fabulous to work with and to be involved in he is a person a long time ago when international ophthalmology had a lot fewer people interested was seriously looking at what could be done and how we could affect different areas of the world and so he's worked very closely with the World Health Organization he's worked very closely in regards to the International Council of Ophthalmology you can't find anything in any of those areas besides that one of the preeminent programs in the world the University of Melbourne and continues to be there does a lot of traveling I found out that those of you who've made the trip it's not a short trip from here to Melbourne that's a good long trip and he made it all the way here he's going to be in the United States four and a half days and head on back so well he hasn't learned any better than Nick Mamelis of the end a lot of us who do a lot of traveling or Jeff Tabin but it's an honor to have him and before he comes and talks to us I would like to have Jeff Tabin has a few announcements he'd like to make. I'd like to welcome we have actually three new international fellows we have Claudia Andrea Lozano-Arvey and she's right here she's from La Paz, Bolivia and she'll be with us on the cornea service for a while and then we have Rochana Singlana and also Rojita Parajuli and they both just right they're both in the Telganga training program in Nepal and they'll be with us for a month each of them will be two weeks on the neuroophthalmology or medical redness service and then they'll be switching and then I'll turn it over to Professor Taylor as many of you know I did my fellowship under Professor Taylor he's been any small amount that I've learned anything whether it's international ophthalmology or life I learned from Professor Taylor which I forgot more than he taught me but it's a great pleasure to have you here. Well thank you Randy and thank you Jeff and it really is a pleasure here let me just wire myself up. As Randy said it's a bit of a flying visitor then if I still have my straight and accent it's because I only left my office at 10 30 yesterday morning. What I wanted to do today as this as you've seen on this slide for the last 15 minutes is talk a little bit about the impact of vision loss and I'm going to talk about that in a range of things I know why to talk about what's the dimension of the problem of vision loss what can we do about it what are we doing about it and what should we be doing about it and talking in a sort of a broad issue but looking at if you know ophthalmology is our profession then blindness and vision loss is really our business and we need to be concerned about that impact of vision loss and blindness and this shows the age specific rate of blindness and vision loss in Australia and which is representative of basically all the developed countries and you can see the amount of blindness or vision loss and visual impairment here is less than 2040 or driving vision and blindness is less than 660 which is slightly different from the American definition of blindness which is 660 or less but you can see the amount of vision loss increases almost three fold with each decade over the age of 40 so that almost half the people in their 90s have visual impairment and one person in five is legally blind now people think you know 80s and 90s are actually sort of too old to really worry about but the average life expectancy is about 80 and once you've had your 40th birthday you've got a two out of three chance of having a 90th birthday so we're not actually talking about very rare people there's a lot of people who are going to be 80 and 90 and if you look at 10 or 20 percent of them being blind it gives a magnitude of the problem we're facing and we look at the cause of blindness again about half the blindness is caused by AMD about 14% from cataract and unoperated cataract and glaucoma and diabetic retinopathy but also refractive error is an important measurable cause of blindness people walking around who are functionally blind who all they need is a pair of glasses and if you look at visual impairment it's the same five conditions AMD cataract glaucoma diabetic retinopathy and refractive error are the five conditions that cause three quarters of the vision impairment of course the proportions and ratios are different and refractive error become much more important and this is the way people function in their day-to-day lives it's not what's their best correct security as we measure it in a lane this is the way they're actually operating and so it's very important for us to remember refractive error as a cause of vision loss in addition to AMD glaucoma cataract and diabetic retinopathy and if you look at the prevalence of blindness and vision impairment in the US the data are actually a little bit flaky because they have to use the Australian data and data from a variety of studies to put together the best estimate and this is the work done through the NEI some years ago now but giving the projected rates of blindness and vision loss in the US and again the causes are similar this is again published in archives but showing those same five conditions AMD cataract glaucoma diabetic retinopathy and in addition refractive error now low vision has a very marked impact even relatively small decreases in acuity have a marked impact a lot of the definition had been used of less than 2060 but in fact most of the work now is focusing on vision of less than 2040 and it's been shown that acuity of less than 2040 presenting acuity of less than 2040 impacts both on the quality and length of life and prevents healthy and independent aging and the break point is really at less than 2040 rather than less than 2060 and it's the the impact on the tasks of daily life whether it's your work or leisure being able to read a newspaper being safe and being able to get around safely outdoors particularly in old people and how people feel about their vision so that's 2040 is not only important as driving vision it's actually a very important functional vision and for people whose vision is less than 2040 they are twice as likely to have a fall four to eight times as likely to have a hip fracture have three times as much depression will be admitted to a nursing home or supported care three years earlier than people match for other health and age just on the basis of having this in 2040 have a doubling in their requirement for social support twice as likely to visit a doctor and factor twice as likely to die so even small amounts of vision impairment are important and looking at those other figures two out of three people will lose vision before they die so it's actually a huge problem in social terms but it's also a huge problem in economic terms and looking at the economic impact of low vision one has to look at and vision loss one has to look at not only the provision of services the curative services I care that we provide but also the personal or out-of-pocket expenses the people with low vision suffer loss of income the cost of a carer that somebody's got a daughter or daughter-in-law he's got to take off time from work to drive somebody to their doctor's appointment or help them with their shopping money that spent on low vision age and equipment around the house or how to make things safe and also transport because they can't drive themselves they may not be able to take a bus and so forth and the amount that people with low vision spend varies tremendously depending on their economic status study we did in Australia is that on average people with low vision are spending about three or four thousand dollars per atom on their various low vision costs and these other out-of-pocket expenses but obviously that's very related to their ability to pay to pay and what they can do we also in Australia looked at how what's the impact of vision loss on on the life that on disability and the impact in the community and how does it relate to other things and we found that vision disorders are actually the seventh leading cause of disability less important than things like depression or dementia but far more important than breast cancer prostate cancer or even HIV AIDS so as a as a sector it has a very big impact in terms of disability within the community and we also looked at the costs of vision loss in Australia and the total cost there's these are figures now some years ago were 10 billion dollars and the estimates that were done last year have increased that number to about 16 billion dollars per atom and Australia's got a population of 22 million about a 1 14th the size of the US half of that cost or impact of vision loss is due to the impact on well-being the loss of well-being or the burden of disease another third of that is on the indirect costs the the loss of income the cost of carers and agents and that sort of thing these indirect cost listed here and about a quarter of the cost is the direct care given to either now as I mentioned if you the average life expectancy now is close to 80 but there's been a big change in life expectancy over the last century or so and basically for every year that we've lived we've got four months for free and the life expectancy has increased dramatically in Australia the US Japan in fact globally although the starting point is different and with that change in life expectancy there's going to be a doubling in the number of people over the age of 60 or over the age of 65 over the next 20 years and with that doubling there's going to be a doubling in the number of people with vision loss and blinders just because of the increasing age distribution in the population and so that the cost of blindness and vision loss is going to become much greater over the next 10 or 20 years than it is today so what can we do about vision loss having shown that it's not it's important not only to the individuals but also it's important to the community and there are actually three simple things we can do it's susceptibly simple we can prevent the things that we can prevent we should treat the things that we can treat we need to solve the remaining problems that's doing research on the things we don't know how to treat or prevent it present and I just like to run through some of the simple things that one can do in terms of preventing the diseases we can prevent what we need is appropriately resourced and long-term high health promotion initiatives to reduce avoidable vision loss what we need to do is make sure that people who need an eye exam get an eye exam is one thing and so we had a show in a moment had a series of public health promotions about the need for eye exams there although many people about 40 percent of people will have an eye exam every year in Australia at least where we've got universal coverage and access to services we still have 15 percent of people who do not have an eye exam in a five-year period and so there are people there who need to be seen the other is preventing diseases and things like and the link between smoking and AMD and cataract is very important and so we've also done quite a lot of work in that and so working with the Australian government we've got compulsory anti-smoking ads on lung cancer heart disease stroke and stuff on cigarette packets we also got eye disease included with this you know very graphic labels on all the packs of cigarettes but to talk the government into doing this as a government program is actually you know quite terrific it's similar things have been picked up in the UK but this is a this is trying to do something about particularly AMD where smokers have three times the risk of AMD and 30% of AMD is probably attributable to cigarette smoking and very interestingly that recent Haines data that have just been published in the last month they're showing a decrease in the amount of AMD maybe a decrease in the amount of AMD in the US that may be due to changing in smoking rates which is which is interesting to think about the other thing we've been working on is getting these community messages out that people over 40 should have an eye exam at least once every five years unless they're in a high-risk group and the high-risk groups are obviously people who've noticed a change in vision should be looked at right away people have diabetes need their annual eye exam in Australia it's actually every two years because in general the level of