Hello and welcome to the digital free thought. I'm sorry. I've got a frog in my thumb. Okay. Hello and welcome to the digital free thought radio hour and WOZO radio 103.9 LP FM here in Knoxville, Tennessee. We're recording this on Sunday morning, November 19th, Sunday before Thanksgiving. I'm Larry Rhodes or a DJ doubter five and as usual, we have our co-host Wombat on the line with us. Hello Wombat. Just add water. Okay. Sounds like something a biologist would say. And with this special guest today is Keith Semple. Welcome. Greetings. Great to be on with you guys. Digital free thought radio hour is a talk radio show about atheism, free thought, rational thought, humanism and the sciences. And conversely, we'll also talk about religions, religious faiths, God's holy books and superstition. And if you get the feeling you're the only nonbeliever in your town, well, you're just not here in the middle of the Bible. Well, Knoxville, we have a group of over 1000 of us, actually 1100. Now we're the atheist society of Knoxville or ASK. And we'll tell you more about us after mid the mid show break. So stick around. Wombat, what's the topic today? Oh, we got a battery of them, including oxygen deprivation, near death experiences and the scariest of them all blind taste test studies with Coca Cola. But we'll get all of it. We'll get all that we'll get all of it. One thing at a time. First thing I want to do is get through my favorite part of today's show. And that's catching up with everybody. I'd love to see how everyone has been and just see the general vibe before we get into the meat and potatoes at the show. One of the things I'm excited about is I've been playing a video game called Baldur's Gate been loving it. And honestly, it's been one of the things where I'm really truly I go to work and then I come back home from work.  Before I get too tired and like start making really bad decisions and then coming back to it the next day. But like in a really, really healthy way. I think it's just an incredible playground that they set up. I've always said that for video games, they keep making things bigger and wider and more expansive and larger, more levels, more detail. But it's not so much that I want a bigger orange. I just want to taste your orange. I just want like an orange that's like sticky and has like a good flavor. If it's really tiny, I just want a good orange, like a good orange slice even full of content. Yes. No, well, not so much full of content. I don't want the Ubisoft approach where they just keep loading it. I just want quality like from every corner of looking at it. And when I play Baldur's Gate, regardless of whatever I do, whether it's just exploring some weird mountain, going to a different part of my map, having conversations with my members, having cool dialogues or just sorting my inventory and just reading some of the descriptions for things. I'm always rewarded with my experience by the time that I'm done and I never feel like I waste time. I laugh. I feel sick with some of the decisions I've made that I dread. There's things that I look forward to. It's just a really fun time to enjoy. And so, yeah, that's my that's my fun thing. Larry, I would love to catch up with you. How you been? Don't just say go to your games and and more video games. This is not the video game show. I'm just being I'm just being ironic. I'm afraid it is. How you been? Oh, good. No, I've been playing computer games specifically Starfield. But I really don't have much choice these days because my knee has been giving me such trouble. In fact, in two days, actually, tomorrow, I get knee replacement surgery. So that's going to be fun for the next six, eight weeks. I won't be riding my motorcycle or any of that stuff. And is this your first step to becoming a cyborg? Yeah, I asked them to put new pneumatics in it, you know, so I could jump higher runs faster. That type of thing wouldn't wouldn't even entertain the topic. No, have they even said like, hey, we can put little gravings on the metal before we put it in your body? Like if they ever find your body just be like, this is where my soul is located or like here, please, please. Put some arrows, put some mystic runes on it or something like that. No, I didn't think about that. Maybe when I go in for surgery, I'll tell them to. Okay, okay, okay. Pretty simple. Good to hear from you again. How are you guys? Thank you so much for being on the show. It's good to be back. Yeah, welcome. How have been the shows and how's been the family? We've been great. I feel bad now talking about my weekend because Larry's talked about his bum knee and I had a fantastic weekend there. I had to, I did a show in Miami on Friday and a show here in Chicago land on Saturday night. So I had a bit of a whirlwind weekend. Are you a magician or something? What kind of show? That's it, yeah. I performed actually with the lead singer of NXS on Friday night. He found me by a mutual friend that knows me in the area and he's doing this thing called rock and roll team building. It's like a huge big corporate event workshop type thing and we were doing a, basically a showcase down in Miami. So we flew me down and we practiced for an evening and then did the whole day Friday and then I literally finished on the stage at 5.30. Got in the taxi and was back at the airport at 6.30 and was on the flight back home and got up and did the show Saturday. And then obviously that was only a few hours ago and now I'm up with you guys. So it's been a real fun weekend. What did you do about the language barrier? Irish and American. Funny enough, actually. Funny enough, Kieran Gribbin is the guy who I was with and he's actually Northern Irish.  Like full broad Norton air and like, you know, I'm like talking so fast. Like nobody can understand a word I'm saying. Like they're just looking at us and they're like, oh yeah, I should probably still kind of soften that a little bit even though I'm with another Northern Irish guy. Have you seen enough of America to where cities start to blend to each other? Where when you like are in Miami or Chicago and another city like, where am I again? I forget. Like just show me where the Walgreens is because I know there will be a CVS right across the street. Just show me where the target like walk to the target. I've never been to this city. I know where the target, but I know exactly where I need to go to just like get the thing that can get right out. Like you ever. That's exact. Yeah. Have you ever. Exactly. Especially sorry. Go ahead Larry. Have you ever confused Sioux Falls or Sioux City? Oh yeah. I think that's the least of what that guy's confused. I haven't done that before unless I did it on purpose as a joke. You know, I haven't said the wrong place yet, but you know, it's only a matter of time. Everybody does it right. Sure. Sure. Sure. Where's the most exotic place in America that you've been help me help me out. Maybe that'll be a really good place for me. America has exotic places. Yeah. Yeah. Yeah. I would say, I would say so. Exotic. Whoa. This is not like any of the major big cities. Las Vegas. You'd say Las Vegas. Okay. Okay. Well, maybe you keep. Actually, it would be something you'd never think like I actually thought that Colorado, because it actually has some decent terrain was nothing like any other place. Like basically you would when we first got there, we went up on like a high rise parking garage, you know, or whatever you guys call them. And I was looking around and no matter where you look, there was there was no horizon, right? Because it was mountains. So like you could not see the distance because there was a big mountain in your way. And that's what I'm used to at home. So like that, that was very nice. And then Utah of all places was like my dream place to go to because I wanted to go to the Salt Lakes my entire life since I saw like them doing the Brit trying to break the speed records on there. And I was like, oh, I got to go see that. So it's really weird what I'm interested in. And I'd already gone with my dad back when I was a kid to do the whole, you know, Grand Canyon stuff and all that. So I've seen that already where that would have been top of my list. Anything that's sciency and like, I want to go learn, you know, that was my, you know, that's what appeals to me. So yeah. Good. Going to. Okay. So keep that a question for you. So you wanted to Colorado, Colorado known for its high elevation. Do you have any issues with oxygen deprivation while you're up there? It's segue. I was working on it myself. I like what you did there. You know what? Not that I'm aware of, but then again, I have been an athlete, you know, for most of my life, like I've played pretty high level tennis. So like, you can't really do that, you know, two, three, four arm long matches unless you're able to have a big lung capacity. Like I don't really notice it. Even when I was singing there in Denver and Boulder, I didn't notice it at all. If you know what I mean, but I'm sure some people did. I think my bass player did. I think Brian noticed that he mentioned it to me a couple of times. He's like, Oh, it's a little hard on the old lungs.  Maybe is that, is that it? Did he have hallucinations? Maybe. Well, he might actually have a little bit of sleep apnea, which I guess is a thing that my old, well, he's not my old roadie. He still works for me from time to time, but my old roadie, you know, has the CPAP machine and everything. And sometimes you can literally not breathe quite a few times throughout the night. Very true. But it's funny because sleep deprivation fascinates me. Because it's also, in my opinion, the same similar thing as to what happens people who have near death experiences because they go, Oh, I'm, I'm experiencing this. Well, I wonder why your brain's got like a 60% less oxygen than it normally does. And never trust, you would never trust anything that was running at 40% capacity. Why do you trust your brain? It's like, Oh, everything else I've seen my whole life at 100% is not right. But everything that I just saw in for the two minutes, my blood oxygen level was too low. Oh, that's the truth.   