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EPISODE 170: A Doctor's View of Traffic Violence

EPISODE 170: A Doctor's View of Traffic Violence

The War on Cars Apr 07, 2026 56 min
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About this episode

Dr. Rex Tai, a long-term care physician, connects the hidden aftermath of traffic violence to car dependence, inequality, and “mobility justice.” He describes catastrophic injuries—especially traumatic brain injuries leading to ventilators, tracheostomies, pressure sores, seizures, and lifelong care needs—then explains how insurance, staffing shortages, and neighborhood design determine who ends up in nursing homes versus at home. The conversation expands into how bike lanes, delivery workers, and immigration/“who gets to move” all reflect whose safety is prioritized, ending with calls to support grassroots advocacy.

Topics: traffic violence aftermath in long-term care traumatic brain injury complications tracheostomy and lifelong ventilator care pressure sores and staffing shortages mobility justice and new mobilities manufactured vulnerabilities vs “accidents” bike lane equity and gentrification narratives deliveristas and dangerous work conditions immigration and controlled movement grassroots advocacy and transportation alternatives maps
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How do we determine as a society whose safety is prioritized, where do they get to be, what
kinds of political decisions are behind, where do people end up and even in the neighborhoods
that they live before they become my patients, what determines the amount of safety that
they can experience in their own home neighborhoods.
This is the War on Cars.
I'm Sarah Goodyear.
Today we're going to be talking with a guest who knows firsthand just how destructive cars can be.
Dr. Rex Tai is a physician who works in long-term care.
Many of his patients are the victims of traffic violence.
His experience providing care for these people has been part of his growing awareness of how our
country's car dependence creates and exacerbates inequality and division in our society and even
in our global politics.
We are going to get to that wider perspective in this conversation.
First, I'd like to acknowledge that the effects of catastrophic injury are something that we don't
talk about much because these things are so hard to face, but it's important to open the discussion.
I do want to caution listeners that some of what Rex has to share with us about his personal
experience as a doctor could be hard to listen to.
So please be aware and take care of yourselves.
We'll get to all of that in a moment, but first we have some quick business to take care of.
If you like what we do here at the War on Cars, please support us on Patreon at patreon.com
slash the War on Cars pod.
You can also order our book, Life After Cars, freeing ourselves from the tyranny of the automobile
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Find out more and learn all about our book tour at lifeaftercars.com.
Okay, let's get to it.
Dr. Rex Tai, welcome to the War on Cars.
Thank you so much.
I'm so happy to be here.
Rex, we met at our first book reading actually in Manhattan at Book Club Bar on the Lower
East Side.
That was the very first event we did, and I was very nervous that night.
And you came up to me after the show, after we read, and you handed me a handwritten note
in your meticulous and beautiful handwriting, and it was about your work, and it really
affected me and hit me really hard.
I mean, I kind of want to ask you what inspired you to write that note.
Was that something you planned or did it kind of come to you in the moment?
Well, thank you for the compliments on my handwriting.
I do get a lot of comments from my coworkers that I don't have typical Dr. Lee handwriting.
But yeah, I wrote you this pretty long two-sided note on just like this receipt, I think that
they had.
And I wanted to ask this question during the conversation, but I know that the program
was relatively short and it was going to provoke a long discussion.
And so I just thought I'm going to hand this to you and we'll see what happens.
And you reached back out to me and I think this is the conversation that we're going to have.
Yeah, so I'm just going to start by quoting from that note.
You wrote, I view our country's privileging of wealthier white car owners and siding with
car owners in the war on cars as a manifestation of a larger phenomenon to exert societal control
with regards to how certain favored groups are allowed and facilitated free movement.
Whereas others like my patients are withheld the safety of liberty to do so.
It's really heavy.
It's really big.
And so we're going to get to these more philosophical questions that you pose and that I think you
struggle with on a daily basis and that you investigate on a daily basis.
But maybe you could tell us a little bit about your work generally and how you got into it.
And then we can talk about some of the stuff that it reveals to you and to the extent that you're comfortable.
You can share with us some of the stories of your patients.
