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Published 4/1/2019
Elizabeth Hofheinz, MPH, MEd

Not Worth It: The Liz Marks Story of Texting and Driving

She wasn’t looking to be on Oprah. She wasn’t looking to be a spokesperson for anything. But those things happened after Liz Marks crashed her car into a tow truck in April 2012.

“I was 17 years old,” said Ms. Marks, “and like all of my friends, I thought I was invincible.”

But a text message taught her otherwise.

While driving in small-town Maryland, Ms. Marks received a two-letter text that would define the remainder of her life. She was going 45 miles per hour at the time. “I heard the message come through, and I bent down to check it,” she said. “I hadn’t noticed that there was a tow truck stopped ahead of me. I collided with the truck, and it went over the hood of my car and hit my head; the airbags did not deploy until after impact because there was nothing to engage until I hit the windshield.”

To those arriving on the scene that day, Ms. Marks appeared all but dead. Her mother, Betty Shaw, said, “We are so grateful that the state trooper who found her actually knew her and took a chance by having her flown to Shock Trauma Center in Baltimore. She had a traumatic brain injury and was not expected to live. The doctor said it was like having a 3-year-old mind in a 17-year-old body; she had to relearn how to walk, talk, read, and write.”

Ms. Marks said it is a blessing that she has no memory of the accident.

“St. Michaels is a small town, so a state trooper showed up at our front door,” Ms. Shaw recalled. “Twenty minutes earlier, I had been cooking when I suddenly became nauseous and had to go lay down. My husband answered the door and then came to the bedroom with a horrified look on his face. ‘It’s Elizabeth,’ he said.”

Her world shattered; Ms. Shaw cried, “‘Is she alive?’ My main goal was to touch her before she died.”

“Shock Trauma was incredible,” said Ms. Shaw. “They worked so hard on Liz. The severity grading is 1–4, and we were told she was ‘over 3.’ At that point, we had no idea what had led to the accident. Our house rule was that Liz would always check in on her way to work if she had spent the night at a friend’s house. She had not done that, and I was upset with her. I texted her, and then two minutes later a wave of nausea came over me.”

Ms. Shaw added, “Two months later, when Liz was being transferred to a brain rehab facility, I went to find the state trooper who had taken a chance and flown Liz to Shock Trauma. I didn’t find him, but I spoke to the officer who had investigated the accident, who told me they were 99 percent sure Liz was texting and driving.”

In the past, when Ms. Shaw and her daughter had discussed texting and driving, Ms. Marks had said, “I wouldn’t be that stupid, mom.”

The Shaws were further devasted when they got access to their daughter’s phone. “Scrolling through her text messages, my eyes landed on the last message before she crashed. … It was from me,” Ms. Shaw said.

The seemingly innocent message just said, “OK.”

“I was absolutely crushed,” said Ms. Shaw. “Liz was having to relearn the basics of life—how to eat, walk, speak, etc.—and I felt an overwhelming sense of responsibility for what had happened.”

Ms. Marks’ journey has indeed been long and frustrating. “I even had to relearn how to breathe,” she said. “I had a tracheotomy put in, so I couldn’t speak for some time. Then I had to relearn how to speak, essentially redirecting the breath through my mouth. At the same time, I was relearning my ABCs. They were coming out more like BGTs, and I was terribly aggravated. I would just draw lines after lines. And my memory was shot. … I couldn’t remember what I said one hour before.”

Ms. Marks endured one month in the intensive care unit and multiple surgeries to reconstruct her face and skull. “All because I thought I was invincible, I am now deaf in my left ear, blind in my left eye, and I no longer have a sense of smell. Every night I struggle because my REM sleep is disturbed, and I need medication to fall asleep.”

Due to the severity of her injuries, Ms. Marks was unable to attend college. With the help of her mother, she has dedicated herself to informing the public about the dangers of distracted driving. The U.S. Department of Transportation created a video about Liz Marks’ experience that has been viewed almost 11 million times. Ms. Marks and her mother also have appeared on an episode of “Oprah: Where Are They Now?

“I think I’m able to tell my story in a powerful way that makes people rethink their initial impulse about texting and driving being safe,” Ms. Marks said. “I know that it takes bravery to go public and reveal the entire story of what happened to me, and for that I am proud. I want to save lives. … I don’t want people to go through what I’m experiencing.”

According to the U.S. Department of Transportation National Highway Traffic Safety Administration, 3,450 people died in 2016 due to distracted driving.

“Distracted driving fatalities are horrific,” Ms. Shaw said. “But for those who survive, there is the overwhelming physical and emotional trauma of rehabilitation and of rebuilding your life. Liz and people like her, their lives will never be the same.”

About texting and driving, Ms. Marks said, “I thought I was invincible, as did my friends. We all did it.”

Her message to young people who are approaching driving age is this: “Life is not a little video game. You can’t buy a new life. There are no more ‘tokens,’ and mom can’t help you.”

According to the National Center for Statistics and Analysis, more than 1,000 people are injured in crashes involving a distracted driver. Sending or reading a text message takes your eyes off the road for about five seconds, long enough to cover a football field while driving at 55 mph.

“[Ms.] Marks’ story—the aftermath of a young woman’s life after a distracted driving crash—is what the U.S. Department of Transportation National Highway Traffic Safety Administration and organizations like AAOS have spent years trying to prevent,” said AAOS President David A. Halsey, MD. “Through the Academy’s Decide to Drive public-awareness campaign and efforts to educate the public about the dangers of distracted driving, orthopaedic surgeons understand that even small distractions behind the wheel can cause larger-than-life consequences, regardless of a driver’s age or expertise. My colleagues and I have seen the traumas due to distracted driving crashes, and we’d rather all drivers keep their bones and limbs intact by deciding to drive each and every time they get in the car.”

For Ms. Marks and everyone else on the road, we can do better. Before picking up your phone while driving, ask yourself, “Is this worth a life?”

Elizabeth Hofheinz, MPH, MEd, is a senior writer for Orthopedics This Week. She can be reached at elizabeth@ryortho.com.

Your Academy has hundreds of free resources to help you connect with and educate your patients and promote your practice at http://newsroom.aaos.org/member-resources/resources. Order your free Decide to Drive posters and postcards through the AAOS Store at http://bit.ly/2IeMa82.


  1. National Highway Traffic Safety Administration: Distracted Driving. Available at: www.nhtsa.gov/risky-driving/distracted-driving. Accessed February 14, 2019.
  2. National Center for Statistics and Analysis: Distracted Driving 2015, Traffic Safety Facts Research Notes. DOT HS 812 381. March 2017, National Highway Traffic Safety Administration. Washington, D.C. Available at: https://www.nhtsa.gov/sites/nhtsa.dot.gov/files/documents/812_381_distracteddriving2015.pdf. Accessed February 14, 2019.
  3. National Highway Traffic Safety Administration: Facts and Statistics. Available at: http://www.distraction.gov/stats-research-laws/facts-and-statistics.html. Accessed February 14, 2019.