When Fate Slips Lead in the Boxing Glove

A black swan stares menacingly at an innocent and undefended metropolis. - Dean Mouhtaropoulos

Black swan health problems can be the worst thing in an athlete's life, arresting or ruining careers and lives. Giving MMA athletes better healthcare to mitigate the effects of black swan problems doesn't need a union. It needs selective targeting of promoters, managers, commission members and coaches with education and information about better options for athletes.

Unseen, in the background, Fate was quietly slipping the lead into the boxing-glove.

- P.G. Wodehouse, Very Good Jeeves!, pg. 421

About this time last year, I had my close brush with death. Three pulmonary embolisms and a collapsed lung popped up out of nowhere and I spent a week in the hospital as a result.

Like Fabio on the rollercoaster, a black swan smacked me in the face.

The overall situation and not-always-spectacular healthcare I received was alarming, scary and mostly out of my direct control. I sat there, experienced pain in new ways, took my meds and waited for an eventual diagnosis of Factor V Leiden + calf injury two weeks before. Fortunately, my family, employer and friends really made it less terrible with their support, constant presence and reminders for me to take it easy over my medically recommended six month vacation from training.

My story isn't unique - Matt Serra had something similar happen to him - and I am basically a hobbyist with a liking for writing combat sports things up, so the strong possibility of me never training again wasn't going to faze too many people. I didn't get up to pastaweight or have a hand in training a dominant new UFC champion, either.

It's a different thing when we talk about athletes like Dan Hardy, Stefan Struve, Thiago Alves, Alan Belcher, Brock Lesnar, Mike Swick, Nick Denis and many others who've had to take a step back, retire and/or seriously contemplate the possibility of never competing again. A strike can be evaded, a submission defended, but all the training, strength and conditioning in the world can't stop a brain aneurysm, Wolff-Parkinson-White syndrome, unexpected second retinal detachments, diverticulitis, the inability to eat or sleep and so on.

These health-related catastrophes come as black swans and they are the best argument for heightened healthcare and commission standards within MMA - and it shouldn't need the existence of a true fighter's union to get us there.

These sorts of black swan problems are beyond the control of any person and thus become somewhat frightening when they suddenly become a part of your reality. The ontological shudders increase exponentially when physically performing for one's living - being an MMA athlete in this case - is what puts food on the table and pays the bills. The body, heretofore well taken care of and often a superbly tuned performance machine, has mysteriously betrayed the athlete, who is left staring at a chasm of uncertainty and decisions requiring a knowledge base that few non-medical professionals develop beforehand. That is the stuff of nightmares for the sane person.

Another scary thought is that what may lie on the other side of recovery is a body diminished. To be unable to perform at prior capabilities is usually something that accompanies aging or lack of serious and proper training, not an immutable performance limiter unexpectedly and unfairly imposed. The questions of "Is it worth it to go back to fighting? What if I'm only 85% of what I was before? What if it's 75%? If I don't go back, what's next?" are hard to answer and require an individual calculus developed with variables beyond my comprehension. I was urged by some members of my family to not go back to grappling and I had to give their perspectives serious weight in my contemplation. I chose to go back (although more cautiously than before), but I respect those who did come back to and those who stepped away from a career in combat sports due to these black swans. I can't imagine what the decision process was like for someone like Frank Mir or David Terrell. Athletic performance is usually a bonus for the average person, rather than an essential component of identity as it is for these professional athletes.

The entire process of having a serious health problem taught me a few things - that it's crucial to have health insurance, to be unceasingly vigilant and even unapologetically ferocious about the quality and nature of ongoing medical care and that all too often, the minimum standards of care are not what you'd want for yourself or for your loved ones. There are any number of platitudes about not appreciating what you have until it is gone, realizing what is and what isn't out of your control, but there is a reason why these sayings have been beaten so thoroughly into the metaphysical ground - this sh*t is unpredictable and can ruin plans, savings and lives within a heartbeat.

That is why I believe that the UFC, as the biggest, richest and most visible promotion within the sport should change its approach to providing healthcare to its athletes and the standards under which they fight. I realize I'm talking about an expensive proposition here as the UFC roster hovers around 600 athletes at this point, but consider the costs of crappy healthcare, bad training camps, missed fights and/or overturned results for drug tests for all of these athletes. These problems actively undermine the UFC's legitimacy and fan appeal.

As its growth slows and the plentiful cards weaken, the UFC should realize that being a world leader in sports and actually pushing for NJSAC-or-better standards worldwide is the best thing for its athletes and the future of its company. The TRT curtailment was a welcome start towards that, but it is just that - a start. The sport and its athletes need more and I believe that there is more money to be made for all parties after these proposed changes. The various vectors of scientific research into athletic performance are apparently converging upon the idea that athletes who are less stressed in their lives outside the sport tend to perform better and get hurt less.

