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As I was travelling along a deserted road on a Sunday last month I saw in my peripheral vision a disconcerting flash of light behind me. Much as I tried to convince myself that the flash was due to the low lying position of the sun, I knew in my heart of hearts that the light was caused by a speed camera. Unfortunately, I was proved right and a week or so later I got a letter from the police and an invitation to attend a Speed Awareness Course. It was either that or three points on my licence, so the decision to attend pretty much made itself really.

The course was held at a hotel in the middle of Swansea Industrial Estate and the people attending were a cross section of local society. There were a few young girls, three portly middle aged men outraged at the injustice of it all, an elderly man who looked as if he shouldn’t have been driving at all, a few angry women who sat down with crossed arms right at the front and a belligerent pregnant woman who was all too happy to announce that she had undertaken the same course multiple times in the past.

The course started when an overweight moustachioed man invited us to look at five pictures of various UK roads and asked us to guess what the speed limit was. Everyone was pretty much guessing different things, sometimes angrily so. He finally tried to regain control by starting a video of a car travelling through some village that looked to be in the Cotswolds and asked the audience to shout out all the hazards. Again, some people were calling out everything; the man in the hat could step into the road, the bus could swerve into the car, the shop could collapse, the water main could burst, that van could contain a dirty bomb and the roundabout might have been constructed over an ancient plague pit. One or two of the others refused to recognise a single hazard.

Stopping distances were discussed next. A video was shown of a car speeding around a disused runway where the stopping distance was measured at 30mph and 31mph. Where the car stopped at 30mph they then placed a pile of boxes adorned with pictures of children and, rather predictably, when the car was travelling at 31mph the boxes flew all over the place. There was a subtle soundtrack of children laughing and playing as the video was suddenly slowed down and a grim faced, also moustachioed man but in a hi-vis jacket this time, appeared on screen and told us all that speed kills. The scene then faded to police blue adorned with a few logos and the quasi fascist tagline of ‘It’s easy when you know the rules.’ Our presenter then switched the video off and shook his head sadly at the senseless loss of box children life. To brighten the mood he then asked us to open our workbooks to page three and fill in the box about how we would feel if we drove into a pedestrian. To aid discussion he asked each table to discuss things amongst themselves. There was pretty much universal agreement that driving into a pedestrian was a bad thing. The teenager in the cheque shirt wrote on the big piece of paper the word ‘guilty’. The angry middle aged woman wrote ‘shame’. The tired looking new father who had driven all the way from Pembroke Dock to attend the course shrugged and wrote ‘sad’. There was also universal agreement that the course was condescending, patronising, boring and depressing.

A change of presenter meant another different moustachioed overweight man then took over and asked us to turn to page four of our workbooks and asked us to fill out the section about what makes us stressed when driving. Lastly, a useless acronym termed ‘COAST’ was discussed, with the presenter imploring that actual ‘coasting’ was a thing to be avoided at all costs. It turned out that ‘coast’ was such a useless acronym anyway that I doubt if anyone anyplace ever remembers what it stands for.

 

 

With this wonderful speed awareness course in my mind I went back into work and discovered that a problem had developed in my absence. There was a bit of a delay in waiting for a pharmacy pathway to be signed off for intravitreal injections and in the meantime doctors had to sign off every single injection for age-related macular degeneration (AMD). To counteract the annoyance of this, doctors were signing sheaves of papers at a time so that the non-medical practitioners could carry on in the meantime without having to seek a new signature each time for every single injection. One of the nurses had become aware of this and decompensated badly, writing a group email to everyone saying that signing multiple sheaves of forms was immoral, unacceptable, unprofessional and was outlawed.

It was then that I had my ‘Road to Damascus’ moment. The two situations were exactly the same. The speed awareness course and the pointlessly aggressive email were both identical. Are we such faulty people that we should be talked down to about the very obvious? Were we so liable to do harm to ourselves and others that we need rules governing every single facet of our lives? Rules exist for a purpose; to protect the weak from the strong, to keep order and avoid chaos. Unfortunately we have become so mired in the minutiae of the rules that we forget the big picture.

The purpose of signing multiple sheaves of papers for the AMD clinic is to get patients their sight-saving injection as efficiently as possible. The upcoming pathway would have dispensed with the need for the signature box anyway. Common sense would therefore tell us that despite being technically against the rules, getting worked up about that to the extent of becoming angry is to display a complete apathy toward the overarching purpose of the whole service. Similarly, the rules make people with borderline sickness stay at home, result in cataract lists cancelled due to some factor not quite right somewhere, result in reduced clinic capacity rather than enduring a few late finishes sometimes, and cause perfectly usable medicines and machines to be thrown away after a certain date.

On the other hand it is true that the likelihood of my being caught again doing 46mph on a deserted Swansea Valley 40mph road on a Sunday is significantly reduced. And it is also true that I now know that there were 24,831 serious injuries on UK roads last year and 1793 people killed. The total cost to society of all this death and carnage is 39 billion pounds. Which in fact is about the same as Brexit, the moustachioed presenter had joked. Which proves that people are inherently bad at judging risk, so perhaps such a course is needed. Perhaps if 17,410,742 people had attended a Brexit awareness course we wouldn’t be in this mess now. Because it’s easy when you know the rules.

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CONTRIBUTOR
Gwyn Samuel Williams

Singleton Hospital, Swansea, UK.

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