Reader response: Boxing with the past

I read with interest Dr. Salomon's¹ reflections in “Boxing with the past.” Boxing is an extremely contentious subject with high risks for both acute and chronic traumatic brain injury. Acute neurologic injuries, such as subdural hematoma, epidural hematoma, subarachnoid hemorrhage, intracranial hemorrhage, diffuse brain contusions without associated hemorrhages, diffuse axonal injuries, and dissection of the vertebral artery/carotid artery, are major causes of boxing-related mortality and morbidity. The burden of chronic neurologic injuries, such as chronic traumatic encephalopathy, dementia pugilistica, chronic post-concussion syndrome, chronic neurocognitive impairment, post-traumatic dementia, post-traumatic cognitive impairment, post-traumatic parkinsonism, and persistent post-traumatic headache, is likely much higher, but remains hidden, as most injuries express themselves after the athlete has long retired. Unlike Dr. Salomon, I am not conflicted with my passion for the sweet science. Military doctors (army physicians) work in the battlefield saving the lives of soldiers and, sometimes, even of the enemy; their role in the trenches does not mean that they personally support the war or feel that war is good and justified. Their critical life-saving skills save precious lives in battlefields across the globe. In much the same way, the presence of a neurologist at the ringside or cageside does not imply that they support boxing or think that boxing is good for the brain. Neurologists bring their unique life-saving skills to the ringside/cageside and help make the sport safer.²