Question:
Many years ago, when leaving work, one of our neuropsychology postgraduates commented upon the helmet that I had bought recently. I mentioned that I didn't wear it much because it was not very comfortable and I was too self-conscious. He then pointed out that he had recently met a patient at the local neuro ward who had been a senior executive, due for promotion to a national level post; he had taken his daughter out for a ride on her new bike. Sadly, he was hit by a car and suffered brain damage that left him in permanent need of 24 hour care. The student advised me that a helmet would have reduced the severity of his head injury. Since then, I have worn my helmet as often as possible. However, I am sure you can accept that surrounded by such emminent people, I have access to fairly reliable information when it comes to brain injury prevention. They are not experts on accidents, but their knowledge on these matters is obviously considerable. I would say "Why should I?", given it was only a personal viewpoint, but I didn't make that clear in the post. So, would you accept that I am more at risk when cycling than when allotment gardening, visiting friends on foot, biological surveying, and hill walking, since those are my usual activities?

Answer: Just as it would be improper to drag into the debate the brain surgeon recently featured on TV, repeatedly shown riding his bike with no helmet. The experts are as divided as the rest of us. Dr Aziz Sheikh is an ardent compulsionist, still convinced that he is right even though his maths have been shown to be wrong. Dr Richard Keatinge is a former consultant epidemiologist who is equally convinced that there is no credible evidence to support any effect on serious or fatal injuries. Barry Pless, editor of Injury Prevention, ridiculed the idea of risk compensation, until his own study proved that it happens. There are no easy answers. So the correct position is to live and let live, to oppose compulsion for many excellent reasons, and to challenge anybody who makes a dogmatic statement to prove it.

A helmet which shatters has simply failed. Polystyrene foam absorbs very little energy in brittle failure; it is designed to absorb energy by crushing. And as stated above, modern medical thinking downplays the role of straight coup/contre-coup brain injury, suggesting that closed-head brain injuries are much more likely to be the result of torsional forces, which helmets of course cannot mitigate.