By Cynthia Hubert -- Bee Staff Writer
Published 2:15 a.m. PST Friday, February 28, 2003
VanBuren Lemons dances across the ring, Nikes bouncing, fists punching
the air, biceps rippling, breaths escaping in measured puffs.
Framed posters of the greats surround him. Ali. Frazier. Tyson. On
the CD player, the band Afro Rican fortifies him with a hip-hop tune.
Lemons is focused, his eyes narrowing to slits. Jab, jab. Circle
right, circle left. Sweat is erupting above his upper lip, and his
face is turning crimson. For a couple of hours this afternoon, Lemons
is a boxer.
But the doctor in him is always within beeping distance. At any
moment, while Lemons is practicing the art of bashing an opponent's
head and torso for sport, he could get paged to the trauma center
to repair an injured brain or spine.
Lemons is a neurosurgeon. He is a boxing fan and a student of its
devastating injuries. He makes no apologies for the apparent contradiction.
"Around here, we call him 'The Professor,' because he thinks a lot,"
says a smiling Angelo Nunez, a retired professional fighter who oversees
the doctor's workouts at a local gym. "But when he has a really, really
good day, we call him 'The Mauler.' "
Lennox Lewis has been through Lemons' Sacramento office. So have
Tony Lopez and many more of the world's most celebrated boxers.
Lemons knows them all, and understands them better than most.
At age 42, he is one of the nation's top medical experts in brain
injuries in athletes, particularly amateur and professional fighters.
As a physician and researcher, he has seen the disabling effects of
too many strategic blows to the head.
Yet Lemons, an athlete in his own right, admires the "beauty" of
boxing, a sport that the American Medical Association has said is
unreasonably dangerous and should be banned. He watches it in person
and on television whenever he can and practices it five days a week.
"It's an interesting paradox, isn't it?" Lemons asks, leaning against
his desk in an office stacked with medical texts and adorned with
an autographed mural of Muhammad Ali, whose devastating neurological
problems he believes were caused, or at least aggravated, by boxing.
"But I find myself in the right place on this issue. Boxing in general
is not to be condemned. It carries a risk and has an injury pattern
that we need to understand. Participation in athletics has many benefits,
and I have no trouble defending boxing or any of the other sports
that can result in head injury."
In fact, boxing is less lethal than many other sporting activities,
according to numbers compiled by Lemons and others. Horse racing,
hang gliding and football, among others, cause many more fatal injuries
than boxing, the statistics show. But boxing, by subjecting fighters
to repeated head punches, is believed to cause brain damage that has
gone largely undocumented until recently.
A study last year by researchers at the University of Pennsylvania
concludes that boxers, soccer players and hockey players may be at
higher risk of Alzheimer's disease and dementia than other people.
An estimated 17 percent of former professional boxers have a form
of advanced Parkinson's disease, commonly called "punch-drunk syndrome,"
that Lemons and others believe is the result of multiple brain concussions.
Former 49ers quarterback Steve Young retired from football in part
because of concerns about the condition, and Ali is believed by many
to be a victim of it.
Because of such risks, the AMA opposes all forms of boxing and recommends
that it be banned from Olympic competition. Likewise, the American
Academy of Pediatrics has called for a ban, encouraging young athletes
to participate in sports "in which intentional head injury is not
the primary objective."
Lemons, who earned his medical degree and graduated summa cum laude
from the University of California, Davis, contends that the AMA and
academy have "little understanding of boxing" or other contact sports.
He emphasizes the discipline, strength, agility and confidence that
sports like boxing can instill in young people. "Sports is a dedication
to excellence," he says. "Excelling in sports offers the encouragement
many of us need to do well in other aspects of our lives."
But he has to concede that if his son, Robbie, 10, wanted to box
competitively, he would think twice about allowing him to do so.
"I might have problems in that area," he says, adding that his wife,
Laura Anderson, also a neurosurgeon, would likely object. "I know
that amateur boxing is safe, but I'm not the only one in the family
making these decisions."
Robbie does play basketball, baseball and soccer, and his dad coaches
youth sports and helps sponsor athletic programs and other programs
for needy youngsters.
While most of his medical practice revolves around treating people
with problems such as brain aneurysms and head injuries from car accidents,
Lemons counts himself lucky to be able to combine his interest in
medicine with his lifelong love of sports.
"It's a hobby, really, a passion of mine," explains the doctor, a
fit, strapping man with a soft-spoken yet confident demeanor befitting
his Eagle Scout background. Lemons, a Sacramento native, owns a black
belt in karate and lettered in football and wrestling at Pomona College
in Claremont. His Carmichael home, which is equipped with a gym where
he practices the martial arts, is filled with signed gloves and other
boxing memorabilia.