Yeah, so the musics that I shared with you in the note are the culmination of many, many years of just listening to this podcast for one.
I think I've been listening for a good few years now overlapping with the entirety of my professional training.
I'm really relatively freshly out of residency now working as an independent attending physician.
My professional clinical focus is uptown.
So trained in the Bronx, I work in Upper Manhattan.
And these are primarily Black, Indigenous, people of color communities where there's a burden of both preexisting chronic disease and even more so significant post-acute morbidity that are disproportionately high.
And while listening to your podcast, reading on this topic, developing a growing interest in environmental, public health, and urban design and how that interacts with the social determinants of health,
I've started to note anecdotally within my own patient population where I work in long-term care.
So many patients that once they are out of the hospital for acute illnesses or specifically to this topic, motor vehicle injuries,
they need to still receive a very, very high burden of care whether that is in a nursing home or in these settings where they need to receive skilled nursing care because they are no longer either fit for their families to be able to meet all of their care needs
or in a lot of cases, frankly, where they might need skilled home health aid care but insurance patterns make it so they can't receive or they can't have all of the care needs funded through whatever insurance plan they might have.
So I've noted anecdotally that a lot of these post-traffic injury patients that are in long-term care settings, nursing homes, and the like are from the uptown communities that I've been training in or in the outer boroughs.
And very specifically, I can't think of all that many white patients, like wealthier white patients that end up as my patients and I was just reflecting on why is that the case.
And so one story that really, really speaks to me personally is a patient that I took care of who was an elderly gentleman. He lived in South Brooklyn. He was a Chinese descent, like myself.
And I knew from getting to know his family that he was very, very active, very independent. He lived a full life with his family and I know that one of his favorite hobbies was to ride his bicycle out to the shore.
In South Brooklyn, he would go ride his bike and then go fishing. And this spoke to me because I love fish. I love to bike. I could very well see this being a future that I would love to have in retirement.
But unfortunately, the bike infrastructure in South Brooklyn is very, very poor. And so he was hit by a car. He was brought to the hospital because of his age. Even though he was quite healthy before this injury, a lot of elderly patients have much poor ability to recover from acute hospitalizations.
And so one thing led to another. He got a severe infection that landed him in the ICU. That made it so he needed to be intubated because his mental status had deteriorated and was such that he couldn't, what we call, protect his airway.
There needs to be a certain level of neurological functioning for patients to be able to breathe on their own and sustain their oxygen levels. And so his doctors made a decision to intubate him, to put him on a ventilator for artificial mechanical breathing.
And when patients are in the ICU, every attempt is made to try and extubate them to get them off of the ventilator because longer periods of time while intubated increase the risk of aspiration pneumonia where patients inhaled their tracheal secretions, like their neck secretions.
And those can go down the wrong tube to the airways, like to the lungs, and then cause infection. So generally we try to extubate patients as quickly as possible. But for these elderly patients, because their bodily recovery is much poorer, they often are not able to come off of the ventilator.
So in his case, they tried, they tried. He wasn't able to reliably come off of the ventilator. And so then his family made the decision that they still wanted him to be around. They loved their father. Everyone has to make very, very difficult choices about their family members who suffered these catastrophic injuries.
And in their case, they decided with this process of shared decision making, having everything explained to them by the medical team, and considering what his wishes were, they made a surgical incision in his neck, what we call a tracheostomy.
So then instead of having the breathing tube go through his mouth, they put it through the surgically inserted incision in his neck. And that, what we call tracheostomy, allows for patients to be ventilated for a much, much longer period of time.
Can be on the order of months to even years. And there are many, many patients as I have come to learn in my professional practice that may be on the ventilator through their tracheostomy for the rest of their lives.
So in this particular patient's case, he came to me after this acute hospitalization. My professional role was to take care of his longer term care needs. And one of those was to see if he could get off the ventilator.
But in addition to being on the ventilator, there's multiple complications that have severely impacted his quality of life and his ability to eventually go home.
So again, this is a gentleman who was very elderly, doing very, very well, fully independent, achieving all of the goals of care that we love to see in geriatric patients.
