Glad someone is talking sense

Daily Telegraph: road safety and Jean Todt

One of the most faithful and productive commenters on this blog has sent this link. It’s fascinating and I encourage you all to read it.

There are some interesting tie-in’s in this story. For example the Qatar connection. We’ll not forget how the miraculous last-minute payment of back dues of some of the Middle East and Gulf ASN’s pushed Jean Todt to victory in the 2008 FIA presidential elections. Nor his almost unseemly chumminess with the ruling regime in the Kingdom of Bahrain.

I’ve complained on many occasions about how incredibly . . . ineffective . . . the FIA’s “Action” for Road Safety campaign seems to be. I’ve seen countless photos of Todt and his ambassador for Road Safety (yes, Mrs. Todt) posing with Transport Ministers and even Prime Ministers of various countries, cutting ribbons for new stop signs, solemnly swearing grade school students to wear seat belts, etc.

SERIOUSLY? It was clear that in a part of the world where vehicle-related deaths are increasing at an explosive rate, the FIA campaign is rather more of a schmoozefest photo-op than a serious effort to make a dent in the problem.

I remember a conversation I had with David Ward in 2008. David was President of the FIA Foundation (and ironically, or perhaps not ironically at all . . ., Todt’s opponent in 2013); the Foundation is in fact the part of the FIA specifically charged with road safety – NOT the FIA proper. More of this later.

I spoke to David about using some of the Foundation’s money to organise a huge project. This would involve development (recruiting the right people to think this through) and implementation of a staged trauma care program for rural areas in the developing world. Only by ensuring that victims actually survive from the village level to higher echelons of care could we hope to have an effect. This project would proceed in multiple steps, culminating in an actual trial, with actual data generation, as to the efficacy and efficiency of the proposed system in improving outcomes on a large scale. In line with current “philanthropy”, it would be subject to rigorous metrics. Money, in no small amounts, would be spent improving survival and quality of life, not for official dinners and luxury travel.

It was clear that conflict between the Foundation and Todt’s FIA began almost immediately. The Foundation’s road safety campaign hit (sorry for the pun) roadblock after roadblock, and was essentially choked to death. The difficulties extended to the FIA Institute (charged with r & d and education). Parenthetically, this is almost certainly why progress on publishing the Medicine in Motorsport book stopped when Todt became president. The book was Max’s project, not Jean’s, and was therefore unceremoniously halted.

Things then got even more infantile, with Todt starting an in-house road safety campaign, taking the Foundation’s stickers off the Medical and Safety Cars, and replacing them with his own. All this was no doubt to better control the pursestrings, and to personally reap the various “rewards”, of putting his face on road safety. Problem is, if you don’t actually DO something for road safety, you kinda can’t become its face. In my eyes, it’s not so much a conflict of interest, as an immensely sad admission of defeat. This man has had one full five-year term (plus, soon, one more year) to accomplish something, anything, in the area of road safety. It’s not hard to imagine, given the resources available, that a well orchestrated campaign would indeed have made Todt a household name, almost a near-saviour for those who’d have benefitted from improved road safety. 

Hearing about these UN pretensions helps all these kilometres (in first class and private aircraft, bien entendu) make sense. I think it’s been clear for all those willing and able to look closely enough that Todt has viewed the FIA presidency as a stepping stone. He has systematically hired up ex-Sarkozy staff, and I’d have thought this was rather with an eye to French national politics. Now that the UN route would appear to be (temporarily) barred, and that Mr. Sarkozy appears to be having his own problems, perhaps we’ll see manoeuvring  with an eye to a national political position. Minister of Sports? 

Looking back a bit, under Max and between 2005 (when Sid retired) and 2007 (my last season with the responsibilities of Medical Delegate), we had g-triggered Medical Warning Lights installed on all cars, made integrated accident simulation exercises mandatory before every F1 race weekend, and wrote and readied for publication a Medicine in Motorsport book.

