The Age - Saturday 22 April, 2006

Driven to destruction

By Roger Rees


Car design and road conditions are not the main causes of traffic deaths and horrific injuries. It is our thinking that needs to change, writes Roger Rees.

THERE is a game traditionally played in Afghanistan called buz kashi, which comes from the type of competitive riding the Mongols went in for. On a great occasion some 300 men from different tribes would turn up to compete. The players in the war game of buz kashi do not form teams. In buz kashi the players ride with cold, often brutal, but brilliant intensity.

They are not absorbed in playing, they are absorbed in winning. Winning means to ride towards, snatch up and carry the 30-kilogram carcass of a headless calf to a prescribed circle, defending it against all challengers. This is not a sporting event, there is nothing in the rules about fair play. The game is won by achieving this single goal.

There are two fundamental differences between buz kashi and driving on Australian roads. First, driving on Australian roads is infinitely more dangerous than the game of buz kashi. Secondly, there is much preparation for buz kashi, as the riders and horses have trained carefully for the event. The discipline required and strategies for anticipation and manoeuvre have been handed down since the time of the Mongol dynasty of Genghis Khan, beginning in the 13th century. In contrast there is next to no preparation for driving a motor car.

"Ninety people killed on Australian roads in the week since Christmas". So read the headline, repeated in different form in every Australian newspaper over the Christmas/ New Year period. Since then it has only got worse. Six dead in Mildura. Five dead in northern Tasmania. Another 21 killed nationally over the Easter break last weekend. Untold pain.

But these very public tragedies account for only a small fraction of the real road toll. Multiply the roughly 1750 people killed on Australian roads each year by four and you begin to get close to the number of people who experience disabling brain injury. Each year 30,000 people end up at Australian hospitals with some form of brain injury, most from road accidents. The injuries range from minimal to profound.

The large majority recover, but some 8000 experience disabling effects for many years, and 2500 people each year are so seriously disabled that they are dependent for the rest of their lives. This group never work again, even though most are in the prime of their lives and should normally expect another 30 to 40 years of productive employment.

At the end of each decade the population of people who have suffered severe permanent brain injury, largely as a result of road accidents, is equivalent to a country town the size of Mildura. The mean age of this group of brain injured people is about 28, with a a ratio of 3.5 males for every female.

The blame is all too easy to spread around. The "appalling" state of Australian roads is one popular theme. South Australia's Royal Automobile Association attributes that state's high accident rate to inadequate State Government spending on roads. A recent survey of Queensland drivers carried out by the Royal Automobile Club of Queensland likewise nominated improved road conditions as the best way to reduce the toll.

Some espouse airbags as the solution, despite evidence that even in head-on smashes airbags are of limited use. Professor Jack McLean of the Centre for Accident Safety Research at Adelaide University says the fitting of air bags represents a marginal safety benefit of "between 5 per cent and 15 per cent depending on the type of collision". (Wearing seatbelts, mandatory since 1970, reduces injuries by 45 per cent, he says.)

Others cling to the belief that the statistics can be turned around with better vehicle design. A Queensland government road safety summit in February targeted improved vehicle technology as the way forward and began with a commitment to introduce alcohol ignition locks in cars owned by repeat drink-drivers.

It is true, of course, that design matters, and that manufacturers need to think not only of a car's occupants but also other road users. Four-wheel-drive vehicles are a case in point. They may be tougher, capable of moving on ever steeper inclines, protected by their huge alloy bumper bars. But are they really safer for the driver or the pedestrian? At higher speeds or on wet roads they are less stable than the conventional sedan, and, because of their height above the road, drivers are less likely to notice pedestrians.

(Motor bikes, of course, are in a category of their own. If you ride motor bikes, you are 16 times more likely to have an accident than if you drive a sedan.)

Overall, however, there is nothing wrong with the modern car. Nor is there anything very wrong with our roads. Despite the criticisms, we have relatively safe roads that are continually being improved. Rather, it is the lack of preparation for the journey and the aggressive, irrational, often non-thinking behaviour that all too often characterises the driver. Put simply, our road toll is high because we are not using our brains. And the main casualty in these accidents is, paradoxically, that most powerful and delicate of human mechanisms, the brain.

This lack of clear thinking manifests on an individual level and a broader social level. Underlying our road toll is a general mindset that says that these casualties, or at least a good proportion of them, are an inevitable part of modern life the price we have to pay. What would happen if more than 100 Australian soldiers were brought home each month in body bags from Iraq? There would be a public outcry and the Government would inevitably withdraw our troops.

Maybe some more vivid details from accident reports should appear in the media to help us be more aware of this madness. Something like this: "The metal of the station wagon smashed into the driver as he was hurled into the windscreen. The tendons in his right hand and foot were severed and his left arm, his face and belly were gouged. Chunks of muscle were ripped from his right hip and thigh, and blood from his broken nose and smashed face covered the air bag."

