Acrophobia can be defined as an extreme or irrational fear of heights. About 2% to 5% of the general population seem to suffer from acrophobia. I have to admit that I do have acrophobia right from my childhood, which has ostensibly worsened in the recent years. Of late, a new-found, unnamed variant of acrophobia seems to be bothering me. I feel extremely uneasy, apprehensive and fearful when I see people working at high structures precariously. This, I presume to be an occupational hazard of witnessing grisly spinal injuries due to falls from heights.
The couple were in their early twenties and a young giggling infant was clinging on to the lady’s crumbled sari. The thin, fragile young lady listened to me with keen ears and folded hands in reverence as I talked to her. Her husband had been admitted with a spinal injury. A mason by occupation, he had sustained the injury when he tripped from the second floor of a building under construction. The injury had left him paralysed below the hip with lost sensations and incontinent bladder and bowels. Dutifully as a spine surgeon, I had fixed his dislocated spine at the earliest and an extensive rehabilitation process had helped him to be independent, but on a wheelchair.
Despite the best outcomes of surgery and rehabilitation three months down the line, they were still aggrieved that he was not able to walk independently. Despite multiple sessions of counselling, they refused to accept the sheer reality. I explained to them again the irreversible nature of the injury and our best effort was to make him independent on a wheelchair and a ‘normal’ life would not be possible anymore. His eyes welled up at the reality of not being able to pursue his previous job, and the loss of his stature as the bread winner. The humongous job of supporting the family financially and emotionally has now fallen onto the already fragile wife, who had multiple questions writ on her quivering face. “What is my husband’s mistake in this injury? He is not a drunkard who injured himself on the road. He is not a rash driver of a vehicle involved in a fatal accident. He has been a caring and responsible man who was doing his job as a mason.”
We, as spine surgeons, see such injuries frequently in our practice. Though road accidents, industrial injuries and fall from heights can all lead to spine injuries, the last one is relatively common in India. Masons, industrial workers, tree climbers and electricity board employees bear the brunt of this unique mode of injury. Often, I notice that the construction workers are the ones to be at maximum risk.
In developed nations, several protective gears are mandatory for workers working in high-rise buildings including harnesses, lanyards, protective nets, scaffolds and helmets. The existence of optimal work schedules and laws that enforce safe working environments ensure that such injuries are kept to the minimum possible. In India, on the other hand, we hardly see such safe work-zones for construction workers. Such workers have been made oblivious to the fact that they are hanging precariously between life and death, and in fact, many believe that it is an essential job skill to work without protective gear.
I could not answer any of the wife’s legitimate queries and I stood helpless. As a spine surgeon, we perform an excellent job of fixing the unstable spine and provide the best milieu for the spinal cord to recover. But he remained far less a man himself than what he was three months ago.
Although everyone talks about the rising incidence of road traffic accidents, and several measures to curb it have been promulgated at several levels, the grisly spinal injuries sustained from falls from high structures sadly has not been given its due attention. The governmental agencies and major construction firms remain unwary or turn a blind eye to their foibles. Though the immediate medical expenses are borne by these firms, the shattered family remains helpless for the rest of their lives. As the young family left the outpatient room, I remained perturbed. The same uneasiness pervades me whenever I see someone working at a height without any protection. That uneasiness is much unbearable than my conventional acrophobia.