"I have always had a big attraction to boxing as a fan, but it has
dangers, which are brain trauma," he says matter-of-factly. "From
that point of view, it's very interesting to me. Football players,
soccer players, lots of other athletes suffer these injuries. But
boxing is the prototypical sport for head injury."
The doctor spends much of his spare time researching the physiology
of head trauma in athletes, contemplating its consequences and searching
for ways it might be avoided. He keeps logs, writes papers and holds
seminars on the subject. He sits ringside at bouts in California and
Nevada and has the authority to halt fights for medical reasons.
As to boxing's risks, Lemons draws a sharp line between the amateur
version of the sport, in which bouts are shorter, more evenly matched
and have stricter safety rules, and professional fighting.
"For a lot of reasons, pro boxers do not back out of fights," says
Lemons, who presides over as many as 20 bouts a year for the California
and Nevada state athletic commissions. "There is so much at stake.
There is a lot of money involved, a lot of pressure to keep going.
It's a completely different animal than amateur boxing."
And it can have far more devastating results.
Consider Ali, the former heavyweight champ who in his prime could
"float like a butterfly and sting like a bee" but now is neurologically
damaged and has trouble walking and speaking. Or consider former middleweight
champion Alex "The Bronx Bomber" Ramos, who says that he, too, is
disabled by tremors, balance problems and other struggles that he
believes are the result of more than 300 career fights.
"Boxing did a lot of good things for me," says Ramos, who five years
ago started the Retired Boxers Foundation to support fellow fighters.
"I got to travel the world. I'm gonna die a fighter. I would never
do anything to hurt the sport. We just have to make sure it's as safe
as possible."
He credits Lemons with helping to make that happen.
Among other things, Lemons helped influence passage of a California
law mandating that ambulances and emergency medical technicians be
present at sanctioned boxing matches. He volunteers his time to teach
coaches and trainers about brain trauma, how to recognize it and when
to allow an injured athlete to return to action. Boxers praise him
for his studies of their injuries and his efforts to help them understand
what their careers might have done to their brains.
"He was the first one to really talk to these guys, and treat them
like people and not lab specimens," says Jacquie Richardson, executive
director of Ramos' foundation, which provides medical referrals, rehabilitation
and other services to aging boxers. "He is making a difference in
their lives."
Rob Lynch, executive officer for the California State Athletic Commission,
says the doctor's skills are "very special," and his medical interventions
during bouts may have saved lives and prevented disabilities.
"He sits within blood and spit range of these boxers in the ring,
and he can look in someone's eyes and immediately tell if something
serious is going on," Lynch says.
That "something" usually means a concussion.
"We used to think that concussion was a minor injury," the doctor
says. "Now we know it is not. It's a complicated topic. We do know
that no two concussions are alike, and the consequences can be very
different as well."
The word originates from a Latin verb, concutere, that means "to
shake violently." When the brain is shaken inside the skull, Lemons
explains, nerves and blood vessels can stretch or break. Depending
upon where those nerves and vessels are located and the severity of
damage, the result can be amnesia, brief loss of consciousness, coma
or death. Just last month, an Indonesian boxer died from head injuries
after his opponent knocked him out.
Doctors have only recently begun to understand that concussions,
especially two or more within a short time period, can have lifelong
consequences, even for athletes who seem at first to have recovered.
Lemons calls Ali the "poster child" for this "chronic traumatic brain
injury," which sometimes is mistaken for Alzheimer's or Parkinson's
disease.
"These symptoms may not surface until years after retirement, and
they are progressive," Lemons says. The brain damage, he adds, may
contribute not only to physical disability but to mental and emotional
problems.
It does not have to be that way, Lemons insists. He believes athletes
can avoid these consequences by staying out of the ring or off the
field until they recover fully from concussions.
"This is a diagnosis that any trained coach should be able to make,
and we should always err on the side of caution," he says. "All of
us who have watched or played or studied these sports know their dangers.
We can't prevent all injuries. But the least we can do is be cautious."
Lemons himself is a relentless boxer, Nunez says, though his training
regimen is highly unlikely to result in a blow that could cause serious
injury.
"He goes at it," observes Nunez, watching the doctor rage against
a punching bag and then hold his own in a sparring session with heavyweight
boxer Hildo Silva. "He approaches it like a professional. He gives
it everything he's got."
The doctor, whose hobbies include international travel and reading
philosophy, approaches life in general the same way.
"This sport is hard, harder than most people would imagine," he says,
reluctantly pausing from his routine, his shirt soaked with perspiration.
"This sport will humble anyone. It's a challenge. That's one of the
reasons I love it."