And because of one inopportune injury, it completely upended not only his life, his quality of life, but also that of his family. I saw his family coming in every single day trying to be as attentive as possible.
This all in the context of very severe staffing crises in the New York City health system, trying to do the best that they could.
So some of these care needs include he remained bedbound. And when patients are bedbound, then they are at very, very high risk of receiving pressure injuries on the parts where there's less cushioning between their soft tissue, like their skin, their muscles, their subcutaneous fat.
Those areas can break down due to moisture and pressure and then open up into these really, really nasty wounds that can get infected and cause deeper complications.
One of the ways that we try to prevent that is through a lot of wound care, applying all these creams, all these pressure offloading devices like bandages, gauze, and then also turning the patient routinely to try and offload that pressure.
So pressure injuries, a huge area of concern for these bedbound patients.
This patient also had some brain issues from what you told me before we got rolling. What are some of the complications that come with that?
So patients that have gotten these devastating traumatic brain injuries oftentimes suffer devastating bleeds in their brain. Blood can accumulate within the skull.
And the issue is that because the skull is a fixed compartment without a lot of flexibility to displace the skull bones, then a lot of blood can build up within a small area and then push on other parts of the brain.
And that can cause injury to other parts of the brain, even not adjacent to where the bleeding is. In the worst cases, it can cause the brain to push down on the brainstem, which controls breathing, other essential physiologic functions.
And so one of the ways that we try to reduce this amount of pressure within the brain, or what we call intracranial pressure, is that neurosurgeons will literally just saw off a part of the skull so that the brain can expand outward.
And so a lot of the patients that end up in my hospital, they are postcraniatomy or craniectomy is the medical term where we've removed the part of the skull. And then so their brains are literally sitting outside the head.
And if you were to press it, you could feel the soft brain tissue. And it is a whole process of later on, if they are clinically stable, then they can have a procedure to put in artificial skull tissue to push it back in.
But that is very far down the road. And I get a lot of patients that are missing half their skull while they're in my care setting. So devastating neurologic injuries is another one, another major complication.
And then because of the neurologic complication, a lot of these patients that have suffered damage to their brain are also at very, very high risk of seizures. A lot of these patients need to be on seizure medications for the rest of their lives.
In some cases, they can be having what we call subclinical seizures, where instead of the classic jerky, like convulsions that we know about, they can have these, I guess you can think of them as micro seizures where they're not having these overt movements.
But it is causing ongoing brain damage that makes it so that they lose their cognitive function. Also, a lot of my patients lose the ability to recognize their family members, respond to questions.
They lose the ability to direct their care, to indicate when they're in pain. So then that makes my care for them exponentially harder, where I have to use all these proxy measures of trying to determine are they in pain or not.
Are they having a seizure that is going clinically undetected? Like you have to look for all these very subtle signs that this might be the case.
What are some additional complications you've seen that most people wouldn't think of when it comes to car related injuries?
Another thing that I see in patients is that if you have a devastating neurologic injury, that can also affect your ability to maintain your bowel and bladder function.
And their bowel to their brain. In this case, a lot of my patients already being bed bound are unable to control when they defecate.
Because we have health care across the nation, but acutely so in New York City, we'd have ideal nursing ratios and shout out to the striking nurses that put this issue on the map with the historically large strike by New York State Nurses Association.
But because of nursing staff ratio crises that have been ongoing for years and years, patients, they sit in their bodily fluids for extended periods of time.
This increases the risk of infections for the pressure sores that I spoke about earlier. And ideally you'd have staff that can clean that up, but a lot of patients have to wait for a long time and families get very frustrated with that.
I don't blame them whatsoever. It causes medical issues for me because then they are at risk of infection of the pressure sores that increases their length of stay and makes it so other care goals get postponed or delayed or much more difficult.
And then if they lose their bladder function, another thing that can happen is then they might retain urine like they're not able to urinate when they want to or when their bladders are full and that can increase the risk of a urinary tract infection.
So one way that we address that is to put in an indwelling urinary catheter or a foley catheter in them so that that can drain out urine without them having to remember to pee.
