An XCC Match on the Walpole Island First Nations Reserve, August 2010. Photo by Jeremy Beal.

The champ climbs into the steel cage against the sounds of loud, thrashing theme music, polite applause, and the odd hiss. Caleb Grummet may be holding the championship belt, but the crowd isn’t here to see him retain the title. Chris “The Menace” Clements is waiting in the ring, and the 900 fans in attendance have already given their hometown boy a hero’s welcome.

Before the crowd even has a chance to roar, Clements opens with a rush of punches that lands one good right hook to Grummet’s ear and sends him scampering back. Grummet, knowing well he’s outgunned by Clements’ standup game, backs out and buys some breathing room. When the pair lunge again, Grummet performs a textbook takedown, twisting Clements onto his back and wrapping his neck in a headlock, cutting off blood to his brain and air to his lungs. Clements manages to wriggle his way out of the hold, only to be trapped yet again. The partisan crowd groans and the referee squints closely for any sign of submission or loss of consciousness. Clements moves calmly and conserves energy, working his weight against an imperfect hold all the while ticking down the seconds he has left.

Mixed martial arts will be sanctioned in Ontario for the first time starting in 2011. This type of combat sport, incorporating aspects of boxing, kickboxing, wrestling, and martial arts, is often referred to as Ultimate Fighting, from the name of its most prominent organization. Though six other provinces and at least 46 U.S. states allow professional MMA matches, Ontario has held out longer than just about any other major jurisdiction on the continent besides New York State.

Opposition to mixed martial arts has generally come in two flavours: concerns over medical health and concerns about the moral problem of condoning violence. At the annual general meeting of the Canadian Medical Association in August, the CMA’s then-president Dr. Anne Doig restated the association’s official call to maintain the ban: “We are concerned when people engage in activities, the sole purpose of which is to pummel, kick, punch, scratch—whatever methods they use—until either somebody is seriously hurt or injured, or somebody cries uncle and submits.”

The other major concern that this kind of fighting prompts is that, beyond being damaging to the body, it is also, in some way, corrosive to the soul—that the spectacle of two gladiators beating each other senseless satisfies an appetite too dark and primal to be sanctioned by a modern society. In August, Toronto writer Susan G. Cole called the new move to legalize “a sign of social depravity” and “repulsive,” in her column in NOW Magazine. “Does anyone really think we can do anything about reducing violence in our culture,” she asked, “when the government is making money by entertaining sadistic audiences with vicious bloodshed? The fact that it’s popular doesn’t make a difference to me. Blood lust has always been big, ever since the Romans sent the Christians to the lions.” The arguments against MMA are both scientific and emotional, but they’ve been outshouted by the cheering masses and the ring of the cash register all the same.

MMA might not have been legal in Ontario, but it has been going strong under the province’s nose longer than the current government has held office. Competitions have been running underground in southern Ontario for more than a decade, one of the province’s worst-kept secrets. As early as 1996, they’ve happened on First Nations reserves near Barrie, Brantford, London, and Windsor. The on-reserve location isn’t coincidental: in the wake of the Ipperwash crisis, the Ontario government has shied away from challenging the boundaries of First Nations’ sovereignty. The result was, and remains, jurisdictional ambiguity, allowing grey-market businesses— gambling, tobacco, extreme fighting—to thrive, a legal blind spot hidden in plain view.

But in less than a year, the Ontario government’s position on legalizing MMA shifted from visceral disgust to “not being on the radar” to fast-tracked official endorsement. The turnaround was in large part the result of concerted lobbying by the Ultimate Fighting Championship, or UFC, the sport’s largest, richest, and most recognizable league.

UFC president Dana White has repeatedly called Ontario’s Golden Horseshoe the “mecca” for mixed martial arts, and expressed his intent to conquer. White told anyone who’d listen that “Ontario is the UFC’s biggest market,” that support for his sport was virtually unanimous, and that it was only a matter of time before legalization threw the doors open. In early 2010, White appeared satisfied with Ontario Premier Dalton McGuinty’s assessment that legalizing the sport wasn’t a top priority. “The world being the way it is, he’d be in real trouble if MMA was at the top of his list,” White quipped. After all, that was solid progress from the premier’s assertion that he “hated” the sport a few short months prior.

