Evidence of brain injury

The BMJ has published an article (Boxing doctor: get involved, BMJ Careers 2009, http://careers03.bmjknowledge.org/careers/advice/view-article.html?id=20000565) that fails to deal with the real issue of boxing—brain injury, which from recent evidence appears to be very widespread and to continue producing biological markers, as well as evidence on positron emission tomography and magnetic resonance imaging, long after the primary blow. In many people, perhaps most, the brain damage gets worse even when they stop receiving further blows to the head.

We all want young people to be disciplined, eat well, and take exercise. Most of us, however, would prefer to see them taking part in sports and activities that enforce rules and processes to protect the brain. Of course we know that relatively few boxers die in the ring. And although every one of those deaths is a tragedy, it is equally tragic that many more are getting permanent, irreparable, and worsening brain injuries. This is preventable harm.

Making it illegal to target the head and policing this rule, or banning boxing, are the only alternatives to prevent these injuries. Any doctor interested in boxing should read the evidence on brain damage and other injuries and not simply an article that fails to deal with these major issues.