About five in the afternoon on a weekday trauma shift we got a call from Native Air, a helicopter medical transport service, about a 17-year-old they were bringing us with multiple fractures sustained in an ATV crash. The accident happened way up in the northern part of the state near St. Johns, a ranching community that borders the Navajo reservation. His vital signs were stable, and they had medicated him for pain and would arrive in 10 minutes. The trauma team assembled in the bay closest to the elevator from the helipad. About 9 minutes later the elevator doors opened and the helicopter crew wheeled our patient in on their flight gurney. I took one look at the patient and cursed under my breath. He had a triangular face with a broad forehead and narrow jaw and chin. His chest was wide and deep, barrel-shaped is the term. His limbs were painfully thin with knobby joints and marked curvature of the long bones, those that weren’t already splinted. His eyes were striking—deep blue, and the sclera, the white of the eyes, were the color of a new robin’s egg. All the markers of Osteogenesis Imperfecta. What the hell was he doing on an ATV? Osteogenesis Imperfecta, also known as ‘brittle bone disease,’ is a genetic disorder, a gene mutation that causes defective collagen synthesis. It may vary in severity, but the classic expression causes weak bones that can break under the patient’s own weight. A sneeze can break ribs. A simple stumble can result in a broken hip or ankle. Patients usually end up confined to wheelchairs by their...