Q&A: Looking for a good, clean fight with Dr. Flip Homansky
Dr. Edwin “Flip” Homansky has exemplified what it is to serve his community during a career spanning three decades as one of boxing’s most recognizable and honored fight doctors. The length of the list of his accolades is rivaled by the innovations he brought to the sport. Homansky was instrumental in championship fights moving from 15 rounds to 12 and in Nevada becoming the first state to test for HIV and anabolic steroids.
He served the Nevada State Athletic Commission (NSAC) for 25 years as a NSAC Commissioner, NSAC Medical Advisory Board Chairman, and Chief Ringside Physician. He also served as Vice President of the Association of Boxing Commissions (ABC).
Currently, Homansky is serving as Chief of Quality Care for Las Vegas’ Valley Health System, is a Nevada State Board of Health member, and Medical Director for AMR (American Medical Response) in Southern Nevada. In April, the North American Boxing Federation (NABF) named Homansky Chairman of its Medical Board. And in August, Homansky was inducted into the Nevada Boxing Hall of Fame.
Homansky has always sought out ways to insure a good, clean fight. In recent years, he has served as the Vice President of the Voluntary Anti-Doping Association (VADA) headed by Dr. Margaret Goodman. VADA has been instrumental in boxing’s growing education about the prevalence of performance enhancing drugs in the sport. In less than a decade, VADA has gone from being simply a third-party testing agency contracted for a few fights a year to a necessary hurdle for contenders in the World Boxing Council (WBC) rankings. Fighters who wish to compete and be listed in the top 15 of each division in WBC-sanctioned bouts must sign up to be tested year-round at any time of day or night by VADA. With Homansky’s help, boxing has come a long ways from the time when steroids were hidden from public consciousness but rampant in the sport. From Las Vegas emergency rooms to “The Bite Fight” to the beginnings of the steroid era in boxing, Homansky has seen it all.
I had the good fortune to catch up with him over the phone from his home in Las Vegas. The following has been edited for clarity.
Gabriel Montoya: Congratulations on the Hall of Fame induction, Dr. Homansky. It is well deserved.
Dr. Flip Homansky: Thank you very much.
GM: I’m curious, what brought you to medicine in the first place?
DFH: You know, I can’t tell you exactly what brought me to medicine but I always knew I was going to be a doctor. I guess it was ingrained into me by my parents, but I never thought I would be anything but a doctor.
GM: Were your parents in the medical profession?
DFH: No, no. My dad never went to school and had a little liquor store. My mother went to high school.
GM: Looking at the history of your career, you seem to be about efficiency; looking at systems and then assessing how they can be better. Correct me if I am wrong. You started as an emergency room physician and then you ended up running six different hospital’s emergency rooms. When did you start noticing that you were that kind of person? Someone who could see a system and then improve it?
DFH: Wow, that’s interesting. You know, I don’t even know how you got to that conclusion, Gabe, but it’s true. I do look at things that way. I enjoy seeing things as they are and then how I could possibly make them better. And I don’t do it from a narcissistic point of view. But how to make my time as efficient as possible and then what I am doing as efficient as possible and how I can improve what I am doing. So, yeah, that’s how I look at things. It’s worked out for me. It’s worked out for me in medicine and it’s worked out for me in sports.
GM: You were in an amateur boxer back in Georgia?
DFH: Yeah. I boxed a little just as a kid in the Golden Gloves.
GM: But you didn’t have an interest in turning pro? It was just more part of the culture then?
DFH: Oh, gosh no. Number one, I wasn’t good enough to move on and no, I knew early on that wasn’t for me.
GM: You kept that love of boxing, but you didn’t see a pro fight until 1978. How long until you made that connection where you said, “I can use my medical knowledge to help out in boxing?” How did that all happen?
DFH: I moved to Vegas. Boxing actually represented all of what Vegas represented. It was exciting. It gathered my attention. I knew that’s what I wanted to be part of just like I knew Vegas was a good place for me. The first fight was in the tennis pavilion. If you remember back that far. Caesar’s had a tennis pavilion and there were some great, great fights back there. That was the first one I ever saw. A friend gave me a ticket and that was my introduction.
GM: How soon after that did you look into being a ringside physician. It seems like a weird job for a physician. I was reading something you said about “The Bite Fight” (Mike Tyson vs Evander Holyfield II) and you were like [paraphrasing] “People were mad at me. And it’s like ‘Look, my job is to make sure the fighters can continue. I am not there as a medical professional in the sense that I am going to stop him and fix him.” So how did you make that jump?
DFH: It was right from that moment that I knew I wanted to be involved and I started knocking on the door. It took a while for them to open the door. There was already a wonderful doctor here doing the fights, Don Romeo. He was very accomplished, very good. And I learned a lot from him. But I probably hung around for over a year before anyone would give me a chance. And it was only because he was out of town and couldn’t do a little, small fight at the Silver Slipper. You’ve probably never heard of the Silver Slipper, but it was a little, teeny casino that is actually where the Mirage is now. It was just this little, small, dingy smoke-filled casino and upstairs on Wednesday night they used to do boxing. It was a great environment. And that was where I did my first fight.
