The series of tests that Ali underwent at the NYU Medical Center in the summer of 1981 was supervised by Dr. Harry Demopoulos, a professor of pathology. Ali had met Demopoulos through Clint Eastwood, the actor, and Demopoulos says, "He [Ali] came here to NYU because he was contemplating going back into the ring, or at least trying to get in shape, to think about it. I don't think any of us encouraged him to go back into the ring. We did encourage him to get back into shape, though. Because he had gotten fat, eating crap, laying around the house. We didn't think that was good for him. So we sort of convinced him that he ought to go through a full battery of tests to see if he could go back into training."
The tests included an EEG, a neurological exam and a CAT scan. Then, before the Berbick fight, Demopoulos was quoted as saying that the Mayo Clinic, UCLA and NYU tests, which involved 30 doctors, all showed "absolutely no evidence that Muhammad had sustained any injury to any vital organ.... His blood tests indicate he has the vessels of a young man." He attributed the slurring to "a psychosocial response" and added, "If the slurring were due to permanent damage, it would be there all the time."
Last February, Casson and SI reporters visited Demopoulos at NYU to review Ali's CAT scan. "They read this as normal?" Casson asked, referring to the NYU neuroradiologists who had approved the report. Demopoulos assented. "I wouldn't have read this as normal," said Casson, looking closely at the sequence of X-rays. "I don't see how you can say in a 39-year-old man that these ventricles aren't too big. His third ventricle's big. His lateral ventricles are big. He has a cavum septum pellucidum." Demopoulos stood by the NYU specialists' negative findings.
In the course of the discussion that followed, Casson made the point that many boxers with enlarged ventricles and a cavum have neurological problems. He said that given what Ali's CAT scan showed, additional testing—particularly exams that identify shortcomings in memory—might have been in order. Such testing was not done at NYU. Demopoulos said that Ali probably would not agree to these tests now because "he's depressed" and because "everybody is telling him there's something dreadfully wrong with him, that, in essence, 'You're no good anymore.' "
Casson asked, "What do you base this diagnosis of depression on if a psychiatrist hasn't examined him? Does he have any of the vegetative symptoms of depression? Loss of appetite, changing sleep patterns?"
Demopoulos: "He has changes in sleeping patterns. But I'll tell you what tips you off that it's not an organic problem. The man perks up sometimes under favorable circumstances, and he's just like the Ali of old."
Casson: "Well, that doesn't mean it's not organic. I've seen many patients, especially the early dementias, who one day seem fine, the next day seem terrible, the next day seem fine.... Do you think slurring of speech is from depression?"
Demopoulos: "I think in his case, yes. You have to see the man. You have to meet him, you have to know him, and you have to talk to him."
The testing methods employed by contemporary researchers such as Casson, Ross and Kaste have centered on CAT scans, neurological exams and neuropsychological testing. A formal neurological exam consists of a battery of tests measuring muscle tone and strength, reflexes, coordination and balance (the subject is asked to walk and then hop in a straight line), eye movement, heart and lung function and basic cognitive exercises. In the cognitive tests, the subject is asked to spell some simple words backward or to name the year and day of the week. Casson stresses that in the case of Ali one cannot make a judgment on the basis of the scan alone; one must also test Ali neurologically. All's previous neurological results have all been reported as normal, although SPORTS ILLUSTRATED has learned that one of those exams nevertheless revealed a mild organic mental syndrome, i.e., failure to perform normally on the cognitive tests.
In their unpublished, ongoing research, Casson and his colleague, Dr. Ozzie Siegel, chief psychologist at the Queens Hospital Center in New York, have introduced a third test to their study of boxers, the neuropsychological battery. These are standardized probes of perception and short-term memory. The subject is asked to recall the details of a paragraph that is read to him. He also uses a pencil to connect dots and to draw simple geometric designs, once from memory and once with the design in front of him. His performance is timed as well as analyzed. To a layman, how somebody draws a squiggle may not seem like a sophisticated test of brain damage. But Siegel points out that this battery had been used for years to measure damage in victims of head injuries, from such things as car crashes or falls, and it had been found reliable. When neuropsychological tests are given to boxers, say Casson and Siegel, the results tend to correlate with the findings of the CAT scans and, to a lesser extent, the neurological exams.