Perito Prize Winners

Perito Prize 2021 – An Interview With Third Place Author Ali Azar

Perito Prize 2021 – Transcript of Our Podcast Interview With Perito Prize 2021 Third Place – Ali Azar


You can find the audio version of this excellent interview with CHIARA on our podcast host here  available on all podcast sites like Apple and Spotify.




Perito:     Welcome to Episode 3 of the Perito Podcast 2021, a special Podcast series all about celebrating the writing and creativity for this year’s Perito Prize and Anthology, now in this episode we are pleased to be joined by Ali Azar, writer of the third place story for the Perito Prize 2021.  Ali wrote the short story Exit The Shaitan which can be found in the Journal section of the Perito website and was selected by judges as the third place story for this year.  (0m.24s)  Hi Ali and welcome to the Podcast. 

Ali:             Hello there and thanks for having me.

Perito:     It’s a pleasure, so before we kick off let’s get a warm up since it’s so cold outside at the moment. (0m.34s)  What is the most important thing in your opinion Ali so is it ambition, talent or opportunity which I guess you could classify as luck as well?

Ali:             Sure, well the boring answer would be a combination of all but I think I will, I’m gonna focus on the third one which is opportunity or I’m gonna rephrase it into a circumstances I think it’s really important that where we were when you’re writing about the things, that you were there or not because it can be very inspiring, it can stir you up, can be very inspiring for your soul, I would say the opportunity, the luck of being in a particular place which will help you to write a particular point of view about the things, I think that’s the, for me that’s the more important part.

Perito:     I think I agree with you as well I was reading something, there’s a fantasy author called Brandon Sanderson on his Wiki page he’s, it took until his 6th novel Elantris to get picked up by a publisher and I was thinking 6! and this guy’s obviously globally famous and does huge books so definitely seems to be that kind of like opportunity, he had the ambition to write, had the talent clearly.

Ali:             Exactly. 

Perito:     And then he just needed that one moment, so yep good answer.

Ali:             Exactly.

Perito:      Thank you very much for entering the Perito Prize I think the judges especially really enjoyed your story. 

Ali:             Oh thank you.

Perito:     (1m.51s)  What you made you enter the prize and how did you find out about it in the first place?

Ali:             Right I had never heard about this and then, I was as a part of my, I had written a few short story with particular themes and I wanted to enter competition and I come across with that and obviously I just wanted to send some random stuff, so when I went to your website the things about your messaging, your website about being inclusive and the jobs you’re doing as a consulting and making the environment of the work more inclusive, so it draw my attention and then I had a chance to read the previous winners’ stories which I really enjoyed that.  One of the recurrent theme of my work is always about talking about the people they’ve been excluded, I just didn’t have a second thought and I went for it because I thought it’s very relevant, so yeah I submit for that and where did I hear about it, I don’t remember it but I think that this prize come up in a few, in several other websites as a recommendation that you can enter the competition so yeah.

Perito:     Perfect thank you very much.  (3m.00s)  So some people won’t have read Exit The Shaitan yet and I’m assuming I’ve got the pronunciation right there as well Ali so?

Ali:             Perfect, perfect.

Perito:     (3m.08s)  Yeah, good, so can you tell us about what the story is all about?

Ali:             Sure just by the way Shaitan it’s Satan so we say Shaitan for Satan so.  Exit the Shaitan it’s about an exorcism.  It’s a about a possessed girl that as his father just ran to an old ladies which is known in the area for helping people out when they’ve been possessed or etc. and in the one midnight and this is all about the journey of this old lady just she had to deal with this possessed girl, yeah if I have to summarise it that way.

Perito:     (3m.45s)  Ingi is the older lady whose, I kind of got the impression she was a bit, maybe a bit like a medicine woman perhaps?

Ali:             Exactly.

Perito:     Providing sort of alternative complimentary therapy to the community but she’s quite a long way away from this place where the family is.  (4m.02s)  You’re from Iran originally, is this kind of the area you’re from did you write about your home area?

Ali:             Your surprised yes, so just to give you a bit of background I am coming from the North West of Iran called the State of Azerbaijan which are the second largest city in Iran, we speak language of Turkic, version of the Turkic which is called Azerbaijani, 30% Iranian are Turkic speaking as Azerbaijani’s so yes which is a very mountainous area and is very close to border with the Turkey and I am from there and this is the story I inspired it is the village that my great parents come from so it’s actually little town and I brought up in the big city called Tabriz which is the fifth biggest city in Iran but we always went for a holiday and all sort of things to this little town called Miskin, these character I inspire, these are the character whether they were a relative, far distant relative of mine or Ingi I inspired by my great grandmother which I was lucky to see her before she died several years, many years ago at the time I was 6 or 7, her character was so strong that has always remain in me and felt is this as the medicine woman it’s a good way to get a better understanding of it but these woman was a Sayyid and Sayyid it means a person who is a descendent of Prophet Muhammad so these people they were kind of a mediator meaning that their prayer heard by the God or Allah so what they did in the Society they kind of, the people come to them and they would kind of channel them through, channel their prayer to the God so God can hear them.  So my great grandmother she was like that and yeah and I found it very inspiring, very interesting.

Perito:     (6m.00s)  Excellent and did she have sore knees and I kind of got the impression with the way the characters have to help her in and out of the Land Rover?

Ali:             Yes.

Perito:     (6m.07)  That perhaps you’d had a lot of experience doing that over the years or someone had?

Ali:             I’m glad you raised it up because it may sound trivial but for me it was a part of his character, she was quite, she was older lady, quite at advanced age but yeah she had suffered from the knees and I think it’s remind me of many of other ladies, woman in Iran particularly very older generation, they work very hard, they wash many things, they always do the things that they eventually had arthritis either because of the knee problem, either because they were doing a lot of household work or it’s because they get, yeah these sort of things and for me it’s always I remember her that because she always couldn’t walk and yeah for me that was the part of that health issue of hers so always a part of her character.

Perito:     Initially Layla struck me as the protagonist of the story but on second and third readings I started to think maybe it’s actually Ingi who’s the character and exclusion comes down to there’s a part where she couldn’t remember the last time that she got out of the house.

Ali:             Right.

Perito:     And then I start to think well from an accessibility point of view that’s exactly it she’d become a prisoner in her own house as you write and then this is almost like a journey for her to go out there and to kind of experience life again.  So that was interesting from the exclusion perspective it wasn’t just, it was how her body had essentially started to entrap her.

Ali:             For me it’s an important point because a, okay many people come, the people like me which coming from, I don’t like this word developing but I have to go for it.  It’s coming from developing country many people say, “oh they come like country, developed country like Britain” they always say, “oh it’s a very nice the rules are, people obey the rules or you’ve got in it’s just etc. etc.” but for me one of the things really struck me is about how many disabled people I can see in the street, it doesn’t, it isn’t because the Britain has a more people that they have accessibility issues compared to Iran, you haven’t many disabled people we had 8 years’ war with Iran they are many people, they lost their limbs and etc. but you don’t see them in Iran on the street because they are not suitable for them, for that reason they can’t find a work, they can’t, they are less preferred finding a job and I suppose it’s not just for Iran for many countries are like that and yeah with the Ingi things she can’t because she can’t walk properly and the house, the way her house is lay out there are many stairs so yeah she become the prisoner of her own house. 

Perito:     That’s really useful I think it gives us the sketch over, we won’t spoil like the principle of people who have to read this story to get the idea but essentially it’s about a small journey to the village which is far away, I kind of get the impression it’s very highland, very bumpy.

Ali:             That’s right.

Perito:     And the Land Rovers kind of Layla’s father is driving too fast and then you kind of so the build-up and then kind of reach the crescendo and then at the end of it it’s very nice and calmly done and your story has this gentle flow despite the urgency of the family situation.  (9m.24s)  We talked a little bit about why you were writing it in terms of the area but what made you use this particular situation of Layla’s to create a story around, what was the reason behind that?

Ali:             The weirdest thing with the writing you remember some of the things you never thought about, I am a late starter when it comes to writing, I start when I was 30 and I’ve been writing nearly for 10 years, I heard this when I was a little boy and the guy who was telling this story was telling to show how can people can be deceived because they are possessed and it’s superstition etc. and etc. but that wasn’t my take on on it and I just found this story very fascinating and it always was in my mind and I didn’t, yeah in back of my mind and then I start writing about the things and after many things they came straight in was this but I didn’t want to focus on superstitious, another thing if I may add to this exclusivity things you can’t hear the woman voice a lot in the Iranian literature, we are quite advanced society we’ve got many ladies working different part of Iranian Society although it’s a very patriarchal society but the literature you don’t see many woman or woman point of view unfortunately, it’s not a surprise so somehow hearing this story I thought okay actually I’m just gonna, because when the guy was writing this story the guy who was going to deal with this possession is a man and I said let’s, I’m just gonna replace it with a woman and let’s see how it’s gonna happen because I didn’t know the end and I say I just like the setting that this old lady is gonna have, her house is gone a bit knacked in and knacked and then when he’s gonna open it and there’s a guard  roaring father that her child has been possessed.  So yeah and then I start writing it up and then I have to decide and what to write up, how to end it but the real driver of it, it was that story that I heard many years ago.

Perito:     (11m.31s)  Thank you Ali, your first language must be Farsi/Azerbaijani perhaps?

Ali:             Turkic.

Perito:     (11m.39s)  Turkic yeah, so do you find when your writing that you write in your Turkic.

Ali:             Yes.

Perito:     (11m.46s) Language first and then you have to translate it, how do you find that when you’re coming up with these stories and having to go through that computation in your mind cos they’ll be a lot of people who will want to embrace the Perito Prize because we get hundreds of entries from around the world and how did you feel about kind of that translation mission and what sort of techniques did you take on to accomplish it?

Ali:             Sure, okay, well although my mother language is Turkish but I unfortunately because circumstances in Iran you can’t write and read in Turkish so if it comes to the writing yeah we’ve been taught to write in Farsi or Persian but it’s a good point because it is not easy, it’s my third language, I am writing in it, what I did initially I write it in Turkish or in Farsi and then translate it in the English but I found it not particularly useful, I mean if you wanna have a plan just to see what you’re writing it might be useful but when you really wanna compose your text I didn’t find it useful or put it this way, it is a bit of a, it’s not the best use of time what you could do instead you can just start with the crude language of English and then you can just filling in, it’s a very slow process.  What I do sometimes, sometimes when it comes to very complex things or I have to really show some, when I wanna say something very subtle or something like that and I, nothing come up to my mind in English I write it in Turkish and then I translate it, let’s say within the paragraph I needed this last bit, last touch, I write it in whatever language is come to my mind because I’m comfortably can write in Persian as well and then I translate it in English and I think that’s useful but to write whole section in one language and translate it I didn’t find it very, what is the word, is a very effective approach. 

