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Mad doctors

By Michael J. Smith on Wednesday October 6, 2010 08:14 PM

Not really a topic for this blog, except insofar as it offers some insight into the ways in which manifest pseudo-science, supported on the public teat, is a vital part of the ideological apparatus. An old pal recently passed this along to me:

New Study Identifies Risk Factors That Lead to Bicycling Injuries in City Traffic The streets of New York City can be dangerous for bicyclists, but they can be especially risky for young adult male bicyclists who don’t wear helmets, have too much to drink, or are listening to music through earphones, a group of investigators from New York City’s Bellevue Hospital reported ....

This study [was] commissioned by the State of New York....

Danger, Will Robinson!
87 percent were men and 96 percent were over age 18; 13 percent were intoxicated; five percent were listening to music. Despite helmet laws, only 24 percent of the injured bicyclists were wearing helmets.
Well, when the State of New York pays you to come up with some numbers, you come up with some numbers. Never mind that the numbers are meaningless.

The problem, of course, is the missing denominator. The Nine Doctors who signed this brain- dead document report that 13% of injured cyclists in New York are listening to music.

Well, that's nice to know. But it tells you nothing about music as a risk factor(*).

If 13% of the cyclists who made it home safe and sound were also listening to music, then music isn't a risk factor at all. If 20% of the safe and sound cyclists were listening to music, then music makes you safer.

You see the problem? 87% of injured cyclists were male? Well, what percentage of cyclists in general are male? 80%? 90%? Without knowing these background numbers, the stats which the long-suffering taxpayers of New York paid these Dr Feelbads to accumulate are, bluntly, dogshit. They mean nothing. Less than nothing; they darken counsel by words without wisdom, as Jehovah observed in one of His testy moments.

There are a few cases where the denominator actually is provided, and the conclusions are, shall we say, unsurprising:

New York City mandates helmets on all working cyclists—the latter typified by the bicycle delivery persons weaving through Midtown traffic. Forty-one percent of the study subjects sustained injuries on the job, but only about one-third of those working cyclists (32 percent) were wearing helmets. “I don’t think the New York City laws are being enforced,” Dr. Frangos said.
Well, duuhh. We could all tell the good Doctor about a number of other laws that aren't being enforced, some of them rather consequential -- when, I wonder, was the last time a New York cop wrote a driver a ticket for failure to yield to a pedestrian? Much less a cyclist?

Frangos' conclusion is accurate though banal; note however that his stats say nothing about the efficacy of helmets, or about "risk factors." He's just discovered the stop-the-presses news that New York cops don't "enforce" Mickey Mouse laws like the one about helmets; rather, they use these law to harass people they don't like.

Some results have a certain, no doubt unintended, drollery:

Eighteen percent of the injured cyclists were using a bike lane and 17 percent collided with a vehicle door.
Hmmm. Same number, roughly. Maybe bike lanes are a risk factor? Maybe they put you in the Door Zone? Why... why... Stop the striping!
The investigators [are] seeking a state grant that would have practitioners speak to community groups to reinforce bicycle safety measures and prevent further traumatic injuries to bicyclists.
I bet they are seeking yet another grant, extracted from my pocket, for dogshit science, and I bet they get it. Propaganda is always well-funded by the public purse.
Coauthors with Drs. Frangos and Ayoung-Chee are George Foltin, MD; Ronald J. Simon, MD, FACS; Deborah Levine, MD; Omar Bholat, MD, FACS; Dekeya Slaughter-Larkem; Steven S. Schumacher, MD, FACS; and H. Leon Pachter, MD, FACS.
Dr Slaughter? Please. Too good to be true. But I wouldn't go to any of these doctors -- not Pachter, not Foltin, not even Ayoung-Chee -- for a runny nose. I don't know what they teach in med school these days, but clearly, elementary arithmetic is no longer required.


(*) Now, if they were listening to Vivaldi....

Comments (38)

Repas du Midi:

Rode for years without a helmet. Got a helmet. Got knocked off the bike. Landed on head. Ruined the helmet. Saved the head. Recommend helmet for cycling despite mixed personal experience.


