The Bittersweet Science

The notion of boxing as the “sweet science” is often thought to have been coined in 1956 by the great New Yorker writer A.J. Liebling. He used the term as the title of his definitive book on the sport, but he took it—with much appreciation—from a British sportswriter, Pierce Egan. In 1813, Egan wrote about the “sweet science of bruising” in his master work, Boxiana. The book is a collection of magazine pieces set in a bloody, bare-knuckled world opposite Jane Austen’s.

As for the “sweet science,” no one ever really defines it. A carefully thrown knockout punch to a sweet spot on the chin is one possible derivation. There’s also the play on a science with so little apparent sweetness. But that’s not it. The sweet science Liebling and Egan describe had more to do with British principles of “stoic virtues,” “generosity,” and “true courage”—altogether, life in a contradictory place. It’s a square ring, after all, where sometimes hope transcends the specter of an awful inevitability.

Or so I’ve come to think, on a journey I’ve begun in the past year, exploring how the sweet science can be used as a treatment for Parkinson’s disease—that increasingly common degenerative disorder of the nervous system, tied to a loss of the brain chemical dopamine, which is involved in movement, memory, motivation, and cognition.

Someone told her she moved like a wavy wind sock outside a used car lot. “Exactly how I feel,” she said.

In October 2022, a longtime tennis partner noticed something “strange” in my stride, along with a noisy shuffle. “Fatigue,” I replied with pique. The truth is I’m 75 and had known something might not be right for years, particularly the ominous hand tremors, as well as the night-of-the-living-dead gait and a facial expression to match. Add severe anxiety in public places and bizarre nightmares, some quite disturbing.

I found a specialist to resolve the matter. We talked on the phone. “I don’t think you have Parkinson’s, but why don’t you come in,” she said. I did and within minutes she changed her mind. She was struck by the tremors on both my left and right side, and by some other more subtle indications, like an occasional difficulty in swallowing. She recommended a physical therapist to conduct the Mini-BESTest: Balance Evaluation Systems Test. Among the challenges: you stand on one leg for 20 seconds then the other leg; walk quickly up and down a hallway, while looking up and down, then to the left and right; stand in a corner on a cushion with eyes closed, not touching the wall. Finally, the therapist holds on to your shoulders and tries to pull you down from behind.

I enjoy these kinds of tests and did well enough that the physical therapist thought I was on the bubble, at least in terms of balance. She suggested I return in six months and brought up the matter of meds. I explained that I ran regularly and would like to depend on natural dopamine for as long as I could. Exercise has long been known to boost dopamine. One of the cruelties of Parkinson’s is that there is no blood or other test to confirm it. But if certain meds like Carbidopa-Levodopa cause certain symptoms to subside, then you probably suffer from it. Probably. Or, perhaps you have a variation, which may be even more debilitating.

In the end, I surrendered to the meds, but in the six months before my diagnosis became clearer, I kept with the delusion that I was athletic enough to generate my own dopamine, and so I began running several miles a week. Then one day a friend asked if I’d heard about Rock Steady Boxing. I hadn’t. “Well,” they said. “You should try it. Might sound counterintuitive, but you don’t really hit anybody. It’s about redoing the wiring.”

Rock Steady Boxing was founded in 2006 by a 40-year-old prosecutor named Scott Newman and a two-time Golden Gloves boxer named Vincent Perez. At the time, Newman had been diagnosed with early onset Parkinson’s. Perez drew Newman into a world focused on optimizing reflexes, balance, dexterity, and coordination. The two men worked six days a week getting Newman back in shape, using prolonged exercises done as strenuously as possible.

As Newman’s health and spirits lifted, he imagined a business opportunity. It was to create a noncontact boxing program to help people in their struggle with both motor and non-motor symptoms. The scientific basis was to use intense exercise to stimulate the natural flow of dopamine. At the cellular level, dopamine also helps protect the nerve cells attacked by the disease.

Now, 17 years later, Rock Steady Boxing operates as a nonprofit organization headquartered in Indianapolis. Today there are nearly 900 affiliates across the country, and more than a dozen abroad.

