HUNTINGTON, N.Y. - On May 24, a day that was to have been Nelson Morales' last on a roofing job, his vision clouded suddenly, and he slumped backward toward the roof's edge.
On the ground below, a broom that had slipped from Morales' grasp clipped his uncle, Alexis Perdomo.
An instant later, Perdomo heard the sickening thump of his nephew's body hitting the ground.
"He was laying like he was dead," said Perdomo, who came to Long Island with Morales from a remote farming village in Guatemala three years ago, lured here by the promise of earning as much as $100 per day. "He wasn't breathing, and foam was coming from his mouth."
Now, Morales lies in Huntington Hospital, unable to move or feel anything below his chest.
He hopes against hope that he will regain the use of his legs, which lay shriveled and motionless under the covers of his hospital bed.
"The doctor told me I will not be able to walk again, but I don't believe him," said Morales, a wiry 24-year-old who before his accident played soccer several times a week.
That disbelief pains Dr. Arnold Schwartz, the surgeon who knitted Morales' shattered spine together during 6 1/2 hours of emergency surgery.
"He is still in denial," Schwartz said. "Because we've told him over and over there is no recovery from a spinal cord injury like this one."
Morales' experience provides a window into the world of undocumented day laborers who face injury in the underground economy that provides cheap labor for roofers, landscapers, tree surgeons and other businesses that support the lifestyles area residents demand.
When workplace tragedy strikes, immigrant workers typically are far from the support of loved ones and family resources, and they often find it difficult to get workers' compensation and other employee protections that would help them get back on their feet.
Schwartz said Morales' fall caused two of his vertebrae to splinter and dislocate right behind his heart.
The dislocation cut the spinal nerve near the bottom of the shoulder blades, leaving Morales unable to control voluntary functions below his chest.
He cannot wiggle his toes. He cannot feel pressure or pain.
"But he's lucky," Schwartz said. "He could have torn his aorta in a fall like that, which would have meant he would have bled to death before the ambulance got to him."
This is the second time Morales has been seriously injured since coming to Long Island. In 2001, he fell into a coma after a fellow day laborer punched him and he hit his head on the ground.
That time, his mother was able to come from Guatemala and care for her son for several weeks.
But this time she has been unable to persuade U.S. immigration officials to allow her to be with her son again.
So he passes his time mostly alone at Huntington Hospital, comforted by the patter of a Spanish-language television station, and by visits from relatives and other day laborers.
Morales worries that he has no way of paying a hospital bill that has zoomed past $260,000 - not counting fees for the services of more than a dozen physician specialists - with no end in sight.
He says the contractor whom he worked for paid him off the books. Since the accident, he said, the contractor has not returned his phone calls.
Several telephone calls to the contractor who Morales and fellow workers say had employed Morales for about two weeks, including the day he was injured, were not returned.
Labor experts say a person in Morales' position typically can file a successful claim for medical expenses and lost wages through the New York State Workers' Compensation Board's Uninsured Employers Fund.
In turn, the board can file a judgment against an uninsured employer, creating liens against the employer's property and possessions.
State law shields employers from employee lawsuits for workplace injuries, even when employers are negligent. But in exchange, employers are required to obtain workers' compensation insurance to cover workplace accidents.
Employers who fail to insure their employees face civil and criminal penalties.
Last year, the board collected $5.4 million in penalties from uninsured employers and paid out $16 million to injured workers on their behalf.
"Without having to worry, he can have medical treatment for the rest of his life," said Martin Minkowitz, a former counsel for the board, who teaches workers' compensation law at New York Law School.
The fund covers workers regardless of their immigration status and country of residence, Minkowitz said, meaning that Morales could continue to receive medical expenses and as much as $400 per week for lost wages, even if he returns to Guatemala.
Morales left his village of Santa Rosalia in 2000.
Expatriate workers are the biggest export of that corn-and-beans village near the Honduras border, where about 1,000 inhabitants struggle to squeeze a living from the soil.
Most men leave town to find jobs, residents there say, leaving young boys and older men as the only males around.
"In Santa Rosalia there are only fields to grow corn and frijoles, so teenagers run away in search of a better life elsewhere," Morales' elder sister, Lillian Morales, said during a recent telephone interview from Guatemala. "Men must also find a job out of the village if they want to feed their children." The fall has left Morales uncertain about where his life will go from here.
The only thing that seems certain, say Morales' doctors, is that he will remain paralyzed for the rest of his life.
But Morales has not accepted his doctor's opinion as final.
"I trust God," said Morales, fighting back tears. "He helped me once, and I don't think he will let me remain like this."