Perito:     (13m.55s)  Okay that’s really useful thanks for covering that off.  So as you know the Perito Prize is dedicated to inclusion, access and inclusive environments did you find that topic difficult to write about or come up with obviously ideas or do you write about that normally with the other stories you do?

Ali:             It is a difficult topic and I didn’t, okay by itself I’m coming from the country you have to self-sensor yourself so but I didn’t find it particularly hard to write. I don’t want to give a spoiler but it’s one of the problems with Iran is the way the woman has been treated for example their virginities, so all the society has made the woman to behave as if their virginity is an asset and there are many things going around that, and also I’m fascinated by that the way the woman or men approach this sort of things.  So you may say what to do with being inclusive or whatever I think it is important because it’s just made in this particular case a woman it is a bit, being considered as a kind of in the position of the men or do you see what I mean so?

Perito:     I do yeah.

Ali:             Particularly with Iran it can be hard issue because there are many layer of it.

Perito:     (15m.27s)  Excellent thank you very much.  What do you think was the most valuable thing about going through this writing process for you?

Ali:             You mean in this particular story or as a whole?

Perito:     Either, whatever you fancy really just go for it.

Ali:             Yeah the thing is I really don’t, when I talk with other people I don’t say I write it because they, then they say, “it’s a good hobby” and I don’t like it, I think if you want to write you have to take it seriously.  When you write it can be difficult and can be very slow process but at the same time the aspect of the writing I love is, you come back, I’m quite a nostalgic guy so you come back to your past, your own past and you dig in and sometimes you got surprised with things you did as if someone is telling you, “do you remember that?” and I love that and you kept being surprised by yourself, this is self-indulgent I know. 

Perito:     To be honest writing is kind of like that isn’t it as you say it’s kind of like the sudden urge to go and do something cool.

Ali:             Yeah.

Perito:     And you’ve got it put it down.

Ali:             Yeah exactly.

Perito:     (16m.35s)  Brilliant so has this prize made you think differently about how inclusive and accessible the world we live in actually is, you kind of hit on this at the beginning with the idea of the streets of Tabriz and Tehran maybe people are not likely to be seen because there’s not the infrastructure or the culture’s not there in the supportive way.

Ali:             Exactly I mean I encourage in audience to read the previous winners or previous stories they have been published, just surprised about how people consider this topic, take it from the being bullied in school to the like sexuality issues or all sort of things and it doesn’t matter where you come from you will always find this margin part of the society those people they’ve been excluded, some of them they are not we always see them in the TV’s and radios and some of them just they are too subtle to see them so I think for me in every society you’ve got this kind of confliction, we feel those kind of, what’s the word, the majority and those people they are in the outside in the skirt of the centre so.

Perito:     Well as Keshe wrote last year Every Other which probably.

Ali:             Wonderful.

Perito:     Sums it up quite nicely isn’t it.

Ali:             Wonderful story yeah.

Perito:     Everyone else and the others but I guess the interesting thing about exclusion and inclusion is that we’ve all been included and excluded in different ways.

Ali:             Precisely

Perito:     Across different stratas and thinking about Iranian Society you can’t just look at one person isn’t one thing they might have social connections, economic, different history, different religious beliefs and you might be and have maybe in Iran Society I think maybe five or six primary identities that you could be moving through on a daily basis.

Ali:             Exactly.

Perito:     (18m.20s) It’s just a lot of shades of grey isn’t there? 

Ali:             It is, the successful community it’s the one, I think it’s one of the goals to see whether society’s been successful, it’s how you’re gonna integrate all this shade of greys you see what I mean?

Perito:     Indeed, brilliant.  (18m.34s)  So Ali finally any recommendations for people entering next year?

Ali:             Yeah, sure I mean first thing is obviously they have to be interested in this kind of topic which is a very strong topic and people write about it and another thing is if they’re interested in it they don’t have to go and catch those things you always hear about, if you, I think if you have a good look around you will find something relevant, very relevant to your own life, your own little circle of people, your own little hub whether it’s at work or whether it’s a neighbourhood or whatever.  I don’t, in my opinion you don’t really have to look hard it’s always it’s interest, you have to have obviously interest to develop this story and then you will see it’s there.

Perito:     Perfect, thank you very much for that.  I think that’s good advice.

Ali:             Sure, thank you.

Perito:     Now it’s been great to find out more about you and your story, Exit The Shaitan, but now it’s time to sign off and tell listeners about the upcoming Anthology which will be available from Amazon around the world and ideally will be on audio book potentially later on but for now you should be able to buy that in time for Christmas 2021, thanks again to our special guest, Ali Azar.

Ali:             Thank you for having me.

Perito:     Absolute pleasure, who was the author of the short story Exit The Shaitan and thank you very much for coming along today Ali.  You’ve been tuning into the Perito Prize 2021 Podcast that’s a Special Edition thanks for listening everyone, everywhere. 




Perito Prize Winners

Perito Prize 2021 – An Interview With Second Place Author Chiara Bullen

Perito Prize 2021 – Transcript of Our Podcast Interview With Perito Prize 2021 Runner Up – Chiara Bullen


You can find the audio version of this excellent interview with CHIARA on our podcast host and its available on all podcast sites like Apple and Spotify.



Perito:     Welcome to Episode 2 of the Perito Podcast 2021, a specialise Podcast series all about celebrating the writing and creativity for this year’s Perito prize and anthology, now in this episode we’ve got Chiara Bullen joining us from Glasgow.  Chiara wrote the runner up story for the Perito prize 2021 called Smelly Cat which can be found in the Journal section of the Perito website and was selected by the judges as a second place story for this year.  (0m.29s) Welcome to the Podcast Chiara.

Chiara:    Hi James, thanks for having me.

Perito:     (0m.36s) Hi, it’s an absolute pleasure so before we start then how about some kind of quick warm up questions iron out any of those nerves or anything that you might have?

Chiara:    Sure.

Perito:     (0m.46s) Let’s a little about your writing routine then so what kind of things like where you like to sit, have to drink or maybe the music that you like to listen to?

Chiara:    So I think quite a lot of writers would be quite horrified at my set up and for most of my PHD it’s been the pandemic so it’s just my desk at home and it’s always super messy and when I’m finished with my PDF work for the day I usually just launch straight into writing so nothing really special about that which is probably isn’t great but I do like listening to sound tracks to inspire my writing kind of like video game and TV shows sound tracks and things like that.

Perito:     I am obsessed with the Elderscrolls Ambiance soundtrack on Spotify I just have it on repeat because it just sits in the background and does its thing.  So I can relate to that but I think what probably surprised me the most with your answer was the fact that you can write after work, I’m normally at the end of work I don’t want to do anything else so I tend to prefer writing in the morning.  (01m.43s) What is it about the afternoon that works for you?

Chiara:    By the time I’ve finished work it’s normally the evening I suppose but yeah I don’t know, I guess I just sort of associate it as my sort of downtime even though it’s still like, it’s still working, it’s still quite difficult, I guess I’ve always just been a little of a night owl when it comes to my writing so I can’t be one of those people who get up really early and do it before work I think I just need to, I wouldn’t be able to start my day at that point so.

Perito:     (2m.17s) So you’re not kind of like a Raymond Chandler with a whisky in hand in the evening?

Chiara:    Not quite (laughter).

Perito:     Good okay (2m.26s) tell us about the PhD, what are you doing at the moment for the PhD?

Chiara:    So I’m in my third year of my PhD, I’m doing it across the areas of publishing studies, literature and law and I’m kind of looking at like the social responsibilities of the book publishers in the 21st Century so for example right now I’m kind of looking at like what happened in the publishing industry in the wake of the Me Too Movement, for example of authors who were accused of sexual harassment and things like that, I’m just kind of getting an idea of what’s happened in the industry in the past few years cos obviously there’s quite a lot of kind of like discussion and controversy around it so it’s just kind of examining that.

Perito:     (3m.07s) Have you come to any kind of hypothesis or conclusion as to what might need to change or is there change underway?

Chiara:    I mean change is definitely happening, I wouldn’t want to talk about any findings I have yet we’ve got another year to go to iron them out but I do have some ideas of what’s going on and kind of what needs to be changed and things like that.

Perito:     Perfect.  (3m.33s)  Okay, so second question then, when you’re wondering about you’re going to write about in the evening who do you turn to for inspiration and why?

Chiara:    Well I don’t really have just like one figure, I suppose I kind of always keep in mind that like widely used advice which is that to be a good writer you have to be a good reader and read widely kind of in your field and know what’s out there and what works, what doesn’t, what gaps are there and how you can fill them.  I think if I ever have a bit of a writing block and like I think I’ll just spend a good few weeks like reading and enjoying myself and then I’, sort of like refreshed to go back to it.

Perito:     (4m.14s) So are you admitting there is such a thing as writer’s block?

Chiara:    I’m currently, I’m actually currently suffering it with my academic writing, (laughter) not my grade of writing but I guess, yeah I guess some things it’s really hard to get the words out, I think you can always kind of writing something is better than nothing in those instances even if it’s not great or what you’re entirely happy with but yeah you can definitely feel a little bit like stuck.

Perito:     I’m sure everyone whose listening can relate to that at one time in their lives certainly, okay perfect, thank you very much for those answers that was really interesting.  (4m.52s) Moving on to the prize then so what made you enter the Perito prize and how did you find out about it in the first place?

Chiara:    I really liked Perito’s dedication to accessibility, for example, I really liked that there was no entry fee which is often a barrier for lots of people and there were options to submit like audio files and an option to get in touch if you needed to submit your application in any other way like the team would help.  I really like that side of Perito and I don’t just enter my writing kind of like anything, well first of all there’s a lot of times where I can’t afford to, so yeah I just thought that was really great also you were open to young adult stories and young adult short stories are quite hard to be placed cos there’s not, there are places for them but there aren’t as many as adult section and things like that, then I heard about the prize via The Mslexia Newsletter so that’s a magazine for women writers and they do, it might be monthly or it might be every few weeks, they do a newsletter where they showcase writing opportunities and things like that.

Perito:     Perfect, thank you very much.  I think you’ve hit the nail on the head from an access point of view, I just always got really annoyed about the idea you had to be from South Norwich, 6 foot tall and have £50.00 waiting to be able to spend…

Chiara:    Yeah.

