Since 2002, when Mike Websterâs brain revealed its roil of malformed proteins, footballâs CTE crisis has only become more public. Bennet Omalu published his findings on tau protein in 2005, in the journal Neurosurgery. The NFL, which had long downplayed the risk of concussions among players, dismissed the research, even calling for a retraction. But Omalu found CTE in the brain of Terry Long, a former player whoâd killed himself at 45 by drinking antifreeze. Soon dozens of former players were diagnosed with CTE. Terry Bradshaw, Brett Favre, and Troy Aikman have worried publicly about their post-NFL mental health. Former NFL players Andre Waters and Junior Seau committed suicide; both had shown signs of CTE. In 2010, a 17-year-old football player in Spring Hill, Kansas died hours after a homecoming game; his brain showed CTE, the youngest reported case to date.

The legal consequences have begun. In 2011, former Atlanta Falcons safety Ray Easterling filed suit against the NFL, charging a "concerted effort of deception and denial" about the risks of long-term brain trauma to anyone who played football. Thousands of former players joined the suit; by late 2013, theyâd reached a $765 million settlement to cover as many as 20,000 injured players, providing money for compensation, testing, research, and education. In January, the presiding judge rejected the settlement, concerned whether payouts would be adequate and fair. (Easterling committed suicide in 2012 at age 62. He was later diagnosed with CTE.) Many other players and families have filed suits against the NFL. And in 2013, a group of retired National Hockey League players sued the organization over its handling of head injuries.

"They need a federal commission. Itâs the only way it's going to get fixed."

Yet among boxers â where the dangers of brain injury, whether labeled dementia pugilistica or CTE, have been long recognized if woefully under-acknowledged, and where no fighters are protected by unions or a cohesive regulatory system â little has changed. The protections provided professional football and hockey players donât exist in boxing or mixed martial arts, and even reaching the highest levels of those sports doesn't guarantee benefits such as insurance, disability, severance pay, or pensions. Combat sports are regulated at the state level: thereâs no national body defining medical standards or deciding who gets to fight.

When it comes to medical fitness, some states have fairly extensive requirements, while others arenât so rigorous. In California, for example, professional fighters must have HIV antibody, Hep B surface antigen, and Hep C antibody testing; they also need a physical, an eye exam, an EKG, an MRI of the brain, and a neurological exam. But for amateurs? Just an annual physical. If New York rejects you because youâve had a subdural hematoma â bleeding in the brain â you can always try Nevada, where that wonât stop you from receiving a fight license. Fighters admit itâs easy enough to get passable medical documentation, no matter your actual health.

THE FOUR STAGES OF CTE Stage I Tau protein begins to build up in the brain, mostly in the frontal lobe. Often there are no identifiable symptoms, but sometimes headache and loss of attention and concentration. Stage II Tau increases in the frontal lobe. Depression, explosivity, and short-term memory loss can occur. Stage III Tau is found not just in the frontal lobe, but also in the temporal lobes. Cognitive impairment, confusion, and memory loss are seen. Normal Brain Advanced CTE Stage IV Tau has spread throughout the brain. Symptoms of serious dementia set in, as well as word-finding difficulty and aggression.

"They need a federal commission. Itâs the only way it's going to get fixed," says Dr. Margaret Goodman, a neurologist who formerly chaired the Nevada State Athletic Commission medical advisory board and served as a ringside physician. She shrugs in disgust, seated cross-legged on the living room floor of her Nevada home, a golden retriever sitting calmly by her side. Sheâs been saying this for a long time.

A fight license is like a driverâs license, she says: you have to earn it. She knows Norrisâ pain at being denied a license in 2000. "It must have been horrible for him," she says. "It was horrible for us." But she took her role seriously. She sees herself as protecting fighters in the face of greed and callousness, but also, sometimes, their own will to fight. "Itâs so hard for them to make these decisions for themselves," she says. Often itâs not just a paycheck theyâre giving up, but their very sense of self. But today Norris recognizes just how lucky he was. "Itâs good that Margaret was there," he says. "Thank God she saved me. She saved my life."

Fighters need protection, she says, the same way NFL players have protection: for contracts, medical testing, insurance, and licensing. She knows that fighters (and their trainers) seek out lax rules; itâs impossible to imagine brain-damaged NFL players staying in the game just by playing in a different state. Only standardized rules will provide serious oversight. "Until something like that happens," she says, "itâs kind of a free-for-all."