(4 July 1995, somewhere in the USA) During my second year of residency in orthopedic surgery, a 35-year-old roofer was admitted to the hospital after falling from a roof. His boss had told him to tie himself off to prevent a fall, but he was an experienced roofer and knew that wouldn't happen. Nevertheless, he fell off the roof, fracturing his pelvis, his right femur, and his left tibia. An avoidable accident, but certainly not worthy of a Darwin Award. The patient underwent surgery, and was discharged from the hospital on July 4th after an uneventful three-day postoperative course.
So far so good.
The patient was back nine hours later, arriving by CARE flight, looking worse than he had the first time. He had torn the external fixator from one side of his pelvis, fractured his femur below the rod that had been used to fix it the first time, and fractured his tibia above the rod used to fix that, as well. And he hadn't been anywhere near a roof.
It turned out that he and his brother-in-law decided to go bar hopping to celebrate his recovery. Since he was stuck in a wheelchair, they figured the best way to get him from bar to bar was to duct tape his wheelchair to the bed of the pickup truck. The plan worked perfectly all evening, as they got more and more soused. If only they had also duct-taped the roofer to his wheelchair.
They were on their way home when his brother-in-law took a corner too fast. The roofer shot out from his wheelchair and landed on the street.
The patient was repaired, and he recovered fully, much to the annoyance of natural selection. I don't know if he ties himself off when roofing these days, but he hasn't been back to my hospital. I'm not sure how long he'll remain in the gene pool, though, and he certainly deserves an At-Risk Survivor.
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Submitted by: dr.g