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

Neurosurgeon also admits to regularly jumping red lights

by Sarah Barth   May 31, 2014  

White cycle helmet

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.”

78 user comments

Latest 30 commentsNewest firstBest ratedAll

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.

http://uk.virginmoneygiving.com/ValentinKokorin

London2Paris24: 450km, 24 hours, 5th-6th July 2014

I will miss TdF in Yorskhire!!! Please donate! Big Grin

koko56's picture

posted by koko56 [313 posts]
31st May 2014 - 22:30

like this
Like (24)

Pick a side of the argument

Be a dick about it

specs's picture

posted by specs [6 posts]
31st May 2014 - 22:39

like this
Like (32)

specs wrote:
Pick a side of the argument

Be a dick about it

I prefer to make my argument rationally, and with respect for those I disagree with.

posted by felixcat [204 posts]
31st May 2014 - 22:42

like this
Like (22)

I ride with an experienced and mature doctor from time to time and he does not wear a helmet though he is cautious and would never run a red light. He explained that throughout his career he's seen helmets make a difference in serious accidents but more often than not it's the difference between being dead and being brain damaged. He'd prefer death. It's a complex issue, not sure where I stand. I wear a helmet when I know I'll be riding through busy areas or if there's a chance of ice, if I'm doing an early weekend summer ride I don't bother. You don't have to be a helmet wearer or a non-helmet wearer. You don't have to take a stand. Just evaluate the conditions and make an informed choice on the day, if you're worried about your noggin put a helmet on, it's your choice.

posted by morgyface [1 posts]
31st May 2014 - 22:51

like this
Like (33)

I would think that most of the brain injuries a surgeon sees which are the result of road incidents are not cyclists, but pedestrians and car occupants.

So the question is, why do some medics pick on cyclists as the ones who should have worn a helmet?

The answer must be that they share the "common sense" attitudes of the rest of the population, outside their area of knowledge which is treating the injuries, not preventing them.

Science uses data to escape the limitations of common sense.

posted by felixcat [204 posts]
31st May 2014 - 23:14

like this
Like (31)

I always remember Chris Boardman saying that his helmet saved his life that time he crashed in Ireland and ended up in hospital for several weeks.

For my own 2p worth, I only recently started wearing a helmet and I've been a serious rider for over 25 years. Had an accident last year and the ambulance crew couldn't believe I'd spent so much on a Trek Madone and eschewed the lid.

Bike and I were both ok by the way but I'm glad my head didn't come into contact with the road. Worried

michophull's picture

posted by michophull [95 posts]
31st May 2014 - 23:45

like this
Like (20)

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.

PhilRuss

posted by PhilRuss [269 posts]
1st June 2014 - 0:44

like this
Like (24)

I have heard from lots of people how have crashed, hit their head and then said 'wow - thank god I was wearing a helmet, it really saved me'

Never ever heard anyone crash, hit their head and then say 'wow - thank god I wasn't wearing a helmet...'

posted by Must be Mad [24 posts]
1st June 2014 - 2:14

like this
Like (23)

michophull wrote:
ambulance crew couldn't believe I'd spent so much on a Trek Madone and eschewed the lid
Well, this sums up the ignorance and idiocy of it - they imagined your helmet choice was cash driven.

One valid reason to wear a helmet that we might all agree on is that the helmet protects one's fragile bonce from having to listen to their idiotic told-you-so as one is carted into their ambulance following some unfortunate run-in with a drunk driver or dreadful infrastructure.

posted by vbvb [220 posts]
1st June 2014 - 2:42

like this
Like (14)

Must be Mad wrote:
Never ever heard anyone crash, hit their head and then say 'wow - thank god I wasn't wearing a helmet...'
This is true of helmet-wearing pedestrians too.

And you never hear cyclists say "thank god I wasn't wearing a proper actual motorbike helmet rather than this foam helmet" after a tumble. Or spine protection body armour. It's just not something they say. Goes to show, something or other.

posted by vbvb [220 posts]
1st June 2014 - 3:10

like this
Like (29)

Must be Mad wrote:
I have heard from lots of people how have crashed, hit their head and then said 'wow - thank god I was wearing a helmet, it really saved me'

Never ever heard anyone crash, hit their head and then say 'wow - thank god I wasn't wearing a helmet...'