Perito:     …in order to even get submitted so the prize is definitely designed to encourage everybody to try and get involved which is why we tend to get, certainly last year, 50 or 60 countries around the world and that’s another great point about sterling GDP, pounds don’t translate well into other currencies…

Chiara:    Yeah exactly.

Perito:     …due to inflation and things, so.

Chiara:    And I completely understand that opportunities, magazines, competitions they do have, they have something to pay their staff, they should always pay their staff but they have running costs and things like that so I am completely sympathetic to that sometimes there just has to be, there just has to be a charge but it’s good when there are options in place, for example if an organisation is gonna charge sometimes they will have a certain amount of slots for people who can’t afford to enter and things like that but I definitely still think there is more that should be done for, to widen accessibility sort of like wider writing competitions and things like that.

Perito:     Thank you very much Chiara that’s a great response.  (7m.21s)  So some people may not have read your story yet and can you tell us about what’s Smelly Cat’s all about and kind of the message that you wanted to write about?

Chiara:    Yeah absolutely I’m don’t blame them if they haven ‘t read it yet (laughter) which is good.  So the story is about a girl, a teenage girl who is bi-sexual but she hasn’t come out to her friends yet and she’s sort of internally agonising over what she should to do because she’s already come across a lot of bi-phobia and bi-sexual erasure and things like that and she’s just not very confident and what the reaction will be like.

Perito:     (8m.01s)  And how does the, without kind of ruining the entire plot line, how does the whole kind of 90’s pop culture vibe fit in?

Chiara:    I suppose, I mean it just sort of got me thinking about how pop culture can really shape it, can really have an impact on our identities but popular culture can also have a kind of harmful effect because it can provide inaccurate stereotypes and things like that, so for example the main character reflects on the fat phobia in friends amongst other things and some people if they watch that a lot when they’re younger in the 90’s or if they’re coming to a little bit later they might always then replicate those stereotypes and those feelings for their whole life, even though they don’t think that it’s harmful because it was a funny joke on Friends, how horrible can it be and that just sort of creates this kind of, kind of strange cycle and makes kind of marginalised people feel even worse and it’s, I think it’s how we get to these conversations when people will say something offensive or hateful and they’re like, “oh but I didn’t mean it, this was just what I was this was what I thought was the case” so yeah, I was just thinking about that when I wrote the story.

Perito:     It’s a great point you make about kind of people reinforcing cycles of exclusion and if you’re watching, how many episodes of Friends are there 300 odd.

Chiara:    Something like that yeah.

Perito:     Yeah and if you’re watching them like I used to, the Sunday omnibuses or whatever, you’d maybe 3 and 4 and yes you’d laugh and things but actually the messaging of and also their casual stupidity as well sometimes, particularly with Ross.

Chiara:    Yeah.

Perito:     Kind of sets in doesn’t it and then as you say the people are then going to think well actually that’s reasonable, if someone whose, and they’re all reasonably good people fundamentally and if they’re saying it then why not, why not we just use that and take that on.  I definitely agree with you the idea of society and media has a role to play in kind of re-framing the conversations around that sort of stuff.  So that’s why I particularly liked Smelly Cat because it really kind of gets to the point and in a nuance way and says, “yeah have you thought about this”.

Chiara:    Definitely.

Perito:     (10m.21s)  So do you find you write a lot about TV shows or popular materials, current affairs and things in your other work?

Chiara:    Actually this is the only time that that’s happened, I usually write like speculative and fantasy and sci-fi and things like that, I honestly, if I may be completely honest, I don’t know where the story came from I think it was just a manifestation of thinking about what we’ve just discussed and a sort of instance where, where that particular episode of Friends might have a negative impact like in real time because the, if people read the story the episode that I’m referring to that always kind of, always bothered me so yeah.

Perito:     Yeah it’s a little bit like Little Britain, even Little Britain I never particularly found it that funny, there were some good bits but often you were still sitting there even back in the 2000’s just thinking, “no I’m not sure that quite works in a way maybe they’re intending” and I think Friends obviously is earlier but at the same time it’s no real excuse because these same conversations were happening then at the same time.

Chiara:    Yeah exactly.

Perito:     Okay, perfect, thank you.  (11m.33s)  So as the Perito prize is dedicated to inclusion, access and inclusive environments did you find that topic difficult to write about or concede with the ideas?

Chiara:    I didn’t really, I do write other genres like fantasy and stuff that’s something that I always keep in mind and I always write about some sort of kind of like injustice and things like that so inclusively is something that I do think about a lot and I like to keep learning and kind of like educate myself to be a little bit of an ally for areas that are that I’m not like part of and things like that.

Perito:     (12m.10s) Despite being a little bit too close to a long conversation but particularly with your skills and understanding of the publishing industry, do you feel that kind of class and social status plays a big role in these sort of coming up with stories and background and certainly being able to get published.

Chiara:    Oh yeah absolutely (laughter) I could be here forever if I worry to talk about that but yeah I mean for so long we’ve had the majority of stories and writers they come from the same, they’re white middle to upper middle class if not more and we have those kind of stories and I started kind of noticing like when I thought about the popular media I consumed like maybe like throughout my whole life, there’s so many recurring issues like, where like the parents getting divorced or not being able to live up to an older sibling or a very successful parent is like the main conflict, the main difficulty and I sort of, and those are horrible things regardless right but I realised that for so many people writing and who they assume the audience to be that those were like the most pressing things that people would ever deal with in their life and then again those are really, those are really difficult things to deal with and recently we have popular shows are tackling things like racism and ableism and tackling the stigma and mental health and stuff that’s really great and I’m really glad to see that happening and there are changes to make publishing more inclusive and diverse, maybe not quite as fast as we would like but I think, yeah I think things are definitely changing but the money that it costs to sort of just often get a story out there, for example creative writing courses and degrees are really popular now and they cost a lot of money and time and there’s scholarships available but there’s not, these opportunities available for everyone and you’re often kind of up against these people who have a lot more time and money to put towards their craft and things and it’s just kind of, yeah it’s definitely kind of been eye opening looking at things from a publishers side and then from the writers side, but yeah sorry that was a bit of a (a ha) a conscientious answer but I hope that kind of answered your question.

Perito:     Well I’m actually thinking of a whole different podcast about these subjects actually to be honest, I’m sure there’s gonna be plenty of people on who’d happily listen to your thoughts all day about that stuff so maybe watch this space, that’s brilliant.  (14m.41s)  So what was the most valuable thing about going through this writing process for you?

Chiara:    I think it really was just with this story in particular it just helped me get my thoughts about pop culture and what we’ve just discussed like really together and put them on the page and just sort of see how that can, yeah how that can impact people but it also helped me to remember that again things definitely aren’t changing fast enough whether that’s in publishing or the film industry or in TV or whatever but there are more pieces of popular culture tackling injustice and raising awareness to issues and issues with stigma surrounding them and things like that and that is great, I suppose yeah it kind of taught me to sort of, there’s still a good reason to be hopeful and things like that.

Perito:     There is definitely, yeah 100%, that’s great.  (15m.34s)  Now I suppose a continuation of that theme, has the prize made you think differently about how inclusive and accessible the whole world we live in actually is?

Chiara:    Yeah, yeah definitely, I think it’s sort of made me think, it’s sort of reinstated that in terms of making an inclusive and accessible world there’s still so much, we’ve so much further to go and just another reminder that there’s still so much to learn and there’s still ways that you can help and things like that, yeah it just sort of reinstated all of those kind of values and the things that we discussed earlier particularly about publishing and accessibility and things, I liked how the prize, that spelling, grammar doesn’t matter and this is open to everyone and we can help with that and I thought that was great and that’s something I often don’t see in publishing and is something that I often, I don’t, for example I don’t end up talking about that in my work and maybe I might or maybe I should think about that when I think about inclusive publishing and things like that.

Perito:     I’m a Dyslexic, relatively moderate to severe and I used to get called stupid at school by my teachers and two in particular and without, what’s that’s done is really set the kind of, the scope for actually what if you aren’t a particularly good speller or you don’t have a Cambridge Grads academic understanding of the English correct grammar than how are you meant to kind of cruise through this, how are you meant to get your voice and story out there if the first people are doing is looking at your, the way that you pronounciate and accentuate your words so that’s, it’s nice that you spotted that as well cos that was a really big important thing for me personally.

Chiara:    Yeah and it often disadvantages people who are, who English might be a second or third or a fourth language, I know that’s a big issue in academia with journal articles for example, people not getting necessarily accepted because of that but all the ideas and the research are right there, it’s not something that should include, exclude people with good ideas and have voices that should be heard.

Perito:     Well exactly if you think from a voices perspective how are you going to engage with a lady from Benghazi if her English is not great and how are you going to get her story, I bet the first thing you do is look at how many spelling mistakes she’s made but that’s only in English.  So it’s a really important point and I think sometimes it does take a while for people to understand, that’s one of the messages that I’m trying to get across by putting this prize together is that idea that we’re not being exclusive just because the be all and end all is whether your grammar and spelling is literally perfect.  You can always pay someone to check it but at the same time if you’re not gonna win that’s expensive.

Chiara:    And also sometimes you just can’t, like that’s not something you have a budget for so yeah it’s just, it’s just something to think about I suppose.

Perito:     (18m.47s) Brilliant and so finally then any recommendations and tips for people entering next year, now I’ve got high hopes for this one Chiara so you (laughter) lay it out there and give everybody as many tips as you possibly can that would be fantastic.

Chiara:    (laughter) So much pressure, I hope you’re not gonna be disappointed with my answer but it was basically, it sounds kind of cheesy but honestly like don’t give up, with this story Smelly Cat I’d entered it in a few places and it got quite a lot of rejections but I would take it back and rework it and honestly went I sent it to this prize I was like this was the last time I’m gonna send this out because I just don’t think there’s a home for this story and obviously it worked out really well but, and it kind of made me realise like oh even if it wasn’t placed here definitely shouldn’t have given up because so much about publishing is just subjective, maybe you don’t quite fit with the theme of like being with the anthology or the issue that you’ve submitted for sometimes the people putting together the magazine or the competition they just don’t feel passionate enough about it, it doesn’t mean that your writing isn’t good and it doesn’t mean that there’s not a place for it, finding the right home for your writing is way more important than just trying to gonna get it published anywhere so yeah, sort of keeping, yeah don’t give up when you’re trying to place a story and just think about what would suit as much, what would suit the story as much as the sort of like just the sort of feeling that you need to get it published, I just think it’s more important to find a good home for it.