care and control of diabetes across the community is better than the US and so the two yearly exams what's recommended there people with a family history of glaucoma need to be assessed those over the age of 70 probably need to be looked at every year or two and obviously if you're under the care of a practitioner you need to follow their advice so if Jeff Tavern says you've got to come back tomorrow for your Cornell also you need to do that don't wait five years but interestingly this this is a another ad or campaign that we had the talk the government into running increasing the awareness of the need for our exams and this is what a healthy eye looks like and this is what an unhealthy eye looks like you can't spot the difference meaning you know that you do need to have these regular exams and what you don't need is if you've had a normal eye exam and otherwise normal you don't need to be examined every year you do not need to be examined every two years those are a whole lot of unnecessary exams that are filling up our chairs and offices with the worried well and we're not getting to the people who need to be looked at who are not being examined and refractive error I mean even though it's it's something we don't spend a lot of time thinking about is actually very important in the community and this shows just in Australia the number of people who have a vision of presenting vision of less than 2040 who just need a pair of glasses to bring it back to 20 or it's a better than 2040 and see there's a large number particularly as you get into the older age groups all right we talked briefly about diabetes but people with diabetes have 25 times the risk of vision loss 98% of that the severe vision loss is can be prevented by timely laser treatment people need their regular eye exams every one year in the US every two years in Australia to be able to find those who need treatment but only half of the people with diabetes are getting those regular exams and a third of the people with diabetes have never had an eye exam and these figures are for Australia but they're exactly the same in the US so we are clearly failing to reach all those people with diabetes who need to be looked at and so there's a message there for us to talk to the internist to the family practitioners to the diabetologist to make sure we have those links so that all the patients they're treating with diabetes are getting the examinations they need we need to treat the diseases we can treat obviously there's we need adequate funding and resources to be able to provide services to the whole community that needs them counteract surgery on the one hand is a classic case where what we need to do that and also providing low vision services for those who we cannot reverse the low vision and in general only a third of the people who are blind are actually using low vision services and only about 10% of people who have low vision less than 2060 are using low vision services and their quality of life and ability can be improved dramatically with even simple low vision aids but with counteract everybody will develop cataract if they live long enough basically a hundred percent of people in their 90s will have lens capacities although half of them have already been operated on cigarette smoking and UV exposure the only two modifiable risk factors I mean other than sort of ionizing radiation or high-dose steroid but but cigarette smoking UV are the only thing that we can address and cataract is by far the most common of all the elective surgical procedures and by far the largest cost in eye care but counteract surgery is also extraordinarily cost-effective and costs 2020-2020 dollars per quality adjusted life year treating hypertension is about $20,000 per quality treating diabetes is about $40,000 per quality and our heart transplant is close to half a million dollars per quality cataract surgery is so cost-effective we cannot afford to have people sitting around in our community with unoperated cataract the community just cannot afford that loss so we need to make sure the cataract surgery is available for everybody in the community not just those with private health insurance and then we need to do more research to solve the present problems particularly looking at AMD and glaucoma and AMD increases dramatically in the older age groups so that two out of three people will have at least early AMD in their 90s and a quarter of people will have vision loss from it there's not a lot you can do to change your family history and there's been a huge amount of work done on the the genes associated particularly with neovascular AMD cigarette smoking is the only modifiable risk factor that we've got and there've been a whole lot of other risk factors listed there that really are not consistently shown but if we could just slow the progression of AMD by only 10% just a small change in the rate of progression of vision loss from AMD it would have huge savings and again you can multiply that figure by 14 fold to bring it up to a US number so that there is a huge impact and cost from even a slow reduction let alone being able to prevent or reverse AMD but glaucoma is has a different sort of appearance through the community about one person in 11 or now about 10% of people will ultimately develop glaucoma if they live long enough glaucoma doesn't keep rising the way cataract and AMD tend to glaucoma seems to plateau off so there are people clearly at risk and a family history is the most important factor by far increasing the risk of glaucoma 3 to 4 fold any of the other risk factors might increase it by 20 or 30 percent but a family history increases it by 3 or 400 percent orders of magnitude difference the most important thing about glaucoma is sort of early diagnosis they can have appropriate treatment and control of the IOP and stuff but half the people with glaucoma are undiagnosed and are therefore untreated and half of those people who are undiagnosed have had an eye exam in the last 12 months and have been missed so somebody's checked their pressure or taken it flashed to some sort of light over their disc and just not actually looked at them properly and so we're actually having walking through our going sitting on our chairs in our in our examination lanes all these people with undiagnosed glaucoma and the reason they're not being diagnosed is people are not doing visual fields on them and the one of the biggest reasons that people are not doing visual fields and not thinking about glaucoma is they don't know that they have a family history that puts them at high risk of developing glaucoma so the single most important thing that we can do is to make sure that our patients who have glaucoma tell their relatives their first-degree relatives that there is a family risk of glaucoma so we see all the patients who are known with glaucoma that's our easy link into everybody who's got a first-degree relative with glaucoma so what we need to do is we need to each patient you see with glaucoma you need to ask them or tell them instruct them inform them encourage them to tell their first-degree relatives their brothers and sisters their sons and daughters hey I've got glaucoma and you will be at risk of having glaucoma too so when their family member comes for an eye exam like you say hey my mother brother whatever has glaucoma please check me out to make sure I don't have it and that will be enough of a cue for us to actually look further than just as a routine exam so that's a very important thing that we can do to pick up those half the people with glaucoma who are undiagnosed and we looked at some of the economic health economic impact of glaucoma and what you can do when we know where things are with drugs and I know there's I've been a whole lot of correspondence recently about all the prostagland inhibitors going generic and what that's going to do for costing but a change in treatment to have initial laser trabeculoplasty would be tremendously cost savings in terms of preventing vision loss from glaucoma you get 24 hour a day seven day a week compliance after your ALT you don't have to worry about the person remaining to put in drops you don't have to worry about whether they can afford to refill the prescription and if it lasts one year or ten years they've gone that long with good control without the need of drops and so there's and you know occasionally having to take pills and med case myself I know if I get to have it fixed up by having one bit of surgery and it lasted for a year or ten years there is absolutely no question in my mind my very first stop would be an ALT or an SLT but that's not what we're doing most people don't do that most people put them on zalatown or something and that and we know that a third of it are probably only a third of the people are fully compliant a third of them well the date even you know not using the prescriptions at the end of a year so our compliance with glaucoma medication is just atrocious so that the really the thinking more about that SLT or ALT as your first line in glaucoma will make a huge difference into that overall management we looked at if we did those three simple things that we were talking about if we prevented the diseases that we could prevent if we had adequate resources to treat the diseases we can treat particularly cataracts and if we provided some additional funds for research now what would that cost what they were saved and in Australia when we model this out it costs about just under two hundred million dollars additional funds per annum not a big amount but in the first year it would return almost a billion dollars so there's a five-fold return on investment and a lot of this is just getting people their glasses getting people getting you know examined picking up some of the diabetics and stuff and the same thing over the lifetime of the people was again over five-fold return so for each dollar invested in I care there is a five dollar return to the community so that's a very good investment for a community to make and if you look at the costs of vision loss in the US and this is you know prevent blindness America data and their estimate there was fifty one billion I think that's wrong by about a factor of three-fold and because there's a lot of stuff that's been left out and there's an article that we had in investigative off the apology about a year back with a consensus panel about the factors that you need to put in and I think people would agree that that figure should probably be in about three-fold larger than that we've also done work on the cost of vision loss in Canada and the UK and Japan looking at and the figures are remarkably similar there may be differences in the distribution of disease there may be differences in the health care system but relative to health care revision that impact of vision loss is remarkably consistent now what's happening globally where is we sort of worldwide and in 1995 the estimate was that there were 45 million people blind and the disease is a little bit different here we've cataract causes half the blindness globally glaucoma still is about 14% and glaucoma is very interesting if you look at data going back to the 1880s and through the early 1900s through today glaucoma stays at around 10 to 12% year after year after year in one country after another and it doesn't matter if you're looking at Germany or the UK or the US or Australia or the developing countries glaucoma has remained while the other causes of blindness who have gone from being infectious disease of family in the in the Torum syphilis smallpox through cataract and diabetes in the developed countries and now we're looking at AMD but globally cataract causes half the blindness and glaucoma still important but anyway trachoma and corneal capacities are still important but the big thing that happened between 95 and 2004 was there is for the first time ever globally there was a decrease in the number of people with blindness and that's been a lot of work done with vision 2020 programs like the Himalaya cataract program the international ophthalmology work that Jeff's doing and others getting these services out to these areas and just in the last month W.A. Joe has released new data to show that now include those with refractive error but again showing a further decrease to just under 40 million when you add in those people