Correspondence

Bicycle Racing

N Engl J Med 2003; 348:566-567February 6, 2003

Article

To the Editor:

The photograph by Gregory Curfman entitled “Echternach, Luxembourg” (Nov. 28 issue)1 was taken on July 7, 2002, during the first stage (Luxembourg to Luxembourg) of the most recent Tour de France.2,3 On the right side of the image, it is possible to recognize, wearing the leader's yellow jersey, the American champion of cycling and cancer survivor, Lance Armstrong.3,4 This picture led me to reflect — first, how medicine is important in facilitating a recovery to full health in a person affected by cancer; second, how the example of such a full recovery has been important psychologically to many persons affected by neoplastic diseases; and third, how physical activity is important in determining many beneficial effects for health.

Giovanni Taccetti, M.D.
Cystic Fibrosis Center of Tuscany, 50132 Florence, Italy
g.taccetti@meyer.it

4 References

1. 1

   Curfman G. Echternach, Luxembourg. N Engl J Med 2002;347:1768-1768
   

2. 2

   Tour de France 2002 Echternach Web site, 2002. (Accessed January 16, 2003, at http://www.echternach-online.lu/Galerien/TDF/index.htm.)
   

3. 3

   2002 Tour de France. Emmaus, Pa.: Rodale, 2002. (Accessed January 16, 2003, at http://www.tourdefrancenews.com/stage/stage_01.shtml.)
   

4. 4

   Lance Armstrong online, 2002. (Accessed January 16, 2003, at http://www.lancearmstrong.com/bio.html.)
   

To the Editor:

Though pleasingly colorful to the eye and showing what appears to be an appealing, Old World setting, Dr. Curfman's photograph of cyclists racing in Luxembourg is unfortunate for its prominent portrayal (in the center foreground) of a helmetless racer. I will choose to believe that the editors' choice of this particular photograph does not mean that the Journal advocates careless neglect of such a simple and accessible preventive health and safety measure.

John L. Udell, M.D.
Gundersen Lutheran Medical Center, La Crosse, WI 54601
judell@gundluth.org

Author/Editor Response

The editors of the Journal strongly encourage the use of bicycle helmets by all riders. However, it is a fact that professional cyclists (as pictured in the photograph) are not required to wear helmets. Most wear them routinely, but a few choose to wear them only in racing situations that carry particular risk. The officials of the Tour de France once tried to introduce a helmet rule, but the cyclists objected, and the rule was dropped. In the 1995 Tour, Fabio Casartelli, who was not wearing a helmet, died of severe head injury after he was thrown headfirst off his bicycle onto a granite marker. In the circumstances, as writer Graeme Fife observes, “No helmet could have saved him.”1

Gregory D. Curfman, M.D.

1 References

1. 1

   Fife G. Tour de France: the history, the legend, the riders. Edinburgh, Scotland: Mainstream Publishing, 1999.