Perito:     That’s a lovely point, thank you very much and I think again there’s lots of wisdom backing that up as well so Chiara that’s wonderful.  Now it’s been great to find out more about you and your story but now it’s time to sign off and tell listeners about the upcoming anthology which would be available from Amazon in time for Christmas 2021 and thanks again to our special guest to Chiara Bullen, Author of the short story Smelly Cat, thanks for talking to us today Chiara.

Chiara:    Yeah it was so good, it was so great to speak to you.

Perito:     That’s brilliant and thanks for all your lovely information as well.  Now you’ve been tuning into the Perito Podcast 2021 special addition, thanks for listening everyone, everywhere.

Perito Prize Winners

Perito Prize 2021 – Winner: ‘Magic Bus’ By Mary Darroch

Magic Bus


By Mary Darroch



My first thought was that he was lying. No one could possibly be wearing those teeth unless it was for a joke.

          ‘Aye right, Mick! Ye got them at Tam’s Joke Shop, didn’t ye?’

          He pulled his mask back up real quick-like before I could reach the teeth to give them a pull just to check.

          ‘Naw, Ah didnae!’ He was doing that annoying laugh that sounded like a donkey hee-hawing. ‘Ah telt ye, ma dentist gave me them! He said he would put them through on the NHS so Ah wouldnae need tae pay, so there ye go! No’ too bad, are they?’

          He was obviously dead pleased with them and I wasn’t about to burst his bubble. He didn’t get many moments of joy in his life and he was my pal and I wanted nice things to happen to him. Actually, what I really wanted was for him to lay off the gear a bit and maybe get a job and make something of himself. Not much chance of that, right enough, but never say die, as my old Da used to say.  

          ‘Yeah, they’re fine, Mick. They look good.’ From the movement behind his mask I could tell that his wee capuchin monkey face was cracking a toothy grin. It never took much. He was the happiest person I knew and he was always the same, whenever you met him, except for those bad times when he was heavy using again, because then he would look a bit out of it but in the main he was always just ma mate Mick, always grinning and always looking on the bright side.

          ‘Anyway, Shona, how ye doin’, pal?’ As usual, he didn’t wait for an answer but battered right on to talk about himself. ‘Did Ah tell you Ah’m gettin’ a job on the buses?’

          ‘Aye right, Mick, is this another of yer daft stories?’

          ‘Naw! Whit makes ye think that?’

          ‘Cos Ah know ye, Mick! Yer always at it!  Mind that time ye were gonnae open a magic shop and that was all ye talked about for weeks and then the next thing yer training to be a stand-up comedian? You and yer daft ideas!’

          I thought that would maybe take some of the wind out of his sails. But no. Not a bit of it.

          ‘Oh, ye of little faith!’’ he asseverated in a ridiculous sepulchral tone. I knew he was channeling Mr Micawber right there. It was a perennial favourite of his because  Mick, for all his shortcomings, was surprisingly well-read and Dickens was his favourite. . ‘Just you wait an’ see!’ He gestured with a dramatic flourish towards his chest. ‘Yer man here has not yet reached his prime!’

More Big Ideas on the way, then. He must have noticed my exasperation because he dropped his voice to a more conspiratorial pitch.  ‘Ah’ve got an interview the morra morning! Jist a ‘preliminary assessment’, like, but at least Ah’ve got a foot in the door …’  

Reaching inside his hoodie, he brought out a folded-up bit of paper. ‘An’ there’s the letter, tellin’ me where to go an’ that.’

I inspected the grubby, dog-eared thing  It was from the Jobcentre right enough. 

          ‘That’s brilliant, Mick! Well done! Ah’m so chuffed for ye! But … whit ye gonnae wear? Have ye got a nice clean hoodie ye can put on?’

          ‘Hoodie? You’ve got tae be kiddin’ me! Ah cannae turn up for an interview  in a hoodie!’ He looked genuinely affronted at the idea. ‘Actually, Shona, I was kinda hopin’ like, that ye’d come tae the shoppin’ centre wi’ me an’ see aboot gettin’ me a jaiket tae wear the morra …’

          ‘But, Mick … Ah’ve no’ got any money right now. And neither have you. It’s no’ yer pay day.’

          ‘Ach, nae worries, Shona! We don’t need money!’ He was grinning under his mask again.  ‘Have you forgot aboot oor special skill sets?’ Nothing ever daunted Mick. He always had a plan.





On the bus over to the shopping centre, I was aware that Mick was buttering me up. This could only mean one thing – he was planning for me to do the dirty work today while he ‘kept edgy’. He would be the lookout. He usually was. Maybe that was his special skill set, then. Well, play to your strengths – that was another thing my Da used to say. 

‘Aw, it’ll be great, Shona! Jis’ think, Ah’ll be able to take ye on a wee bus run tae the seaside. Mibbe Saltcoats, even! Ye like Saltcoats, don’t ye?’

‘Mick, see this job – is it like coach trips an’ that?  No’ like jist drivin’ folk intae the toon?’

‘Aye! It’s coaches, an’ they dae trips tae the seaside – Saltcoats, an’ … beaches an’ castles an’ that.’

‘Oh, Mick, that sounds magic! Ah really hope ye get it!’

‘Aye so dae ah. Ah’m gettin’ a bit fed up wi’ never goin’ anywhere nice except mibbe the wee park across the road fae ma hoose. Ah mean it’s a nice park but ye jist stoat’ aroon’ the place wi’ the auld coffin-dodgers and their designer dugs! Aye, It’ll be great to go somewhere different. Jist think – the wide open spaces where we can take in aw that fresh air …’

The rest of the bus journey was spent in quiet reflection – Mick breathing deeply through his blue mask and his ridiculous teeth as he practised taking in the fresh air while sounding like an emphysemic old coffin-dodger himself and me, looking out the filthy bus window on to the dismal grey streets and imagining blue skies and sparkling water and eating ice cream on the promenade.



Debenham’s was closed. Permanently.  Debenham’s –  our favourite place to pick up a few luxury items. Gone. This was a disaster.

          ‘Aw naw man, what’re we gonnae dae?’ Poor Mick looked a bit distraught. I thought he might start greetin’ in a minute. 

          ‘’Well, there’s Next, an’ H&M, and there’s TK Maxx and maybe Tesco would be worth a go  …’

          ‘But they’re all CCTV-ed up tae the gills! An’ the security guys there are total wideos, man! Huckle ye as soon as look at ye! We huvnae a hope in hell!’ His despair was making his voice increasingly screechy and he was starting to draw looks of suspicion and downright contempt from disdainful passing shoppers.

          ‘Mick, just shut it, will ye! Stop actin’ like a wean.  Where’s yer fightin’ spirit, eh?  We’re no’ beat yet!’ I said these words to pacify Mick but inside I was panicking, too. Mick absolutely had to have decent clothes for his interview or he wouldn’t get that job and I wouldn’t get to the seaside.

But it wasn’t just that.. In some strange way I felt responsible for Mick and for everything that happened to him. He was the closest thing I had to family now and despite all his own problems with the smack and the relentless stream of Big Ideas, I knew that Mick was always looking out for me, too. 

I looked around in the hope of seeing something that could help us. Anything. I started walking and Mick followed, neither of us knowing where we were going, really. 

 ‘Over here, Mick.’

Up ahead, almost at Tesco, I saw our way out. Cash Converters. I touched the small diamond at my neck.  It would only be for a wee while.

Mick stopped. He saw where I was heading. ‘Naw, Shona, no’ the necklace. You love that necklace. Ah’m no’ lettin’ ye dae that.’

‘Aye well, try stoppin’ me! You need that money. Mick, yer like a wee brother tae me, an’ this came from ma Da, so in a way it’s yours, too.  Anyway, Ah’ll buy it back as soon as ma ESA comes in!’

Mick was torn, I could see that, but in the end the thought of the new jaiket won the day. He helped me take off the necklace and even gave it a wee shine and polish on the sleeve of his grimy hoodie.

‘Shona,’ he announced, handing the necklace to me with a flourish, ‘my dear friend, I am deeply indebted to you for what you are doing as I know how  much …’

‘Jist give it a rest, Mick, will ye?’ I tried to sound irritated but couldn’t help smiling at his overblown display of gratitude. 




A guy with owlish specs and a tiny light clipped to his forehead  was offering us quite a lot of cash, more than I had expected, to be honest. Apparently, it was a quality South African diamond set in 22 carat gold. I nodded and tried to look nonchalant as he dictated the details to his colleague who noted it all down.

          ‘I can give you a good price on this.’

Relief. I looked at Mick. He was going to get his new jaiket and I was going straight from here to Tesco to buy a bucket and spade and maybe a wee bikini for the seaside.

          ‘First, I need some details. Do you have some ID?’

          ‘Some ..?’

          ‘Passport? Driver’s licence? We need to see some ID before we can make you an offer. Fraud Initiative and all that.’

‘Um …well, actually …’ I knew there was nothing in my tiny crossbody bag except  my fags, my phone, my purse and my Rimmel Highland Mist lippy. I didn’t own a passport or a driver’s licence – never had a need for either. I looked at Mick. He was standing there, staring straight ahead. ‘What about your driver’s licence, Mick? We can show him that, can’t we?’ No response.  ‘Mick?’

          Suddenly, he seemed to snap into life.  ‘Look, jist forget it,’ he said to the owl guy. ‘Shona, get yer necklace back an’ Ah’ll meet ye outside.’




We were sitting at Costa – one coffee between us.   

‘Mick, Ah think we would’ve got a good price for that necklace.’ I looked at my dirty, bitten nails and pondered. ‘There might even have been enough left to get mysel’ a wee manicure …’

Mick sat back a bit in his chair.

          ‘Nah, Shona, ye’re right. Me and ma big ideas …’

I stopped looking at my nails and looked instead at his wee face, unmasked now in order to drink his share of the coffee. He looked sad.

‘ Ah was lyin’, Shona. No’ aboot the interview – that was legit – but aboot me. Ah would never have got that job. Ah’ve no’ got a driver’s licence. Never even had a lesson. Ah never had the money, to be honest.’

          ‘Then … what was aw’ that aboot? Yer interview?  The bus runs tae the seaside?’

I didn’t really need to ask because I knew what it was about: a few moments of shared happiness, of shared dreams. It was what Mick did best. I understood.