with which about five or six percent who have got uncorrected refractive error and this is despite a very significant increase in the population in the global population and a particular increase in the older people in the global population so that progress is being made globally on reducing the amount of blindness and vision loss and these are some data that came out last year that show that the total impact of blindness globally is about four thousand billion dollars per atom I mean it's a huge cost on the world and it's interesting that about one and a half trillion dollars of impact is due to refractive error and then the two and a half trillion dollars is the other causes of vision loss and you don't have to worry necessarily about all these different categories about the direct cost and dead weight cost and stuff there's some of the health economic mumbo jumbo that goes to give you these sort of global figures which shows the huge impact of vision loss and globally not only does blinders lead as I've talked about to that individual impact but it's a major contribution to contribute to poverty both for the individual who loses their economic livelihood to the family who's got to look after somebody who's not generating income or helping grow food and in some of these countries are blind person can be referred to as a mouse without hands it's somebody who and actually you have to have a child often look after the blind relative so you're actually losing two people from the economic system of the subsistence farmers and of course it contributes to community poverty globally 80% of this blindness and vision loss is preventable and some of the interventions are extraordinarily inexpensive we talked about cataract surgery at 2020 or 20000 dollars per quality distributing vitamin A capsules is about the most cost-effective thing you can do in the world it's even more cost-effective than immunization at $2 quality adjusted life year and screening for diabetic retinopathy much more complicated much more difficult is still only $15,000 per quality and there's some some work done recently by Pollock and Cooper from London looking at the impact of cataract surgery in these developing countries and looking at the change in economic benefit in the community and in the households of people who've had cataract surgery showing that those people have been operated on vastly improved compared to how they were before surgery and this is a measurement of quality of life again showing huge changes not only not only in the economic area but also in the rating of ability all right so what can we do about about vision loss I mean one a little bit like climate change one needs to think globally but you need to also act locally and locally each of you here can work somewhere along a spectrum at least you need to be aware of the problem of vision loss in your own community in your own country in your own hemisphere in our own world be aware of it the next step of engagement would be supportive or become an advocate see what you can do to help it may be you change your research you start to focus on some of these issues or diseases to see how your research could contribute to doing something about vision loss you may go and work with Jeff Tabard and you know we spend three months a year overseas ready I didn't say that I don't want all your faculty to go overseas but you may do that or some people may say well I'll become an Albert Schweitzer and go and live in Africa and commit myself full-time there's a range of things you can do but even if you're just aware and an advocate and are supporting other people who are doing this work you're making a big difference but in our own practice in our own the patients you see this morning you need to think about the things we talked about you need to think about glaucoma you know what are you doing are you were learning all your patients with glaucoma about family history I actually checking relatives who have glaucoma well enough what are we doing to reach the the diabetics are we making sure that everyone with diabetes is actually getting their eyes examine what are we doing about the underserved people in our community are we actually providing care out there or are we just sitting there looking at the people who come into our clinic you know are we actually doing what we can in our own community to practice these things about trying to reduce or minimize vision loss and a lot of that is also advocacy you know talking to to people about the importance of vision and the importance of things that we can do about as I've been going through today and vision loss is difficult and I get a lot of inspiration from Helen Keller who is photographed here and the quote that she said because I can't do everything I will not refuse to do the something I can do and we can do something about vision loss and blindness it's very achievable to eliminate blindness and vision loss if we wanted to we could operate on everybody with vision loss from cataract by Christmas there's no way we could get rid of obesity by Christmas or alcoholism by Christmas or cardiac disease by Christmas but to eliminate cataract blindness would give everybody a pair of glasses is very finite we can actually do that the other thing I like about this photograph and it's actually you can see there's some writing here Helen Keller writing pencil and it's pressed into the photograph and then Polly Thompson who at this stage is this woman who was her eyes and ears and companion and it's written in thank you to my grandfather who was also an ophthalmologist there. So I'd like to end there and I'd be very happy to answer any questions thank you. So you're very good and obviously a great chance for us to get a good international look at the problem where it is. I'd like you to comment a little further on the hate study because I mean they're purring about it a lot to talk to you and they're giving figures as though that since 2004 and now that there's potentially a decrease in much of almost a third. I'm a little fearful of people so we've got a couple of low hanging fruit that right now seem to be stabilizing fairly well if indeed it is taking antioxidants and smoking sedatives but I worry we've got a really a sampling error problem and you're the one who's done a lot of this epidemiology. I'd love to hear your input about that because it's a big deal right now. The implication is we're looking at this problem. I don't believe the data. They had over 900 people that they excluded out of a sample of 7,000 about 7,000 so it's almost 20% of people they threw away and they threw away people they couldn't get a photograph on they threw away people who are blind. So if you if you're throwing I mean it's those people were not randomly distributed. The people who were excluded from the analysis are going to be your highest risk people and so those numbers are really flaky. Well I mean I think that with that high percentage of exclusion or you know failure of ascertainment those data are very suspect and what you really there is a sensitivity analysis and say if everybody we didn't look at had AMD what would be the number because what they've assumed is nobody they didn't look at had AMD or so you go from the they presented the very best case example you need to present the well if the rate in these other people was the same as those we examined what would it be and then you get a third estimate so that and that's the sort of sensitivity analysis that I think the reviewers or the editors should have insisted that paper had. Absolutely right and I don't believe the analysis was a secondary analysis and if you look at the breakdown of the average data those with neovascular did a little bit better than the average which means those with geographic atrophy did a reverse and those never properly teased out and we know that zinc on its own doesn't do anything we know that vitamin E on its own doesn't do anything we know that vitamin C on its own doesn't do anything we know that we can't use vitamin A in the high risk people because they're all smokers and that increases the risk of cancer so I think that that arid's bubble was not well evidence-based that's pretty controversial position it'll be really interesting to see what it comes up with and you know Israeli said there's lies and statistics and you can pull these analyses in different ways and you know they I had a hundred million dollars in arids the drug companies wanted to sell it people want to have good news stories you know you got to sell something to the Congress to get your funding and so there's lots of pressure to put and of course I'm always just want to do something I want to have patients come and say look you're going to go blind from AMD there's nothing I can do about it they say look you know you got early AMD but if you take this you might not go lose vision so I mean everybody wants it to work but I don't find those data convincing arid's too will be very interesting to see what they what they come up with yes and you'll see that by current position is I'm working on Aboriginal indigenous I health where we're not only working across a doctor patient barrier or divide but we're also working across a cultural divide as well and so it's extraordinarily important to understand what other if you like the patient perceptions there and you know it's you've got to sit down talk to people and it's sort of in a structured way you know you're not going to do research by sort of putting a drop by something on a 96 well played or strangling a cattle or something you go to do a properly designed study you're not going to get information about the community perceptions without doing properly designed studies and you know whether they focus groups whether they're different ways of consulting but it's to understand the patient barriers to utilisation and care is very important if you're planning those larger services absolutely agree with you yes sir yeah no that the the there are a couple of things that were interesting everybody except for I think one patient had measurable detectable field defect the range of pressures were were in the same range as those with diagnosed glaucoma the range of discupping were in the same range as those with diagnosed glaucoma so it wasn't as though they were all very early glaucoma there was actually some very advanced glaucoma that was missed but the thing that they all had or almost all had was the field loss so if somebody checked their field they would have been picked up but you're not going to do a field on everybody as part of a routine exam which is why that alert of say hey you know somebody my family's got glaucoma can you make sure I don't have it is so important and the only way we'll get that is by us telling our patients with glaucoma you've got to tell your first-degree relatives does that help I mean I'm a cordial surgeon so I'm a trachea ground I'm talking about AMD and antioxidants or glaucoma or low vision but I think yeah glaucoma is important as a disease in its impact on visual function that's what's important you know the number of nerve fibres you've got or don't have don't matter what matters is what you can see or what you can't see so so to my mind the siniquanon glaucoma is field loss now of course if you pick it up early you can treat it before it gets worse and and you know I'm not saying that you should forget about the disc and nerve fibres all together but to my mind the key the thing I mean if I lost you know 40% of my nerve fibres and still had complete field who cares and if that's the day before I die who cares so the fear the loss of nerve fibres themselves in the absence of demonstrable field loss is on the self not important the so so I put a lot of value into field but I'm not suggest and I also think that the FDT is terrific and when we did you know examination a whole lot of Aboriginal people who know you've got all the cultural barriers and language barriers and stuff I mean they will all do FDT in a snap you just tell them to push the button when they see the lightning flashing you know it's nothing about grids or patterns it's just you know the lightning flashes and they are being why they go so one could do that very quickly and easily if you want it to as a routine test and and I'm suggest it's actually a lot easier to do than OCT on everybody