I think the helmet encourages drivers to hit you. Hey, he's wearing a helmet, he'll be OK.


"I think the helmet encourages drivers to hit you. Hey, he's wearing a helmet, he'll be OK."


Why are doctors involved with this report anyway? Did they make any statement about the physiological nature of the injuries (eg, "oooh, this guy is really a mess!")? This is an epidemiological study cranked out by public health students, or passers-by paid $5 an hour. I guess the doctors give it "gravitas".

(DISCLAIMER: I've not ridden a bicycle regularly since college, when I used to haul ass across campus to class after doing my regular early morning "wake'n'bake" with black coffee.)

I can't speak to the effectiveness of helmet laws, but wearing a helmet while on a motorcycle or bicycle just seems like the kind of basic common sense that you just can't legislate.

As far as riding a bicycle while listening to music through earphones... well, shit, yeah, you're just begging for it. You can't hear the traffic, you can't hear the approaching sirens or cars, you're not "being here now". Cycling with your iPod cranking? Yeah, man; you're an accident waiting to happen.

Their making a big deal out of the number of men involved in accidents rather bugs me a bit, as if they're playing to the stereotype of men as bravado risk-takers. (DISCLAIMER no.2: I rode stoned regularly in college. Nothin' like it, man.)

C.F. Oxtrot, as I recall, made some excellent points over at his blog about how bike lanes are basically a version of "keeping 'em on the reservation". I honestly had never thought of it that way, and up until then thought cyclists having their own lane was a good idea. The remarks about keeping cyclists "on the res" woke me up to something I was taught in high-school drivers' ed, which was that bicyclists have just as much right to the road as cars, and don't need to have their own goddamn' lane.

If anybody should be confined to their own lane, it should be the goddamn' Segway riders. Put the goddamn' Dorkmobiles in a lane right there in the Door Zone, so I can have the pleasure of opening my car door right in front of their yuppie asses.

I ride my MTB with an .mp3 player using earbuds, and I do the same when skiing alpine. Would use it when nordic skiing, if I did that with any regularity, but I don't.

I wouldn't do a road ride with music, though. I've been hit by a car 2x in my lifetime of cycling, without music distracting me. But on trails there's nothing but me and the trail.

In any case, what in Hades is the point of being all quasi-scientific about the dangers of cycling? Stem the "green" tide, keep people in cars-trucks-SUVs-crossovers-whateverothernichetheycandreamup?

"Remember, dear scientifically ignorant reader, that those arguments about cycling being healthy, they're communist party propaganda! It's actually lethal, and will soil your clothing as well as your reputation. Just horrible!"

PS to Mike --

Can't remember making that point but I do agree that the use of bike lanes is problematic. It's a rookie mistake, it's one of those things designed to get the casual or non-cyclist encouraged to ride a bike. It doesn't take a lot of saddle time sharing the road with a car to learn how to survive on a bicycle in traffic. And the bike lane is just a security blanket anyway, in most situations.

Some towns are physically separating their bike lanes. My town did so for about a half-mile of the main "commercial" street in town, and it's totally fucked up. Just idiotic, confusing everyone, including long-time cyclists and long-time residents of the town. Talk about a recipe for making drivers frustrated with cyclists -- I avoid those lanes now whenever I ride down there. I'll ride an extra few blocks to avoid them.

Traffic laws are the easiest things in the world to enforce firmly and consistently, and police forces everywhere I've lived have been useless at traffic law enforcement. It seems worlds worse since cell phones appeared. Maybe they need a dozen donut bonus for every legit traffic citation, or something.

In any case, if someone can't balance they're going to fall and get hurt no matter what athletic thing they try. If they're not falling down and busting something on a bike, they'd do it on roller or ice skates, on a skateboard, on skis, on a snowboard, on a pogo stick, on a Razr scooter, whatever. Some people don't have The Balance Gene**, some do.

**All rights reserved, Oxtrot Industries LLC


bike riders
do you wear your ball caps turned to the side on your wee hours ...paper routes ??