In October 2022, I began going to a Rock Steady Boxing gym at the southern end of Silicon Valley, in Santa Clara, near Levi’s Stadium. It’s a modest, two-ring gym called Relentless Boxing, equipped with a farrago of bags, weights, ropes, tires, medicine balls, and gloves, and on the walls, poster tributes to local champions. The mood is both friendly and guarded. Most participants have mild to moderate tremors and mobility issues. There are at least a dozen regulars, four or five women, all mostly retirees over 50, a handful over 70. One man arrives with his wife to help him along. A few people work from chairs, rather than yoga mats.

COACH ROB: After beating childhood cancer, Rob Putnam went on to become a featherweight boxer. Now he’s the head coach of the Rock Steady Boxing program in Santa Clara, California, helping people fight Parkinson’s disease. Photo courtesy of Rob Putnam.

Class includes three major components: aerobics, strengthening, and balance training. Also, core muscle stretching. Postures come from yoga, judo, jujitsu, and other martial arts. Calisthenics include coordination drill-stations such as jumping jacks, jump ropes, the speed bags, situps, and pushups—always as many as you can, and when you can’t go on, the coaches, particularly the local franchise owner and head coach at Relentless Boxing, Rob Putnam, 36, urges you to keep going anyway. You work as hard as you can for short periods of time. Exhaustion is healing. The idea is you survive Parkinson’s by thinking in terms of three-minute rounds.

The daily routine varies but often it’s in the last 30 minutes that you put on the gloves and hit the heavy bags, as hard and fast as you can for three minutes, the length of a round in the ring. Boxing features four core punches: jab, cross, hook, and uppercut. Add basic defensive moves: bob and weave, advance and retreat. In one exercise, you quickly memorize a six-punch combination, which might include punches and moves. Then you box for 60 seconds. Rest for 10 seconds. Then another combination, rest, and another. You’re working mind and body, ever faster. As you become proficient, over months and years, Coach Rob urges you to visualize the heavy bag as an actual opponent, so you imagine facial features, body type, strengths, and weaknesses. The purpose is to sharpen focus, personalize, tune the signals, and learn to be meticulous.

The most satisfying part of a class is when the coach puts on his mitts, not unlike a catcher’s glove, and invites you to punch him. Or her. The coach literally catches your punch. This is the closest you get to real contact. The coach calls out punches by name or number (1 for jab, 2 for cross, etc.) and you hit the corresponding mitt. If you’re skillful, and resilient, you get into a rhythm. You hear it as the gloves make contact. You’re working in and out of range of your opponent, bobbing and weaving, and it all becomes an aesthetic, a kind of dancing.

From time to time someone falls in class, which includes exercises for falling and getting up again. Falling is the great menace with Parkinson’s. Phyllis fell a few weeks ago, with hardly any warning. She was standing by the gym entrance, chatting. No need for an ambulance but unnerving. “It’s not like fainting,” she said, “more as though gravity had pulled you down out of thin air.” She’s a retired teacher, ever optimistic, sweet as anything, and while at the beginning of class we stand in a circle practicing voice exercises, she moves around in place, endlessly swaying. Someone told her she moved like a wavy wind sock outside a used car lot. “Exactly how I feel,” she said with a smile.

Phyllis has been with Rock Steady Boxing for more than three years. She finds it enormously helpful, particularly the cognitive aspect. Rock Steady Boxing is her one refuge. “The reason I joined was less for the exercise than to learn something new,” she told me. She’s lost 50 pounds, become calmer, less frustrated, more confident, and slightly more coordinated. She especially appreciates the way coaches can read her movement and suggest ways to retrain her body. She’s come to depend on the immediate effect these directions often seem to have. And yet as much progress as she’s made, she still has moments when her legs freeze. She told me she was in a nightmare running through a field and jumping a hurdle. “Actually, I was throwing myself out of bed. It’s happened before. I’ve had several black eyes. The worst was when I hit my face on the nightstand and broke my nose.”