Privately, however, the UFC was lobbying hard. In May, White decided to flex his company’s considerable muscle: with almost no notice, he announced that the UFC would be making a “major announcement” at a Toronto press conference a few days later. That vague promise drew a scrum of reporters of every stripe, who turned out en masse. The move turned out to be some well-scripted posturing, and White announced to a disappointed crowd the opening of a satellite office in Toronto, helmed by former Canadian Football League commissioner Tom Wright. In addition to the well-known football heavyweight, the UFC had already retained former Ontario premier David Peterson’s bulldog lobbyist law firm Cassels Brock, who had already been applying pressure behind the scenes for some time.

The PR stunt was a pushy, calculated move, but the numbers did their share of talking as well. The nanny-state accusations, the lobbying pressure, and the promise of adding millions to the provincial coffers through sanctioned events proved enough to let MMA legislation skip the queue. On August 14, Sophia Aggelonitis, at the time Ontario’s minister of consumer services, announced that in the interest of keeping fighters safe, Ontario would be giving professional mixed martial arts the go-ahead starting in 2011.

Photo by Jeremy Beal.

On the Tuesday before the August 28th match, I’m hanging out at Adrenaline Training Center, a pristine MMA training centre sitting behind a hardware store parking lot in London, Ontario. Adrenaline opened in 2007, a stone’s throw from a rough neighbourhood notorious for OxyContin abuse and prostitution, but the gym’s interior strikes a hard contrast to its host neighbourhood. It’s almost fussily clean, with perfectly maintained equipment and clean-cut staff and patrons. A regulation boxing ring and an MMA-specific steel cage occupy opposite ends of the gym, while punching bags, free weights, and even a gift shop sit neatly between.

Alex “Pecker” Gasson greets me at the front desk and gives me the tour. He stands just under six feet tall and has won enough accolades in kickboxing, MMA, and Pankration (a fighting style descended from ancient Greek wrestling) to fill several trophy cases. Today he sports a pink crescent scar around his left eye, courtesy of a full three-round bout two months prior.

“Three stitches, a nice, clean cut,” he waves dismissively.

Upbeat and energetic, Gasson talks up the mix of groups that use the gym. It plays host to wrestling clubs, fitness fanatics, boxers, martial arts groups, and, of course, MMA classes, their bread and butter. (Though matches have never been sanctioned, official training in the sport is condoned and prolific throughout Ontario.) Their patrons come from varied backgrounds: students from nearby Fanshawe College and the University of Western Ontario flood in every fall; thirtysomething professionals arrive in their BMWs alongside teenagers on ratty 10-speed bikes.

The Ontario decision is only a few days old, but having spoken with Gasson a few weeks earlier, he thought the change was bound to happen. He thinks the organizations that have been operating illegally will flourish under a new regulatory regime. “The people going to the shows, they aren’t die-hard fans of the promoters,” he says. “They’re fans of the fighters. The organizations that know the fighters, that already have relationships with the big names—they’re the guys that will thrive.”

New sanctioning will bring with it a new provincial governing body and, most likely, strict guidelines that help justify the Ontario government’s change of heart on the issue. That means a board of governors and an oversight body. I ask Alex if there is anyone from the tightly knit community he thinks the province should bring onboard, in terms of expertise. “Sure. Me.”

When you make your living getting kicked in the face, a healthy dose of narcissism is more or less requisite. But Gasson and his cohorts from Adrenaline might just be the people best suited to take their sport into the light. They take it seriously, train top-shelf athletes and run a very tight, respectable ship. What’s clear in talking to Gasson and others is their ambition towards the mainstream credibility at home they enjoy everywhere else on the continent.

Chris Clements, a trainer and mainstay of the Adrenaline team, is often credited with holding the world record for fastest knockout in the sport, thanks to landing a quick haymaker to an opponent’s charging jaw in Montreal in 2006. Clements, 34, has been involved in MMA for about eight years. Trained originally in tae kwon do and then as a boxer, he was taking some time off when he read about MMA in the newspaper. Seeing a chance to fight in real matches for real money, he got involved and became one of the bigger Ontario names in the sport while it was still in its infancy.

