The Hazards of Driving

Driving is one of my least favorite routine activities. For as much as people complain about the MTA in New York City, the extensive public transportation is one of the things I miss most about living there.

I have never been a good driver. Within the first several months of having my license, I ran a stop sign on a two-way stop street that I thought was a four-way stop and hit another car. Not only did I misread the right of way, I wouldn’t call what I did a “stop”; it was a yield at best. Thankfully, I was only moving about 15 miles per hour when I hit the other car, which didn’t have to stop, so she was traveling closer to 30. Bodily damages were minor, but the cars were not unscathed and my confidence in my ability to operate a motor vehicle vanished the moment that airbag inflated in my face. Rightfully so. As much as I’ve worked on trying to be a better driver, I have yet to feel competent and safe behind the wheel. My ADHD medication helps improve my focus, but it does little for reducing the anxiety that swells when I take the wheel because my problems driving safely are not solely products of inattentiveness.

The main issue seems to be my lack of proprioception and position sense. Similar to my hazards of walking, I have little awareness of where my body (or car) is in relation to other moving and stationary items. I crash into things multiple times per day with my shoulders, hips, or limbs. Door jambs, countertops, bushes, fences, boxes, you name it: I swipe it, catch my body on it, or topple it. One door frame in our old apartment was visibly darkened at the level of my shoulder from habitual collision. I have no appreciation for my body’s volume and especially none for its orientation relative to other items while I’m moving. This extends identically to being in a car, both as a passenger and driver. In the former, I’m just relegated to an anxious “backseat” driver, paranoid that my pilot has poor lane position and other cars are veering towards us as they pass. I hate highways for this reason. It always feels like the cars are not traveling parallel to me but closing in about to sideswipe us. I’ve learned that my best course of action is to not look out the window and stay immersed in some distraction phone process or reading material; the resultant carsickness is preferable (especially to the driver) to the incessant anxiety and frantic bracing of my limbs on the dashboard in preparation for a phantom collision. Over time, trust has been earned by most people who drive me, so I stifle my fears and avoid concerning myself with the passing traffic, even if it means missing the landscape.

Clearly when I’m driving, this is an impossible coping mechanism. I have to look. Not only do I still have the sense that cars or objects in my peripheral vision are coming towards me laterally, I also react accordingly, moving my vehicle unnecessarily and dangerously to one side or the other, often swiping things in the process. The right side of my car looks like it has race car stripe across its entire length: scars from the year I parked next to bushes that I collided with every time I pulled it in. There’s also a large dent on that side from hitting a dumpster. I can’t visualize my lane position and the moving cars around me capture my attention and distract me from staying attentive to the world through inside my windshield. On the highway, other cars often honk at me. I thought it was because I tend to drive obnoxiously slow (at least to Connecticut drivers) because I do have an appreciation for the fact that moving faster on the highway means my reaction time must be faster. They are honking because I allow my car to drift from the central position in the lane and encroach others, not because I’m not paying attention, but because I can’t tell where it is relative where it should be. I often think I’m correcting the position when I’m actually exacerbating it. I also noticed that I have to fight the urge to maintain focus ahead (where I’m going!).

My natural inclination seems to be to want to watch through the rearview mirror or side mirror. I have to fight my tendency to fixate on these targets and reroute my gaze appropriately ahead. As soon as I stop consciously reminding myself to look ahead, my eyes relax their focus back to their inappropriate mirror selection. Driving does not go well when you’re looking behind instead of ahead!

Lastly, it’s hard to control my thoughts while driving. For me, operating a car obviously requires dedicated attention but all of the rapidly presenting visual stimuli overwhelm my brain and monopolize its processing power. My OT has said this is an SPD issue and that many adults with SPD struggle with driving. My brain fixates on interpreting and organizing all of the visual cues coming in and it cannot filter out unnecessary “noise” (the color of that house, the number of people walking on the sidewalk, the license plate number of the oncoming car). All of the information is treated as equally important and it’s so superfluous that it gunks up the system and steals processing speed or mental RAM from appropriately tuning into and analyzing necessary cues. I imagine it’s analogous to setting a band pass filter to screen out certain frequencies of noise: a normal brain can filter out the clutter, the details of the moving surroundings, and gone in on the critical data. My brain completely lacks a filter and all visual messages flood in equally fast and loud, and are simply processed in the order in which they are received.

