Russian Roulette: Part Two

By Ted Sares on January 22, 2014
Russian Roulette: Part Two
In 2007, Michael Katsidis and Czar Amonsot waged a brutal 12-round war in Las Vegas.

If a boxer has suffered a subdural hematoma, my personal advice, having survived a subdural hematoma several years ago, is never return to the ring…

“Boxing is the only sport in which the objective is to render blows to the head and body of the opponent so as the cause the opponent to be incapacitated.”—Various medical sources

“An injury that caused the brain to hemorrhage is as bad as it gets… Not many guys get a second chance. If you are lucky enough to have recovered from a bleeding brain – Get on your knees and thank whatever God you follow… To allow guys to take shots at your head, in a boxing ring is crazy… Beyond crazy even.”—Poster named Eddie F (Yahoo Answers)

“I couldn’t put my socks on. Now they say I’m a miracle.”—Kieran Farrell

“A few weeks after the fight, I was still affected by the damage that was done…My speech was a little bit off. I was slurring a little bit. But after about two months, I cleared up and I have my wits about me now.”—Timothy Bradley

“Step in just once to punish the people responsible for knowingly allowing a fighter who’s on medical suspension to fight. If that happened, people would start toeing the line. Things would change real fast. But the federal government has made it clear to us again and again that it simply isn’t interested in enforcing federal law as it relates to boxing.”—Tim Lueckenhoff, president of the Association of Boxing Commissions

In boxing, the most common life-threatening injury encountered by its participants is subdural hematoma (SDH), a rupturing of the veins between the brain and the skull; and the most dreaded (and longer range) consequence of chronic insult to the nervous system is dementia pugilistica. (SDH) often requires surgical intervention. Neurologists are working to make boxing safer by trying to pinpoint subtle changes in examinations and scans that portend serious future damage in order to whisk fighters out of the ring in time.

In July 2007, Michael Katsidis and Czar Amonsot waged a brutal 12-round head snapping war in Las Vegas. Czar suffered a subdural hematoma (bleeding on the brain) thus presumably ending his boxing career in the United States. During the same bruising card, Oscar Larios suffered a similar injury against Jorge Linares. Larios eventually returned to boxing fighting three times in Mexico and twice in Japan before calling it quits in March 2009 with a fine 63-7-1 record. Meanwhile, Amonsot, after an 18-month layoff, also returned and has now gone 7-0-2 against moderate opposition since his savage encounter with Katsidis. Six of his fights have been in Australia and three in the Philippines.

Jermain Taylor says he has “nothing else to do.” He has now fought four times since being knocked unconscious by Carl Froch and Arthur Abraham in 2009. Taylor has already suffered a subdural hematoma; he is playing the same dangerous game as “The Great One” and the “Czar.” Says Kevin Iole, “It’s time for Jermain Taylor to say when, no matter how many tests he’s passed. Boxing is about to get him. This is a fight that he cannot win.” (Yahoo Sports, December 13, 2013)

The case of Joe Mesi who was injured badly when he fought and beat Vassiliy “The Tiger” Jirov in 2004 has been vetted. According to Thomas Hauser, reportedly one of the few outside the Mesi camp to see a report on Joe’s MRI exams, “the first MRI exam on March 17 showed a left parietal hematoma pressing on the left side of Joe Mesi’s brain. A March 25 MRI exam apparently was misread and the problem appeared to be resolved. However, the next MRI exam on April 8 showed two subdural hematomas that went undetected in initial readings. The next MRI exam on April 27 showed the two subdural hematomas were still present. Mesi finally had a clean MRI exam on May 27.”

After two years of countless medical examinations and mind numbing courtroom battles to be allowed back into the ring, Joe took advantage of a legal technicality that allowed him to get boxing licenses in Puerto Rico, Louisiana, Arkansas, Michigan, and Rhode Island. Against the advice of his friends, fans, and writers, he returned to fight and thankfully, his last five bouts lasted a total of only nine rounds against opponents who were limited at best. Joe finally retired undefeated (35-0), but more importantly with his health intact.

In my view, what Mesi did and what the others are doing may be one of many forms of Russian roulette that boxing entails.

Controversy

“There’s no evidence he’s [collision-sport athlete] at greater risk for a brain bleed than if he ever had the first brain bleed…and that’s the reason we’ve got many athletes playing football, rugby – all kinds of sports – that have gone back after a subdural hematoma, especially one that did not require surgical incision.”—Robert Cantu, Chief of Neurosurgery and Director of Sports Medicine at Emerson Hospital in Concord, Mass.

