AUSTIN TROUT has a lot on his mind.

He is 37 and does not want to stop fighting. He is a former world champion who believes his best days might still be in front of him. But Trout is aware of the dangers of continuing too long and what might happen to him over time, both sooner and later. As part of the world’s largest ongoing brain study into combat sport athletes, Trout is also a husband and a father, but he knows what could happen if he takes one fight too many, or, worse, he has already been living this brutal life too long.

He pauses to think about a future with his brain health compromised; when neurological deficits begin to creep in and his family have to deal with his decline. “I don’t want to be a burden on them,” Trout sighs. “I’m supposed to be taking care of them. I’m a fighter and I’m their protector and provider and how can I protect and provide for my wife if she has to wipe my mouth and feed me.”

Trout is trying to stay a step ahead.

Pictures of sporting icons hang everywhere you look on the walls of one of the world’s leading sporting neurologists in Boston, from the NFL and major ice hockey leagues to other contact sports. The names are legendary, and all of the framed 10x8s appear to be signed although there are only two boxers that I can see images of. They are both autographed, with thoughtful messages. One is from Micky Ward, the Lowell light-welterweight hero and one of the most crowd-pleasing fighters of all time, and the other is from Austin Trout.

Trout is best known for beating Miguel Cotto before losing to Canelo Alvarez in back-to-back fights in 2012 and 2013.

Trout was a stylist. The New Mexican southpaw was slick, quick, and did lots of the things Ward – a far more straightforward, blue-collar warrior – did not.

Of course, brain trauma from boxing is not just about taking big hits, it’s the steady drip, drip, drip of years of punches that even the most skilful fighters fail to survive unscathed, be it the brilliant Wilfred Benitez, the at-times almost invisible Herol Graham or the wondrous Sugar Ray Robinson.

Trout was more Benitez than Ward. He is a southpaw who has, so far, stopped 18 of his 36 victims, having lost five times and drawn once. The defeats have come in top class, against Canelo, the Charlo twins, Erislandy Lara and Jarrett Hurd but the veteran is in limbo, in that almost impossible wilderness between realising your best years have gone and accepting they’ve gone. It is a period when one has to understand the difference between what you were and what you are and when you see there is a necessary transition to make from life as a fighter to one as a civilian.

That loss of identity can be crippling but it is why, despite being well-informed about the dangers of carrying on, Trout finds himself at a junction that has him debating his choices.

He took a bareknuckle fight in February, which he won with a fourth-round stoppage, but his last boxing contest was in August 2022. Trout says he’s trying to stay busy – as pros at that age often do – and contends a newfound desire to make the sport a priority will add to his longevity.

By his own admission, he “mucked around between fights, getting fat, going up in weight and getting out of shape.”

Trout would put on as much as 30 or 35lbs from the end of a fight to the start of the next training camp.

“I’m doing things now that I should have been doing when I should have been 100 per cent focused on boxing,” Trout laments. “I could have done it. I was just being lazy and now the discipline I’ve implemented in my life is allowing me to do it.”

Trout’s eyes, however, are open about the dangers of boxing too long.

Initially he was sent to Dr Robert Cantu, arguably the world’s leading sporting neurologist, when scans revealed part of his brain stem stuck out too far. It meant an area of his brain was not protected as well as it should be.

“What I like to tell people is I have more brain than my skull can handle,” Trout jokes.

He became part of the Professional Fighters’ Brain Health Study and familiarised himself with the dangers of boxing, both long and short term.

The study is in Las Vegas and has been going on almost a decade, tracking damage over time to current and retired fighters from boxing and mixed martial arts. In part, it has been funded by major networks and promoters.

The study is designed to learn more about CTE (chronic traumatic encephalopathy – boxing’s old punch-drunk syndrome which later became dementia pugilistica) and boxing’s awkward but inevitable relationship with it.