But having a foreign device in their bladder increases the risk of an urinary tract infection as well. And so we try to remove that whenever possible but for some patients because of the neurologic injury that is also not possible.
So as you can see, there's a wide array of medical complications that can occur after a devastating traumatic brain injury and this is exactly what I wanted to capture with this conversation where the most devastating or the most overt consequence of these motor vehicle crashes is death.
But there's also a very hidden side of patients who don't die and then for many reasons their families want to keep their loved ones around.
But then that means all the medical complications that I talked about, it means that they might be unable to get out of bed, unable to walk, unable to talk ever again because again they have a tube in their neck and that prevents airflow allowing them to talk.
So that can be the case for the rest of their lives and that is a segment of society that we very deliberately try to visibly hide or not talk about but it creates a lot of strain on families.
It creates a lot of strain on our healthcare system. The way that our healthcare system is financed means that insurance decisions dictate where do these patients get to stay, whether it's at home if they have the resources to pay for a home health aid who can meet all their needs.
But in a lot of cases, especially the neighborhoods I've been speaking about where it's lower income people of color, they don't have those resources. So then a lot of their family members end up in nursing homes where some of the most severe staffing shortages are found.
And so I have to have very frank conversations with a lot of these family members where because of decisions and structures that are beyond my control, they no longer are able to stay in the hospital.
We have to discharge them to a nursing home where they know the staffing ratios are in critical condition. And this is exactly the conversation I'm wanting to have about how do we determine as a society whose safety is prioritized, where do they get to be?
What kinds of political decisions are behind where do people end up? And even in the neighborhoods that they live before they become my patients, what determines the amount of safety that they can experience in their own home neighborhoods?
Yeah. Wow. That's so much you've given us there. And you've made it so painfully clear. And as you say, this is something that is not only not clear to most people, but it's actively concealed the society. And a lot of people want to look away from this.
I have thought about this a lot because when we talk about motor vehicle fatalities, there's this 40,000 people a year killed in motor vehicle crashes in the United States of America on average. And then there's these, oh, hundreds of thousands of injuries.
And there's a phrase that you hear in regard to these injuries, which is many of those injuries are life altering. We talked to a woman a few years ago, Teresa Sorreo, who experienced a life altering injury. She lost her leg at the hip from a motor vehicle crash.
That's life altering. But the level of life altering that you're describing is so cataclysmic for an individual who one moment is a functional happy person, maybe an older person, maybe a younger person.
I'm sure you have younger patients as well. And then all of that is just taken away in a moment. And they are in a position where they have very few of the functions that we consider to be essential to leading a meaningful life.
And then you speak about the families because these injuries also profoundly alter the lives of families. And that is just excruciating to listen to you. And then there's the knowledge that all of this is preventable, right?
And as a physician, you work with so many situations that are or you train to work for so many situations that are not preventable, at least not in this very clear way that these things are.
Could we get plastics out of our environment so that people have less cancer? Yes. But it's not nearly as easy as saying we could make streets safe so that people don't get hit by cars as much.
Or that people who are driving cars don't crash them and themselves suffer these life altering injuries. So I'm interested in hearing about during your training, I presume you had some kind of public health module, some kind of learning about public health and approaches to public health.
And I'm curious to know how much these motor vehicle crashes, how much that is considered to be a public health issue or how you would talk about it as a public health issue.
I think that public health is starting to recognize this as a broader issue, especially now that there's this infusion of climate perspectives, environmental racism affecting the social determinants of health.
But at the same time, well, first of all, I don't have formal public health training. It's something that I pay attention to a lot. It's an area of interest for me professionally, even though right now I'm exclusively in my professional life within the clinical realm.
But in a lot of ways I had to seek out these sorts of statistics and scholarship on my own. And I'm definitely not an expert in this area. I'm really, I know you have a lot of very scholarly, academic people that you have on this podcast.
That is not me. I'm just an observer, a participant in the complexity of urban life. And I'm just thinking very carefully about the narratives we build about who belongs in the city, whose movement is sanctioned, how their movement safety is protected or not.
