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Helmet debate

Please take the time to read this article to get a better idea about helmet safety.

A Second Chance
By Jeff Sambur

Late lunch? Bonus miles in Glacier National Park? Early Happy Hour?
These were some of my random thoughts as I huffed up the final pull toward the summit of Marias Pass. I was en route from West Glacier, Mont., to East Glacier on what was supposed to be a mellow seven-to-10-day circumnavigation of the Glacier/Waterton National Park complex. I was a mere half hour from completing these decisions when I was thrust into a cave.
Total darkness … no sound … no brakes screeching … no thud of my body smashing the sedan’s windshield … no noise as I went rolling and tumbling across 35 feet of asphalt and gravel. When I awoke in a ditch, a Good Samaritan was applying spinal traction to my neck. The peripheral vision from my left eye saw the drip, drip, drip of blood oozing from my nose. My right eye was swollen shut.
“What happened?” I asked weakly.
“You got rear-ended by a car. Don’t move!” she answered. She then called out, “He’s coming around. I’ll need some help here.”
I estimated I had checked out of planet Earth for two to four minutes. First responders in civilian clothes assisted me as they poked and plodded my body and took primary and secondary surveys of my injuries.
“Can you move your feet? Can you wiggle them? Squeeze my hands. Are you having trouble breathing?”
The questions came fast and furious: I passed the tests with flying colors. My spinal column was not severed. I was alert enough to pick up a distinct British accent from the crowd gathering above me. I got his attention.
“Was it you who hit me?”
“Yes. I was sightseeing and looking at the mountains and drifted into you.”
I might have said a few choice words to him, but I don’t recall. I don’t remember much, although I remember he never said he was sorry.
An ambulance from Browning arrived and I was placed on an unforgiving backboard and cervical collar. We raced back to the ER with the emergency lights on and sirens blaring. It was a bumpy, rough ride as we careened down the pass and through a construction zone. A paramedic attempted two sticks to get an IV into me and failed both times.
“Please don’t stick me again. I hurt enough already. They can do that in the ER under better conditions. I promise I won’t die before then.”
“OK. We can hold off on it.”
“Thanks.”
At the ER, a doctor made her orders known. “He’ll need a CAT-Scan of his head. Get a set of X-rays for his neck, chest and spine. Set him up with an IV ASAP. We’ll need to monitor his vital signs.”
The nurses and technicians efficiently carried out her orders. I was then in the hurry-up-and-wait mode of emergency medicine. A nursing student gently dabbed the grit, grime and dried blood from my many facial wounds and multiple areas of road rash. I even had road rash on the tops of my feet. Apparently, the force of the impact literally knocked me out of my shoes.
The compassionate ER doctor came to my side to survey the carnage to my face. She held my hand as she said, “Those lacerations and avulsions will need the care of a plastic surgeon. I can stitch them for you, but they can do a better job. Would you like me to arrange a helicopter transport to Kalispell Regional Medical Center? We can have a plastic surgeon waiting for you.”
“Please do. I am not a handsome man to begin with and I can use all the help I can get.” With that sad news, I knew my Hollywood contract as George Clooney’s double would surely be terminated. Shucks!
“We’ll arrange it. The CAT-Scan of your head and brain came out with negative findings. That is a good thing. We are waiting now for the radiologist to evaluate your neck, chest and spine X-rays.”
“Thanks for all the help. Can I get off of this backboard? It is really beginning to hurt me. I’m OK. I can move all of my parts.”
“Please wait a few minutes until we get the radiologist report. This is all precautionary.”
“OK. I’ll try.” The pressure point where my head contacted the backboard was starting to throb.
A few minutes later, (which seemed much longer) the nice ER doctor came back. Once again she held my hand.
“I have bad news. The radiologist found 11 fractures in your first 11 vertebrae. You have a broken sternum, too. There will be a neurosurgeon waiting for you in Kalispell, also.”
“What? How can that be? I can move all of my parts. Are you sure those were my X-rays?”
