A to B: How not to die on a bike in London

Hayley Campbell is inexplicably still living. She shares her tips on how to master this impressive feat yourself.

I’ve been a cyclist in central London for almost two years and I am not yet dead.

This is probably statistically rare given I am 20-something and female, and when thinking back over my first year it certainly feels like an unlikely outcome. Look at me typing on the internet. I could be dead instead of doing this but somehow I’m not. Either I'm invincible or I have learned how not to die. Since I burn myself every single time I make toast, I can assume the invincibility theory is bogus, so it must be the latter. 

I feel I should share my discoveries. If you’re going to jump on a bike and head out into London, these are the things you need to know that you won’t find in any guidebook:

1. The most dangerous person on the road is the suit on a Boris bike. Avoid him. He is the first move in every Rube Goldberg-esque pile-up. The last time the suit on a Boris bike was on a bike he was eight and he fell off. Now he’s loose on the open road and has no idea where he’s going but he’s a businessman and he gets stuff done so he’s going to do it anyway. You know what these people are like, you’ve seen The Apprentice. Grade A bullshitters. He goes the wrong way down one-way streets, he goes straight down the centre of a two-lane bike path. When correcting him you are summarily told to "fuck off" and reminded that he earns more than you do. (NB. This could also be straight up “Boris Johnson on a Boris bike”. Political.)

2. The second most dangerous person on the road is probably HGVs but really it’s a toss-up between the bone-crushing huge vehicles that glide over steel bike frames/fleshy humans and “the lady with the billowing skirt who obviously has not seen that documentary about Isadora Duncan”. Avoid both. The lady with the skirt will crash because she is i. attempting to tuck her skirt between her legs instead of looking where she’s going, or ii. her skirt will become entwined in the chain and she will fall over exactly sideways and become inextricable from her bicycle. She will take down everyone in a 20-foot radius and will blame everyone but herself.

3. The new cyclist about London will learn that there is a lot of buttcrack in this city. Miles of buttcrack hang out of London trousers every day of the year. Even February.

4. The new cyclist will learn (eventually, emphatically) that “bicycle maintenance” is not just a thing for other people. If something is going weird on your bike – wobbling or making a strange noise – investigate. This might involve taking it to a person who knows better and just coming clean, ignorance-wise. Do not think “it’ll probably be fine” because it definitely won’t be, and do not under any circumstances “MacGyver” a solution. If you do not sort this out properly your bike will collapse beneath you after something important snaps off (for instance) and you will smash your face in on an Islington footpath (for instance) and leave a blood-based Jackson Pollock street-painting behind when the ambulance come to take your concussed ass to hospital (for instance). Buy a book or do a google. Buy a tool or two.

5. Cherish your teeth and eat crunchy food while you still can. Avoid soup and porridge so that when you have to spend six months eating only soup and porridge you can handle it without turning to suicide. For instance.

6. Think about your crash position now before it happens. When it does happen, don’t scream. Teeth are surprisingly durable but only when covered by lips, and dental work is more expensive than you can possibly imagine. To put it in the terms that hit home for me: dental work is "two overdrafts and you have to phone your parents" expensive.  

7. Find a dentist who is endlessly weird-looking so you don’t get bored of seeing his face twice a week for half a year.

8. You can never have enough locks. Two, minimum. London bikes work like umbrellas in that you never actually own one, you just occupy it briefly in a time-share scenario. Love your bike but know it will eventually leave you just like everything else.

9. People in cars have no idea how long their car’s nose is and will stick that nose right out into the middle of your bike lane. Or whatever that thing at the front of a car is called. I don’t know, I don’t drive, I have a bike.

10. You will find yourself hating one of the finest inventions of all time: the wheelie suitcase. Dragged behind tourists in Bloomsbury, this suitcase is always left in the middle of the cycle lane long after the tourist itself has leapt out of the way. Tourists do not see it as an extension of themselves. The tourist believes they are not defined by their tour/carry-on.

11. Just because someone is wearing more Lycra that you does not mean they’re a more experienced rider, it just means they bought more Lycra than you. See also: artists with better tools, leather portfolios; writers with Moleskines. Do not follow this person’s lead on the road, they are lost.

12. Nurses treat you better if you were wearing a helmet when it all went wrong. Even if the helmet actively made your injuries worse, the nurse is slightly less likely to badmouth you to the doctor inspecting your face/remains of your mouth. Wear a helmet but know it’s for nurses, not your own head.

13. Black cab drivers want you dead. Once a year a black cab driver will scream out of a passing window a sentence along the lines of “I HOPE YOU FUCKING DIE YOU CUNT” just to remind you of their feelings. The last time I was in a black cab I actually sat in a puddle of cold human semen, so: black cabs, the feeling is pretty mutual.

14. Related: There is a man in London with "FUCK" tattooed down one calf and "TAXIS" down the other. He wears shorts all winter and even Michael Fish can forecast how he is going to die.

