Doctors puzzled by boxer's sudden death

2002-07-16 08:24

Las Vegas - Panama's Pedro Alcazar spent much of his last day alive like any other tourist. He watched pirates do battle on the Strip, had lunch atop the tallest building in town and fed some coins into slot machines.

The night before, he had taken a beating before being stopped in the sixth round of the biggest fight of his career. Yet now he was in remarkably good spirits, joking and laughing, posing for pictures and signing autographs for the occasional tourist.

"I know I lost the title, but I didn't lose everything," he said. "I'm going to try to win a world championship for Panama and my family."

Late in the evening, Alcazar grew tired and said he had a slight headache. The young boxer took some Tylenol and went to bed, knowing he had to get up early for a flight back home to Panama.

A few hours later, he was found dying on the bathroom floor of his hotel room, his brain so badly swollen that its blood supply had been cut off.

Alcazar had been battered by punches to the body and head, but through tears of dismay complained to a ringside doctor only that his ribs hurt. Two other doctors who examined him in his dressing room found nothing out of the ordinary.

Now they're wondering why his brain swelled as it did so many hours afterward - and whether his death means doctors have to rethink everything they know about head injuries in boxing.

Boxers die in the ring, five of them in the last two decades in Nevada alone. When they do, though, they leave the ring on a stretcher - they don't die 36 hours later, without showing the usual symptoms.

"I've never seen anything like it," said Dr. Flip Homansky, a Nevada Athletic Commission member and longtime ringside physician. "To my knowledge, there has never, ever, been something like this happen so long after a fight."

Pedro Alcazar was a 52.163-kilogram champion, but he had never been in a fight like this.

At 26, his 25-2-0 record was built mostly in Panama against a collection of fighters few had heard of. Before coming to Las Vegas for his June 22 bout, his only two fights outside of Panama were in Costa Rica.

Now he found himself in the ring with Fernando Montiel, a tough Mexican who was also unbeaten. Worse, a heavily Mexican crowd of more than 12 000 waiting to see Marco Antonio Barrera fight Erik Morales in the main event at the MGM Grand hotel-casino was rooting against him.

Alcazar was getting $ 40 000 to defend his WBO super flyweight title, a belt lightly regarded most everywhere but in Panama, where a rich history of boxers such as Roberto Duran and Eusebio Pedroza has given way to lean times.

At home, Alcazar was known as "Rockero," a nickname given to him because he used to shave his name into the hair in the back of his head and wear boxing trunks that, he once said, hung down "like a skirt."

At a news conference a few days before the fight, Alcazar was mostly ignored by the media gathered to hear words from Barrera and Morales. When asked to speak, he did so only to correct his record, which should have listed two draws instead of one.

If Alcazar was intimidated, he didn't show it in the first round. He boxed and moved well, winning it on the three ringside scorecards.

In the second round, though, he took a hard punch to the head and the fight quickly turned. Montiel began dominating and - even worse - tried to show Alcazar up by pretending to wind up with punches as the crowd cheered him on.

By the sixth, Montiel was pummeling Alcazar with punches to the body, and he had fallen against the ropes when referee Kenny Bayless stopped it at 1:16 of the round. Many at ringside thought Alcazar had simply quit.

"Most of the rounds were competitive," said Marc Ratner, executive director of the Nevada Athletic Commission. "I thought the referee stopped it perfectly when he did. There were some others who thought it was stopped too early."

A wobbly, haggard Alcazar walked back to his corner. Even before he got there, neurologist Margaret Goodman had climbed quickly through the ropes and was shining a light into his eyes and talking to him in Spanish.

To Goodman's trained eye, Alcazar seemed OK, although distraught. Shining a light into his eyes, she could tell some 30 different neurologic things. None seemed out of the ordinary.

Goodman was left to console Alcazar as he cried in her arms.

"I can't go home without my title," he sobbed.

Goodman left the MGM that night feeling pretty good. Just the night before, she had sent five fighters to the hospital at a local fight card for reasons ranging from a concussion to a broken hand.

There were no such problems on the Barrera-Morales card, from the boxers in the preliminary four-rounders on up. In the main event, Morales and Barrera traded more than 1 200 punches but walked away unscathed.

Goodman had worked 350 fight cards, examined more than 3 000 fighters. She prided herself on being so fanatical about a fighter's safety that sometimes she annoyed other doctors.

"I'm just devastated," Goodman said. "It's worrisome for people involved in ringside medicine. It's hard to know now what you look for."

Goodman went over the fight again and again in her mind, trying to think of something she had missed. She had seen Alcazar at the weigh-in, and he showed no signs of dehydration that sometimes puts a fighter in danger. Two more doctors had examined him in the dressing room and found nothing worrisome.

Alcazar's head didn't hurt, and there was no indication he was bleeding in his brain. He complained of sore ribs, then went out and watched the main event from the stands.

That night, his trainer stayed up with him until 5:00 to make sure he was all right. After a few hours' sleep, Alcazar and three other countrymen went out to enjoy their last day in Las Vegas.

The next morning, he woke up early to catch his plane and went into the bathroom to take a shower. When he didn't come out after a while, his handlers kicked in the door and found him lying unconscious on the floor.

Tests at the hospital showed a small amount of bleeding in the brain that apparently triggered the swelling that killed Alcazar. By then it was too late. His brain was already swollen, and he was declared brain dead.

An autopsy ruled the cause of death as blunt trauma to the head. But it didn't show the multiple large hemorrhages that other fighters who die of brain injuries have.

That puzzled ring doctors, who now must worry that fighters can drop dead well after a bout.

"Any other case we've heard of, looked into or seen autopsy reports from, there's never been this kind of a fatal injury in a fighter," Goodman said. "Obviously there are a lot of things we don't know. There are a lot of things we'll never know."

Alcazar returned to Panama one last time, where he received a mournful farewell.

Panamanians filed by his open casket placed next to a deserted boxing ring at the Roberto Duran gym on the outskirts of Panama City.

A year earlier, thousands had filled the gym to cheer Rockero as he beat Nicaraguan Adonis Rivas in a split decision to win the WBO title. The fight helped Alcazar become boxer of the year last year in Panama, where the sport is second only to soccer.

Now his fans and fellow boxers cried together.

"I am sad and I am crying because I loved him like he were my son," Duran said. "What happened hurts a lot." - Sapa-AP