Posted by: sayamika, the killer bunny | 2008 April 1

The MOT

In most jurisdictions, physicians are meant to provide information to the ministry of transportation about patients who have “a medical condition which may make it dangerous for the person to operate a motor vehicle.

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They are provided with a list of conditions, which is not exhaustive by any means. One such list:

Diabetes or Hypoglycemia or other metabolic diseases- Uncontrolled
Mental or Emotional Illness-Unstable
Dementia or Alzheimer’s
Sleep Apnea-Uncontrolled
Narcolepsy-Uncontrolled
Motor Function/Ability Impaired
Alcohol Dependence
Drug Dependence
Seizure(s)-Cerebral
Seizure(s)-Alcohol related
Heart disease with Pre-syncope/Syncope/Arrhythmia
Blackout or Loss of consciousness or Awareness
Stroke/TIA or head injury with significant deficits
Both Visual Acuity and Visual Field Impairment
Visual Acuity Impairment
Visual Field Impairment

Docs have to report people with these conditions to the ministry, at which point the ministry undertakes to ensure that the person in question is evaluated for road safety. With some folks post stroke, for example, the testing can result in restoration not only of a driving license but in self-confidence after a solid pass.

I have had a few days in the diabetic clinic here, and one thing that really doesn’t surprise me about a lot of teenagers with diabetes is that, like most other teenagers, they are immortal and invincible. They are totally normal and they shouldn’t have to do any ridiculous blood sugar testing, whatever their parents say. They can invariably “tell” when their sugars are high, and from this feeling, independent of blood sugar testing, they stochastically choose boluses.

Kids are great at repeating back what you want to hear and then going their own way. Kids hate that their glucometers tell on them.

They also know when they have screwed up. They often think the doc and the team want to punish them for poor diabetes control.

It takes a lot of effort to convince a kid that this control is for nobody but herself; that the damage won’t be to the team or to her parents, but to her own feet and kidneys and eyes. We saw a kid who, when warned that she needed to get control of her diabetes and test at minimum four times a day plus before driving by the time we saw her next, rolled her eyes and asked, what if I just don’t show up?

We talk to the ministry, is what.

No, it’s not a punishment, whether it feels that way or not.

In this country, a driver’s license is not a right, but a privilege.

PS. Narcolepsy? Really?

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