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From Patient to Safety Advocate

Rachel Johnson, who sustained a brain injury in an e-scooter crash, aims to improve the safety of this new mode of transportation.

Like many people who’ve hopped on the nation’s newest street transportation trend, Rachel Johnson had never ridden an electric scooter before.

But the 28-year-old physical therapist was in a hurry to get to a soccer match one weekend in May 2018 in Nashville. While walking to the field, she and a friend jumped on a pair of parked scooters to make sure they made it on time. Rented by the mile through a phone app, the scooters had come to Nashville in a wave just weeks earlier. Riding through a busy intersection, Rachel and her friend were struck by a car. The impact sent Rachel flying 50 feet, causing occipital and temporal fractures in her skull and a diffuse axonal brain injury. She was rushed to Vanderbilt University Medical Center, where she lay in a coma for nine days.

Her friend sustained a compound leg fracture and a concussion.

“They told my parents I was hour-to-hour,” Rachel says. “I don’t remember even going to Nashville.”

After two-and-half weeks at Vanderbilt, and another two weeks at Select Specialty Hospital in Knoxville, Tennessee, where she lives, Rachel transferred to Shepherd Center’s Brain Injury Rehabilitation Program.

During her four weeks at Shepherd, Rachel went from using a wheelchair and not remembering her age, to walking on her own and solving 100-piece jigsaw puzzles.

“Everyone there was insanely nice,” Rachel says. “They push you in all the right ways.”

Rachel spent another six weeks at Shepherd Pathways, Shepherd Center’s outpatient rehabilitation program for people recovering from brain injury.

She continued intensive therapy while living with her parents in Oak Ridge, Tennessee, her hometown.

In November, about six months after her crash, Rachel returned to work at the University of Tennessee Medical Center. She recently bought a house in Knoxville and ran six miles in the Knoxville Marathon’s relay event.

Though Rachel has experienced a remarkable recovery, she remains concerned with electric scooter safety. She talked with the mayor of Knoxville about her experience and says cities are often unprepared for issues that arise from the scooters’ sudden and seemingly ubiquitous appearance. She also says e-scooter companies don’t sufficiently prepare riders for the dangers.

“Cars don’t even see motorcycles, let alone bicycles, let alone e-scooters,” she says. “There are no helmets to rent; the companies say they’ll mail you a helmet, but who’s going to know they’re going to need a scooter in five days? There needs to be better rules for where they can go.”

Hospital emergency departments around the country have seen increases in scooter-related injuries. Doctors at Vanderbilt University Medical Center, where Rachel was initially taken, report almost an injury a day related to scooters, including one or two traumatic brain injuries each month.

Cities have responded in various ways.

In Salt Lake City, Utah, where ER doctors reported a 161 percent increase in scooter-related injuries, city officials distributed helmets and safety leaflets on downtown sidewalks with representatives from Bird and Lime, two of the largest e-scooter companies.

After a scooter-related death in Austin, Texas, which has one of the nation’s highest scooter-to-citizen ratios, city leaders asked the Centers for Disease Control and Prevention (CDC) to investigate scooter crashes and injuries.

In Atlanta, the City Council recently passed a resolution asking local hospitals and healthcare outlets to voluntarily track scooter-related injuries. The results will help the city write new safety requirements.

Atlanta’s Grady Memorial Hospital estimates it treats as many as 100 scooter injuries a month. As a result, Grady, among the nation’s busiest Level 1 trauma centers, has launched an internal project looking at the rise and scope of such injuries.

Scooters are lauded by many as a clean, convenient alternative to cars on city streets. Yet as with any new form of transportation, experts say, both riders and city officials need time to adjust to the risks.

“We’re definitely in period of flux,” says physiatrist Ford Vox, M.D., who is also medical director of the Disorders of Consciousness Program at Shepherd Center.

“A big experiment is taking place right now. We’re learning how dangerous they are and what types of injuries are happening. Gradually, we’ll figure out ways to make it safer.”

Written by Drew Jubera

About Shepherd Center

Shepherd Center provides world-class clinical care, research, and family support for people experiencing the most complex conditions, including spinal cord and brain injuries, multi-trauma, traumatic amputations, stroke, multiple sclerosis, and pain. An elite center recognized as both Spinal Cord Injury and Traumatic Brain Injury Model Systems, Shepherd Center is ranked by U.S. News as one of the nation’s top hospitals for rehabilitation. Shepherd Center treats thousands of patients annually with unmatched expertise and unwavering compassion to help them begin again.