Respectful Insolence

“It’s a miracle!”

How many times have you heard that one, usually invoked when someone survives serious injuries that would kill most people? Personally, the use of the word grates on me and did even when I was a lot more religious than I am now. Yesterday, it grated on me when I saw this story:

NEW YORK — Alcides Moreno should be dead.

But Moreno, a 37-year-old window washer from Linden, not only survived a 47-story fall from a Manhattan skyscraper, but will likely walk again and make a near 100 percent recovery, doctors said yesterday.

“If we can talk about medical miracles, this certainly qualifies,” said Herbert Pardes, president and chief executive officer of New York-Presbyterian Hospital, during a news conference.

No, it does not. Improbable? Yes? Amazingly improbable? Sure. But a “miracle”? I don’t think so. It’s not even unprecedented. There are records of people surviving falls from airplanes after their parachutes failed to open.

Moreno certainly did have some devastating injuries, as the article describes:

Philip Barie, chief of critical care, Department of Surgery, at New York-Presbyterian/Weill Cornell, was so incredulous about Moreno’s survival that he had to ask emergency room physicians twice about how far Moreno had fallen.

“I asked the resident, ‘How many stories did he fall again?'” the doctor said.

“Above 10 stories, most of the time we never see the patients because they’re brought to the morgue at Bellevue.”

With Moreno drifting in and out of consciousness, two medical issues quickly became priorities for the trauma team — massive bleeding and a buildup of pressure in his abdomen, Barie said

Moreno was bleeding profusely because several of the fractures he suffered were compound, meaning the bones had broken through skin. The most severe injury Moreno suffered was a broken left shinbone and a shattered right ankle, Barie said.

It’s true. Survival is rare for falls greater than 10 stories. In urban environments, falls of three stories or more are associated with high mortality, particularly in adults. However, the height of the fall is not the sole risk factor for mortality. Moreno himself suffered multiple fractures, internal injuries, and massive bleeding. Indeed, the fact that his main fractures were lower extremities fractures suggests that he landed feet first, which is one factor that can increase the chance of surviving a high fall. That Moreno didn’t suffer a major head injury also suggests this possibility. Another factor mentioned in the article is that he may have been holding on to the scaffolding as he fell. If the scaffolding was still attached to the rest of the structure, this could well have slowed his fall or even broken it, a possibility suggested by reports that paramedics found him lying on top of the remains of the collapsed scaffolding while his brother’s body was apparently found lying partially underneath the wreckage. Moreover, in the same report it was stated that Moreno might have followed training that window washers are taught to maximize the possibility of survival if their scaffolding ever gives way:

Window washers are taught that if a scaffold gives way, they should lie down flat on the platform, on their stomach because, Mr. Bustamante said, it gives them the best chance of survival should the scaffold catch on something on the way down. Maybe that is what Alcides Moreno did, he said.

“If you go over, that’s it,” he said. “You’re dead.”

He believed that that was what happened to Edgar Moreno — that he was either thrown from the platform, or jumped from it out of fear. “That’s your first instinct, because you’re scared — to jump,” Mr. Bustamante said.

Also, let’s not forget the skillful intervention of the paramedics and trauma team, as well as the excellent care that they provided. Even so, despite all the more mundane reasons that can be invoked for Moreno’s survival, that doesn’t stop God from getting the lion’s share of the credit:

Moreno attributes her husband’s recovery to his faith as well as his physical fitness.

“My husband is very religious and very healthy,” she said. “He keeps telling me it wasn’t his time.

“He speaks, he watches TV, he asks for his glasses,” Rosario Moreno said. “Thank God for the miracle.”

Does this mean that Edgar Moreno was allowed to die because his faith wasn’t strong enough? Inquiring minds want to know. Sadly, even the doctors are falling into the “miracle” trap:

Meanwhile, doctors who are treating Moreno continue to marvel at his survival.

“After 30 years, I thought I’d seen it all,” Barie said. “I don’t know, you guys pick the adjective — if you believe in miracles, this was spectacular.”

Here are the two reasons that attributing unlikely survival from trauma or disease to a “miracle.” First, if we’re going to give God the credit for the unlikely survival of someone like Moreno, shouldn’t He get the blame for the scaffolding having given way in the first place? Shouldn’t He also get the blame for the death of Edgar Moreno, who was not as fortunate as his brother? It’s a question that can’t be escaped if one is going to attribute Alcide Moreno’s survival to divine intervention: Why didn’t God save both both brothers? The second reason using the term “miracle” in this context annoys me is that it discounts the skill, dedication, and hard work of the rescue workers and paramedics, as well as the team of doctors, nurses, respiratory therapists, physical therapists, and everyone else involved in saving Moreno’s life.