Clements’ 80-kilogram frame sits slack and comfortable behind the gym’s desk, flanked everywhere by merch bearing his and his partners’ names. He speaks calmly and thoughtfully with the quick cadence of the southwestern Ontario accent, and falls naturally into a conversation about the state of the sport in the province.

“That’s one thing about these fights. Everywhere else you fight, there’s a commission guy watching you get your hands taped. There’s blood tests, steroid tests. On the reserves there’s no one. They could be taping metal bars to their hands. There’s hepatitis, HIV. Blood can get into your eyes, your mouth, you just don’t know.”

Consistency and fairness is another black-market problem. “Pecker and another guy had a draw at the last one. [The promoters] wanted them to go another round, and they said no, so they just went back and changed the scores.”

“With the amateurs it’s even worse. These promoters are making a lot of money. When I first started you had to be training for years. You’d have to have a known MMA coach, he’d put in a word for you, and you’d get a small fight. I’ve been at fights on native reserves, you go talk to the guy in the dressing room, ask him how long he’s been training. He says some guy in a bar offered him $500 to fight the night before. It disrespects guys like me who put in 10, 15 years of martial arts training. It makes us look bad. With some of these events, if they have 15 fights, I’d say out of 30, maybe six guys actually belong in the cage.”

Clements shares the opinion with the rest of the gym that the decision to sanction the sport is a good one. “I’m in the main event this Saturday on the reserve, and it’s my home town. I wouldn’t do it for any other reason. I’d rather see them get wiped out … I think they’ll go under.”

Crossing the bridge onto the Walpole Island First Nation on the Saturday evening, there isn’t much to tell you anything’s changed. The only visible difference is the lack of brand-name franchise stores in the strip mall. The hockey rink hosting the fight looks like anything you’d find in a thousand small towns across Canada.

But the reserve still carries a stigma among outsiders; I was surprised at the friends and family members who warned me of the dangers of setting foot on the reserve. Some expressed concern for my safety, others refused an invitation to come along. An astonishing number recited hearsay about the calamities that had happened to friends of friends who “went over there.” Of course, it was all disturbingly bigoted nonsense: whatever problems exist on this reserve, the urge to rough up white MMA fans with money to spend is not one of them.

The racial dynamics of the event are curious. You get the impression—from the demeanor of the Bkejwanong security guards and police on site and the notably small number of aboriginal fans in the crowd—that the event is regarded as an oddity at best. Native kids with skateboards stand and watch the crowd of almost exclusively white revelers lined up outside the arena with a wary curiosity. There are 900 people here to see the fight, but only a dozen or so are residents of the reserve.

Historically, these events have played the indigenous iconography to the hilt: the last organization to set up shop at Walpole was Fighting Spirit MMA, which bills itself as Ontario’s “Ab”original MMA organization. (The band council at Walpole recently cut ties with the group over some outstanding bills.)

Tonight, however, the promotional team is a company out of Michigan called Xtreme Cagefighting Championship, or XCC. The American league found an aboriginal silent partner to get around local ownership bylaws, which was contentious, but not contentious enough to stop the fight. The coming change could be a bellwether for the soon-to-be-legal business. With legitimacy looming, the larger, better-funded American leagues look poised to crowd out the smaller organizers—mainly aboriginal entrepreneurs—that have controlled the black-market sport for more than a decade. Tonight, titled “XCC 64: Battle at the Border 10,” marks XCC’s first foray into Canada.

MMA events may be illegal, but patronage, promotion, and sponsorship are alive and well: restaurants, energy drinks, gyms and gear outfitters are keen to slap their logos all over the event’s promotional material, and a select few are even shilling their wares in the arena the night of the fight. Local businesses, both directly related to the sport and others looking to advertise to the target demographic the events pull in, actively and aggressively sponsor rounds, intermissions and official after-parties. A small family-owned vitamin water company has been following the various tournaments so closely that their daughter is invited to sing the national anthem to start the night.

