I’ve unintentionally kept this blog blank for a while.  Here’s the final story I wrote for a graduate long-form journalism class at Boston University.  I feel it’s as worthy of my first post as anything I have.  This should mark a period of more frequent updates.

When mixed martial arts world champion Georges St. Pierre fought challenger Carlos Condit to retain his title in mid-November, the two men traded blows for twenty-five minutes.  St. Pierre, the top fighter in the Ultimate Fighting Championship’s (or UFC’s) 170-pound division, blasted Condit with a hooking right fist to the chin in the first round that staggered the challenger.  When St. Pierre lands that punch with all his might, it generates 2800 pounds of force; over twice the amount of force produced by a blindside hit from an NFL linebacker.  St. Pierre is known for his powerful kicks, too.  When he stands guard with his left foot forward, the UFC welterweight champion can torque his back leg around and connect his shin with his opponent’s thigh, kidney or temple with almost 4000 pounds of force.

But the challenger rocked St. Pierre with an equally devastating high kick.  In the second round, Condit threw a looping left fist that scraped the left side of the champion’s jaw.  St. Pierre raised his right glove to the side of his face where the punch landed, protecting himself from future punches.  He then countered with his left, but his reaction was too predictable.  Condit changed levels, bending forward at the waist and ducking so low that St. Pierre’s probing left hand was over a foot too high.  Condit then used his forward momentum to wind up his left leg and snap out a kick that hit a few inches higher than the clenched fist protecting St. Pierre’s face.  The lowest part of Condit’s shin collided with the top of his opponent’s skull.  After the strike, St. Pierre experienced another impact as his head hit the mat.  His respite was a couple precious inches of foam propped up by plywood.

Amazingly, St. Pierre recovered, made it to the end of the round and eventually won the fight with more precision strikes to Condit’s gashed face.  The fight went the distance, meaning that neither competitor surrendered or was incapacitated during the allotted five rounds.  By the end, both men were unrecognizable.  St. Pierre’s head and face were swollen like he had ignored a shellfish allergy.  Condit couldn’t stop bleeding from the gashes under his eyes.  Fans of the UFC lauded both athletes’ performances, and St. Pierre-Condit was immediately hailed as the fight of the year.

Chris Cole does not fight in the UFC, but he could catch a break soon.  He has only been a professional mixed martial artist since 2010.  Short and lean with big ears that poke out of cleanly buzzed brown hair, Cole is 23 but could pose as 18.  In addition to his career as a mixed martial arts competitor, Cole teaches self-defense and martial arts classes in North Attleborough, Massachusetts.  Many of his students are children.  He may be the least intimidating man on the planet attempting to make a career out of bullying opponents around a cage.

Cole has practiced martial arts since he was ten years old.  He wrestled in high school and found mixed martial arts in college.  MMA suited him as a hybrid of “stand-up” styles of fighting (like Muay Thai, karate and boxing) and ground-based techniques (like wrestling and jiu-jitsu).  Now, Cole has four professional MMA fights behind him and a fifth coming up in February.  He fights in the 125-pound division of a regional promotion, equivalent to the minor leagues of MMA.  If Cole continues to succeed in Massachusetts, he may get noticed by the UFC and called up to the big leagues.  He won three of his first four fights: two by submitting his opponent with wrestling techniques and one by decision, or having the judges determine the victor after neither competitor submitted.  In his one loss, Cole suffered a technical knockout (TKO) and a minor concussion.  His opponent caught him with a punch he didn’t see.  For the next few days, he had some light headaches and blurry vision.  That was the first and only concussion Cole has experienced in his life.

“I’m really not worried about getting hurt too much,” Cole says.  “Obviously we don’t want to get hurt.  The real risk for me is losing.  I hate that feeling.”  He tries not to think about life after professional fighting.  He hasn’t planned for it.  “I don’t want to worry about it,” he says hesitantly.  “I’m trying to live my life now and worry about it later.”  He pauses, lets his own words sink in and laughs.  “That isn’t the smartest thing to do.”

In the UFC, mixed martial arts’ highest and most visible display of talent, there is no collection of fighters lobbying for safer practices.  The situation is unique.  There are technically no teams, aside from the collection of coaches and trainers a fighter keeps in his corner.  Each fighter is not owned like each team in the National Football League is owned.  The fighters own themselves.  The organization is owned by Frank and Lorenzo Fertitta and managed by Dana White.  The UFC does follow the Unified Rules of Mixed Martial Arts, a doctrine that outlines rules, regulations and purportedly safe practices of the sport.  The California State Athletic Commission approved these regulations in April of 2000.  Cosmetic safety precautions include 4-6-ounce gloves, mouthpieces and specific instructions for wrapping hands in bandages, soft gauze and surgeon’s adhesive tape.  Many smaller organizations adhere to the Unified Rules of Mixed Martial Arts, but some allow more brutality, like the ability to kick a downed opponent in the head, for flashier fights.