At risk of sounding repetitive, I point out again that in 2008 Todt appointed Gérard Saillant, an orthopaedic surgeon with no motorsport experience, as president of the Medical Commission. The members of this body have several centuries of cumulative motorsport experience between them, and found their Chairman seat, formerly occupied by Sid Watkins now hosting . . . the above mentioned. He also appointed Jean-Charles Piette, a rheumatologist with no motorsport experience, as Formula 1 Medical Delegate.

I’d almost defy anyone to point out ANY advance in medical/rescue science, technique, or prevention (with the exception of the Zylon visor reinforcement, developed purely by engineers) applied by the FIA since 2008. 

The lack of progress, I believe, results from leadership that views the organisation as a cash cow rather than as a means to an end. From a leadership that either doesn’t understand the stakes (worrisome indeed), or doesn’t care (a truly terrifying prospect).

46 thoughts on “Glad someone is talking sense

  1. HI Gary

    One of the amazing things about your blog is that it has brought people together from different countries. Because I know you are working in Liege I have got interested in Belgium and when the WW1 100th anniversary ceremonies were taking place I immediately thought of you.

    The news is so depressing today with the beheading of James Foley and the gathering gloom.
    I know your twitter posts are often about politics and so I thought you might be interested in this. It just seems like a time when countries should stick together and as an American in Belgium I thought you might be interested in this item about how Britain handled its biggest wave of refugees ever in 1914 who came from Belgium but then returned after the war.

    http://www.bbc.co.uk/guides/zcn3b9q#z8vc4wx

  2. Gary, would you be able to use your contact with Steven Laureys at Liege to ensure that all traumatic brain injury patients who have been in apparent vegetative state for 6 months have access to brain scans and the most accurate testing? Would be wonderful if we could use any F1 contacts at Addenbrookes like Peter Hutchinson as well. Would be a fitting tribute to all we have learnt about prolonged disorders of consciousness from reading your blog.

    http://www.coma.ulg.ac.be/home/steven.html
    http://www.coma.ulg.ac.be/papers/coma_vegetative_state.html

    • I’ve no doubt that the sophistication and accuracy of testing for residual consciousness will increase dramatically in the mid-term future. Until then, these techniques remain research tools.

      Beyond the need for further validation and other methodological issues, this question is also complicated by the relative paucity of MRI machines, and by the costs involved. All the coma patients we scan have an anaesthesiologist at their sides for the exam, further increasing costs.

      • Thanks Gary – it always comes down to money. I think this TMS-EEG bedside research would be cheaper but it comes from Italy. Don’t suppose you have any contact with any of these Italian researchers? This shows that cortical potentials evoked by TMS (TEPs) are different in minimally conscious and vegetative patients and are mostly bilateral in minimally conscious state.

        http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3584112/

      • Recent consensus statements on management of patients with prolonged disorders of consciousness insist on the difficulty in diagnosing inconstant moments of consciousness in patients with severely damaged brains. As researchers develop and validate additional tools to probe the person’s consciousness WITHOUT depending on fully intact “output” pathways, these will find themselves being added to the standard assessment tools in these situations.

        More importantly, let’s remember that decisions about withdrawing nutrition and hydration depend on accurate diagnosis of a persistent vegetative state. Because by definition PVS means there is no consciousness of self or non-self, the patient feels no pain, no hunger, no thirst. It’s pretty clear that this is a decision we (the judges) cannot fuck up (evidence of absence ≠ absence of evidence); I’m sure Steve’s research has made more than one judge sleep just a bit uneasier. I say this because I think that as these techniques become more statistically, neurologically and epidemiologically robust, the COURTS will drive a good part of their adoption, specifically to help address the withdrawal of care conundrum.

  3. From all that Jean Todt and company i’m not going to watch next season of F1… They only care about money. As much money as they can get from it. And they’re not interested in anything that can stand on their way to money. Formula 1 can be cruel if it’s about money – just remember San-Marino GP-1994 and the total ignorance and indifference about driver’s lives and safety back then.

  4. Modern medicine is getting better and better at saving lives but then patients who appear to be vegetative are ‘warehoused’ in the US or dumped in nursing homes in the UK. Michael will be OK – he has his 1billion to provide him with high-tech help. How about the FIA, Ferrari or Mercedes sponsoring research. Jean Todt could put his own logo on the research if he wanted….