“Yes, those were your X-rays. You will get the best of care in Kalispell. I have a special place in my heart for bicycle riders. My son was killed by a driver 20 years ago when he was riding a bike. We will take care of you.”
No wonder she was holding my hand.
The helicopter flight crew came and checked me out. “We will hold off on the morphine drip until we get him to Kalispell. Jeff, we are going to give you a scenic ride over Glacier National Park. I am sorry to say you won’t get a chance to enjoy the views.”
With little fanfare, I was loaded and airborne. They had placed painkillers in my IV, so I became groggy, blurry and disconnected. I remember peeking at the snowcapped mountains briefly. Alas, I would not get to enjoy my $11,000 taxi ride to Kalispell. This was all business.
Upon arrival to my second ER of the day, a plastic surgeon went to work on my tenderized face.
“I will try to stitch you to minimize the scarring. However, there will be some scarring no matter what.” All in all, 20 stitches were applied to my eyebrows and right cheek. When she was done she asked. “Would you like to see my work in a mirror?”
“Sure!” I steadied myself for the view. OMG! I was staring at a mini-version of Frankenstein. My mug was enough to make a child cry. Dating would truly be more challenging in my future.
It was time to get past the cosmetics. A large neurosurgeon with sandy-colored hair and a stoic bedside manner approached me. “We won’t be operating on you. With all of your breaks, we would not even know where to start. Your spinal column is intact and not being impinged upon. We will place you in ICU and monitor your X-rays. We will hope there are no radical changes or shifts in your column. Now it is time for you to go on a morphine drip …”
“One question please. What is my long term prognosis?”
“We don’t know. We don’t see many patients like you.”
“Why is that?”
“Because they are usually dead.”
I whispered a lame, “Oh!”
The next few days on the morphine drip were a haze of dreaming and snippets of reality thrown in. Concerned friends and family members phoned me. I have no recollection of the conversations. I do recall the nursing staff getting me up and out of bed. I even walked up a flight of steps under their watchful eyes.
Best of all, my older brother Mike arrived from New York City to take care of his “baby” brother. I wept shamelessly as he entered the room. He went on to prove once again why he is the best brother in the world.
Four days after the impact, I was discharged from the hospital. My post-discharge orders were written out and terse. “Do Not Remove the Brace!” It looked like sponge baths and partial shampoos would be my method of hygiene for awhile. Gross.
Mike and I began a 1,000-mile journey south to my old hometown of Fort Collins, Colorado. He drove and I navigated. The plan was for me to get a second opinion from neurosurgeon number two and to convalesce in familiar surroundings.
I told Mike a few times: “I always wanted to take a road trip with you, but this is not what I had in mind.”
Eight days after the accident, Mike and I listened to neurosurgeon number two, a no-nonsense, no-sugar-coating doctor who calls it like he sees it. He does not believe in small-talk. I suppose after 35 years in the game, he has that right.
“Your vertebrae fractures are mild. You do have a definite broken sternum. I believe you will heal OK. We will take another set of X-rays in a few weeks to see if there are any changes. I doubt there will be. I’ll see you again in three weeks.”
In my former life, I worked for 28 years as a firefighter/EMT for the city of Fort Collins. In emergency services, the term “mechanism of injury” is bandied about to predict the outcome of an accident.
A small, 138-pound man being struck from behind by a sedan traveling at more than 50 mph is an obvious assault upon the body. Humans are not wired to survive such an ordeal. During my career, I went on calls for three similar bicycle accidents. For those unfortunate victims, there was no tomorrow. The one and only thing that separated me from them was my use of a bicycle helmet.
Now in Fort Collins, I meet former lovers, friends and acquaintances on the street. I smile grandly as I maneuver in to hug them. If the hug lingers long enough, I usually score a life affirming squeeze at the end. I make sure to pay back that squeeze in kind.
Second chances in life are precious. I do not wish to squander this one.

