What happens when cyclist and car collide?

Updated





In the hourly contest between bicycle riders and motorists on our roads it's not just civility that can go out the window, it's the knowledge that when metal meets flesh and bone there can be only one outcome.

It's a crisp 8 degrees Celsius as the cyclists begin their descent down Dornoch Terrace — a nip in the air, as Brisbanites like to say during what passes for the depths of winter.

But the leaders in the group of about 15, which calls itself Venerdi Corsa, have stored body heat during a climb of more than a kilometre up nearby Highgate Hill.

The sun is rising over the Brisbane River and CBD to the right, Mt Coot-tha looms ahead in the west, and the wide, flat meander of the waterfront Corso — which skirts the South Brisbane Cemetery — has been replaced by the commuter rat run of inner-city West End.

But it's too early to be troubled by the steady stream of cars, buses and bikes forcing its way through this bottleneck during morning peak hour.

The group is just a couple of clicks from Milton and the end of the 40-kilometre River Loop, a popular route on the social cycling scene. A quick coffee with friends and the last working day of the week await.

Gliding along on high-end machinery and endorphins, this group boasts decades of road cycling experience. Yet despite their collective awareness, single-file formation and well-rehearsed system of danger signals to each other, they don't see it coming.

Sorry, this video has expired Video: Cyclist Calvin Treacy recounts the horror crash that nearly cost his life (ABC News)

A flash of silver and two riders are suddenly airborne, one of them smashing the sedan's windscreen with his head on his way across the bonnet. A fraction of a second later, another two go down, but rather than flying over the car they slam into the passenger side and drop to the bitumen.

A fifth cyclist upends and lies dazed in the road, although she is able to stagger to the kerb and sit down, head in hands, as shock sets in.

Another day, another bout in the zero-sum game of car vs cyclist, in which nobody wins and not much seems to change.

The first responders — often just unlucky passers-by woefully ill-equipped to process the stress and gore of such a scene — do what they can, emergency services workers pick up the pieces, surgeons repair what damage they can and the driver is left without a vehicle but physically intact.

Questions about who was at fault — if anyone — will need answering.

The cyclists, if not dead, are almost certainly bloodied and bruised, perhaps permanently injured — and that's just the damage you can see.

You don't want your surgeon saying 'you gave me a fright'

Recovering at the Royal Brisbane and Women's Hospital, where he drily notes he is sharing a critical care ward with two motorbike victims and a plane crash survivor, Calvin Treacy recalls being the third lycra-clad but otherwise unprotected human body to slam into the silver sedan that day.

He has suffered a broken pelvis, broken leg, broken ribs, a fractured collarbone, lots of bruising and skin off, and a hole in his thigh that exposed the femoral artery.

When his sentiments drift to the two cyclists ahead of him, neither of whom had time to apply their brakes, and to the first responders on the scene that day — and even to the young driver of the sedan — he needs to remind himself that he is far from OK.

"I remember seeing the car and thinking, 'Oh my God' … I had that instant, 'Uh oh, this is bad'," the father of two recalls.

"I must've blacked out for the impact because I can remember hitting the brakes and I can remember being on the ground.

"Somewhere along the line my bike was broken and a bit actually stabbed into my leg.

"I could have died. It was pretty close. You don't want your surgeon coming in and saying, 'You were lucky', and 'You gave me a fright'.

"He said he could see the femoral artery in the wound. You don't get much closer than that.

"When your heart's beating 170 beats a minute, [add] trauma to that and you bleed out very quickly. It bled a lot as it was … the whole dramatic thing, blood squirting out of my leg. Not nice at all."

After hospital, the healing starts

When a car and a bicycle collide, the only party physically injured is likely to be the cyclist, RBWH trauma surgeon Jerry van de Pol says.

The chances of permanent injury are high, he adds, and head injuries are the major concern.

"Bike vs car, the cyclist is always going to lose. There's no protection apart from a helmet, which definitely has been shown to limit head injuries and brain injuries," he says.

"Head injuries are hard to judge at the time whether it's going to be permanent, but we do see long-term brain injuries from collisions."

Dr van de Pol, originally from the Netherlands and himself a cyclist, says the severity of the injuries depends almost entirely on the speed of impact, although an average of four is expected: "Think spine, head, an arm, and a leg."

"Sheer speed against a very solid object is what causes the injuries — the energy involved in the impact," he says.

"Low speed versus high speed is a big difference. The situation where cyclists are riding pushbikes at high speed in traffic is very different to where someone is riding on a commuter bike to work through the city and doing 15-20kph. You have time to react, to protect your head.

"I'm a cyclist too, and I would not go out riding on my pushbike at high speed in traffic without a helmet."

During his time in Australia, working at the RBWH and at a major hospital in Adelaide, Dr van de Pol has seen a consistent rate of admissions from bike collisions with vehicles.

"About once a week — that's quite frequently, whether it's direct collision or the cyclist has to get out of the way of a car turning and crashing at speed. Once a month [we see] serious bodily injuries — multiple fractures — that's quite a lot, actually," he says.

"Head injuries are common; the internal injuries include liver and spleen lacerations that bleed, that happen from the impact and deceleration — the sudden stop. They sometimes need surgery, and they're the injuries you don't often hear about. Someone had a broken leg or shoulder, they're the things you see — there are a lot more injuries that happen."

And while recovery times vary, doctors talk in terms of months and years, not days and weeks.

"People might get out of the hospital after a few days, but then the healing starts, and the time it takes is mostly done outside the hospital," Dr van de Pol says.

"There's the bit we don't see, either — the anxiety and mental problems people have after they've been involved in an accident like that. A scene of mass casualty, with a lot of blood can impact on your mental wellbeing. Bones generally heal, but all the other injuries?"

