- The most unique request of injuries,
medical emergencies, horse racing.
Horses in general,
beautiful, majestic,
understand humans quite well.
But we need to diagnose some of these injuries.
Let's get started. Be-woop!
- [Announcer] Coomhill at the second last, Marion Square,
reach for it slightly,
gets the other side just in front.
- Are they supposed to sway across all the lanes like this?
I feel like they should be all in their own dedicated lane.
- [Announcer] Down towards the last.
Marion Square, wandering around.
And look it, (indistinct) the rider!
- Ooh!
- [Announcer] Takes a horrible fall!
Coomhill out in front.
- Blunt force trauma causes massive bleeding internally.
When the areas that's surrounding your heart
fills with blood,
the heart actually can't expand,
and you develop a condition known as cardiac tamponade,
where actually,
the rate of bleeding
exerts so much pressure on your heart
that you're unable to circulate
the remaining blood you have in your body
and that can lead to death.
Lewis is absolutely fine.
Unbelievably, he walked into the parade ring
and was chatting away as if nothing had happened.
Okay, there's too much of this that I see in sports
where a major, devastating injury happens,
and because the person's walking around,
they're like, "Oh, no big deal."
After a collision of that speed, of that mechanism,
you're going to the ER,
because the chance that they have a bleed
that's expanding internally
is so high based on the mechanism of injury.
If you slip and fall a few feet,
that's very different than going
40 miles an hour on a horse
and hitting rock solid stop.
That type of injury is way more devastating.
(horse neighs)
- [Announcer] Courier Wonder and (indistinct) Amazing Star.
Hot King Prawn's down on the inside from stronger.
Three Wide Lucky, Patch with cover,
four wide dead-on smash.
- I have no idea what the announcer is saying,
'cause this is so new to me.
- [Announcer] Then Resistencia, oh there's a fall!
Coming up towards the home turn!
It's a really nasty fall,
down went Amazing Star, Nabua Tech,
and also Lucky Patch!
- Hewitson ended up having a fractured hip
and a small bleed in the brain.
Zac Purton suffered four fractured ribs,
a fractured wrist, and a broken nose.
Yuichi Fukunaga broke his collarbone.
Honestly, the most serious one of them all
probably is the bleed in the brain.
Four fractured ribs.
If it's just fractured, non-displaced ribs,
you're not even really doing anything for it.
The only thing you're really trying to do
is to make sure they heal with adequate pain control.
'Cause when someone has a broken rib,
sometimes it's hard to take a deep breath,
so you end up splinting,
which means that you're taking really shallow breaths.
And when you do that,
you don't actually aerate the bottoms,
the bases of your lungs.
Therefore that can lead to a process known as atelectasis,
where essentially the lower parts of your lungs die off
and you have less lung capacity as a result.
So you try and challenge that, and at the same time,
encouraging breathing treatments
with something called an incentive spirometer.
It's like a fun little plastic toy
where you try and breathe,
inhale and exhale really hard
against a balloon pressure gradient.
(horse neighs)
- [Announcer] And we're heading down under
to the Oak Bank steeplechase track near Adelaide,
to witness one of the luckiest sporting escapes
ever captured on camera.
As jockey Simon Mills comes across.
- Oh no!
In these types of injuries,
what happens a lot of times,
you get something known as a Lisfranc fracture.
Pretty unique to horse racing,
'cause it happens in this scenario quite often.
- [Announcer] His horse, Sir Sagamore,
had stumbled on the previous fence,
throwing the 23-year-old from the saddle
with his foot still well and truly
stuck in the right stirrup.
- In a Lisfranc injury,
the bones of the midfoot
that actually connect to the metatarsals
can either get sprained or fully broken.
When the foot is in this kind of unique position
where it's plantar flex,
it's nothing to joke about,
'cause it actually is a serious injury
that requires heavy, heavy rehab,
and surgery, in some cases.
- [Announcer] Bibi misses barrels, and runs wild,
snorts and tosses her head.
- This is turning into a vet channel.
(laughing)
(bleeps)
- [Announcer] Natalie yanks hard on the reigns,
sending Bibi that much more out of control.
- Wow.
- [Announcer] When the horse flips-
- Oh, and the horse fully lands on her!
- [Announcer] You can actually see the saddle horn
cut into Natalie's head.
- Oh my god.
- [Announcer] It almost completely rips off her face.
- Her face literally came off?
- [Announcer] It takes 400 stitches and numerous surgeries,
but they are able to put her face back together.
- That's when people usually get killed
on horses at barrel races,
is when the horse starts dragging 'em
and their foot's in the stirrup,
because their head's on the ground
and that horse's feet are coming at that head
and they usually get kicked in the head,
and that's how they get killed.
- And potential infection, I mean,
modern medical marvels here with antibiotics
being able to treat these infections.
But you're in an area
where I'm assuming there's like,
horse manure and all sorts of bacteria
and you have an open wound on your face.
For the fact that we have antibiotic coverage, is like wow.
And if we don't use it responsibly,
like we're not doing lately,
we're gonna create resistance
and we're gonna be really unhappy with ourselves.