Things are shutting down. Your brain's going, wait, what can I switch off to keep maintaining a level of, of cognizance, you know, and then people wake up and go, Oh, everything I saw was so accurate. I'm like, Oh, you might want to rethink that. Yeah. Before we get to layer, I just want to say, so it sounds like you're saying there's a connection between oxygen deprivation, sleep apnea and some of the religious experiences that have been told as like revelations that happen while people are unconscious, right? Near conscience. Yeah, for sure. I mean, just, just look at the, the whole 60s thing with LSD, right? As an example, you know, the Catholic church did their best to not, you know, like to basically make, try to not have anybody take any kind of drugs because they were, the people were reporting instances that were actually like religious iconography. Essentially the things that people thought they'd saw that were meant to be religious were actually just things that people naturally experience on psilocybin and these different chemicals, right? It's just basically brain states that you can initiate by taking the right chemical. And it's like, Oh, but we can't have people thinking that that you can get to that heavenly so-called state by, you know, so. Yeah. Larry, what do you got? Oh, I was just going to mention it. You got Tyrone with your background in biology. I know that the brain manufacturers a lot. I mean, it fills in the gaps if it doesn't have the input that it needs for something it may just, you know, manufacture things like you have a blind spot, both of your eyes have blind spots in them that the brain constantly fills in with with tertiary data that it gets from the sides of the blind spot. When you're going to sleep, not only are you losing consciousness, but your brain is shifting from a state of being able to have a lot of input, you know, from, from your hearing in your site and all this other stuff to a state of not having any input. Now, when you're dreaming, you know that the brain is just supplying all this input. But what about in between that that's a state like when you're going under and the doctors on the surgery table, or if you're going under just going to sleep. A lot of times you'll imagine things happen. You'll hear voices, you'll hear sounds, you know, things like that because the brain is basically trying to fill in the input that it's not getting. Right. So I also want to extend. So my background is in biochemistry. I have HD in it and it's not a brain, it's not a brain surgery degree, but it does give me some impression that our brains are very reliant on reception from external sources largely through chemical input. And the cool thing is if I were to hold up like a blue pen or green pen, I got a green pen in front of me right in front of the camera for our radio listeners. I have light from my light sources in my room. The light is composed of small particles called photons. They'll bounce off the pen. They'll go into my eye. My eye has light receptors that will like trigger and say, oh, I think it's this much of this color, this much of this color. I'm going to combine them together and send that input to my brain. My brain's responsible for the high cognitive function where we'll take that information and say, OK, it's this color and it's this shape. I'm going to put some cognition together and say it's a pen and that impression of a pen, right? So like I am taking patterns from my past. I'm taking the most up-to-date information I can get from my body parts and I'm coming to conclusions. I might be wrong, right? Like my brain might come up with the wrong conclusion, but it's largely just trying to work with whatever it can. The consequence of that is I'm working with what I'm informed by and if I'm misinformed or if I'm in a state where my brain can't necessarily make the best connections because I've impaired it or introduced additional, I would say, chemicals or states of mind, my ability to like look at this and say, oh, it's a dragon. It's the same pen. But now I'm like, oh, no, it's a snake. Oh, no, it's a cucumber. Oh, no, it's a pickle. And it goes back to what Keith was saying. It's why would I trust my brain when it's in that much of a state? The weird thing is if I'm in a weird state and I'm not aware of it, then how can I even be aware that I can't trust my brain, right? Because now I'm in this double, double-bladed or what's the right word for it? Double-edged. Double-edged storage where I don't know what I don't know and I don't know who I can trust, even if it's myself. My brain has become its own worst witness and I need to rely on it and connect thoughts for me. Larry, what do you think about that? Well, yeah, think about goat sightings and monster sightings. They always seem to take place at dusk when your brain doesn't have the input or at night. And you're possible. Your brain state is in a state of fear and a lot of times there are at least tension and trepidation so that it may force input to take certain shapes in other for its evolutionary role in trying to save your life so that you'll get the heck out of there if it even thinks that it's something that might be dangerous so it will project it and you will basically see what isn't there. That's what's ironic about the evolutionary process. The evolutionary process actually caused the ability to believe in imaginary things easier because it's the old adage of there's two guys and they hear a bush rustle. The people like us three, we were dead because we would go and investigate the bush rustling. Unless it was wind. Right, but we'd be going to investigate the bush rustling going I am curious about the world. The other people just ran the other way and didn't even stop to think what it could be.  It's ironic that that's led to basically an entire race of people then basically human race that are susceptible to that so easily and because they fill in the blanks like you were saying Larry and they fill in the blanks of the rest of the story and that's the other thing actually that I think that's true for me is memory and I've studied memory recently a lot and memory is so unreliable. Yeah, so unreliable that it's not like you even you know like what do they call it? Banana firsthand. First-hand accounts. Yeah, I witness accounts that's the word I was quoting in trials are notoriously. Yeah, but sometimes that's all you have so you have to rely on it. Right, but it's notoriously you know like they've done studies basically where they've tested that and it proves basically that they'll show a group of people you know an event and they'll all recall it completely some people will even get the like the color of the skin of the person that they saw wrong like that big of a change you know. You're speaking to the choir here because I love I love the idea that you know you just went to Miami you just went back to Chicago and you're probably wearing a colored shirt let's say it was a blue shirt right you could probably reconstruct every single memory that you had last weekend and just make your shirt red or green like if you really wanted to you can just sit down and say I'm just going to pretend I had a blue hat on the entire time and you'll your brain's like great I love blue hats here's the memory here's the lighting here's the people you talk to and action because that's how your memory works your memory is a is a theatrical event of your brain just piecing together what it feels would fit a model of what happened in the past but is not in any way an accurate representation or an objective recalling of the past events and we don't have the capacity to be able to do that but we do have the capacity to be very confident with a reconstruction that our brain is capable of making and if you think you have a perfect memory just pretend like you did something or this earlier morning at what we're wearing a different color shirt or had a mustache or had yellow socks on you can make just as convincing a memory as you did otherwise like there's nothing stopping you from that and again it's just your brain doing what it does best taking information but piecing it together in a way that makes you feel happy confident and comfortable so that you can move on with the rest of your life and find more resources to eat eat stay safe stay warm and if you're lucky procreate and move your genes on to the next society because at the end of the day evolution isn't a guided process we just it is a it is a expansive trial and error where we try to just do what we can to get to the next step with no end goal insight we're just trying to get to the next step and so the idea that a society that doesn't cultivate good critical thinkers isn't as important as one that survives and move to just move on to the next generation is totally what evolution is all about it's just get to the next step yeah but you guys make a society and if you're lucky maybe you have some scientists but we have to keep in mind that evolution has no goal I mean other than the preservation maybe of the chromosome but there's no mind out there thinking I need to preserve my chromosome it's just how evolution works it's more or less a mechanical process mechanical physical process of how organisms relate to their environment yeah you can replace the word evolution change because change doesn't have a goal it's just changing there may have been a perfect human being in the past that was absolutely critically the best being for its environment and then next generation it changes anyway well that's what happened to our the pre-humans you know they were they weren't quite human but in the environment change and pushed us toward what we are now I was just gonna say that I love that example by Stephen Fry when you're talking about it not be a guided process is like I'm like all these people in there you know the religious they'll talk about look at the trees and look at you know our wonderful ability to regenerate and these type of things right and I'm like yeah but Stephen Fry he goes yeah but what about the larva that's only job is to burrow its way into a child's eyeball so that it can just eat it so that it can basically eat the inside of your eyeball so that it can procreate to you know are to live on and do it again you know or whatever excrete out of you and go and do it again like there was no mind there's no guidance that could ever have gone you know what you know what I think we need you know is these micro organisms like let's let's make these tiny things and there'll be the smallest living creatures but they can do the most damage of anything out there a virus let's make a virus like nobody know in any way caring being whatever can even consider conceiving something like that you know yeah so it's one of those things where I get very frustrated whenever I meet somebody who is religious and also I mean I think it's still step forward they're religious and they believe in evolution yeah but I mean it's still a good step but it's like now do the cognitive work to get of why this part is the ridiculous part the compartmentalizing their place absolutely I would also say it makes sense that someone would look at the world and say that this seems like it's been built with some intention because that's again what your brain does you as a person build things and operate with intentions your actions are based off some sort of intent that you come up with first and then try to impact on the world and so when you see things in the world particularly if you live in a city where things have been planned out by person in the past and you're like wow this city this street goes exactly to my house and back to my job and back to my house again it's like yeah because someone put them there but when you go out okay these coyotes that are attacking this school bus full of children there has to be a plan behind that too right it's like no not necessarily because these is not the design that you are pointing at is simply just you trying to assume that there's been a construct or an intent behind everything that you see in the universe including every single animal that exists in every single force of nature that we can observe but the fact is we don't have a we have no reason to believe that those intents exist because we'd have no reason to believe in a grand intentor who put those actions into place and until we have a good reason to believe an intentor a means that we can test it we are essentially looking at a process that's that seems to be not necessarily cruel but wholly uninterested in protecting the vulnerable the weak protecting those protecting those that protection it is very much a cruel and uncaring world out there and we are very fortunate to be able to survive in the states that we are right now but Keith along with what you said with boring holes viruses diseases you know like infestations parasites like there are things that just exist where you think man like it would be so great if I had none of these things