Brian M:

I have mixed reactions to bicycle lanes. In somewhat congested City traffic, I agree they seem a little pointless and in a stop and start environment like much of San Francisco, I would indeed rather share the road with cars in mixed traffic.

Helmets? I cracked one this year. If you ride a lot, you will go down inevitably...so you might as well improve the odds. I'm sorry, the anti-helmet crowd is as stupid as the "I have a friend of a friend whose cousin was thrown clear of flaming wreckage so I never wear a seatbelt" crowd.

HOWEVER...in a suburban/rural environment with heavy, faster, consistently moving traffic, I still want the separation. Is it partially psychological? Perhaps. But in this setting, (more so than an urban environment like San Francisco or Berkeley) it reduces the conflicts between drivers and riders. I don't need a full bicycle lane with signs and pavement markings and all that, but I do want the paved shoulder lane and a little space. After all, I wouldn't want to get in the way of some middle manager in a Lincoln Navigator on his way home to his gated community tract home from his job "managing" 45 miles away.

Nothing is a cure all. I live near and bicycle in Napa County. A helmet and a bicycle lane won't save me froma family of 50 year old upper middle class twits who have visited six wineries during their holiday excursion and plow me over on Silverado Trail.

Brian M:

Even in congested City traffic, though, there is the amusement factor of sailing by frustrated car commuters at 20 mph while they are sitting in their steel coffins of convenience. :)

@ CF Oxtrot, 10.06.10 11:44pm:

Some people have the Balance Gene; the rest ride Segways.

While not a hardcore jock, I still had pretty good balance and enough natural coordination to handle most sports, and ride a bike without crippling myself. That's how I managed my early-morning rides across campus without plowing into anybody on foot.

This is why I always try to cut the bicycle messengers a break -- and, yeah, bike messengers are actually making a comeback in DC -- on those occasions when they have to leave the street and take to the sidewalk and have to weave in and out of the foot traffic to avoid colliding with people. Remembering my own experience in school, I trained myself not to instinctively look for a place to dodge to as the cyclist approaches, because he's doing his own rapid-fire mental calculations in order to plot his path around the pedestrians, and when I start doing shit like dodging around like a spooked horse, it totally fucks him up and actually increases the chance that he's going to hit someone. So, I've learned to just be cool, stay in my space, keep my eyes open, and just let the bike messenger ride around me.

As a longtime bus-person who's about to start trying to be a bike person, this post and discussion is having the paradoxical effect of making me more nervous about biking in traffic.

I suppose you think Telemann is a murderer, too.

Over the last few years, I've noticed about 47% fewer bicyclists out on the street and a 15% uptick in dangerous driving, defined as not giving a road bicyclist some leeway. The bike trails around here are all in the Metroparks system, and most drivers do take it a bit easier there (speed limits are, of course, lower as well).

Even those damn kids get off my lawn tend to pedal with a bit more of awareness when cars are about.

As for helmets, only the hardcore bicyclists, however that's defined, tend to wear them.

(all numbers made up, but it's the anecdote that counts)

Repas du Midi:

"Hardcore cyclist" is defined as "a cyclist who wears a helmet." If only the casual cyclists had heads of stone...

The helmet by giving way on impact also protects the cervical spine to some extent thereby reducing the n-plegia risk.

@ethan: Biking in traffic will teach you new and amazing things about human beings when they are in control (?!) of giant rolling boxes and multitasking with the phone/radio buttons/juice-dripping hamburger/navigation program/and (last of all) steering wheel-brake pedal. Get a helmet mounted mirror and a flashing light to hang on your back. You may get their attention.

Transportation research is as corrupt and laughable as all the other kinds of grant-funded research.

In other words, grant funding works extremely well. It provides those with money and power command over the direction and details of investigation. It reliably overwhelms independent thought, as preserving space for any non-grant researchers is seen as a money-flush, hence intolerable. Once the grant is made, nobody much cares about the results, so it is highly compatible with the kind of pseudo-scientific posing MJS catalogs here.

