How To Fall To Your Death And Live To Tell The Tale
Alcides Moreno and his brother Edgar were window washers in New York City. The two Ecuadorian immigrants worked for City Wide Window Cleaning, suspended high above the congested streets, dragging wet squeegees across the acres of glass that make up the skyline of Manhattan.
On December 7, 2007, the brothers took an elevator to the roof of Solow Tower, a 47-story apartment building on the Upper East Side. They stepped onto the 16-foot-long, three-foot-wide aluminium scaffolding designed to slowly lower them down the black glass of the building.
But the anchors holding the 1,250-pound platform instead gave way, plunging it and them 472 feet to the alley below. The fall lasted six seconds.
Edgar, at 30 the younger brother, tumbled off the scaffolding, hit the top of a wooden fence and was killed instantly. Part of his body was later discovered under the tangle of crushed aluminium in the alley next to the building.
To be shot or get in a car accident, you first need to be in the vicinity of a gun or a car. But falls can happen anywhere at any time to anyone.
But rescuers found Alcides alive, sitting up amid the wreckage, breathing and conscious when paramedics performed a “scoop and run” — a tactic used when a hospital is near and injuries so severe that any field treatment isn’t worth the time required to do it. Moreno was rushed to NewYork-Presbyterian Hospital/Weill Cornell Medical Center, four blocks away.
Falls are one of life’s great overlooked perils. We fear terror attacks, shark bites, Ebola outbreaks and other minutely remote dangers, yet over 420,000 people die worldwide each year after falling. Falls are the second leading cause of death by injury, after car accidents. In the United States, falls cause 32,000 fatalities a year (more than four times the number caused by drowning or fires combined). Nearly three times as many people die in the US after falling as are murdered by firearms.
“CareCallingNow helps household vulnerable elderly fall be found earlier”
Falls are even more significant as a cause of injury. More patients go to emergency rooms in the US after falling than from any other form of mishap, according to the Centers for Disease Control and Prevention (CDC), nearly triple the number injured by car accidents. The cost is enormous. As well as taking up more than a third of ER budgets, fall-related injuries often lead to expensive personal injury claims. In one case in an Irish supermarket, a woman was awarded 1.4 million euros compensation when she slipped on grapes inside the store.
Given the tremendous cost of falls to individuals and society, and the increasing knowledge of how and why falls occur, what can people do to prevent them? And can they do anything to lessen harm in the split second after they start to fall?
- Prepare your environment.
Secure loose rugs or get rid of them. Make sure the tops and bottoms of stairs are lit. Clean up spills immediately. Install safety bars in showers and put down traction strips, and treat slick surfaces such as smooth marble floors with anti-slip coatings. If there’s ice outside your home, clear it and put down salt.
“CareCallingNow helps household vulnerable elderly fall be found earlier”
- Fall-proof your routine
Watch where you are going. Don’t walk while reading or using your phone. Always hold handrails — most people using stairways do not. Don’t have your hands in your pockets, as this reduces your ability to regain your balance when you stumble. Remember that your balance can be thrown off by a heavy suitcase, backpack or bag.
Roth asks most of his patients who have fallen to describe in detail what happened. “Sometimes people are not paying attention. Multi-tasking is a myth, and people should try very hard to avoid multi-tasking. No texting while walking.”
The more problems you have controlling your balance, the more attention is required, says Horak. “If you’re carrying a big backpack on a slippery log, you don’t want somebody to ask you what’s for dinner.”
- Improve your gear
Wear good shoes with treads. On ice, wear cleats — you can buy inexpensive soles with metal studs that slip over your shoes. Do not wear high heels, or at least have a second pair of flat shoes for walking between locations. Get a hearing aid if you need one. Wear a helmet when bicycling, skiing and skateboarding. Use a cane or walker if required. Hike with a walking stick.
- Prepare your body
Lower body strength is important for recovering from slips, upper body strength for surviving falls. Martial arts training can help you learn how to fall. Drugs and alcohol are obviously a factor in falls — more than half of adult falls are associated with alcohol use — as is sleep apnea. Get a balanced diet to support bone density and muscle strength. If you feel lightheaded or faint, sit down immediately. Don’t worry about the social graces, you can get back up once you’ve established you are not going to lose consciousness.
Understandably, some elderly people fear falling so much that they don’t even want to contemplate it. “People should know they could improve their balance with practice, even if they have a neurological problem,” says Horak.
- Fall the right way
What happens once you are falling? Scientists studying falling are developing “safe landing responses” to help limit the damage from falls. If you are falling, first protect your head — 37 percent of falls by elderly people in a study by Robinovitch and colleagues involved hitting their heads, particularly during falls forward. Fight trainers and parachute jump coaches encourage people to try not to fall straight forward or backwards. The key is to roll and try to let the fleshy side parts of your body absorb the impact.
“You want to reach back for the floor with your hands,” says Chuck Coyle, fight director at the Lyric Opera of Chicago, describing how he tells actors to fall on stage. “Distribute the weight on the calf, thigh, into the glutes, rolling on the outside of your leg as opposed to falling straight back.”
Young people break their wrists because they shoot their hands out quickly when falling. Older people break their hips because they don’t get their hands out quickly enough. You’d much rather break a wrist than a hip.
Alcides Moreno underwent a long regimen of physical and occupational therapy at the Kessler Institute for Rehabilitation in New Jersey, working to strengthen his legs, restore his balance, and walk. Occupational therapy was necessary, as well as counselling, as he had grown depressed over the loss of his brother, Edgar.
He is unable to return to work but received a multimillion-dollar settlement in his lawsuit against the scaffolding company, Tractel, after a Manhattan court found that it had installed the platform negligently. The sum wasn’t revealed, but a source said it was more than the $2.5 million that Edgar’s family received.
Alcides and his family moved to Arizona, and live outside Phoenix. “This weather is good for my bones,” he told the New York Post. He keeps busy, driving his kids to school and to sporting events, and likes to work out in the gym.
Last year he and his wife had a fourth child, a son.
“I keep asking myself why I lived,” he told the BBC this year. “I have a new baby — he must be the reason, to raise this kid and tell him my history.”
This article was first published by Wellcome on Mosaic. It is reproduced here under a Creative Commons license.