here our quality of life would be so much higher but that's not the goal of evolution again the goal of the evolution is just change Larry a lot of people think of how successful humans are in the world yeah we're we pretty much checking control of our environment which is good we can kind of control the way that we go in the future but we've only been around for 150,000 years the cockroach has been around for millions of years million I guess 500 million years a long times not only that but you think about termites there are less on the earth than humans by times 11 by weight by weight by weight I mean how successful are they we never even think about them except as an occasional pest yeah yeah it's funny we're talking about this because my my next weeks podcast so my last one of my first season is is wrapping up see so episode 10 and it's all about evolution I basically just do like a what would you call it an idiot's guide to you know and I always think about like I have already quoted Stephen Fry I always think about the quote from Hitchhiker's Guide to the Galaxy has to be the best quote for explaining how silly it is to think that everything's designed for us is the whole you know the puddle you've heard of the right puddle quote where he's like the puddle becomes sentient and goes oh this this hole is so perfectly it must have been designed for me and as he's contemplating this he's evaporating you know right before he evaporates he goes oh I get it it's brilliant I love the example I got we need to take a break it's bottom of the hour this is the digital free thought radio hour and woz radio 103.9 LPF I'm here in Knoxville Tennessee we'll be right back after this short break welcome back to the second half of the digital free thought radio hour I'm doubter five and we're on woz radio 103.9 FM here LP FM sorry in Knoxville Tennessee let's just take a moment to talk about the atheist society of Knoxville ASK was founded in 2002 we're in our 21st year now and we have over 1100 members we have weekly in-person meetings every Tuesday evening in Knoxville's old city at barley's taproom in pizzeria looks for us inside at the high-top tables or for its pretty weather outside on the deck you can find us online in Facebook meetup.com or at our website KnoxvilleAtheist.org you can just Google Knoxville atheists it's just that simple by the way if you don't live in Knoxville you should still go to meet up and do a search for an atheist group in your town don't find one start one that's right one that where do you want to pick up all right so how about we wrap up our thoughts from the first half of the show and then we can get into some blind taste tests which I mean by I will get into more detail but the idea that your brain is an impressionable squishy thing in your body and it's not just when I say it's in your body a lot of us like to say here's your brain and point at their head that is true you do have a thing called a brain in there but your brain is connected to almost every other part of your body through your central nervous system it's connected to your eyes where it receives eye information your your taste buds where it gets taste information your nose all the way down to your gut where it gets a bunch of hormones that are being produced down there to you if you're a guy at testies where you'll get additional hormones that will trigger more muscle inflection and strengthen rest of your body down to your toes to inform when you stubbed your toe which was weird because whenever I get hit in the balls it's an immediate thing but whenever I get stuck in my toe it's like oh this is going to hurt in like seven seconds dang it I hate it when I stubbed my toe we're what we're why are different Tyrone it's the opposite for me if I get kicked in the if I get kicked in the nuts there's that like seven seconds and then you fall oh it's it's that it's that three seconds where you know it's gonna I thought that happened to every guy I must be different is that pre-delay where you're like this is going to really oh there it is so okay so brains are different yeah that's another thing to brains are different so wait wait I just I do want to labor the point so you're saying when you stub your toe it's an immediate pain sensation oh goodness yes like it's like the the the the speed between stub and swear word is almost instantaneous that's surprising further away from your brain than your your your your sexual organs your balls that's weird though I thought that was every guy's experience no I was to have that delay reaction between my mind further away from my brain that's that is I hope that's not something you're gonna have to talk to your doctor about like hey when I get hit here I get down here is that a problem no he'll probably just say no that's because that's that's where your brain is yeah yeah yeah okay yeah your brain's different your brain is impressionable and I loved what Keith had said why do you not trust your brain where that 100% you know you wouldn't trust anything else at 100% so you know don't don't come to grand conclusions honestly here's my here's my takeaway don't be 100% about anything because you never know when your brain isn't working right and you could never know and it's never good to be a lot of logic logic dictates that at the end of the day like we shouldn't you can if you say you're 100% sure and I think I mean that's pedantics of course I mean you can be pretty 100% sure that the sun is gonna rise in the morning but you actually still can't be 100% sure that it will happen because there's a day it won't so you know so and and this idea of you know when somebody says to me like well are you one of these like you know a theist that you know is 100% sure like how can you be 100% and I'm like not 100% sure that God doesn't exist but I'm as close as you can get with enough nines at the end of the decimal point but it is we're not talking knowledge when we're talking atheism we're talking belief now I don't know that there's any guys not we're talking about knowledge here and that is agnosticism but I don't believe in any guys so that's atheisms I am an atheist agnostic atheists I don't know I don't believe yeah but I think we would all from what I can gather would probably in our heads would be okay to say no on an argument because we wouldn't have proof but we'd be okay to say to ourselves we're pretty pretty sure there is no God I'm comfortable saying I'm comfortable saying there's no God in the same sense that I believe you would say that there is a God in which they do all the time so therefore I reserve the right to hold the counter position and my opinion would be like you know in certain circles when I understand that people understand the context of how I'm speaking I can say certain things without having to go through the the multiple onion skin layers of defining every term that I mean because I'm in a culture that already understands what I'm saying so I get what Larry's saying I also get what you're saying Keith too because like when you talk out with the public particularly on a podcast and you're worried about people taking snippets of what you're saying out of context to bolster their aims and further misinformation for other people I can understand the need to be clear is just a consequence of a very terrible communication system because even though we are using words we are making sounds and we are assuming you understand what I'm thinking just based on the sounds that I'm saying so even if I explain myself with full intricate clarity I'm hoping that you understand what I'm saying based on the sounds that I'm coming up with my mouth it's a very weird system convenient in some senses hopefully not in others though speaking of weird comments that you can make we did get some from our comment from our commenters I wanted to go over a couple of them thank you guys so much for leaving the comment this comment came from Exvangelical Carol 100% I agree with you guys thank you so much for making this post that was from our show give me a reason from our show God's leadership qualities which was one month ago we got a comment that said you guys had mentioned that so you guys had talked about how we pay taxes to help having good health care system and free schools don't you know that Christians also pray for that too and what did you explain why you're laughing I mean we understand but go ahead okay so I'm and again I read it so I make sure I don't say anything rude but the idea is God's leadership qualities we had talked about potentially how it's important for people to have health care and like take care of ourselves and give us good guidance and rules but we never really get those leadership qualities from God God's just like maybe some rules and disappears and we have to do the best with some arbitrary rule system with a bunch of trap doors and consequences with physics phenomena but the idea of us wanting to have good health care and free education we pay taxes to be able to support that and what the commenter has mentioned is that well don't you know Christians also pray for that too well yeah but praying for it it's like how do you feel like you're doing something without actually doing something sure we pay taxes and they use for all kinds of different things that you know I don't approve of and you don't approve of a lot of people don't but as a society we're a very rich society we should be able to take care of our citizens and we are not we are letting them flounder in their old age in their destitution if they have no if they're what crippled I mean we have we have some you know the veterans too but I mean we we have very little safety net in their society so which therefore we're failing our own citizens yeah I just remember the first time I ever had a sorry go ahead Tyrone oh no I was just saying Keith came all the way from a place that had a good health care to to wonderful terrible USA to fly him claims and he's like do I get a parachute is like no you don't get a parachute or anything like that yeah that's what I was going to say is my first experience of the American health system was I had a bad hot dog I think it was I had got I was on a hurry to a show and actually no it was earlier in the day I thought I'll just have a quick oh there's like a little hot dog joint it gave me food poisoning and I was feeling bad and worse as the day went on and by the time I got to the stage I was like I don't know if I can do the show ran out the back and like projectile vomited everything that I had all over the place and then I started having balshians I was that sick like it was really wet and my two roadies are holding me down so I didn't like bite my tongue or smash my head it was really creepy I ended up you know waking up in the hospital and a few days later I got a seven thousand dollar bill in the in the thing it was for the ambulance and for the three or four hours that I was in their care right and of course I didn't even know at the time I was so fresh off the boat I didn't know I needed health insurance do you know I mean I heard of it of course but it wasn't like the sort of thing you jump off the boat and go okay let's get my health insurance in order who should I be calling right and it caused me so much money I was like oh my goodness like how can people sleep welcome to America it's a lot of people get shot and they're like call an Uber call 911 get an Uber it's true yeah Larry well healthcare is a huge part of it but the real thing that really grabs me is education system not only do we not fund it sometimes