PITTSBURGH — PITTSBURGH -- It began to show up five or six years ago when Billy Conn forgot the name of his granddaughter. His family thought he must have been joking, but it soon became clear that he was not.
Then, about a year ago, Conn's memory lapses became more severe.
He would go to a movie and an hour later have no memory of it. He stopped reading and watching television, though they had always been two of his favorite activities. He also, for the most part, stopped eating and sleeping.
The doctors ran many tests. A CAT scan and an MRI and finally a SPECT brain scan, which gave the best indication of how serious the damage to his brain really was.
"Both frontal lobes, both temporal lobes and the right parietal lobes have defects in the blood flow," said Dr. Paula Trzepacz, an associate professor of psychiatry at the University of Pittsburgh school of medicine. "That's a lot of regions. Almost all of them."
The name they have for Billy Conn's condition is remarkably, almost painfully, descriptive. They call it pugilistic dementia.
It is similar to Alzheimer's disease, but there are some important differences. One is that while Alzheimer's can develop in any number of ways, pugilistic dementia almost always comes from repeated blows to the head.
For the last two months, Billy Conn has been in a hospital in Pittsburgh. His memory is not entirely gone, but it is not good. He recognizes Mary Louise, his wife of 50 years, and his sons, Tim, Billy Jr. and Michael, when they come to visit, to take him out for ice cream or, as they did recently, to bring him home for an afternoon.
What with his relatives and his old friend Ray Conley, a former fighter who owns a local bar, Conn seldom lacks for company. But he is quite thin, his walk is slow, his look is often vacant and his conversation, limited at best, does not always make sense. He refers to people no one seems to know.
Billy Conn is 75 now and, to a great extent, lost in a world of his own.
In an era when boxing was America's most glamorous sport, Billy Conn was the stuff of legend. A magnificently handsome and stylish fighter, he won the middleweight and light-heavyweight championships of the world and then, in the summer of 1941, he climbed into a ring in New York's Polo Grounds and nearly took the heavyweight title away from Joe Louis.
The buildup to that bout, which is widely considered one of the greatest in heavyweight championship history, was incredibly intense.
Out in the South China Sea, the U.S. Navy battleship Ticonderoga steamed to a halt and the commanding officer ordered the radio tuned to the fight. At Forbes Field, a Pittsburgh Pirates game was halted and the players sent to the dugouts while Conn's hometown fans listened to the concluding rounds over the public address system. What they heard was almost too much for them to believe.
"Don't you want the title anymore?" Louis' trainer, Jack Blackburn, begged when, after 12 rounds, Conn was clearly ahead on points.
"Stay away from him," said Conn's manager, Johnny Ray. "You've got him. Just stay away."
"Who are you kidding?" Conn sneered. "This guy is ready to be taken out and Little Willie is about to do it."
Conn then walked out for the 13th round, took a wild swing at Louis' body and missed. Grateful for this reprieve, Louis hit Conn at least 25 times before Conn fell.
"The referee never should have stopped the fight," said Conn, who struggled to his feet but was not allowed to continue. "He should have let Joe kill me for being so stupid."
Conn and Louis soon went into the Army, and their rematch was delayed five years. An out-of-shape Louis easily beat a more out-of-shape Conn, and Conn retired. It would be 40 years before the effects of boxing would catch up with him.
"The good thing is, he was so healthy all his life," said his son, Tim. "A lot of boxers don't do as well as he did for so long."
One difference between Alzheimer's disease and pugilistic dementia is there is not as much language disturbance in the latter. Another is that the patient is far more active.
Conn, for instance, is constantly on the move, finding it hard to sit still. At home, he would pace the floor as much as eight hours a day, often at night.
"We tried to change his medication over the years to help him sleep through the night so his family can sleep," Trzepacz said. "His family tried valiantly, even longer than they perhaps should have. Sometimes the stress is harder on the care-giver than the family."
Another difference in the two diseases is how they are acquired. The tests run on Conn showed neurofibrillary tangles -- pieces of dead nerves -- indicating what Trzepacz called "repeated closed-head trauma." That means there is no evident fracture of the kind that might have been sustained in an auto accident.
"In all our testing, he doesn't show the Alzheimer's pattern," Trzepacz said. "The symptoms are agitation, restlessness, disorientation, memory problems. He's confused about where he is. He's focused inappropriately. For instance, he will ask, 'Where's the car?' when he's in the doctor's office."
Conn did not go gently into his good night. In 1990, a time when his dementia was well advanced, he and his wife were in a convenience store near their home when a robber entered, hit the proprietor and demanded cash. Conn sent Mary Louise to call the police, wrestled the robber to the ground and held him until help came.
"Until the very end, he would come in here impeccably dressed," Trzepacz said of Conn's visits to her office before he was hospitalized. "He was a very distinguished, a very handsome man, so well dressed. Only at the end could he not superficially hold it together anymore."
Conn's family is relieved at how he has responded to being hospitalized. He is sleeping more regularly, eating better and, though still easily agitated, calmer than he once was.
Last weekend, his wife and sons brought Conn home to the house he bought 50 years ago with the money he made from his first fight with Louis. They all sat and watched "The Pittsburgh Kid," a movie he made at a time when Hollywood was fascinated by his fame and good looks. Though he was offered another starring role, Conn was interested only in returning home. The part went to Errol Flynn instead.
Despite his memory problems, Conn recognized the movie, remembered many of the actors, recalled at least something of the days when he was young and strong and had the world at his feet.
Conn's life is in no imminent danger, Trzepacz said, though she believes his condition could lessen his ability to fight infections. A recent bout with pneumonia had her particularly worried, but he recovered with no apparent lingering effects.
Still, there is no question about Conn's future.
"Oh heavens, no," Trzepacz said when asked if Conn's condition might ever improve. "It's just a downhill course."
"I want people who remember him to know Billy is well taken care of," Mary Louise Conn said a few days ago. "He's fighting a tough battle now, but Billy has always been a great fighter."