If Dana White took all of the time he spent cussing at fans on Twitter for a month and put it into researching WADA/VADA, finding better healthcare options for Zuffa athletes and so on, the UFC would be a far, far better place. (It appears Lorenzo has been working on random drug testing for Jon Jones and a few others, which is another step of progress.) If more state athletic commissions were like that of New Jersey - proud, tetchy and delivering the best care for athletes as possible - the MMA industry would be enormously better. If athletes refused to fight for shady promotions and sought out management that make it clear that fight night insurance and related healthcare is a bare minimum, change would be easier - although a rocky start would doubtlessly ensue and the pioneers of that strategy could have a hard time getting fights.

People talk of a fighter's union and so on being the only serious avenue for change in the MMA industry, but I don't believe that this is so. I believe what is needed is the specific targeting and education of the executives of the big promotions, similarly making the prominent coaches in the industry educated on these things, and pushing for states to improve their athletic commission standards to NJSAC levels at the very least. That is easier said than done, but it's easier than convincing thousands of fighters worldwide to join a union.

What's even easier is that the major organizations are already doing this - particularly in the West. They already talk to the commissions, hire ex-commission members and lobby for the legalization of MMA in New York (almost a Don Quixote level endeavor at this point). This strategy involves talking to those who already have vested interests in boosting athletic safety and performance, structures and policies in place and budgets to implement new tactics and tests. This is an overall strategy of finding free-market solutions in private industry and legislative politics, rather than throwing in the hot button and murky issue of union-organizing into the volatile mix as well - and most of the major players are already doing it, albeit with different goals.

Thankfully, the progress of medical evaluation and treatment in mixed martial arts thus far has allowed most of these higher-profile fighters to be diagnosed before things went disastrously wrong. Despite athletes like Alves and Struve stepping into the cage multiple times with undiagnosed problems, nothing actually went wrong for them (we were lucky there). Most of the problems of the specific athletes noted above have been addressed and some are still on-going processes that may have nice endings for those involved.

Another thing to be thankful about is that the MMA industry as a whole seems to not mind if an athlete has to take time off or retire due to these black swan problems. We have seen the UFC give Dan Hardy a talking head gig, they displayed enormous patience with Paul Taylor, Mike Swick, Dominick Cruz (who also got a talking head gig) and others, they have let Struve work his way past the leaky heart valve and there are more stories that we are and aren't aware of. Invicta gracefully dealt with Laura Sanko's pregnancy (although that's a much happier kind of unexpected thing) and a few smaller promotions have had athletes bow out with career-ending injuries without too much kerfluffle. Bellator, apart from the sudden retirement of Cole Konrad, seemingly has not had to deal with these situations thus far - although injuries have occasionally forced their shuffling of matches and events.

But... honestly, all of these organizations and the athletes themselves would rather that they be fighting and have dealt with these things earlier in their careers or not at all.

As Patrick Wyman and others have shown, fighting careers are short and maximizing their length and quality for all fighters, not just champions, with this approach is the smart thing to do, financially and ethically. That's why the UFC and other promotions should push for and require the highest medical standards possible for their athletes from commissions, put together a better health insurance package and start engaging in selective cases of pre-hab treatment. Embracing this and doing this better than the big leagues of other sports would be an amazing selling point for MMA. It's already something Lorenzo talks about, even if it's not actually being delivered.

When fate tries to slip lead in the boxing glove for athletes, I'd like for there to be an anti-fragile system to deal with the effects. We need coaches, training partners, managers, medical professionals and commission officials and inspectors, empowered by strong legislation and using high medical and ethical standards to notice problems, actually call foul on something and/or mitigate negative effects as soon as possible. We already yell at each other about terrible referees, incompetent commissions, awful promotions and oblivious fighters. It is time to start doing more and actually getting the right information to the right people - educating those promoters, managers, commission members already within our sport to higher and higher levels.

Doing more and more of this selective targeting will keep this mission of educating from bogging down into a morass of super-vague mission statements like "edumacate everyone" that nobody can shepherd through to the end. This is crucial because we need to keep the pipeline of smart and stellar athletes open - especially those highly prized wrestlers graduating from college - and keep our beloved combat sport alive and well. That way, even if some athletes have to step away for whatever reasons, we have more waiting and willing to step in and a safety net ready to catch those who fall or stumble.

After all, what's the cost of saving someone's life and career versus the cost of watching everyone who didn't make millions in the sport bottom out, turn bitter, become crippled or die as a result of sport-incurred injuries? Ask the NFL with their three-quarters of a billion dollar concussions lawsuit ordeal.
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