CTE is a neurological disease that manifests itself in a brain that has taken a significant volume of blows over time. It is not always revealed promptly and can lie dormant before rearing its debilitating and increasingly unwelcome head years after retirement. It can be two years, it could be five, 10, 20 or even 30, but it is more common than any of us would care to admit.

“It’s real,” Trout says. “We need to protect people against it… Every year I’ve got to do a MRI, CAT scans, and a series of [largely iPad] tests with speech, memory, balance and they compare the results, and we see what we’ve got. They ask how many fights we’ve had, how many times we’ve sparred, so they get the data and they compare your brain and your results against something like 1,000 other fighters, including UFC fighters, and then they compare them against another 1,000 non-combative people.”

Perhaps most importantly, they track the changes in individuals from year to year and Trout is invested in the ongoing outcomes.

“Just being in it, from the first to the second year, I got to see the results and I was like, ‘Thank God,’ they were steady,” Trout recalls. “By the third year, some things were even going up. So that’s a good sign, not to say that you may or may not see before the CTE comes, but I think you would because just getting older, you start forgetting stuff. So imagine being older and getting the trauma of a small car crash [a fighting equivalent], it’s definitely going to take its toll, so I’m glad they’re letting us do it.”

Austin Trout looks on after losing against Jarrett Hurd on October 14, 2017 in New York City (Al Bello/Getty Images)

It is something Trout is passionate about, to the extent that in 2016 he travelled to Capitol Hill, Washington DC as part of a boxing delegate that included the study’s chief, Dr Charles Bernick, Paulie Malignaggi, Larry Holmes and the late Senator John McCain to discuss improvements that should be made in the sport, from pension funds and unions to improving knowledge about brain health in fighters.

Trout is apprehensive about his own neurological data but welcomes the knowledge he hopes to glean from being a pioneering volunteer.

“I can see when the results come out that they can say, ‘These are the results, based on this, we need to…’” Trout tails off, as if contemplating best and worst-case scenarios. “I’m active still. I’m 37 years old and people are like, ‘When are you going to stop?’ And I say, ‘I feel good, my head’s good. I don’t want to put a number on it because what if I say I’ll go another five years and I’ve got two years in me and I’m struggling, or on the flipside I say five years and I’m in my prime in five years.’ I just want to continue these tests and determine, based on the results, weighing up whether I’m going to hang them up or not.”

Trout is using them as a guide. And he is convinced he has the discipline to acknowledge and listen to them, despite knowing he might want to act to the contrary.

He told those on Capitol Hill, “I want to fight until the wheels fall off.”

That sentiment is not readily accepted at home, though.

“My wife, my mother, my kids, they’re like, ‘When are you going to stop?’ This [study] gives me a better idea, because you may feel great, but these tests don’t say that. I may still look good in the gym but my speech, balance, memory starts to deteriorate. That’s more important than how I feel. That’s concrete proof. That weighs heavier on my decision to hang them up before more permanent damage happens.”

Trout before fighting Jermall Charlo at The Cosmopolitan on May 21, 2016 in Las Vegas, Nevada (Steve Marcus/Getty Images)

Trout reckons his coaches from Day One, Bobby Benton and Louis Bourke, will let him know when the time comes.

“They’ve told me some hard truths that I haven’t wanted to hear a couple of times,” Trout reasons of his trainers. “Luckily, I’m no diva and I don’t throw fits or anything, but I know what’s out there. You see it with so many guys. Muhammad Ali, his last fight, he was fine, [in that] he passed the tests, it was later on that it crept up on him.”

Ali had, in fact, already been shunned by several commissions and wound up boxing in the Bahamas against Trevor Berbick in his final fight.

No tests can detect CTE. That can only be done during an autopsy when the brain is sliced open and checks are made with high-powered microscopes that look for the tau protein that causes neurological mayhem – as a result of repeated blows.

