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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.”

After an unpromising start, having to be bribed by her parents to learn to ride without stabilisers, Sarah became rather keener on cycling in her university years, and was eventually persuaded to upgrade to proper road cycling by the prospect of a shiny red Italian bike, which she promptly destroyed by trapping a pair of knickers in the rear derailleur. Sarah writes about about cycling every weekend on road.cc.

80 comments

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Rouboy [91 posts] 2 years ago
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Here we go again!!
Do or Don't the choice is yours?

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Pazaa [3 posts] 2 years ago
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This isn't about HGVs etc...I came off my bike on black ice last winter. Bike shot right, I got whiplashed left and cracked my head on the ground. According to the neuro doc who saw me, the point of impact could have been fatal if I had not had a helmet on. Cheap little £30 helmet saved my life probably, and I was only doing 5mph! Agree the choice is yours, but for a few 100g, I will always wear one.

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nuclear coffee [209 posts] 2 years ago
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Ah ha ha ha ha.... that's going to cause a ruckus. Though, next time someone tells me about how the bored nurse they once talked to said helmets save lives...

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Sangharaja1 [9 posts] 2 years ago
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Im with Ms Myles on this one so I will carry on wearing a helmet.....I fell on ice at slow speed a while ago... the helmet saved my head from hitting the road directly, so I avoided concussion at least,I think.
For me its more worrying when an emminant brain surgeon jumps a red light surely he must of seen the result of those kinds of accidents .. for me its a kind of percentage game, eventually I could get hit,(and it doesn't get car drivers so wound up, I hope)

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Jack Osbourne snr [438 posts] 2 years ago
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When I was younger, I didn't wear a helmet. I had several crashes including being run off the road into a ditch but somehow never smacked my head.

My wife eventually persuaded me to wear a helmet about 15 years ago and since then I have smacked my head off tarmac twice.

By this measure it is surely a result of me wearing a helmet that has led to these incidents?

Seriously though, while a helmet won't do much in a head on collision or prevent injury when a truck rolls over the top of you, it will help when you come off otherwise.

Recently, I crashed at just under 30mph and was unconscious for nearly 15 minutes, I had and still have have memory issues, mild aphasia, and issues with irritability and mood swings... Nearly three months later.

Had I not been wearing one...?

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Forester [116 posts] 2 years ago
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Agreed, it sounds as if he is referring to the tiny padded leather helmets worn by the pros in the 50's and 60's. 'Eminent neuro surgeons' tend to think they are experts on everything, and he will only see the most severely injured people transferred from lesser hospitals. Views of experienced road cyclists equally valid, and the jury is still out.

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darrenleroy [213 posts] 2 years ago
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I was riding on black ice once and fell heavily on my left arm. I wasn't wearing a helmet, but I'd wrapped my entire body in several layers of bubble wrap as a precaution and this made the bruising on my arm less severe than it could have been.

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Jimmy Ray Will [470 posts] 2 years ago
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FFS...Not again!

I will only day the following... If you bang your head in a helmet and walk away unscathed, the chances are that it didn't save your life.

If you spend three days in a coma and have a serious concussion, then yeah, maybe your helmet made a life and death difference.

It bugs the hell out of me when folk was lyrical about the magical life saving properties of helmets.... It's an inch of polystyrene, that's all. Yes they add protection, and that protection van make all the difference, but for lives to be at stake, you'd still be walking away with a mighty headache.

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specs [6 posts] 2 years ago
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No this again...Wear or don't wear, it's a choice.

I don't really care what other people do.

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Jack Osbourne snr [438 posts] 2 years ago
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specs wrote:

Wear or don't wear, it's a choice.

Of course it is.

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CanAmSteve [252 posts] 2 years ago
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Got a book to promote, do we?

Look - you can wear a helmet or not - your choice and I'm not in favour of laws. But let's say we each get one smack at the other's head with a cricket bat. I'll have my helmet on, thanks.

Remember the MMR anti-jab 'Doctor" ? How many people's lives has he ruined?

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Steezysix [21 posts] 2 years ago
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Trouble is, he's only going to see a narrow cross section of accident victims. While he might deal with serious head injuries. he's not going to be seeing the minor scrapes that people walk away from, or dead people is he?
And the line about "his life, his risk" makes him sound like a complete tw@ - how about the person that hits you? I'm sure they just carry on with life as usual?

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Paul J [884 posts] 2 years ago
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So, a helmet effectively makes your head significantly *wider*, and adds a modicum of extra weight. If you fall sideways and your helmet bangs the road that DOES NOT necessarily mean your helmet saved your head from a bang. Without the helmet, your head would effectively have been narrower, and slightly lighter, and may not have hit the ground *at all*.

See also: https://www.youtube.com/watch?v=Lqo4hwnJt6Y ("glad" is dutch for slippy). Note the instinctive reactions people have to lift their heads away from the fall, while sticking out their arms. There are maybe 1 or 2 people who /maybe/ hit their heads. If all those people had been wearing helmets, more would have hit the ground with helmet and have "a helmet saved me!" stories like yours I suspect.