I suspect that even this, with accompanying photographs, would have little effect because people watch this carnage nightly on television or DVDs as part of regular entertainment. The more horrific the movie the better the ratings. Is this insanity?

We pride ourselves on being a scientific society; that means a society in which knowledge and its integrity are crucial. This involves behaving appropriately and therefore safely. Yes, the human brain is an instrument for action, but before action it has to be an instrument for preparation. The effective organisation of such behaviour is lodged in the frontal and prefrontal lobes of our brains (the areas most susceptible to damage in road accidents when soft tissue is bounced around inside the hard confines of the skull).

These lobes enable us to think of future actions, make plans and wait for a reward for them. One reward is arriving home safely because we have thought through journeys in advance. Sociologists call this the "postponement of gratification".

Yet, the urgency so often involved in driving, the need to overtake even in hazardous situations, the thrill of high speed central to car advertising are all examples of immediate gratification.

Impulsiveness and aggression are a principal, yet rarely identified, cause of almost all accidents. Their roots lie within the individual and society. On the one hand there is the person's state of mind, and on the other the environmental stimuli aggressive advertising, the easy availability and social acceptance of alcohol or drugs, and ultimately a culture that does not stress careful preparation for the journey.

Given that road travel is a central part of our culture and that learning to drive is a priority for most teenagers there needs to be long preparation for this daily, high risk activity. Take the test and obtain the P plates: this is hardly the long and sustained preparation required for the war game of driving on Australian roads. Instead we need to approach a trip to the shops with the same single mindedness as needed for a game of buz kashi. The goal though, instead of victory over our fellow drivers, is to arrive safely.

This involves a radical rethink in the way we teach our young people to drive. It is not enough that they simply learn the basic physical and technical skills needed to direct and control their vehicles; they must be taught how to think. Firstly young drivers (and many older ones) need to understand that their feelings are created internally as a result of their own ideas and thoughts the language they use to talk to themselves. They need to understand that when they are tense, anxious, angry or just tired these feelings generally result in poor judgement and often impulsive and risky driving.

When the self talk is negative and aggressive "Get off the f--king road, you halfwit," or even "Do you think I've got time to wait for you!" then the person's perception is distorted. For them, other drivers become enemies. The risk of fines shrinks to a mere pinprick of annoyance. Then he or she unthinkingly believes they can overtake on a bend in the face of oncoming traffic, or far exceed the speed limit on a gravel-edged country road. When this happens, the correspondence between perception and response breaks down and aggression becomes maladaptive, violent and dangerous.

For drivers, the cost of such extreme language and behaviour severe brain injury and death for themselves or others far outweighs any short-term benefits. Each week I observe the disabling and tragic damage to young lives. On just one 20-kilometre stretch of the Victor Harbor road south of Adelaide four deaths and 20 serious injuries occurred on average each year from 2000 to 2005. Exceeding the speed limit, impatient and intolerant behaviour were the major causes.

New drivers also need to know that they, and they alone, can learn to control their own thoughts, and to translate this into constructive driving behaviours. There are a couple of simple techniques that if practised can become as automatic as putting on a seatbelt. The first it to visualise the trip ahead a brief mind map of the route you will follow and to imagine arriving safely.

The second is to repeat to yourself a phrase a mantra if you like that will help put you in the right frame of mind for the journey. In my work with young people with brain injury, I sometimes have them read from the late Judith Wright's poem Homecoming: "Spring and the road is plushed with tender dust. The house waits near and is expecting him/" How much harder, with your mind filled with language such as this, to see the world as your enemy.

A simple piece of research could demonstrate the benefits. Let us suppose that 100 people in the high risk 16-26 age group are given training on co-operative driving. The training might involve videos, lectures and demonstrations, as well as role playing, anger management, problem solving and practice.

The program would focus on developing each person's self-awareness, imagination, conscience and feelings in relation to themselves and other road users. At the end of this brief period of training, we would choose, at random, another 100 young people within the same high-risk group who had not received any such training. Then, over time, we would compare their lives and their experiences of road accidents, assault and high-risk behaviours such as binge drinking and drug taking.

We could call this project "A week of gentleness in the life of Australia". My hypothesis is that the trained group would experience significantly fewer accidents and traumas than the untrained group.

The opportunity to drastically reduce the death and maiming on Australian roads teeters in the balance. But it can only happen if we are prepared to change our thinking, language and behaviour. There will always be a sense of uncertainty, but we cannot maintain an informed integrity if, given our current knowledge, we allow the situation to continue a situation in which we are driven by a ragbag of aggressive, irrational behaviours.

Ask anyone with severe, permanently disabling brain injury whether a change in thinking might have altered their lives.

Roger Rees is Emeritus Professor Disability Studies, School of Medicine, Flinders University. His latest book is Interrupted Lives: Rehabilitation and Learning Following Brain Injury , Melbourne IP Communications.


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