The paramedics brought in a twenty-two-year-old man who was found hanging by his ankle under a freeway overpass.
The story he told me was so bizarre, amazing, funny and sad that it ranks near the top of all the stories I have come across in the emergency department.
He told me he wanted to “dance,” hanging upside down. When I asked for clarification, he said he was doing “hardcore acrobatics” and repeated, “I just wanted to dance.”
To do that, he went, alone and at night, to a large freeway overpass. There, he climbed up onto a ledge and tied one end of a rope to a “big-ass pipe” that formed part of the overpass structure. He then tied the other end of the rope around his left ankle. Having secured both ends of the rope, he let himself down over the ledge so he was hanging, upside down, against the concrete wall that formed the vertical support of the freeway overpass. He then spent forty-five minutes doing his “dance.”
What he didn’t count on, he said, was that by the time his dance was done, he was too tired to pull himself back up onto the ledge. He hung there for six hours, flailing in his vain attempt to right himself.
It was not clear who found him hanging there, but the paramedics, who were eventually called, cut him down and brought him in, exhausted, dehydrated and complaining of severe thirst and pain in his leg.
My emergency department evaluation was aimed mostly at the health of his leg. He had rope burns around his ankle. His foot was swollen but the blood flow and sensation were normal. His entire leg was tender and almost all of his skin was red and covered with scratches from where he had scraped against the concrete wall.
I gave him pain medicine and intravenous fluids. I took x-rays and ran some blood tests that showed he was dehydrated but, more importantly, he had developed a condition called rhabdomyolysis. The stress on his leg caused widespread breakdown of the muscles. That caused proteins to leak from the damaged muscle cells into his blood stream. A high concentration of these proteins is toxic to the kidneys so he was admitted to the hospital for care to prevent that complication. See my favorite medical reference, Wikipedia, for more information about rhabdo: http://en.wikipedia.org/wiki/Rhabdomyolysis
I posted another case of rhabdomyolysis. Please see Too Many Pushups.
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