but but I think that the easier thing for us to do when there's something we can do immediately today with almost no change in our practice every patient we see with glaucoma you should put that message is please tell your relatives first-degree relatives that they are at risk to and to get checked out now that's very simple thank you yeah we're one more sorry I I think that to have a non-mediatic retinal photograph and a visual acuity test because you're not going to pick up all the early macular edema and necessarily on a retinal photograph and not a non-mediatic retinal is a single retinal photograph so that and you're not necessarily going to pick up their cataract either on the retinal photo photograph so you need a visual acuity and a retinal photograph and I think that the best way to do that is actually put the retinal cameras in the local pathology labs where people go to have their blood taken and they go to have their ECG or their urine down or what have you put cameras there so the family docs can sign EC EKG you know electrolytes hemoglobin A1C whatever and retinal photography that's where I see is that's a one-stop shop I mean people with diabetes have to go to the the pharmacy every month to get their prescriptions they got to go to the family practitioner every two or three months to get their blood pressure or the blood sugar or something else sort of out you know they don't want to spend half a day sitting outside somebody's office in an eye center and then come away not being able to work for another five hours because they're dilated I mean there's not enough hours in their year to do that so you'd need to make it easy and I think that non-mediatic photography plus an acuity check somewhere where they go and you're not going to be able to put those cameras in every family practitioner's office you can put them in every diabetic clinic so that'll be another place to do it but the place all the diabetics go to sort of at least well at least once a year sometimes a lot more often is that local path lab and so to my mind that'll be a very smart place to put it yeah I've got my sorry ready yeah I've just been reading some interesting papers written by Pelly you know who did the Pelly Robson charts and stuff looking and also from the people in the fight in Alabama where they're doing in Birmingham where they're doing a lot of work on sort of driving and stuff and the field defects I have a variable impact on driving and a very individual specific which is interesting the other thing is if you just do field checks without anything else you're going to pick up all those people who've had strokes and or got cataract or something else and so you need to if you're just doing a field screening this is something else we sort of tested out in a population people aged in their 70s that you need to do a couple of questions before you do the field test and a measure of visual acuity because if there are visual acuities down they need an automatic referral but but it's built you know the idea of building some sort of automatic system makes it's got a lot to explore it's a good idea the idea of the United States I mean everybody has to drive almost if you can that's one time you can catch everybody every five years yeah and it as a screen if there's a problem as they do now I mean if they have a visual acuity problem they say you've got to go have this check yeah and to throw a put an FDT you know push the button when you see the light link would work well too


Is there a level playing field for men and women in your world? As in, you know, we don't see as many female gurus, you know? Just asking. I mean, is there a glass ceiling there as well? Somewhere they just don't get enough. Let's… let's understand this properly. You being a male or a female essentially is of the body. If you're talking spirituality, we're not talking about the body. We're talking about the inner nature of this life. So, one thing I want to say is women can never get enlightened. They're already enlightened. They can assume. But a man, it's impossible for him to be enlightened. Because if you're identified with your body parts, how will anything larger than body happen to you? If you're only identified with your body parts, how something beyond the body can ever happen to you?  The question is whether you're identified with your body parts or is it something beyond which is functioning within you? So, the question of you being a man or a woman doesn't even come into the picture. So, generally always women have been more spiritually oriented. Maybe they did not become well known in the society as spiritual leaders simply because you must understand it's a question of transport and transmission. Because in ancient societies, a woman got pregnant. From fourteen to forty-five, she was either constantly pregnant or breastfeeding a child. This… this was simply happening all the time. There was no… this was the natural process. Today we have a choice. This is the first time we have a choice about this, isn't it? Otherwise it was simply happening. So, she traveling long distances and teaching and becoming known in the world did not occur that time. But these days some are coming, but I wish they had put in little more sadhana about themselves. In the Isha Foundation, in the Isha Yoga Center, and I did not do this by design because I don't look at them as men or women when I give them responsibilities. But somehow, somehow, though I'm very level in my head, in spite of that I think nearly seventy percent of the positions are held by women. Not because I'm trying to promote women, I won't do that. I don't promote men or women, I just promote intelligent people.


Hello everyone and welcome to Inside Leather History at Fireside Chat. I'm Doug O'Keefe, the host and producer of the chats, which are a program of the Leather Archives and Museum. Today, I'm conducting an interview with Mr. Graylin Thornton, who was Mr. Drummer 1993. How are you, Graylin? I'm blue. Well, Doug, how are you? Great. Let's start right at the very beginning. We want to learn a little bit about you. Tell us a little bit about where you're from and a little bit about your family circumstances. Well, Doug, I was born in Birmingham, Alabama in 1960. And what's great about that is that my birth certificate says that I'm colored. And so I've always felt that I was growing up as a colored boy who was a product of the 60s, then the 70s and 80s. When I was six years old, my family moved to California to San Mateo. And that's where my family settled. All of my cousins, aunts, uncles all ended up in San Mateo and most of my family still lives there. Why did your family choose to move to California? My family chose to move to California because in the 1960s, Alabama was just not the place to be for black people or people of color in general. There was obviously the civil rights movement all happening there. But then there was the brutality and the lynchings and everything that was going on with black people there. So my family felt that moving to California would just give us a better start at life. You said that a number of your family members joined you in moving there. Pretty much all of them. My mother has actually 13 brothers and sisters. And so little by little, we started moving to California just to get out of the South. And California just gave our family much better opportunities than we would have had had we stayed in Alabama. Ironically, some of my family has gone back to Alabama and the Carolinas and to Georgia and the Florida. But our base is still here in California. That had to be a very big step when you're from somewhere and you pick up like that and move away. It's a huge step to move away, but it was necessary, especially for black people in the South. We wanted to have opportunities that we wouldn't have there, schooling, jobs, social lives, all of that we could have in California, but not so much in the South. You said that living in the Bay Area was very enlightening for you and that you were sort of unofficially, quote, quote, adopted by a Jewish godmother. Tell us a little bit about her. Who was she? That's a funny story because when I met her, her name was Renata Chase. And when I met her, I was eight years old and she was a friend of my mom's from work. My mom's a kindergarten teacher. And so Renata pretty much adopted me as her own son because she didn't have children. But she was and still is a hippie right from the 60s going to the protest, the long hair, all of it. And so as a child, she took me to San Francisco to the Vietnam protests. She also took me to my first nude beach when I was 12 years old. She took me to my to my first concert, which was the I Can Tina Turner review because I loved I Can Tina Turner at that time. So, you know, as I was growing up, she really influenced me culturally and also gave me the tools to become more active as I was growing up. Well, what do you remember of any of these protests? My favorite thing, you know, the protests were all happening in San Francisco at the Civic Center. And I remember very well. In fact, there are pictures someplace.  I had the little headband on and every time we would go to San Francisco to the protest, I would wear my little protest outfit. And so growing up, I thought that this happened every week in San Francisco because every time that we went, there was a protest. So as I got older, I was really, really disappointed to find out that this wasn't an all the time occurrence, that the protests were something special to that time period. But it also gave me the feeling that I needed to be involved and make a difference in the world. And so I credit her for all of that. So you said the protests were Vietnam war related, mostly? Yes. Yeah. Are there other protests? I remember there was one, and this was when I was first exposed to the Black Panther movement. There was a protest there around the killings in Oakland of Black people. And I remember being there and the Black Panthers were there. And I was so overcome with emotion about that because I was Black and I was experiencing growth because that was the time when Black is beautiful. There was a lot of James Brown. There was a lot of Black pride starting to happen.  But growing up around the Black Panthers and all of that was really enlightening for me. And in fact, the Black Panthers opened a school in San Mateo. It was an after-school project that they were doing.  We would go to the Black Panther school. They fed us. And so that was usually the motivation to go. We would always have peanut butter and jelly sandwiches. I remember that very well. So we would sit there. We would eat and they would give us all of those historical facts that you just didn't get in school at the time. Such as? Well, it was the first time I had ever heard that Abraham Lincoln didn't free the slaves just out of the goodness of his heart. And I was shocked by that actually because growing up in public schools, that's what you hear. Actually, I was going to private school at the time. But that's what you hear is that Abraham Lincoln just freed the slaves. That's also when I learned that George Washington owned slaves. And so I was relearning history, especially as a Black man, and finding that we weren't just given things. We weren't just given our rights. We had to fight for them. And so that's where I learned all of those things. That's very profound. It is. It is. Because even today, when you look at school books, they're rewriting history all the time and we need groups. Then it was Black Panthers. But we need groups to always reeducate Black kids and other kids of color to know what our history really is and not through the view lens of white people. Yes, absolutely. What else do you remember of the Black Panthers? I would think that had to have had a huge impression on you. It did. You know, what I remember most about the Black Panthers were the uniforms. They wore the jackets, the more military look, the little caps. I remember all of that very well and seeing them all lined up. And I wanted to be one. And they also had, the Black Panthers had a drill team that was part of their school. And so the Black kids would go there and they would put us through drills, marching and walking and reciting songs. And that's, again, when I learned a lot of the Negro spirituals at that time, and I learned that