It’s All Fun And Games Until You Break Your Arm On A Bird

Dignity is a virtue left at the doorstep of the emergency department.

I broke my arm ten days ago, riding a Bird scooter downtown.

Yes, I am perfectly aware of the absurdity of a 45-year-old fat guy in a sport coat riding a scooter up Ted Turner Drive. I am aware of a great many things, now that the painkillers have worn off.

Suddenly, I have formed strong opinions about scooters, and about myself, and about humanity writ large, because my arm is broken and I have little better to do than contemplate the depravity of mankind and write policy notes with one hand.

Yes, of course I’m left handed, damn it.

If you had asked me about scooters two weeks ago, I probably would have said something wonky about the value of last mile connectivity and how much more successful scooters will be in Atlanta because we hate traffic and are too polite to chuck them off a bridge like they do in San Francisco. At least, that was my view in May when Bird dumped scooters on street corners in the dead of the night.

My vestigial libertarian reflexes kicked in the moment I realized there are no rules for this. No advertising. No publicity. No preliminary public hearings. No study committee. Here. Go play. The thought of someone at city hall fielding phone calls from community busybodies hollering “they can’t just do that, can they?!” made me smirk. 

I took my first ride two weeks after they landed. I had about 30 rides on scooters from Bird and its competitor Lime, for about 30 total miles before eating pavement. 

I like the democratization of transit electric scooters represent. Most of the kids downtown still use free promo codes, but scooters are still cheap. They’re priced a bit below what Uber might charge for a short trip – a strategy that appears intentional in retrospect. Uber’s baseline for a fare starts at about $3 plus time and mileage. Grabbing a scooter for $1 plus $0.15 a minute for a trip a mile out looks frugal compared to $6 or so for an Uber.

That’s where my head was Wednesday afternoon, as I zipped up the street looking for the homeless man I had spoken to earlier. I’d been burning money on Uber all day, and it was a hair too far to walk in the cold. Three-tenths of a mile in, I missed the angle on a sidewalk curb cut. The scooter went right and toppled with an angry chirp. I kept moving forward.

The Bird ride cost $1.60.

I took a $7.60 Uber to Grady, because ambulances are expensive.

My wrist looked dislocated. I popped it back in on the way, more or less. My driver, Margil, just kept saying “I’m so sorry” over and over in plain horror while I made small talk. Endorphins, man.

I hobbled into Grady’s walk-in clinic. You don’t just walk straight into the emergency room unless you can actually see the bone sticking out of your arm, right? What would my insurance agent think?

Five minutes in the waiting room, the endorphins stopped. A nurse and I walked over to the ER. She put her coat on. I took mine off.

I now know what morphine and fentanyl feels like.

Grady’s care is excellent, and their emergency room conditions are a sea change from the nightmare my mother and I went through six years ago today.

Four hours later, I watched two beefy orthopedic surgeons tie my hand to a pole and then violently yank the crap out of my forearm while massaging the broken end of my radius back in place underneath my wrist. I imagine that would have hurt like hell if I could have felt it.

I now know that the sound of broken bones moving under the skin is called crepitus, which would make an excellent name for a Norwegian black metal band.

I made small talk.

Is this happening a lot, I asked? “Oh, you’re the third one today,” a nurse replied. “They’ve been coming in steadily for six months, three or four a day. We had someone in last week, she broke both arms and a leg.”

“You should study that,” I said, oh so sagely, through the morphine haze. “That seems important.”

“Sagely.” Heh.

I’m a nimrod who hit his deductible. But the specific kind of idiot I am matters for policy purposes.

Two psychologists at Cornell – David Dunning and Justin Kruger – produced a seminal paper in 1999 looking at skill competence and cognitive bias. They found that people with low competence in a skill lack the metacognitive ability to recognize that they’re poorly skilled. High skill people tend to under-estimate their relative competence, because they assume if something is easy for them, it’s easy for everyone.

One can say this in a thousand ways, from a Yogi Berra-ism that you don’t know what you don’t know to Shakespeare in As You Like It, “The fool doth think he is wise, but the wise man knows himself to be a fool.” We call this the Dunning-Kruger effect now, which has become synonymous for “well of course, he’s an idiot.”