          ‘But jist so ye know, ah would never really have let ye sell yer necklace. Ah know what it means to ye, bein’ the last thing yer Da ever gave  ye …  No, Ah wouldnae have let ye. I’m a better man than that.’ He looked thoughtfully at the table, quite impressed with himself I think.  Then he sighed. ‘And yer Da, he sounds like a good man, too. The best. May he rest in peace,’ he added, respectfully.

          I nodded. Let him bask in his delusions.

Of course he would have let me sell the necklace.  But I couldn’t, because neither of us had any means of proving our existence. Makes you think, that.

It wouldn’t have mattered, though. The necklace had value, but it had no meaning. My Da had brought it home one night with a bag of stuff he’d got from a ‘house clearance’ as he called it,  and I’d nicked it from the stash under his bed before the cops found it and  took it, and him, away. One day I’ll tell Mick, but not today. I don’t want to spoil his dream.


Perito Prize Winners

Perito Prize 2021 – Runner Up: ‘Smelly Cat’ By Chiara Bullen

Smelly Cat

By Chiara Bullen


You know that feeling you get when you’re watching something on TV – or watching a film, or reading a book you love – and something big is going to happen? And I mean, change the story big. But you already know what’s going to happen. The story isn’t new to you. It’s the second, third, fourth-and-beyond time you’ve consumed it.

Just as the moment is about to arrive on the screen, on the page or through your headphones, you recognise the steps and plot points that will put this action into motion and you plead to the fictional entity about to do something catastrophic: please don’t!

Please don’t listen to Scar, Simba!

Please don’t kill Dumbledore, Snape!

Please don’t follow that noise into your garden shed, Will Byers!

Of course, if these things don’t happen then the inevitable outcomes and climaxes of the story you love so much would not come to be. The character development needed to make certain characters become the one you’re absolutely obsessed with rely on these moments. So, it’s worth it in the end.

Still. It would have been nice if Kylo Ren hadn’t done that in The Force Awakens.

Anyway. That squirmy, clenching, anxious feeling has me in its grip right now. On my bed, in my room, in my dad’s flat in Glasgow. I know something is about to happen on the show I’m watching and I really, really wish it wouldn’t.

But we aren’t watching anything epic. Nothing scary. Nothing twisty, nothing turn-y.

We’re watching Friends.

My scratched, chunky iPad I got from CEX is propped up on the top of my washed-out looking bookshelf, the sounds jarring from the small speaker on its right side. Eleanor is lying on the floor, arms propped up on a pillow as she lazily scrolls through Twitter. Olivia is on the bed with me, her legs crossed tightly, up at the top end against the wooden headboard covered in old stickers. She’s engrossed by the events unfolding on the 9.7” screen (she’s never seen Friends before – she’s only just got Netflix). I’m leaning on the pink wall my bed is shoved up against, one leg stretched out whilst the other is still on the duvet, my toes digging anxiously into the soft sheet.

It’s a lazy Sunday. A ‘Sunday Funday’. I know this because it said so on several Instagram stories. I’m tapping my screen now, flipping through the stories so fast I only get a glimpse of faces, gym gear, steaming cups of tea and books arranged so beautifully it makes me sad I never really took care of mine.

I barely register the weekend life of my friends and mutuals. My eyes flick back towards the iPad screen, squinting a bit at the distance. I can’t remember the last time I got my eyes tested, but I’ve watched this episode so many times I don’t really need them. Phoebe Buffay is picking up her guitar. My relationship with her is more than a little bit complicated, and within the next few minutes it will be strained, once again, to its limit.

The episode is called ‘The One After the Super Bowl’, but it should be called ‘The One with Phoebe’s Biphobia’, if you ask me. Which I suppose nobody did, least of all the creators of a show who wrote the lines well before I was born.

The knot in my stomach tightens, and I can only imagine it resembles what my white earphones look like inside my jacket pocket. All twisted and chaotic, so tight that my stubby, bitten nails will never be able to pry them free with ease.

I suppose it’s my own fault for loving this show. Members of Gen Z aren’t supposed to like Friends. I read an article about it on Teen Vogue. Plus, my eighteen-year-old cousin said Friends is ‘problematic’ on Twitter, and she’s about to study journalism. So, I know she’s right. Then, amidst the claims of us being another snowflake generation, the article I read pointed out all the issues with the sitcom that my progressive generation is sure to find problematic.

And I agreed with them. There are plenty of reasons why this show is problematic – and I don’t feel this way because I’m as ‘soft as a snowflake’ (I try to be as sharp as an icicle, personally).

There’s racism. Sexism. Fatphobia. Homophobia. Double-standards, and some really shoddy editing work for something so embedded in my sister’s (a die-hard 90s’ kid) pop-culture.

So, I get why people my age aren’t supposed to like Friends. I really do. I’ve always known this. Our generation is the hope for change, tolerance and acceptance – I read that on Tumblr. I felt the slow burning of the beginning of hope and ambition. But, Joey Tribbiani from Friends’ hurtful stance on dating fat women is the same as my pal Craig McKenzie’s views on it, too – and these opinions are at least fifteen years apart.

Then there’s the improbable, frustrating, irresistible case of Phoebe Buffay.

She’s still on the screen and almost ready to sing now.



Her blonde hair is in an impossibly high ponytail, a scrunchie thicker than the iPhone in my hand keeping it firmly in place. She’s about to perform her song to the chic café she’s always in, which makes me wish I had a Starbucks in hand even though I don’t like coffee.

I feel the clamminess in my palms and put my phone down on the bed. I know what’s coming next, I know what will make me feel the sting of hurt and the forced feelings of shame and embarrassment her words elicit, as they have done every time I’ve re-watched the show over the past three years.

And to make it worse, my friends are here watching, too.

“So, Oliva, who’s your favourite Friend?” El asks, twisting awkwardly to look up at us on the bed. There’s no room for three of us up here, and only barely room for two people on the floor. It makes for awkward sleepover arrangements. I hope student halls are bigger, if I get into university.

“I donno yet,” Olivia replies. “Rachel. No! Joey. Uh… It’s too hard! Who’s yours, El?”

“I think Ross is hot. What about you, Lauren?”

“Oh, Phoebe, probably,” I reply a little too quickly, not taking my eyes off the screen.

The sound of real laughter – not fake, blaring, audience laughter – drags me back into my room away from my impending doom. El is looking up at me with an eyebrow raised, and Olivia is giggling.

“What?” I ask, snapping a little.

“She’s your favourite, or you find her hot?” El asks, teasing.


“Both?” Oliva suggests, her right eyebrow raising to match El’s, before they both relapse into a fit of giggles.

“Em, yeah!” I respond, trying hard to make it sounds like a joke and laughing a tad too loudly at myself as they both turn their attention back to the show.

I haven’t ever told them properly that I’m bisexual. I was just sort of hoping they’d figure it out.

That happens, right?

I didn’t even tell myself I was bisexual until recently. When I was younger, I started to get crushes on women around me and female celebrities. Keira Knightley in Bend it like Beckham had me slayed. Then she did the same in Pirates of the Caribbean.  Convinced at first I was a lesbian, I spent many a night on Google searching how I would know if I were gay. It was only after I realised that I fancied both Lupin and Tonks from Harry Potter that I altered my search terms slightly, and found what I was looking for.


‘Bisexual’ fitted me like my snuggest knitted jumper. I know not everyone is happy with labels, but I leapt into the arms of mine.

I practised saying the word over and over, enjoying how it felt slipping from my tongue and imaging how I’d tell the people I loved most in my life. I knew it was scary, but I thought; doesn’t everyone in the LGBTQA+ community say, “It gets better”?

But then, as I was taking time to gain the courage to tell people, I was sitting in registration class and heard Jess Wallace joke that bisexuals were only good for threesomes.

At a sleepover, Amy Barrie told me, fearfully, that she thought her sister might be bisexual, and her sister’s boyfriend was terrified that he’d be cheated on because of this.

She was never invited to mine again after that. It was the only small stand I could take.

I couldn’t share the hurt with anyone in school, or my family. They didn’t know I was bisexual in the first place. I didn’t even want to find people online to talk about it.

And so, my knitted jumper became impossibly tight, the neckline stealing and squeezing the breath from me so that it would be impossible to utter those defining words comfortably.

Phoebe Buffay begins to sing.

            “Sometimes men love women…”

It isn’t fair.

            “Sometimes men love men…”

Without warning, I feel the sting of hot tears as she strums the lullaby-like melody to her audience. Each word sang with such authority that for a while, I believed them. I wonder if a tiny part of me still does.

            “And then there are bisexuals…”

            Please, don’t!

            “Though some just say they’re kidding themselves…!”

The laughter of the studio audience is a deafening roar, each guttural sound a punch to my stomach, a personal insult thrown my way. Sometimes I wonder if I’m overreacting. Isn’t it OK to joke around sometimes?

But if those jokes hurt, shouldn’t people listen to how I feel?

The sound stops.

I look up towards the small screen, and an even smaller pop-up has appeared. “Are you still watching Friends?” Netflix asks.

If Netflix was a person, I would kiss them. Passionately. Has there ever been a time when anyone actually wants that message to pop up? It gives me a second to compose myself, get ‘over’ myself as my friends would probably say.

“Lauren, can you start it again?” asks El, even though being on the floor, she is closer to the iPad on my bookcase than I am. I nod in response to her plea, grinning slightly as she continues scrolling through her Twitter feed.

            I stand up to tiptoe over to her, and end up standing crushed against the wooden shelves, the top one just level with my shoulders. Before I tap the screen to continue, a rush of bravery floods through me.

“You know, I think that’s one of Phoebe’s worst songs,” I say lightly, restarting the programme and turning the volume down a bit. Adrenaline makes me light headed and I have to be careful not to stumble and step on El as I gingerly edge back towards the bed.

What am I doing?

            “Hmm? Why?” asks Oliva, the Friends novice who cannot yet recite every single one of Phoebe’s songs off by heart.

            Please… don’t?

“It’s just not funny,” I reply, twirling a strand of my loose hair lightly as I take my seat on the bed. I can hear my heartbeat thundering in my ears, drowning out the rest of the episode. “I mean, I’m bisexual, and I know I’m not ‘kidding’ myself.”

Silence. I can feel Olivia’s surprised stare, catch her mouth forming a small ‘o’ in the corner of my vision. My heart is livid at my mouth’s betrayal.

I am furious at myself. Furious. I’ve potentially just ruined two friendships. I know what everyone thinks about bisexuals and I’ve just—!

