Watching 22-year-old cricketer Will Pucovski collapse after a rock-hard ball travelling at more than 100mph smashed into the side of his head was literally sickening. The ninth time he would be diagnosed as having concussion, the cumulative damage to his brain could be very serious.
The cricket season is young and attracting much attention, probably because Covid has starved us of much exciting sport and also because the touring Indians are arguably the world’s best cricketers. However, there has already been a disturbing number of occasions when a ‘bouncer’ has struck a player’s head and caused concussion.
A number of commentators are now calling for the bouncer to be banned. Quite a few ‘old-time’ players have rushed to the defence of this “exciting and integral part of first class cricket” – an assertion I regard as indefensible. As Sydney Morning Herald sports writer Malcolm Knox wrote: “What do you say to a retired cricketer who is battling depression and can no longer remember slabs of his career? Thanks, you’ve left me with some great memories.”
There is a growing realisation that contact sports need to be redesigned to protect the human brain. A number of rugby players are participating in a class action seeking damages for brain impairment. But the problem blights far more sports than cricket and rugby as I discussed previously herein.
It was a right hook in the third round that sent the 26-year-old boxer to the canvas. The crowd cheered with excitement; after all, this is what they had hoped to see. On the referee’s count of “five” the man struggled to his feet and was directed to the ring side doctor. That professional shook his arms looked at his pupils and asked if the man wanted to continue. “Yes,” he said, upon which he was allowed to return to the slaughter. Twenty seconds later he was back on the canvas, 24 hours later he was dead. Numerous small blood vessels, torn asunder as his brain bounced back and forward inside its bony cage, bled and bled. All the intensive care staff could do was watch him die.
Boxing is a blood sport that can result in sudden tragedy, as above, or, more frequently, dementia among those who have suffered years of brain damage while fighting. With so much entertainment now based around violence and killing (from computer games to movies), there is now pressure for fighting to become even more dangerous and exciting for spectators who, like the crowds in the Roman colosseums, enjoy the thrill of seeing a fellow human subjected to damaging violence.
Enter the UFC, the “Ultimate Fighting Championship”. Here men (and, God help us, increasingly women) fight in a wire cage. Punching and kicking are allowed, while falling to the floor or bleeding is not a signal for the referee to halt proceedings. Far from it. UFC is hugely popular and you can see in televised fights huge crowds yelling encouragement as a floored UFC fighter has his head battered time and time again by hands that wear, instead of boxing gloves, a hard rubber strip across the fingers.
There are rules for this violent mayhem: “No grabbing the fence, holding an opponent’s shorts, head-butting, biting or spitting at an opponent, hair pulling, fish-hooking, intentionally placing a finger into any orifice, or into any cut or laceration of an opponent, or eye gouging of any kind.” That’s a relief!
Recently Donald Trump was allured to a big UFC bout at Madison Square Garden in New York, calling on $65,000 taxpayer dollars to attend the event.
I would like to think most of us would find such “entertainment” disturbing to say the least, but I am not at all sure this is the case. If the silent majority agree with me then the majority needs to become less silent!
I find myself being philosophical, wondering, not for the first time, if we humans are born with natures programmed to be violent and selfish that we must subjugate as our intelligence and life experience teach us there is no happiness, or indeed survival, if these attributes dominate.
Perhaps we are born pure and delightful but in danger of becoming selfish and anti-social in a world where so many people are both? I am inclined to think the evidence supports the former contention.
All the above was generated by my appreciation of, and concern for, the ever increasing numbers suffering avoidable brain trauma. Since records have been kept, more than 500 fighters have died from explosive brain damage. Some 23 acute deaths were reported in 1953 alone and this year (2019) we have had four professional boxers die in the ring or shortly after a fight.
To date 10 fighters have died in major UFC mixed martial arts events, and about 15 in total if all the minor promotions are included. There seems to be on average about one death per year.
Hundreds have died in Thai boxing in Thailand, which is far more violent, dangerous and brutal and hugely popular. There have been periods in which one boxer a month has died, and even fights in which both boxers died.
The greater risk for boxers, however, is the development of dementia. The boxing fraternity itself coined the phrase “Punch Drunk” to describe this degeneration while the medical community describes this condition as “dementia pugilistica”!
While most boxers escape long-term damage, especially if their career is short, a British study of more than 200 professional boxers found a dementia rate of about 30%, after which the British Medical Association called for a ban on boxing which, of course, was ignored.
