YES, DRIVING IS MORE DANGEROUS NOW

After decades of declining fatality rates, more people are speeding, plowing through intersections, and driving impaired

- Matthew Shaer

During her residency at the Albert Einstein College of Medicine in the Bronx, New York, Deborah Kuhls, MD, had been taught how to handle what's known in the trade as penetrative trauma—stabbings, impalements, gunshots. Then, as a surgical fellow at the R Adams Cowley Shock Trauma Center in Baltimore, Maryland, she underwent an education in blunt-force injuries, which are often considerably harder to diagnose: A body battered in a car crash tends to yield fewer clues than a gunshot wound—the damage can be invisible to the untrained eye.

“If you're going very fast, and then suddenly you're not, the floppy parts of your body—your intestines, your kidney, your liver—will keep going,” Dr. Kuhls says. “That’s just plain physics. And our brain is floating in our skull, surrounded by fluid. But what if the skull bounces around or the car roof caves in and connects with the driver’s head? It might not look like it, but that person is probably bleeding to death internally. You don’t have much time to save them.”

The center sees a particularly high proportion of the region’s car and motorcycle crash victims, and not everyone can be saved. On bad days, it can seem as if as many patients are being shipped down to the basement morgue as are being revived. Dr. Kuhls worked alongside a surgeon named Carl Soderstrom, who was an unusually committed chronicler of data. When evaluating patients, he made it a point to collect information on everything from the size and scope of their wounds to the number of intoxicants percolating in their systems. It was one thing, Dr. Kuhls believed, to talk about a roll-over wreck that broke a 13-year-old girl’s neck. It was another to be able to prove that dozens of children were being injured in similar crashes every year.