By Lem Satterfield

A former Nevada State Athletic Commission Medical Advisory Board Chairman and Chief Ringside Physician, Dr. Margaret Goodman (pictured above, working with Wladimir Klitschko and Vitali Klitschko) has a private practice as a neurologist in Las Vegas, Nev., but worked more than 400 professional bouts as a ringside physician.

FanHouse spoke to Dr. Goodman regarding her thoughts on this past Saturday’s one-sided HBO pay per view televised, Top Rank Promotions WBC junior middleweight championship bout during which Manny Pacquiao battered Antonio Margarito, resulting in Margarito’s being hospitalized with a fractured orbital bone that requires surgery to repair.

When did you feel that Antonio Margarito was first noticeably in danger?

Dr. Margaret Goodman: I think that it’s reasonable to say that the tide changed significantly when he [Margarito] got that cut [in the fourth round.] But actually, it wasn’t so much the cut, but what was underneath of the cut, which is the whole point.

When the referee and or the doctor is assessing the fighter’s injury during a fight, obviously a cut below the eye is of no great significance unless it’s right below the globe of the eye, and that’s a different issue and that almost never happens.

But a cut that is on the cheek bone or the orbital bone like that suffered by Antonio Margarito is not the only issue. What is also of significant concern is what is happening underneath of that cut.

What do you believe should have been considered to be happening given the severity of Antonio Margarito’s cut?

In looking at how Margarito’s eye swelled up so quickly, you have to assume that there is a fracture under there. And, then, the concern is ‘Do you need to stop a fight based on the orbital fracture?’

And, trust me, I’ve faced that on several occasions. It’s a difficult decision, especially when you have a fight of this magnitude. So there are obviously indicators of when a fight should be stopped any way in that situation.

Obviously, from the perspective of the referee, the doctors and the corners, you want a fight to proceed to its natural conclusion. You want the fighters to dictate when a fight should be stopped, and not the officials.

But, sometimes, when no one is willing to finish one off, so to speak, and when the tide has turned significantly, but maybe not enough when you’ve got a tough fighter like Margarito in there, someone has got to make the decision for him.

Because with a fighter like Antonio Margarito, I mean, you would never assume that Antonio Margarito would ever quit.

What are some of the indicators you speak of in relation to Antonio Margarito against Manny Pacquiao?

From the standpoint of the referee and the physician, the fight should be stopped, yes, if the fighter can’t see. But also if he is unable to protect himself.

And, obviously, despite the fact that Antonio Margarito was able to throw punches and that he was able stand on his feet at the final bell, he was not able to protect himself. That was obvious.

I mean, all that you had to do was to look at Margarito’s face to see that. Was he able to see punches coming? Obviously not.

Was there a point or a round or a condition within a round where, in your opinion, the Manny Pacquiao-Antonio Margarito fight should have been stopped?

First of all, it’s hard, because it’s not right for me, ultimately, to throw my two cents in and to say that there was a specific round that the fight should have been stopped because I wasn’t there.

There is a difference between actually being at a fight and watching it on television and making a decision based on what you read. It’s unfair to do that and it’s hard. So I can’t actually say that there was a specific round.

But what I can say is that obviously, and I saw other people say this as well, and that is that after the eighth round, it just really looked hopeless for Antonio Margarito.

By hopeless, I mean, that was the point at which Margarito had no chance of winning, and I think that it was obvious. If not then, then I would say that after the 10th round, that it was even more clearly obvious.

In your opinion, what was Manny Pacquiao doing in comparison to Antonio Margarito as an indication of Margarito’s futility?

I just think that Manny was being so aggressive at that point and that Antonio Margarito was just eating so many punches. And even though he was still able to throw a punch back, he was more listless.

He didn’t have the amount of energy necessary to win, and his legs were gone. Regardless of the other things that were indicators that there should have been as stoppage, you have to look at the actual injury as well.

So are you saying that the fight had reached the point where Antonio Margarito’s punch-absorption versus his punch-output also justified the fight being stopped?

Yes. Not so much throwing punches, but landing punches effectively. He wasn’t able to do that any more. I think that probably at least after the eighth round thereafter that he was absorbing too much punishment.

That doesn’t mean that they should have stopped it then and there, but that you should really strongly consider it, and that you would do the appropriate evaluation to make that determination.

What sort of evaluation?