when we fund it we take half of the funds and give them to religious schools in the form of vouchers we are we're basically cutting the legs out from under our education system and I would like to quote at this point Sam Seabourn from West Wing have you ever watched that series he said yeah education is the silver bullet education is everything we don't need little changes we need gigantic monumental changes schools should be palaces the competition for best teachers should be fierce they should be taking making six figure salaries schools should be incredibly expensive for the government but absolutely free of charge for its citizens just like national defense and I couldn't agree more I mean it is the silver bullet so the good side of that is if we had more high quality education a lot of the problems that come with developing a good healthcare system or at least observing in how to improve and modify the one that we have now could be more strategically implemented because we'd have a society that would care about more long term benefits and quality of care for people that don't necessarily just look like them but people who don't look like them people who have very different states and if I've never been in the military but I've gone through college and I understand that there are people who've been veterans and there's these issues that are going on outside my country then I might care more about how can we take care of our veterans more like just by being break the value of college for me was in part learning new things but meeting different kinds of people and working with them in a collaborative atmosphere towards a single goal towards improving ourselves intellectually so Larry go ahead yeah just answer your listener they have been praying for that for how long and what are the results that's what I'm saying Larry leave him alone it's okay it's okay thank you for the comments keep leaving comments don't mind Larry go ahead Keith I was just going to say get off my lawn I was just going to say that you talk about it was brilliant because you sort of alluded a little bit to other countries ways they do things and to me the the what's the word I'm looking for there's a word and I'm just blanking on it banana there it is see bananas again you've got it right twice in one it's America's inability I'll use my own words to think outside the box and buy the box I mean their own country so what I mean is like if I was running a country tomorrow and this is why I said this am I allowed to talk about the big orange elephant in the room I mean capital T we really shouldn't okay well I'll not let's just say that I was talking on a previous part about how I would choose my daughter right now that you just met there briefly that 10 years old to run the country more efficiently and I didn't mean that hyperbolically I meant that really like literally because the first thing she would do is come to me or come to somebody she trusts and say I need to make a decision about this that they're asking me who do I talk to and I would say I would go talk to is this on you know climate change and how we can best do that let's talk to the main guys at NASA and the main guys at this and this and this and get the consensus and go with that and you will probably be on the right path and my point was is that healthcare there are some countries that are doing it right yeah and yes it costs them cost them a lot of their GDP but you know what because their citizens are not fearing for their lives on a basis of what happens if I get sick they also quite often if they've got that they've also got some set of some sort of free health free education they are also putting more money back into the economy as healthy educated citizens that are not worried about you know you know some kind of serious illness because they know what will be taken care of if we could just look outside if Americans could look outside and go I'll take the German idea of this I'll take the British version of this I'll take the Scandinavian Scandinavian let's just take all the bloody Scandinavian stuff if you pretty much take it you'll be good you know I just wish they could look outside but because of that American elitism thing where they think they're the greatest country in the world at all times they don't it doesn't process that they can have better ideas elsewhere and of course the further right you go the more that feeling increases and the less you would ever take advice from someone else if that makes sense I agree I would also say you know Scandinavia has some really really cool stuff in terms of efficiency and work culture too I learned a lot from them but I'd also say I think there's an advantageous point from a capitalistic society and outlook to have people be misinformed or uninformed and work hard regardless right because or even undereducated right because then you've locked in what do you call it a voting pool and the more educated we see this every single time the more educated people become the less likely they are to vote for people wearing red hats right and you don't have to look anywhere more than like our state which is my state's Tennessee Larry also lives in Tennessee a wide swath of rural areas from east to west across Tennessee however the most populous locations in the major cities Knoxville, Nashville, Memphis, Chattanooga they tend to be incredibly liberal and you can notice by just looking at the license plate because in America in Tennessee if you do not believe in God your license plate starts with letters and if you believe in God your license plate starts with numbers that's a choice you can make here in Tennessee to have a God we trust on your license plate or not and the reason why is because there's a cosmetic option for when you register for your license plates that asks hey we have the state license plate that says just the standard text but if you want the in we believe in God or God in God we trust if you want that on your license plate you can get the version that starts with numbers it looks the same but it's from a state perspective different enough that's not going to be a big deal and you can click this button and get that license plate so all the people who believe in God will get those and when you drive around especially in rural areas it's like numbers numbers numbers numbers but as soon as I'm like driving up to a bigger town it goes or even in a Kroger parking lot it goes directly from lighter lighter lighter lighter lighter lighter and it's more populous like there's like 10 maybe 100 times more people living in the bigger cities or in these smaller cities and by virtue of the fact that they're interacting with different kinds of people all the time they're going to better schools they have these higher paying jobs and it's trickling out into the rural areas and causing change but as that happens more and more those rural areas become more impacted by the different ideas different cultures and they stop being as conservative as they originally were so if you are a person who banks on people not being liberal and being conservative it's in your best interest to make sure that these people stay far apart from each other as much as possible staying in their low paying sectors as much as possible populate as much as possible because you got to refill that you got to refill that pool and ideally not get as educated so you'll make different priorities you'll say we need to bomb these people because that's good rather than I need to educate the people who are my voting electorate there's a lot of other ties to it but I do see and maybe it's just me doom and glooming but I do see a very concerted interest in keeping people not educated as a factor of staying in control if I have control Keith, what do you got? That's a good point Lara, you had something? No, go ahead I was just going to say I find that to be a really strong point against religion too actually is the idea of the greatest populated areas are generally highly liberal and I would always use that with arguments with family members here and stuff that I argue with not going to go into detail but it's basically like isn't there something doesn't that set alarm bells off in a conservative person's mind that wait a minute these people that are living together in close proximity and there's a gay person there's a black person there's a white person there's an Asian person and they all end up loving each other and going like what's that happening on the corner oh there's two dudes making out anyway I was talking there's absolutely no reaction to the other anymore and it's this fear of the other is gone and when fear of the other is gone look what you get you get utopias or at least you would have closer to utopias if the other stuff like education and healthcare and stuff was also taken care of too right so I use that as an argument of like hey look conservatism does not work because it all it leads to is us and them thinking it's all it ever leads to is there's this tribe and this tribe obviously the tribe doesn't fit anymore in our societies but it kind of still is the word tribe if you think about it it's still people like to belong to something and think that the people that aren't like me are somehow evil or less worthy or are just inherently bad that doesn't happen in cities or at least you know the percentage of that thinking is minimal yeah and it's always surprising to me how much of that dividing line between conservatism and liberalism is marked by religion mainly I guess because religions wanted the old way they don't want change their laws and morals and values are all set in concrete which makes them conservative defines the word conservative at that point imagine you were talking to somebody oh sorry go ahead oh no go ahead finish up it's just because it's like when you talk to somebody when you see somebody like I don't know if you're let's say the current speaker of the house and you hear him talk he sounds like he literally walked out of 1955 like he's currently in 1955 and that's too liberal for him and you think about if it was 1955 right now that somebody that's say in their 60s at that point some young kid in 1955 who's listening to Elvis or whatever thinks that person's going oh I wish 1900 it was better than you know everything was better than a conservative frame of mind whereas I think it gets everything is better tomorrow if we work toward it give up on prayer well we're getting close to the end of the show we had a pretty extended show break I think we have enough time for a couple of rounds of did this come from God a tyrant or a disney movie princess go for it a blind taste study and I'm going to throw out quotes I'm going to go back and forth between Larry and Keith and I'd love to see how you guys rack up whether or not these quotes that I'm giving you came from a god which could be from any biblical text a human tyrant that existed in history or a disney movie princess alright and we'll probably do this as a close up and we'll keep the score up going for whoever else comes into the show but Larry you're first are you ready remember your options are god, human tyrant or disney movie princess you ready alright here's your quote one day you will wake up and there won't be any more time to do things you've always wanted to do it now what are my options disney princess god or what tyrant or disney movie princess one day you'll wake up and there won't be any more time to do the things you've always wanted do it now princess actually it was a tyrant it was a good try that was from Stalin