My eyes are like cameras set in sport mode, methodically snapping a series of pictures of my surroundings every fraction of a second, amassing enough stills that they could be viewed in succession and make a near seamless stop motion animation movie. The faster I drive, the faster my lens’ shutter speed and the higher the percentage of photos pile up. There’s no conceivable way to process the sheer volume that aggregate in even a single mile, let alone a trip of twenty or so and it’s frustratingly impossible to change my eyes’ setting to operate at a reasonably controlled rate. Essentially, my brain cannot keep pace with my eyes and I not only get a massive headache, but I fail to interpret or react to crucial main points in favor of useless details, should the details have been spotted first. Strangely, the visual inputs that evade processing when they inundate and overwhelm the processing speed don’t disappear. They seem to get stored in a holding area. Once visual information enters in a substantially slower rate (certainly when the drive is over but likely at the end of the day when my eyes close, ceasing the import of new input), each cue is systematically removed from storage and digested. I am bombarded with images of hundreds or thousands of images passed in the drive: useless details like car colors, passengers eating, bumper stickers, overgrown grass, a runner’s form as well information that should have caused adjustment in response to potholes, stop signs, traffic lights, brake lights ahead, a turn signal, etc. My mind will not welcome sleep until each picture is acknowledged. Too late.

There’s not an easy or favorable solution to this problem besides limiting the driving I do. I am extremely reluctant to drive, to the detriment of plans I’d like to make. I’m hoping that continued work in OT may improve my ability to filter out extraneous visual messages, but the interaction of factors that contribute to the hazard of my driving make it such that it’s unlikely that I’ll ever be a competent and secure driver. Eyes and a brain that collect and store endless visual information? I’ve got that covered!

 

 

All kidding aside, I severely restrict the amount of driving that I do, even though this is very limiting and sometimes prevents me from getting to places or seeing people that I’d like to visit. I know this greatly frustrates some people whom I’d like to see more, but thankfully, many are willing to visit me. I also like walking and biking and can often obtain rides when absolutely necessary.

 

I Keep Falling

I keep falling. In the past week, I’ve had three rather major falls of increasing severity. In the worst, I fell all the way down a flight of stairs, save for the very top step. I simply stepped down onto the first step and before I knew it, I was thumping down the entire flight on my back and landed with a big thud at the base of the stairs on the hard floor. My tailbone and sacrum have not yet forgotten nor forgiven the incident. In fact, I had to spend over two hours in urgent care yesterday, after deciding that instead of slowly resolving, the pain seems to be steadily progressing to intolerable levels.

I’ve mentioned before that SPD causes issues with balance, proprioception, body control and kinesthetic awareness, and overall stability. Therefore, I’m predisposed to falls and accidents and my physical history confirms this correlation. I’m guessing that the inattentiveness, impatience, and hastiness inherently symptomatic of my ADHD also contribute to the unintentional recklessness that characterizes my movements. I’m like a spastic marionette, blindly operated by forces outside of my conscious control or ability and with seemingly bizarre, jerky, rapid, and unexpected actions.

My movements epitomize clumsiness and klutziness; they are erratic, disorganized, hasty at times, and sporadically and unpredictably controlled and executed. The only time I step into a veil of grace and agility is when I run, although, I’d be remiss in failing to mention several catastrophic trips and tumbles; I tend to have to steer clear of trails and uneven surfaces, despite their health benefits and forgiveness of the demands on the anatomical structures. I’m so accident-prone that if there is any potential risk of injury or malfunction with some sort of task that demands movement—particularly those requiring any degree of coordination—even if exceedingly unlikely, I’m one of those unlucky few that will experience it. I’m probably why warning labels have to exist on certain products or on informed consent forms for certain activities. When “normal” people read such information prior to engaging in the said activity, they probably wonder, how could that possibly happen? The answer: if you’re Amber. Those who know and love me dearly even joke after I do incur such injuries, “that would only happen to you!”

I don’t wear this as a badge of honor. I certainly wish I could trade this “luck” for highly unlikely positive outcomes like winning the lottery or at least the gold coins at Big Y supermarket! At the same time, I don’t want to cede responsibility or my self-efficacy in improving my balance and coordination and decreasing the incidence of undesired or hazardous movements and the resultant injury risk.

I consciously try to slow my body movements so that I only travel (or flail) at moderate velocities, so that any impact is somewhat attenuated (remembering the concept of momentum from physics class equaling mass multiplied by velocity; reducing velocity with decrease my momentum, impulse, and impact force). Instead of bombinating around like a wild ricocheting bullet, I attempt to pull back on the reins and let up on the throttle. This doesn’t directly improve my coordination, but it can augment the allotted reaction time before an impending crash or fall and dampen impact forces. I also practice balancing and stabilizing my body and limbs during my OT appointments and on my own at home. Admittedly, it’s frustrating work because I have yet to notice an appreciable improvement during dedicated practice (like single-leg stance time) or in “real life” applications (hence, the three bad falls this week). I’m not going to give up though. I harken back to a quote I had on my wall growing up from Jacob Riis:

When nothing seems to help, I go and look at a stonecutter hammering away at his rock perhaps a hundred times without as much as a crack showing in it. Yet at the hundred and first blow it will split in two, and I know it was not that blow that did it, but all that had gone before.

Maybe all of the work and practice is quietly mounting beneath the surface in an undetectable manner, but suddenly, one day, I’ll notice that I am moving more fluidly, controlled, gracefully, and safely.

(For now, I’ve got ice on my back to ease its throbbing. I must not have hit that 101st blow yet…)