BIG FIGHT IN BOXING : Neurological Testing Only Seems Logical

One year ago this month, the California State Athletic Commission began requiring yearly neurological exams of all professional boxers in California.

At last, many thought, here was progressive reform in boxing. No longer would boxers who stayed around too long and taken too many punches be allowed to box in California. Possibly, even younger boxers who were found to be at risk of the so-called punch-drunk syndrome would be refused licenses.

It hasn’t quite worked out that way.

Since last July 1, the same neurological exam has been administered to 656 pro boxers in California. Only eight have been denied licenses. Moreover, neurologists contracted by the state to administer the tests report that the young boxers they’re testing could be passing their exams and still have boxing-related brain injuries.

The clinical exams consist of written and verbal tests, as well as a personal evaluation by the neurologist. That part costs about $100 per boxer, and is paid by the state, from an account financed by boxing promoters. If the neurologist suspects a problem, he can order a computerized axial tomography (CAT scan) or an electroencephalogram (EEG) both of which must be paid for by the boxer or the promoter. A CAT scan costs about $200, an EEG $100.

The tests aren’t thorough enough, according to four neurologists contacted by The Times.

“What it comes down to is that a young boxer could pass our clinical testing, and still walk out of our office with a subdural hematoma (a swelling on the brain that fills with blood) or some other type of boxing-related brain injury that we couldn’t detect,” said Dr. Laurence Carnay of the Los Angeles Neurological Center in Paramount, one of three neurological facilities in the state administering the exams.

“A subdural hematoma would show up in the CAT scan, and if we suspect that kind of a problem, we make sure he takes one.

“If we could give these kids MRIs (Magnetic Resonance Imaging scans), that would be fantastic. That would show us much more. Unfortunately, they cost about $800, and it’s a question of money.”

Carnay said he and his partner, Dr. Dale DiSteffano, examined 254 boxers in the first year of the program, and flunked three.

Dr. Clark Espy of Los Angeles, another neurologist contracted to provide the boxing exams, is an even harsher critic.

“I think the exam is fairly worthless,” he said.

“But it’s a start . . . the start of a consciousness that we need some kind of early warning system to spot the kind of brain damage boxers get if they box too long.

“The tests need some changes. One problem is that the written parts don’t allow for language problems, cultural differences. A lot of young boxers are Spanish speaking, or inner-city black kids with poor educational backgrounds. Kids like that aren’t going to be good test-takers to begin with. So maybe they couldn’t pass the tests to begin with, even if they weren’t boxers.

“Frankly, I get a lot more input from a young boxer by conversing with him than I do from a written exam. If I see slurred speech, slow responses to physical stimuli . . . those things tell me a lot. I’ll have him take a CAT scan.”

Dr. Michael Sukoff, a Santa Ana neurosurgeon not involved in the boxer testing program, is another critic of the tests.

“Every boxer should be required to have a CAT scan,” he said. “And if experienced neurosurgeons or neurologists are doing the testing and they have the wherewithal to use CAT scans, EEGs and MRIs, they won’t make many mistakes.”

Data accumulated from years of test results will be far more helpful in coming years, Carnay pointed out.

“What is really going to help in future years is comparing these young boxers’ future test scores to their old ones,” he said. “Perhaps we’ll be able to spot trends of boxing-related encephalopathy (brain damage).”

But Southland boxing promoter Don Fraser, a critic of the tests, says professional boxing’s dropout rate is roughly 50%.

“The number of pro fighters who fight for years and years . . . that’s less than 1% of the total,” he said. “About half the fighters who boxed for me last year--they’re not around any more. It’s a tough way to make a living. So kids drop out, get a job, go to school . . .

“Another problem is security for the tests. Let’s say a fighter from Mexico is sent to a neurologist for the test, so he can get a license to box in California. So here’s this Mexican kid with no I.D., no photo . . . how does the doctor really know who he is? Or let’s say a Mexican kid’s trainer goes along and translates everything for him. It wouldn’t surprise me if copies of the test were floating around.”

A major flaw in the state boxer exams, Fraser points out, is that a professional boxer denied a license in California can simply apply in Nevada or Arizona, which brings us to the story of Bobby Chacon.

In the early 1970s, they called him Schoolboy Bobby Chacon. He was a phenom. He came fighting out of the San Fernando Valley and became a world featherweight champion at 22. Chacon had it all--speed, style, knockout power in both fists, and movie-star looks.

Today, Bobby Chacon is not a schoolboy. He’s 35. He had a fight in Tucson recently. He stopped a club fighter, after he’d been on the deck twice in the first round. Said Ken Brazell of the Tucson Citizen, who covered the fight: “He (Chacon) looked pitiful. He threw a lot of punches but he had no timing at all. He never landed a solid punch.”

Chacon, who has been boxing since 1972, wasn’t boxing in Arizona because he failed the California neurological exam. He was suspended indefinitely a year ago by California’s State Athletic Commission because of repeated incidents with police in Oroville and being a “discredit of boxing.” He was also arrested on an alleged assault charge, filed by a woman who later dropped the charge and married Chacon.

Chacon was the first boxer in California to take the neurological exam a year ago. And he passed. Actually, he passed it twice. He also passed a neurological exam in Phoenix, where he obtained his Arizona license.

A lot of Chacon’s friends say they are worried about him these days. They say he has slurred speech, unpredictable outbursts of temper, and a marked loss of coordination in the ring, all symptoms identified by neurologists as possible signs of boxing-related encephalopathy.