Before that can happen, though, an emergency of sorts breaks out. Woodrow James, the XCC lieutenant and promoter responsible for the evening, has been flitting in and out of the arena, dressing rooms, and small circles of agitated entourages, putting out fires. There have been some no-shows (more the rule than the exception at these events), and James is calming down a supremely agitated manager whose fighter is apparently without an opponent. The confrontation degrades almost instantly into a shouting match.

“Your guys should fucking be here; this is bullshit! You’re fucking amateurs! The whole setup is amateur!”

“Fuck you, then, leave—fucking leave!”

As it turns out, the two missing fighters had been pulled over en route from London by the police, who had clocked them at 180 km/hour in a 50 zone. Inexplicably, they were only delayed and all the fights advertised on the card went on, although in shuffled order.

Speaking with James, flush with excitement from having successfully quarterbacked his first Canadian event, he sounds more like the biggest fan in the building than the orchestrator. He is a thirtysomething former fighter who was plugged in to the London scene well before he got his job with XCC. He was roommates with Chris Clements and is on a first-name basis with most of the staff at Adrenaline. “Chris Clements is my best friend,” James says. “Business is business, but I’m scared as shit for him and I want him to win.”

James loves the location and considers it well above the median. “I love the arena atmosphere. The fighters get to have showers, a little breathing room, a place to sit.” Even south of the border where the events are legal, it seems frills like showers and proper dressing rooms are few and far between.

The fights start a full hour and 15 minutes later than advertised but the crowd barely seems to notice. The national anthems are belted out, the announcer spills out the opening ceremony and the fighting commences.

The first match of the evening neatly illustrates the Canadian Medical Association’s assertions about the risks of brain injuries in MMA: Jeff Silver, an Adrenaline-trained fighter, lands a right hook not 20 seconds into the match that leaves his opponent, D.J. Gamble, stupefied on the ground, announced colloquially as TKFO—“Technically Knocked-theFuck-Out.” The crowd doesn’t seem to mind trading substantial fights for highlight material, and excited chatter bubbles up while the next fighters are immediately introduced in the interest of making up the lost time.

The second fight is the sole women’s bout of the event, pitting Bernice Booth against Randa Markos. Their fight is a particularly technical one, filled with more punches and kicks than the average men’s bout. It ends with a full flip into an “arm bar submission,” whereby Booth’s elbow is hyper-extended against her opponent’s thigh, that forces Booth to tap out.

The evening is filled with strange juxtapositions: all-American looking dudes taking on tattooed punks; flabby bodies pitted against muscle-bound Atlases. Throughout the entire night there is a palpable current of energy flowing through the crowd, punctuated by the oohs and ahhs that accompany landed fists, knees, and all sorts of bloodletting. That it caters to baser instincts doesn’t make it any less irresistible or troubling. It’s dangerous and brutal, disciplined and technical, entertaining and grandiose, cheap and sickening.

Chris “The Menace” Clements looked to be on the verge of passing out from the arm twisted around his neck, complemented by an ongoing introduction to Caleb Grummet’s elbow. Somehow, Clements slips free and quickly rises to his feet, and the momentum of the match turns, with Clements landing a string of solid punches until the sound of the bell ends the round. The fighters retreat to their corners, Clements eerily composed, as if he’s standing in his own living room.

Thirty seconds into the second round, Clements’ fist opens up Grummet’s forehead, sending a torrent of blood spattering over both fighters. The cut is bad enough to put the fight on hold for some first aid, but Grummet is soon back on the mat, showing a brave face but not much else, and absorbing blow after blow until the referee halts the fight, calling the match in Clements’ favour and awarding him the belt. Adrenaline has another champion on its staff, and The Menace spends the next 20 minutes posing exhausted but victorious for the cameras, smiling and looking not even slightly dangerous.