no it was Stalin Keith you're ready for your quote remember your options are god, tyrant or disney movie princess here's your quote in my father's house there are many mansions if it weren't so i would have told you give him the easy one i'm pretty sure that's a jesus quote i think oh he got it that is a jesus quote in my father's house are many mansions if it weren't so i would have told you do you think that's just how he said it at the time i would have told you if there was yeah my dad has a lot of mansions he's pretty cool he's an astronaut and a rock star i would have told you that how do you have mansions inside a house that's the word larry here's your next one are you ready okay it is not good that man should be alone i'll make a helper fit for him oh that was god oh he got it good job good job larry garden of eden keith character of man is not clear to you look at his friends when the character of a man is not clear to you look at his friends i'm gonna say human tyrant oh it's disney princess so close it came from the movie malon good job though good job good job oh i haven't seen that one that's why i'm gonna say you know what it's a good point it's a good point made but oh well yeah larry here's our last round i think you guys are tied right now okay you guys ready yeah uh the next one is a little bit okay here here all right here we go it is not the strongest of the species that survive nor the most intelligent but the one most responsive to change um tyrant yeah so i am getting mine from uh a website that is called chat gbt and it has listed charles darwin that's a human tyrant really oh my goodness just there because i was thinking that was darwin but i i just process elimination all right all right key simple here we go you ready all right when the winds of change blow some people build walls and others build windmills what are you thinking give me your mental gymnastics is i mean when the winds of change blow some people build walls and others build windmills that's i mean it doesn't sound like something the tyrant would say okay it sounds like something a good person would say so i'm gonna say disney princess good job hey i'm glad it took so much like thinking it's like did that come from god because it sounded like it came from a good which disney princess was it that is a that's pocahontas again haven't seen it so okay okay these are the classics it made sense it makes i love how it was like wait a second that sounds like it's a good person so it couldn't be god i'm gonna have to go for disney make sense well not not that disney started out by a good person either we're gonna go down that road we're we're at the end of the show but i'll say this will keep the scores going layer yet to our guests key simple you're at to we'll try to maintain this and have larry on the chopping block for next time thank you so much larry why don't you take us out uh no final words keith when are you showing coming up next time oh um again i'll try to get on with you guys and maybe once a month i'll talk about your website sure anytime but i was talking about when you're gonna perform again or all that so the cool the cool thing today is all i want to mention is my bass player text to me while we're in the middle i'm gonna put it in the text and he just said by the way dude did you know that today is the fifth anniversary of our live blu-ray dvd um and i just wanted to put so i put the i put the thing in there it was our first live we recorded the whole thing on a you know steady cams and our you know roman cameras and all this stuff and um it we did our entire first album live from start to finish and put it put it on blu-ray dvd so okay that's all i care about today i just hope you're having the time of your life with all this this sounds like you your your passions are finally into fruition where they are affecting other people they're having a huge impact and you're getting a lot of that out as well you're traveling the world you have a beautiful family like you're you're rocking it dude and i'm so glad that you spend some time in your awesome life with us on this show where we can continue to lambass and and and uh what is the right word for blaspheme together yeah you might you might not believe me but this is as much fun for me as what i was just doing a few hours ago on stage in front of a couple hundred people i love this just as much so we'll keep it up thank you guys absolutely keep it up time where can we find your stuff i'm on let's chat on youtube um i've i've made an announcement to the people that i work with that i have this youtube channel they all wanted to see it uh the thing is i imagine that there will be fluctuations of my subscribers based off like the views though the thing is i want the people who don't subscribe or the people who unsubscribe to know that they're still interacting with a person who has uh who's non-religious who is you know like not a white southerner in Tennessee it has nothing but kindness and love in his heart and willing to work with other people and have positive impacts on the society so even if you unsubscribe you're still dealing with me on a daily day basis so stay subscribed and continue to have uh an ear open to some of the conversations that were happening on this show because i guarantee you they'll help you broaden your perspectives sounds good just to remind you you can find this show on podcasts everywhere you can find it on youtube uh just search for digital free thought radio hour and if you're watching this on youtube be sure to like and subscribe uh mike my main content can be found at digital free thought dot com be sure to click on the log button for our radio show archives atheist songs and many articles on the subject my youtube channel is at doubter five and you can find my book atheism what's it all about on amazon remember everybody is going to somebody else's hell the time to worry about it is when they prove that heavens and hells and souls are real until then don't sweat it enjoy your life and we'll see you next wednesday night at seven o'clock on biozio radio here in Knoxville say bye everybody bye everybody bye guys


I come from the Victoria Institute of Forensic Medicine and people might ask what's a forensic doctor got to do with fitness to drive and coming to talk about impairment, but in fact we have a lot to do with not just analysing crashes after they happen and with the unfortunate consequences of them, but we do a lot of work with VicRoads and other organisations which I'll talk about a bit later on this afternoon in assessing fitness to drive and trying to make sure that the fitness to drive of people on our roads is optimal. Well when Joe asked me to come and talk about impairment and about the nature of impairment I actually had to sit back and think well what does this actually mean, what does the impairment mean? And went and did a little bit of looking into what definitions of impairment means, I suppose in the broader sense they mean deviation from normal. The World Health Organisation obviously went to great lengths to provide a definition of impairment I was quite surprised to see how tiny it was when you think about what an enormous amount of consultation and important people jetting around the world must have gone into producing this, but they say that impairment means a problem in body function or structure which is really about as general as you can possibly get and could really apply to just about anything including indigestion after a bad meal a night before or almost anything. In a medical dictionary I found that impairment really does have a more general definition than really any abnormality of anything and there are various different ways of looking at impairment which I'll talk about and the way that we consider them when we're thinking about fitness to drive on the road or what the effects of the impairment might be on driving performance. So why does impairment have an impact and you know I can sort of be a bit trite and say that we want to actually avoid impacts meaning impacts on the road but it's important to think about what the relationship between impairment and the driving task might be. Now the driving task is a really artificial situation you know up until the turn of the last century nobody had ever driven before. People on horseback might have done you know 20, 30 Ks an hour whatever velocity a horse does and people in trains might have gone a bit faster but it was only from about the early 1900s that people actually began driving and when you think about it it's a really artificial man-made environment, very dangerous environment. You put people of sort of arbitrary ability and health behind the wheel of a machine with a big chunk of hot metal up the front and a tank of explosive fluid up the back and you let them loose pretty well and they're surrounded by other people in the same sorts of vehicles and they're on roads of indifferent quality they might be really good quality roads or they might be terrible roads with poor signage and bad lighting and capricious signals and in this totally artificial environment we expect people to work to their optimal ability and to preserve safety and to perform an accordance to those rights that Richard talked about. In an ideal sense I guess we would have evolved to do this but 100 years is really nothing in the spectrum of human evolution and the way that the road system has evolved has perhaps been a bit faster than that and people have begun to appreciate the difficulties of coping with this unnatural environment but I think we're a long way from perfection yet. I have a background as an engineer as well as a doctor and I can very well remember in my engineering days seeing a picture of a person that had been designed to fit into a holden so taking a holden car as being natural if you like some engineer had sat down and tried to engineer a man to actually work to his optimal ability in such a car and in those days perhaps cars weren't designed as well as they are today but you know the person that came out of this design study looked like an alien more than any of us in this room today so they had eyes out on stalks and they had one longer than the other and you know very unusual looking body proportions because the car had been designed by some engineers somewhere and really there hadn't been much consideration about fitting it into the human interface hopefully things have improved a bit since then but the correlation is still capricious and imperfect and the correlation between you know the fragile chunk of sort of gooey wet material inside the metal cage is still not perfect and so we have to cope with trying to understand the way in which people function in relation to this very artificial environment it is an unnatural act you know we deal with all sorts of unnatural acts in forensic medicine but this is probably the most common of them things that people have to do when they drive are often aren't natural all these things that I've listed here basically have to do with how fast we're traveling and we have to take in a vast amount of information was very interesting to hear about the the particular demands of racing and rallying but being on on sort of domestic roads perhaps not quite as as difficult as that but similar sorts of skills people have to take in vast amounts of information mostly visual they have to think about them really quickly they have to be able to respond to the unexpected you know is there a pedestrian stepping off the side of the road is has someone else done something