Quis custodiet ipsos custodes?

[Megan]  Radley Balko on Jon Corzine's car accident:

As you might guess, I'm not going to criticize New Jersey Gov. John Corzine for choosing to not wear a seatbelt. And I find the suggestion from one of his aides that he be issued a citation for not buckling up back when Corzine was fighting for his life mind boggling.  Who thinks like that?

I do wish Corzine the best, and I hope he recovers in full.

But there is a legitimate public safety issue, here.  And it's this:

he SUV carrying Gov. Jon S. Corzine was traveling about 91 mph moments before it crashed, Superintendent of State Police Col. Rick Fuentes said Tuesday.

The governor was critically injured when the vehicle crashed into a guardrail on the Garden State Parkway just north of Atlantic City last week. He apparently was not wearing his seat belt as he rode in the front passenger's seat.

The speed limit along that stretch of the parkway is 65 mph.

The state trooper-driven sport utility vehicle was in the left lane with its emergency lights flashing when a pickup tried to get out of its way. Instead, it set off a chain reaction that resulted in the crash.Corzine was late for a meeting (between--guess who!?!--Don Imus and the Rugters women's basketball team). So his driver rushed him through traffic. At ridiculously high speeds. And caused a serious accident.

When you live in the D.C. area, this kind of thing happens all the time (not the accident, the VIPs taking over the road), and just from personal observation, I'd say it's happening more frequently. There seems to be an increasing feeling among many politicians that their meetings, their business, and their appointments are somehow more important than everyone else's. Therefore, they can fly down highways, ignore red lights, and purge everyone else to the side of the roadway. If they can get their own police escort or caravan, even better.

I get caught in a caravan in D.C. about once every two weeks. When it's the president or vice president, it's merely annoying. They shut down all the streets on the route a good 3-4 minutes before the caravan arrives. And I'll concede that there are probably good security reasons for the president and vice president to travel like this, though they do tend to abuse it (Bush has shut down cities in the past during rush hour in order to attend political fundraisers). 

When it's not Bush or Cheney, it can be downright scary. You glance in your review mirror to see a limo or three or four barreling up at you, flashing their lights. When you're already in freeway traffic moving at freeway speeds, everyone scrambling to get out of the way, it's not difficult to see how this can be pretty dangerous.

Increasingly, lesser-ranking public officials seem to think they shouldn't have to obey traffic laws, either. Why was Gov. Corzine's meeting that day more important than the meetings of everyone else on the road? Why was it so important that he had to endanger everyone else on the road?  Because he's an elected official?  Posh.

He's absolutely right.  Still, you really should wear your seatbelt:

Did you ever notice how often the words “unrestrained passenger” turn up in Trauma: Life in the ER just before something Really Messy rolls in the door? In a collision, you have three or four sub-collisions all taking place in sequence. First, the vehicle hits some object. The vehicle abruptly slows, but unrestrained objects inside it continue at the same speed, in the same direction. Then the unrestrained body hits the interior of the vehicle, and starts to slow. That’s the second collision. That body’s internal organs are still moving at speed until they hit the inside of the chest (or get cheese-sliced by their supporting ligamentsand that’s where you get things like bisected livers or aortas). The fourth collision is when the bowling ball you left on the rear deck hits you in the back of the head, because that continued at the same speed in the same direction. Newtonian physics: Learn it, live it, love it.

There are two major routes that unrestrained persons take in a front-end MVA (Motor Vehicle Accident). Up-and-over or down-and-under (AKA “submarining”). With up-and-over, the upper body launches forward and up. The head strikes the windshield. (This produces the classic “windshield star”) Your injuries here include concussion, scalp laceration, and various brain bleeds. You can suspect fractured cervical vertebrae (and if you have a fracture with compromise to the spinal cord at C-4 or higher, you’ve lost the nerves that control chest expansion and the diaphragm. “C-4, breathe no more,” as the saying goes).

Go a little farther through the windshield, and it isn’t unexpected to leave some or all of your face behind stuck in the broken glass. You’d be surprised by how easily faces come off the facial bones. You can also expect fractured wrists, arms, and shoulders, from folks trying to brace themselves. A little farther through the windshield, all the way out of the vehicle (a situation we call “pre-extracted for your convenience”), and in addition to whatever damage you took on the way through, you get the damage from hitting the ground, trees, and metal poles at however-many-miles-an-hour.

Sure, you hear people talking about wanting to be “thrown clear” in the event of an accident. If you want to simulate being “thrown clear,” go to the fifth floor of a building and jump out the window. Let’s talk briefly about being thrown clear, because it happens more often than you’d think. Unrestrained driver: side impact. Vehicle spins. Driver goes out the window. In one case I recall, the driver was half-way out his window when the vehicle rolled over on top of him. That was the second-most grotesque scene I’ve ever been to. Another scene, the driver went out the window when it spun. The vehicle went into a snow bank and was drivable from the scene. The driver went into a river and drowned. Any time you go to an accident and the windows aren’t rolled all the way up and unbroken, look 200 feet in all directions for the other patients. It’s pure heck finding them three days later when someone wonders why all those birds are over there, or when someone at the hospital wakes up enough to ask “Where’s Joey?”

Okay, let’s look at down-and-under. In this one the patient goes forward and down, under the dashboard. Here’s where you’re going to find fractured femurs, broken knees, and compression fractures to the lower spine. If you’re asking “Is it possible for a human femur to be pushed through the floor of the pelvis?” the answer is “Yes.” If you ask me how I know that, the answer is: “Seen it done.” Unrestrained driver, 40 MPH impact. As the legs collapse accordion-style, the patient’s chest hits the dashboard. This can give you rib fractures, a fractured sternum, cardiac bruising, or that ruptured aorta that we all love so well. The nice thing about going submarining is that there usually isn’t any brain damage (unless you got clonked on the knob by that bowling ball, and seatbelts won’t help with that). On the other hand, femur fractures can be, and frequently are, fatal.

I think I’ll leave Traumatic Asphyxia, Hemo/Pneumothorax, and Flail Chest for the Trauma and You post that I’m going to do one of these days. Let’s just say that they’re associated with having your chest hit the dashboard or steering wheel, and they Really Suck (and not in a good way).