Medicine: Death in Manhattan

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Ever since Freudian patter became the common currency of the cocktail hour, the idea has been spreading that people who have accidents are "accident-prone." But for a massive group of accident victims—the 8,000 U.S. pedestrians killed each year by motor vehicles—there is no clear medical evidence one way or the other. Last week an American College of Surgeons meeting in Boston learned the results of an intensive and ingenious study that enlisted experts from the New York State Department of Health and the Bureau of Motor Vehicles, Cornell University Medical College, the office of New York City's chief medical examiner, and the police department.

For six months, investigators logged the place and hour of each adult pedestrian fatality in Manhattan. Then, reported Dr. William Haddon Jr., a team went there at the same hour the next day and interviewed the first four pedestrians who happened along. The researchers went so far as to collect breath samples from them. The victims presumably differed somehow from their neighbors who crossed the same streets safely at the same hours. How?

¶ Of the 50 adult pedestrians who were killed, 74% had been drinking cornpared with 33% of the chance passersby.

¶ Average age was 59 among the fatalities v. 42 among the others.

¶ Foreign-born made up 63% of the victims v. 45% of the others.

More surprising but less illuminating were some random facts: most pedestrian deaths occurred on straight streets with no unusual obstructions, and in good weather (though in rain and poor visibility, the toll increased). Except for the Bowery, heavily congested business districts had fewer fatalities than residential areas with lighter traffic.

For the surgeons as well as for pedestrians there was a sharp lesson. Many people hit by vehicles show no obvious sign of life-threatening injury, yet die within hours. The explanation, said Harvard's Dr. Richard Ford, is simple: fracture of the pelvis. Doctors too often overlook this injury, and should bear it in mind when examining every accident victim.