If you're new please join in and if you have questions pop them below and the forum regulars will answer as best we can.

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109 comments

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felixcat replied to Saved by a helmet twice | 11 years ago
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If British cyclists want to see safer roads for cyclists, and I'm sure we all do, it beats me why we should want to follow the example of the countries which have a high casualty rate for cyclist, and not those which have a low casualty rate.
Helmet advocacy is a symptom of dangerous roads, not a cure. I can understand why cyclists want to believe that helmets will make them safe, but a scrap of polystyrene is really not much defence against a ton of carelessly handled steel.

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giff77 | 11 years ago
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All anecdotes aside. Jump on to YouTube and compare cycling in any UK/US city to any European city and you will see a huge difference. Take note of the types of bike, style of cycling, motorists attitude towards cyclists. All this contributes to a safer environment for cyclists. And guess what, hardly a helmet!

Here's a clip http://m.youtube.com/watch?v=a_8dGodhGtI&api_format=3&vndel=watch

Rather than advocate helmet use we should be lobbying for better laws and infrastructure for cyclists.

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Paul J | 11 years ago
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Again, I really hope the nurses and EMTs here who are so sure about the wisdom of cycle helmets also advocate just as strongly for car-occupant helmets and pedestrian helmets.

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felixcat | 11 years ago
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Hippy69, I DO NOT want to try to discount the pain you must feel seeing the hunan results of road accidents, I would find your job very difficult. As Paul J says, surely the victims who were in cars or on foot need consideration, or, if helmets are the answer, should wear helmets.
With all due respect for your compassion and skill, I would no more take the advice of a nurse or a doctor on how to avoid an accident than the advice of a mechanic or panel beater.

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hippy69 | 11 years ago
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Paul J & Felixcat, Guys, I was merely using anecdotes to show why "I" wear a helmet and how I believe it saved ME from more significant injury. I feel helmets should be purely optional and have no interest in making them compulsory, and yes dangerous roads probably do exacerbate the use of helmets. Helmets are not the answer to increasing cyclists safety, merely an added precaution I and others wish to take. Woulter Weylandt wasn't saved by his helmet! RIP182, but I'll still wear mine thanks.

Improving road layouts etc as they have in europe, and educating car drivers are far more effective ways of increasing safety. I've been lucky enough to ride lots of dutch streets and am constantly amazed at how safe it feels. Driver attitudes are far better in most of europe compared to the UK, I ride in france every summer and rarely experience the hostility I encounter on every ride back home. incidentally, I am a member of several campaigns to develop the 'Go dutch' systems to improve safety for me and others in London.

Cyclists are no blameless angels , we need to educate cyclists as well. Dangerous cyclists injure pedestrians by jumping lights etc. Would I ever tell a pedestrian to wear a helmet? Certainly advise them to look both ways before they step into the road! And remember, cars drivers have a big metal box and airbags around them, not fresh air and lycra, and most serious injuries to drivers are caused in high speed RTC's.

And guys, I'm the last person to ask about crash avoidance technique, my wife's getting a little fed up picking me up from hospital. Just can't resist those fast descents! the best thing about going uphill is coming down the other side. Does wearing a helmet make me take more risks, I doubt it, dude I'm dressed in Lycra, more concerned about tearing my skin off. BUT, I believe it may help me avoid a worse head injury if I wear one.

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Stumps replied to giff77 | 11 years ago
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giff77 wrote:

All anecdotes aside. Jump on to YouTube and compare cycling in any UK/US city to any European city and you will see a huge difference. Take note of the types of bike, style of cycling, motorists attitude towards cyclists. All this contributes to a safer environment for cyclists. And guess what, hardly a helmet!

Here's a clip http://m.youtube.com/watch?v=a_8dGodhGtI&api_format=3&vndel=watch

Rather than advocate helmet use we should be lobbying for better laws and infrastructure for cyclists.

I agree with your comments completely in relation to infrastructure and laws, but as we know there are numerous drivers who dont either care or cant be bothered. In the short term a helmet will cost 60 - 100 quid whereas infrastructure changes are in the region of billions.

It should be a long term goal but there is no way on this earth that the present govt will sanction money to be spent in that amount when they are cutting back everything (apart from effects them).

