It’s an unsettling thought. Every time that bell rings and the fighters touch gloves, a fatal outcome is possible. I know it, you know it, Dana White certainly knows it. It must be his worst nightmare.

March 16th 1998, Douglas Dedge and Yevgeni Zolota square off in the cage for a Vale Tudo match at the International Super Challenge in Kiev, Ukraine. Dedge, an American fighter from Florida, is suddenly mounted by his opponent who unleashes a barrage of bare-knuckled strikes to Dedge’s head. The referee is forced to stop the fight, and after trying to get to his feet, Dedge collapses to the ground unconscious. He dies two days later at the Kiev Institute of Neurosurgery. The Vale Tudo event was unsanctioned and Dedge had not been cleared to fight in the U.S.  Since these were the early days of MMA, the event was held in the Ukraine and not televised in the U.S., Dedge’s death went mostly unnoticed by U.S. media.

Over a decade later, on October 20th, 2007, U.S. MMA fighter Sammy Vasquez is knocked out in a Renegades Extreme Fighting bout in Houston, Texas. Vasquez is carried out of the cage on a stretcher, his twitching body in plain sight of the attending audience. He later dies on November 30th, succumbing to blood clots, brain swelling and a massive stroke brought on by the head trauma. Vasquez’s death is the first documented MMA death in a sanctioned event in the US.

A lot has been written on the topic of MMA death, especially since Sammy Vasquez’s tragic demise. Following this incident, some observers were actually surprised by the lack of negative backlash aimed at MMA, a combat sport that is still illegal in some states. The most common explanation for this lack of backlash is the fact that the event in question was not televised, the organization wasn’t a popular one, and that the deceased fighter was relatively unknown. Some may have written this off as a tragic accident occurring in a very dangerous profession. However, what would have happened if Chuck Liddell had died in the UFC octagon during a popular pay-per-view event? Due to the fighter celebrity status and the UFC’s popularity, it’s a certainty that this death would have sent shockwaves through the MMA community and the mainstream media. Talks of “human cockfighting” and pressure to ban the sport would probably resurrect.

Because MMA is such a young sport, there are no long-term studies on the health of fighters and their injuries. Yet one would have to assume that it’s just a matter of time before serious injury, and even death, occurs in the octagon. According to statistics, boxing averages roughly 11 deaths per year worldwide. Even if MMA is much safer than boxing when it comes to head traumas, it’s reasonable to expect that sooner or later someone will get seriously injured or killed in the octagon. Actress Natasha Richardson’s death of epidural hematoma after a minor skiing accident reminds us that even a seemingly minor head concussion can be deadly. Every MMA fan has vivid memories of recent brutal knock-outs: Chuck Liddell unconscious for several minutes after being knocked out cold by Rashad Evans, Wanderlei Silva’s twitching limbs, following the brutal knockout delivered by Quinton “Rampage” Jackson.

I don’t know Dana White, but I do know that he and the Fertitta brothers have a very keen business acumen. After the dark underground years, MMA is one of the fastest growing and most profitable sports around. Pay-per-view numbers are increasing, sponsors are flocking in, MMA apparel is becoming trendy and some fighters have become iconic figures. In other words, what was once a frowned-upon, barbaric past-time is now big business.

So I am wondering how are Dana White and the UFC preparing themselves for the inevitable? I wouldn’t be surprised if they already have a plan to deal with such a crisis. They probably have strategies planned, legal teams ready to battle, press releases drafted and sorrowful speeches ready for delivery. You can bet that the UFC will not be scrambling to put together a “damage control” strategy in the wake of a tragic event. They won’t be caught off guard.

Their defense of MMA will probably hinge on numbers and statistics. Injury and death are hazards in any athletic event. There have been deaths and major injuries in just about every sport: basketball, football, boxing and hockey. On November 3, 2007, marathon runner Ryan Shay, only 28 years old, died during the U.S. Olympic trials, victim of a heart attack. The UFC lawyers will probably argue that even when all procedures are respected and athletes are closely monitored, people can die or suffer serious injury in competition. Sometimes these deaths occur due to pre-existing medical conditions, sometimes they occur as a hazard of the sport. Boxing’s high death rate will probably be their main argument. If boxing was never banned, why should MMA be treated any differently?

The truth is that this issue isn’t really based on logic, but rather on emotion and culture. We grew up with historical boxing matches, hard-fought football games and epic marathons, we cannot imagine a world without these sports. They are part of the fabric that makes up our cultural DNA. On the other hand, MMA is a new sport with no cultural and historical roots in most countries. It is an offspring of no-holds-barred, bare-knuckle underground fights, which are illegal almost everywhere and are considered a bloody and barbaric activity. Dana White and his partners have worked tirelessly since the acquisition of the UFC to distance themselves from the sport’s roots. Even before the White/Fertitta takeover, the old UFC management introduced weight classes, time limits, gloves, referees and medal awards, in an attempt to curb the bad press and the attacks brought on by politicians that eventually drove the organization underground.

For many, MMA is a new strange sport, something that for a long time has been considered “low brow”. I know many MMA fans in the closet. My own wife – a rabid MMA fan – would never talk about MMA with friends and co-workers because she knows that many consider MMA a brutal ‘sport’ that only draws a certain type of low-brow fans. The fact remains that MMA is still very much on the knife’s edge when it comes to public perception. In the aftermath of a horrible injury or death in the octagon, it would be very easy for a politician to gain free publicity by promoting a campaign to ban MMA. The question is, has the UFC managed to build enough credibility to weather the storm?

One positive effect the tragic death of Sammy Vasquez has brought about is that it has brought to the spotlight certain topics that can no longer be ignored: appropriate health insurance for fighters and adequate life insurance for families of those who die in the cage.

On the day after Vasquez’s death, the state of Texas officially changed its “combative sports” rules, requiring promoters to buy more costly health insurance to cover seriously injured fighters, including “medical, surgical and hospital care with a minimum limit of $50,000 for injuries sustained.” Promoters will also be required to pay $100,000 to a fighter’s heirs if the fighter dies in competition. Hopefully other states will soon follow suit.

It’s certainly my hope that the UFC, with its high-level safety standards, will defy the odds and will never have to experience serious injury or death in the octagon. It is also my hope that other non-UFC organizations that put together small shows in obscure venues and casinos, will take all possible measures to protect their fighters from serious accidents.

If such a tragedy, however, will strike the UFC, it will put the whole sport of MMA to its ultimate test, and we will see if the sport has permanently grown into a lasting entity.