On August 28, 2021, Jeanette Zacarias Zapata was knocked out in a Montreal boxing ring. Just five days later she died, aged 18.
During the bout, the Mexican boxer had taken a succession of punches to the head with the final hook even knocking out her mouthguard. These strikes are celebrated, but what is it that's being glorified? On the surface, some might say the art of fighting. A look inside the brain, however, reveals an ugly truth.
"You lose consciousness. If it's bad, your brain will start bleeding," world-renowned neurologist Steven Laureys told DW. "Our brains are fragile. They need a lot of energy. There are four big arteries but a lot of very small vessels. If these blood vessels rupture blood in the skull, it compresses the brain and you can die."
Silent killer
Boxing by nature targets that "fragile" part of the body, as the brain bears the brunt of the force. "10, 20 years later what you see is a shrunken brain, a sick demented brain because of the repeated blows," continued Laureys. "It's the long-term damage that we call punch drunk or pugilistic dementia or now chronic traumatic encephalopathy (CTE)."
In simpler terms, brain disease. There is no cure for it and the damage is so far reaching that it can even change someone's personality, impacting parts of the brain that are responsible for memory and emotions.
"Your brain cells interact, and they will do so through these bridges. When you take a blow, these connections will literally break. So, you shake it, you break it."
What makes boxing so tricky is that the injuries are not immediately visible. Society would never expect a tennis player to continue playing with a broken arm or a footballer with a broken leg. But when boxers are expected to fight the invisible repercussions of brain injuries.
"There are a lot of boxers, young boxers who have CTE without even knowing it because you can't see it," said Laureys. "You need special brain scans to see what's going on inside. The effects are only visible to the boxers themselves 10, 20, 30 years later."
The art of boxing
The lack of visibility adds to boxing's complexity, but for those that live and breathe the sport, mastering the art goes far beyond the brutal first impressions.
"Many think boxers enter the ring and beat each other up to hurt one another. No, it's about coming up with ideas. How can I be faster in the ring? To avoid punches. To hit and not get hit," Michael Timm, head coach at one of Germany's Olympic training centers, told DW. "To annoy the opponent so that he doesn't land a punch. That is the art of boxing. Fencing with fists."
Many boxers insist the best protection is the skill of dodging punches. Talking to DW, former German amateur boxing champion Kevin Boakye-Schumann, said his main aim is to "make sure that I don't get hit a lot."
"Boxing is about hitting without getting hit. There are a lot of boxers that have perfectly implemented that and with live perfectly normal lives at 50, 60, 70 or 80."
Before he started boxing as a teen, Boakye-Schumann admits that he too had the "wrong impression" of the sport. Now he thinks the sport is misunderstood. "Boxing is more than just two men or women that hit each other," he said. "It has a lot to do with intelligence, diet, individual strengths and discipline. It can take people very far in life."
Saving grace
For two-time amateur German champion Sarah Scheurich, boxing was a game changer, as she doesn't believe she would have graduated without it.
"I had ADHD as a child," she told DW. "Boxing brought me success and self-confidence. But it also allowed me to release my energy so that I could be somewhat 'normal'."
Boxing has helped many, but not everyone needs saving. Nina Meinke is a professional German boxer and holds the European female featherweight title.
"I really can't complain. I had a good childhood," she told DW at one of her training sessions in Berlin. "When I was 12, I wanted to start boxing. After the first training session, I was so knackered. I remember coming home where I couldn't even lift the glass and I was like, ‘I love it'. Since then I haven't wanted to do anything else."
The right kind of evidence
Like many boxers' back stories, their experiences later in life can vary as well.
"I had 150 fights and I don't even have an injury to my eyebrow, because I had good cover," said Timm. "Do I have a speech problem? No, I don't think so. And I had lots of fights. Lifestyle also plays a role."
Neurologist Laureys admits there are several factors that play a role, but isn't a fan of Timm's line of thinking. "Anecdotal evidence means there will always be people who don't develop the disease. But we can't ignore the strong correlation between the hits, the brain and this brain disease."
Boxing fans argue that other sports have higher casualty rates, but what makes boxing different is that the target is not a crossing line or putting a ball in the back of a net, it's to hit the head.
"In ancient Rome, Gladiators were killing one another. We don't do that. It's illegal. I think future generations will look at boxing as it exists today in just the same way," Laureys said. "How is it possible that as a society, we permitted young athletes to have these blows to the head and make them sick?"