I chose a career in emergency medicine because it was the only specialty I could imagine in my 20s that would interest and challenge me when I was 50 and beyond.

I’m 50 now and in most ways I was right. I have the best job in the world and am still excited coming into work. I’m the Director of Emergency Medicine at the Royal Darwin Hospital. Some of the challenge of my job is for a reason I didn’t anticipate in my 20s and sometimes find difficult to reconcile myself to. It comes from the relentless toll of lives lost and damaged because of traffic accidents in the NT.

My team and I see people maimed or killed on Northern Territory roads every few days and in a relatively small community there is often only one or two degrees of separation from the victims. The road toll in the NT is 21.8 per 100,000 and for each of those deaths there are many more serious injuries. To give you an idea, if you go to the World Health Organisation website you’ll see that this figure is comparable to countries like Afghanistan, Botswana, Angola and India. Australia as a whole has a figure of around 5 per 100,000 which is comparable to most rich western countries.

There are many reasons for this, but the role that speed plays in exacerbating the severity of trauma in accidents can’t be underestimated.

In October this year our ED got a call from one of the local paramedics. He was on his way out to a traffic accident outside town and was giving us a heads up. There’d been a crash about 40kms south of Darwin. One death on the scene confirmed. No further details yet.

The story that emerged was fairly typical. Four teenage friends had gone racing through Darwin in a sedan. They’d been pursued by police who had broken off the chase when it got too fast. The kids headed south down the Stuart Highway and 20 minutes later ran into an intersection and hit a jeep, killing the driver who was on his way to work. When the emergency crews got to the scene they had to cut the sedan open to free the passenger in the front seat. One of them noticed the speedometer had jammed at the moment of impact at 180kph.

Remarkably, the driver of the sedan had not been injured. He had fled the scene on foot. The two girls who had been in the back seat arrived at the ED first. One of them had minor injuries and was able to go home after 24 hours. The other had been ejected from the vehicle on impact and had been thrown 30 metres through the air. She had lung contusions and rib fractures and couldn’t remember anything about what had happened.

The passenger in the front seat had to be cut out of the wreck and was unconscious with broken limbs and obvious facial fractures. When he arrived at the ED we put him on a ventilator and CT scans revealed major head injuries with subdural haemorrhages and cerebral contusions. Once we stabilised him we passed him onto the Intensive Care Unit via the operating theatre. He would go on to make a recovery but requires ongoing rehabilitation.

Of the five people in that accident one is dead. The driver is currently (November 2015) awaiting a court date. The male passenger received neurological damage that may impair him for life. The girls are both physically ok but are psychologically traumatised by what happened. Five damaged families.

We’ve had two further deaths on the road since then. We’re up to 41 so far this year, two more than last year and we have the festive season still to come.

The Northern Territory is a fantastic place to live. I wouldn’t be working here unless I loved the place. But the amount of death and destruction we see here is disproportionately great for such a small population.

The figures are shocking. The causes of road trauma are multifactorial but speed is a factor. The faster you are travelling when you hit something, the more damage occurs. It’s simple physics. Everywhere else in Australia the community is protected by speed limits. Why should Territorians not be similarly protected?

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