    They could select several young patients. First they could use brain scans to prove they were minimally conscious rather than in pvs. Then they could design an electric wheelchair for each patient which could be operated with whatever minimal movements the patients had left.

    At the end of the project they could even publish the research. Might even be a good photo opportunity in it for Mrs Todt – she could pose with the patients in their wheelchairs!

  5. I have just read that Corinna is selling their private jet. If true that says more than all the medical updates we have had so far.

    • What are you reading into her selling the jet? They don’t need the money. She will still be travelling to Texas and wherever. Maybe she is buying a new one.

    • My first response: Women are so practical! (we have a kinship)
      I remembered 8 years ago when a good friend’s husband died. Within a month of the funeral she sold his new Jag, his vintage race car, carrier, and all the accoutrement. It was not a money thing, she just didn’t want to be bothered with all of it. At the time we thought it a sacrilege, but realized she was right. One must move on and shape your new life to your own needs.
      lm

  6. This research would benefit Schumacher and other patients in the future – this is a field that needs a high profile patient. Who knows – perhaps some of his 1billion could be used to help patients………

    ‘Post-coma persons in a minimally conscious state and with extensive motor impairment or emerging/emerged from such a state, but affected by lack of speech and motor impairment, tend to be passive and isolated. A way to help them develop functional responding to control environmental events and communication involves the use of intervention programs relying on assistive technology’

    http://journal.frontiersin.org/Journal/10.3389/fnhum.2014.00048/full

  7. Another excellent piece, echoed by the quality and thoughtfulness of the commentators. One thing Michael’s accident has done is prod me into actually making an advance directive. It’s a sad fact of life that this, or event with similar consequences, could happen to most anyone at any time with no possibility of mitigation or control. I encourage everyone to make their own decision but then TALK about it with your loved ones so they know – either way. You surely owe it to the people you love to make that decision known to them so they won’t have to make that call in what will probably be the worst hour of their life.
    Along with, I suspect most people, it’s been a case of head against heart for Michael and his family. My heart aches for them all and has been hoping for the best, but logically; thanks in part to the great information Dr. Hartstein has provided over the months – … well, fate is a cruel mistress sometimes.

    • Jane A,
      One of the great advantages of watching the races in a group (sometimes lubricated with breakfast champagne cocktails) is the rising chorus of joy, excitement, irritation, disgust, anger whenever a notable incident occurs. Massa’s move on Mags was met with a universal groan of irritation followed by snarls of disgust when he claimed victimhood.
      (Lewis on the podium after his excellent drive blaming Jenson for his less-than expected lap time embarrassed us all.)
      lm

  8. (Is this crazy or what? Today several reports have Schumacher’s eyelids “fluttering” to convey messages, plus he’ll soon be controlling an electric wheelchair! Who said tragedy becomes comedy just by sitting down?)

    Autoweek – 22 July:
    “According the the London Daily Mail in a published report on Tuesday, Croatian neurosurgeons have developed a microchip implanting technique that may be able to help Schumacher to walk and talk again. That microchip technology has had some success in at least one other case of paralysis, according to one of the doctors in the report.

    There have been no recent official reports of Schumacher’s condition, but it is being reported in the Daily Mail that the seven-time Formula One champion is awake from his coma. However, Schumacher remains paralyzed and is only able to communicate through blinking. He is recovering in a Swiss clinic, and doctors hope that Schumacher will soon be able to sit in a wheelchair and control that chair with his mouth.”

    – See more at: http://www.autoweek.com/article/formula-one/advance-microchip-implant-michael-schumachers-future#sthash.XvxcppCz.dpuf

    • In the unlikely event that anyone can speak Croatian the doctors involved are Darko Chudy and Vedran Deletis

      ‘Doctors at the Lausanne clinic hope to have Michael sitting upright in an advanced electronic wheelchair that he can control via his mouth within a few weeks’.