Unlike almost every other popular sport in the country, mixed martial arts competition appears so outwardly violent that New York’s State Senate struck down a bill to legalize it within the state last May.  The sport is legal in 46 other states.  Vermont became the last state to approve it in May of this year.  It is legal in Massachusetts but not regulated by the state athletic commission.  The trend of its increasing legality comes from three places: the Unified Rules of Mixed Martial Arts (which turned a glorified bar fight into a standardized sport) increasing popularity and increasing profits.  Last year, the UFC entered a broadcast partnership with Fox Sports Media Group to air live and taped UFC programming through January 2019.  The deal is reportedly worth $100 million annually.  The sport Senator John McCain (one of boxing’s most influential fans) famously called “human cockfighting” peaked at 8.8 million viewers during the first UFC on Fox special.

Boston University’s Center for the Study of Traumatic Encephalopathy, more eloquently known as the CSTE, was formed in 2008 as a partnership between the Boston University School of Medicine and the Sports Legacy Institute, a leading Boston non-profit working toward “solving the concussion crisis” in athletes and the military.  The crisis has dogged the National Football League for the last decade (or at least has become more visible), as more and more retired stars develop neurological problems.  But the crisis has yet to permeate MMA, where fighters are unaware of risk partially due to the sport’s infancy.  The center focuses on a neurodegenerative disease called Chronic Traumatic Encephalopathy, or CTE.   Recent neurological studies of deceased athletes with repetitive brain trauma (which can include multiple concussions or sub-concussive blows) reveal a progressive degeneration of brain tissue and a coating of tau, an abnormal protein.  CTE leaves a brownish, charred footprint on the brain; a cross-section of brain cells with CTE looks like pieces of burnt popcorn.  Tau is like plaque in the brain.  It corrodes brain cells.

CTE is associated with memory loss, impaired judgment, impulse control problems, depression and eventually progressive dementia.  It ages the brain.  A 45-year old former NFL Linebacker with CTE could present the same symptoms as a 65 year old with dementia.  Earlier this month the CSTE published the results of the largest case series of CTE.  The study documented 68 cases of CTE among the 85 brains studied.  It doubled the amount of published cases around the world, and with it came a pathological four-stage classification of CTE: Stage I symptoms include headaches and issues with attention and concentration.  Stage II expands the symptoms to depressions, explosivity and difficulty with short-term memory.  The symptoms of stage III progress to cognitive impairment (problems with planning, organization, multitasking and judgment), until full-blown dementia presents itself in stage IV.  Of the 68 cases, 50 subjects played football in high school, college, semi-professionally or professionally.  Two of those football players were John Mackey and Ollie Matson, NFL Hall of Famers who died from complications of dementia.  The post-mortem research revealed stage IV CTE in both of them.

The study also included eight boxers and a professional wrestler.  The CSTE reaches into the realm combat sports, but not with the same frequency.  Boxing, wrestling and mixed martial arts display a repetitive nature of head trauma akin to football.  In boxing, the trauma is obvious.  A boxer’s goal is to knock out his or her opponent, and that does not happen often through a vicious shot to the liver or kidneys.  Professional wrestling is staged, but the showmanship has consequences; specifically shows that end with one wrestler’s head bouncing against a thin foam mat supported by wooden boards.  In 2007, professional wrestler Chris Benoit was at the center of a horrific double-homicide and suicide.  Benoit murdered his wife and son before killing himself.  Chris Nowinski, co-founder of the Sports Legacy Institute and a former wrestler, offered Benoit’s father the hypothesis that repeated trauma to his son’s brain may have influenced his behavior.  The doctor who tested Benoit’s brain after his death deemed it so severely damaged that it resembled the brain of an 85-year-old Alzheimer’s patient.