That’s why I’m hoping to get my readers to resolve in 2008 to try very hard not to fall into the trap of attributing to miracles what is merely highly improbable. “Miracle” implies something that can’t happen without divine intervention, and I’ve yet to see such a case. We can rejoice that Alcide Moreno was so amazingly fortunate to survive his fall, but please don’t attribute it to a “miracle.”

Comments

  1. #1 Narc
    January 5, 2008

    When three wise men were thrown into a furnace by King Nebuchadnezzar and walked out unharmed, that was a miracle.

    A man just barely surviving a tragic accident with horrible injuries is a miracle? It sounds like the bar for “miracle” is set really low these days.

  2. #2 Schwartz
    January 5, 2008

    Orac,

    You’re getting fixated on the religious definition of miracle. You should really look up the meaning of words before ranting like that.

    There is a casual definition as well:

    From Wikipedia:

    “In casual usage, “miracle” may also refer to any statistically unlikely but beneficial event, (such as the survival of a natural disaster) or even to anything which is regarded as “wonderful” regardless of its likelihood, such as birth. Other miracles might be: survival of a fatal illness, escaping a life threatening situation or ‘beating the odds'”

    From Oxford online:

    “Function: noun
    Etymology: Middle English, from Anglo-French, from Late Latin miraculum, from Latin, a wonder, marvel, from mirari to wonder at
    Date: 12th century
    1: an extraordinary event manifesting divine intervention in human affairs
    2: an extremely outstanding or unusual event, thing, or accomplishment
    3Christian Science : a divinely natural phenomenon experienced humanly as the fulfillment of spiritual law”

    Although some of the quotes definately reference divine intervention, the word “miracle” is actually derived from latin meaning “wonderful event”. The story itself certainly qualifies.

    You must have quite a hate for religion, because from the article it hardly seems that the doctors who actually performed the work are upset about not getting credit. Your anger also seems directed at those that attribute divine intervention as assuming that the people doing the work are unappreciated.

    I certainly do not get that impression in this case that the doctors didn’t receive credit, or that they were unappreciated. In fact, they are expressing wonder at the circumstances and my experiences with religious people is that they are usually quite appreciative of help that they receive. I’m sure there are exceptions — but it didn’t look like it in this case.

    The doctors themselves certainly classified this as an extraordinary event, why do you feel you are qualified to determine otherwise? If anything it is you who are detracting from their “miraculous” work.

  3. #3 Common Sense
    January 5, 2008

    Well said. However traumatic the circumstance, the news reporters are the ones who should be getting this message. Whenever someone says that they have been saved by “god’s miracle” then they should be asked all of the questions that you ask above. Let’s see how they answer them.

  4. #4 Abstruse
    January 5, 2008

    Agreed.

    A few months back when that pro-football player injured his spinal cord a reporter tossed his doctor a slow pitch asking about his “miracle” recovery. The doctor replied that it was no miracle but rather an example of the convergence of skill and research that preserved the patient’s ability to walk. I almost cheered.

  5. #5 Common Sense
    January 5, 2008

    That’s “well said” to respectful insolence, not to any apologist for god.

  6. #6 Karl
    January 5, 2008

    Intelligent comment: I agree. I always have that reaction to a plane crash or traffic accident, expecially to a crash of a busload of a church group – he survived, it’s a miracle – even though the other 42 people died.
    Smart Alec comment: Boston Red Sox winning the World Series – now THAT was a miracle.

  7. #7 Cuttlefish
    January 5, 2008

    I always found it rather odd
    When people think to credit God;
    The doctors helped, at least a bit,
    The rescue workers didn’t quit,
    The strangers there, who saw him fall
    And made the first responder call
    So many people did so much
    But still we see His Holy Touch–
    You see, it seems the signs are there
    That show this man has seen God’s care:
    The shattered ankle, broken shin
    The shards of bone that pierce through skin
    The massive bleeding in his gut–
    Yes, every fracture, every cut–
    This is the way that God Above
    Displays His omnipresent Love.
    And just in case He’s still denied
    Remember, this man’s brother died.
    Such agony makes Man aware
    Of just how precious is God’s care
    And when Humanity forgets,
    God has a way to hedge his bets:
    He’ll find a patsy, just some guy,
    Like this Moreno, way up high–
    When disbelievers start to scoff
    God simply pushes this guy off;
    With bleeding, pain, and broken bone,
    God shows us that we’re not alone,
    With just a little Godly shove,
    He gets a chance to prove His Love.

    http://digitalcuttlefish.blogspot.com/2008/01/its-miracle.html

  8. #8 Orac
    January 5, 2008

    You’re getting fixated on the religious definition of miracle. You should really look up the meaning of words before ranting like that…You must have quite a hate for religion, because from the article it hardly seems that the doctors who actually performed the work are upset about not getting credit. Your anger also seems directed at those that attribute divine intervention as assuming that the people doing the work are unappreciated.