And like when we talk about these car crashes, the kinds of injuries that are happening are different in different parts of the city. So those are some of the trends that I've been noticing and then trying to infuse it with this public health lens.
And one of the theoretical frameworks that I've started to appreciate in thinking about this is the emerging field of mobility justice or another name is New Mobilities. This has been advanced by John Urie and Mimi Scheller.
And this really gets to these kinds of broader political questions about what kind of movement is deemed permissible, what types of movement do we not really protect.
And another book that I've been that I've read recently is There Are No Accidents by Jesse Singer. And she articulates this very poignantly when she asserts that what we keep on calling accidents to try and displace blame in our society are actually manufactured vulnerabilities.
So the way we build our environments allows for certain kinds of accidents to happen at greater rates for people that are not prioritized by our society over others.
So when we talk about the kind of automobile infrastructure that has taken over America and frankly feels like there's way too much in New York City as well, even though it is a leader in the country in other ways.
When we adopt these perspectives, a lot of what I've been seeing in my clinical work becomes more apparent because and this is where I really try to be a more involved political actor in my personal time.
Because as a doctor, what I'm really doing is just addressing the injuries and all the complications after the fact. And at best, what I can do is promote some degree of recovery, try to make it so they have a little bit more freedom of mobility than they might otherwise have.
I just try to set small goals by being off the ventilator, then that means that there's a greater range of nursing facilities that might accept them because if they remain on the ventilator, then there is a very, very narrow set of facilities that can accept that complicated of a patient for lack of a better term.
Or in some cases, like in better cases, then I can make it so they can be in a wheelchair so then their family can wheel them around more easily. In the best cases, we get them walking again, but for a lot of my patients, there's really no guarantee.
So that's why in my personal life, I care about being involved in the political movements that try and prevent these injuries in the first place.
Yeah. And you talk about Jesse Singer, we had Jesse on the show, friend of the show.
I think I learned about that book from the show.
Yeah, maybe. And she's so great. And also, we do talk about Mimi Sheller's research in our book. I think it's so important. And I know that you get around New York on transit and bicycle and walking.
Maybe you could talk about when you're moving around the city on those modes, how you see this issue of mobility justice being manifested in front of you on the streets of New York City.
Absolutely. So I love to get around the city by bike. It's one of the reasons that I love living here. We've made many, many great strides in improving bike lanes and protected bike infrastructure.
But as someone who goes across the city, it's very apparent that some neighborhoods it is safer than others. But then what is also very curious are the narratives that come with the installation of a bike lane and certain neighborhoods and some of the connotations or associations that come with that.
We all know, especially listeners of this podcast, that there is this perception that bike lanes bring gentrification. It brings these wealthier bikers to the neighborhood.
But probably the most frequent use of these bike lanes comes from people like the Deliveristas, many of whom are immigrants. And there's a whole host of reasons why they might be in this line of work.
But it's actually one of the most dangerous lines of work in the city. They spend probably more hours combined on their bikes than anyone else. And they tend to live and work in neighborhoods that might not necessarily have this protected bike infrastructure.
And so as someone who lives uptown, I see like as soon as you cross 110 for Cathedral Parkway, the protected bike infrastructure is almost completely absent.
That's not to say there aren't tons and tons of immigrants and POC bikers uptown, but their mobility, this is exactly what I'm talking about, where their safety, their mobility is not prioritized in the same way as it is for Park Slope where we are.
Yeah, I've written a lot about this over the years, this struggle between bike lanes being seen as a literally sort of an avenue of gentrification. And the really stark reality that the highest rates of pedestrian and bike injury and fatality are consistently in black and brown neighborhoods, economically disadvantaged neighborhoods, exactly the places
that sometimes there can be resistance because it's seen a bike lane is seen as infrastructure that's not for the people who live there, not for the people who are currently living there. And, you know, I don't think it's really a surprise that that those communities would feel that way, given the history of urban planning and, you know, going back to Robert
Moses and, well, before that, the whole idea of slum clearance, quote unquote, and, you know, planners going into neighborhoods and saying, we're doing this for the good of the city, we're doing it for your own good, and we don't really care what you feel about it in the moment.