I crashed hard, I had concussion with temporary memory loss (minutes not days). I do not think a helmet would have made any difference, it could have made the concussion worse - rotational injuries. It could have even lead to me being brain-damaged if I had worn a helmet - they aren't magic. I couldn't move my neck for a few hours, split my lip open, if I'd have been wearing a helmet then the neck injury would have most likely been worse - the size of the helmet would have caused a bigger angled deflection of my head off of the road.

All of these people saying 'thank god I was wearing a helmet' don't really know what level of head injury they might have had if they weren't wearing the helmet, perhaps wearing a helmet leads to one subconsciously protecting the head less whilst crashing. I know in the moments before a couple of the crashes I've had, I've had time to make decisions to mitigate damage, for instance rolling on to the pavement to avoid being run over.

Some of the evidence suggest that people who wear helmets are more prone to head injury, for a multitude of reasons, such as both drivers and cyclists altering their behavior for the worse. And of course the perception of cycling being so dangerous that you need to wear a helmet puts people off of cycling, for some whether or not they commute is whether or not they get any exercise.

Why aren't all of the people espousing the virtues of helmets recommending that pedestrians wear them? And why are race cyclists wearing rubbish polystyrene helmets when obviously motorcycle helmets are far superior and better suited to the speeds they are going?

And we should recognise the fact that the dangers are vastly different for a race cyclist, a downhill MTBer and a commuter.

posted by kie7077 [434 posts]
1st June 2014 - 11:27

like this
Like (20)

Three times knocked off in London; first time in 1989: helmetless, concussed and very lucky I didn't catapault through the passenger window of the Transit van that cut across me. I've worn one ever since. Second time: sent spawling over a bonnet in a yellow box junction and head hit windscreen; no ill effect on me. Third time: flying over a bonnet at speed when cut across on fast downhill. Believe it or not I landed and stopped by falling off. A few cuts and bruises and helmet scraped down to the polystyrene.

It is the choice of the individual whether to wear a helmet or not, but I will always wear a helmet. Always.

posted by gussieboy [5 posts]
1st June 2014 - 12:44

like this
Like (18)

Must be Mad wrote:
I have heard from lots of people how have crashed, hit their head and then said 'wow - thank god I was wearing a helmet, it really saved me'

Never ever heard anyone crash, hit their head and then say 'wow - thank god I wasn't wearing a helmet...'

Is it really necessary to point out the flawed logic of this argument? Its the same logic that lies behind all forms of superstition.

posted by FluffyKittenofT... [639 posts]
1st June 2014 - 12:50

like this
Like (15)

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.

posted by fluffy_mike [79 posts]
1st June 2014 - 12:56

like this
Like (28)

gussieboy wrote:
Three times knocked off in London; first time in 1989: helmetless, concussed and very lucky I didn't catapault through the passenger window of the Transit van that cut across me. I've worn one ever since. Second time: sent spawling over a bonnet in a yellow box junction and head hit windscreen; no ill effect on me. Third time: flying over a bonnet at speed when cut across on fast downhill. Believe it or not I landed and stopped by falling off. A few cuts and bruises and helmet scraped down to the polystyrene.

It is the choice of the individual whether to wear a helmet or not, but I will always wear a helmet. Always.

Sorry, your anecdotes have no effect on the evidence, which shows clearly that helmets have a marginal or zero effect on head injuries or personal safety while cycling normally.

posted by fluffy_mike [79 posts]
1st June 2014 - 12:57

like this
Like (21)

fluffy_mike wrote:
gussieboy wrote:
Three times knocked off in London; first time in 1989: helmetless, concussed and very lucky I didn't catapault through the passenger window of the Transit van that cut across me. I've worn one ever since. Second time: sent spawling over a bonnet in a yellow box junction and head hit windscreen; no ill effect on me. Third time: flying over a bonnet at speed when cut across on fast downhill. Believe it or not I landed and stopped by falling off. A few cuts and bruises and helmet scraped down to the polystyrene.

It is the choice of the individual whether to wear a helmet or not, but I will always wear a helmet. Always.

Sorry, your anecdotes have no effect on the evidence, which shows clearly that helmets have a marginal or zero effect on head injuries or personal safety while cycling normally.

The evidence for me personally was clear mate: I wore a helmet on the latter two occasions and it saved me from injury. What you and others choose to do based on a limited number of studies and the anecdotes of a cowboy neurosurgeon are your business entirely.

posted by gussieboy [5 posts]
1st June 2014 - 16:01

like this
Like (22)

I have FAITH; You have SUPERSTITION.

