By Dr. Darren Markland
James can’t remember the accident. A year after leaving the intensive care unit and struggling through his rehabilitation at the Glenrose Hospital, relearning how to speak and walk and trying to step back into the life he left behind on the that fateful September morning, James still can’t remember being hit by the car.
The paramedics found him face down in the middle of a residential road, his face covered in blood. His body had been flung 10 metres away from the end of the skid marks on the road. He had been in the crosswalk, but the sun was just rising and likely had been in the eyes of the eastbound driver. Witnesses said the car was not speeding. The impact speed was estimated at 40 kph.
James’s injuries were devastating: two broken legs, multiple broken ribs and facial bones, and, most concerning, a severe traumatic brain injury. The collision report described a shattered windshield, with a basketball-sized depression in the centre of it. James’s skull had made that impression. I knew that the swelling in his brain would, if he were to survive, change his life forever.
As a critical-care physician, I encounter tragic stories like James’s far too often. Every time I care for a pedestrian or cyclist involved in a collision with a motor vehicle, I think about speed limits on our roads.
Research worldwide has proven that the risk of death or serious injury increases exponentially as vehicle speeds exceed 30 kph. Head injuries make up 15% of those who are seriously harmed. In pedestrian-heavy areas, speed reductions afford drivers more reaction time to avoid collisions and, in impacts with pedestrians, improve the odds of avoiding death or serious injury. It is an unequivocal fact: slower speeds on residential streets don’t just prevent deaths, they preserve lives.
The effects of collisions at 40 kph are often catastrophic and life-long for pedestrians and cyclists.No amount or type of medical therapy can restore someone with a traumatic head injury to their previous self. We can pin the bones, release the pressure on the brain and treat the accompanying shock and bleeding, but patients are rarely ever the person they were before a brain injury. The repercussions in loss-of-earning potential, compounded by ongoing need for social and financial support required multiplied over the remainder of their life span, costs millions per case. The only recourse is prevention.
Edmontonians want a healthier city. Enriching the urban landscape with active transportation options has clearly demonstrated health benefits, with reductions in the incidence of diabetes, vascular disease and dementia. Key to maintaining this goal and keeping people active is the assurance of public safety. Reductions of speed limits in residential areas is the equivalent of seat belts in cars. One hopes they’ll never be needed, but they can save your life in a collision.
Lower speed limits help to not only save lives; they can revitalize neighbourhoods and make them healthier places. When streets feel safe, families, children, and seniors go outside more. People form social connections, which in turn have benefit the physical and mental health of communities.
As his doctor, I got to know James well during his four-month stay in hospital. His mother and I chatted often about his former life. He had been fresh out of university, just starting his job as a high school math teacher. He had been an accomplished artist who worked in water colors and was training for his first marathon. He had played the guitar and had recently bought a mandolin.
James made a remarkably quick recovery and eventually left our unit for further rehabilitation. In total he underwent four surgeries and survived two separate bouts of pneumonia. He spent six more months in a rehabilitation hospital. Despite this, he was never the same. He was unable to teach again. He just didn’t have the short-term memory to keep a classroom organized. James also struggled with depression and severe anxiety, and his daily headaches were more powerful reminders of his accident than the scars on his face. He has receded socially as well, often spending weeks in his apartment alone. The world moves too fast for him to keep up on most days. He jokes about selling me his mandolin.
We need to slow down vehicles on our residential streets and normalize human speeds in our neighbourhoods. The research is indisputable: collisions between pedestrians and vehicles going 50 kph are deadly. Some have argued that a reduction to a speed limit of 40 kph is enough. It isn’t. As James’s story illustrates, with a vehicle moving at 40 kph, a momentary distraction, a flash of sunlight, can result in a lifelong disability or worse. From a medical perspective, a residential speed limit of 30 kph is the safest course. Sure, it may add a few seconds to every vehicle trip, but aren’t human lives worth it?