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'Flimsy little helmets' completely pointless, says leading brain surgeon

Neurosurgeon also admits to regularly jumping red lights

Cyclists who wear ‘flimsy little helmets’ are wasting their time, a leading neurosurgeon who never wears one has said.

Henry Marsh, who works at St George’s Hospital in Tooting, London, said his patients who have been in bike crashes have not seen any benefit from their helmets.

He told the Hay Festival, where he was in discussion with Ian McEwan about his new novel featuring a brain surgeon: “I ride a bike and I never wear a helmet. In the countries where bike helmets are compulsory there has been no reduction in bike injuries whatsoever.

“I see lots of people in bike accidents and these flimsy little helmets don’t help.”

Instead, he said, he wore a cowboy hat on his bike, which he had been riding for 40 years.

According to the Telegraph, he also cited evidence from the University of Bath that suggests that wearing a helmet may even put cyclists at greater risk.

The research suggests drivers think riders in helmets are more experienced and predicatable and can be passed up to three inches more closely.

Women and the non-helmeted tend to be passed more slowly and widely.

A Department of Transport study has shown that helmets could prevent 10-16 per cent of cyclist fatalities, although this was also an estimate based on a small study.

Angie Lee, Chief Executive of the Bicycle Helmet Initiative Trust said: “I hope he is going to take responsibility for the cyclist who gets injured because they take their helmet off following his comments.

“This may be his opinion but there are a lot more neurosurgeons and surgeons who would counter that argument.

“My advice would be the same as the Department of Transport’s which is that helmets have a place in protecting the head.”

Marsh, who retires in March, also said he jumps red lights to get ahead of the traffic.

“It’s my life at risk,” he said, ‘So I regularly cross over red lights.”

Recently we reported how three of London’s air ambulance doctors called for an overhaul of the capital’s cycle safety measures after three cyclists were killed in three weeks.

In an article for the Evening Standard, entitled How To Ride Safely, by Cyclist Doctors Who Save Lives, Mr Tom Konig, a trauma surgeon, Ali Sanders, an emergency medicine consultant and Mark Wilson, a Neurosurgeon, all defended cycling in London, saying: “Cycling remains a wonderful way to commute and travel cheaply and remain fit and healthy in the process and so should continue to be encouraged.”

But they added that it remained risky, and outlined a number of safety measures, including:

  • Avoid sharing roads with buses and HGV’s
  • Remember large vehicles are bigger than you and you will definitely come off worse - so give them a wide berth
  • Defensive riding
  • Wear a helmet
  • Use all your senses (don’t wear headphones)
  • Make your own decision about how ‘safe’ a cycle route is

And in 2013 we reported the comments of Lynn Myles, a consultant neurosurgeon at the Western General Hospital in Edinburgh.

Ms Myles acknowledged that she is “under no illusion that it [a helmet] will save me in the event of a high speed collision with a car or lorry (nothing will)” – a common criticism aimed at those who insist all cyclists should wear one – but adds that “most cycling accidents aren’t of the high-speed variety.”

Instead, after outlining other things that can be done to improve cycle safety such as addressing traffic speed and improving road layout, she says: “Most of the head injuries I have seen in cyclists are the result of low velocity crashes or simple falls due to ice or wet roads.

“There is no doubt in my mind that a well-fitting cycle helmet will reduce the incidence of scalp laceration and open fracture and will help to reduce the energy transfer to the brain.”

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80 comments

Avatar
Comrade | 10 years ago
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Helmets are not mandatory, we decide. Personally I wear one...my choice. Simple. On a separate note, many years ago my brother was killed skydiving. He was unconscious in the air...he never wore a helmet, I don't know if it would have saved him or not. (He had a D license so it was his choice, not mandatory). My point is, each to their own, but I imagine the doctor is simply seeking to plug his book.