So of course, there's generation upon generation built up of resistance to city planners coming in and saying, hey, we're going to give you a facility. So in your political work or in your political life, have you seen any hopeful signs or any constructive ways that the city can engage with its residents about these issues about improving
infrastructure for bicycle riders in particular and for pedestrians as well? Is there a way that we can approach the installation of this kind of infrastructure in good faith and then really follow through in such a way that it delivers the mobility justice that we're talking about?
Yeah. So when we talk about people like the delivery bike carriers, the deliveries, they introduce a lot of really interesting complexity to these conversations because I mean, when we talk about like, oh, these bike lanes are harbingers, a gentrification, they also facilitate a considerable level of convenience for a lot of the wealthier New Yorkers who rely on delivery services.
So I think one promising trend is how we see the delivery status organizing themselves. Like there's what's that union called? Delivery status unidos. Yeah. Yeah. Yeah, that's right. Where they've been negotiating not only for their own wages, but also to put in certain regulations around the time that their jobs or their tests are allowed to be completed on delivery.
So they aren't not necessarily needing to speed as much or to do behaviors like salmoning. And this is a really interesting conversation for us to have because the way I see it is, well, first of all, we need to think about, again, how do certain segments of the population get into this more dangerous line of work?
And I think a lot of, like we've seen an explosion in these deliveries, especially after COVID. And when we think about essential workers, that to me really illustrates this broader theme about whose movement was deemed acceptable or like whose safety was protected because there is a certain class of New Yorkers who were allowed to stay in and were frankly told like not to go out because
we don't want you to increase your risk of getting sick. But then there was still this huge segment of New Yorkers who they needed to provide these essential services. And in a lot of cases, it's more immigrants or especially undocumented immigrants who they might have precarious legal status.
And there are these arrangements that might be made for them to fill these roles.
And one thing that is really interesting is to the extent that we talk about all these complex rules of the road that are coming up with this clash between pedestrians and bikers and then bikers on the sidewalks or salmoning like going the opposite direction on a road.
I'm not going to lie, there can be frustrations about that. But I also, like when I take a step back, I see it as them reflecting different values of who gets to move about the street in various ways.
And so in the US, we have this automatic encoded from a young age assumption that cars are king, they get to take up all of the road. And then we have very complex legal framework for movement patterns.
Like cars need to go in a certain way, certain streets are one way. But I've gotten to travel a lot and I see different patterns of street usage where there might be many more bicycles or like tuk-tuk or motorcycles going about the streets.
And it comes off as very chaotic to us. But one thing that I kind of find beautiful is that there's just this different negotiation of how they get to move about in the street. And sometimes that means going in the opposite direction.
But it also means that in these other countries, cars don't have this dominant place in the street hierarchy in quite the same way. And so yes, these sorts of movement patterns do get brought to places like New York.
It's a very globally diverse city. We interact with all kinds of cultures and especially culturally encoded patterns of movement on the street.
But at the same time, I think it's interesting to see that if we truly build safe street infrastructure like protected two way bike lanes on the streets or like things like the Hudson River Greenway where it's very, very apparent that this is safe infrastructure, then people do use it in the intended ways.
And so that's all to say. I think it's really interesting how like people make do with the street infrastructure we have and they need to get about their tasks and they're going to bring the values that they have to the street.
But then also if we foreground safety from the beginning and think about what is the best way to use a street for the most people in the safest way, then when we establish our street infrastructure along those desire lines, so to speak.
Then in a lot of ways people do use it in the intended ways and we are able to bring this chaotic beautiful symphony into a way that can be used by everyone in a safe manner.
Yeah, I think that's really true and as somebody who's lived most of my life in New York and since long before there were any bike lanes at all, I have seen a real transformation in the city in terms of an acknowledgement that people riding bicycles are human beings.
Like that used to actually not be necessarily that way and I have seen the change and I do think that two things are mainly responsible for it, well maybe three things.
There was an explosion of construction of bike infrastructure and during the Bloomberg administration for all its faults, which are legion.
That provided a baseline of bike infrastructure and then when Citibike was introduced, we suddenly had way more people on the street, civilians if you will, people who didn't consider themselves to be hardcore bicycle riders in the sort of Lycra Road Rider mode.