Is the helmet debate the most polarising and entrenched in cycling? Until someone does some definitive and comprehensive research that we can all agree on then I think this matter will remain unresolved.

posted by levermonkey [341 posts]
1st June 2014 - 20:58

like this
Like (14)

i don't think many are anti helmet,

The problem is the pro helmet evangelists seem to be unaware of the design parameters of bicycle helmets. Read the specs, under-stand that they are crap then you might start to understand why helmets are the wrong question to start with.

Start with what causes accidents, standard approach to industrial workplaces.

mrmo's picture

posted by mrmo [1030 posts]
1st June 2014 - 21:23

like this
Like (20)

mrmo wrote:
i don't think many are anti helmet,

The problem is the pro helmet evangelists seem to be unaware of the design parameters of bicycle helmets. Read the specs, under-stand that they are crap then you might start to understand why helmets are the wrong question to start with.

Start with what causes accidents, standard approach to industrial workplaces.

+1 - bear in mind too those commenting how the fatality rate amongst motorcyclists dropped when helmets were made compulsory in 76 tend to overlook that motorcycle helmets are rather more protective than the bits of plastic passing themselves off as head protection for cyclists.

OldRidgeback

posted by OldRidgeback [2132 posts]
1st June 2014 - 21:47

like this
Like (20)

levermonkey wrote:
Until someone does some definitive and comprehensive research that we can all agree on then I think this matter will remain unresolved.

I think the "experiments" in compulsion in NZ, Oz and some North American jurisdictions are pretty conclusive. Take a look at this.

http://rdrf.org.uk/2013/12/17/the-effects-of-new-zealands-cycle-helmet-law/

Of course there are those who prefer not to accept evidence they don't like, and it will always be impossible to convince them. Look at the climate change deniers.

And it is always difficult to go against conventional wisdom and common sense.

posted by felixcat [204 posts]
1st June 2014 - 22:48

like this
Like (16)

felixcat wrote:
levermonkey wrote:
Until someone does some definitive and comprehensive research that we can all agree on then I think this matter will remain unresolved.

I think the "experiments" in compulsion in NZ, Oz and some North American jurisdictions are pretty conclusive. Take a look at this.

http://rdrf.org.uk/2013/12/17/the-effects-of-new-zealands-cycle-helmet-law/

Of course there are those who prefer not to accept evidence they don't like, and it will always be impossible to convince them. Look at the climate change deniers.

And it is always difficult to go against conventional wisdom and common sense.

I didn't mention "compulsion" in my post and I never would.

Just to make my position clear
1) I am not pro or anti helmet.
2) I am anti EN1078.
3) I am pro informed choice.
4) I am anti self appointed radicals who give themselves grandiose titles and pontificate on matters calling for actions that do not and will not affect them. Quite frankly it's like a celibate man pontificating [note careful choice of word] on contraception.
5) If helmet wearing was made mandatory for cyclists then it should also be mandatory for all users of the highway as all users of the highway are at risk of head injury.
http://www.copenhagenize.com/search/label/helmets%20for%20motorists

I hope this helps to clarify my position. If not tough! Big Grin

posted by levermonkey [341 posts]
2nd June 2014 - 6:46

like this
Like (8)

I wear one. I make my kids wear one. I couldn't care less if you wear one. If they were made compulsory I wouldn't care very much at all (although according to a poster on another thread, this is because I am a supporter of TYRANNY). I would prefer it if people who elected to wear a helmet put them on properly (not backwards - yes, I've seen it done - or too far back on individual's skull). But otherwise I just don't care. really, we should all stop this and go and worry about something much more important.

Dear Road.cc: can we please, please, please stop it with helmet articles? I assume they are only published to get page impressions up. The articles themselves are of no value whatsoever.

posted by surly_by_name [137 posts]
2nd June 2014 - 9:11

like this
Like (13)

The biggest issue with the whole helmet debaracle. Is that *if* the pro-hemlet lobby is correct (and I am not entirely convinced that it is) is that there is a much stronger argument for pedestrians to have madatory helmets (given that there are far more pedestrians and far more pedestrain-vehicle collisions).

posted by Wolfshade [92 posts]
2nd June 2014 - 9:40

like this
Like (18)

Surely it's the unpredictable nature of a crash away from a race circuit, whether it's an urban commute or a recreational ride with mates, that makes helmets a sensible choice. Consider a MotoGP crash, where a rider comes off at 150mph and slides down an empty track (or across the grass) generally avoiding serious injury… and contrast it with some poor commuter who gets nudged at 30mph and hits a lamppost or a kerb with potentially life-changing results.

www.mombee.com - Muddy bikes, Road bikes and Family rides in Malmesbury and the South West

posted by Mombee [40 posts]
2nd June 2014 - 9:44

like this
Like (11)

Mombee wrote:
Surely it's the unpredictable nature of a crash away from a race circuit, whether it's an urban commute or a recreational ride with mates, that makes helmets a sensible choice. ....