silly in a car have the lights changed so they've got to be able to do all that really really rapidly they've got to be able to plan in their mind where they're going they don't have the luxury of a co-driver telling you where to go unless it's a GPS these days and they can be a distraction on their own and then you know do all these things at once and then translate them into movements of the arms and legs to control the vehicle road trauma as a result of these things not going right is in fact the greatest non-homicide cause of traumatic death that we see at the Institute is about six times as many people end up in our pathology department from road trauma that end up from homicide and for every one of those that's killed there's a very large number that are injured and have all sorts of other effects on society so it is an important issue and it's important because of legal implications I'll talk about a bit later on today there's issues of culpability if people have a crash whose fault was it was it the there because there was a medical condition that wasn't properly recognised is there an issue with the responsibility of health professionals also a very vexed question and of course driving essential in the 21st century it's very hard to leave in the 21st century unless you can drive and especially here in regional areas where people can be quite isolated if they can't be mobile well what's the evidence base for driving fitness we'll hear a little bit about this I guess from myself and other speakers the evidence base is not perfect it's getting better all the time and it's been embodied as best it can be in the new guidelines there's a lot of research still happening especially to do with chronic conditions and this is quite important as the population ages the baby boomer generation as they've gone through life have been responsible for a lot of great medical advances for whichever particular ages they were at now that they're getting to the geriatric stage there's a lot of interest in older drivers and the effect of chronic conditions as they affect people and this reflects on the way that assessment methods are developed for driving fitness and some can be appropriate and some can not and there's the example of whether or not visual fields have an effect or can sorry whether the effective visual fields on driving fitness can be measured easily by other methods of testing and I'll talk about that a bit later on as well there was some reference to the Muac review this was a study that was done by a group of us at Muac that's been done twice now the most recent review was in 2010 and had a bit of input into the formulation the most recent guidelines it was basically a meta-analysis of the current scientific literature about various sorts of conditions and disabilities and their effect on crash risk and was divided into acute problems which cause sudden disability and chronic illnesses which affect fitness again I'll talk a little bit more about those later on we have a lot of experience in both of these things at the Institute because of both our rollers Vic Rhodes medical reviewers and also because we get to analyze crashes so when things go wrong we get to see what's happened when things go wrong and we get to see the sorts of cases that can happen when medical conditions might be a factor and I've got to say over about the last 20 years the number of nasty you know death crashes that the police have asked us to look into that have involved medical conditions has increased and this may be a reflection of the greater population but perhaps also the aging population certainly in the last year or so I've probably myself dealt with about three or four of these and this would have been unheard of 20 years ago and in those days just about every death crash involved alcohol and perhaps some other extraneous issues now there are crashes that are before the corona based on epilepsy and diabetes and all sorts of other medical conditions there is actually one case the first one in my experience and of any of my colleagues there is one case before the court at the moment here in Victoria that involves hearing so it's not thought to be a really big issue but it can happen so how do we classify impairments and I like to think of them this way there's the issues of sort of cognitive and intellectual abilities does a person have the capacity for learning and can they learn to drive in the first place whether it's it's an off-road test or doing a knowledge test or has a perception test or whether they can perform and actually have the capacity to learn from their mistakes when they've got all plates and then there's conditions that have episodic disability where people are okay in between physical deformities a situation that I call deceptive fitness that I'll elaborate on a bit later on and of course the thing that concerns most of us here I guess which is the effect of chronic conditions which can be physical and psychological or mental or a combination of all of those things intellectual disability occasionally crops up as a question in people's fitness to drive and it's more than just the capacity to learn the capacity to intellectual quotient or IQ is sometimes defined as the capacity to learn and you know there are people that can learn to drive and we we find it hard to assess fitness purely on a number as to a person's IQ I don't think anybody's ever been able to show a really good correlation between the actual number on an IQ test and the risk of crashing we usually give big roads a sort of advice that if a person can pass a driving test there's really no basis to deny them a license even though they might appear to be intellectually disabled if they've got the capacity to learn enough to pass the driving test that's assuming that a driving test is a good gateway into into being able to drive then there's no reason not to let them drive but there are people sometimes that are outside that frame and sometimes it's very hard to know you know you can't really assess them before they actually get on the road there's a particular patient I'll call Miss T who is an intelligent person this is based on a case that's been before us who was an intelligent person you know had a university qualification and all but sustained some brain damage and this person could pass any test you liked as far as driving and driving instructors thought she was wonderful but she lacked the ability to have insight into driving behaviour and if something went wrong she'd panic at one point you know things went wrong she just left her car parked somewhere with the engine running and ran away because she couldn't cope with the stress of an unfamiliar situation so intelligence and ability to learn is not necessarily something which is the Bill and end all. Episodic impairment is an exercise in risk assessment there are conditions like epilepsy, diabetes and the things I've listed here where people are completely okay most of the time and then they have something that happens to them if it's for instance epilepsy it's a transient unpredictable impairment caused by the disease and then there's conditions like diabetes where the impairment being a low blood sugar is caused by the treatment but whichever way you go people are disabled transiently and in between they might be totally okay they go and see their doctor they're totally okay and doctors or other health professionals have to rely on the history you can't do a test in many cases you have to rely on the history and you have to rely on the person being truthful to give you a good history as to how frequently these things are happening in some cases for instance in diabetes or you know conditions where people fall asleep for instance it's possible to modify these things by treatment in some cases it's not. Epilepsy is really interesting condition because it's so variable and it was the basis of the beginning of our driving clinic which I'll describe a bit later on today highly variable condition lots of different sorts of seizures some of which totally disabled people and some of which don't you know some people just have a funny feeling which is classed as a seizure without really losing awareness and they can still continue doing all sorts of things including driving some people get a warning some people don't some people respond well to treatment some people don't investigations can be illusory sometimes there's another patient I'll call miss S who came before us who you know had totally normal investigations had a normal MRI had an EEG even though there's a history of epilepsy years before had a had an EEG that was normal when she wasn't having a seizure and on the basis of those tests they reassured her to the point where she thought well I'm cured I don't have epilepsy anymore got a driver's license unfortunately that wasn't the case so you know some investigations might not necessarily be the appropriate ones for these sorts of conditions then of course there's other issues of compliance there's a there was a lady jailed a few years ago for culpable driving Victoria that hadn't taken her doctor's advice about compliance with medication killed somebody as a result so there's an overall risk assessment is not simple it's not as simple as just picking a disease and saying yes there's this disease this is this is what we need to do we have to take into account the whole clinical picture diabetes is a classic example high-posed may be preventable totally for persons on an adequate regime but there are competing treatment priorities endocrinologists if you talk to them they love to run people with low blood sugar as low as possible because that has the best outcome for the long-term health of the patient but on the other hand that almost assumes that they're going to have a high power at some stage during the day and we of course don't like that behind the wheel if we see a report from an endocrinologist saying this person's got terrible diabetic control we actually feel quite reassured even though we know even though we know that at some time in the future they might get some of the long-term effects most of which can be dealt with in one way or another deceptive fitness is a condition that that that I think about when the assessment method is really not sensitive to the impairment so I talked about the lady with the EEG and the MRI before which really didn't tell us whether she was going to have a seizure or not another other other classic examples might be people that have got visual fields now you know these are people that have lost part of their visual field and you know they can drive perfectly well in a lovely bright sunny day down a dead straight highway where there's no other vehicles or no pedestrians or no bits of road furniture on the side but it's the unpredictable that's the issue they can't see the whole visual field and I was interested to hear about the fact that rally drivers need to be able to take in the whole field everywhere and you know you sort of do it subconsciously and you know get a picture in your mind of it these people can't do that so you can test them on the road till a couch come home but you can't predict what the effect of that visual field loss is going to be so there are certain conditions like that where people appear to be fit but aren't necessarily so chronic impairments of those where there's really no prospect for improvement and there's lots of different ways of classifying those as well they can be something someone's born with and people might have actually made an adjustment to it people are