Says his former manager, Joe Ponce: “I worked with Bobby before that Arizona fight. Then he got mad at me three weeks before the fight and left. The poor guy . . . he couldn’t even move anymore. The coordination isn’t there anymore. I’d hate to see him get hurt. If he keeps fighting, he’s going to get hurt bad.”

Chacon seems unworried about what others are saying about him. “Muhammad (Ali) took a lot of punches--he’d get in a corner and take a lot of punches he shouldn’t have. I know that can catch up to you, and if I felt I was taking too many blows to the head I’d quit. But I haven’t taken a lot of punches to the head. Mentally, I feel OK. I haven’t lost anything.”

Ken Gray, executive officer of the California State Athletic Commission, said money was the legislative roadblock in considering tougher neurological exams for boxers.

“I have to say it troubles me that Chacon could pass the test,” he said. “But we are working to refine the tests, to make them better. I can tell you that some boxers, who we intuitively believed had some problems, did fail the test.

“When we were planning the (testing) program, we looked at all the things we wanted to do and it added up to $1,700 or $1,800 per exam. MRIs were just too expensive.”

After his sorry performance in Tucson, Chacon told Arizona boxing commissioner John Montano he’d decided to retire. However, Chacon later told The Times in a phone interview he was only “considering” retirement . . . and that he was also “talking to someone about a movie role coming up.”

Chacon’s wife, Deborah, said Chacon was working out in Van Nuys. She also referred to the state’s suspension of her husband’s boxing license as a “denial of Bobby’s right to earn a living in California.”

Carnay commented on the coincidence of a boxer such as Chacon getting suspended by the commission for his troubles with police on the same day the commission announced its neurological testing program.

“Here you have a state boxing commission denying a fighter a license and calling him a ‘discredit to boxing’ because he’s exhibiting exactly the same symptoms they’re looking for in these tests,” he said. “Then a testing program is mandated that is so weak it can’t even weed out a boxer who’s been fighting since 1972.”

Fraser brings up one other point.

“As guy who’s been fighting as long as Chacon has also spent a lot of years in training, sparring, taking blows to the head,” Fraser said.

Writing on encephalopathy of boxers, Dr. Ira R. Casson wrote in Neuro View Journal in 1985 of some classic symptoms.

“The boxer is usually not aware of his difficulties,” he wrote. “His wife is often the first to notice subtle personality changes. Extreme intolerance of alcoholic beverages is a common symptom in the early stages . . . confrontations with law enforcement authorities are often the result of lost social inhibitions or sudden changes in mood and behavior.

“Early motor symptoms usually are noticed first by the trainer. A mild lack of coordination, subtle loss of balance or a generalized ‘slowing down’ initially are attributed to the natural aging process. However, as these symptoms worsen, it may become apparent to the boxer’s companions that something is terribly wrong, even while the boxer insists that he is perfectly healthy.”

Casson, in the same article, also wrote: “Recent work (1985) employing detailed neuro-psychological testing and CAT scanning, logical testing and CAT scanning, has demonstrated that almost every professional boxer (even those without clinical signs or symptoms), has sustained some degree of chronic brain damage.”

Casson also cited studies identifying three other symptoms believed to be related to boxing-caused brain injury:

--Severe recent memory dysfunction.

--A morbid jealousy syndrome, characterized by groundless accusations against supposed spousal infidelity.

--Uncontrolled outbursts of violent rage.

Carnay said the onset of symptoms showing what neurologists call, among other terms, “dementia pugilistica,” commonly thought to result only after years of boxing, could actually be the result of a single blow to the head.

“The type of a case where a person suffers a brain injury in a serious auto accident--that’s one blow to the head,” he said. “Now, that’s definitely not the normal result of what we’re talking about, but it is possible.”

He said neurologists have no answer to the question of why some boxers such as Archie Moore and Max Schmeling can box for decades and show no symptoms of boxing-related encephalopathy, while others, such as Muhammad Ali do.

Ali, diagnosed as having Parkinson’s syndrome (when it’s believed to be boxing-related, neurologists call it pugilistic parkinsonism) in 1984, was reported to be under treatment in Mexico City this week, and considering a new surgical procedure. Ali denied the report.

Amateur boxing’s medical surveilance of its participants is far more thorough than is the case in pro boxing. The sport’s governing body, the USA Amateur Boxing Federation, requires a medical “passport” of all its 17,000 boxers.

The passport must be presented by the boxer to the physician administering physical exams prior to every fight. Any health problems are entered in the passport. In addition, any amateur boxer who is knocked out is automatically suspended from competition for a period of 30 to 365 days.

Amateur bouts are also limited to three rounds, and headgear is required.

In addition, the USA/ABF is in the midst of a long-term neurological project with the Johns Hopkins University medical school, aimed at creating a system whereby signs of boxing-related encephalopathy can be detected early.

In other words, it appears that it may be amateur boxing that brings the sport into the 20th Century, not the professionals.

For years, both critics and fans of pro boxing have pleaded for Congress to establish a federal boxing commission to govern the sport. Among other benefits, adherents of such a plan maintain, is the fact that a nationally standardized neurological exam could be administered, eliminating the present practice of a boxer who’s failed a neurological exam in one state from simply boxing in another state.

A process of subtraction occurs when the brain is subjected to repeated blows to the head, Dr. Carnay points out.

“Humans are born with roughly 100 billion neurons,” he said. “You never develop any more. In fact, you steadily lose them as you age. They simply atrophy. In boxers, it’s generally confirmed by most studies I’m aware of that that process is accelerated somewhat.”