And also not working cyclists but just people who were just really genuinely using cycling as a convenient mode of transportation and occasionally recreation but really for a lot of last mile uses and short trips that they might have done by walking and taken longer might have taken the subway.
So that got a bunch of people onto the street and then it really has been the explosion of the Deliverista culture.
And what's given me hope, I was at the Vision Zero conference that Transportation Alternatives did last year and the Deliveristas were there and they were on a panel speaking in Spanish with an interpreter and that to me was a real hopeful sign.
And then recently near my house, I live in Cobble Hill, there's a bike lane, a protected bike lane that was put in on Court Street, which is heavily, heavily, heavily used by people who work on their bicycles.
Because there are a lot of people who get delivery in that neighborhood, a lot of affluent people who order delivery and that bike lane was opposed by many of my neighbors unfortunately and the businesses on Court Street and they sued over it.
They lost their suit and I appreciate that the judge recognized this was a legitimate safety facility in the city was exercising its legitimate function to protect the people who use the streets.
And now even in the terrible winter weather that we've been having, the lane has been pretty well cleared.
They've kept it pretty clear and it is being used by Deliveristas and it's also being used by a lot of other people.
And including, I saw a kid riding his bike to school today, you know, so that I think that we should really recognize the contribution that the Deliveristas have made to show us those desire lines and to show us how we could be using the street.
And, you know, and maybe that is one of the bridges that we can use to say every neighborhood deserves safe bicycle infrastructure.
It shouldn't be, if you get it, you have to be worried because then you're going to get gentrified because it should just be something every neighborhood gets car infrastructure, right?
Don't worry about that gentrifying you.
But what we need is that universal approach for pedestrian safety as well and really having good quality infrastructure in terms of intersections and crossing distances.
And, you know, all of that can be done without there is going to be enforcement.
But I think we all recognize that that's kind of a last resort with these things, especially these days.
So I want to pull back like to sort of another level because when you wrote me this email about stuff that you think about coming out of this mobility justice kind of framework,
you were talking also about other kinds of movement in terms of, for instance, who's allowed to come into the United States and who's excluded from that and how the current regime is formulating that.
Could you talk a little bit about your thoughts about that?
Yeah, absolutely.
I mean, a major theme of the news these days is immigration patterns and who is allowed to travel into the US.
But this has been the case for all of the United States history.
Maybe the newer current is just like thinking about it in this mobility justice framework.
But the US has always functioned based on controlling who gets access to what kind of land, who gets sanctioned legal movement into the US or not.
I'm thinking about just the origins of like our immigration system come from the Chinese Exclusion Act affecting my people where because there were perceived economic pressures and also a lot of racist assumptions about Chinese people,
they were the first people to be formally banned from coming to the US.
And then in the era of World War II, then Japanese Americans were the target and then they were forcibly moved to camps by the FDR administration.
And then if we bring it more toward the current day, we see travel bans from certain kinds of countries.
We now have a much more legally enforced system of immigration than it used to be the case with our system of visas.
And then also I would be remiss to point out Jim Crow and the system of segregation dictating how black Americans were allowed to exist in society having their own separate accommodations.
The idea of sundown towns where it was literally unsafe for black people to be in certain towns after sunset.
And I think all of this is coming to a head in the current era where there is ascendant right wing movements, fascism that are controlling movement across the globe, also with the undercurrent of climate change creating more climate refugees and that affecting migration patterns.
So, yeah, I mean, we've gotten pretty far from the original topic, but I think all of these things are linked where we as a society need to actually confront the question of who's valued in our society and to the extent that they're valued.
How do they get to move in society? Where do they get to belong? Where is their safety actually considered a priority?
Yeah, you talk about also the way that people who have been subjected to state violence in the form of war and bombings, etc.
So many of those people end up as amputees and that is another way that that movement is limited for people who are living under those kinds of threats.
One of the most harrowing things that I've heard, I can't not mention my ties to a lot of pro-Palestinian activists and organizers who point out all the very well documented horrors in Gaza and also the West Bank now.