“We know, Lauren,” El replies, obliviously smashing into my downwards spiral like a juggernaut, not looking up from her phone.

I don’t reply, don’t dare let the hope that has ballooned inside me carry me away.

“And,” she continues, “I know ‘Smelly Cat’ is your favourite Friends song anyway.”

Perito Prize Winners

Perito Prize 2021 – Third Place: ‘Exit The Shaitan’ By Ali Azar

Exit The Shaitan

By Ali Azar


The fists landed on the door, pounding on its old wooden frame. Inji jolted from her sleep.

‘Who is it at this time of night,’ she shouted from her bed, but the door continued to be knocked without pausing.

‘Coming! Stop it before the door comes off the hinge.’ She took her cane, plummeted toward the door. Her joints started aching once she was out of her warm bed.

It was two fellows, a man wearing a wool hat and a boy.

‘Mrs Seyid, my daughter had gone mad.’ The man voice was shaking.

‘If a Shaitan has gone to her skin, the rock of misery has dropped on my head. You are my only hope. Save her, and I shall be your servant for the rest of my life.’

‘Go and fetch my chador. It hung on the hanger beside my bed,’ Inji said to the boy.

The man took from one arm of Inji and his young boy from another, they helped her to walked down the uneven stair steeps which opened to the street. She couldn’t remember the last time she got out of the house. Her knees didn’t allow her to walk more than a few steps. She had become a prison for her own house. Though she couldn’t see anything in dark, the earthy smell of clay walls was telling her that she was now in her beloved neighbourhood, where she once sat in front of her house, the whole the women gathered around her.

The two dazzling headlights of Land Rover lit up once the man started the car.

‘How am I going to get in this car? It was hard when I was younger and lighter, let alone now that I am old and well above hundred-kilogram. God, you help me,’ Inji said.

The man held Inji’s hand from the driver’s side, pulling her toward himself. Using the boy’s head as a handrail, Inji climbed on the car, landed with velocity on the leather chair.

The man moved the car, quickly shifted the gear to four, put the pedal to the metal.

‘Where are we going,’ Inji said once breathing allowed her to talk.

‘Jilodarli’s summer quarter.’ The man, hunched over the wheel, was scanning the road.

‘The one below Mount Savalan?’

‘Yes, Mrs Seyid.’

‘That is far. Slow down man if you want me reaching there alive.’ Inji said, grabbing the dashboard firmly.

‘I will be your servant forever if you just help my little girl. My quiet harmless Leyla has now turned into a monster, hitting, screaming, swearing.

Exited the town, the car entered the realm of nature, split fiercely the utter darkness of the surround with its glaring light.

‘Shaitan must have gone to her skin, her voice has changed, her eyes turn white. I don’t even know the meaning of some of her swearing.’ The man broke down, hitting his lap, his shoulders were bouncing. ‘The rock of misery has landed on my head.’

‘Come to yourself, man. You are scaring the boy.’ Inji rested her hand on man’s shoulder.

The car turned into bumpy off-road. Inji large body was jolting up and down while the boy was floating between the chairs and the roof in the back. Glowing lights appeared over yonder, tents came into sight, fiercely barking dogs welcomed the car. They were running, inch away, along the approaching metal monster. Unlike their village counterparts which just stood further away and barked and growled, nomad dogs, being on the constant threat of tactician wolves, attacked savagely to any unknown object entering in their territories. They dispersed once the car reached the yurt where the gathering crowd were awaiting them. A woman ran to the car when it stopped, opened the door of passenger side.

‘Mrs Seyid, thanks god you have come. My girl is perishing in front of my eyes.’

‘Where is she, ‘Inji said, rested her hands on the woman’s shoulder, got up from her seat. Other men approached to help her to step on the ground.

‘Bring me a chair, my heart is going to burst,’ sweating Inji said, wheezing in and out, once she reached the tent of the driver. A folding chair was bought for her, which could hardly accommodate her big bottom.

The man came in, dragging the girl. Her dishevelled hair had covered her face. The father was holding her delicate wrists firmly-not an easy task to get away from the pilers-like hands of a nomad man. Leyla looked at Inji with resentment, gowned her teeth. The mother was whimpering, hitting her laps, and the boy was staring at his sister.

‘What are you looking at me you nosy people. Apart from the girl’s family, everyone else march home. Yallah!’ She threw her cane toward the tent entryway. The people quietly left the tent.

‘Have her sit in front of me,’ Inji said.

With help of his heavyweight, the man pushed Leyla to her knees.

‘Leave me alone with her.’

‘But, Mrs Seyid, she may hurt you.’

‘She won’t. Everyone out.’

The man let her girl loose with caution. The curse breaker and the cursed were left alone. The girl was staring at the red kilim thrown in the middle of the tent. Two lanterns stood in two opposite corners aiming to do the futile task of brightening the spacious tent, a gratefully brewing Samovar, a few cushions rested against the wall, a pile of neatly folded duvets and mattresses on the corner were all the family had.

‘Is that ayran?’ Inji saw pitcher containing white fluid. ‘It must be made from ewes’ milk. My mouth’s as dry as a parched well, my dear girl, pour me a glass of it.’

Girl looked at the old woman for sometimes, then rose with hesitation, grabbed a glass, poured ayran and gave it to Inji, who emptied the glass with one gulp; it was rich, viscous, creamy and sour.

‘Shahseven nomad’s ayran tastes something else. So, your name is Leyla. It is a beautiful name.’

The girl didn’t say anything.

‘I don’t think you have gone crazy, but you have a problem, and I want to help you.’

She stood in front of Inji, her head sunk into her neck.

‘You see here.’ Inji tapped her chest a few times. ‘It is full of secrets, scandals and untold stories. I have kept them in here and will take them to the grave with myself. May god be my witness. Now tell me what is bothering you?’ Inji said in a lower tone.

The girl still stood unmoving.

‘Now, you have two options: one is to tell me your problem, and we can find a way out, or you continue playing your daft game, and I promise you that your dad will then take you to Tabriz, to a mad house, and there even if you’re not crazy, you will become one. You decide.’ Inji straightened her back, rested her hands on the cane.

Leyla burst into cry, held her mouth with her palms to suffocate her outcry.

‘Cry my girl, you are safe here with me. I am on your side,’ Inji whispered.

‘No one can help me?’ Leyla said half cried and half whispered.

‘What is troubling you my girl?’

‘Can’t tell, can’t even tell myself. I have committed the most grievous sin.’

‘Have you fallen in love?

The girl triggered another mighty sob.

‘More than that?’

‘I am done. There is no way out.’

‘What did he exactly do to you?’

‘My own fault. I am a fool.’ She punched her head a few times.’

‘Where is he? We can make you married to him. I know a very good mullah who can help. Convincing your parents on me. Just tell where the hell he is?’

Leyla swung her head.’

‘Doesn’t he want to get married? It is not up to him. Tell me where he is, and I will have him dragged here to your feet, then marriage will be proceeded.

‘He has run away.’

‘Son of a dog. Where has he escaped?’

‘Hell,’ she wailed.

In her mind, Inji went through the similar cases she had encountered in the past to find a way out, but this case was hard to solve.

‘Pour me another glass,’ she said.

Girl, whimpering, brought her another glass of Ayran, then sat beside Inji, looking at her quietly.

‘Are you pregnant?’

‘I would have killed myself if I was. I waited till I made sure I didn’t carry the child of that pig.’

‘Don’t be silly. I may have found a way to get you out of this trouble, but I need your complete cooperation.’

Leyla nodded firmly. Inji could see her face completely for the first time. She hardly looked like a grown-up woman; she was small and thin; her breasts have hardly developed.

Inji called out Leyla’s parent. They instantly entered the tent. She asked the mother to take Leyla out of the tent. She kissed her daughter’s head, then they went outside. While following her mother, Leyla was looking back worryingly at Inji. She looked more like she has lost her doll than her virginity Inji thought.

‘Shaitan has gone inside her body indeed but I will expel him.’

‘God bless you Seyid Inji, I shall be your servant for the rest of my life.’

‘But the procedure that I am going to carry out will not be done without a consequence.’

‘What consequence?’

‘Shaitan exit will cost her virginity.’

The man who sat on his knee froze, his gaze fixed at the floor, grabbed his trouser, pressed hard.

‘And of course, I won’t do it without your permission.’

The man still couldn’t utter a word. His fuming face soon sunk, became sad and desperate.

‘My son, it is not up to me to tell you what to do, but something has to be done.’

‘No man will marry her.’ He sighed bitterly. ‘Better off be a sound minded spinster than be a lunatic!’

‘Who says she can’t get married. When a suiter found, send him to me, and I will confirm she hasn’t done any wrong.’

‘Whatever you approve, Mrs Seyid.’

‘Bring the girl inside.’

Leyla was brought in, and they were left alone again. Inji said to her to eat well as she looked like a resurrected dead, not to get out of her bed for a couple days, and after that, behave normal.

‘Now, take, this agate ring. It is blessed from Karbala.’

Leyla took the ring with face of a rich-brown agate.

‘Now, my dumb girl, gather your wisdom from your heel to head. Since now, be careful of every step you take. Life is unforgiven.’

Girl’s face shone, a shy smile appeared on her face (youth gets sad easily, happy easily). Inji stroked her head, then call out her father to come in.

‘How did it go Mrs Seyid?’ he said. Inji could see the gathering crowd outside of the tent.

‘The girl needs rest. I will tell you in the car. Take me home now.’

The Land Rover ambled away from the tents, and in no rush, headed toward the town. Gaynarja spring had to be somewhere close to here Inji thought. She wished to have her ill feeble body bathed in its therapeutic hot water coming from the heart of Mount Savalan, whose silvery shoulder dimly shone in the dark.

‘The procedure went well, and with might of Allah, your girl will recover.’

The man profusely thanked him, promised he would pay in cash when his lambs were old enough to sell.

‘I don’t want your money, just look after your girl.’

The glowing lights of Meshgin appeared. Inji was thinking what she was going to do once arrived at home: to eat a couple of halva’s slides that one of her neighbours had brought, then take her red pill, and best of all, lay on her bed and have the sweetest sleep.

Perito Prize Winners

Perito Prize 2020 – Winner: ‘EVERY/OTHER’ By Keshuan Chow


Keshuan Chow


I can’t remember where I first heard it, or when. All I remember is that the girl who said it was an Every. Long, silvery blonde hair, straight as corn silk, shiny with the echoes of a million others like her.

I brush my hair one hundred times, she said, as she pulled the brush along those long, long strands.