they weren't all written by Black people. And we learned that Negro spirituals were the catalyst for runaway slaves. You know, we didn't hear that in church and we didn't hear that in school. But that's where we learned all of those things. How fascinating. Truly. It was growing up in the 60s was in one way horrifying and then another way enlightening. And it shaped me. It shaped, I think it shaped most Black kids of that era. How do you mean horrifying? Horrifying because it opened our eyes. It opened my eyes. I knew what was happening in the South. I didn't know our history. And around that time, Martin Luther King was assassinated. And that was my first big emotional sense of loss, a big sense of loss, a huge sense of loss. Because I knew who he was and to young Black kids, he was our hero. He was our savior. And to have him assassinated, I just remember the sadness and the grief of me and everyone around me thinking, how could this possibly happen? Of course, I can see how it was enlightening for you. But what other emotions did that provide for you at that time? Fear. I think that time there was a lot of fear, which is, which is ironic because during the time where we were having such a resurgence, a renaissance of Black pride and Black people and feeling beautiful, Black is beautiful, was happening all at that time. To have our leader, Martin Luther King and Malcolm X taken away, it instills so much fear in us because they were the people who were teaching and leading us. And if they could be assassinated, if they could be killed, if their lives could be taken away, our lives could be taken away too. And I think, and that's where the fear came from. And also the police department, you know, that was, that was a time when there were a lot of killings, especially in Oakland and East Palo Alto. And so we grew fearful of the police. We felt there was no place for Black people to go. We had no sanctuary, no savior. So while we were experiencing Black pride and a renaissance, there was also this fear that was growing in us. You specifically mentioned Reverend Dr. King, but what were your feelings about Malcolm X? My feelings about Malcolm X, you know, I, I believe I identified a bit more with Malcolm X than with Martin Luther King. Martin Luther King was, he was part of my parents' generation in terms of everything that he said and, and marching and peaceful demonstrations. But I was young and I had been to the Vietnam protests and all of that. So I wanted action and I wanted to march and I wanted to take arms and I wanted to be part of that part. I didn't, I didn't necessarily believe in the peaceful approach anymore. I want, I wanted action. Now, I can't help but ask you about the Icon Tina Turner review. That had to be incredible seeing live. Yes, seeing the Icon Turner, Icon Tina Turner review. Yes. It was at the Fillmore East, I believe, which was a seedy little nightclub in San Francisco.  It was smoky in there. I was the only child and they were so close because it wasn't the big arena. It was a very small club. And so I wanted to be an agate, of course. I love it.  You know, I wanted the little skirt the whole bit and I practice. I had the album on Icon Tina Turner live and I would play it daily and daily and just practice being an agate. And so by the time I got to the show, I felt I knew all the songs. I thought I knew the moves. I wanted to be part of it. And again, it was such a sense of pride to see black people on a stage making music and just influencing by voice and art and culture. Well, by no means were they the only artists doing this. Did other artists have a similar impression for you? Jackson 5. Because, you know, again, I was a young man when the Jackson 5 hit. And they were young and they were kids. And again, and they were what we thought were wholesome. So you had this family there making music and bright colors and Motown was happening and Diana Ross and Aretha Franklin. And there was just such, I used the word renaissance earlier. There was just such a renaissance of black culture and music and art happening. And to be young in that time period when it was happening was just unbelievable. So, you know, on one side you had this happening, the music and art. Then on the other side, you had the protests and police killings and everything that was happening in the South. So there was always this battle going on. Who are we as people? I can't help but wonder. What your godmother must have thought of going to the Icon Tina Turner review concert? My godmother, by taking me to that concert, she wanted that to be a bonding experience for the two of us. And it was, you know, it was my first concert and she knew how much I loved Icon Tina Turner. You know, just like the first concert she took me to my first nude beach. I mentioned that and it was perfect for me because I didn't have a concept of the body being anything dirty. It all seemed very natural to me. And I remember getting to the beach and thinking, this is it? This is what people are all up in arms about. Yeah, there's nude people here, but no one was doing anything.  And I believe started to shape my own sexuality because you know, suddenly I was there and I was seeing the body as a beautiful thing. And you know, with her being there and her being a hippie and part of that whole movement just made it even more special and accepting for me. I can't imagine if my parents had taken me or if I had just wandered there on my own, but having someone there who's a positive influence in my life just made all the difference. That's a beautiful statement to her. Yeah. And you know, I think I said we talk at least every other week still on the phone. And she still influences me when I'm having difficult times. That's who I call. Oh, that's beautiful. Well, you mentioned a moment ago that going to the nude beach was your first sort of inkling about sexuality. Let's look at that a little bit. Tell us about your early sexual exploration and discovery. Well, my early sexuality and discovery happened in San Mateo where I was growing up. And during that time period, San Mateo was literally divided by a railroad track. So on one side of the track were black people and Tongans. San Mateo had a huge Tongan population. On the other side of the track were white people and mostly Japanese and Chinese. We didn't have very many Latinx people in San Mateo at that time.  And I remember being... I could easily say nine years old and being sexually active at that time. I didn't really understand what was going on, but it was common for young boys to have sex with older boys at that time. And it just seemed like a natural normal thing. I didn't think anything about consent. There was no harm done to me. It was all part of growing up. And I know today it'd be very, very different. But at that time period, it was growing up and that was kind of what was expected.  And that's pretty much how I started exploring sex. That's astounding. I can't imagine something like that today. But when you say have sex, I mean, do you mean the full penetrative sex? Oh, absolutely. Absolutely full penetrative sex. Younger boys would be penetrated by older boys. And it was such a natural and normal thing for us. Today it would be horrifying. And even thinking back is a bit horrifying. But it was how we learned about sex. Incredible. What did adults have to say of this or were they not even aware? I think adults were aware. And I remember being, I had a cousin who was caught having sex. And we were exactly the same age. And he got into a lot of trouble for it. But again, it was something that parents knew was happening. It wasn't considered a really, really bad thing. We were told not to do it, but that was about it. Because it was happening all around us. And I also want to add, growing up in a predominantly black neighborhood and being there our whole lives, you knew all of those people. I went to kindergarten with the same people I went to eighth grade with. We were all together at that time. So you knew the people and you trusted them. And there was a great sense of safety at that point in my life too. Because we didn't have people coming into our neighborhood that we didn't know. So we felt safe. We could stay out late at night. We could wander the streets. We could do pretty much whatever we wanted as long as we stayed on our side of town. We did not venture across the railroad tracks.  How did you even know about that? Well, you know, San Mateo is about 20 minutes from San Francisco. And I remember one time being on a field trip. There was a summer program happening in San Mateo where they would take the inner city kids as we were considered. They would put us on one of those school buses, drive us to San Francisco to Golden Gate Park, open the door, let us out. There was no chaperones or anything. And so, you know, we wander around the park and then, you know, we go, we have lunch together. Then we go back in the park, they put us back in the bus and they take us back to San Mateo. And this happened every weekend. Sometimes we went to the zoo, sometimes it was Golden Gate Park, but they always put us on the bus and took us places. And being in Golden Gate Park, again, this is the late 60s, early 70s, there's a lot happening. There's a lot of music going on. Tower of Power was always there. There were, the Grateful Dead was always there. So all of these bands that you hear about were always playing in Golden Gate Park, which means we were exposed to a lot of different music and a lot of different types of people. So at that point, I started to see people that I later would find out would be gay people, but they were always fascinating to me. You know, there were trans people, there were drag queens that everyone was hanging out in Golden Gate Park during the music scene. And so, I remember for my 16th birthday, I got my driver's license. And the first thing I wanted to do was go to San Francisco. So that's what I did. I got in my dad's car, I drove to San Francisco and I hung out on Polk Street because I heard that that's where the gays hung out. And even though I didn't really know I was gay or what that meant, I wanted to be where the gays were because they were fascinating, they were colorful, they were interesting, they were on the street. And that just gave me a sense of belonging. So I actually started out on the street mixing with gays in the Polk area. Tell me more about that. What sorts of things did you experience? Anything that really stands out? Okay, so going to the Polk area at that time, there were adult bookstores. And the adult bookstores all had arcades in the back where you could drop a quarter. And it didn't take me very long to realize that I could go into the back of the arcade and have oral sex for a few quarters. And I would even plan it out. So I would think, well, if I have $2.25, I could get a blowjob in the arcade. And so I would just plan for these things and I'd drive to San Francisco, on Polk Street going to the arcade. I can't imagine how I was getting in because I was only 16 years old, but it was a thing. And so I would go there.  So it was a thing for me. It was a regular thing for me to go to the arcades to have sex. I should think none of that exists anymore. None of the arcades or anything. There are a few arcades still here in San Francisco. Oh, OK. Yeah, there are. They've closed a lot of them, but they're still there. People are still going to them. And not just the arcades, they were the parks. I learned about the parks later on.  I felt I had it all down. You were a dancer, though, when you were young and you traveled around doing that. It was a very, very from what you told me when we prepared for this. It was a very fascinating new element of life for you. Where did you go? What did you experience? Tell us about it. Well, when I was I was 17, I started to work at Marriott, Great America. I don't know. Can I say that in the interview? Can I? I started to work at Marriott, Great America. And my first job there was as a street character and I was Buns Bunny. And so I would wander the street in the Great America streets in this big bunny costume and I would have escorts there. We couldn't talk. And that's when I started to understand life as a performer.   