Medical Associates Clinic

 Quality Care Close To Home

Gettysburg Medical Center
 The Clinical View
 by P.E. Hoffsten, MD
25 May 2005

THE HIGHER THE PERCH, THE FARTHER THE FALL

            The lady was 92 years old and no longer able to walk.  Her mind was sharp and she could converse with family members but repeated indicated that she was very tired, always uncomfortable and really saw no future for herself.  She passed away quietly in her sleep.  Family members and friends were sad but almost thankful that her discomfort had ended.

            In contrast, consider the situation of a 17 year old young lady graduating from high school on her way to her Senior picnic with 4 friends in the car.  They had not been drinking but in the levity of the moment were not paying as much attention as they might have.  This was the height of their perch.  They were about to graduate from high school, proceed on to college and get on with the wonderful life.  It all ended in an instant when the driver just drifted slightly over the line and ran head on into another vehicle.  Two of the four girls were killed.  One had a spinal cord injury but the driver somehow escaped with only minor injuries.  The fall from that high perch, and instant before the car accident was devastating for everybody involved.  It wasn’t not just sad, it was a devastating tragedy.  The driver of the automobile attempted to proceed onto college but was unsuccessful.  A failed marriage, drug and alcohol problems have plagued her since the time of the accident.

            Summer is coming, and it is a time for leisure, relaxation, vacations and all kinds of fun.  But those are the time that we tend to pay the least attention to safety, and our vulnerabilities.  Accidents are the leading cause of death in our young population and the 5^th leading cause of death overall for the population of the United States.  Leisure time activities are a major preoccupation with our population.  Leisure time activities tend to relax safety consideration.  There is something much more tragic about accidents that occur at leisure time.

            In our area in the past year, there have been a number of such tragedies.  Easter dinner was going to be very special and Grandpa was going to go a family members home.  He was looking forward to the opportunity but as he walked out the front door, a gust of wind pushed the door against him and he fell off the steps breaking his hip.  There wasn’t any Easter dinner that day and the added tragedy of his passing away a week later from complications, compounded the tragedy.  Attention to avoiding falls, is important.  The use of walkers or a cane or perhaps even putting a ramp in in  place of steps can prevent tragedies.

            Of the 50,000 people who die in automobile accidents each year, more then half are caused by alcohol related activity.  Driving and drinking is a horrible tragedy.

            In central South Dakota, water sports are a major form of recreation.  Riding the jet ski at full speed is a heady thrill.  Imagine the disappointment of the young man who was jig jagging with another jet ski when the two ran into each other.  That resulted a four months stay in a cast as a broken leg as allowed to heal.

            Teaching children to swim at an early age can be lifesaving.  A young man went fishing on the edge of Lake Oahe.  The bank tapered off faster than he knew and when his minnow bucket started to drift out into the water, he waded out to get it.  Unfortunately, the water was over his head before he knew it.  He had never learned to swim.  He was unable to recover and drowned.  Water sports require a person to no very well how to swim and even then to use a life jacket at appropriate times.

            One of the sickest people I have take care of in the last year was a young man who went hiking in the mountains.  He just knew that that wonderful clear mountain water would taste wonderful.  When his canteen ran dry, he filled with the good mountain stream water.  Unfortunately, raccoons soil that water with a parasite called Giardia.  When this organism infected the young man’s bowel, he became unusually ill and was hospitalized for three days with diarrhea and dehydration.

            I don’t know how tell someone to be careful playing baseball, or football, or basketball, or tennis, or racquetball where accidents occur.  Perhaps the best advice in these areas is to be aware of one’s capability and the potential for very disappointing injuries.  Broken legs, broken wrists, and knockout concussions, all happen.

            In spite of all the training and warnings occur, scuba divers still have very dangerous accidents.  The young man well versed in all of the runs of scuba diving heard that the intakes at Oahe Dam were going to be turned off for the weekend.  That meant that he could dive down and retrieve various fishing lures and other debris that had collected on the screens of the intakes over months of time.  Her was having a wonderful time finding all kinds of treasures but didn’t pay attention to how long he could stay under the water without getting the bends.  He got to serve some time in the oxygen chamber in Sioux Falls after a horrible episode of muscle pain when he just didn’t pay attention.

            Of all of various modes of transportation, there probably aren’t very many that lead to a higher perch than riding a motorcycle.  Every year at the Sturgis rally, there are accidents and mortalities secondary to the use of motorcycles.  I am very sure that they will never be outlawed but no group of individuals in this world should be more conscious of safety than motorcycle riders.

            In summary, we spend a great deal of time in our nation involved in leisure activities.  People describe “getting a high” from whatever leisure things we do but it is almost as if that is the time when we are most vulnerable being that “there is nothing to worry about”.  But the fall from that lofty perch when an accident occurs is horrible.  Attention to safety can never be pushed enough.