born with visual problems there are certain visual conditions that look terrible you know there's a particular condition where people where people's eyes dance around and they can only see well out of the side of their vision but they can drive perfectly well because they've had this ever since they were little kids and they've learned to live with it whereas if something like that happened to an older person they might have great difficulty there are conditions that you know once you get a disability it's always going to be there for instance a person might lose a limb thing you know that's not going to change and and there's also chronic conditions that gradually get worse a lot of these people require individual assessment and I'm pleased to see that we'll be hearing from occupational therapists about that later on today there's also problems of you know whether or not a person had a pre-existing impairment and then as they get older the significance of that impairment might change so the sorts of chronic impairments that I guess you're all familiar with are these and I don't really need to go into great detail about a lot of these I suppose except to say that some of them are going to be the fairly static and some of them are going to get worse as time goes on older drivers are a sort of a special case and they're causing a lot of concern now as the population ages all of these problems can be there in general you saw that bath type that bathtub shaped curve that Richard showed about you know crash sorry about death risk going up as people get older that's part of the combination of the onset of chronic conditions and partly because older people are more fragile and tend to have a lot more trouble surviving injuries that might not necessarily hurt a younger person or at least keep them disabled for very long the most difficult issue that people always worry about in older drivers is cognitive decline that people are getting demented or they have trouble coping with complex conditions on the road and we've heard a little bit about the intersection problem that is something that hopefully will be coped with by better road designers things develop in the future but it's a problem that is going to be with us for a long time and it's hard to assess across a desk it's hard to do a pure medical assessment in a consulting room that will give you a clue as to how much this is going to be a factor for people's on road performance dementia well that's the condition that once is diagnosed the decline is inevitable and that's one of the reasons why the new guidelines have have put in mandatory regular review the idea being that they're lost to follow up otherwise if they're not followed up doesn't mean they have to have complicated OT assessments every year means that somebody who knows them needs to cast an eye over them regularly and just raise a flag if they're getting worse and anybody who's worked with people with this condition will know that there's enormous amount of variability in dementia there's different sorts of dementia some people go downhill very quickly some people grumble along for a long time they have ups and downs and hopefully most of them tend to self limit things themselves but along with dementia comes a lack of insight and sometimes there comes a time when difficult decisions have to be made for people and families have to get involved often because by the nature of the condition they can't actually understand the difficult decisions that have to be made so actually testing very helpful for things that are required where a person has something happened to them and they're not the same person after that so they've been quite okay and then they've had a stroke or something's happened to them or they've got a condition where they're deteriorating these sorts of things they're classic conditions any of the people here that are OTs will certainly know this but there are conditions where no T assessment is not appropriate you probably guess from what I've said before that some of these unpredictable impairment conditions or deceptive fitness conditions you can test them forever and you know they'll come up perfectly because you're not testing them at a time when they're disabled or you're not testing them appropriately for the problem they've got we think it's very important that people are fit to have driving tests if they're going to have OT assessments or on-road tests of one way or another they do need to be tested first of all to make sure that they can play with the driving guidelines on-road testing is no substitute for medical fitness so people need to have adequate vision their diabetes epilepsy what have you needs to be properly controlled before they're allowed out on the road because otherwise they're putting the testers at risk as well as themselves just a bit of a word about visual disabilities or visual impairments some of the guidelines have been relaxed for car drivers the amount of visual field that people need according to the new guidelines is less than it used to be for the old guidelines and that's going to make life easier for a lot of people but it's important to realize that visual defects can be associated with other problems especially if they've happened as a result of a stroke there are certain kinds of strokes that affect visual fields and they affect other things as well so other people's cognitive abilities and other things of that sort might also be affected at the same time so it's not purely an issue of visual fields there's also a lot of new technology coming out to plot visual fields now years ago a visual field was a visual field you put a person in a dark room or got them looking into a big white bowl and your flashed little lights to see what they could see and it was easy to do a plot these days there's an almost infinite number of devices on the market that'll plot visual fields in all sorts of different ways there are ones that use large targets little targets ones with moving targets ones with both eyes open you know some with only one eye open some with the eye fixed on a target and some where people are allowed to look anywhere they like so visual field plotting is not as easy as it used to be and the interpretation of them is not as easy as it used to be either and we put a tremendous amount of time into thinking about this and we have an expert committee that helps us try and make sense these aren't all the same patient but it's not uncommon to get a whole swag of these on a single patient they all look different and you've got to try and understand why they look different and actually what this means for what happens when they're behind the wheel just to put these sorts of risk into perspective everybody knows about alcohol it's been around for a long time and everybody knows about point oh five being the legal limit for driving if you're not on a probationary license and the relative risk of a crash at point oh five so that's the risk of having a just the pure risk of having a crash compared to if you're at zero if you're point oh five somewhere between three and five times and that's the risk that society has decided is unacceptable so this is not science really I mean the science tells you what the risk is but the government or the parliament picked point oh five because you know they have to let people have a little bit of social drinking but at about three to five times it's considered to be unacceptable and if you're at about point one then you've got about a ten times risk and that's the level at which the courts really give people a very penalty if they've had a nasty crash if you're in that central part of that bathtub curve if you're if you're a if you're a safe experienced driver aged 40 and and you take alcohol to make you as dangerous as an 18 year old you have to get up to about point oh six and it's illegal to drive at point oh six but it's not illegal to drive when you're 18 that people have the same risk but to compare that to medical conditions some of those don't have enormous risks compared to drink driving you know the relative risks the overall relative risks of treated people with these conditions not high but there's a lot more of them and and so that's why we have such an emphasis on trying to do something about them because every little bit incrementally reduces the overall risk on the road many of the concerns and sometimes of people who work in areas like social work and actually have to deal with families and so forth have to do with preserving people's lifestyles and mobility for as long as possible and I've got to say that's also one of our aims and I'm talking again later on this afternoon and I'll be talking about trying to put licensing conditions on to people that maximises those opportunities you know the aim of medical review of drivers well it's partly to take unsafe drivers off the road but it's to keep people mobile for as long as possible because you know it's certainly known that there are major public health implications if you take people off the road that shouldn't be taken off well look it's a bit hard to know about cost benefit analyses in a formal sense you did hear also in a previous talk that some of the Monash research has shown that Victoria's got the lowest rate of of all the driver crashes and deaths compared to places where there are different regimes now Victoria has got the most lenient fitness laws in that it's not compulsory to have medical review as you get older but Victoria does have the most thorough medical review system so that once people are known to the medical review system action is taken probably more than it is in other jurisdictions in Australia now the cost of a of a death on the road has been variously estimated as being at least a million dollars to society it's probably even more than that when you think about other sort of hidden intangibles so you know at the moment in Victoria there's about 260 deaths a year so that's a quarter of a billion dollars every year in direct costs associated with death and I'm not sure what the you know what the whole medical review industry an assessment industry costs but it couldn't possibly be as much as that certainly health professionals you know such as OTs, physios, doctors etc deal with lots of other things it isn't the only thing they do isn't the only thing I do either but there is a cost in doing all of this and you know I guess the only positive indicator I can say of the fact that it's money well spent is that we have the lowest death rate of older drivers in the country