The development of Parkinson’s disease as a result of frequent punches to the head is controversial but most neurologists think there is an association. (Muhammad Ali?) While there is evidence that the headgear/padding demanded in some amateur boxing events prevents skull trauma, it doesn’t do much to prevent brain trauma. Many closed head injuries (such as concussion) can be caused by rapid acceleration of the brain’s movement within the skull. There is no evidence that headgear protects one from a “knockout”. If you lose consciousness, you have suffered a traumatic brain injury.
In all forms of sanctioned fighting, the aim of the boxer is to inflict serious trauma on an opponent for our pleasure. While the occasional boxer may make a lot of money, most boxers come from socio-economically deprived backgrounds, will make little money and are, in fact, being exploited by promoters who have little concern for their welfare.
Incidental and unintended trauma to the brain among football players in all codes is increasingly recognised as a huge challenge to the sport. Concussion among American NFL footballers is so common (about 500 cases reported each season) that the NFL sees recognises that this threatens the viability of the game and has pledged $100 million for research into preventing brain damage to players.
The features of the game that expose players to traumatic head injuries varies from code to code but concussion is prevalent among League, Union and AFL players. Recent studies show that “heading”, a prominent feature of modern soccer, can cause brain damage. Unlike the “fight game” football authorities are taking the threat to players seriously.
Sideline doctors are becoming more common. English researchers believe they have come up with a sideline test of a player’s saliva that can in two minutes detect specific molecules that are released with head trauma.
Surely there should be no place in enlightened communities in the 21st century for entertainment where participants are rewarded for causing brain damage to the other opponent. However, we must live with the reality that there is a barbaric element within our humanness that needs to be conquered.
There is at last public advocacy for the necessary changes to be embraced. The debate needs to be imbued with a sense of urgency that must keep it topical or the opportunity for action could so easily fade away.
Professor John Dwyer AO, is an Immunologist, Emeritus Professor of Medicine at UNSW and for many years heavily involved in efforts to improve the delivery of healthcare in Australia. He was the founder of the Australian Healthcare Reform Alliance.
Comments
6 responses to “Surely pre-senile dementia is too high a price to pay for sporting glory”
Oh, Emeritus Professor John Dwyer,
How you must be wrestling – still – with the paternalism that your wisdom invites, despite that wisdom so paradoxically neutralising, epistemologically, your hope for it to be effective!
What you propose is that reflection – wisdom – displace the immediacy of the testosterone thrill!
Sorry, mate – no go. Right brain hormonally-promoted immediacy will displace left-brain logic. Outside of strategical excellence in parenting/mentorship: forget it.
Medicos are condemned to cleaning up this psychological detritus. Sorry.
But empathic parents – maybe not.
I was relatively wild in my youth, with the one exception of exposing my body to extreme or wanton damage. As school friends returned from weekends of rugby glorying in torn ligaments, dislocated shoulders and the like, I would mutter to myself, ‘You’ll be sorry for this thirty years hence.’ A body is something like a library book, on loan and hopefully returned in much the same condition one borrowed it in. My acquaintance with motor bikes was brief, ending when a bike I was riding spun out of control on a patch of oil on the road. Two members of my immediate family had accidents that left them permanently scarred, and when my eldest son acquired a red Toyota 750 cc, I hid it in the garage when it broke down, refused to have it fixed and waited for him to lose interest in it.
Contact sport is a game that supposedly fit’s one for the travails of life, or battle, and the British empire, it is said, was forged on the playing fields of Eton. All that may be very romantic, but then I never had any intention of finding myself on a battlefield or forging an empire.
This sort of contribution to the concussion issue in sport is very welcome. At present, the discussion is generally ill-informed.
Sad to say, but Will Pucovski would be wise to abandon cricket and apply his considerable abilities in another field – golf?
The cricket administrators should re-examine their occupational heath and safety obligations.
They are big boys, they can make their decisions about their own health for themselves. I am more worried about the kids ever since my concussion as an eight year old in a rugby scrum (yes, you don’t have to have a high velocity tackle to enjoy the risk of presenile dementia). Yes we should have a discussion and change our very very important and immutable Australian values of sporting prowess and identity to better fit the science but do it like the smoking bans not like the alcohol lockouts, we’re a democracy not an autocracy.
Good public health means having our behaviour shaped by scientific knowledge. How do concepts such as democracy and autocracy help that process? They don’t. They’re worse than useless.
Democracy for me means jaw jaw, autocracy means law law (dictated law that is, not law that is put together by an unelected lot without agreement from the governed). I think it is great Professor Dwyer is highlighting the long term problems head injuries from sport can cause, this will hopefully lead to lots of jaw jaw, like the news segment I just saw on TV. The problem is this advocacy business and the introduction of words like “should” and “ban”. Entirely appropriate for children who cannot fully appreciate the science and consequences but not for adult fellow members of a liberal society.