Significant controversy exists over how to use the medical information available regarding subdural hematomas. In fact, some, like the highly respected Vincent Miele, Julian Bailes, Robert Cantu, and Craig Rabb,  cite the cases of Marco Antonio Barrera and the late Edwin Valero as examples of boxers who successfully returned to competition after brain issues and argue that more research is essential to objectify the reasoning behind possibly ending an athlete’s career and livelihood. See Subdural Hematomas in Boxing: The Spectrum of Consequences. Neurosurg Focus. 2006; 21(4)

Others assert the contrary. As Dr. Margaret Goodman, former head of the Nevada Medical Advisory Board and Nevada State Athletic Commission (NSAC) says, “I’m of the philosophy that if a fighter has suffered a cerebral hemorrhage, they should never fight again. So few fighters suffers bleeds, that they must have some predisposition. So to put them in harm’s way again, whether they fought one more time or five more times, is just playing Russian roulette with their life.” (RingTV.com / 2.14 Page 78)

Renowned boxing doctor John Stiller, Chief Physician-Md State Athletic Commission and Director of Neurology Service at St. Elizabeth’s Hospital, Washington, DC, also drives home the point of zero tolerance.

“If a boxer sustains a subdural hematoma (SDH) while boxing, he/she should NEVER be licensed to box again. The argument that if the boxer recovers “completely” in that he/she passes all exams/tests, then that boxer is no more likely to have another SDH than any other boxer, ignores the possibility of an increased susceptibility. This should be obvious in that the boxer already sustained an SDH after passing all exams/tests. If the boxer is fortunate to recover from an SDH, he/she should be grateful and not tempt fate. Francisco Leal may well be alive today if he was not licensed to box again after suffering an SDH in Texas [against Evengy Gradovich on March 31, 2012].”

Going Forward

Until more is known about the long-term effects of subdural hematomas and whether they put someone at greater risk of experiencing another, there will continue to be controversy over whether athletes with a history of hematomas should be allowed to compete. In this regard, I believe Nevada may have changed its policy and will now license a boxer who has suffered a SDH while boxing as long as he or she passes all requirements for licensing. The statement that was made by a physician for the commission was essentially that if the boxer passed all the tests he/she would be no more likely to sustain an SDH than any other licensed boxer. Of course the individual who made that statement has no convincing data to support it. A more candid statement would be they don’t know if the individual would be at increased risk. I further believe New York has followed suit.

Notwithstanding the fact that dealing with brain injuries is a complex and not-so-exact science (and acknowledging the two sides to the controversy), I’ll nevertheless go with the fail-safe (zero tolerance) position of Drs. Goodman and Stiller to wit: There is a cogent argument that the individual would be at increased risk. At the end of the day, no neurologist will say that being struck in the head is good. In my view, that goes double for a SDH survivor?

Suffice it to say that if a boxer has suffered a subdural hematoma or cerebral edema, my personal advice, having survived a subdural hematoma several years ago, is never return to the ring, never.

Russian Roulette: Part One
Russian Roulette: Part Two

Ted Sares is a private investor who enjoys following and writing about boxing. A member of the Elite Powerlifting Federation, Ted actively competes in the sport throughout the US and Eastern Canada and holds several state records for his age class.

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Michael Katsidis vs Czar Amonsot [Full Fight]



Carl Froch vs Jermain Taylor



Arthur Abraham vs Jermain Taylor



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  1. Ted 01:38pm, 01/28/2014

