Tom Wilemon, The Tennessean
Brittany Leedham points to the stains on a hackberry tree.
"This is my blood," she says.
Rain cannot wash it away. She was in a speeding convertible Mustang GT with her boyfriend on Nov. 29, 2008 - the Saturday night after Thanksgiving - when Zak Kerinuk lost control. The car wrapped around the tree like a crushed Coke can.
He died. She almost did.
Her flesh embedded into the bark of the hackberry. One leg was degloved of tissue, and she lost half her blood. Besides broken legs, she fractured her pelvic bone, three fingers and the second vertebra in her neck.
Just over three years later, after 21 surgeries with another one scheduled in May, she stands in front of that tree on Holt Road in Brentwood wearing shorts, her legs as misshapen as its gnarled branches. Leedham knows what happened is not the tree's fault. She blames the teenage sense of indestructibility.
Tennessee has a 15 percent fatality rate for drivers ages 16 to 17 who are involved in crashes - the 12th-highest in the nation, according to statistics from the U.S. Centers for Disease Control and Prevention. It's a problem across the South because of its winding rural roads, scarcity of trauma centers and love of vehicles not built for safety. Not all public high schools here offer driver's education classes, and many teenagers don't abide by age-specific rules to prevent wrecks.
Tennessee has a law that forbids teenagers from piling up in one vehicle. Dr. Tom Abramo, physician-in-chief over pediatric emergency medicine at Monroe Carell Jr. Children's Hospital at Vanderbilt, says it's not being followed.
"The majority of cases are when a bunch are riding together," Abramo said. "It's rare that we see it as single-person involvements."
Too many teens in a vehicle is just one item on the list of bad driving behaviors, but it leads to other risky actions - not wearing safety belts, distracted driving, underage drinking and speeding. Last fall, the Vanderbilt children's hospital began a pilot program at two Middle Tennessee campuses, Station Camp High School in Gallatin and East Robertson High School in Cross Plains, to better engage teenagers about safe driving. Next year, it is looking to partner with other schools in Robertson, Dickson and Wilson counties because that's where the most crash victims in this area are coming from.
Season of risk
The Cross Plains school held an assembly program Friday focusing on the dangers of texting behind the wheel and driving while drinking. It featured a landing by Vanderbilt's LifeFlight helicopters.
"Being responsible for 746 students, I feel like the more we can educate them about this and make them aware of the dangers, that's part of my job," said Principal Mary Cook. "It's not only to teach them academically but to teach them social responsibility."
But school won't be in session this summer, the time of year when teenage motor vehicle accidents spike. It's also "off-roading" or "mudding" season. Vanderbilt is already admitting three to four patients a weekend injured on all-terrain vehicles.
"We just saw a child who was riding his ATV who got hit by a car and has significant head injury, a femur fracture and a fracture to the left arm," Abramo said. "He was a 14-year-old."
Rural and suburban areas are where teenagers are more prone to be injured in all types of crashes, said Purnima Unni, the hospital's pediatric trauma prevention coordinator. Crashes are the leading cause of hospitalizations for its patients ages 10 to 19.
"Between 2008 and September 2011, we saw more than 680 admissions that involved teens 14 to 19 years of age," Unni said. "To me, the more startling thing was about 46 percent of them - close to 50 percent - were not wearing their seat belts. There are definite concerns that need to be addressed."
After talking with injured teens, she realized the prevention campaign needed to be brought to the schools. In the past, health officials have advocated for increasing the age for a driver's license. But driving a car is a rite of passage, just as "off-roading" is a way of life.
"If children get minor injuries in an ATV accident and come in, it's really hard to talk to parents," Unni said. "To them, it's almost like riding a bike."
The CDC gives parents of teenage drivers valuable advice through its Parents Are the Key program (www.cdc.gov/parentsarethekey). The agency also supports graduated driver's licenses, which basically give young drivers training wheels. In Tennessee, the restrictions range from not being allowed to drive from 10 p.m. to 6 a.m. to limiting the number of teenage passengers.
Family car is safest
Nationwide, teenage deaths from crashes are on the decline, but CDC epidemiologist Ruth Shults is still wary. She worries that the bad economy may be a factor in that trend. Fewer parents have been able to buy cars for their teens since 2008.
"The safest car for a young person to drive is one that is shared in the family," Shults said. "Once a young person gets his or her own car, probably because they drive more - and possibly some other reasons - they are more likely to crash their own car than the family car."
Leedham's boyfriend's Mustang was exceeding 70 mph when the crash occurred that Thanksgiving weekend. Her first memory afterward is being told two weeks later that Kerinuk, 19 - a young man with eyes so blue they almost glow in photographs, an aspiring mechanic at Nashville Auto-Diesel College - didn't make it.
"He absolutely loved his car," she said. "It was his life."
Leedham spent four months of her 17th year at the Vanderbilt children's hospital. She underwent so many blood transfusions that her iron levels spiked, causing her to lose her hair. She would not eat. She went from an athletic, 150-pound member of the high school swimming team to a skeleton of her former self.
"I had no sympathy for anybody else," she said. "I was a very mean patient."
But on graduation day from Father Ryan High School, she was able to walk across the stage. She had studied from her hospital room. She had persisted.
Now a senior at Middle Tennessee State University in Murfreesboro, Leedham is on schedule to graduate later this year with a degree in recreational therapy. She will be interning at Vanderbilt this summer, helping hospital patients recover through fun activities. She knows what it's like to live with limitations. She tried swimming again, but she has so many rods, screws and anchors in her legs that they weigh her down.
Leedham still has to wear a brace on her left leg and is scheduled for surgery next month to remove scar tissue in her abdomen. As a volunteer with the Trauma Survivors Network at Vanderbilt, she got a dismissive look from an injured teen during one of her first hospital visits when she wore long pants.
Now, she makes a point of showing her scars.
"They can see I actually know what I'm talking about. ... I don't sugar-coat it," she said. "I don't come in smiling big and all happy, because it sucks being there. I tell them recovery doesn't end. It's an ongoing process."