The recent deaths of Alejandro Tello, who was struck by an SUV while crossing an intersection on his skateboard, and Neftaly Ramirez, who was sideswiped by a garbage truck while riding home on his bicycle, underscore the perilous dangers we all face on New York City’s streets.
As an emergency physician, I’ve spent my career in busy, urban ERs treating hundreds of heart attacks, strokes, respiratory problems and broken bones. But when I moved to practice in Brooklyn — where both of these recent accidents occurred — I was struck by the number of patients with significant injuries due to traffic-related accidents, particularly traumatic brain injuries, or TBIs.
Brooklyn’s hospitals treat more than 1,200 cases of TBI annually — more than any other borough. It is conservatively estimated that more than 15% of these TBIs are the result of car-related accidents. (Comparatively, 40% are the result of falls.)
With the densest population in New York City, it is not surprising that the borough has the highest number of accident-related head traumas. Its wide avenues are conducive to speeding — which, in turn, leads to serious accidents and horrific patient outcomes.
Drivers share Brooklyn’s busy roadways with bicyclists, who are often struck by speeding motorists, and vulnerable pedestrians, especially the elderly. In fact, older, less agile people who are involved in traffic accidents have a higher likelihood of extremely serious injury, as many suffer from other medical issues that complicate treatment and recovery.
So what can we do to prevent TBIs and many trips to the ER? First, we need to slow down traffic. Statistics show that if someone is hit by a car at 20 mph, they are 10% likely to die. If they are hit at 30 mph, they are 50% likely to be killed, and at 40 mph, their odds of dying skyrocket to 90%.
Because of these staggering statistics, I applaud Vision Zero initiatives that have reduced posted speed limits on major streets. Along Brooklyn’s Fourth Ave., a street near my hospital once prone to speeding, the implementation of a new speed limit, school speed cameras and a street redesign have greatly reduced pedestrian crashes.
However, for all of the success of Vision Zero, the DOT reports that pedestrian and cycling deaths citywide have mostly stayed flat since the program’s inaugural year in 2014. We need to broaden the use of street cameras, which have statistically proven to lower the number of accidents at signalized intersections. Lawmakers need to particularly seek to expand their impact beyond just areas around schools.
There are other steps I would also recommend: We must improve lighting and street signage; create barriers to discourage jaywalking; install more countdown clocks at crosswalks; designate more bicycle lanes; and widen medians where pedestrians caught mid-crosswalk can wait more safely. This is particularly important in the outer boroughs.
The health-care community also has a role to play in reducing TBIs and treating them effectively when they do occur. Most importantly, we have to make life-saving services that address these injuries more accessible throughout the five boroughs.
At my hospital, NYU Langone Hospital-Brooklyn (formerly Lutheran Medical Center) in southwest Brooklyn, our Level 1 trauma service — the only one in the borough verified by the American College of Surgeons — includes a highly qualified team comprised of full-time trauma and critical care surgeons on-site 24 hours a day, as well as the latest technology to quickly diagnose and treat TBIs and other cerebral injury like stroke.
There is a saying in the medical profession, “time is brain,” meaning the sooner a cerebral injury such as trauma or stroke can be addressed, the less likely there will be permanent damage.
Other health-care providers should follow our lead in offering educational outreach in the community to the most vulnerable — kids in schools, their parents and families, and adults in senior centers and other neighborhood facilities.
We can treat damaged brains, repair internal injuries and fix broken bones. But, even after rehabilitation, many survivors of traumatic brain injuries are forever changed by their injuries. As capable as ERs are at saving lives, there is no substitute for prevention. Safety is everybody’s business and everyone’s responsibility.
Gavin, MD, is chief of emergency medicine at NYU Langone Hospital-Brooklyn.