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muffies | 10 years ago
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"he also never crashed"
the debate is sensationalistic and senseless:

if you never get hit, never fall a helmet doesnt help more than a cowboy hat. NO FUCKING KIDDING.

if you get hit by a 50mph car a bike helmet doesnt help much. NO FUCKING KIDDING.

if you fall and your head hits NOTHING, the helmet is again useless. NO FUCKING KIDDING.

if you get hit or fall at 20mph the helmet MAY saves you from lacerations, trauma and potentially can even save your life.

Damn thats DIFFICULT LOGIC.

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pablo | 10 years ago
0 likes

I work in the car industry and regularly get to see the results of pedestrian impact testing. When you see a dummies head deform a windscreen a helmet always looks like a good idea. Don't get me wrong these tests are to prove that these impacts are survivable but i always think you maybe alive but what quality of life would you have. It's a personal choice i've made my mind up.

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PhilRuss replied to pablo | 10 years ago
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pablo wrote:

I work in the car industry and regularly get to see the results of pedestrian impact testing. When you see a dummies head deform a windscreen a helmet always looks like a good idea.....

[[[[ Pablo---I agree wholeheartedly. Pedestrians (and dummies) should definately wear helmets. Especially the ones that insist all cyclists should! Funnily enough, I must have hit the deck at least 10 times while cycling over the years, sustaining road-rash, big bruising, hip-pain, red-faced embarrassment, boiling rage almost to the point of violence, but no bone-breaks or dislocations, and it's never been me HEAD that's hit the roads, the trees, the vehicles, or the jay-walking pedestrians....and to think that all these years, I should, according to many pontificating promulgators (oooh!), have been sporting a lid. Actually, I do sometimes pop on the old Banana hat (trackhat, "hairnet") over the cotton race cap, but really just for nostalgia and the funny comments, but I don't kid myself it'll do much for me if I head-butt a truck at 26mph....but then neither will any other polystyrene thingy.
P.R.

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Some Fella | 10 years ago
0 likes

I fell off my bike once and...............

.....oh.......... never mind.

 37

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Stumps | 10 years ago
0 likes

The building of decent infrastructure costing millions of pounds has not got one iota to do with helmets and who does or doesn't wear one.

Anyone who thinks it makes any difference to politicians views on the matter is sadly wrong.

No doubt this article will go back and forwards with the usually crappy and some insightfull comments until the road cc computer bursts.

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Paul J replied to Stumps | 10 years ago
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Stumps: *If* helmet cultures discourage cycling - as laws are *proven* to do - then actually helmets *would* negatively impact the building of infrastructure. Fewer cyclists == less political impetus to build infrastructure.

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felixcat | 10 years ago
0 likes

It is interesting that all the helmeteers above attacking this surgeon keep their mouths shut when when surgeons advocate helmet wearing.

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indyjukebox | 10 years ago
0 likes

1. Surgeons are arrogant; Agree, 99% of the ones I meet are and it seems to be something designed into their training curriculum. This chap sounds like a prime example of a self appointed cock. If I remember rightly, he is the same chap who wanted to leave the UK and work overseas because he hated his job and wanted to become an architect or something like that.
2. Neurosurgeons would be out of a job if they did not have to treat head injury patients. Maybe this chap has an ulterior motive?
3. Social cost: Well, someone has to pay for the treatment, even if it is just a large stitch to your head. It doesn't happen for free. So the non-helmet wearing folk who fall and end up with just a gash to the head (that the other lot wouldn't), still cost the tax paying public as such. And if on a daily basis 10 of these so called avoidable sutures could be avoided then that is 10 other patients who could be treated quicker?
4. PaulJ, your post is full of conjecture. If I could be bothered, I could make up a similar argument in favour of wearing helmets. Although I do sometimes think that not wearing a helmet may actually help with the process of natural selection. And maybe I should just agree with you.
5. Cycling infrastructure is not going to change overnight in this country. Till then I will continue to wear a helmet, but that is my choice.

Avatar
zanf replied to indyjukebox | 10 years ago
1 like
indyjukebox wrote:

1. Surgeons are arrogant; Agree, 99% of the ones I meet are and it seems to be something designed into their training curriculum. This chap sounds like a prime example of a self appointed cock. If I remember rightly, he is the same chap who wanted to leave the UK and work overseas because he hated his job and wanted to become an architect or something like that.