      ‘According to the Croatian media meanwhile, Croatian doctors Darko Chudy and Vedran Deletis, who have developed a revolutionary microchip implanting technique, have been approached to see if they can help.’

      ‘It is believed that the microchip may be able to help him to walk and talk again after his extended period in a coma.’

      ‘It has been claimed the family of Schumacher made the initial contact with the two doctors from the Croatian capital Zagreb after reports in specialist publications indicating that their technique had already helped other patients.’

      ‘The medics reportedly confirmed when questioned that there had been contact but declined to discuss the case in detail.’

      ‘We’ve had a case with Croat schoolboy and he started to walk after two months,’ Doctor Darko Chudy confirmed in a short interview with local media.

      ‘But he added that he cannot talk about the Schumacher case, other than to confirm that there had been contact and it is believed his technique would be able to help.’

      http://www.dailymail.co.uk/sport/formulaone/article-2701535/Michael-Schumacher-home-hospital-end-summer-reports-claim.html

      • I’ve looked somewhat extensively for scientific publications by Drs. Chudy and Deletis. One would think that with work as earthshaking as this, where implantation of a “chip” wakes those with prolonged disorders of consciousness, would not only be published, but trumpeted from the highest rooftop. Such a success would clearly earn the developers a Nobel Prize for Medicine and Physiology.

        Perhaps Drs. Chudy and Deletis have kept their R & D secret. Such a fantastic tool should OBVIOUSLY be kept out of the wrong hands!

        The problem is that these fellows would have had to be at the head of a massive, insanely expensive top secret project to elucidate enough of the components of consciousness to THEN allow development of a “chip”. A bit hard to imagine, given that there’s no recorded mention of this research in the usual literature on this subject. Furthermore, NO LEGITIMATE scientist has mentioned this miraculous technique. And the only patient mentioned is a . . . Croatian boy. A randomised controlled multicentre trial? Ha! Not for THESE guys!

        Further, the backgrounds of the two fellows mentioned certainly are NOT what we’d expect to see for two guys who, if they’re ready to do what they say they are, are some of the most important neuroscientists on the planet at this moment. Why are Harvard, Cambridge, Oxford, etc not DESPERATELY trying to woo these fellows? Why are the Medical Research Council, or the American National Institutes of Health not working overtime to hire these geniuses?

        As much as I’d love to think there’s a quick fix, this sounds to me (with nothing other than my instinct to go on) like the exploitative ravings of two con men, and the desperation of a vulnerable wife. Some will lose, some will gain, and I’m pretty sure I know who’s who.

        Oh and if you think I’m being cynically negative, I’ve got a working cold fusion reactor in my basement. Anybody care to invest????

      • Hi, I am from Croatia, and kind of ashamed of it right now…😉
        First of all, the story about Chudy being in contact with the Schumachers was first published by Jutarnji list, not a very credible source, full of sensationalism. Secondly, a doctor who knows Chudy was a guest in the midnight news the other day, and said that he was appalled with what was written in the article and that someone from the US called to confirm the story and dr. Chudy denied every having said that he was in contact with the Schumachers. Now that could be because it is a legal breach for a doctor to do that or because he never actually spoke to Schumachers and the journalist made it up to sell the story. The story also said that the chip would help Schumacher walk, which is kind of suspicious since there is a video of O.Panis saying that Michael´s motoric functions have not been damaged. It´s in French, you can look it up. I´d trust Panis with this. He lives in Grenoble, and has probably seen Michael. If you ask me, it´s a Croatian journalist wanting attention.
        Regarding the scientific work of Deletis and Chudy, I have no idea, as far as I understand it, they really are working with deep brain stimulation, there are some articles online.

        Best regards!

      • Hi Gary

        I have been trying to find out more about brain-computer interfaces as I think they might help Michael as well as people in locked-in state. I think Niels Birbaumer sounds genuine, and he is now working on a new system described in this article which sounds like it may be the origin of the microchip story.

        http://www.bio-pro.de/standort/03483/index.html?lang=en&artikelid=/artikel/08923/index.html

        The idea is to implant electrodes into the brain where the electrodes capture thoughts and transfer them to chips implanted in a patient’s fingertips. This idea has the advantage that patients would no longer need prostheses and drugs; surgery to implant the chips would be the only intervention required.