Cole is preparing for his fifth professional fight with Sityodtong Boston, a world-renown mixed martial arts training facility in Somerville, Massachusetts.  He trains once a day, six times a week with instructor John Johnson and owner Mark Dellagrotte.  Dellagrotte is one of the premier practitioners of Muay Thai, an aggressive style of martial art from Thailand that concentrates on strikes with the shins and knees, in the United States.  As he gets closer to the fight, Cole will move from training once a day to twice a day, and from six days a week to seven.  He will focus more on strength and conditioning and eventually move onto sparring, or full-contact practice to simulate the fight.  In the NFL, a lot of head trauma doesn’t come when teams matchup on Sundays.  Instead, it comes in practice and the offseason.  The big game is just a frenzied culmination of all the concussive and sub-concussive blows sustained in practice.  This is why, in the latest collective bargaining agreement between NFL players and the owners, less time was allotted to full-contact practice.  The new standard for offseason workouts is a maximum of three and a half hours on the field per day, Tuesday through Thursday.  During the regular season, teams are allotted only 14 total padded practices (out of a 17-week season) and just one padded practice per week in the postseason.  These padded practices must be limited to three hours.  On the field, players and owners agreed on a rule change in kickoffs in an effort to minimize some of the nastiest collisions in the game.

The CSTE has yet to dissect the brain of a mixed martial artist.  The research in football is in its infancy.  Twenty years ago, a football player didn’t experience concussive and sub-concussive collisions; he “had his bell rung” or “took a lick.”  Mixed martial artists face an uncertainty with some similarities.   No one knows exactly how dangerous mixed martial arts competition is for the brain.  The sample size of fighters removed from the sport isn’t large enough and the research hasn’t been done.  In UFC competition, the average fight lasts anywhere from eight to eleven minutes depending on the weight class.  A boxing match that goes all fifteen rounds lasts 45 minutes.  Additionally, MMA fights can end in a submission, where one fighter uses a grip technique to make another tap out, or resign.  Submissions involve no head trauma.  Fighters who are submission specialists may be exposed to far less head trauma.  Then again, they could come across a lot of opponents who like to brawl.

All diagnoses of CTE are post-mortem.  There is still no way to diagnose the disease during life, but Christine Baugh is working to change that.  Baugh oversees the DETECT (Diagnosing and Evaluating Traumatic Encephalopathy Using Clinical Tests) study at the CSTE.  Its goal is the holy grail of neurodegenerative disease research (a very specific holy grail): to confirm a living case of CTE.  Once that happens, the search for treatment can truly begin.  Until then, it is tough to test the efficacy of a treatment when the subject may not actually have the disease.

For Christine, the center’s research is a fulfilling union of sports and neurological science.  Baugh was a four-sport scholar athlete in high school and captain of Harvard women’s rowing team for two years.  She graduated cum laude with a certificate from Harvard’s Mind, Brain and Behavior program, completed a Master’s in Public Health at BU then joined the Center in June 2010.  But the CSTE is not just a vessel for her interests.  Tom Baugh, Christine’s father, played three years of professional football for the NFL’s Kansas City Chiefs.  Tom played in 45 games at Center, one of the highest-impact positions on the field.  To Christine and most other researchers, treatment is vital, but prevention is an even higher priority.  She loves football, but doesn’t know if the game we see today will ever be deemed “safe.”  There is a lot of talk about improving the equipment: stronger mouth guards and more secure helmets.  “Helmets were invented to prevent skull fractures,” says Baugh.  “And people stopped dying on football fields when they put helmets on.  Unfortunately, players still hit each other, and all of that energy has to go somewhere.”  Christine still isn’t sure what more research will find.  Christine talks about peewee football, and the level of concern in her voice rises.  “Kid sports are more problematic.  Kids don’t have the knowledge to know and appreciate the risks they are being exposed to.”

According to Cole, the fastest growing class at his gym in North Attleborough is a mixed martial arts class for kids.  The class is only open to children over ten years old; Cole won’t allow anyone younger learning preliminary MMA techniques.  “They see their parents doing it and they see it on TV and they want to come in,” he says.  “Especially with the kids who play football and the more aggressive sports.  They don’t want karate anymore.  They want MMA.”  He starts them off with stand-up techniques, primarily boxing.  Then they work on positional ground techniques, but no submission attempts.  Cole doesn’t want the kids using arm bars or leg locks that could hurt their joints at such a young age.

“In our society, adults will do dangerous things for money,” says Christine.  So what sort of obligations do the UFC and other organizations have to protect the future of their fighters?  What are the ethical implications between organization and adult mixed martial artist?  Christine insists leagues have a responsibility to make reasonable efforts to disseminate information so those who are participating are informed of the risks.

Cole’s dad was always okay with his son’s decision to become a mixed martial artist.  He was military, and according to Cole that helped him understand.  But his mother was afraid.  She comes to every one of his fights now, but she is nervous.  She winces and closes her eyes.