These are the last days of underground MMA on the reserves, and whatever your opinion on the sport itself, having events sanctioned and governed by stricter and safer regulations should be a welcome change. Distaste for the sport does not justify indifference to the well-being of its participants. For all the gladiatorial hyperbole put on by the organizers who market the sport, the fighters consider themselves, and each other, legitimate athletes who are due the same protections and respect that their peers in boxing, hockey, and every other violent sport receive. This is a sport that prides itself on pushing limits and buttons, but the core of this phenomenon is still the men and women who choose to enter the ring, but have had to risk shoddy conditions to do so. Those conditions are set to improve, but there is a more important change coming next year. It’s all too clear that the appetite for this controlled violence exists: pay-per-view numbers and the draw to events like the ones on Walpole Island speak for themselves. These blackmarket venues provided a moral cover for Ontario’s collective self-image. MMA was condoned, but could essentially be dismissed as de facto criminals servicing a fringe group of ultraviolent thrill-seekers. Now that the sport has been embraced, it becomes a true piece of Ontario’s official identity. One wonders whether the province will be able to tell the difference.

If Maclean’s was looking for someone to explain Canada’s teenage girls to their parents, Sax was a strange choice. He does have a PhD in psychology from 1980, but he primarily interprets and popularizes research rather than doing peer-reviewed work himself. Unfortunately, his interpretations are pretty controversial.

A blog called Language Log has criticized Sax for over-interpreting and distorting research on gender differences. This stands out to me because I know Language Log to be home to particularly smart take-downs of bad statistics. The New York Times also published a fairly critical profile of Sax a couple years ago.

So I shouldn’t be surprised to find Sax up to his usual tricks in this Q&A. Take his claims about self injury:

…if you look at the literature, you see that more than one in five girls is cutting herself and/or burning herself with matches. […] In a very well-executed study published in the Canadian Medical Association Journal two years ago, a demographically representative sample of young people 14 to 21 years of age was surveyed in Victoria, and there was an overall prevalence of roughly 16 percent. Although in the abstract there’s no mention of sex differences, if you pull up the tables you see that only eight percent of boys but 24 percent of girls were cutting or burning themselves.

In fact, that’s not exactly what the paper found. (You can read it here.) Sixteen percent of young people and 24 percent of girls had, at some time, injured themselves. But the way this statistic is repeated presents two problems. First, Sax implies that all self injury in these papers is cutting or burning, when in fact the authors also measured some kinds of drug and alcohol use, and other behaviours. This is an understandable memory lapse. But second, and more importantly, Sax’s statistics are for youth who had ever hurt themselves. When we look at how many youth had injured themselves more than three times, prevalence falls to six percent. (The paper doesn’t provide a gender breakdown for that smaller group.)

The difficulty here is Sax’s verb tense. The fact that he says “one in five girls is” and then later “24 percent of girls were” suggests an ongoing, long-term problem. As unpleasant as it is to imagine, I think we can accept that a large number of teenagers try out self harm, and that this is quite different from someone who injures repeatedly, over a long period of time. It is the latter scenario that Sax goes on to describe in titillating detail:

The girls themselves tell you, “I cut myself because it’s real, it’s not fake.” It’s not a cry for help: most girls don’t want adults knowing they’re cutting, which is why they cut in places we won’t see, like high up on the inner thigh. And they don’t want to kill themselves. There’s research which is quite astonishing to many people: when girls cut themselves, they are getting a release of endogenous opiates—they’re actually getting high.

This is a small misinterpretation, but it is important. A surprising result has unusual power in this sort of piece—it stops readers short, overturns their assumptions, and encourages them to reassess the rest of the article’s claims. And it’s especially disappointing coming from a magazine that just last year published a comprehensive package on how well teenagers are doing:

In light of these facts, [Reginald] Bibby [sociology at the University of Lethbridge] expects strong resistance to his findings from the very teen crisis apparatus he partially credits with all the good news. “The experts act almost annoyed when you suggest kids are actually looking a little better,” he says. Some of that blowback stems from genuine difference of opinion. But a lot grows out of popular wisdom coming out of the United States.

Unfortunately, with this piece Maclean’s has uncritically repeated that misleading popular wisdom. And from a cover this sensationalist, I think we have a right to expect more.

Never, right? Doctors are our go-between, the ones who prescribe and manage our health, who pay attention to developments in pharmaceuticals, and we generally have to trust them to know what we need. While many provinces are increasingly giving power to pharmacists to renew and consult on prescription drugs, we’re mostly at the mercy of the GP.

