Too Many Punches, Too Little Concern

...See, all the bruins are in a sort of cup, and after you get hit a few times it shakes them out of that cup. When they give you smelling salts it pulls them buck into the cup. It's when the brains get shook up and run together that you get punch-drunk.
—SONNY LISTON

...I don't want to be one of them old [retired] fighters with a Hat nose saying 'duh-duh-duh' before a fight.
—MUHAMMAD ALI, announcing his withdrawal from boxing on Dec. 12, 1981

If a boxer ever went as batty as Nijinsky, all the wowsers in the world would be screaming "punch-drunk." Well, who hit Nijinsky? And why isn't there a campaign against ballet?
—A.J. LIEBLING, "The Sweet Science"

The death of Korean boxer Duk Koo Kim last fall aroused yet another cry for the reform or abolition of prizefighting in the U.S. Haifa dozen times over the past 50 years a fatality has prompted a like reaction—in editorials or in Congressional hearings—but the result has been nil. Certainly reform is needed, but no amount of it will eliminate death in the ring. As long as there's boxing, there will be fatalities. Boxers die from acute brain trauma, caused either by a blow (or blows) to the head or, sometimes, a heavy fall to the canvas. The brain is like so much jelly suspended in a bucket, and when you strike the bucket sharply, the brain inside accelerates, twists and bumps around. In a knockout, which is technically a concussion, the force of a punch, transmitted to the brainstem, causes the fighter to lose consciousness. A KO is considered an acute injury, but it's relatively mild compared to what happens if the jarred brain ruptures the blood vessels that surround it. Then a hematoma (a massive buildup of blood) occurs in the narrow space between the rigid skull and the soft brain. As it expands, the hematoma simply squeezes the brain to death. There has been no dispute about that for 50 years.

But no one can predict when a punch will cause a knockout or a killing hematoma, and the wearing of protective headgear is no guarantee against serious injury or death. Some of the more recent boxing deaths occurred despite the use of headgear. The only way to prevent fatalities is to ban blows to the head—or ban boxing altogether. On these drastic alternatives the reform movement founders.

Another type of boxing injury has received less public attention. It's chronic brain damage, and here there's the possibility of real reform. Chronic brain damage occurs when a fighter is hit in the head thousands of times during the course of a career. Boxers' encephalopathy is the scientific term; the colloquial expression is punch-drunk. The volume of research on this condition hasn't added up to much over the years, yet, ironically, each time a prominent boxer dies in the ring from an acute injury, a physiological event bearing little relation to chronic brain damage, the impetus for discussion of and research into this more widespread and insidious problem is increased. The widely noted editorials denouncing boxing that appeared in the Journal of the American Medical Association last January weren't merely inspired by the death of Willie Classen in 1979 or of Kim so much as by several new studies, based on new medical techniques, that shed hard scientific light on the punch-drunk syndrome.

After the JAMA editorials and the reports of new studies appeared, Muhammad Ali was interviewed on national TV. He was seated in front of a fireplace at his home in Los Angeles. He did not speak particularly clearly and he seemed distant and grim. Asked whether he might have suffered brain damage from his 61 fights and 21 years in the ring, he replied softly, "It's possible." To many observers, the interview seemed to substantiate rumors within boxing that the 41-year-old Ali, who has been slurring his words more noticeably and acting depressed of late, was indeed becoming punch-drunk.

In a subsequent telephone interview (box, page 67) Ali declined a request by SPORTS ILLUSTRATED that he undergo neurological testing to set the record straight. He said he'd been tested before his last two fights, in 1980 and 1981, and had been found normal. (But an investigation by SI, detailed below, shows that those test results are open to a quite different interpretation.) Ali asked why he, a black champion, was being singled out and whether SI was planning to "check the brains" of white fighters who'd taken a lot of punches. Among others, he cited Jerry Quarry.

A few weeks ago heavyweights Quarry and Randall (Tex) Cobb and a bantamweight named Mark Pacheco were brought together by SI for neurological examinations at Quarry's rural training camp north of Los Angeles. Quarry, 37, retired in 1977 after 63 professional fights. Beaten by Ali in 1970 and '72, he was the last white heavyweight to make a serious championship bid until Gerry Cooney challenged Larry Holmes last year. But Quarry wants to come out of retirement; he has reportedly agreed to fight again in June. Cobb, 28, has a record of 20-3. Last year he earned a measure of fame when, courageous but incompetent, he lost to Holmes in a WBC title bout. He took such a bad drubbing that a dismayed Howard Cosell, who announced the fight for ABC-TV, declared he'd never broadcast a professional boxing match again. Pacheco, 23, isn't a celebrated fighter. With a record of 11-11-1, he's one of those unsung battlers who hit and get hit on undercards in cities like Portland, Ore. and Sacramento. But Pacheco has become a minor notable because of two defeats. He was TKO'd in Portland in May 1982 and denied a license, on medical grounds, to fight in Oregon again for 45 days. But he had a bout 43 days later in New York, and he was again TKO'd. In the current round of Congressional hearings on boxing, which began after Kim's death and the JAMA editorials and reports, the Pacheco case has been cited as evidence of the sport's inadequate medical supervision.

All three men signed releases waiving their rights to medical privacy, and Quarry and Cobb were confident that nothing would be found amiss. The three were examined by Dr. Ira Casson of New York, a board-certified neurologist at Long Island Jewish Medical Center who was acting as a consultant to SPORTS ILLUSTRATED. Admittedly, this trio doesn't constitute a scientific sample. But recent research published by Casson and others indicates that the degree of a boxer's brain impairment can, as a rule, be related to the number of bouts he has fought. This indeed proved to be the case with two of our subjects, as will be shown. But none of the three are at this point in their lives punch-drunk.