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Stumps | 11 years ago
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I asked this once before but can anyone who does not wear a helmet explain why without rambling on about it.

For instance i wear one because i feel safer at the speeds i travel and roads i travel upon.

So if you dont feel safer please tell us or is it just down to looks  13

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Paul J | 11 years ago
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I don't wear one because they're hot.

I actually don't *want* to feel safe from wearing one. That's because I know, from previous experience, just how much the *other* parts of your body get injured in a crash. A helmet will not protect my limbs, my torso, my face. To the extent a helmet makes me feel safer, it may make the *rest* of my body less safe by making me accept more risk. I don't want any sense of false security a helmet might give.

My approach to safety is to slow down when I see hazards (e.g. cars waiting to come out of, or turn into a side road). To avoid the risk in the first place. I've been with helmeted riders in group rides who've asked me how I can be so reckless with safety. Then I see the same riders speed into turns¹, with very little margin for error. I've seen helmeted riders take daft risks on descents, then seen them on the floor after a corner. With bad cuts on their body, they've praised their helmet for saving them - but to me it looked like they risked their life speeding into blind corners on a 1-vehicle-wide, narrow country lane. Did the helmet protect, or did it suck them into terrible risks through a false sense of security?

I don't want to *feel* safer, I want to *be* safer.

1. This doesn't even always get them any further than me, because it's speed on corner exit that's the important bit - faster speed on entry needn't mean faster speed on exit.

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Gkam84 | 11 years ago
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I have a helmet, there are only two reason's I wear it, if I got to an event where you HAVE to wear it or if i'm off the roads and doing the local paths on my cross bike. Because they are shared use paths, I am never at high speeds and I can see the dangers of tree stumps and things if I was to come off.

On the road, I simply don't see ANY benefit to wearing one. Apart from the steepest of hills, I am never travelling in the 12-15mph range that helmets are designed for.

If I am hit by a car AGAIN, then a helmet is not going to do anything apart from save me going bald with scars.

If you think being knocked down by a car from your bike is going to cause any less damage to your brain by wearing a helmet, then good on you. But the fact is, there is no proof to this, just anecdotal evidence.

I feel that if I am stuck again, some foam around my skull is going to do nothing, I might aswell wear some bubble wrap, it works protecting things in the post.....

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Saved by a helm... replied to hippy69 | 11 years ago
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Thank You Hippy69.

I think people who are on the receiving end IE:ER nurses and first responders of these broken people have a different perspective on things.

Peoples lives can change in an instant.

Death is so long term too.

You summed it up well.

Be safe out there,
Jeff

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Saved by a helm... replied to felixcat | 11 years ago
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felixcat.
please throw you (without a helmet) and your bike in front of a sedan and see how you fare?

Thanks!

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Saved by a helm... replied to Gkam84 | 11 years ago
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Gkam 84,

Please take the test yourself and don't wear a helmet and get rear ended (like me) by a sedan going at 50 mph.

I think your opinion days will be over.
Please don't expect society to take care of you either.

I bet you smoke cigarettes too.

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Saved by a helm... replied to Paul J | 11 years ago
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I just wish I had the helmet I was wearing that day to show you Neanderthals proof positive about the helmet use.

I never said a helmet is a panacea for safety.
I adamantly state that helmets can make a difference between death vs life, brain injured vs. none brain injured.

limbs and even vertebrae heal. the brain doesn't.

I have scars on my body from the crash. I am still alive.

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Saved by a helm... replied to felixcat | 11 years ago
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Felixcat

My head would have been smashed like a crushed watermelon without that tiny bit of plastic.

safer roads? how about safer drivers?

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Saved by a helm... replied to hippy69 | 11 years ago
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Hippy69

thanks for telling the folks in GB the way it is.

I feel like I am banging my head against the wall, I better put on my helmet!

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Saved by a helm... replied to Paul J | 11 years ago
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Paul J

we are talking apples and oranges.
get a grip.

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Saved by a helm... replied to Stumps | 11 years ago
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Thanks Giff

True Words!