GM: Is being a ringside physician like being a ref in that you have to jockey for fights to work or is it once you are in you are in?
DFH: Luckily enough for me, once I was in, I was in and I worked under Dr. Romeo for a number of years. But yeah, there came a time when I became the chief ringside physician. And the first fight that really mattered for me, which I made my bones, was the Bobby Chacon vs. Cornelius Boza Edwards fights at Caesars. From there, I kind of took off.
GM: Can you talk more about that concept about being there to make sure a fighter can continue vs. being a medical professional whose job it is to heal an injured person immediately? How do you draw that line?
DFH: There’s a couple of distinctions. As an emergency technician, I was very comfortable with cuts. Very comfortable with concussions. Very comfortable with any kind of head trauma. So, I saw my role at ringside was strictly the same thing. I was looking at that fight in terms of what decisions I need to make medically. So quickly turning back to “The Bite Fight.” I made the medical decision that Holyfield could continue. That wasn’t a moral judgement. That wasn’t an ethical judgement. That was up to the referee and (then executive director of the NSAC) Marc Ratner to make that decision [to stop the fight or not]. If it was my decision, ethically, I probably would have stopped the fight after the first bite. Medically, after the first bite, the question put to me was ‘Could Holyfield continue?” And medically, he could. So that’s what I tried to do in my career is see those fighters as my patients and what was the best thing medically that I could do.
GM: Why were you drawn to emergency rooms? That seemed to load you perfectly for boxing. Was that happenstance?
DFH: When I was in training, I moonlighted in emergency rooms and I knew it was for me. I could go in and work as hard as I needed to do for as many hours as was necessary and then I was gone. I could go and develop my interest in whatever else I wanted to do, i.e. boxing. So emergency medicine filled the bill for me. I wanted to do interventional medicine where I could go in and do something and help but not have an office and a telephone that was always ringing. Or high blood pressure or blood sugar problems. I wanted to take care of emergencies.
GM: How long into your ringside physician career did it take for you see that there was a performance enhancing drug problem in boxing?
DFH: Before I knew there was a problem, I knew that we had to make sure that there wasn’t a problem. I’m not sure if that makes sense. But I didn’t know for sure that anabolic steroids were a major factor in boxing. But I knew how dangerous the sport was. And I knew it had to be as even a playing field as possible. And I did see certain fighters appear (better as they aged). . . while typically as a fighter aged, their skills went down. They became slower. They might have gotten smarter. They might have gotten better in the ring. But their physical skills didn’t improve. And then I saw a subset of athletes – small but a definite subset – that after they aged or came back from an injury, their skills improved. And it didn’t make sense until I studied about anabolic steroids, saw that that was possible and believed that it was a problem in boxing.
GM: I look back to the Gatti-Gamache fight and I wonder. It was the first time boxing seemed to notice a huge increase in weight for a fighter from the weigh-in to the fight and then go in and destroy a guy. Do you think that weight cutting is the gateway to the drugs? In what the sport has done with moving the weigh-in to the day before the event which allows people to drop a ton of weight and then regain it with a 36-hour cushion?
DFH: I don’t believe that corollary is there. Weight loss, weight gain, dehydration, rehydration, I believe that is a separate issue because that is a short term situation. Typically, anabolic steroids, PEDs, won’t work that quickly. So, it’s usually on a cycle. So, I think those are two different issues. I know exactly the fight you are talking about and I still remember being astounded at the weight gain and the size of one fighter over the other. And that’s when I began to worry about the weigh in. I believe that that is a separate issue from PEDs.
GM: I’ve just always wondered, and you’re the doctor here, like, the Lamont Peterson case. That was the first urine sample VADA collected and tested and he came back positive for endogenous testosterone. I always looked at his body and thought, “He should be a 147 and he’s probably killing himself to make 140.” They were trying to figure out what is wrong with his body. So, they went to this TRT clinic in Las Vegas. His endocrine system is obviously out of whack. But he ends up going to an anti-aging clinic and getting a testosterone pellet inserted in his hip to combat his fatigued body instead of fixing the problem. So, I always wondered if making an unnatural weight can damage your endocrine system and so you start compensating for it by taking PEDs.
DFH: Absolutely. Now I see the connection you are making. And I think, long-term, yeah. The yo-yoing, the making weight, and the debilitating nature of making weight can throw off your endocrine system. Your own innate testosterone may go down. But that’s because of your own error. You can’t go and make up for that by taking exogenous PEDs. So that’s the problem. But usually if a fighter like that who does a horrible job of weight loss and then is destroyed in the ring, they will take PEDs after that fight because they know they need to get to a championship level.
GM: I think PED use has a lot of the same addiction rhythms, I guess you’d call it, as other drugs.