And just when we think about safe movement, I hear stories like I know doctors who've gone to do medical aid in Gaza and there are a lot of children.
The Gaza war has been described as a mass amputation event for children.
When the doctors there are working without so many resources, then they can't save limbs the way that we can hear if children have been shot at or bombed.
And then I even hear that there's stories of like selective pressure on who gets to survive where certain very young kids are not able to make it because they can't run as fast as older children or adults.
This all fits into these larger patterns of settler colonialism where certain people are allowed to exist in a land but global patterns of the security state and surveillance and just state sanctioned violence dictate people's safety of movement wherever they are.
And I think being the age I am, I can remember that a lot of children in Southeast Asia during the Vietnam conflict and also subsequent wars in the region and Cambodia and other places were routinely losing limbs to mines and unexploded ordinance that they were finding.
And that happens around the world today, we see it in Ukraine, we see it in so many places.
But what's really shocking is that in our society this is almost like a discretionary thing that people are being injured in these life altering ways and having their mobility forever restricted and their families mobility circumscribed.
Social mobility for their families may be taken away because of the burdens of caring for an injured loved one that I do think it all goes together.
It does seem like maybe we have gone afar but you had pointed out something to me that maybe we could end with this because it's a little bit of a more hopeful note or at least a more empowering note is that in the English language the word that we use for the effort to build action in the social justice space is we call that a movement.
And so that's the movement that we're here to talk about really is the movement to provide a safe world for people to move around in, whether that be physically, also socioeconomically.
And to move society, to move the narratives we talk about who belongs where, how they get to move around.
I mean that's what, again, I guess fills my cup in these dark moments getting to be in community with so many wonderful, principled, passionate, informed people.
I think one interesting thing bringing it back to like the conversation of like lands and like how we build safer infrastructure in New York City.
One thing that you pointed out that is really reassuring to me is we look towards cities like Amsterdam or Copenhagen as the models of safe bike infrastructure and we'd love to model New York off of these.
But I think what's really pushing the envelope in this city are organizations like, let's deliver this, who are pushing for much more democratic use of city space.
And so just reflecting New York City's diversity, complexity, it's really from the grassroots up that all these changes happen.
And so to that end, I mean, again, I don't really have a public platform.
I'm not really a scholar in this area, but I do consider myself a student and like very much a recipient of knowledge from these movements that have come before me.
So what I can plug are more organizations that I'm involved in and work that I think is really important.
So that includes organizations like We Act for Environmental Justice, which is uptown.
They do a lot of work in environmental justice.
There's a Democratic Socialist of America Ecosocialists working group that also thinks a lot about this.
I think transportation alternatives has done very fantastic work with their spatial equity map that they put out online.
I think people should really take a look at that because it illustrates all of the disparities that we've been talking about.
And then really, I mean, at the end of the day, we have to get involved.
We have to be in community, working together to push the envelope to build the society that actually values all of us and the kind of movement that we deserve.
Thank you. That's a great place to end.
That's it for this episode of The War on Cars.
Thanks again to Dr. Rex Tai.
He reminds us that car dependence is a public health crisis that affects every aspect of our individual and collective well-being.
We will put links to all of the organizations he mentioned and maybe any others he might think of along the way in the show notes.
Remember, you can support us and get exclusive bonus content, pre-sale access to live show tickets, free stickers and more by signing up on Patreon at patreon.com slash The War on Cars pod.
A big thanks to everyone who supports The War on Cars, including our top contributors, Charlie G of Human Powered Law in Portland, Oregon, Mark Headland, Virginia Baker, and Brandon DeCoster.
And please pick up a copy of our book, Life After Cars, freeing ourselves from the tyranny of the automobile wherever you get your books.
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This episode was edited by Samantha Gatzek.
It was recorded at Brooklyn Podcasting Studio by Chrissy Drobish.
Our theme music is by Nathaniel Goodyear.
Transcripts are by Russell Gregg.
Our logo is by Danny Finkel.
I'm Sarah Goodyear, and on behalf of my co-host Doug Gordon, this is The War on Cars.

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