And but I went and it was a major dance studio and they took me on as a scholarship student. And after the first year, I auditioned for Great America as a dancer and I was cast in the Bugs Bunny show there. Again, as Bugs Bunny, but in the show. And from that point on, I started taking more dance. I started taking voice. I got very interested in performing. And I can also say that that's when I started getting my first taste of racism as a young adult because especially working in a theme park, there were unwritten rules. Like there were four of us in the show for our black men and we couldn't all be on stage at the same time without being in costume because that would be too many black guys on stage at once. And they felt that that would be offensive to the people going to the show. And remember, this is California, this is the Bay Area and we were being told that, you know, we were just not all on stage at the same time. And then to take that even further, we went tour as part of the shows and we wouldn't all tour together either. They would split up the black guys. So I remember I went to Flint, Michigan. Another really close friend of mine went to Japan. One went to Hawaii. One went to Guam and I ended up in Flint, Michigan which I thought was just the worst place to possibly be. But that's when I started discovering, you know, the racism and the fear that people still had about black people and especially going to Flint, Michigan because Flint and I'm assuming is still the same way. Flint was really separated racially. Again, there was the good white side of Flint and then there was the black side of Flint and the black side of Flint was impoverished. And being from California from the Bay Area, I hadn't seen that type of poverty before and I hadn't seen that big of a discrepancy between black and white classes. So again, that taught me something that the rest of the world is not like the Bay Area and that's when I started to see that. No, we would always say that being in California, we live in a bubble. Being in the Bay Area, we live in a bubble. You get outside of that bubble and you see the real world and the real world is not as pretty as we thought. You also said it taught you responsibility. Oh, absolutely. Being a young black man and feeling as if I had responsibility to, sorry, getting a little emotional. One of the things that I learned from my godmother, Renata was to be responsible for everyone around me, that you have to be part of the community, part of the solution and being a black man and seeing other black people impoverished and having their rights violated. And I felt that I needed to do something. I needed to make a difference. I needed to grow up. I needed to teach other people that life doesn't have to be that way, especially in Flint, Michigan, because I had a lot of friends there that were from there and they were the people who worked in the theater. And I would sit there and I would tell them about California, about San Francisco and it helped me grow as a person and learn to take responsibility for other people, especially black people. Do you think you were able to make a difference for anyone? Was I able to make a difference for anyone? I would say absolutely yes and I still do. That's, it's my calling. And I don't think it's just my calling. I firmly believe that as black people, we have a responsibility to other black people to help, to pull us along because no one else is going to do it for us. We have to do this for ourselves. And that's something that I've heard over and over growing up from black people who are older than me would always say, you know, whatever you do reflects on all of us. And that's, that's something that I carry today. Whatever I do reflects on all black people. You were in San Francisco at a very historically significant time. Particularly, you were there for the assassination of the mayor of Mayor Mascone and Harvey Milk. Tell us what you experienced with that. When Mayor Mascone and Harvey Milk were assassinated, I was a senior in high school and I remember this sense of loss and grief, much like I felt when Martin Luther King was assassinated and when Malcolm X was assassinated because at that young age, all I knew was being black.  It was devastating once again because our leader is being killed. Someone is being taken away from us. And at that same time period, Jonestown happened and again, the grief of black people in the Bay Area because that church was in San Francisco and a lot of the parishioners from that church who went to Jonestown were from San Francisco and they were black and they were killed. So once again, being gay, our leader is being taken away.  It was the sense of loss that I felt with Jonestown because before that happened, we all thought it was a good thing. We knew about Jim Jones. We knew about the church. We knew about the black people going to Jonestown. There was this sense of pride that was happening of, you know, we're going to make a settlement sort of like the early 1920s when black people were going to settle in Liberia. You know, we had that same sense of we're going to create a place where we belong and to have a massacre and all those people killed. Again, it was it was a sense of loss that was community-wide. We all felt it. Did you ever attend a service in the People's Temple? No, because my parents, my parents went to the Church of Christ and you know, that's a Southern church and that's that's the church that I grew up in. And ironically, being a Southern church, that church took a very different approach to life, especially in San Mateo. I remember when the AIDS crisis first hit, the pastor of that church who was a dear friend of mine and my family called me in and asked me how to help. And so we started to do a dinner on Thanksgiving every year for everyone who didn't have a family and didn't have anyone to spend Thanksgiving with and the church would cook it and then I would take it to the bars and open the doors and let people come in and eat. So that's the kind of church of Christ it was. It was quite unique and even when I tested positive for HIV AIDS, they brought me in and took care of me. I never felt ostracized. I never felt shamed, any of that and that was unique for a church, a Southern church at that time. How long have you been positive? I tested positive in 1987. Wow, long time. This is a long time. And I remember, I remember testing positive being in the doctor's office here in San Francisco because that's where I went for my test. And I remember she called me in and she gave me the diagnosis and told me that I was positive for a virus. They didn't quite have it down yet what was going on, but she said there's something there.  I I walked out of that office feeling like I'm going to be okay and I was. I also have this sense of guilt because you know, I had friends who were dying very close friends. I was put on a trial AIDS vaccine trial being done at Stanford and this was the very early 90s. Later late 80s early 90s when they were doing trials and I never ever develop any type of symptoms.  I've never been sick. I think that that time period I felt such a sense of injustice because here I was getting a shot every Thursday at Stanford. No one could tell me what it was they were giving me, but I would get a shot every Thursday and yet I had friends dying and so I would always say, well, why can't they have the shot? You know why they're dying? If you give them the shot, it may save their life, but that's not how it works and it was explained to me. That's not how it works. We have to do these trials. We have to do this.  They let my friends die. Do you feel that the program at Stanford is what saved your life? I absolutely believe the program at Stanford saved my life. No, not only did they give me a shot once a week, but they took my vitals. They watched my health once a week. They take, you know, all these vials of blood and so it was in their best interest to keep me healthy. They kept me healthy. You know, anytime I had a cold or a sniffle, I was there and they were taking care of it. So I was being looked after. So you had a very different experience with the AIDS crisis than other people may have had. Yes, my experience with the AIDS crisis, you know, again was I knew I would be okay. But I also knew that I needed to help those who weren't okay. And so that led me into Leather and BDSM and Kink and looking after Leather people because, you know, when AIDS first hit, the Leather people were the ones who were blamed for it. Yes. No, by other days, especially because, you know, everyone needed to point fingers. So at first it was the bathhouse fall. Then it was the poppers. Then it was the lifestyle of Leather people. So there was always something, but I knew that I had friends that I need to take care of and I learned from those people how to do that. Take us to that. How were you exposed to the Kink Leather community? When it came to Kink and BDSM, remember I told you that at 16, I was going to San Francisco and there was a small movie theater there in the mission and they played X-rated movies and I could get in. I can't imagine how I got into these places, but I could get in and one of the movies that they were showing was the story of O and I fell in love with the movie and not even from a sexual aspect, but from wanting to understand what was happening in that movie. And so I saw the story of O and I read the book. I still have the book. I still have my copy of that book that I got. I read the story of O. I saw the sequels and so in my mind to be loved meant giving yourself to someone as the greatest gift. That was the essence of the story. She loved him so much that she could give herself and that's what I wanted to do. I wanted someone to love me so much that I could give myself to them as a gift. And so I set out finding that person. Ironically around that same time Mandingo, the movie came out and I put the two together. So I had on one hand the story of O where she willingly gave herself and then on the other hand, I had Mandingo, but I saw him as a big proud strong African black man and I wanted to be that I want to be big. I want to be strong. I want to be handsome. I wanted all of those things that he was and I wanted to give myself to someone as a gift and that's how I started searching for that person and I found him. I met this guy. I was living in San Diego at the time. I was in ballet school in San Diego as a matter of fact and I was considered the bad boy of the school. I can't imagine why but I would I love motorcycles and there was a guy in town who had a motorcycle and I would get on the back of his motorcycle. He right me around and one day he said to me, if I could get my handcuffs on you, I will do anything I want to you and I agreed to this. He took me to the hotel and he said to me again, if I get these handcuffs on you, I'm going to do whatever I want and I agreed and in seconds those handcuffs were on and I was so shocked that they were on. I couldn't even fight back but he got them on me and he pounded me in the chest. He spit on me. He kicked me. He pissed on me. That was my first piss experience. He did all those things that deep down I wanted him to do. I wanted him to earn me. I guess it's what I'm saying. You know, if you want me, you have to fight me and that was my thought and he fought me and he made me submit to him and at that point I was his and I willingly gave myself and that was that was my first real BDSM experience. Wow, that's very intense for a first experience. I loved it and it wasn't intense for a first experience, but it was exactly what I wanted and it was what I was looking for all that time. I knew that I wanted someone to make me submit and once it happened, then I felt like I've arrived. Now I understand all of this. Obviously, I didn't understand all of it because you know, in my young mind, I thought, well, now that we are together and you've done this, this is a forever thing.  It's not a forever thing for everyone. Some people, yes, some people not, but I learned a lot and I love that experience. You also have mentioned mentorship and when we prepared for this interview, you mentioned some very big names that you can identify as personal mentors to you. You brought up Tony de Blas, for example, Mr. Marcus Verne Stewart, Alan Selby. Who were these? Alan Selby was the owner and founder of Mr. S Leather and that's where the S comes from. It's Selby and when I was 26, I was living in San Jose because I had gone to San Jose State and graduated from San Jose State and I was hanging out in the Leather bar there and some guys came up to me and said, you know, we've been watching you, which is the way it happened back in the day. You didn't just walk up to Leather people and say, hey, I'm a Leather person too. Let's hang out.  