    Great post Don, great

  2. Don from Prov 11:34am, 01/28/2014

    JC45: Always great to hear from you.  I enjoy seeing your posts.  Yes, let our (in my case, non-existent) children compete in chess—the opposite of brain damage will be their gift.  But, of course, some of us want more physical challenges/ have a need, desire, or drive toward a more contact oriented release of—well, who knows what? Ted will understand this, competing in power-lifting in his seventies—injuries could (very well might) occur.  I decided AS AN OLD man to begin training in Krav Maga and earn a black belt as a EVEN OLDER MAN: Not a bad decision even when understanding that a black belt really = the START of a even longer journey to proficiency.  Yet, that didn’t matter as I harbored no secret desire to become a tough guy, which I’ll never be, but simply wanted a challenge—a goal. There is sparring in Krav but a practitioner is not likely to sustain a brain injury; however, one allure of Krav is that it is not only very trying but very violent and intense.  A person is going to find release for tension in the constant attacking of the “sport,” but at the same time ANYONE who practices it is going to be injured.  Period.  I had likely pre-injured a wrist, but after time into Krav, I badly hurt it—didn’t pay attention to what doctors told me and came back to soon, and then REALLY did the wrist in.  Because the thing is, we become addicted to the release and aggression.  One needn’t be twenty-four and heading for a world championship to become really and truly addicted to the whole rhythm and physical demand of something that could be breaking him down.  Finally, I had to stop (and that is the other thing: we don’t WANT to quit) before I was eating meals with my feet.  And I was depressed when I stopped just months short of taking my black belt test—but would have been depressed quitting at any point most likely as doing it becomes hard wired.  So, I try to even begin to imagine what drive a TRUE fighter must have to express himself—find a sense of himself / let loose demons—through the challenge of a fighting sport, and I can’t, not really.  I liked the post from JOHN who was obviously going to help his son find a different way to channel himself.  Actually, there were a number of great posts on here.
    Then came my babbling, “point lost” post.  At any rate, Cheers to JC.
    And “good stuff” to Mr. Ted.

  3. Ted 07:03pm, 01/27/2014

    Yes but believe me, you would not want to see it.

  4. dollarbond 12:50pm, 01/27/2014

    Do you have any photos from your episode?

  5. Ted 12:34pm, 01/26/2014

    Tex, actually there are some fights where you can tell such as when Michael Watson was almost killed and when Dave Moore was killed each by the same type of situation.


    Though I could never prove it and I sure would not want to start a shit storm, I think that last shot that Mago took with seconds to go in the fight could well have been the bad one.

  6. Tex Hassler 11:51am, 01/26/2014

    It is hard and probably impossible to pinpoint exactly which punch or punches damage a fighter’s brain. Fighters get hit in sparring and in fights and all these punches can hurt a fighter’s brain to some extent.  Some fighters like Archie Moore can have 200 plus fights and seemingly have no damage. Others can be damaged or killed in just one fight. All humans are built differently so some can take a lot more punishment than others.
    Great article Mr. Sares and very thought provoking.

  7. Ted in Portland 07:00am, 01/26/2014

    JC40 MATEY!!!!!!!!!  Maybe the most knowledgable boxing guy I know cheers lad

  8. john coiley 03:36am, 01/26/2014

    THANK YOU, Ted…ditto

  9. Mike Silver 11:54pm, 01/25/2014

    Whatever the reason, whether an accumulation of punishment or one punch, no boxer who has suffered a SDH should be allowed to compete. It is truly playing Russian roulette.

  10. Ted in Portland 10:22am, 01/25/2014

    Always nice to hear from you JC.

  11. Ted in Portland 10:18am, 01/25/2014

    Mike Silver with all due respect, I manifestly disagree. I can point to any number of fights where one punch did the trick. You cite Ernie, I can cite Laverne Roach. The volley Paret was hit with killed him. Yo Sam Choi is the best example. I can show where one head butt did the damage.

    And even if I were wrong, then my argument that once a fighter suffers brain damage, he should not fight again is affirmed.

  12. john coiley 04:16am, 01/25/2014

    Nicholas, I was 21yrs old, hungry to realize my father’s dream of being World Champion. Thus, my naivete in agreeing to the Boston rematch in front of my people. In hindsight I did see how my management was hungrier than I. So, NO, I was not robbed first time. He was as nervous as I and so didn’t fight as he was able. And NO, a fight need not be stopped if the margin is so wide, unless there is an evident beating / bombardment. One punch by the sad sack can change anything…

  13. nicolas 07:13pm, 01/24/2014

    TO MR JOHN COILEY: On looking up your fights with Tony Licata, I saw that you fought him twice within a two to three months period. I found that odd, since the first fight the judges had you losing by a pretty wide margin. Did you and your management feel that you won the first time and were robbed in Licata’s home state? Also, as a former boxer, do you think that it would be something to think about to stop fights early, and perhaps call them decisions if one fighter is too far behind on the score cards of the judges, weather unanimous or majority, to even win the remainder of the rounds, that they would not even get a draw or a win?

  14. JC45 05:08pm, 01/24/2014

    “Boxing/football—too many injuries, too many early deaths

    I wouldn’t allow a child of mine to participate in either sport
    But I’ve grown up watching boxing and will probably continue “

    That’s it in a nutshell Don .
    I wouldnt allow a child of mine to box or play Rugby League football let alone American football.

