Ringside physician criticizes Dr. Johnny Benjamin

Thursday, May 02, 2013

Dr. Johnny Benjamin fosters invaluable debate about critical issues in MMA, through his biweekly column for MMAJunkie and via Twitter. He is also occasionally the source of controversy, a position he does not shrink from.

In 2008 he questioned Pat Miletich fighting Thomas Denny, noting of himself that he is “a pretty fair, fellowship-trained spine surgeon.” Dr. Benjamin asked rhetorically “Isn’t this the same Pat Miletich who retired because of a serious neck injury – then underwent surgery to address a herniated disk in his neck? Same guy, right?” He then went on to say Miletich’s “safety is very open for debate.”

The problem is that Pat Miletich had not, in fact, undergone surgery.

As Miletich reported via Twitter, the column cost him $4,000.

@DrJCBenjamin wrote I shouldn’t fight after neck surgery. Thr was no surgery n cost me 4k 4 extra tests 2 fight.

Miletich knocked Denny out early in the 2nd round.

Dr. Benjamin’s 2009 remarks that women should not fight five-round championship fights due to the dangers of fatigue is in various measures paternalistic, insulting, and remarkably goofy.

In 2010 he accused the UFC and ProElite of ‘promotional lynching’ for putting Kimbo Slice in the limelight. Lynching is one of the great evils in American history. On average, for nearly 50 years between 1882 and 1930, a black man, woman, or child was murdered nearly once a week, every week, by a hate-driven white mob. The ‘lynching’ Dr. Benjamin referenced made Slice a millionaire, with a TapouT contract alone worth $50,000 per month.  Dr. Benjamin noted “I do know what the word means,” which only makes it worse.

In 2011 Dr. Benjamin said UFC marketing appeals to racism.

Part of the popularity of the UFC seems to be related to the domination of the white male wrestler.  I think it may be seen as one of the last sporting bastions of white male superiority.

Simply put.  The UFC/MMA, in large part, appeals to a young, white male demographic because young, white males are very good at it.  They can cheer for their own, drink with their own and feel good about it when their guy wins.

Do I think that the UFC and/or Dana White are racists?

Nope…not at all.

Does Dana understand his fan base (for better or worse) and markets to them like any successful businessperson…even if it appeals a deep-seated human deficiency?

Yes sir!

In 2012, Dr. Benjamin directly implied Frank Mir wrecked his body with past steroid abuse.

Let’s be honest here. How many people who never wrecked their bodies with past steroid use, naturally need TRT at 33? Less than one or two percent.

However, setting aside the growing evidence of a tie between head trauma and low testosterone levels, given that far less than 1% of the 15,000 registered fighters in the sport have received a TUE (the number is closer to .1%) the remarks by a respected MD seem ill-thought through and unfair, even reckless.

The messages above are by no means comprehensive, but rather illustrate the unfortunate directions Dr. Benjamin sometimes veers into, year after year. 2013 is no different than 2009, 2010, 2011, and 2012.

Saturday night Jon Jones beat Chael Sonnen. In the process, at one point Jones pushed off so forcefully that his toe dislocated, breaking the skin. The toe was treated by a ringside physician, and Jones went to the post-fight press conference, before going to the hospital for further treatment.

Dr. Robert Klapper, Chief Orthopedic Surgeon at Cedars-Sinai Hospital, later appeared on UFC Tonight and explained that the bone did not fracture, but dislocated, and that Jones would be back fighting within two months.

“The rehab involves, number one, you put it back into place. Line it up again. Wash out the joint because there’s lots of bad bacteria on that mat, and you need to make sure there’s no infection. The rehabilitation is just let things scar down, which they will. Because there’s no fracture of the bone — it’s just a dislocation — in six weeks it’s healed, then you start range of motion and strengthening. Back to fighting, six to eight weeks.”

Dr. Benjamin took issue with Jones’ treatment, first via Twitter, and then in his column, comparing what happened to Jones unfavorably with what happened in the case of University of Louisville basketball player Kevin Ware. Ware suffered a compound fracture of the leg, and was immediately transported to the hospital.

This type of open injury, whether it involves a bone in the leg or foot, requires proper immediate care at the scene and surgical intervention within eight hours to limit the chances of serious infection. Surgery usually consists of a thorough wash and inspection with removal of any foreign bodies (dirt, sand, clothing fibers, etc.) that may have been introduced into the open wound, strong antibiotics, and hardware to fix the bone injury (pins, plates, screws, rods, etc.).

Unfortunately, Jones was allowed to give a post-fight interview in the cage, and then he went to the dressing room, where someone closed the wound with stitches, possibly trapping dirt and bacteria inside, and fashioned a rudimentary splint. He then sat through some portion of the post-fight press conference to answer questions – all with the eight-hour clock ticking away.

I have a question: Where was the UFC orthopedic surgeon or medical director during the immediate on-scene triage, care and medical decision-making process of one of the promotion’s and MMA’s greatest stars?

Jones’ future is relatively easy to predict: very, very bright if he does not get an infection, but not so much if he does.

Now, in an interview with Fightland, Dr. Michael Kelly, the ringside physician who treated Jones at UFC 159, characterized Dr. Benjamin’s remarks as “somewhat irresponsible.”

I’ve read some of the criticisms that have been making their way around the Internet about what we should have done as doctors. I know there’s a doctor who writes a lot about MMA but doesn’t really cover any shows who always has a lot to say, and he derives most of his opinions from pictures on the Internet, which I think is somewhat irresponsible.

The treatment for a compound fracture is to clean up the wound, have it set, and then use antibiotics to make sure there’s no infection. I saw that somebody had said it was sutured and he was allowed to just walk on it. It wasn’t the case. It wasn’t sutured in the arena. Jones wasn’t walking on an open wound. That sounds like a silly quote from someone who doesn’t work many fights. Many fighters get cuts and wounds during their bouts and they’re cleaned up and covered or sutured and allowed to go about their day. The wound was cleaned, it was dressed; there were no sutures placed at the event. The injury was splinted and closed and covered with a dressing, and arrangements were made to have him taken to the emergency room.

As for the criticism that Jones shouldn’t have been allowed to go to the post-fight press conference before going to the hospital, everybody that practices medicine knows that a patient has a right to autonomy and to make their own decisions. You can’t force them to do anything. If he wanted to talk at the press conference, he had every right to, as does any other patient. You can’t force them to go to the emergency room that second. If they’re awake, alert, and oriented, and they can make a reasonable decision, they can decide when to go. It wasn’t a life-threatening issue, contrary to the nonsense I’ve seen on the Internet. It’s very funny when you’re there looking at something and then you see what propagates and how things get twisted and distorted. But it happens from time to time. Everybody plays Monday morning quarterback.

Dr. Benjamin is generally an immensely useful resource for the MMA community. He descibes himself as a “nationally respected orthopedic spine surgeon and author,” adding, “best of all, I make complex medical issues easy to understand.” Unfortunately, he sometimes makes complex medical issues harder to understand, not easier, too regularly offering positions that appear designed more to generate heat than light, something akin to high-level trolling.