Before and after class, people exchange tips. “This neurologist returns calls, not that one.” “So-and-so is going to have Deep Brain Stimulation.” “Have you heard about the work of Peter Tass at Stanford who has developed a vibrating hand glove that may have a profound effect on Parkinson’s?” “If you have Parkinson’s, how do you explain to your children they may inherit it?” “You’ve got to read Ray Dorsey’s new book, Ending Parkinson’s Disease, a Prescription for Action. He traces the disease back to the London smoke fogs in the 1870s. He says Parkinson’s is preventable if you can limit your exposure to the deadly chemicals around us, like the children who worked as chimney sweeps in the 1700s defeated scrotal cancer.”

If you can rebuild self-acceptance, then you don’t care what somebody in the restaurant thinks of your tremors.

In these conversations at the gym, there are always the questions underneath: Does Rock Steady Boxing really work? And for how long and under what conditions? The consensus among people I spoke with—neurologists, physical therapists, trainers, and participants—is that it does work. For me, it has. After a year, I’ve acquired strength and agility, although the arm tremors and awkward gait are about the same. Friends say I seem more energized and focused. The Rock Steady Boxing 1 to 5 scale, where 1 is high, meaning 1 is your goal, had me at one 1.5 when I started and after 8 months, I moved up to 1. A subtle improvement but encouraging, if only for a moment.

Terry Ellis is an associate professor at Boston University who investigates the effects of exercise on the progression of Parkinson’s. She’s a coauthor of a 2019 Frontiers in Neurology article on the effects of Rock Steady Boxing on Parkinson’s, which offered a rather depressing conclusion: “Despite growth in the popularity of boxing for Parkinson’s and some positive findings, there is limited evidence of efficacy.”

Recently, Ellis took a much more positive position. Rock Steady Boxing, she told me, was “a great idea, a great program,” but it’s not about boxing per se. It’s about how jabs, crosses, hooks, and undercuts get your heart rate up, just as aerobic, strength, and balance training do. She added, “There’s been many rigorous studies that show aerobic exercise impacts the brain of people with Parkinson’s and reduces the severity of motor symptom problems. Those studies also show aerobic exercise stabilizes the progression of Parkinson’s.” Still, the question remains how to keep adjusting the program over many years, especially for people who may face other illnesses.

Kimball Magoni, 69, was diagnosed with Parkinson’s 10 years ago. He lives in Massachusetts and has been going to the same Rock Steady Boxing class for nearly five years. He’s also a licensed clinical psychologist and these days accepts only Parkinson’s patients. Magoni has become increasingly interested in the power of camaraderie to deal with the whole Parkinson’s kit of grief, anger, loneliness, helplessness, self-pity, and shame. Many people, following their diagnosis, Magoni said, feel lost from their community.

“It’s like coming home when you were a kid,” Magoni told me. “If you had a happy house, a sanctuary you’re a part of, that takes care of a whole lot of crap. You walk in, you’re valued. That’s what’s so unique about Rock Steady Boxing. With the right group, people will connect, they will support each other, they will feel much less anxious about their Parkinson’s. Why? Because they’ve got a place where they’re back to being valued for who they are, not what symptoms they have, or don’t have. They find their way through places like Rock Steady Boxing back into the tribe. And if you can rebuild self-acceptance, which is so critical, then you don’t care what somebody at the next table in the restaurant thinks of your tremors.”

Magoni noted that one benefit of Rock Steady Boxing is the feeling of control derived from boxing itself. Even if you’re unable to stand, and box while sitting in a chair, you feel relief by being physically aggressive, active rather than passive.

Fortunately, every other day there’s the curative promise of the gym and the song of the speed bag.

Not long ago, I paid my regular visit to the physical therapist. Once more she gave me the Balance Evaluation Systems Test. The score had barely changed. In fact, the result was slightly better than six months earlier. The therapist was delighted. Yet there was something amiss. One exercise involved walking briskly a few yards to a cone and back, while counting down from say 100 in threes. I mangled it. Twice. Which was strange because a few months earlier I had no problem. The therapist shrugged. “No matter, this happens sometimes under duress. What else is going on in your life?”

A few days after the promising test score, I have one of my periodic nightmares. I’m hiding in a small room in the district attorney’s office. I once served as the public information officer in the San Francisco DA’s Office. In the dream, my archenemy is standing just outside the door. I’m terrified he’ll discover me. I decide to rush him, make a last stand, howling as I go. And then as I crash through the door I see the face, but it’s not my archenemy, whoever that might be, it’s someone I don’t recognize at all. I wake up and find myself hitting my wife with the back of my hand. She yells at me to stop and then firmly, without a word, she holds down my arm until I go back to sleep.