And so I felt I knew everything to do. So I hung out in the Leather bar. Eventually these guys came over to me and they said, we're starting a Leather club here and we want you to be part of this and the club was called South Bay Leather and Uniform Group, also known as Slug. Um, and I think now they're the Santa Clara Leather Association, but there's still an existence and the club was forming and I was one of the founding members of that club and my first job was to go to San Francisco and be mentored by Alan Selby for the summer and they gave me that job because I had been a dancer and they wanted the club to put on a contest, a Leather contest.  You have stage experience. You should learn how to put on a contest because it'll make sense to you. So I and I drove to San Francisco. I went into Mr. S, which was a little house at the time and I walked in and I said, I'm looking for Alan Selby and I heard this big British voice say, well, that's me dear. And he said, let's go and we got in my car. We drove to the Eagle for the Sunday beer bus and for the whole summer I was with Alan Selby every Sunday at the beer bus and because I was with Alan, I met everyone else. So I met Vernon Stewart and Mr. Marcus and Tony de Blas and all of the Leather daddies and I was looked after again for a complete summer and I grew to know and love these men and they were definitely the men who took care of me. And it just so happens that I was dropped in their laps and I always say that because I arrived not knowing who any of them were and they just happened to be audience. I'm sorry for the benefit of the audience. Why don't you give us a couple of words about each of these men so that people can understand why they were so significant. Alan Selby, I mentioned that he was the founder of Mr. S. Leather and all of these men were very, very deeply involved in the Leather community in BDSM and the Leather clubs and Alan Selby is considered the mayor of Folsom Street and he took such great pride in being south of the market and his house was actually on Folsom and his back door faced Ringgold Alley and at that time in history, young men would go to Ringgold Alley and hang out in the alley and cars would drive around and eventually you'd get into a car, you'd go off with that person, you'd have sex or play, they'd bring you back and then you either wait for the next car or go off with your friends and it was one of those times when everyone knew everyone and you didn't get into a car with anyone that no one knew and because Alan's back door faced Ringgold Alley, he would be on his back porch watching and there was a rule that if we were ever in trouble, we would go to Alan's house and so at any point, you know, it could be two or three in the morning, you could go and you knock on Alan's door, Alan would always answer, he'd always let you in, you could go up to his apartment and you could sleep, you could rest, you could eat. There were times when there'd be three or four people on the floor, someone on the couch, people sitting in the bathtub, there were just always people there and everyone knew you go to Alan's place when it gets too late and if you've been drinking or whatever or if you feel like you're in trouble, you go to Alan's cell B. Philip Turner was another one, he was the disciplinarian of all of them. Philip would call me into his office at least once a week and he would say to me, I know what you did, don't make daddy sad, don't make daddy angry, I want you to make daddy proud. What are you going to do, boy? Make daddy proud, make daddy proud and I'll get out of here and that was a weakling thing with me because I was always getting in the trouble. You know, I was young. I was adventurous. I was spirited. Vern Stewart is the one that really taught me the responsibility of being a black leather man. In fact, when I was running for my title, which was International Mr. Drummer, Vern said to me, none of this is about you. This is about all of us and he meant it and I knew it.   So it did, it had a lot of responsibility to be the first and only black Mr. Drummer. Yeah, Tony de Blas was the editor of Drummer Magazine at the time, publisher of Drummer Magazine. So I was with all of these men all of the time. I could easily say Thursday through Sunday, we were, we were doing something. There was a fundraiser. There was a dinner. There was a benefit. There was a something all the time because AIDS was ravishing our community and money had to be raised. And I want to say about this about Alan. Alan firmly believed that everyone deserved to be touched and people needed to be touched. Every Sunday, Alan would go to a ward. I think it was called Ward 5B and he would give a massage to all the men in the ward who were suffering from HIV AIDS. And that was a thing that he did religiously. He never missed that. And it taught me to not be afraid to not be afraid to touch that, you know, as men as people, we need love. We need, we need that. And Alan really embodied that. One of the other men I would love to mention and he's still alive. Dirk Daener from Toma Finland Foundation. I met Dirk walking down the street in LA. I was to emcee an event and I was lost and I was in full leather and I saw a man in full leather. So I thought, well, he must know where I'm supposed to be. So I went over and I and I said, excuse me, I'm lost. I'm supposed to be at a leather event. Do you know where I'm supposed to be? And Dirk said yes. And so he took me to the event and said, when you're done here, come find the Toma Finland booth because this was LA pride. And so when I was done there, you know, I do what I'm told. I went to the Toma Finland booth and I asked for Dirk and everyone at the booth behaved like, you know, I was asking for the pope. So, you know, eventually they got Dirk and Dirk came out and he taught me everything that I need to know about art and and the preservation of art and the beauty of iconology and, you know, how we view ourselves as leather people that this all comes from someplace and the images and all of that I learned from Dirk and and how to how to not take things so seriously.   Is it? And so, you know, he would always say those things to me. He did always say, also, remember who you are. That was another one of Dirk's lines because, you know, I get in the trouble and he would say, remember who you are. And again, those were lessons that I was learning from these people without really understanding who they were in history, but they were there and they were teaching me. Let's take a step back to that because when we prepared for this interview, you said that these fine gentlemen groomed you for success and that that you really didn't have an option not to succeed because they had set that up. Now, I'd like you to talk a little bit about that particularly as it relates to being Mr. Drummer. All of the men that were around me at that time were were community minded men and also at that time the title holder system was really taking off and title holders were being given duties. Fund raising was big in the title holder community giving speeches, representation. All of that was was happening because the title holder system didn't start off that way. It basically started off as poster people, poster boys, but then responsibility happened. And so early on, I went to Alan Selby to learn to produce contests and that was my job to learn to do that. And as time went on, I realized that they were preparing me to do that very thing to hold a title. And so I was constantly being given jobs. I was being taught responsibility. I was being taught how to present myself in public. Again, that's why Philip Turner was always calling me to his office and saying, don't embarrass daddy because he wanted me to present myself in public. And so by the time I ran for Mr. Drummer, I had been groomed by all of these men really unbeknownst to me. It just seemed like the thing to do. They knew when I was ready to run for a title. And I was expected to win and not in a way that was pressurizing. It was I was expected to win because I had been taught by the best. And when I lose, it didn't really matter. The only thing that mattered was I present myself well and I knew if I present myself well, I will do well in this contest. I'll tell you another little funny story. So in my judges panel for the Mr. Drummer International, Mr. Drummer were race Bannon, who's a really, really, really close friend still today. We talk pretty much every day. There was Michael Bales, who was head of Michael Bales studios. There was another name for back. I can't remember right now. And there were a lot of heavy hitters in that in that judging panel. Tony de Blas, again, all these names. And in my interview, I wore cut off shorts and boots with my socks, two fingers above the top of the boot because that's what Philip Turner liked. The boots were for Alan Selby. He only liked boots. I wore no shirt and I had on a vest and the vest had been given to me at an auction that I was working because I had no leather at that time. And I was wearing this vest. So people could auction it off and the auction buyer gave me the vest. He bid on it for me and walked up and said, it looks good on you. You keep this. And so that's what I had on in my interview and everyone else was dressed up. So when they asked me in my interview why I was wearing what I was wearing, I said, because this is what I wear. You know, I'm a leather boy. I'm a leather man and this is my uniform. And so I was asked if I were ready to be a Mr. Drummer and I said yes. And the next question was, well, you know, Mr. Drummer appears in Drummer Magazine and he will be on the cover of Drummer Magazine. So I took off my clothes because I figured, well, if I'm going to have to do a layout in a magazine, then I'll show them that I'm okay with that. So I took off all my clothes in the interview and I stood there and Michael Bell said to me, do you think you're slick? And I said, yes. And so from that point on, he always called me slick. Anytime he would call, he'd send me letters and he'd always address them to slick. So again, right there in the midst of all these men who were making a difference and there was me being taught that I need to make a difference also. But let's come back to the actual title there. You created a bit of controversy with all of this. Tell us about that. What happened? Being the first black Mr. Drummer came with a lot of responsibility, but it also came with a lot of racism. And again, growing up in our little Bay Area bubble, it wasn't something that I was expecting, but a big deal was made out of me being the first black Mr. Drummer. And there was a lot of pride, a lot of pride with black leather people and a lot of pride with the people here, but there was also fear of, oh no, there's going to be black title holders now because there had never been a black Mr. Drummer. And if I'm recalling correctly, there had only been two black International Mr. Leathers and only one black International Miss Leathers. So this was new to people who were not black. They weren't used to seeing black international title holders. And so I was the first black man on the cover of Drummer magazine and to this day, it's, it's, I do believe it's the biggest selling Drummer magazine that was ever done. However, there were other magazines that did not want me on the cover of their magazines because they felt that the black man wouldn't sell their magazines and there was a famous one. I don't know if I could say that here or not. But it's your call. I will say it because there's a, there's a portion of it that I want people to know. So at that time, the, the Leather Journal would always put the new Mr. Drummer on the cover of the Leather Journal. And I wasn't on the cover. And so when Drummer magazine inquired why I wasn't on the cover of the Leather Journal, they were told that they didn't want to put a black man on the cover because no one would buy the magazine with a black man on the cover. And it caused a bit of