        Niels Birbaumer is one of the leading figures in the history of brain-computer interfaces (BCI), which are direct communication devices between the brain and a computer. Birbaumer has been dealing with BCIs for as much as forty years. He believes in the power of BCIs, a power that is based on human imagination and is used to treat brain disturbances. The director of the Institute of Medical Psychology and Behavioural Neurology in Tübingen was awarded the prestigious Leibniz Prize in 1995 for his pioneering work on BCIs

        .

      • Thanks for this Jane. Really fascinating. This is so sci-fi that it for sure is going to be a huge way forward. Just before we learn how to use stem cells to reestablish structure and function in the damaged brain!

    • Lulu, from what I’ve read the family is going ahead with the surgery to implant the chip. I guess there is nothing to lose.
      And if the family has built an addition to their mansion why hasn’t there been aerial pictures of the new building? They can’t control the air space.

    • Having eliminated the obviously ridiculous microchip part of the story I am interested in the comment about Olvier Panis which I had heard before and also the part of the story in the Daily Mail about him using his mouth to operate an electric wheelchair, which seemed to come from a different source. Moral is of course that no-one knows anything at all!

  9. Without a general manager you’d require too many areas of expertise, the management team better in specifics..

    But peoples care for their own safety, personal self respect astounds me with all extreme sports, mental health, a balance between achieving a social image and achieving the talent…

  10. Pingback: F1 Fanatic round-up: Vettel's criticism blamed for small crowd

    • But justified, it seems to me. The term “sour grapes” is used too often without discretion to cover anything from whingeing because someone else has simply done better or been more successful, to voicing a genuine grievance about an injustice. In the latter case the negative connotations of the expression are not warranted but remain nonetheless.
      Normal people don’t turn others over just to satisfy their egos or political ambitions. That’s a quasi-psychopathic behavioural problem. Mr Todt certainly appears to display some tendency for this.
      I am of course not privy to the details, but from what I’ve read, Gary Hartstein was indeed turned over for political reasons and motorsport is the worse for it.
      So you can call it sour grapes if you like, but the comments seem perfectly reasonable to me in the circumstances.

  11. If anyone else had written that, Id say it sounded like sour grapes. But I know you have little time for that, and are writing because you truly care. And I agree with you. Jean was great at Ferrari but is terrible as FIA president.

    What can actually be done about this? From the sad way you were ousted it is clear Jean has no time for your views. He has turned into a dictator but is there anyone who he DOES respect, who we could petition to take this argument to him?

    He is screwing up the marketing & image of F1 too.

    • Oh it IS sour grapes – in the sense that we’re seeing an edifice that Sid and others have invested hugely in, and that still has fascinating and useful work to do, and to diffuse, being allowed to crumble by the indifference (or outright hostility, c’est selon) of the leadership of the FIA, and the ignorance of the people in charge of the Medical side.

      What’s to be done? Trust me, if, as I suspect, Todt doesn’t renew Charlie’s contract at the end of this year (unless it’s already BEEN renewed, in which case it’s an immense victory over Todt’s negligence of quality over his own mates) there are going to be MUCH more important issues to be dealt with in short order.

  12. With the combination of stepping stone and cash cow, it’s little wonder that M. Todt and Company show no real interest in advancing race or road safety. As you would well know, advancement requires risk, and the possibility of failure. Failure looks bad, and risk is expensive. It’s politically( in both applications of the word) safer to do nothing and blame random chance when things go terribly wrong, than to “squander” precious profits on “negligible” safety advances.
    I presently have bosses that run their business on that same sort of model. They are frequently getting caught flat-footed, but as long as there is someone further down the pyramid who can fix it or take the blame for it’s failure, then they see absolutely no reason to apply any further safeguards to their process.
    I’m guessing that M. Todt is planning of being elsewhere before things blow up, let alone fail to improve.

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