'This is about the safety of a human being'

As head of safety policy for Queensland's main motorist body, the RACQ, Steve Spalding is keenly aware of driver sentiment around cyclists. He says it's not all bad — but people are still missing the point.

"I don't think there's been enough discussion around the human element and the fact that cyclists are fellow citizens — citizens who choose to get around by a different form of transport," he says.

"It's a destructive conversation — and social media unfortunately seems to drive these conversations where, very quickly, groups polarise and you end up with very strong views on both sides, and the moderate views in the middle get lost, and they probably exit the conversation, and you're left with two extreme views that completely lose sight of the fact that this is about the safety of a human being.

"It's been a long time since I've had a conversation … about the fact that it's about keeping a fellow human being safe on the road."

Mr Spalding says recent changes designed to protect cyclists on Queensland roads have delivered a practical buffer zone — namely the introduction of a one-metre passing rule. However, the lack of understanding about why the new rules were introduced — and inconsistencies in road rules across state borders — diminishes their effectiveness.

"States have all approached this slightly differently — national aligned road rules make it far easier and safer for everybody, but states don't always adopt changes at the same time," he says.

"Queensland was one of the first to put a trial in place around the one-metre passing distance. We saw first-hand the lack of understanding, not just over its application but around the why — why people need to give cyclists that safe space."

Mr Spalding's message to motorists regarding cyclist safety is blunt: "They are a vulnerable road user and they will always come off far worse in a crash. They're not equal in terms of protection and the consequences of a crash.

"When you have a size and weight difference, say between a cyclist and a truck, that's when you see those catastrophic outcomes, and we've seen many over the years."

So how do motorists really feel about sharing the road with cyclists?

"I'm happy to say I haven't had those conversations with people who are advocating doing the wrong thing around cyclists," Mr Spalding says.

"You do see those that pop up on social media, but they're not the conversations that I've had. Regardless of who has done the wrong thing, there is this general concern about consequences."

'The fear of someone dying is awful'

Mr Spalding says driving isn't a "right", but rather a privilege with great responsibilities — a point not lost on Mr Treacy as he contemplates teaching his children, both L-platers, when he's finally able to get back behind the wheel.

Firstly, however, he must regain the use of enough of his body to perform such simple tasks as washing, going to the toilet and transferring his weight from wheelchair to bed, among the unseen consequences of this life-altering accident.

"The trouble is, because I have a broken pelvis and a broken leg, I'm immobile — no weight bearing," he says.

"I can't stand up — so it's bed or wheelchair, and transferring between bed and wheelchair without putting weight on your legs is not easy — particularly when you can only use one arm.

"It's a massive disruption [to family life]. I consider myself a modern male, so I do a lot around the house — cooking and stuff, so forget about that. You're just a burden. You can't dress yourself. I have one good limb out of four — we're not designed like that.

"Certainly I feel like [I have] a lot of support. It's a great country to get injured in — fantastic medical services. This place is pretty awesome — if you get hurt, you want to be in Australia close to a centre like this. There's a lot of comfort in not having to worry about costs, and, 'am I being treated properly?'

"We [the injured cyclists] all got head-to-toe scans. The impact was so hard. We were doing — I don't know — 35-40 kilometres an hour when we hit that car, and when you come to a dead stop, there's going to be internal injuries. To know that we were checked out head to toe, make sure everything was in its place … that's reassuring.

"We spend a lot of time complaining about the 10 per cent that's bad in Australia, and very little time thinking about the 90 per cent that's just amazing."

He says he immediately spared a thought for those unwittingly caught up in his accident.

"Having been on the other side where you're not injured, it's terrible — it's so stressful, waiting for the ambulance, calling an ambulance, particularly with people who are going in and out of consciousness, because we're not medically trained people and the fear of something happening — of someone dying, fundamentally — is awful," he says.

'We all do things that are a bit dangerous'

Bicycle enthusiasts like Mr Treacy, who on the day of his accident was training for a distance ride to raise money for the Children's Hospital Foundation, don't see the fuss when it comes to the growing cyclist presence on our roads, but he acknowledges not everyone agrees.

"It's a hobby — it's not a job, not something that I have to do," he says.

"Everyone has friends who aren't cyclists who say, 'Why do you do it? All those people on the road, it's so dangerous', but we all do things that are a bit dangerous — we swim in the ocean.

"This is a selfish endeavour — I do it because I love it. But whether you play football and break your leg, or tennis and hurt your shoulder, that's sport.

"I'd rather go out and do a sport and stay healthy, then I can contribute [to society] because I'm healthy and fit."

At 49, Mr Treacy does not want to be counted among those ageing Australians who've neglected their health and become a drain on the system.

"[Cycling is] becoming more and more popular, more recognised as a great way for someone, once your knees have blown out from old age, to stay fit and healthy," he says.

"We're all going to live longer, so the question is how do I not destroy my joints and stay fit. Swim?

You're either a swimmer or not, and not all of us have an Olympic swimming pool outside our home, but we all have a road.

"It's not like I haven't sat down and thought about what other sports I could do, but it has a uniqueness about it — accessibility, it's low-impact, cardio, very good for keeping the weight down — all very important things as we age. Australians gain one to one-and-a-half kilos of weight per year as they age."

Will he get on a bike again?

"Not even thinking about it — not saying no or yes, it's just a moot question because I just don't feel like I want to think about it," he says.

"There's other types of riding — mountain biking. The thought of not riding is not a pleasant thought because I really, really enjoy it."

Credits

Photography: James Maasdorp

James Maasdorp Video: Nick Kilvert

Topics: disasters-and-accidents, safety-education, health, west-end-4101, highgate-hill-4101, australia

First posted