Pot calling kettle... come in kettle... your time is up.

indyjukebox wrote:

2. Neurosurgeons would be out of a job if they did not have to treat head injury patients. Maybe this chap has an ulterior motive?

What a load of fucking twaddle!

I can imagine that: the worlds neurosurgeons sitting around in a room, awaiting an alert to come in on the fax that someone has fallen off their bicycle and needs emergency brain surgery.

The fact that you think neurosurgery only involves head trauma surgery shows that you are talking a load of bollocks.

indyjukebox wrote:

3. Social cost: Well, someone has to pay for the treatment, even if it is just a large stitch to your head. It doesn't happen for free. So the non-helmet wearing folk who fall and end up with just a gash to the head (that the other lot wouldn't), still cost the tax paying public as such. And if on a daily basis 10 of these so called avoidable sutures could be avoided then that is 10 other patients who could be treated quicker?

This rambling mess of reactionary nonsense is easily countered with studies that show helmet wearing increases risk taking with both cyclists and vehicle drivers, and so not wearing helmets reduces your chances of being in a collision with a vehicle, therefore reducing your chance of visiting a hospital (and where I live health care is socialised and free at the point of use).

If you want to bring in the cost of healthcare then you would be arguing for taxing the fuck out of private motorised usage for journeys under 5km because those are the ones that are making people obese and so putting a huge strain n all healthcare systems around the world.

indyjukebox wrote:

5. Cycling infrastructure is not going to change overnight in this country. Till then I will continue to wear a helmet, but that is my choice.

The advocation of helmets and other PPE such as hiviz, is more of a hindrance to decent infrastructure being built, than contributing to it.

Avatar
indyjukebox replied to zanf | 10 years ago
0 likes
zanf wrote:
indyjukebox wrote:

1. Surgeons are arrogant; Agree, 99% of the ones I meet are and it seems to be something designed into their training curriculum. This chap sounds like a prime example of a self appointed cock. If I remember rightly, he is the same chap who wanted to leave the UK and work overseas because he hated his job and wanted to become an architect or something like that.

Pot calling kettle... come in kettle... your time is up.

indyjukebox wrote:

2. Neurosurgeons would be out of a job if they did not have to treat head injury patients. Maybe this chap has an ulterior motive?

What a load of fucking twaddle!

I can imagine that: the worlds neurosurgeons sitting around in a room, awaiting an alert to come in on the fax that someone has fallen off their bicycle and needs emergency brain surgery.

The fact that you think neurosurgery only involves head trauma surgery shows that you are talking a load of bollocks.

indyjukebox wrote:

3. Social cost: Well, someone has to pay for the treatment, even if it is just a large stitch to your head. It doesn't happen for free. So the non-helmet wearing folk who fall and end up with just a gash to the head (that the other lot wouldn't), still cost the tax paying public as such. And if on a daily basis 10 of these so called avoidable sutures could be avoided then that is 10 other patients who could be treated quicker?

This rambling mess of reactionary nonsense is easily countered with studies that show helmet wearing increases risk taking with both cyclists and vehicle drivers, and so not wearing helmets reduces your chances of being in a collision with a vehicle, therefore reducing your chance of visiting a hospital (and where I live health care is socialised and free at the point of use).

If you want to bring in the cost of healthcare then you would be arguing for taxing the fuck out of private motorised usage for journeys under 5km because those are the ones that are making people obese and so putting a huge strain n all healthcare systems around the world.

indyjukebox wrote:

5. Cycling infrastructure is not going to change overnight in this country. Till then I will continue to wear a helmet, but that is my choice.

The advocation of helmets and other PPE such as hiviz, is more of a hindrance to decent infrastructure being built, than contributing to it.

Yawn! You must be a surgeon too. The arrogance shines through. So does the demeaning attitude and a need to call everyone else names. Well done. Did you get a distinction with that attitude?