    Two points:

    1. The word “miracle” was clearly used in a religious context in this story. Consequently, your relying on the dictionary definition to refute what I said is basically semantics. Can you honestly claim that one person quoted in this story meant “miracle” in a non-religious context? Face it: The colloquial meaning of the word “miracle” overwhelmingly has a religious connotation.

    2. I do not “hate” religion. In fact, as a lapsed Catholic, I’m arguably the most religion-tolerant, even religion-friendly, ScienceBlogger here, with the possible exception of Razib or Chad Orzel or maybe a couple of others. However, invoking “miracles” for such unlikely survival raises some very uncomfortable questions, such as the ones I asked about why the brother died or why the scaffolding collapsed in the first place. If God is given the credit for Alcide’s survival, why, then, is he not given the blame for Edgar’s death, the fact that the scaffolding collapsed in the first place, or for Alcide’s horrific injuries, from which it is likely to take him over a year to recover? These questions bothered me even when I was a died-in-the-wool Catholic who went to Mass each and every week and on nearly all the Holy Days of Obligation. Personally, I liked the saying, “God helps those who help themselves.”

  9. #9 Ken Phelps
    January 5, 2008

    This goes to the old maxim: “If the patient lives, thank God. If the patient dies, sue the doctor.”

    KP

  10. #10 Patrick Pricken
    January 5, 2008

    cuttlefish: that was great!

  11. #11 Sigmund
    January 5, 2008

    In the past I’ve been involved in clinical meetings where case materials are re-examined and occasionally it happens that individual cases, originally defined as malignancies, are realized to be something different. In these situations the patient has usually undergone a round of chemotherapy and been ‘miraculously’ cured of the cancer. I seriously wonder if this sort of misdiagnosis situation is a common reason behind a lot of miraculous recoveries from incurable diseases. If this is the case then we might predict that more modern diagnostic techniques will result in a higher accuracy and less incidences of false positives – and thus a smaller number of such ‘miraculous’ recoveries overall – despite the improvement in treatment outcomes due to improved drugs and other therapies.

  12. #12 Beth
    January 5, 2008

    God gets all the accolades and none of the blame. The ultimate teflon deity.

  13. #13 Schwartz
    January 5, 2008

    Orac,

    Yes, I certainly admited that it was used in a religious context several times in the article. However, your concluding sentence is pretty definitive:

    “”Miracle” implies something that can’t happen without divine intervention, and I’ve yet to see such a case. We can rejoice that Alcide Moreno was so amazingly fortunate to survive his fall, but please don’t attribute it to a “miracle.””

    That is not true in all contexts at all and the Doctor’s comments appeared to be spoken more out of amazement than religious context.

    From a non-practicing Catholic to a lapsed one, to try to convince people not to attribute amazing things to the divine is pretty futile, and the logic of faith is an eternal argument — I can already hear someone saying that the incredible work of the doctors was inspired by God. Now all parties get credit. :)

    I read the same article, and personally was amazed by both the fortunate circumstances, the apparent positive will to survive, and mostly, the incredible work of the doctors.

    I apologize if I attributed your post to anger at religion. On my initial read, it just came across that way. Perhaps it was more exasperation.

  14. #14 isles
    January 5, 2008

    How refreshing that there’s a new Common Sense posting in these comments! Visited and liked your blog.

    (Backstory = there is trollish commenter who posts as “Common Sense” here sometimes.)

    Cuttlefish, that was hilarious.

  15. #15 Blaine
    January 5, 2008

    It’s been said before but,

    Cuttlefish wins the intertubes! That was great.

  16. #16 Robster, FCD
    January 5, 2008

    “Miracles” are easily among my top ten pet peeves. I don’t consider myself anti religion, but anti stupid, and all too often people make very ignorant statements based on religious imprinting.

    Common Sense, isles is talking about an antivax – mercury militia woman named Sue, using the same name de blogeur. I haven’t seen her some by this blog in a while, but the similar handles will probably lead to some confusion.

  17. #17 Ken Shabby
    January 5, 2008

    Fundamentally, ‘miracle’ means only a surprise. Like a fart with a lump in it.

  18. #18 Common Sense
    January 5, 2008

    The name “Common Sense” evolved into the blog title six moths ago, it’s mainly a skeptical look at marketing lies (inc those of religion), but in many posts I detail the development starting from Tom Paine and all the misuse of the term since. Hence I usually comment here under my name (Rana) or initials (RNB).

