OF course, the book doesn’t say so directly.

But if boxing legend Sen. Manny Pacquiao reads Damage: The Untold Story of Brain Trauma in Boxing, he would be convinced without an ounce of doubt of the stark reality of the career that has brought him fame and fortune beyond his wildest dreams.

Damage, written by renowned boxing journalist Tris Dixon and released last month, reveals in vivid detail and through scientific studies professional boxers such as Pacquiao have a very high chance of suffering brain damage not just from his 71 official fights but in his thousands of sparring sessions to prepare for his bouts.

By winning public office, especially the presidency, Pacquiao will be putting his country at risk of having an official unable to undertake his functions because of brain shrinkage and degeneration, the scientific term for which is chronic traumatic encephalopathy (CTE), referred to before in boxing reportage through the pejorative term “punch-drunk” and later “dementia pugilista.”

A study published in 2020 in the journal Neurology demonstrated “three different brain regions shrink in active boxers compared with controls. The degree of shrinkage and the different regions that shrink suggest several disease processes related to repetitive head injury may be attacking the gray matter together.

Worse for Pacquiao, who is at the twilight of his glorious career, the study pointed out “shrinkage was more pronounced among retired fighters, suggesting the more trauma fighters sustain, equals more long-term consequences for brain health.”

MedicineNet author Dr. Benjamin Wedro explained: “CTE symptoms start slowly and creep up on the patient. Initially, there may be concentration and memory problems with episodes of disorientation and confusion, dizziness and headache. It is as if the concussion symptoms were starting to return even without a new head injury.

Parkinson’s

“The patient can become aggressive and psychotic. As CTE progresses, behavior becomes even more erratic, with aggression and symptoms similar to those of Parkinson’s disease. Finally, thought processes decrease even further, leading to dementia with more Parkinson’s symptoms, including speech and walking abnormalities. The symptoms are progressive and cannot be stopped.”

This of course is no rocket science. The brain didn’t evolve to withstand thousands of blows on the cranium which contains it. In the gladiator bouts of ancient Rome, from which modern boxing evolved as a more “civilized” sport, gladiators, who were armored after all, probably fought less than a dozen fights until they were killed or mutilated. Today’s successful boxers have almost 50 fights throughout their career.

The book Damage has become a bestseller in boxing circles because the author brought to life the heartbreaking stories of the world’s top fighters – whom he had covered in his career – who ended up as total physical wrecks. The most famous of this is Muhamad Ali, who at age 42 – Pacquiao turns 43 in December – was diagnosed with Parkinsons’ disease as a result of CTE (Parkinson’s is a long-term degenerative disorder of the central nervous system that mainly affects the motor system, resulting in tremor, rigidity, slowness of movement and difficulty with walking).

According to Damage, Ali’s doctors found a type of brain atrophy in his scan that is apparently present in 50 percent of boxers with more than 20 bouts – a percentage far higher than in the general population, and that, by other criteria, these same boxers often show evidence of brain impairment.

From the Golden Era of heavyweights, the book narrated the following died from or with symptoms of neurological problems: Muhammad Ali (aged 74); Duane Bobick (70); Jimmy Ellis (74); Joe Frazier (67); Ingemar Johansson (76); Scott LeDoux (62); Jerry Quarry (53); Floyd Patterson (71); Ernie Terrell (75); and Jimmy Young (56). It lists more boxers whose lives ended in tragedies, afflicted with the most terrible symptoms of CTE.

How many blows

How many powerful blows to the head did Ali suffer in his career? The book cites statistics by Compubox: He took 8,777 blows in 47 out of 61 professional fights. How many professional fights has Pacquiao fought? 71.

The number of blows by a prizefighter like Pacquiao is many times that figure, because his most important training is through sparring. A British boxing star meticulously calculated how many blows he has received in his official bouts (424 rounds in 106 fights) and sparring sessions (10 for each fight): 44,520 blows.

The headgear boxers use in sparring sessions, the book pointed out, has been found not to have protected them from head concussions. In fact, it increases the number of head blows because of the bigger target it presents.

There are of course notable boxers who seemed impervious to brain damage, among them George Foreman and Floyd Mayweather Jr. The problem with CTE however is its onset cannot be determined so far by medicine; it could occur years after a boxers’ last head trauma, and is irreversible. “Boxing is Russian roulette with gloves. You start taking the punches and slowly the chamber empties,” the book noted.

Psychological

What is frightening about CTE is it could have horrible psychological consequences. “The list of boxing suicides is painfully long,” the book noted. This may be due to the total breakdown of the boxer’s mind or to the depression that follows when he realizes he is far, far from the warrior in the ring he had been.

“Ricky Hatton was the most popular fighter in British sport who could draw 20,000 fans to watch him fight in Las Vegas,” the book narrated. “But in retirement he found himself alone in his kitchen, a knife to his wrists crying through a fog of depression. All those fans were gone; he felt isolated.”

Worse was the case of Edwin Valero, “the brutal punching Venezuelan who committed suicide after being accused of murdering his wife in 2010, was suffering from anything more than a criminal mind. His wife had been stabbed three times.”

Pacquiao would read – or ask somebody to read for him – with much interest a chapter devoted to the famous trainer he owes most for his victories, Freddie Roach, titled very appropriately: “Dilemma: A damaged fighter wonders whether he should train boxers.”

Filipinos would be familiar with him and his disease as he would often be interviewed whenever Pacquiao has a coming fight. He slurs terribly, his hand often in a tremor, his head shaking. Roach fought 53 fights, and stopped in 1986 at 26 years old when he contracted Parkinsons’ disease to eventually become a trainer of several of the most famous fighters in the past three decades. Two brothers who became boxers also contracted neurological disease, but not a third brother who didn’t go into boxing.

Fighting

The book narrates: “For a long time, Roach didn’t believe his Parkinson’s was related to his fighting career, or at least he didn’t admit publicly. Now he sees things differently and accepts boxing damaged him. He visits a neurologist regularly and his most visible symptoms have been an unsteady gait and at-times-violent hand tremors. He also has concerns about his short-term memory and, at 60 years old, he has seen some of his contemporaries struggle with neurological issues in retirement. On the frontline, he’s also had to warn boxers about the dangers of fighting for too long or staying in the sport when it can do more harm than good. How do you tell a fighter it’s over or they’re ‘shot’?”

Roach was quoted in the book: “I’ve told seven guys to retire in my lifetime… five told me to go and fuck myself.” I bet one of those was Pacquiao.

Indeed, just before his fight in July 2019 with Keith Thurman (which he won by split-decision), Bob Arum, who promoted many of his fights until 2017, said Pacquiao runs the risk of suffering brain damage if he continues to fight at the highest level.

Arum said at the time: “You know the doctors will tell you the cranium as you get older, thins out. So, a guy that’s younger gets hit and the cranium absorbs the blow so it doesn’t affect the brain matter. When they get older the cranium is thinner, and when you get hit it affects – that would be the worst thing in the world if Manny Pacquiao suffered brain damage at this point.”

Pacquiao replied: “God will take care of me.”

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