'Cause once we get a bug
that is resistant to all antibiotics,
you're in for a real problem.
(horse neighs)
- [Man] Watch out! Move out the way!
- Are these horses just loose?
- [Unidentified Person] Oh no!
- Oh my god!
Why weren't they out of the way?
Crush injuries are really dangerous,
because when you have a bony crush injury,
you can develop what's known as a fatty embolism,
where a piece of fat that was usually found
in the area where the crush injury occurred
can get sent into your systemic circulation
and then end up getting lodged
in the cardiopulmonary tract,
and that could be absolutely lethal.
There's also issues related to crush injuries
that happen not in an acute way,
but you're laying under something,
it's crushing your body.
You're getting this massive release of electrolytes
and other factors,
and then once you remove the object crushing you,
all those substances get sent
into your systemic circulation.
That can cause a lethal response as well.
I'm pretty sure that's called crush syndrome.
Your boy knows some ***.
(indistinct announcements)
Oh my god, the hedges scare me.
- [Announcer] All the way (indistinct).
- Oh! (gasps)
Trample! Trample injury!
Trample injury!
Oh my god, I didn't see it.
It was too fast.
David Byrne by was taken to the ambulance
where he underwent back surgery over the weekend.
He expected to make a full recovery.
A Robert Walsh broke his collarbone in the fall.
Yeah, I mean these types of bony injuries
are not the most dangerous part of it.
It's when the bone breaks in a way
where it can actually impede, either circulation,
or lead to nerve damage,
and nerve damage of a collarbone, for example,
can lead to a brachial plexus injury,
which is the nerves that come off the cervical spine
and give sensation and motor control to the arm.
I've seen that actually happen
where it creates like a wrist drop.
The collarbone breaks,
causes injury of the nerve,
and then they can't literally
extend their wrist as a result.
(horse neighs)
- [Announcer] Would have at least eight lengths to find,
probably 10, jumping the third last.
That's the flight down the side.
- Oh my god!
- [Announcer] (indistinct) a faller there.
- When I got the fall, I lost consciousness.
- Yeah, that looks like the biggest head injury
of all the ones we've watched this far.
- I was taken to hospital with a 3% chance of survival.
- I never know how they make these claims.
Who in the ambulance
is sitting with this gentleman saying,
"3% chance. That's what I'm giving him."
- [Narrator] He was clinically dead for seven seconds
and had part of his skull removed
and a titanium plate inserted.
- Wow.
- [Narrator] In order to survive the fall.
- A lot of times,
these craniotomies where
they actually remove a part of the skull
happen as a result of bleeding in the area.
So as the blood keeps pooling, pressure builds up,
and pressure on the brain
means the brain starts degrading and actually failing.
One of the ways we treat this is a craniotomy
where they actually take a portion of the skull out
and allow the area to heal.
- [Narrator] In 2015, at Soville Racecourse,
Brian defied his life-threatening injuries
to make an incredible sporting comeback.
- Wow.
The art of rehabilitation
is truly an underappreciated art.
That's why you gotta give a huge shout out
to physical therapists, occupational therapists,
speech language pathologists,
or actually many people don't know,
there's a specialty in medicine called PM&R,
Physical Medicine Rehabilitation.
There are rock stars in this space,
and I feel like a lot of times
they don't get adequate representation in medical media.
(horse neighs)
- [Announcer] That's when Jet goes berserk.
- What happened?
- [Announcer] The colt kicks Roy with all his strength.
- Oh my god.
- [Announcer] Punting him off the carriage.
- Oh my god.
- I heard a shot, and I didn't know what it was.
- The strength at which a horse kicks is just so scary.
I would never stand in the back of a horse,
and I know nothing about horses.
- [Announcer] When Jet kicked,
one hoof grazed Roy just below the temple,
then smacked him again on the way back down.
- Ooh.
- [Announcer] But the second, more dangerous blow,
happens when Jet's left metal shoe
punches Roy square in the chest.
- Oh yeah. That is so dangerous.
Especially if it happens during a very specific
electro conductive moment of the heart rhythm
that it could actually stop the heart.
This is called commotio cordis.
This is what most people speculate
happened to Damar Hamlin,
that a hit came to the center of his chest
causing his heart to stop.
This is frequently why you'll see some Little Leaguers
wear protection over their chest,
because they don't want a baseball
to be line drived directly into the chest.
But again, it has to happen in that exact,
exact millisecond.
- [Announcer] Was this quick-thinking moment right here.
(dramatic music)
While it appears Roy is kicked off the carriage,
he actually dives off,
just in time to avoid another brutal whack from Jet.
- And he took like an upper cut to the face,
just ate that steel shoe.
I know what that feels like,
but I didn't get hit by a horse.
I just got hit by this guy.
(horse neighs)
- [Announcer] He's played the Man of steel
in the Superman film.
- Christopher Reeve.
- [Announcer] Now Christopher Reeve
is in a Virginia hospital,
paralyzed and unable to breathe on his own.
- He has sustained complex fractures of the first
and second cervical vertebrae,
that have resulted in an injury to the spinal cord.