It’s clear … now … that I am not competent enough at using a scooter to operate one safely. It’s also clear to me now that, because I lacked experience using them, I didn’t understand that I wouldn’t be able to use one safely.I had overestimated my competence out of ignorance.

The public policy problem is that I’m probably among the majority of scooter riders.

Their wide availability on street corners downtown sends a powerful presumptive message about the safety of dockless stand-up scooters: if they’re everywhere, they can’t be that hard to use, can they? Yes, one must wear a helmet, but I don’t see much of that, and really … it’s beside the point. One would not issue a helmet to a motorcyclist who couldn’t actually drive.

We have little experience with these scooters. People reach for comparisons to more familiar skills. If we think of them as bicycles we don’t have to pedal, then people will use a bicycle as a registration baseline for their own competence. And about 94 percent of Americans know how to ride a bike. About 467,000 bicycle-related injuries occurred in 2015 in the United States, but 45 million people — nearly one in seven Americans – are on a bike twice a week. That’s half a million injuries after at least 6 billion road miles and billions of trips. On any given bike ride, a cyclist has odds of thousands to one against landing in the emergency room.

I suggest the proper analogue is the skateboard. It’s a motorized skateboard with a handlebar. The average skateboarder travels about 8 miles an hour. An electric scooter tops out around 15.

Estimates vary, but only about nine percent of young people ride skateboards, and only about a fifth of them are any good. The popularity of skateboarding has been falling for a decade, but I’ll guess that about 10 percent of adults skateboarded as kids. About 9.3 million people skateboarded last year. In 2016, about 121,000 people went to the ER for a skateboard injury: 1.3 percent, or one in 76 participants.

How likely is it for someone to get hurt on an electric scooter? Right now we can only guess, and that’s a huge problem if we are crafting policy. But let’s try to guess anyway.

Bird hasn’t been particularly transparent about its ridership, but it claimed 39,000 rides in its first 70 days to one council member in July. I would bet that figure has at least quadrupled since. A wild guess: call it 2,000 rides a day.

Grady’s nurses said they saw three or four scooter injuries a day. That’s consistent with spikes seen in Salt Lake City with increases in wide availability, with the rate of serious head injuries in San Francisco, and elsewhere. Let’s say half of the city’s scooter injuries land at Grady, for seven a day in Atlanta.

Divide 2,000 by 7. With those assumptions, one in 286 rides ends at the ER. Ride once a day and you’ll end up in the ER once every nine months. 

Before the hearing, I asked staff if they had any safety statistics on the scooters, or if they had bothered to get the public hospital to give them injury data. They had not.

From a transportation safety standpoint, that figure is utterly insane. 
But most people think they’re above average, and that those risks don’t apply to themselves.

Bird, Lime and the rest know when a rapid deceleration – a crash– occurs. They also know how many trips and road miles their devices log. Grady can count ER visits.

This data could be a legal pre-condition for companies to operate here. This information is knowable now. We don’t have to guess. But the firms appear reluctant to part with the data, and public officials haven’t pushed enough.

The Atlanta City Council is contemplating ordinances to regulate the electric scooter business. Most of the discussion I’ve heard has been about the nuisance factor of parking scooters on sidewalks or of operating without a helmet. But whether or not they’re safe for their intended use – and the true public cost – isn’t a meaningful part of the debate.

“The spirit of the legislation, very generally, is nearing the laws around bicycles,” Atlanta’s chief bicycle officer Cary Bearn said in a presentation to the city council’s public safety committee Thursday. “That’s their guiding principle throughout this process.”

A lower limit to speed or even mandating one rider to a scooter wasn’t yet warranted, she said.

The office will evaluate the program in a year. “Our ability to enforce right now is very limited without any ordinance in place. With large events like the Superbowl coming up, it’s a little nerve wracking to be moving in that direction without any sort of regulatory framework.”

“Bird is a reliable last mile electric scooter rental service. Our mission is to make cities more livable by reducing car usage, traffic, and congestion.” – Bird

“Through the equitable distribution of shared scooters,bikes and transit vehicles, we aim to reduce dependence on personal automobiles for short distance transportation and leave future generations with a cleaner, healthier planet.” — Lime

That’s how the firms present themselves.

