• head injury
• motor crashes

Sometimes we don't respond to the statistics on trauma among adolescents because they are so mind numbing. Stereotypical views of adolescents as reckless and irresponsible also may inhibit our prevention efforts. Too often we focus on mortality and ignore morbidity. The difference between the two is measured in fractions of a second at the time of the injury event and forever in the lifetime of the survivors. Let me illustrate what I mean by telling you about Rhonda.

I first saw Rhonda as a patient when she was 15 years old. She had come from the Okanagan Valley and was referred because of acting out behaviour. She came from a religious family. Her mother was a homemaker and father ran a small contracting business. The family was very respected, had a reasonable standard of education, and a comfortable lifestyle. Rhonda had been an above average student who did not smoke or drink, and was an accomplished pianist. At least that is the way things were before she was injured.

It was a hot, clear summer day when Rhonda hitched a ride home from a schoolmate. They had been at the beach with friends. Steve was 16 years old, had had his driver's license for three months, and was driving his “new” pick-up truck. He was very proud of it. They set out for town with four teens in the front cab and three, including Rhonda, sitting in the back. They had shared a few beers so every one was happy but not drunk. No one except Steve was wearing a safety belt. It was supposed to be a fun filled 20 minute ride but it proved to have a lifetime impact.

The last thing Rhonda remembered was the three of them sitting in the …