Maryland has been on the cutting edge of medical care with its pioneering shock-trauma system, the Maryland Institute of Emergency Medical Services. The state has also instituted safety laws to protect citizens so shock-trauma care won't be necessary. Maryland has a mandatory seat belt law and a mandatory infant-seat law. The next logical law should be a mandatory motorcycle helmet law.

Motorcyclists are exposed to high-speed impacts without any protection. The No. 1 object the crash victim is going to encounter is the hard, unforgiving cement off the roadway. Simple head trauma accounts for 45 percent of motorcyclist deaths -- and these deaths could be prevented by the use of a helmet.

As an emergency physician at Suburban Shock/Trauma Hospital, I daily employ my skill and technical equipment to minimize the permanent damage and the likelihood of death. Facing the unhelmeted motorcycle patient who has a serious head injury is a tragedy, but facing the mother and family of the victim is an emotionally draining and dreaded necessity. Friends' and relations' hopes and expectations are smashed to pieces when I explain that the loved one will probably be permanently brain damaged or brain dead. The outcries of disbelief and sorrow are heart-rending. All I can do is be supportive and understanding of their grief.

All this misery could be prevented by enacting a law that requires motorcycle helmet use. KENNETH PHILBROOK Bethesda