fights, Miele wrote in the journal Neurosurgery that while counting punches can distinguish between fatal fights and average ones, it's not enough to predict when a highly competitive fight will be fatal. "It does show that you can objectively, perhaps, by counting punches eliminate fatalities, but you would also eliminate the competitiveness of the sport," he says.
In fact, his study showed that in some of the most competitive fights, chosen by The Ring magazine as "fights of the year," "the fighters took more punches than the fatal fights," he says. "They're the ones you watch and you just love and you want to watch again," says Miele. "They're the heart of boxing."
"It's scary," he says. "These people, if they don't have problems acutely, they're going to have problems 20 years from now, 30 years from now. It's scary to see the extent of the damage that they are taking in the ring."
Miele says his findings highlight the need for force-measuring devices that record how much impact an athlete's brain is actually taking. He's now beginning tests using devices called "accelerometers" similar to those already being used in football helmets.
"We can get an accelerometer small enough that we can place it in the back of a mouthpiece, it goes back where the back molars are, which I think is ideal," says Miele. "Where the mouthpiece is and where the accelerometer is in the mouthpiece it's literally an inch from the center of the brain, from the midbrain. So you can't get much closer to the middle of the brain than using the mouthpiece."
"You as a ringside physician would have a computer next to you which would actually measure the force the athlete's taken, the amount of damage being done to the central nervous system," says Miele. "Once a certain level is reached during the match or during a career, it's stopped. The athlete has to forfeit the fight."
He says the first step is data collection to establish those levels, not only for monitoring individual matches, but also for cumulative impacts that can cause chronic damage to athletes, including during training. "A lot of injuries to the brain are done in training as well as in actual competition," he says.
Miele acknowledges that boxing is "a community that doesn't accept change readily," but says his ideas are gaining support from boxing officials as well as legislators.
The American Medical Association has called for a ban on boxing, but like Miele, also has a backup policy advocating the use of new tools to protect the athletes.
"I don't think that's ever going to happen," Miele says of a ban. "And the more that we find out about brain injuries, both acute and chronic, the more that we realize that [boxing] is hurting a lot of people and we have to do whatever we can as physicians to try to limit the damage to their central nervous systems."
Miele and Heater still share a love of boxing. Heater, who says she'd still be boxing if she could, feels blessed to be alive and completely recovered today. She water skis, snow skis and jet skis. "I wear a helmet," she says.
Miele's research is published in the February 2007 issue of Neurosurgery with no external funding.
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