So I adopted the habit, in an effort to be more Every. Each night, I sat at my mirror, looking into my Other face. Looking into my Other eyes, dark like obsidian or black holes or voids. I would brush and brush, counting carefully. Always precisely to one hundred, so that I may become more like an Every. More like her.

Brushing my hair was soothing. So soothing that I never saw it as a chore. The sound evokes such calm that people trawl the internet for videos of women brushing their hair. What these people do with the videos I do not know. I imagine them leaning forwards, ear buds in, staring at the screen with a sort of manic grin.

The sound of brushing hair is otherworldly. (You can approximate the sound by putting the flat of your tongue against the back of your front teeth and repeatedly exhaling. It’s not an exact replica, but it comes close).

As a child, I was like a Bowerbird, eagerly picking up tips on how to be more Every. The Everys seemed to be of peak human stock: often blonde, or at least light-haired. Their noses were small and neat, their skin freckled adorably in the hot summer sun. They had eye creases which didn’t puff up and change location when they cried. They didn’t have epicanthal folds.

I remember attending auditions for school plays, year after year. Being an Other meant that I was consistently relegated to minor roles. It didn’t matter how hard I tried; the main part would go to an Every.

I, like the other Others, would be in the chorus, or cast as a Token. Once, I played a Japanese schoolgirl. Another time, a dirty Vietnamese street child. It was as though all of us who were Others were one and the same. It did not matter if I was Chinese, or Malaysian, or Japanese, or Viet. All that mattered was that I was Other.

The night before my Grade Six play, I scratched my face. There was a mole there, a blemish in my Other skin. It wasn’t like the light smattering of freckles I so coveted. It was dark, almost black, the same colour as my hair and eyes. I thought if I removed it, I would somehow be more Every. So I scratched and scratched, until I felt wetness. When I looked at my fingernails, they were caked in blood.

I did my chorus the next day with a plaster on my face.

I distanced myself from other Others. Picked a football team that sounded very Every. I surrounded myself with Every friends, friends whose parents didn’t carry their belongings around in plastic bags, or make them attend Chinese school. I read Every books, I watched Every television. When I flicked through magazines, the faces were all Every.

As I grew, and traversed the rollercoaster that was puberty, I would sometimes be noticed for my Otherness. Boys would actually say they liked me for being Other.

But I don’t want to be Other, I would say. I want to be like you.

They would say, We wouldn’t like you if you were Us.

No matter what I did, I was distinguished as an Other.

I tried my hardest to get part-time work, but suspected my résumé was often thrown out. My name broadcast me as an Other, and it was almost too hard to say. The Everys in charge of hiring probably didn’t want to bumble through an attempt to pronounce it. So it was easier to just not try.

Years later, I read research that confirmed my suspicion. Some Others had found that changing their name to something more Every-like landed them better jobs. It’s a strategy as old as time, really. People who were Others — women, the enslaved, the persecuted —  changed their names to become more acceptable, more appealing. Apparently, the onus is on the Other, not the other way around.

Eventually, I won a place at med school, where I painstakingly sweated out the letters that would follow my name. Afterwards, I would write out my complicated, unpronounceable Other name, then write those two letters: M.D. It is such a common mark of Others like me, that it could almost be a trademark.

Not OtherTM, but OtherMD. In fact, there were so many Others in my graduating class, that I almost felt more Every.

Almost. But not quite.

My habit of brushing my hair never stopped. Every night, one hundred strokes. It didn’t matter if I was up late, studying the bones of the hand (tip: use this mnemonic. So Long To Pinky, Here Comes The Thumb. Straight Line To Pinky, Here Comes The Thumb). It didn’t matter if I was passed out drunk on my friend’s bedroom floor. Whenever I remembered, I would swipe my brush through my hair one hundred times.

It was shortly after starting work as an OtherMD that I started to inspect the brush. For so long, the brush had just been an object, a prop. But as I rode the cresting waves into adulthood, it became an extension of my arm. A totem, or talisman, something that represented myself, my diligence. The parts of my personality I carefully crafted, just like my now-hidden yearning to be more Every.

I looked at my brush, after my one hundred strokes, and saw long black strands of hair tangled through the bristles. The dust collecting amongst the hair was abundant, and unsettling.

One morning, I put my hands on the back of my head, and felt it.

Maybe I’m imagining it, I said to myself, but my head feels smaller.

Don’t be stupid, said my reflection. Your head can’t get smaller from brushing your hair.

Every night, though, there would be more hair snarled into the brush’s bristles. And every night, more dust was caught up in the hair, grey and fluffy, like a cat.

It soon became clear I would always be an Other. Some of my patients insisted I had seen them before (Remember? In June last year?) and I would shake my head and tell them, No, I’m afraid you’re mixing me up with another Other.

They still could never pronounce my name.

So I shortened it.

When I met my now-husband, it was in a bar. He had the blonde hair and the blue eyes of an Every, and a devastating smile that made my stomach fizz. That night, I imagined my gastric bile, yellow and pungent, bubbles popping on the surface. (You can approximate this sound by bringing your lips together and then rapidly pulling them apart).

He took my hand, his white hand clasping my dark one. I forced myself to forget the names of the bones (do not, I repeat, do not mention the mnemonic). We danced. We kissed. His hand caressed the small of my back.

Later, he pushed his Everyness into my Otherness, over and over again, while he whispered my shortened name into my ear.

We married quickly. Everyone thought too quickly. Except my Mother, who told me I was lucky.

He’s a good man, she said. Rich. He will support you.

I didn’t want to tell her that all his ex-girlfriends were Others. That my Otherness seemed, to him, exotic. Something to be cradled and cherished, like a flower.

But not unique. Never unique.

I brushed my hair on our wedding night, while he was sleeping. This time, the hair didn’t just snarl in the brush. It started falling out, drifting down in a dark mist, collecting in a puddle at my feet. When the hair hit the ground, a cloud of dust puffed upwards, rising into the air like curling fog. I breathed in that dust, the dust that came from me.

I turned my head. The back of it looked flat. My head was shrinking, my features disintegrating. In my quest to become more Every, I was losing myself.

Slowly, each day, my skin cells were dying. And dead cells turn into dust.

When my daughter started growing, I felt her Everyness inside of me. Twisting and stretching, she would kick me from the inside, angry at the fleshy prison of my womb. She kicked so hard she cracked a rib.

It’s a known complication, said the doctor. You Others are built to have small babies. But this baby is half Every, and this baby is Big.

What should I do? I panted, breathing through the pain.

The doctor looked at me squarely, over his glasses. Try not to laugh. He wasn’t even joking.

The first glimpse of my daughter was a thatch of black hair, peeking through the lips of my labia. The midwife asked if I wanted to see, with a mirror. At first I said no, but then I said yes.

Black hair. Black, sticky hair. How very Other.

Four months after she was born, the last of my hair fell out. Nature’s cruel trick means that a Mother at her lowest — sleep-deprived, hormonal, with stretch marks and sagging breasts — is also destined to lose her hair. Of course, I was already losing my hair, but the hormones sped up the process. Each time I had a shower, I saw strands getting caught in the drain. And swirling in the water was the dust that came from me, slowly but surely washing away.

My daughter was born looking Other, but over time began to look more Every. And shamefully, I was relieved. They say girls are born with every egg they will ever produce already in their ovaries. I marveled at this fact, and thought about the grandchildren that resided in her belly. Mendelian genetics means that she might have blue-eyed babies. Just think — in only two generations, my Otherness could fade, and end up as nothing more than an interesting anecdote, or something that results in an almond-shaped eye.

I still brushed my head once my hair fell out. It had become such a ritual; a ritual I couldn’t break. It didn’t matter that my scalp was scratched and bleeding, that dust fell from it like the crumbling wings of dead moths.

It didn’t matter that I was shrinking, slowly fading from existence, becoming Invisible like I’d simultaneously wanted, and not wanted, to be.

The last day I brushed my head was when the last scrap of skin dissolved and fell away. I sat staring into my mirror, now no longer flesh-and-blood. All I saw was a gaunt skull, empty-eyed and grinning, staring back at me.

Finally White.

With no connective tissue to hold me together, I collapsed onto the ground in a clattering pile of bones. (You can approximate the sound of clicking bones by putting the tongue on the roof of your mouth, and drawing it downwards quickly to break the vacuum).

It was then that He approached, all black cowl and shroud and large, curving scythe. Just like I had dreamt last night, and every night before that.

He stroked my head with a skeletal hand, bone on bone. It hurt in a way that was both tangible and sweet.

Come with me, Child, said Death.

Yes, I replied. I will come.

Death gathered me into the folds of his cloak, and made me look in the mirror one last time.

Congratulations, he said.

I stared, entranced, at the sight of my bones. The same bones that are inside every other human. (Remember the mnemonic?)

Congratulations, Death repeated, as he brought down the scythe.

You have what you wanted. You have now become an Every.


Perito Prize Winners

Perito Prize 2020 – Runner Up: ‘Mary Poppins Was Wrong About Pie Crust’ By Lucy Grace

Mary Poppins Was Wrong About Pie Crust

By Lucy Grace


Dear Judith,

Today at work Jerry from accounts said my piecrust was perfect and the colour of caramel like Sarah’s hair. He didn’t say it to me, they never speak to me, but I heard them in the kitchenette.  It wasn’t even his pie. I only make it on Sundays, with enough to last for Monday lunch. They didn’t ask if they could eat it, they just stole it. They never said. They said other things.

“What’s that awful smell in the fridge?”

“I’m guessing it’s Martin’s lunch again. It lingers.”

“Well, uh, there’s nothing in here that looks like food.”

“Usually in a green box. Martin has a thing for eggs and onions – I dread to think what his kitchen smells like.”

I don’t know what they’re talking about. My kitchen smells like a kitchen, what else would it smell like? I doubt they have kitchens, they’re too young. They’ll stay as thin as those too short trousers they wear if they keep eating things from packets for lunch every day, skinny in the wallet as well as the body. And someone really should tell them that tumble drying can shrink clothes in peculiar ways, sometimes just lengthways. And that if they bought socks all the same colour like my brown ones, they will always be able to make a pair. I never suffer from cold ankles.

It takes me three minutes to walk to the office kitchenette to collect my lunch, two and a half minutes to walk back (I am quicker on the downhill stairs) and three-quarters of a minute to set up my desk with the blue cloth, cutlery, flask and cup. I eat my lunch at 12.35pm. At weekends I eat at 12.30pm because my table is in my kitchen and it takes nine seconds to open my fridge and I can be ready with my cloth and cutlery before the clock chimes. But of course I don’t have a clock that chimes. That would be too much. I hope I’m writing this right, Judith.