The #1 threat to cyclists, by a huge factor, is the motherfucking automobile. That, of course, is unmentionable in any grant-funded research project.

If they aren't too busy hunting/gathering and/or being attacked by Mad Max, our grandchildren will be amazed at our contemptuous neglect of one of the top ten machines ever invented.

Well, Brian M. says that if you ride a lot, you will go down inevitably, and recommends "improving the odds".

Not so sure if I'm one of the anti-helmet folks, but riding is my chosen means of transport and I'm quite comfortable without the headgear. At between fifty and a hundred km per week over the last nine years, I've dumped it three times and managed to escape unscathed.

But to stats: I'd like to see some, um, hard data on injuries to bicyclists with versus without helmets.

On second thought, and regarding the need for additional stats to draw accurate conclusions: Don't encourage them.

Regarding bike lanes: They're great. I use 'em when they suit my purposes, and use the street when they don't. Ironically, in my town they are planning the opposite measure, ie. moving the bike lanes back onto the streets. They think that will decrease incidents of drivers running over bikers whilst making right turns - the assumption being that they don't see us.

What the planners don't realize - as any cyclist could tell you - it's like a game of chicken: they think, "Oh, he'll stop when he sees me starting to take away his right of way..."

Of course there are those who don't know about having to look in their rear-view before turning right. They're called tourists; and making us more visible will only confuse them more.


It's a little depressing to see that nobody appears to have understood what I was trying to say. It's not my claim that listening to music on a bike is a good idea. It's not even my claim that wearing a helmet is a bad idea, except insofar as you still care about how you look.

My point was that "studies" like the POS I described -- and I've seen dozens of them -- demonstrate absolutely nothing about these questions either way.

I'm groping for an analogy here. Men make up 50% of burials in cemeteries. Therefore testicles are responsible for half the world's deaths!
20% of SAT test takers who scored less than 500 were wearing boxer shorts. So switch to budgie-smugglers and boost your score!

This is *elementary*. We're not talking about some subtlety of the T-test or the higher esoterica of regression. It's a comparison with no comparand.

I tried talking about that, Fr Smith. It seems the issue of car vs cyclist has more cheese in its pile.

False correlation is one of the tenets of quackery, a/k/a pseudo-science. Since most Americans either never learned, or don't remember the scientific method etc, and even fewer take logic or rhetoric, it's easy to get all science-ish and gull a lot of people with the science-ish-ness of the presentation.

Remember Charles Murray's "The Bell Curve" in the late 80s? Uh huh.

Paul Alexander:

We got it Mike, it's just that you said something about a bike and it got us all hot and bothered. It's just like if you were to make an analogy using Kim Kardashian's butt. I would be completely distracted by the thought of that lucious, juicy derriere. Shit, I forgot what I was talking about.

I think I got you pretty well; just spent too much time addressing the rest of the sound on the thread.

The thing is: show me a stat and I'll show you figures culled together to come to a predefined conclusion. That the results defy logic is a given.

That is: the correlations drawn defy logic.


In experimental design what Smith is going on about is what is called a "one-shot". Something has been shown but because nothing disconfirming was possible to be shown, no one can say what has been shown. The social sciences have been choc-a-bloc with one-shots forever.

Next week: the 'pilot' study.


Sorry, folks. Bad day, Makes one a little testy.

As a runner, I just wanted to pipe in for no good reason, and tell all you bikers to get the fuck off my roadways, paths and de-railed train tracks.

Soon enough, a study will confirm that you are bad for my health.

Mike F,

I live in the city that gave the world the Segway. Sigh.

My son and I, when we are running one of the river paths, like to play a game. Let's call it, Cops on Segways.

It involves us swerving as close as possible to the patrol cops wheedling ahead on their gyro machines (yes, equipped with sirens). Then we chuckle as they do the balance convulsions that send them off in opposite directions.

In case I need to spell this out - the cops patrol on Segways, in pairs. Two-fers. I endorse this. Heartily. Every city needs cops on Segways, roving around in be-shorted pairs, wiping out generations of cultural indoctrination as to the badassery of cops.