The extent of the damage is not known.
- I'm really glad that doctor said that,
while we know the physical situation of what happened,
we don't know the exact extent of the damage.
The spinal cord itself,
which sits inside the vertebrae,
which we frequently call the spine,
but that's just bones that protect the spinal cord inside.
When that has injury to it,
a lot of times we don't know
the extent of that injury until some time goes by.
In some instances, patients lose the ability to walk,
they lose sensation, they feel numbness and tingling.
And only after a few days go by
can we start understanding the situation more fully.
That's why when anyone after a spinal cord injury
comes out and says,
"I know exactly what's going on,
here's your prognosis, this and that."
Unless you know something like, more permanent,
like the spinal cord is severed,
you're gonna be making a lot of guesses and assumptions.
- [Announcer] 42-year-old actor
was thrown from his horse Saturday
while competing in an equestrian show-jumping event
in Virginia.
Reeve, who was apparently wearing a riding helmet,
landed on his head.
- Spinal cord injuries affect areas
below the region at where the injury occurred.
Sometimes that gets a little complicated
when you're in like the mid areas of the spine,
the thoracic areas of the spine.
'Cause depending on the level you're on,
you may have sensations in some areas,
you may have motor control of some areas, and others not.
But if you're having it that high up at C1, C2,
you're not gonna have ability to move,
you're not gonna have sensation.
It's gonna make life significantly different moving forward.
(horse neighs)
- [Announcer] Although Frank believes
he is born to be a jockey, his genetics beg to differ.
He weighs 142 pounds, much heavier than most jockeys.
Fate steps in when the owner of a horse named Sweet Kiss
finds himself without a jockey.
- The owner says,
"Listen, if you can lose 10 pounds somehow,
in a day, then you can ride this horse."
- Well first of all,
losing 10 pounds in a day is not unheard of.
Boxers lose way more than that
when they do their pre-weigh in rituals.
That includes sauna, excessive sweating,
limited fluid consumption,
fluid restriction, diuretic use,
for people who are pushing to the extremes.
I'm not recommending it,
I'm just talking about what people are doing.
Not healthy, but possible.
- We are talking about shadow boxing.
We're talking about running, fasting,
not drinking water, losing as much weight,
sweating, doing whatever he can,
to drop as much weight as possible.
- The next day when he weighs in,
he actually loses 12 pounds.
It's about eight and a half percent of his body weight.
This sort of rapid weight loss
is really taxing on the body.
- It's definitely taxing on the body,
and the biggest reason for that is electrolyte shifts.
In order for muscles to work,
you have to have a really good electrolyte balance.
It's not even enough just saying
that there's enough of them.
It's having enough in the right places,
and the way that electrolytes are distributed in the body
largely has to do with how much fluid is in your body.
So if you suddenly have a drastic decrease in fluid,
that can actually spike the amount of electrolyte
you can have in a specific area.
If you don't have proper electrolytes, people think,
"Oh, well yeah, you cramp."
But remember what also functions with the aid of a muscle.
Your heart is a muscle, your diaphragm,
your breathing muscles,
these are all also run by muscles,
and if the muscles aren't firing properly,
you could die.
- The horse that Frank Hayes is riding, Sweet Kiss,
enters as a 20 to one underdog.
The far and away favorite in this race
is a horse named Gimmy,
who was expected to just run away with this race.
- So it was a gimmy?
(laughing)
(bleep)
- Frank is living the dream.
Then he slumps forward at one point during the race.
- Hold on a second.
Is this the guy that we did the thing on?
- [Cameraman] There you go!
- Oh.
Run, baby, run!
He commanded, as Sweet Kiss inched further and further
ahead of the competition.
- He crosses the finish line in this hunched position.
- He has won the race.
Frank Hayes has done it.
He has achieved his dream of being a champion jockey.
- But he finished the race,
winning the race as a dead man.
- Frank Hayes falls off the saddle,
face first into the racetrack.
- As it turns out, Frank has had a heart attack.
He died before crossing the finish line.
- This is the part of the story
that I think is kind of BS.
If you weren't having EKG leads on him
while he was riding the horse, you're making *** up.
- Frank Hayes becomes the only person
in horse racing history
to ever ride across the finish line of a race
and win as a dead man.
- Cool story. I've used it before.
I wouldn't say it's necessarily true.
I think he died in the midst of a race.
Is it before the finish line?
Was it after the finish line?
Hard to say.
Technology wasn't advanced enough
to know when he had the heart attack.
Like, did we draw serial troponins?
The muscle enzyme that is released into the blood
when there's cardiac damage?
Did they even have an EKG in the 1920s?
- [Cameraman] Look it up.
- When did EKG become used for heart attacks?
By the 1930s.
In 1923, it's very unlikely that they were using the EKG
to be making the diagnosis of chest pain
from a heart attack.
This is a mysterious death doctors can't explain.
If you wanna see more of them,
including that animated story,
click here to check that out,
and as always, stay happy and healthy.
- [Cameraman] There we go!
(chill beats music)