Avatar
koko56 replied to indyjukebox | 10 years ago
0 likes
indyjukebox wrote:
zanf wrote:
indyjukebox wrote:

1. Surgeons are arrogant; Agree, 99% of the ones I meet are and it seems to be something designed into their training curriculum. This chap sounds like a prime example of a self appointed cock. If I remember rightly, he is the same chap who wanted to leave the UK and work overseas because he hated his job and wanted to become an architect or something like that.

Pot calling kettle... come in kettle... your time is up.

indyjukebox wrote:

2. Neurosurgeons would be out of a job if they did not have to treat head injury patients. Maybe this chap has an ulterior motive?

What a load of fucking twaddle!

I can imagine that: the worlds neurosurgeons sitting around in a room, awaiting an alert to come in on the fax that someone has fallen off their bicycle and needs emergency brain surgery.

The fact that you think neurosurgery only involves head trauma surgery shows that you are talking a load of bollocks.

indyjukebox wrote:

3. Social cost: Well, someone has to pay for the treatment, even if it is just a large stitch to your head. It doesn't happen for free. So the non-helmet wearing folk who fall and end up with just a gash to the head (that the other lot wouldn't), still cost the tax paying public as such. And if on a daily basis 10 of these so called avoidable sutures could be avoided then that is 10 other patients who could be treated quicker?

This rambling mess of reactionary nonsense is easily countered with studies that show helmet wearing increases risk taking with both cyclists and vehicle drivers, and so not wearing helmets reduces your chances of being in a collision with a vehicle, therefore reducing your chance of visiting a hospital (and where I live health care is socialised and free at the point of use).

If you want to bring in the cost of healthcare then you would be arguing for taxing the fuck out of private motorised usage for journeys under 5km because those are the ones that are making people obese and so putting a huge strain n all healthcare systems around the world.

indyjukebox wrote:

5. Cycling infrastructure is not going to change overnight in this country. Till then I will continue to wear a helmet, but that is my choice.

The advocation of helmets and other PPE such as hiviz, is more of a hindrance to decent infrastructure being built, than contributing to it.

Yawn! You must be a surgeon too. The arrogance shines through. So does the demeaning attitude and a need to call everyone else names. Well done. Did you get a distinction with that attitude?

He nailed you on point 3 though. That is a poor argument and you can use anything as an example. Crossing the street and getting hit by car? Wow, such social cost. Doing DIY and falling off a chair, oh no, poor system. Fire in your house? Very money, much fire engine.

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steven miles | 10 years ago
0 likes

ok so usual witter on here.

consider a 20mph impact and think how meaningless the speed alone is in describing the impact.

also ask yourself, what will do more damage a cyclist travelling at 20mph hitting a stationary car or a car travelling at 20 mph hitting a stationary cyclist.

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contrabland | 10 years ago
0 likes

Neurosurgeon that only sees cyclists requiring neurosurgery believes helmets do no good. Slow  41

I get the feeling his neurosurgery would be considerably busier if we all stopped wearing them.

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fluffy_mike replied to contrabland | 10 years ago
1 like

Yes, your instincts are obviously much more reliable than the reams of evidence that show very clearly that if people don't wear helmets, they don't suffer more head injuries.

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peterben | 10 years ago
0 likes

Most surgeons are arrogant. At least the ones I know.

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peterben | 10 years ago
0 likes

Guy crashed on my club ride this morning; broken clavicle and trashed helmet. At least he didn't leave his scalp on the tarmac as would have happened without it.
Why take the chance with something you forget you are wearing most of the time?

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Legin | 10 years ago
0 likes

I wear one (I have two actually; training & racing); the rest of you can do whatever you like  1 Your bonces are not my problem!

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Paul J | 10 years ago
0 likes

Welsh Boy,

If you don't care to read something, then don't. Replying just to put others down is, frankly, the mark of a cock.

