I love a nice drive down a wide-open stretch of road as much as the next person. Windows down, music up, tearing through the countryside a little faster than recommended — now that’s living. I’ve been pulled over more times that I care to admit for a particular heaviness of my right foot. What can I say? Driving fast is great. Or at least it was great before I started working in trauma and taking care of patient after patient with devastating crash injuries. Fortunately, these experiences brought my lead-footed days to an end. The exhilaration of feeling the wind in my hair is simply not worth my life. 

I cringe now when I receive word that an incoming trauma patient fell victim to the same behavior I used to cherish. Rarely does a Level I trauma patient with an alert that reads “150 mph MVC (motor vehicle crash)” come in with a pulse. And speed does not discriminate. I’ve seen straight-A college students with non-survivable traumatic brain injuries because they were speeding home from the library in an effort to get a little more sleep before the final exam they were supposed to take the following day. I’ve seen road construction workers mangled while they were just trying to make a living, all because drivers refused to slow down in a work zone and clipped them coming around a curve. 

Not only are the injuries more plentiful and severe for patients injured at higher speeds, but their physiology is altered by the sheer blunt force of impact. Traumatic rhabdomyolysis, compartment syndrome, pulmonary contusions, blunt cardiac injuries,  and blunt cerebrovascular injuries are all things I encounter much more frequently when a patient was traveling 80 mph than when they were traveling 15. A broken leg, in isolation after a low speed injury, is a much more straightforward problem than a broken leg with compartment syndrome and rhabdomyolysis. 

Very few people have had the first-hand experiences I have had, thankfully, and so rather than relying on an appropriate level of fear and caution within each driver, there are laws about how fast one can drive. Speed limits, though seldom followed strictly, are meant to require travelers to maintain a speed that is safe for them and fellow travelers. Civil engineers determine what constitutes a safe range of driving speeds based on a variety of factors. Traffic accidents and fatality rates have been shown time and time again to be directly correlated with speeding. According to the National Highway Traffic Safety Administration, speeding has been a contributing factor in around one-third of all traffic fatalities, a statistic that hasn’t budged despite numerous advancements in car safety in recent years. Unfortunately, this makes sense. No air bag, no matter how fancy, can reliably cushion a 100-kilogram body traveling at 100 mph. After all, momentum equals mass times velocity, and we can’t change the laws of physics. 

Although we all know somewhere in the deep recesses of our consciousness that we take our lives into our hands each time we get into a car, it’s a fact upon which we choose not to dwell, because there really are no appropriate alternatives in most of the country. But what if, instead of avoiding certain roads or modes of transportation, we could simply make roads safer for everyone by eliminating speeding once and for all? When you consider that an average of 100 Americans are killed every day in traffic collisions, it suddenly feels like giving up the freedom of a gravity-prone foot is probably worth it. If 100 Americans die in motor vehicle crashes per day, and a third of those were speeding related, our collective sacrifice of pumping the gas from time to time could save the lives of at least 30 American mothers, fathers, sons, and daughters, every single day. I would gladly make that trade.

It may seem like a pipe dream, but the truth is that technology capable of limiting the speed of vehicles has actually been around for decades. The United Kingdom has a history of successfully using speed limiters, also known as speed governors, for mopeds, public vehicles, and heavy goods vehicles going back as far as 1977. 

There are certainly lots of issues that might come to mind immediately were vehicles forcibly restricted to the highest speed limit in the country. Although it might be perfectly safe to travel at 70 mph down a deserted and flat stretch of highway in rural Texas, it is probably not safe to do so in a crowded residential area. Enter geolocation technology, and its pairing with speed limiting devices. This combination can use your current geographic location to set your maximum allowable speed. Not only can speed limits be tailored to location, but several models also offer “override” functions, where you can override the speed restriction by firmly pushing down on the accelerator for a period of time, giving you the freedom to pick up the pace if your passenger is suddenly having severe chest pain. 

Is it a perfect solution? No. The perfect solution would involve eliminating the need to drive anywhere or safety mechanisms so sophisticated they somehow prevented vehicles from crashing. But short of those options, I do think that speed governors could be a solution. And I believe that this solution can be made palatable to Americans via features such as the override function and the potential benefit of saving 30 lives from needless tragedy each and every day. 

Have you provided medical care for car crash patients? Share your experiences below.

Dr. Danielle Pigneri is a trauma and acute care surgeon practicing in the Dallas-Fort Worth metroplex. When not working, she enjoys her other job, being a mom to two sweet young children. Dr. Pigneri was a 2022-2023 Doximity Op-Med Fellow, and continues as a 2023-2024 Doximity Op-Med Fellow.

Illustration by April Brust