I once, after a sportive, allowed myself and my bike to flop sideways onto a grassy bank, I was so exhausted. I was just expecting to break the fall with my hip and shoulders. I actually ended up with a bang to the head, because the width of my helmet meant it hit the ground and transmitted the shock to my head. Without a helmet, I'd have been fine.

Helmets *do* make a noticeable difference to head injury rates (circa 1.25 to 1.6 times improvement). However, they also slightly increase other types of injury, neck particularly, because of the width and weight issues - and possibly also because of risk compensation issues.

The thing is, the difference helmets make is *piddling* compared to building safe infrastructure for cyclists. The Netherlands has a *many fold* (don't have the figures to hand, something like 5 to 7 times from memory) better death/injury rates than UK.

A 5 to 7 times improvement is *much* better than a 1.2 to 1.6 times improvement. But wait, I hear you say, surely it's not an either/or thing? Wouldn't it be best to have *both* the helmet improvement *and* the safe infrastructure improvement? Well, that's an interesting question. First, if things are much safer, the small improvement may matter much less. Second, it assumes you can have both. However, what if the 1.2 to 1.6 times improvement might actually *decrease* your odds of ever being able to achieve the 5 to 7 times improvement? What if helmets made the safe infrastructure less achievable?

If that sounds ridiculous, consider that countries with helmet pushing cultures or laws, seem to also have low cycling rates, and refuse to invest significantly in proper networks of high-quality cycling infrastructure. Given that helmet pushing seems to discourage cycling (laws definitely do, so it's not unreasonable to think cultural pressure might also), it's actually possible there's a causative process there:

1. In response to increasing perception of danger to cyclists on the roads, various people and orgs push helmets or help reinforce a helmet culture, and so implicate cycling as being unusually dangerous.

2. Some people choose not to cycle (or let their children cycle), because it seems dangerous

3. Fewer people cycling means that:

a) motorists become less aware of how to behave around cyclists, and so the roads become a little more dangerous;

b) politicians have less reason to do anything substantive for cycling safety, so more safe infrastructure just doesn't get built, and any such infrastructure that's there doesn't get maintained. Further, the smaller cyclists become as a group, the more susceptible the politicians become to victim-blaming, cycling-reducing measures from various car and "grieving but unfortunately clueless mother" lobbies. E.g. see helmets laws in AU, NZ, etc., and the daft crack-down on cyclists in New York in the USA.

4. Go back to 1, ad infinitum.

Unfortunately, it's really hard to setup well-controlled experiments involving entire societies. However, comparing the Netherlands and the UK, I feel the above is a very plausible effect.

Helmet cultures may make it *harder* to get safe infrastructure and *real* safe cycling for the masses.

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Welsh boy [293 posts] 2 years ago
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Paul, one word for your verbose post - and that is "yawn".

Now, before deciding if you are going to wear a helmet or not, next time you are doing 30mph in your car, look out of the window and ask yourself if you were going to jump out at that speed, would you rather have a little bit of head protection on or not? A 30mph crash off a bike is going to be similar, the choice is yours.

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jamiemfranklin [8 posts] 2 years ago
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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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Sensible [68 posts] 2 years ago
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That's just one experts opinion. There will no doubt be many others that disagree.

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kie7077 [877 posts] 2 years ago
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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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drfabulous0 [409 posts] 2 years ago
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He wears a cowboy hat? That's cool but how does it stay on at speed?

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drfabulous0 [409 posts] 2 years ago
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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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mlimburn [28 posts] 2 years ago
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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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graham_f [186 posts] 2 years ago
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CanAmSteve wrote:

But let's say we each get one smack at the other's head with a cricket bat. I'll have my helmet on, thanks.

Yes, but it's an awful lot subtler than that though isn't it? If wearing a helmet increases the chances of you getting hit in the first place, and there are studies that suggest that, then it's not as straight forward as saying "I want a helmet on if I bump my head"

For me the most compelling argument is that the countries with the lowest levels of helmet use also see the lowest levels of cyclist head injuries. That's probably largely down to the fact they have proper infrastructure, so that's what we need to concentrate on instead of endless arguements about polystyrene hats.

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Mathelo [21 posts] 2 years ago
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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.

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IanW1968 [271 posts] 2 years ago
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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 [21 posts] 2 years ago
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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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Khas01 [4 posts] 2 years ago
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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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Kenbuterol [11 posts] 2 years ago
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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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vbvb [597 posts] 2 years ago
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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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goggy [153 posts] 2 years ago
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Pazaa wrote:

This isn't about HGVs etc...I came off my bike on black ice last winter. Bike shot right, I got whiplashed left and cracked my head on the ground. According to the neuro doc who saw me, the point of impact could have been fatal if I had not had a helmet on. Cheap little £30 helmet saved my life probably, and I was only doing 5mph! Agree the choice is yours, but for a few 100g, I will always wear one.

I'm with you on this one - I had a similar experience and while the helmet doesn't help with concussion from the impact, it does stop your skull from cracking open on the tarmac or pavement and little splinters of bone going into your brain. I think until people who are anti-helmet have an experience like this they will keep their views. Does it discourage people from cycling? Yes, some. Do I care about helmet hair? No.

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Paul J [884 posts] 2 years ago
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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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Legin [97 posts] 2 years ago
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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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