Rwiti Bhattacharya
On a random Tuesday in 2016, the famed boxer - Muhammad Ali’s wife took him to the hospital for a cough, they were given some medication and they returned home. When that didn’t help and his condition worsened, he decided to visit the hospital again. However, within the next 24 hours, his condition steadily deteriorated and all his organs started to shut down. After a point, he had to be put on the ventilator and a decision had to be made - Ali chose to die a painless death rather than live a life of possible paralysis (CBS News, 2016). This paper will try to explore and explain the causes surrounding Muhammad Ali’s death and how his illustrious boxing career might have unknowingly paved the way for a crippling disorder.
Muhammad Ali and the people around him first began to notice patterns of awkward motor movement and postural instability in the years following his retirement, in 1981. He had all the major symptoms of Parkinson’s disorder - muscle stiffness (rigidity), slowness of movement (bradykinesia), and tremors (NHS, 2021) - but he didn’t know it yet. A clinical diagnosis was only formalised in 1984, but by then his motor functions had been severely compromised. When he died of a septic shock i.e. a condition that results from a dangerous drop in blood-pressure due to an infection (“Septic shock symptoms and treatment”, 2021), doctors linked it naturally to Parkinson’s. As the disease progressed, it made it increasingly difficult to swallow food or drinks without choking. This caused him to aspirate, leading to pneumonia - an infection that triggered sepsis (“Parkinson’s disease”, 2021).
While the circumstances leading up to his death have been clearly discernible, the factors that made him susceptible to the disorder have been relatively vague. However, it is highly likely that Ali’s career and patterns of fighting predisposed him to Parkinson’s. Boxing is a heavy-contact sport and it involves a lot of intense physical interaction, some of which might even be aggressive and violent. As a result of this, boxers frequently suffer repetitive head trauma and brain concussions. This can lead to Chronic traumatic brain injury or chronic traumatic encephalopathy (CTE), informally known as the ‘punch drunk’ syndrome. CTE is characterised by symptoms such as speech and gait disturbance, pyramidal tract dysfunction, memory impairment, extrapyramidal features, behavior or personality changes, and psychiatric disease - thus proving to be a sufficient cause for neurocognitive disorders such as alzheimer’s, dementia, and Parkinson's (McCrory, 2002). Evidence for this was especially overwhelming after the seminal paper by John Corsellis that discussed the association of neuropathological findings in boxers (McCrory, 2002). Although some recent research has found an association between CTE in boxers and a particular genetic predisposition, the majority of literature on the topic points to environmental factors as primary determinants. For example, in a 2006 study conducted by the Parkinson’s Institute and Clinical Center in California, researchers found that in pairs of twins where one of them had Parkinson’s, the number of head injuries sustained was directly proportional to the likelihood of developing Parkinson's later in life (Tedeschi, 2015).
It is therefore not a surprise at all that in his professional career spanning 21 years, Ali suffered consistent head trauma and that set off a degenerative cascade in him. Parkinson's develops when dopamine-producing cells begin to deteriorate and die. Dopamine transports signals to parts of the brain that control movement. Parkinson's symptoms appear after enough dopamine-producing cells die that there's too little of this neurotransmitter in the brain (CBS, 2016). In Ali’s case, while his cognitive abilities were left relatively intact : he could think clearly, understand what’s going on, and analyze situations properly - his motor abilities took a severe hit. Speech became increasingly difficult and he developed a tremor. Shaking, which usually begins in the arm and is more likely to occur when the limbs are resting, is a characteristic feature of parkinson’s (NHS, 2021). Dystonia - a condition that inhibits muscle movement or facial expressions because of cramps and spasms in various parts of the body - also develops with the progression of the disorder. Ali showed early signs of these symptoms, along with others. Even at the 1996 olympics when he lit and held the olympic flame, his hands and body trembled consistently. By the late 2000s, his body had begun to show clear signs of fatigue and decay. But despite his situation, Ali kept fighting on till his last breath and even took up the cause of Parkinson’s by actively advocating for it and setting up the Muhammad Ali Parkinson’s Cenetr in 1997, which works to find a cure for the disorder by employing research and medical investigation techniques.
The life and experiences of Muhammad Ali in the face of challenges posed by Parkinson’s Disorder are a source of inspiration to draw from. But at the same time, the unethical practices and methods of boxing that predisposed him, and several others, to such a life-threatening disorder is a major cause for concern and must be addressed legislatively by bringing in structural reforms and redesigning od such games, before they turn into more of a public health menace than what they already are.
References
CBS News. (2016, 6 june). Muhammad Ali’s long struggle with Parkinson’s disease. Geraadpleegd op 17 april 2022, van https://www.cbsnews.com/news/muhammad-ali-parkinsons-disease/
McCrory, P. (2002, 1 february). Boxing and the brain. British Journal of Sports Medicine. Geraadpleegd op 17 april 2022, van https://bjsm.bmj.com/content/36/1/2
NHS website. (2021a, november 18). Parkinson’s disease. Nhs.Uk. Geraadpleegd op 17 april 2022, van https://www.nhs.uk/conditions/parkinsons-disease/
Septic shock symptoms and treatment. (2021). NHS Inform. Geraadpleegd op 17 april 2022, van https://www.nhsinform.scot/illnesses-and-conditions/blood-and-lymph/septic-shock Tedeschi, B. (2016, 5 june). Muhammad Ali and Parkinson’s disease: Was boxing to blame? STAT. Geraadpleegd op 17 april 2022, van https://www.statnews.com/2016/06/04/muhammad-ali-parkinsons-disease/
Sepsis Alliance. (2021, 26 november). Parkinson’s Disease. Geraadpleegd op 17 april 2022, van https://www.sepsis.org/sepsisand/parkinsons-disease/#:%7E:text=For%20example%2C%20as%20Parkinson’s%20disease,infection%20that%20can%20trigger%20sepsis.
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