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felixcat replied to Saved by a helmet twice | 11 years ago
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Saved by a helmet twice wrote:

felixcat.
please throw you (without a helmet) and your bike in front of a sedan and see how you fare?

Thanks!

After you. You may wear your helmet.

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Saved by a helm... replied to Stumps | 11 years ago
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thanks Stumps!

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felixcat replied to Saved by a helmet twice | 11 years ago
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Saved by a helmet twice wrote:

Hippy69

thanks for telling the folks in GB the way it is.

I feel like I am banging my head against the wall, I better put on my helmet!

That is my sensation too. Have you really read and thought about the posts you dismiss?
If you think that your foam hat saved you from an impact which would have smashed your head like a watermelon I would suggest you put a deal too much faith in it.

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felixcat replied to Saved by a helmet twice | 11 years ago
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Saved by a helmet twice wrote:

Neanderthals proof positive about the helmet use.

I never said a helmet is a panacea for safety.
I adamantly state that helmets can make a difference between death vs life, brain injured vs. none brain injured.

No need to get abusive. The people who disagree with you are sincere in their beliefs. What is more, they have presented real world evidence to back up their views. You only give us anecdote and unsubstantiated assertion
As I wrote above, why are the helmet compulsion and high weearing rate countries the ones where cycle casualty rates are high? If helmets are the answer, why is your country so dangerous for cycling? It is the original home of foam hats, but still remains dangerous.
I do get the impression that you are so convinced of the rightness of your cause that you do not engage with the arguments of others.

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Gkam84 replied to Saved by a helmet twice | 11 years ago
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Saved by a helmet twice wrote:

Gkam 84,

Please take the test yourself and don't wear a helmet and get rear ended (like me) by a sedan going at 50 mph.

I think your opinion days will be over.
Please don't expect society to take care of you either.

I bet you smoke cigarettes too.

SO you say you believe in free choice, but when we explain our choice, you slam it and say things like this.

Maybe your helmet has caused unknown damages.

As I stated before, I do some cigarettes. I have also been rear ended at high speed, as I documented on here. I was no wearing a helmet either.

I don't know how it works in the US, but here in the UK, we do take care of society, if something happened because of an accident, people are taken care of, whether that be by the NHS, friends and family, care workers.....etc

We look after our own no matter what happens to them, their own doing or not. SO please take your narrow minded views somewhere else.

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notfastenough | 11 years ago
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I spent years doing martial arts. Much of the training involves conditioning the body in particular ways, so that (gradually-increasing) impacts can be sustained without incapacitation. Toughening up of the torso and limbs, basically, combined with the mental focus to continue to operate under such duress.

However, you can't toughen the brain or skull, so instead learn to keep your guard up, protecting the 'knockout zone'. The idea is that, providing you retain full mental capacity and focus, the other injuries can be either withstood (since taking punches etc during combat is inevitable), or hopefully recovered from. If not, then hopefully you at least got away with your life. You wouldn't believe how easy it is for a person to be knocked out by a well-placed, but not particularly forceful, impact.

Cyclists don't routinely crash, so we don't practice dealing with it. We don't fall off dozens of times a day, learning to adopt the correct posture, muscle tension, and rolling with the impact. When it happens, it's all aarggh-crunch-f*ck-hitthefloor. Some form of protection that doesn't depend on you thinking and acting rapidly is a rather good idea.

Sure, helmets aren't perfect, but if a boxer's headgear (just foam, after all) can absorb some of the impacts from head shots, I see no reason to doubt at least SOME effectiveness from helmets.

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Paul J | 11 years ago
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Actually, bones needn't fully heal. Even if they heal well, they're often never quite the same as before. Particularly if you get fractures or chips in or around joints. Further, sometimes they can't heal back to the way they were, particularly if bones were displaced. I have chipped bits of bone inside finger joints, and a 2-piece collarbone.

Your brain is actually very well protected, and it does have quite an ability to heal. No more, no less than other part of your body. Your mistake is to think that injuries to rest of your body are trivial compared to head injuries. They are not. They can be easily have long-term consequences, they can be life-changing.