Welcome to Toffy TV, it is the player ratings for Manchester United's one ever to one great performance, great performance by Evan and Oatafodd, with the very difficult circumstances, lots and lots of injuries and obviously difficult circumstances that we haven't been very, very good recently so Man United have been quite good recently but I think the first thing to say, the tactics were also quite good as well from Duncan Ferguson, women in 4-4-2 sort of caught them as well by making it think it was a five at the bath, at times in the first half we looked like we were pushing up just a little bit but then we quickly sorted that out. Man United maybe will tell me just get this to go forward so they can play on their counter-attack but I think the message got through to dropping so yeah, really pleased with that under the circumstances. John Pickford, I've given John Pickford a six, I thought he could have been stronger at times with his kicking was on and off, I actually think he could have done a little bit better with the goal, I don't think he moves his feet quick enough, I don't think he moves his feet to get over quick enough, listen loads of people will argue with me over this one no issue, I just thought that he could have got a little bit closer to, don't get me wrong it needs to go finish, I just don't think he got anywhere near it to be honest. So I've given him a six. Sheamus call my face, getting back for Sheamus after injury and being out of the side, I've given him eight, I thought he played really really well considering who he was up against, I thought he defended really really well. I thought he was disciplined, showed the leadership that we needed, never got caught too many times, a couple of times he got maybe the wrong side but he never really gave too many far's away either I don't think, not that I can remember. I was always in the right place, I thought he had a really good game considering it was his first game back so I've given him an eight. Look at Dean on the other side, I've given him a seven, obviously went off injured, thought he'd done alright up to them but obviously had to go off injured with the groin injury and now he's a major problem with two games in the week. I can't really see him making either game to be honest so that's disappointing. Yeah, he mean it was also his first game back as well. I've given him a seven and a half. I've actually given him an key, seven and a half. I thought he were both. I thought he both were always in the right place at the right time, never lost their position. Okay, first half, a couple of times I could just mention, maybe he got too high up the pitch and allowed to get behind them but he soon rectified that and they did really well and kept the shape and that's what it was all about today, keeping the shape. I'm not letting anyone get behind them. After a little spell in the first half I thought we settled down and I thought they did really, really well. Never really allowing anyone to get past them. I think Pickford has one save in the second half to make which was a good save but they made sure they were always putting blocks in and they were never getting dragged out to leave space in behind because that's what Man United wanted to do. There was a lot of discipline in there and they showed it really, really well. Into my field, making Hallgate a given, when I started I thought he was being considered, it was his first game at the centre of my field. I thought he was and again was in my positional sense, centre of my field is not an easy to position to go into and just play. You know if you're playing full back or whatever it's a lot easier, that's to do one thing, centre of my field you can get dragged all over the place. You've got to have a good football brain to play centre of my field to make sure you stay on your job and I thought he did that really, really well. It wasn't just like a stop at either, he showed some really nice touches and trying different things to just keep the ball and move the ball into space and get us up the pitch. So it wasn't just a case of being at another centre of my field, another centre defender in my field. He really showed some really nice technical touches as well to get us going. I thought he was excellent. Tom Davis, I've given him a 7, Tom obviously hampered by having that early booking which was silly rarely to do something so early in the game like that. There was another one where he did something just on the edge of the box which was a little bit, you know, it was only a far but you know what rest are like now. But I thought he had a really disciplined performance without doing anything major because he couldn't because but I thought there was a level of maturity to just keep the shape, get back, get behind the ball, not diving. And that can be, you know, that can be very tempting when everything's going well and when your manager's filling you loads of confidence. You know, there's a tendency for players to just go jumping in all over the pitch but he didn't do that so I've given him a 7. I liked a Wobie, I've given him a 6. I thought off the ball he did quite well, I thought on the ball he was, wasn't great. He put one good crossing in the first half. It was a little bit like last week, I just thought he'd give the ball up a little bit too cheaply. But off the ball I thought he did okay, I thought he again got back into shape. You can't imagine how important, well that's so important especially in the way games is just those first five yards getting back into the shape. It's huge, huge when you're trying to keep a disciplined performance. Every single player and it's the players like a Wobie and Bernard, you've got to do it more than anyone because they're not used to it. They go up the pitch and then have a tendency to just jog back. Duncan Figgs in his last oldest place to get back, get behind the ball, get a good shape so the opposition can't break you down. So I've given him a 6 and as I said off on the ball I just thought he was poor. I just thought he'd run into a few blind alleys, a bit like last week. I've given him more of the benefit out this week because he was away from home. Bernard on the other side quite similar, I've given him a 6.5. Quite similar, but he was trying to get the tackles in. I just don't think, probably just not fit enough. Not that many games of football recently come on sub last couple of games. So really difficult for him to probably have those fitness levels that he's required but he tried to get his foot in. He did the job he was asked to do again. It's going forward, not brilliant, nothing really outstanding from him. Maybe lost the ball too easily at times when it was better to just keep it. But again, it's that off the ball shape that I thought him and Nairobi did quite well today. With Charleston I've given a 7.5, always thought he was a threat, always thought he was dangerous. Actually now I'm going to give him a 8. I'm going to give him a 8. I thought on the ball and off the ball was always good for us. He got the tone early on when he went running back to break up. And I think he hit his ankle in the process to break up the play. And then on the ball just got started getting more intelligent. The link up to him and him and Dominic Arvillian is really, really good. He's got different strengths and I think you see that when they're on the pitch. Charleston wants to get the ball and Caledwell. The only disappointing thing I would say about him today was is that he tried to take one basacar on three times. And the end result was always the same. It was like a challenge that he couldn't help but go. Unless one basacar is really, really good. Well, he's probably one of the best in the Premier League for one-on-one defending. He always seems to time it right. And I just thought like once, twice yet, but the third time I was just thinking. Just put a ball in the box, but it was like this challenge I want to beat you. And that's good. I can understand that.  I just thought that maybe on the third time because they just smashed a ball across the box or something early. But I suppose it's about showing the players marking you no fail, is it? You know what I mean? One basacar reminds me of the young Tony Hibbers, if I'm perfectly honest. So he's got a great future ahead of him. So, yeah, with Charleston. And again, always a threat. And unlucky not to meet, you know, not to get on the end of a couple of crosses as well today. And Bob McAvelin, I've given eight and a half. Again, outstanding, got in the highest face for the goal. You know, could have been disallowed, I suppose. Just one and all, like a bull in a Chinese shop, if I'm perfectly honest. Duncan Feggson has shown him the red rag and he's bought into it.  Like other managers might have said to him, no, no, do pressing. Like Duncan said to him, no, go out there and hit a few people. You know, leave a little bit on them. You know, they'll leave a bit on you, but that's the life of being a centre forward. He's running, he's working hard, he's closing down. He wants to be the other number nine. This is something I've always said about Dom. And I understand why other people haven't necessarily bought into it, because his performances haven't bought into it. But I always remember that man's city game, Cumin's second game. He just batted company oil game. And I don't think we'd ever quite seen the levels of it maybe a couple of times. And I just thought, that's the player that I know is in there. Maybe playing up front on his own. That's the suit of him. Confidence managers actually want to do different things. But I think in like two games under Duncan Fawkeshire, I think we've seen like a proper old fashion centre forward. And maybe the days of old fashion centre forwards are on their way out. But for me, I think that's what we've seen and he's been leading from the front. And you can understand why, you know, at the end of the match, Duncan Fawkeshire has put his arm round him and telling the fans to sing his name and not Duncan's name. And that confidence that Duncan will have given us, it must be absolutely huge. So I've given Dom a caffman an eight and a half. The Sub's Bains, I've given seven and a half. Obviously he played a lot of the game and I thought he did really, really well. Stuck to his task, he got forward as well. Still, you know, he's not a slouch, he still tries to get forward. Very disciplined. And to see him and Coleman on the pitch is amazing, isn't it? Absolutely amazing to see them both going. We started the decade and we ended the decade with them. Moise Keane. I've given Moise Keane a six.  I don't know. Listen, I'm not the person who's given the instructions to tell him to go out and do that. I think Duncan Fawkeshire has come out and said he's told him to play on the right and he's not his position.  Duncan all gave different reasons and you can understand that. But I was giving him a six and he went on there and he wanted to impress. He didn't quite work. People saying he was blowing out of his arse and he didn't look fit and all those kinds of things.  So I'm not going to have that go with that lad. I'm not, you know, I'm not the manager. The manager made a decision and he stuck by it and there's reasons behind it. A lot of people are calling Duncan for all kinds and he will. But he made a decision. He made a decision and that's football isn't it? That's football and whether people agree with it or not. He was 10 other players out in that pitch working their arses off to get a result there. So let's focus on the positives and not on one thing that happened in the match. And the arse I've given six as well. He run on, probably run around a little bit and done mad stuff because that's what he always does. Imagine if he'd got the winner. Oh my God. Oh my God. Imagine if he'd got the winner. That'll give him a six. So there you go. Let me know your thoughts in the comments. You agree, do you disagree? I don't think I've been overly harsh on anybody to be honest. I don't think I have. I think I've tried to be fair. But you know, you'll have people out there that have different views of the game. That's fine. That's fine. I've got no issue with that. So let me know your thoughts in the comments. Make sure to check out my match reaction video. Bas is match reaction and Bas is three things from today. And if you're buying anything from our shop for Christmas tomorrow, Monday. Monday is the last day you can get it guaranteed for Christmas. So the link is in the description. So check that out. Thanks for watching Toffy TV and I'll see you later.