stir with Drummer magazine, of course, but then I didn't tell a lot of people because I just didn't feel that it was important enough. I wanted to do my job as Mr. Drummer and my job wasn't to be on the cover of the Leather Journal. So I went about doing my job. People inquired and I let it go. But a few years ago, I was in a chat room with members of Onyx. Onyx is a BDSM kink club for men of color. Yes. And I was in the chat room and we were talking about representation. And I just happened to mention that, you know, well, as Mr. Drummer, I was never on the cover of the Leather Journal. And as you can imagine, there was disbelief, outrage, but then you have to remember also this was 1993 and the world was a very different place then. But luckily for me, Dave Rhodes, who is the publisher of the Leather Journal, was in that chat and I have to give him credit because he spoke up and I didn't know he was in the chat. He spoke up and said, that's true. I did not put him on the cover because he's black and it was a mistake and I'm sorry for that. And I have to give Dave credit for speaking up because most people I think would have just gone away or not said a thing. And he also, when I saw him in person, he apologized then and he's made good on that. He last September, I was on the cover of the Leather Journal and I wanted people to know that story and not just think that, oh, here he's just being on the cover of the Leather Journal. I was on the cover of the Leather Journal because it was making up for something that had happened in 1993. But I definitely want to give them Dave credit for speaking up and taking ownership of that. Wow. That's profound. Yeah. Yeah. Now, when we prepared for this interview and you've alluded to this a little earlier, you mentioned that the work you do in the community is not for personal fame, but for historical importance. Talk with us more about that. What does that mean? We talked a little bit about the men who groomed me and all of them worked until they couldn't work any longer. I was with Philip Turner during his last days. Alan Selby during his last days. Mr. Marcus, I was with him during his last days. And so what they taught me was you don't stop. You just keep going and you do the things that you're supposed to do that you've been trained to do that you've been taught to do and they did it and they worked until they couldn't work anymore, which means I work until I can't work anymore because that's what they expect from me. And I talked to Queen Cougar a little bit about this when we were doing things in the early days. It wasn't because we thought we would be important someday. It was because it's what you do. You know, when you're given responsibility, when you're part of a community, you do what you're supposed to do. You're part of a bigger picture. You're just a cog in the in the wheel and we're doing what we're supposed to do because we're part of something. It had nothing to do with wanting to stand out or be famous or do a fireside chat 40 years later. It was only this is what we're doing today and we're going to keep doing these things today. And that was 40 years ago. What do you think has been or is the legacy of you being the first Black Mr. Drummer? I think the legacy of me being the first Black Mr. Drummer showed other Black men and women that we don't have limits. I think that Black people especially we put limits on ourselves thinking that we can't do something because it's a white thing. No, as I was growing up, leather was a white thing and Black people outside of the leather community viewed us as wanting to be white. When my viewpoint was always I want to do everything that everyone else is doing. If people are having BDSM and kink and doing those and playing, I want to play. I want to experience those things. It doesn't matter if I'm Black. If white people can do it, I can do it and I could do it better. That's basically the way I looked at it, you know, but outside of the Black community, outside the leather community, the Black community was not in favor of Black people being in the BDSM and leather. In fact, still isn't in favor of that. There's a lot of backlash that Black people face because of BDSM and leather, especially when it comes to terminology, words like master and slave and boy and all of that. So I hope that my legacy is showing Black people that we don't have to put restrictions on ourselves based on someone else's interpretation of who we should be as Black people. We can make those decisions. We can be in the BDSM. We could do whatever we want because other people are going to enjoy it. We can enjoy it. Very profound statement. Very profound. An interesting bit here that you brought up when we prepared for this was that you saw the very first Imzel, Judy Tallwing McCarthy, you saw her win. That's a historical moment. Tell us a bit about that. Being at the first International Miss Leather contest, just like meeting Alan Selby, was a drop in the bucket for me. It was being in the right place at the right time. I had no idea that the first Imzel would be historically important. I had no idea that Judy would set the stage for women to come because she is Native American. And so for the first International Miss Leather to be Native American was huge. Again, like being the first Black Mr. Drummer, being the first Imzel to be Native American showed other women of color. I can do this too. It's not a white thing and Judy is still here.  Judy is still working. She's I call her mother because that's who she is.  And I remember being at her contest and seeing her on stage as she had on Native American garb and she made a point to let people know that she is Native American, that she belongs here. She is indigenous. She and her people were here first and that that moved me. That that made me and helped me realize that we all have a place here and there's going to be first forever. You know, there's a first Imzel. There's a first Black Mr. Drummer. There's going to be first forever in history and to be part of that and the witness part of that, you know, I didn't think much of it at the time, but looking back, it was significant and I just happened to be in these places with these people.   So I want to say that especially early on the the people of color and Leather bonded. No, we we may have had differences, but we always kept those differences to ourselves. We presented to the rest of the world and United Front, and that's what the world needed to see. And that's what we showed the world that, you know, as people of color, we're not going to have the drama that you're expecting us to have. We are going to show you our strengths and not our weaknesses and, you know, knowing Judy, knowing by knowing King Cougar, knowing Jill, knowing all those very strong women, you know, that gave me a sense of belonging. Are you a community elder? It's it's it's being a community elder. I don't really know what that means. I think that other people see me as a community elder. Some people like me. Some people don't. That's all part of it, but I feel like I'm 30 years old, and so when I meet people who are younger and they say things like I look up to you, I think why? Because, you know, I'm just a kid. I still have things to do. The other day on one of the apps on one of the hookup apps, I got a message from this really good looking guy and black guy and he went on to say that he had seen one of my podcasts and how much he enjoyed seeing me there and representing and all of that.   But, you know, people see us differently. I don't see myself as an elder. However, I do know who I am. This Dirk would always say to me, remember who you are. I know what I've done. I know where I stand. I know the influence that I have. I know the ability that I have to work with other people. I understand all of that, but that's just what I was taught to do. That's what I was trained to do. So to me, I'm just doing what was expected. You're working on an interesting program right now called On Guard with a couple of other very big named people. Tell us a little bit about that. What are you guys doing with that? On Guard is a podcast of, we describe it as four old guys sitting around talking and it came about because the guys on there, I mentioned Race Bannon was a judge at my International Mr. Drama Contest and that was in 93. That's almost 30 years ago. Mr. Christopher worked with me back in the mid 90s. I was working at Brush Creek Media as a video producer and Mr. Christopher was the director. So when we all get together, we talk and we laugh and most of our talks are always about the good old days and the kids these days and what the kids are doing and we see each other once a week at least because we're either out at the bar. We're at each other's places smoking cigars. And so at one point we thought, well, Mr. Christopher thought, we should put this on the air because that's what we do. We're old guys who like to sit around talking about the good old days. And then we started comparing our good old days to what's happening today. So the podcast is about taking a topic and looking at it through our eyes of being old men and we don't say we're old guard because that has that has this connotation of being, you know, old white men sitting in the back of some crowded room making rules and that's not what it was at all, but we are old guys who'd like to talk about, you know, our experiences and so that's what we do now. Chris calls us classic guard because that sounds a little bit better than old guard. So we're classic and what's really funny is of the four of us, I'm the most conservative. You didn't you did forget one person though. You meant you mentioned Mr. Christopher and Reese Band and the pig. Yes, because we don't want to forget. We can't forget the pig.   And so, you know, we do we get to sit around talking about the good old days. Yeah. And being classic guard. I like that very much. What's the biggest misconception about you? The biggest misconception about me. People don't know that I'm shy. I'm extremely shy and not only am I shy, but I'm very much an introvert and no people who've traveled with me, especially race, race will tell you this usually when I'm on the road going into a leather convention or a contest or something. If I have a duty there, I do that duty. You know, I check into my hotel. I go to my room. I order room service. I study. I go over my notes. I do all those things. I stay away from the general public because I have a job to do. And because I'm very shy, I get really nervous and crowded rooms when I have to be myself. It's much easier to be Mr. Drummer or an elder or one of those people. But when it comes to being Grayland, Thornton, I panic and I've always been that way. Part of me being a dancer was had to do a lot with that because on stage, I could be anyone I want and I've been on a lot of plays dream girls and once on this island and on stage, I love being on stage. But when it comes to going to the cocktail party, that's where there's a problem because my shyness comes right out. So people don't don't believe that, but I am really, really shy. Grayland Thornton, I would like to thank you for an amazing interview for Inside Leather History of Fireside Chat. Doug, thank you for including me.  It's important. Can I just say that I really miss a lot of men that we talked about earlier, Mr. Marcus and Alan Selby and Philip and all those men, Vern. And I know you've done some chats with Vern, but I really wish that this sort of thing had happened with some of those other men because they're gone now. And one of the things that I try to do with the younger people, especially the Onyx members, is pass down the words that these men said to me, you know, when I'm talking to the Onyx kids, they think that I'm, you know, I'm being profounder on I'm making up things or these are my words, but they're not. These are just things that have been said to me years ago and we're passed down to you passed down. And and I think this my job to keep those men alive, to keep Alan's words alive, keep Vern's words alive because, you know, recordings weren't made of them. So I'm hoping that, you know, years to come, young people will repeat things that I've said to them and remember that it wasn't me that said it originally. This came from Vern Stewart. So that that's what I'm hoping comes with this.