The next morning, I wake up with my daily unease, that whole kaboodle of dream bits and now new guilt, plus the ominous specter of insignificant tasks, the idea that I am slowly disappearing, and the worry over empathy’s end—for others and myself. Fortunately, every other day there’s the curative promise of the gym and the song of the speed bag. Today is on but I’m caught between the desire for solitude and the solace of others. I pick others.

When I arrive, Michael, a retired building contractor, greets me with his mantra about this being the one exclusive club nobody wants to join. We smile. We shake our heads. I look to see who else is there. Phyllis is swaying rhythmically to gym pop. Steve, on the speed bag, throttles it like a pro. And then there’s Cyndie, a lithe, red-headed spirit and a former executive assistant to a county health officer. She’s been coming to Rock Steady for six years, she just turned 60. She joined Rock Steady Boxing on the recommendation of her neurologist at Stanford. Friends told her she was nuts. Her parents, churchgoers from the Midwest, were both supportive and very curious. They came to visit. She showed them there was no danger because there was no contact and anyway, she was the last person in the world with any interest in punching or being punched. They came round and over the years many of her symptoms have not progressed. “Frankly, I don’t know if it works,” she told me. “I think it does. All I know for sure is that I came initially out of curiosity, and now I stay for the comradery.”

As people gather ’round, Coach Rob takes quick stock of how people are doing: who’s on a peak, who’s in a valley. He doesn’t see plateaus with Parkinson’s, he sees arcs: the man who arrived in a wheelchair and two years later discarded his cane and stood up to punch the bags; the man who was making good progress but then stopped coming, reclaimed old bad habits and declined. One truth about Rock Steady Boxing is you have to stay with it, and of course nothing is certain.

Rob was once a featherweight boxer by trade, 5’6”, 147 pounds, reminiscent of Daniel Mendoza, a 5’ 7”, 160-pound Jewish fighter from London’s Whitehall district who in the 1780s became one of the great boxers of his day. He was distinguished by lightning glove speed, a mesmerizing ability to bob and weave, and, above all, to anticipate his opponent. He pioneered Muhammed Ali’s rope-a-dope strategy and in 1789 started a boxing school devoted to technique. He also wrote a book, The Art of Boxing, in which he described the sweet science in terms of maximizing reflexes, balance, dexterity, and coordination—all aspects of the Rock Steady Boxing training.

Coach Rob had three bouts of cancer as a child, including a bone marrow transplant at age 9. At one point, all the other children in his ward had died. Doctors said his survival was due partly to the muscle mass he acquired learning karate at age 3 and partly to the martial-arts-style physical therapy he received in the hospital. He said he learned to “visualize my white cells literally beating up my cancer cells.” Which led to his notion of imagining a face and arms on the big body bag. He told me he came away from childhood with an iron optimism based on the conviction that “I wasn’t allowed to lose. That was my mother’s doing. Each time the cancer came back she taught me to think of it as an opportunity: ‘OK, well, I guess I get another fight.’ Does that make any sense?”

Of course it does. And yet I’m not so rock solid in my own conviction. The metaphor that describes my orientation is not the ring but the high wire, where I feel as though I’m plodding along mile after mile, trusting that my good balance will save me, if I’m lucky, disciplined, and follow all the best advice. I’ve come to believe that Rock Steady Boxing works best that way—if you make it into a mission control center that brings together the newest exercise and medical strategies, and the power of the group.

I’m actually more loner than comrade. But I won’t forget the fellow boxer who came up to me to ask if I could re-strap his glove, which had come undone. He looked exhausted and proud, stoic, and very thankful for my small help, thankful in a way that captured exactly the definition of the sweet science, which I now think of as an antidote to inevitability, an untightening of the fist.

Lead image: wabeno / Shutterstock

Mark MacNamara

Posted on December 8, 2023

Mark MacNamara, a writer and journalist based in Asheville, North Carolina, has written for such publications as Nautilus, Salon, The Stanford Social Innovation Review, and Vanity Fair.