    Thank you for a great article Ted , hope the New Years is treating you and your loved ones very well amigo .

    It defies logic that so called medical practioners and boards give anyone who has suffered a subdural hematoma a license to box.
    The sport is dangerous enough for someone with a relatively undamaged brain .

    Cheers Ted , Donny .

  15. Mike Silver 02:31pm, 01/24/2014

    Ted, I think it’s impossible to say what punch starts a fatal brain bleed. The damage might have been incurred in an earlier round-or even an earlier fight. The final punch may have occurred when the boxer was beginning to lose consciousness from earlier punishment. Ernie Schaaf was hit by a left jab by Carnera and went down. His injury obviously occurred earlier—the jab was perhaps the straw that broke the camel’s back, so to speak.

  16. kid vegas 11:47am, 01/24/2014

    That is some scary shit Bro

  17. Larry Link 07:05am, 01/24/2014

    http://sports.espn.go.com/sports/boxing/news/story?id=3032059

  18. Larry Link 07:04am, 01/24/2014

    http://www.thedailybeast.com/articles/2013/10/25/boxers-be-brave-and-quit-before-your-brain-turns-to-mush.html

  19. Ted 06:36am, 01/24/2014

    “What is not being addressed here is why so many fighters are getting these subdural hematomas in what seems greater frequency than in years past.”

    Not sure about that.  Also, it only takes one blow to suffer one of these. Yo Sam Choi won a fight several years ago in South Korea but was hit by a final shot as the bell rang. He later died from the injuries of that single blow.

  20. john coiley 01:23am, 01/24/2014

    Ted, after the beating I took from Licata, I had a headache for 2 years…non-stop, no amount of aspirin (and the stronger stuff I took) could relieve the pain. It was not until my third chiropractic treatment did I know relief…it is truly a scary thing…thanks for bringing it to the forefront. with some fighters, and ex being of the super macho personality, this pain could be overlooked for ego’s sake…

  21. Mike Silver 08:03pm, 01/23/2014

    What is not being addressed here is why so many fighters are getting these subdural hematomas in what seems greater frequency than in years past. I believe a major reason is the lack of defense displayed by the majority of today’s fighters. It is all aggression and very little defense. 90% of punches aimed at the head. Most fighters even 20 or 30 years back displayed better defense because that is what they were taught. The training today is pathetic. Fighters are at greater risk today than ever before. Every fight is a war. Today’s fighters even brag about how well they can take it and welcome the punches to prove how tough they are, as Pascal said in the post bout interview. The “sport” today is more absurd and dangerous than ever.

  22. Ted 06:20pm, 01/23/2014

    Mine was non-traumatic where as boxers are traumatic -based and frequently include a blood clot and coma (induced or non-induced). That is a bad sequence and if they are put on life support, it is 50-50. But if they are unconscious when carried out of the ring and there is brain bleeding, then the chances are not great that thy will survive. Frankie Leal survived in his fight against the Russian in Nevada even though he made it through that scenario, , but then when he came back a few fight later in Mexico and was killed by the blows he received in the last round. That is exactly why I am 100% behind a zero tolerance policy.

  23. Ted 06:14pm, 01/23/2014

    one day for the operation and 4 days to recover. 5 days in all which is a lot these days.Went from a local hospital to Maine Med in Portland by helicopter and was on the operating table faster than you can say DDDRILLLLLLLLLLLLLLLLLLLlllllllllllllllllll.

  24. kid vegas 06:05pm, 01/23/2014

    How long were you in the hospital Ted?

  25. George Thomas Clark 02:39pm, 01/23/2014

    Dr. Cantu should be reminded that few, if any, football players resume their careers after “surgicial incisions” to repair subdural hematoma. 

    “There’s no evidence he’s [collision-sport athlete] at greater risk for a brain bleed than if he ever had the first brain bleed…and that’s the reason we’ve got many athletes playing football, rugby – all kinds of sports – that have gone back after a subdural hematoma, especially one that did not require surgical incision.”—Robert Cantu, Chief of Neurosurgery and Director of Sports Medicine at Emerson Hospital in Concord, Mass.

  26. Ted 01:23pm, 01/23/2014

    No. None whatsoever. I rehabbed for a short period and then was fine. I lost a lot of weight but gained it right back once I stared eating again. I don’t take aspirin or anything else that can thin the blood, but that’s no big deal. I have a large indentation at the top of my forehead where they drilled into my skull to relive the pressure but it’s not all that noticeable. Of course, I resumed my weight training and golf after I recovered and was as good as eve. All in all, I was pretty fortunate that they got to it when they did. Another day could have been very bad. as I could n o longer tie my shoelaces or button my shirt and the migraines were brutal.

