Free association

So my beloved sister mentions in an email that her boyfriend fell off a ladder.

Not, as she put it, by slithering and grasping, but by becoming completely airborne, backwards, off the top of a six-foot stepladder. He apparently brought down the ladder, the bookshelves, and a computer desk with him as he fell. The boyfriend, incidentally, is in his fifties. Sister said the impact noises that his limbs made as he tumbled down were quite impressive.

I had a patient two weeks ago in his fifties who became a quadriplegic through missing his chair and sitting down hard on the floor, then whacking his head on the desk. And Sister's Boyfriend does a credible imitation of the Jamaican Bobsled Team and is okay.

Which leads me to pondering this: could it be that he's from India that contributed to his relative lack of injury? Bear with me here.

Sister and I are Northern European. Fair skinned, blue-eyed, red and blond hair. We break easily. We scar easily. Toss one of us off the top of a six-foot ladder (I have done this, in college) and we're lucky if we break only a few ribs (as I did). If we'd tossed our father off a ladder at age 50, he'd likely have ended up like my chair-missing, floor-sitting patient.

Now, then. You can maintain as much as you like that we're all brothers under the skin, but a quick study of comparative anatomy will reassure you that it simply ain't so. African-American leg bones have a different ratio and thickness than Caucasian-American leg bones. In the same vein, African-American women are much less likely to suffer from osteoporosis than their brunette, brown-eyed Caucasian sisters, who in turn are luckier than their Scandanavian relatives in that department. It's a matter of bone density that relates to ethnic background.

I hear tell from my pals in the ED and the labor unit that they hate to see redheads coming; the rumor being (although I have no clue if this is true) that we carrot-tops have less collagen in our skins than others and are therefore more likely to scar/rip/wrinkle/you name it.

There's a movement afoot in the African-American community nationally to raise awareness of the need for donor organs--especially kidneys. Again, although non-Black and Black donors and recipients share a good number of characteristics, there's something about the differences in donated organs which (as I understand what little I know) makes it easier to cross-match all the zillion factors when the donor and recipient are of the same ethnicity.

This all sounds like the worst racist hooey if you aren't careful. Still, I wonder. Could Sister's Boyfriend's lack of injury--aside from a few bruises--be partly attributable to some difference in bone density between his ethnic group and ours that I'm not aware of? Or is it just that his top is made out of rubber and his bottom is made out of springs?

Anybody got any nice studies they'd like to pass along?