The best way to keep yourself safe is to *use* your head, and think about the risks you are taking before actually taking them.

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felixcat replied to notfastenough | 11 years ago
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notfastenough wrote:

Sure, helmets aren't perfect, but if a boxer's headgear (just foam, after all) can absorb some of the impacts from head shots, I see no reason to doubt at least SOME effectiveness from helmets.

Helmets are designed to pass a test. The test I am familiar with simulates an impact speed of 12 to 16 mph. I would be surprised if manufacturers make them stronger than need be to pass the test. To do so would detract from other qualities the market demands, like ventilation and lightness, and would cost more, cutting profits. Incidentally, the profit margin must be huge. The energy to be dissipated by a boxing helmet must be a couple of orders of magnitude less than the energy of an impact from a motorvehicle.
The effectiveness of a helmet in any real crash must be tiny. This is born out by the accident rate changes when a large population of cyclists is forced into helmets by a change in the law. There is no detectable change.
www.cyclehelmets.org
This site has much more on the subject than I could even begin to include here. It looks at all the studies the compilers can find on the subject of cycle helmets, no matter what the studies conclude.

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notfastenough | 11 years ago
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@Paulj
Please don't twist my words - I think we both know what I'm getting at. Being knocked out incapacitates you completely, whereas a broken leg, for example, doesn't. There's a drastic difference in how much you could then react to secondary dangers.

@felixcat
Frank Bruno's punches were measured and found to be comparable to being hit by an elephant at 30mph. How many orders of magnitude do you want?

@everyone
I provided my thoughts, but I've just realised that I can't be arsed getting into an argument where no participants, or any persuasion, are going to be swayed to an alternative view. You will note that I haven't suggested anyone else should (or should be made to) wear one. It's your skull.

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felixcat replied to notfastenough | 11 years ago
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notfastenough wrote:

@felixcat
Frank Bruno's punches were measured and found to be comparable to being hit by an elephant at 30mph. How many orders of magnitude do you want?

I find this very difficult to believe. People hit by cars are sometimes thrown many metres. Boxers hit by another are not even knocked across the ring. If Bruno's punch had as much kinetic energy as a car doing 30 mph he could stop it dead with his fist.

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Paul J | 11 years ago
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notfastenough: Broken bones don't incapacitate you? I literally could not move after I broke and pulled apart my collarbone. The smallest movements (including breathing) were difficult for the next *2* days. That's a longer incapacitation than a *severe* concussion. And that was with a bone that isn't even that important! (One option for really badly broken collar bones is to simply remove them completely).

Are you really arguing that the head is the only part of your body that matters?

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hippy69 | 11 years ago
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Paul J just so you are fully appraised of the technicalities of head injuries I suggest you do some research on subdural/extradural haemorrages, which can be caused by simply falling in the street.

And no the brain is not the only part of your body that matters, however it does control how the rest of the body works! A fractured clavicle /leg etc although debilitating and extremely painful with heal either with or without fixation, screw your brain and guess what, moving at all again may prove difficult.

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trikeman | 11 years ago
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The pro's and con's of helmets always stirs some debate.

I was firmly convinced of thier merits both off and on road. The on road one didn't happen to me, but I was behind a guy on the way to work minding our own business cycling along the A370 to Bristol. Then a skip type vehicle came tearing around the corner in the opposite direction and a half house brick came off/out of his skip and hit the guy in front - right on the helmet - and then the brick bounced onto the bonnet of the car just behind him and in front of me. Both I and the car driver stopped to see if the other cyclist was OK - though shook up he was fine but the helmet damage was huge, smashed the front and top of his helmet ribs to bits, in fact it just fell to bits. He was fine though.
I thought from then that a helmet was for me. Though never to be proved I honestly think it would have caused quite a gash on his head at least - for sure, the bonnet of the car was also badly damaged and I don't think any of us were going over 15 MPH - but I bet the brick part/rubble was travelling at 30 MPH+.
Food for thought - stay safe.

Trikeman.  3

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