Thanks,

Paul

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harrybav | 10 years ago
0 likes

Angie Lee, part-time "chief executive" of BHIT, is a single-minded heavily overweight non-cyclist.

BHIT has received approx. £750,000 over the last 5 years. Up to a half is used each year to raise more income. The rest publicises the dreadful dangers of cycling and the helmet solution to schools and the media.

No infrastructure advocacy, just the dangers and the helmets.

Here she is:
http://www.getreading.co.uk/special-features/pride-reading-nomination-an...

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Kenbuterol | 10 years ago
0 likes

I have the dubious pleasure of interacting with neurosurgeons on a daily basis. It is important to ignore most of what they say that doesn't pertain to the patient in front of them. Even then it's important to let them change their mind a few times before taking action.
This is because they will offer an opinion on everything from the best way to brew tea to the management of head lice.

Wonderful people really....

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Khas01 | 10 years ago
0 likes

Your head, you decide.

Henry Marsh talks a lot of sense, and other people in the trade have similar views. But remember they see the bad end of the spectrum.

I think RTA with vehicle = minor reduction in damage to head but even a 30 mph impact will result in no meaningful protection.

Fall on my own ie stationary and still clipped, or wash out front wheel on bend then head safer and less cut.

Legislation not the way to manage this, unless it's part of a law that tells us how to hold a pencil when running...

I wear goggles in playing squash and a helmet to protect me from my stupidity when cycling.

Strict liability will have much greater impact.... But that's another discussion.

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IanW1968 | 10 years ago
0 likes
Quote:

I don't accept this argument when one of the choices has a social cost. You get hurt or killed and society bears the cost.

Theres nothing to support this argument and a lot to discredit it.

Quote:

Do or Don't the choice is yours?

First poster has it nailed..

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mathelo replied to IanW1968 | 10 years ago
0 likes

As in what to discredit this argument? Please provide support. Clearly there is a cost to society - hospital bills, cremation costs. Admittedly the latter may have a social benefit.

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mlimburn | 10 years ago
0 likes

It is a choice, Although I do wonder about these studies showing motorists take more care when someone isn't wearing one!

I had a big accident and wasn't wearing one. Estimated impact speed 40MPH on to the road with my head leading, concussion was the least of my worries.

I wear one all the time now, otherwise the wife won't let me out to play on my bike  102

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drfabulous0 | 10 years ago
0 likes

He wears a cowboy hat? That's cool but how does it stay on at speed?

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kie7077 | 10 years ago
0 likes

Angie Lee, Chief Executive of the Bicycle Helmet Initiative Trust said: “I hope he is going to take responsibility for the cyclist who gets injured because they take their helmet off following his comments.

1) He's a leading neurosurgeon so yes %^&$% he takes responsibility.

2) Are you going to take responsibility for all of the close passes by drivers who assume that wearing a helmet means you don't need to cycle around pot holes? No, because your responsibility is to bitch about things when someone threatens the profits of helmet manufacturers, money 1st right?

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Sensible | 10 years ago
0 likes

That's just one experts opinion. There will no doubt be many others that disagree.

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jamiemfranklin | 10 years ago
0 likes

The key phrase here, in the second paragraph, is 'his patients'. He only sees/operates on the patients with significant neurological brain injury, but not those who potentially saved a trip to Neuro ICU/theatre by their helmet. Equally, for all he knows 'his patients' may have had even more significant injuries without their 'flimsy helmets'. He has extrapolated from his personal experience.

Are helmets likely to cause harm in the event of head trauma? No. Could they offer some protection in the event of head trauma? Clearly. You don't need a randomised-controlled trial of parachutes...

Concerning to hear drivers give a helmet-wearer less space, but this is about driver behaviour and not about the efficacy of helmets.

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drfabulous0 replied to jamiemfranklin | 10 years ago
0 likes
jamiemfranklin wrote:

Are helmets likely to cause harm in the event of head trauma? No. Could they offer some protection in the event of head trauma? Clearly. You don't need a randomised-controlled trial of parachutes...

That's your opinion, not science. The world is clearly flat.

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