DFH: I agree. If you talk to NFL players. The toughest thing in the world, the toughest thing they do, is not game day. The toughest thing they do is in late summer when they start two-a-days. And that’s where they get into trouble. When they work out in the morning and then they are expected to come back and bust their chops in the afternoon. That’s not normal. And its debilitating. And that’s where I believe a lot of NFL players reach for PEDs. It’s not so they can improve for the game. It’s so they can get through training.
GM: Since Mayweather asked Pacquiao to do third party testing for a fight, we have had this kind of system in place: A fighter asks his opponent to do testing that lasts from training camp to the fight. But it reminds me of changing the day of the weigh-in. Now fighters use this testing as a loophole. They do testing when they know it is going to happen because they pay for it. And then there is this big gap with no testing in between when the fight ends and the next fight is announced. So that said, where do you think we are? What is our report card as a sport in this regard?
DFH: Well, let me go back a little bit. Here is the problem with state commission testing. So, in Nevada, which does a very good job, but say they have a fighter who knows they have a big fight coming up in December. But he’s not licensed there. He’ll get licensed in October or November for the fight. But Nevada can’t test him until he is licensed there.
DFH: People say that this is an issue that state commissions have to tackle. The problem there is that a federal commission could tackle it but it is very difficult for the state. So this is where someone like Top Rank or the WBC is more important because they can mandate out-of-competition testing by the contract. So a fighter can get around whatever regulation is in the state of Nevada but he can’t get around out-of-competition testing. And that’s what’s changed is the advent of out-of-competition testing. When the fighter doesn’t expect it. Before the fighter signs the contract. That’s where you can really make a difference. If you wait until the contract is signed, it’s too late.
GM: No question. And it is always the last thing anyone wants to talk about and certainly the last thing negotiated. Here is my problem. And I agree with what you are saying. But there is a loophole on the back end. So, the fighter gets caught, like Big Baby Miller, but he hasn’t applied for his license yet so no one can give him a punishment.
DFH: That, and it’s just a pet peeve of mine. And the person who believed in it, John McCain, passed away. But John McCain was always a champion of a federal commission. And I truly believe that is the only way you can get performance enhancing drugs out of boxing. The best that we can do at this point is organize programs like the WBC has where if you are in the top ten or top fifteen, you can be tested at any time. That can be successful. But waiting for someone to get licensed for a specific fight, in a specific year? Very difficult.
GM: That and reinventing the wheel as the Nevada commission sometimes does. It’ll be VADA, VADA, VADA and then “This time we are going to contract with some other lab. We aren’t going to tell you who it is. Or what the protocols are.” Bradley-Marquez and Pacquiao-Thurman come to mind. Is there another solution if not a federal commission? Could all the promoters start a league? Would people trust that or would it be like the NFL or MLB where it is all in-house and a big wall of secrecy comes up?
DFH: I think it could be done if you got the five families together. All the world bodies in conjunction with the promoters. So, you couldn’t be on the top fifteen list unless you agreed to be tested. And again, this is only the contenders. You’d need to go beyond it to get everyone in boxing. But at least if to be a contender, you knew you would be subject to out of competition testing, that would be a huge leap forward.
GM: I visit Vegas and Los Angeles. Both cities seem to be rampant with the “anti-age clinic.” These Testosterone Replacement Therapy clinics.
GM: It became a big thing that people were talking about. Back when Keith Kizer was still Executive Director (of NSAC) he held a conference with UFC fighters showing them how to get a TRT TUE (Therapeutic Usage Exemption for Testosterone Replacement Therapy). But [getting TUEs] seemed to be something that athletes in other sports were talking about. Do you think that’s subsided?
GM: … or do you think it’s still rampant?
DFH: I think it is still rampant. And remember, just like you are going into this before, if you take performance enhancing drugs, you can shut just your adrenal gland off and shut down your own endogenous testosterone. So, let’s say you cycle PEDs. Then you come off the cycle. You get your endogenous testosterone checked and its low, well, that doesn’t mean you have a disease.
That’s why [The TUE process] has to be refined further. It can’t just be willy nilly in letting these people take exogenous testosterone. The reason their body is low is they took performance enhancing drugs and suppressed their natural testosterone. This is ridiculous that so many athletes have suppressed testosterone. That’s impossible. Testosterone is the building block for muscle and bone. So how did you become a world-class athlete in the first place if you weren’t making enough testosterone? It’s ridiculous.
GM: I was looking back at an old article about the commission with Dr. Robert Voy and Dr. David Watson and they were arguing against blood testing in Nevada.
GM: Why is there this chasm between people that should know better and the sport? Like, we know what the problem is but we’re not putting the regulations in place to fix it. Like blood testing as a state commission rule would be helpful. Why do you think it happens. Is it politics?
DFH: I think that certain people have difficulty separating who they ultimately work for. Do they work for the state commission? Do they work for the promoter? Do they work for the manager? I mean, that’s what the issue is. The doctor should only work for the fighter. That’s really who his responsibility is towards. And where you have organizations with their own physicians who are in charge of OKing fighters or checking their medicals or doing this or doing that, boy that can lead to a real problem.
GM: That’s a great way to put it. And really, are we serving the fighters or serving them up?