15. Nobody likes the guy on the fixie bike who balances at the lights. Put your foot down. We’re grown-ups. We’re not playing that game where the ground is lava.

16. On any given ride you will invariably encounter two women cycling side by side, chatting, taking up the entire road with their slow-moving floral basket machines. If you hang back for a minute you can catch one slapping the other in the face when they both indicate right.

17. Pedestrians never look where they’re going. Like, never. You will spend your first year marvelling at the confidence with which they stride into the road looking at their phones or run right out into intersections unexpectedly. You will spend the rest of your life dodging them and wondering when they’ll notice how close to death they just came. They won’t. My mum once gave me a piece of advice: “Assume everyone else is an idiot”. I can’t remember what it was for or about (maybe dudes, condoms) but I’ve repurposed it for cycling in London.

19. Your first year on a bike is terrifying but brilliant. You learn how London fits together. You realise you can propel your feeble human body from one end of it to the other for no money and get less fat doing it. A day of errands becomes an hour of errands. There are reasons bike couriers exist: it takes them a fraction of the time it takes someone in a car to do it, or someone on legs or in a bus or tube. Being on a bike in London is one of the most liberating things in the world: it’s as close to wings or a jetpack as we’re going to get until those scientists stop mooching about and make us some cooler stuff.

But at the end of your first year you will wear this expression almost permanently. Shocked and appalled, over and over and over and over. 

Unless you’re dead or your face is broken and you can’t make any expressions at all. All of which are possible.

This piece is part of A to B, the New Statesman's week of posts about transport.

The bike of Andrew Mitchell MP. Photograph: Getty Images

Hayley Campbell writes for a number of publications, but then who doesn't. You should follow her on Twitter: @hayleycampbell.

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David had taken the same tablets for years. Why the sudden side effects?

Long-term medication keeps changing its appearance – round white tablets one month, red ovals the next, with different packaging to boot.

David had been getting bouts of faintness and dizziness for the past week. He said it was exactly like the turns he used to get before he’d had his pacemaker inserted. A malfunctioning pacemaker didn’t sound too good, so I told him I’d pop in at lunchtime.

Everything was in good order. He was recovering from a nasty cough, though, so I wondered aloud if, at the age of 82, he might just be feeling weak from having fought that off. I suggested he let me know if things didn’t settle.

I imagined he would give it a week or two, but the following day there was another visit request. Apparently he’d had a further turn that morning. The carer hadn’t liked the look of him so she’d rung the surgery.

Once again, he was back to normal by the time I got there. I quizzed him further. The symptoms came on when he got up from the sofa, or if bending down for something, suggesting his blood pressure might be falling with the change in posture. I checked the medication listed in his notes: eight different drugs, at least two of which could cause that problem. But David had been taking the same tablets for years; why would he suddenly develop side effects now?

I thought I’d better establish if his blood pressure was dropping. I got him to stand, and measured it repeatedly over a period of several minutes. Not a hint of a fall. And nor did he now feel in the slightest bit unwell. I was stumped. David’s wife had been watching proceedings from her armchair. “Mind you,” she said, “it only happens mid-morning.”

The specific timing made me pause. I asked to see his tablets. David passed me a carrier bag of boxes. I went through them methodically, cross-referencing each one to his notes.

“Well, there’s your trouble,” I said, holding out a couple of the packets. One was emblazoned with the name “Diffundox”, the other “Prosurin”. “They’re actually the same thing.”

Every medication has two names, a brand name and a generic one – both Diffundox and Prosurin are brand names of a medication known generically as tamsulosin, which improves weak urinary flow in men with enlarged prostates. Doctors are encouraged to prescribe generically in almost all circumstances – if I put “tamsulosin” on a prescription, the pharmacist can supply the best value generic available at that time, but if I specify a brand name they’re obliged to dispense that particular one irrespective of cost.

Generic prescribing is good for the NHS drug budget, but it can be horribly confusing for patients. Long-term medication keeps changing its appearance – round white tablets one month, red ovals the next, with different packaging to boot. And while the box always has the generic name on it somewhere, it’s much less prominent than the brand name. With so many patients on multiple medications, all of which are subject to chopping and changing between generics, it’s no wonder mix-ups occur. Couple that with doctors forever stopping and starting drugs and adjusting doses, and you start to get some inkling of quite how much potential there is for error.

I said to David that, at some point the previous week, two different brands of tamsulosin must have found their way into his bag. They looked for all the world like different medications to him, with the result that he was inadvertently taking a double dose every morning. The postural drops in his blood pressure were making him distinctly unwell, but were wearing off after a few hours.

Even though I tried to explain things clearly, David looked baffled that I, an apparently sane and rational being, seemed to be suggesting that two self-evidently different tablets were somehow the same. The arcane world of drug pricing and generic substitution was clearly not something he had much interest in exploring. So, I pocketed one of the aberrant packets of pills, returned the rest, and told him he would feel much better the next day. I’m glad to say he did. 

This article first appeared in the 13 March 2018 issue of the New Statesman, Putin’s spy game