    Sorry for the diversion … remember, a miracle is “an unlikely event”, it is not “god deciding to nearly kill you”.

  19. #19 Lisa Emrich
    January 5, 2008

    Unfortunately, discussing ‘miracles’ will not end any time soon. Check this out:

    http://brassandivory.blogspot.com/2008/01/sharing-miracles-brought-to-you-by.html

  20. #20 Shawn S.
    January 5, 2008

    As my english teacher significant other has told me: “Dictionaries are not definitions, but usages.” In ALL of these usages of the word “Miracle” the divine is implied explicitly. The “miracle doesn’t always mean relgious” argument against Orac is useless because within the article the word “miracle” is meant in the religious sense. The Morenos were highly religious. It is unlikely they were thinking of a secular usage. The doctors involved may or may not have meant “highly improbable fortuitous even” or “divine intervention in a positive (for at least one poor bastard) fashion”. I didn’t think it was clear. Still, the most popular usage of miracle seems to be religious and THAT is annoying to both Orac and ME and others who think that God should quit getting credit for only the good things that happen to people. Either God cannot prevent bad things, in which case he is not omnipotent, or he refuses to prevent them, in which case he is malicious.

    This guy was what statiticians call a statistical outlier and the way he fell shows that if he hadn’t fallen “just so” he would’ve been dead nearly instantly from burst organs (including his skull). This is to say nothing of highly advanced medical care.

    God, even if he existed, had nothing to do with this.

    I guess poor Moreno’s brother and his family deserved his death, right? After all, why save one and not the other? I find it more comforting (which is irrelavent, of course) to think there is no god and that the world is a dangerous and chaotic place. Otherwise we have to deal with a God that is as capricious and malevolent as any dictator you could name in human history.

  21. #21 Sastra
    January 5, 2008

    One of my favorite “miracle” stories:

    Malignant Tumor Sees Every Day As a Gift From God
    http://www.theonion.com/content/node/28423

    Throughout the ordeal, the tumor has found comfort in its strong Christian faith.

    “Going into that surgery, I thought, ‘Well, this could be the end of the line for me,'” the tumor said. “But, by some miracle, a few of my tendrils had adhered to the occipital lobe without the doctors realizing it, and I made it through the operation. I know in my heart it was God’s hand guiding that surgeon’s scalpel to the wrong place that day.”

  22. #22 inkadu
    January 6, 2008

    The biggest problem with “miracle” is that it discourages asking questions that might lead to preparation that would lead to more “miracles” in the future — for instance, following the training, landing on your feet, scaffolding cushioning the fall, etc.

    However, the most ridiculous use of “miracle” happens to be when a woman has intensive fertility therapy, and after a 12 hour operation ends up giving birth to 9 children, 7 which survive and remain viable. That is almost always called not just a “miracle” but “a miracle from God.”

    And “miracle” completely pales in comparison in its misue in news to the word “tragedy.” Tragedy implies some sort of irony. For instance, a dog that runs up to greet its owner as the owner is driving up and accidentally gets hit — that’s a tragedy. The dog’s desire to greet the owner is what killed it. But in the moronic (moranic?) land of prime-time news, any time a little girl gets killed or a train crashes or people are laid off, it’s called a “tragedy.” Bollocks.

  23. #23 stewart
    January 6, 2008

    Moreno’s survival and current degree of recovery is fortunate and extremely unusual. Good for all involved, but he would have died if many things had not been just so, including getting hurt near a major trauma centre, the current standards of surgical care, etc.
    It’s not unprecedented. Shall we use miracles to describe the opposite cases, the gentleman who suffers an unexplained seizure, falls to the floor and suffers profound brain damage as a consequence? Just as unlikely, just as extreme.

  24. #24 Jud
    January 7, 2008

    “Consequently, your relying on the dictionary definition to refute what I said is basically semantics.”

    Yah, but do you know what an online sub to the OED costs? I love my compact version, complete with magnifier and backlight, but the online version? Mmmm, I’d consider giving up body parts….

  25. #25 Dr. Val
    January 7, 2008

    Well, I dunno. I think we should all enjoy the refreshing use of “miracle” to refer to a pretty rare and wonderful event rather than its usual and unhappy association with homeopathy and diet pills. The poor word just can’t get away from those buggers. :)

  26. #26 Sid Schwab
    January 7, 2008

    Here is a quite detailed article about bold medical efforts on behalf of a spinal cord injury that led to an improbable recovery, and which is hailed by the religious as a miracle, in the god-did-it sense. God, and some quick hypothermia, timely well-placed surgery by skilled surgeons.

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