Revolutionary crime must surely follow...

There's even a second level to the stupidity of the stats MJS highlights. Who needs any statistics at all to know that not wearing a helmet, listening to headphones, and being deprived of bike lanes are all minor but important risk factors to cyclists? Despite the bikers who get an ego stroke from equating their personal non-deaths with disproof of helmets, helmets are a safety factor. Divided attention is detrimental to operation of any moving machine, and headphones divide attention. Bike lanes are better than no bike lanes.

To do "research" into any of this is to participate in the diversion of moeny and attention from the only topic that matters, which is why cyclists don't have their own streets, free from cars.

Of course, the answer to that requires no research, either.

But still, playing the research game in stead of speaking the truth about power is letting yourself get humped by the devil.


@MD By and large right-wing cranks are paranoid, racist, selfish assholes, and far more often than not their professions of "common sense" are carelessly crafted justifications for their paranoid, racist, selfish assholism. But when they mount their hobby house of skewering the pointy-headed university intellectuals for wasting beaucoup taxpayer dollars on research that only reveals already-grokked "common sense," they sometimes have a (very good) point.

(Do not take this as an endorsement of fantastical left-right populist coalitions and alliances, however. Such coalitions and alliances are impracticable and undesirable, both. Which is precisely why the US is hopelessly fucked.)

I, for one, wish I could land me a job as one of them there Ivy League innaleckshuls. I would enjoy creating the polysyllabic word salads, sonic pigpiles (SY's phrase) of pretense and puffery. I could get interviewed by Charlie Rose with softball questions that let me seem objective and detached while I make a segmented speech on behalf of one of Our Empire's newest projects. People like Digby would ask if they could be on my staff. Lots of them would offer to do all kinds of work for free simply to pad their resume. Truly, that would be a fine existence. I have these cool new pills from Glaxo called Sielevol, it's basically a conscience-eraser in tablet form. Never an anxious moment!

Gluey, I'm so witcha on the ultra harebrained idea that the left and right can unite for anything other than supreme time wasting. Personally, I despise libertarians, and consider them to be unwittingly but clearly worse than the conservatives they sometimes pretend they're peeved at.

Two wrongs don't make a right, and reversion has never been an answer to anything as thoroughly fucked up as "civilization."

Every quarter-way mature citizen knows (if not admitting) that big government is part and parcel of contemporary capitalism, and to propose going back and starting the whole nightmare over again is to spit poison into a gaping deadly wound. And simply willfully childish, to boot.

There's 7 billion of us on this rock now. Only the left can possibly come up with a decent and feasible plan for getting us from here to stability. The right will ignore this until Mad Max knocks on the door.

Al Schumann:

Yep, minarchists are usually full of shit—and corporate dispensationalism. If they truly wanted a genuinely small government, they'd have to slash the military back to the Coast Guard and the National Guard; get rid of the NSA, CIA, FBI, DIA, etc; get rid of the Federal Reserve. There's more, but that's a good start.

How many minarchists advocate anything like that? The paleocons, maybe. The rest of the "self-identifying" libertarians want the biggest, nastiest, most intrusive government possible.


Of course inside-the-Beltway "libertarianism" is 99% window dressing for unmitigated corporate capitalist power. And while outside-the-Beltway "libertarianism" -- one variety of which is paleolibertarianism, I suppose -- may sometimes be less disingenuous, it is invariably rooted in wishful thinking about returning to a mythical (19th Century) past when (white) self-earned property ruled the roost. It is petty bourgeois claptrap through and through. That's why oppressive power is always conceptualized as the zoning commission, and never Cargill or Exxon Mobil (much less the entire system of private appropriation of public wealth).

What is even more pathetic is that these sorts sincerely moan about problems that cannot be resolved through means other than collective ones, but they stupidly fantasize that there exists some Robinson Crusoe frontier to which they could withdraw, if only they were "left alone" by "big government." For example, in the inter-Mountain West a lot of culturally conservative natives bitch about the liberal yuppie invasion. And goddess knows, more than a few of their beefs are justified. But this comes along with a huge helping of cognitive dissonance. They complain about subdivided ranches and exurban sprawl. Then in the next utterance they worship the market and excoriate regulation.