  27. John 01:08pm, 01/23/2014

    Ted: Have you suffered any ill effects from your injury?

  28. Ted 01:04pm, 01/23/2014

    An example of the great cooperation I got:

    Ted,
            A fighter who has suffered a subdural hematoma must be cleared by our Research Consulting Physician, the Medical Advisory Panel and then the commission must vote to issue the license.  See NAC 467.017(3)  http://leg.state.nv.us/NAC/NAC-467.html#NAC467Sec017

            If you need any further questions answered please feel free to contact us.

    Colleen

    Nevada Athletic Commission

    (702) 486-2575

  29. Ted 01:00pm, 01/23/2014

    John, yes, latent is the word. As opposed to a gradual one that leads to dementia. Glad you liked it.

  30. Ted 12:58pm, 01/23/2014

    Thanks Kid and welcome back from Dallas!!!!!!!!!!!!!!! I did a ton of research on this to make sure I was up to date on the rule changes,

    I exchanged a number of emails with the Nevada State Commission and they were very helpful.

  31. John 12:49pm, 01/23/2014

    Don from Prov: Although my son was boxing at 8-years-old, I’d never allow him to do it again. It was a PAL boxing team in Ventura, Calif. and he was watched carefully to insure he didn’t get into the ring with anyone that didn’t realize this was a sparring session. Additionally, he used the best headgear possible, a mouthpiece, and 10 ounce gloves which I purchased separately. I wouldn’t want my son to play Pop Warner football or ride a motorcycle either. Nice piece, Ted. Thanks for bringing attention to a latent injury that could turn into a disaster.

  32. kid vegas 12:48pm, 01/23/2014

    Great article. One of your best, Ted. Well researched.

  33. Ted 12:09pm, 01/23/2014

    Great to see you back Walter and my deepest condolences on your loss. Ord will be missed by all who knew him.

  34. Big Walter 12:05pm, 01/23/2014

    Great series. Very sobering. Every boxing writer should read this one and learn something.

  35. Ted 11:53am, 01/23/2014

    Irish, Dr. Stiller is my favorite fight doctor and is nor afraid to state his position. He also is a great boxing guy and very accessible and humble.


    On the other hand, so is Dr. Cantu and that is what makes this controversy so interesting.

  36. Ted 11:51am, 01/23/2014

    FightClubWriter, how very nice of you to say that. It makes the effort worthwhile.

  37. Ted 11:50am, 01/23/2014

    pauly , actually, that’s what they are doing now. It’s a change from the zero tolerance that used to be the rule.

  38. FightClubWriter 11:20am, 01/23/2014

    Great informative read. It’s so refreshing to read something so thoughtful and without any grandstanding BS and propaganda.

  39. Irish Frankie Crawford Beat Saijo aka Gimpel 11:03am, 01/23/2014

    Ted Sares-Dr. Stiller is the one who, as you often post, ” has the beat” here regarding “increased susceptibility”, in that a fighter who passes all the tests and then sustains a SDH is ipso facto more likely to sustain another subdural hematoma even if all post recovery tests are negative.

  40. pauly 10:05am, 01/23/2014

    wow great article. here are some facts to add . head injuries are the the top of the ladder currently. that makes these cases very relevant. but what is also relevent is the human body which has the simple ability to heal and to adapt. its when the body is over stressed such as returning too quickly to the ring. instead of just banning it why not monitor it. develop a series of teats that monitor the situation.

  41. Ted 09:36am, 01/23/2014

    Yes, but boxing is different. Using the argument that football players may return safely to play after complete recovery from an SDH as a reason to allow boxers to return ignores the fact that exposure to angular acceleration from punches occurs much more frequently in boxing than football. Angular acceleration is what places the greatest stress on bridging veins which when ruptured cause an SDH.

  42. Don from Prov 09:33am, 01/23/2014

    Boxing/football—too many injuries, too many early deaths

    I wouldn’t allow a child of mine to participate in either sport
    But I’ve grown up watching boxing and will probably continue

  43. Ted 08:44am, 01/23/2014

    Thanks for the prop Bill. I enjoyed writing this one.

  44. dollarbond 08:42am, 01/23/2014

    Ted, this was indeed an easy-to-understand piece on something I never realized about boxing.  Thanks for an informative read with an extraordinary attention to detail.