Surely it's the unpredictable nature of a fall or collision away from a race circuit, whether it's an walk to the shops or a recreational jog with mates, that makes helmets a sensible choice

FTFY

posted by kie7077 [434 posts]
2nd June 2014 - 12:13

like this
Like (12)

Looking at this with a purely scientific view,

I've never seen/heard or read anyone/thing or where that managed to replicate the exact same crash they had to see if the helmet saved their life/brain or sanity. In fact replicating the exact conditions would be impossible as both parties to the crash would know what was going to happen. Nor have I seen someone produce figures that prove that the helmet reduced the impact they encountered. I.e. I suffered a 4G impact, the helmet soaked up 2G and my brain survived the resulting 2G impact. The last crash though was 5G and, oops please excuse me whilst I wipe the dribble, I suffered brain damage.

Citing an increase in brain injuries doesn't prove the uselessness of said bits of plastic, as exactly the same figure could be used to prove an increase in cyclists, increase in cycling accidents, increase in cyclists taking chances, increase in motorists and on and on on on....

I have two, I've smashed several, would I want to find out if they helped, NO! Can I say they helped, no! I'm still here talking bolxs tho.

posted by Yorkshie Whippet [282 posts]
2nd June 2014 - 13:34

like this
Like (6)

felixcat wrote:
levermonkey wrote:
Until someone does some definitive and comprehensive research that we can all agree on then I think this matter will remain unresolved.

I think the "experiments" in compulsion in NZ, Oz and some North American jurisdictions are pretty conclusive. Take a look at this.

http://rdrf.org.uk/2013/12/17/the-effects-of-new-zealands-cycle-helmet-law/

Of course there are those who prefer not to accept evidence they don't like, and it will always be impossible to convince them. Look at the climate change deniers.

And it is always difficult to go against conventional wisdom and common sense.

To be fair, there's a difference between 'conclusive research' on mandatory helmet laws, and 'conclusive research' on the effectiveness of helmets in accidents. They are two slightly different things (the former seems to be as you say, the latter seems to be undecided), hence you might be arguing at cross-purposes.

posted by FluffyKittenofT... [639 posts]
2nd June 2014 - 15:54

like this
Like (4)

surly_by_name wrote:
I wear one. I make my kids wear one. I couldn't care less if you wear one. If they were made compulsory I wouldn't care very much at all (although according to a poster on another thread, this is because I am a supporter of TYRANNY). I would prefer it if people who elected to wear a helmet put them on properly (not backwards - yes, I've seen it done - or too far back on individual's skull). But otherwise I just don't care. really, we should all stop this and go and worry about something much more important.

Dear Road.cc: can we please, please, please stop it with helmet articles? I assume they are only published to get page impressions up. The articles themselves are of no value whatsoever.

I can't help seeing something contradictory about saying you don't care, while simultaneously throwing your ha'pennyworth in!

I would care a lot if they were made compulsory, and I'd care even if I didn't cycle myself.

Compulsory helmet law = cycling suppressed = more cars on the roads. I don't want that, entirely independently of whether I cycle myself or not. For one thing, I quite like breathing, for another they get in my way regardless of whether I'm walking, cycling, or taking the bus.

My main interest in all of it really is as someone who thinks there are far, far, too many cars on the streets of cities, rather than being that bothered about my own cycling.

posted by FluffyKittenofT... [639 posts]
2nd June 2014 - 15:57

like this
Like (10)

Can we put a lid on this thread?

It's going round in circles like a rider at a velodrome, but with less achievement.

OldRidgeback

posted by OldRidgeback [2132 posts]
2nd June 2014 - 16:40

like this
Like (11)

Very unprofessional. This 'doctor' is a disgrace to his profession - and the cycling community.

Advice is a form of nostalgia. Dispensing it is a way of fishing the past from the disposal, wiping it off, painting over the ugly parts and recycling it for more than it's worth.

jmaccelari's picture

posted by jmaccelari [144 posts]
16th June 2014 - 19:32

like this
Like (6)