This, of course, is no longer solely a boxing problem but one that is being addressed in the worlds of football, rugby, American football and beyond. Yet Trout recognises boxing is not doing what is needed to explore or treat arguably it’s most significant problem.

He also knows some fighters enter into and compete in the sport without knowing what CTE is.

“That’s ridiculous,” he smiles, somewhat mournfully. “It’s like becoming a police officer and not understanding what different type of criminals there are. These are the dangers of the job.”

Trout now wants to talk about it more, to help others and for the greater good. As he says, “Bringing out more knowledge to the masses.”

But he is more than aware that it is an uncomfortable topic and not one that either fighters or trainers want to discuss for any amount of time. It is a hard conversation, and there is no harder discussion than telling a boxer that he needs to retire for his or her future well-being.

They might feel fine, that does not mean that they will be.

“It’s like talking about your favourite horse that’s not running anymore, it’s hard to tell that horse that they’ve got to take it out the back and shoot it,” Trout shrugs.

Then, discussing more obvious fixes – including “it [education about CTE] just needs to be shoved down their throat” – Trout mentions sparring, and how he advocates more body sparring and tactical and technical work.

“A lot of trainers are afraid that you lose that intensity,” Trout states. “I want my ‘dog’ to be a ‘dog’, but it’s like at what price? If he’s got in him, he’ll be a ‘dog’. I’ve been in different gyms around this country, even around the world. In Europe, I’ve noticed the sparring is more technical. It’s not so rough, just balls to the wall. Then you’ve got that, every time people get in the ring, 100 [per cent], go. In the DC gyms, the Philly gyms, a lot of kids out there could have made it but they left it there in those rings sparring. Maybe just go to the technical aspect of it. We don’t have to go 100 all the time.”

But there comes a point where the ‘dog’ might not have any teeth left for the fight and Trout reckons fans should have a say on it too, by voting with their feet and remote controls and not encouraging boxers to carry on dangerously long.

“I think the public also needs say, ‘Hey man, I think it’s time to hang them up instead of encouraging these guys to get in ONE MORE TIME. Maybe they’ll listen to the fans, they may not listen to the coach but maybe they’ll listen to the fans.”

Trout speaks at Cleveland Clinic Lou Ruvo Center for Brain Health on April 26, 2016 in the Russell Senate Building in Washington, DC (Paul Morigi/Getty Images for Spike TV)

Regardless of what his own future holds, Trout is part of ground-breaking research and is proud of it, and that he is a pioneer in trying to help future generations of fighters stay safe.

“Absolutely,” he says. “I think we can get this down to a science and see the numbers before us, whether it’s putting people on longer suspensions, whatever it is we can do something about.”

That Trout wants to box again sets off an alarm bell. That he seems to be interested in the science behind his health, however, puts a mind at ease a little.

It is well-known and documented how hard this boxing drug is to be weaned off, especially when you have had the highs that Trout has. He has not just lifted a belt above his head, he shocked a living legend to put his name into the history books.

Trout wished he’d been allowed to breathe after Cotto, a few easy defences before fighting Canelo.

He’d thrived in the underdog role against Cotto and felt he’d needed to take the commercial momentum of that victory straight into another big event.

“I’m a very rhythmic fighter and I’m better when I have activity,” Trout explains. “So I fought Cotto in September, I didn’t fight Canelo until April of next year. I should have taken a fight in February. Stayed sharp. Keep up the hype. Who knows? Enjoy that longer victory lap and gain more fans and make more pressure on that fight with Canelo.”

Regrets are a bad thing to have for a fighter. They manifest themselves for years, harvesting doubt, a lack of understanding or acceptance that time goes on and they keep a candle burning in the hope of putting things right.

Perhaps that is why Trout finds himself where he is. Trapped between science, sense, and the need for a victory lap he never got.

But if he listens closely to the science and chooses to look through some history books, he might start to think that after 160 amateur wins and 42 pro fights the checkered flags are waving on the horizon.