But should we cut the distance between us and our drugs? If we’re locavores in the sense of what we ingest food-wise (how many times have you heard the virtues on consulting your local farmer?), why not go right to the source for our pills too. Sure, they’re not always made in our backyard, but no one knows better what goes into our drugs than the makers.

Of course, this will never happen. Big Pharma wants to sell us what they’re developing, not always what we need. But the Canadian Medical Association has an idea that might bring us closer—or, rather, bring drug makers and medical insurance companies closer.

The piece quotes Bob Nakagawa, an assistant deputy minister of pharmaceutical services in British Columbia:

Payers like the BC government “want to see innovative products for significant health care gaps… we are more and more squeezed to live within the allocation government provides us…. We want a return on investment in terms of health outcomes and a sustainable model.”

So the report suggests the drug makers and government medical plans work together on developing and prescribing pharmaceutical treatments. This way, pharmaceutical companies would spend their time developing drugs that we actually take.

But while it might seem advantageous to pair insurance and Big Pharma in theory, I’m skeptical about the effect on the patient. While most of us know that some GP’s are influenced by sponsorship and speaking deals, what happens when those who approve or deny our coverage stick their hands in the pot?

If this idea were to catch, instead of tempering the development of unnecessary drugs, we’d just see more options available to us. And in health care, more is not always better. While governments say they would be able to influence pharma company research, I fear it’s most likely to go the other way. We’d have more options, more prescriptions and we’d continue to be an over-prescribed and medicated culture. We need regulations, not partnerships.

Mental health care for foster children is desperately needed, but patients are being failed by an underfunded system. Illustration by Graham F. Scott.

Susan Chamberlain says she’s reluctant to complain about money. We’re talking about the difficulties in providing mental health care for foster children, and the problem is essentially one we hear from so many reaches of health care policy. The ‘R’ word: resources. There’s not enough money.

“There’s no question that the kids need it,” says Chamberlain, the Director of Residential and Day Treatment Services at the George Hull Centre for Children & Families in Toronto, of mental health services. “The problem is getting access to it. The system is cash-strapped, kids are on waiting lists—in many ways, children’s mental health services is the least sexy issue.”

Late last year the Canadian Medical Association Journal ran an editorial entitled “Health care for foster kids: Fix the system, save a child,” which called for better mental health services for Canada’s foster children.

Mental health is an issue that Canadians struggle to talk about publicly. Recently, efforts have been stepped up by journalists to report on issues like depression, anxiety and postpartum depression. Most of the time the reports come from the standpoint of grown-ups, and how we can use treatment to bring them back to stability.

But mental health and children is rarely discussed. According to another CMAJ article, the rate of antidepressant prescription for young people has been on the rise over the last decade, though some see this as an extension of over-parenting and obsessive diagnosis.

At the same time, thousands of children enter foster care and group homes each year, and as Paul C. Hebert writes, there’s no doubt that many of them have mental health problems that need treatment.

“What is astounding is that one of the richest countries in the world doesn’t provide these children with supportive health care that could mitigate or, even better, prevent some of the devastation caused by parental abuse or neglect, alienation from family and becoming part of a system outside of the mainstream.”

But they’re not getting it: wait lists are long, private treatment is expensive and previous medical records can be hard, if not impossible, to locate. It’s common for children to move from home-to-home, so establishing any sort of mental health care regime for children who need it is practically impossible.

“There’s no big bad person withholding money,” Chamberlain says. There’s just not enough of it to go around. Chamberlain notes that the issue often comes second to education and traditional health care.

“Not everyone has child mental health issues to relate to. I don’t envy politicians and bureaucrats who want to get re-elected. Focusing on education and health care keeps more people happy.”

When I ask what can be done to help the issue, Hebert mentions the need to relax current adoption laws, making a comfortable home life easier to find for foster children.

“We came to the conclusion that the system was causing huge problems, there’s never a chance to remake a family,” he says.

“It’s easier to adopt overseas than in Canada…”

The editorial suggests that a number of steps be taken to improve the current state of care for foster children, including establishing universal and portable health records and increasing collaboration between medical professionals and foster care workers.

But most of all, it calls for action now:

“It is time for our governments, institutions and health care providers to commit to building these children and youth instead of trying to fix them as adults.”