Which is, first off, you go back to very early in the fight. I think that soon after the beginning of the first three or four rounds, you could really tell that there was no evidence of the tide really changing.

It was going in one direction. Number two, the evaluation of the swelling on Antonio Margarito’s face was important and this is very rarely talked about. Obviously, he had two eyes that were swollen.

But it was mainly that right eye that was the issue. No eye swells up like that unless there is something wrong underneath with the bone.

And when there is something wrong underneath with the bone, you have to worry about a serious problem with the eyeball itself, you have to worry about a serious problem with the muscle, and the nerves that are underneath there as well.

What you do, as a doctor, when you examine a fighter between rounds to see whether this is a more serious injury than it appears to be than just a swollen eye, is that you look for a couple of things.

You had [referee] Laurence [Cole] holding up the fingers in the 10th and 11th rounds, which, there is no reason for a referee doing that. The ringside doctor [Manuel Gonzalez] should have been doing that.

But what you have to do when a fighter starts to get a swollen eye like that that is swelled shut, then you have to examine the eye. Once the eye is swollen shut like Margarito’s was, it’s almost impossible to tell if the eye is okay.

Meaning what, exactly?

The point is that you get in there and you look at the eye. You examine the pupil, examine the eye, but you also look at how the eyeball is moving. This should be done by the doctor.

And you do it before the eye is swollen shut because you can’t tell once the eye is swollen shut. At that point, it’s too late. The horse has left the barn.

You ask the fighter to look at your finger in different directions. You ask him to hold his head still and look over to the right, look over to the left, to look up and to look down.

And you see if that eyeball is moving normally. If the eyeball isn’t moving normally, that means, in all likelihood, that the fighter has a condition that is called entrapment.

And entrapment means that there is enough injury under there that it is somehow pressing on a nerve and an eye muscle that is not allowing the eye to move properly.

That means that that fighter is going to almost 100 percent have surgery on that eye. Allowing that fight to continue with that entrapment in there could be career-ending. So that’s why you have to make that determination early.

Maybe the doctor did that, but I didn’t see it. But if he did, then why does he need surgery? The examination should have begun right after he got that cut and the eye started to swell. So, right after the fourth round.

You make sure that the fighter isn’t exhibiting double-vision. The fighter may not tell you that he is seeing double-vision, but you can see double-vision by looking at how the eyeball is moving in conjunction with the other eye.

If one eye is moving one way, and the other eye is moving the other way, then you can determine that a fighter is exhibiting double-vision whether they complain about it or not.

As a doctor, you then tell that to the referee. You keep a close watch on it, and you tell the referee to keep a close watch on it, and, periodically, you go up to the ring and you check on it depending on how the fighter is responding.

It doesn’t mean that you stop the fight then and there, but it means that you keep a close watch on it because something like that could be a career-ending injury.

Do you believe that the punishment absorbed by Antonio Margarito was potentially career-ending?

This was bad, and his face looked bad, but that’s not so much the issue. The issue is what was going on underneath his with his skull. What is happening to the brain when you get punched that much? He absorbed more than 400 punches?

What do you make of the fact that Antonio Margarito was hit 474 times, with 411 of those being power punches, according to CompuBox ringside statistics?

Oh my God. That is just scary for anybody, no matter how hard a head a fighter has. It is so hard to know what the right decision is, and you always, as an official, from the point of view of a referee or a doctor, you always hope that the corner is going to bear that responsibility and do the right thing.

Nobody knows that fighter better than the corner. The benefit of having [trainer] Robert Garcia there, who I think is a great guy, is that he knows boxing as well as anyone and he’s been in the ring as a fighter himself.

But the comment that, ‘The fighter told me not to stop the fight no matter what,’ well my response is, ‘Well then don’t work the corner.’ If that’s what you have to do, then you are there to protect your guy.

You are there to step in when no one else will. If the fight doesn’t stop on its own because Margarito is just too strong and won’t go down, then he should stop it.

But everybody just wipes it off on the trainer too often and says that he should have stopped it. But, wait a minute, that’s not only his job. It’s also the job of the referee and the job of the ring physician.

I read Robert Garcia’s explanation regarding why he didn’t stop the fight. I do like Robert and don’t want to discredit him. But it is always best when the corner stops the fight.

But when the corner won’t do it for whatever reason, the referee and/or the doctor must. That is what the doctor is there to do: To keep the fighters out of harms way when needed, irrespective of the repercussions. read more