As the Emergency Department staff were rolling me on a gurney to a CT scanner, Jerry Glenn, a colleague and one of Penn State’s lead general surgeon’s, walked with us for a bit and said, “Tom, you’re lucky since 50% of falls greater than five feet are mortal for a man your age. ”Two hours earlier, I had been helping the carpenters at my new house install birds-eye maple hardwood flooring. Around 4 PM rain began to fall and pretty quickly a lot of water was splattering on the freshly laid flooring. It wasn’t clear to us if the water was coming down the chimney or between the chimney masonry and the roof. I had the not so brilliant idea to go out in the rain and open my eight-foot step ladder on the deck next to the outside of the chimney. I climbed the ladder in the rain and tried to figure out where the water was coming from. I looked around but couldn't find any obvious reason for the water coming into the front room and decided to get off the roof and out of the rain.
At eight feet the top of my step ladder was level with the edge of the house roof. When I climbed up the ladder, I had to use the next to last step of the ladder to be able to crawl onto the roof. I thought I could simply reverse these moves for my descent. But now the physics of the situation were different, starting with the fact that rain had lubricated the four points of contact of the bottom of the step ladder with the deck. As soon as I put one foot, and my weight, on the ladder it slid away and I crashed to the deck. I wasn’t knocked out, but I couldn’t breathe. It had been decades since I had had the “breath knocked out of me,” but it had happened often enough in childhood and from falling off the flying rings in the college gym that I knew, or hoped, that my lungs would spontaneously inflate. The carpenters inside heard the crash, came out, looked down at me and said, “Are you all right?” To which I could not answer for twenty or thirty seconds. As my lungs filled and my head cleared, I found I could breathe and move all my limbs, so I rolled over and stood up. It was quitting time, so the workers left and I decided to drive back to my house in Mt. Gretna.
Over the five minutes of the drive home, I started having more and more trouble breathing. Uh Oh. I knew I needed to get to an ER so I took off my work clothes, put on my work uniform of a blue oxford shirt and khakis and drove the 12 miles to the Hershey Medical Center. By the time I presented myself at the ER registration desk I could only whisper, “I fell off my roof, I need to see a doctor.” It turned out that one of my former students, Eric, was now an ER resident and I was thankful that he took over my case. His examination quickly brought up the question of whether I had internal bleeding or other internal injuries. A CT scan of my torso was ordered and within an hour Eric and Dr. Glenn told me that the scan did not show extensive internal bleeding, but they were concerned that I might have one or more slow bleeds. The way to determine whether I did was to keep me in the hospital overnight, take blood every hour and see if there was any drop in my hematocrit values. This meant keeping me in the step-down unit, which provides a level of care intermediate between Intensive Care Units and general medical-surgical wards. At the Hershey Medical Center, it was a dormitory-like room with half a dozen beds separated by curtains. It was about 8 PM by the time I was rolled into the step-down unit and placed between two beds with very sick patients, both of whom cried out for help every few minutes all night long. An hour or so after I arrived, Aaron, who was in his last year of medical school, stopped by and said, “Dad, I think you are going to be OK, but don’t expect to get much sleep tonight.” No truer words could have been spoken. I was just very very thankful that my hourly hematocrit values remained stable and that I was discharged the next day.