Even though I have long been clued into left ecological analyses of looming peak oil and runaway global warming, and idly contemplated making long-term plans to move to a transition town or "self-sufficient" rural compound, deep down I know I won't do it -- not in the US, anyway. Why? Because petty-bourgeois lunacy (of both right survivalist and left "small is always beautiful" varieties) reigns in the US. If shit goes really wrong and survival is at stake, I don't want my material fate (or that of my family) to depend on such people.


a worthy confession:

"I have long been clued into left ecological analyses of looming peak oil and runaway global warming ..."

"... idly contemplated making
long-term plans to move to a transition town or "self-sufficient" rural compound..."

"... deep down
I know
I won't do it
-- not in the US, anyway"

then comes this meme pretzel

"bourgeois lunacy (of both right survivalist and left "small is always beautiful" varieties) reigns in the US. "

reigns or subsides ??

"If shit goes really wrong and survival is at stake "

you can reasonably imagine this in your life time ???

clued in or glued in
which is the mot juste ???

i delight in the leap of faith
of u natural doomers

".. I don't want my material fate (or that of my family) to depend on such people."

then u will depend on what ??

yourself herr crusoe

mad max end times
as literalism

my my how bible thumper like
that is


op, you misread me, or I mangled my delivery.

1) How gloomy or doomy I'm feeling on any given day depends far more on subjective and irrational factors than it does on cool-headed analysis of the latest forecasts, I'll readily admit that much. But FWIW, no, I don't subscribe to end times eco-apocalyticism. In fact, I constantly see such narratives cynically leveraged for the banal evil of green capitalism, so I'm pretty immunized against them. Without going into detail, OTOH I do anticipate a steady deterioration on this front, as global capital exhausts commercially exploitable environmental frontiers.

2) My point is that if one is to do something as radical and irreversible as get off the wage labor/commodity economy treadmill and join a (US) transition town or some variation thereof (in the US), one better have confidence not only in the practical skills of one's mates, but also their social aptitudes and their political inclinations. I don't and probably won't trust (or like the company of!) libertarian survivalists nor even (flaky) "appropriate technology" enviros, and wouldn't put myself at their mercy unless no better options were available. And of course I reject the whole concept of hermetically sealed self-sufficiency as a total phantasm... you really pegged me wrong there, fella.


fine g
but then what does this mean:

"OTOH I do anticipate a steady deterioration on this front, as global capital exhausts commercially exploitable environmental frontiers."

how slow ??
one life time will bring it too this:.

" If shit goes really wrong and survival is at stake"

this isn't about a world wide depression
let alone only a stag like we got in the north hemi now
but i assume far worse something that disrupts normal trade channels even intra national commercial connections
if not

what's the big deal here ???
the great war gave us revolution counter revolution the unstable 20's
the 30's crisis gulags death camps
another world war
and yet
we as a planetary population
came out the other side ...
more or less
without reversion to dark age market break down

so what's ahead that's worse ???

I'm chuckling.


"get off the wage labor/commodity economy treadmill "

i'm a wild amoralist personally but
on the scale of human society
i'd only dream of gettin off the tread mill if i could be part of everyone gettin off
the tread mill

why ??

no interest in saving my self
or living "clean "

why ???
shit if i know

"being in the world "
comes to mind in a half assed sense

rowing away from devils island
makes me ...just wanna row back



With foreclosed properties comprising one in every four homes sold in the United States, the spreading moratorium could disrupt real estate deals in progress, slow down the process of clearing the backlog of troubled home loans and prolong the economic recovery, analysts said.

Prolong?? An odd way to put it.

What is behind this proposal? A guess: avoiding a threatened house price collapse


this gets complex fast

yes banks might well wish to hold off the flood of property onto the market

but the common defense of our " homes "
is in fact a great mass mobilizer

even if we rugged system buckers
here at SMBIVA prefer
the great walk away

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