Scooters aren’t presented as a recreational novelty. They’re presented as an alternative to driving and a means of making bus and train services more effective. That’s purposeful. The growth story they’re selling to Wall Street depends on it.

Uber has reportedly been in talks to buy Bird for $2 billion in stock, after investing $335 million in Lime. (Bird denies it.) It would be a maddeningly high valuation for a 19-month-old company which – if reports that it has provided about 10 million trips so far are accurate – implies revenue of less than $50 million.

(Uber’s supposed $120 billion valuation ahead of an IPO is also hilarious; the firm has never been profitable. I think of buying Bird as a way of buying relatively “clean” EBIT profits to keep Uber’s growth story from collapsing. But that’s another story.)

Again, at best only about 10 percent of Americans can skateboard. Deployed throughout ITP Atlanta, that’s about 100,000 potential riders. But if you define the market as transit commuters, it’s four times larger with 435,000 daily MARTA riders. Never mind, of course, that 80 percent of that market isn’t skilled enough to operate one safely. Nor that they may appear to be a more common replacement for walking.

Scooter firms lay every bit of liability off on the user they can, with a binding arbitration agreement that the city could ban as a precondition for operating … if lawmakers actually cared about consumer protection. Bird’s valuation depends on a regulatory and legal environment that doesn’t price in the cost of accidents. And from an investment perspective, I get that. Gross negligence is a thorny legal nut to crack, and that’s probably what it would take for lawsuits to prevail.

But electric scooter firms are telling lawmakers that they’re a last mile connectivity solution. That has different public policy implications. 

By moving fast and breaking things, scooter firms may have hoped to build a user base to defend themselves from political blowback just long enough for a financial exit in acquisition or IPO … before we really catch on that a substantial number of their customers are getting injured and governments start cracking down.  

Electric scooter companies can justify their valuation only if the public doesn’t realize how much it will pay in increased health costs and regulate scooters appropriately.

The average ER visit costs about $2,000. A bad break like mine, which requires a plate and pins, will cost about $10,000. A traumatic brain injury averages $160,000. (We know of at least one of those locally.) Let’s be conservative, and assume $2,000 a visit.

Seven a day, times 365 days a year, times $2,000 is $5.1 million in medical bills.

2,000 scooter rides, times 365 days, times an average cost per trip of $3 is $2.2 million in revenue to Bird. Figure the same for Lime.

You could lay a 100 percent tax on scooters and use the revenue for medical services, and still not cover the cost. Of course, if the fee doubled … people would take an Uber instead, walk, or abandon the trip. It stops being a last-mile connector if it captures the cost of medical services.

About 20 percent of Grady’s care is uncompensated. If Grady sees three or four scooter crash injuries a day, that’s $7,000, of which about $1,400 will be on taxpayers – about half a million a year under these assumptions. If most injuries are like mine, taxpayers will eat more like $2.5 million. And none of this gets at the secondary costs of lost work and pain.

And yet, the proposed ordinance before the Atlanta council calls for a fee of just $12,000 per year for each company’s first 500 scooters, with $50 for each additional scooter. If Bird and Lime have 3,000 deployed between them right now, that’s $124,000 – maybe enough to cover the cost of three code enforcement officers to fine them for sidewalk parking violations. Not close to enough to offset public health costs.

Again, we don’t have to guess. The city and state can ask for data. 

I’m not against scooters. I’m against a laissez-faire approach that leaves us in a state of willful ignorance about risks. We want the private market to solve a thorny public problem: Atlanta choking to death on its traffic. We can’t turn a blind eye to broken bones and brain injuries in service to the last mile. 

That said, I’ll never ride one again. I needed to walk more anyway.

(NOTE: This story has been corrected to reflect the proposed public fee structure accurately.) 

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bethebalanceGeorge Chidichefdavid Recent comment authors
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chefdavid
chefdavid

So what you are saying is that individuals need to get scooter insurance like motorcyle insurance? When they are in there tweeking the insurance laws let’s add bicycles as well.

bethebalance
bethebalance

Sorry to hear about the injury. Plates and pins….
I would’ve been eating pavement after just one ride.
Perhaps the silver lining is your focus on solving this problem.
The liability, safety, and health costs all need to be worked fairly into regulation and contracts.
Speedy healing.