I haven’t eaten with another person for twenty-two years. Not an actual person. There’s Radio Four in my kitchen, and the odd-bods who work in my office, but they mostly eat in the upstairs kitchenette and I eat at my desk so that doesn’t count.  When I was nineteen, I went to a pub with a misused carpet with the girl from the bus stop who made promises. She ordered pie. I tried to stop her, but she said I was a bully and she could eat what she wanted and I wasn’t the boss of her and did I think she was too fat? She said so many words so quickly, they fell out of her mouth like teeth and I couldn’t catch them all. And by the time I’d made sentences out of them, she had gone. The pub smelled funny and the tables were too close together so I left. She wasn’t too fat. She ordered cottage pie and that isn’t even a pie.


Grandad always made me wait for the chimes before eating pie – he said the neatness of the hour made the pastry taste better. His table is still in the same place and it’s the same table anyway. Everything is the same in the house, apart from the sharp knife with the butcher string handle, because the string began to unravel and dragged in the washing up bowl so I bought a new one. The girl in the shop made quite a fuss because of all the blood on the blade and the floor and she wouldn’t listen to me explaining that the only way to test a blade is to run your thumb across it, not along it, but in all the noise and shop lights I must have muddled my ‘across’ with my ‘along’ and there was the blood. It was only because of the way I banged my head when I fell that the ambulance had to come but the ride was white and quiet and it made a change from the bus. They said I could lie down. I was just glad it happened on a Saturday. The scar is a white threadworm on my left thumb.


The secret in piecrust is cold hands, Judith. I have cold hands and chilblains, but they’re on my feet, the chilblains.

“Don’t overwork it, lad, leave it alone,” Grandad would say.

Grandad was good at leaving things alone. Some days I didn’t speak to anyone. I showed the driver my free bus pass and the dinner lady my free school-dinner pass and the shopkeeper Grandad’s free milk coupons and they didn’t need to speak to me at all. It is better to have passes and vouchers to show people because then they don’t see you. At work I have a pass which hangs around my neck in a plastic wallet. It opens doors too. That’s even better, as people don’t even have to look at my face, they can look at my middle and they’re done with me.

Grandad showed me how to make pie.

“Measure your flour carefully, lad. Too much flour in your piecrust an’ you’ll go from tender to tough.”  Then he would say,

“This is the only time in life it’s good to be flaky,” and laugh wetly until it turned into a cough, and have to go outside for a cigarette for his lungs. I didn’t like the smell, but I liked to watch him smoke the neat little roll-ups from the flat tin. I would stand behind the brown kitchen curtain and watch him leaning back into the weak sun, his floured fingers on the fence.


Mary Poppins said in a film on the television that a piecrust promise is easily made, easily broken.

Judith – I don’t think Mary Poppins has ever made piecrust, it is not as easy she thinks. Her promises must be rubbish.


This morning the woman in the paper-shop said I had cold hands. She touched my fingers when I paid; I don’t know why because the paper cost exactly twenty pence and she didn’t need to touch me. Twenty pence is a single coin. I have that ready before I go into the shop. When the price of that paper goes up I will swap to a different one which still costs a single coin and has too many parts to it, but I don’t have to read them all.

She said,

“Cold hands, warm heart,” and smiled right at me. I had my gloves on so she didn’t know if my hands were cold and my heart is inside me anyway. Her hair is shiny like conkers. I look at her hands every day, they are pale and soft like raw pastry. I wonder if there would be a mark if I pressed them, gently.


She wasn’t in the paper-shop today. It was a fat man instead and he didn’t say anything about my hands or my heart.


Perfect piecrust has secrets, not promises. Grandad told me that. He said,

“You want little bits of cold fat in the crust – they’ll melt when it bakes. That’s the secret of flaky crust. Never tell other folk our secrets, lad.”

Does it count if I write them down?


Judith – she is back! It has been the fat man in the paper shop for twenty-six days and I thought she had gone forever but this morning she said,

“Cold hands, warm heart,” and I was so happy I walked to the bus stop forty-five seconds more quickly than usual.


My cupboard:

  • Two white cups, one for tea and one for coffee.
  • Saucers, none (unnecessary).
  • One drinking glass, medium, chipped.
  • One plate, green.
  • One bowl, for everything else.
  • One white enamelled pie dish with a blue rim, medium-sized.


Today isn’t a pie day, but I have thought about it a lot and know it’s risky but I am nearly forty-one and after writing up a pros and cons list like you suggested I’ve worked out the probable hazards and Grandad isn’t here anyway so I’m going to make the pies a day early and take them to her tomorrow. Antiques Roadshow won’t be on but I will hum the music instead.


This morning it was difficult to open the door to the paper-shop because I was carrying two pies in a bag. The bell jangled when I went in so she knew I was coming. When I gave her my single coin, I put her pie-cup down on top of the stack of papers and it looked tiny in my man’s hand and maybe not the right size. She didn’t say all the four words. Instead she smiled with the whole of her mouth and said, “Warm heart,” and I felt yellow like softened butter.  I smiled back, just a bit, without teeth, but I didn’t say anything because I didn’t have anything to say.


Jerry from accounts stole another pie. I had put it on the second shelf of the fridge, at the back, with a pink post-it note where I’d written DO NOT EAT and underneath that I’d written POISONED because they are too vain to risk getting sickness and diarrhoea in front of Sarah’s hair. I wrote it with my left hand as a disguise.

At 12.30pm I left my desk and at 12.33pm I reached the kitchenette, which was too soon for someone to eat a whole pie, but there on the worktop was my dish, scraped out with crust remnants on the edge. I was rageful. They are short-trousered idiots, I don’t know how they managed to get a job at all. Perhaps they cannot read. I went back to the stairs, but everything was ruined so I went to the toilets instead even though they smell purple and the long lights give me a headache. In the first cubicle I had a seven-minute sit down on the lid and the door opened and some people came in and I heard Jerry from accounts say, “Perfect pastry, just like Sarah’s hair,” and I hated him.


This morning I got to the paper-shop at 08.02 and she was there.

“I’m Jo,” she said.

Her words are as small as the pies. It is perfect. On the walk home I thought about cold fat, melting between the cracks.



This is the last page I will write. It’s a bit annoying thinking about what has happened in the day just to write it all down. Judith said, neuro-typical or not, it is Important to Process Events in order to Feel Things Properly. She has a fixation on Feeling Things, she’s always wanting to talk about Feeling Things. She said to pretend I was writing to her, to make it easier, but I have ended up writing to me. I still speak to her on Wednesdays anyway. The social services cardigan lady said it would either be medication every day or Judith’s leather chair every Wednesday, to Ensure the Stability of my Mental Health. Some people use so many words. One in seven is clearly better than seven in seven, so I chose the chair.



Tomorrow is New Year. I know I said I wasn’t going to write again, but I bought a green notebook. I have good news:

Jerry from accounts left work.

I took in a medium-sized pie in a foil dish to celebrate, with a note saying HELP YOURSELF. People wondered where the pie was from even though I held the pen in my right-hand. I didn’t eat any because other people might have licked the knife.

I still make pie on Sundays, but now I make two, and use both cups. I’ve bought another glass. Later, maybe tomorrow, I’ll tell Jo about Grandad and his pies, not anything worth mentioning really, but just so she knows, about piecrust and secrets and things.

Perito Prize Winners

Perito Prize 2020 – Third Place: ‘The Little Black Stool’ By Fatema Matin


By Fatema Matin


When people think of accessibility, they may think of sophisticated software or state-of-the-art technology. They may think of equipment that changes lives in previously unimaginable ways and therefore equipment that is expensive. However, accessibility tools don’t always need to be complex. Sometimes, they can be as simple as a little black stool.

The little black stool that lived in our kitchen was like a member of the family. Well, it was to me at least. It was about fifteen centimetres high and I grew up using it every day. The top of the stool was designed with a pattern of circular holes and it had four reliable, stubby legs. It was made of cheap plastic, so it wasn’t worth much in terms of money but when we moved house twenty years ago there was no question of forgetting the stool and leaving it behind. The stool came with us. Whenever I needed to wash my hands or wash the dishes or help with the cooking the stool was there. Whenever I needed to reach up to put something away or to get something down, the stool was there ever loyal, ever helpful. I loved that stool. It meant a lot to me because I have Turner’s Syndrome and kyphoscoliosis which make me shorter than average. When you are shorter than normal, a stool like that is the best tool you can have.

But one day, my big brother stepped on it (the blob!) and it snapped into pieces. The stool died an unnecessary death after a long term of faithful service and my heart was broken into as many pieces as the stool. Slightly ridiculous, I know. We had another stool in the kitchen, but it just wasn’t the same. It was completely the wrong height! When I stood on it I was raised two feet above the ground! It’s kind of hard to explain but when you stand that high above the ground, you physically can’t bend your knees to reach the sink or the counter without the threat of unbalancing and slipping off. I also didn’t need to be two foot in the air every time I wanted to reach the lowest shelf of the cupboard- my family were mindful enough at least, to put most of what I used on a daily basis there. The only other option was to kneel on the stool for prolonged periods of time to be at the right height. but that was uncomfortable! My knees began to hurt so I stopped.

My brother didn’t see fit to replace the stool and no one else missed it like I did- no one else needed it quite like I did- so I wasn’t allowed to complain about it. Instead of replacing it myself- after all, I wasn’t the one who broke it- I do the stubborn thing and force myself to manage without it. My elbows may be by my shoulders, or I may be kneeling on the stool in front of the cooker flames just so that I can see into the cooking pot, but I still do everything that I need to do.

I guess that I’ve always been a bit stubborn. I remember, when I took a GCSE in Textiles, I reached the medals of the sewing machines reasonably well and got on with my practical work just fine. This made me so happy because I felt almost the same as all of my peers in the class. However, the technology department saw fit to arrange for the construction of a wooden pallet which slotted under the desk onto the floor. There was no need for me to feel quite as targeted by this as I did because the wooden block was meant to make the equipment more accessible to me by raising the pedal. It was meant to be a positive thing. Unfortunately, at the time, I couldn’t see it that way. I couldn’t help but feel singled out and I cried tears of shame. Needless to say, I refused to use it. I never touched it. Not even once. I told you I was stubborn.

It’s a pity because something I would have appreciated would have been making the jigsaw in the Resistant Materials Room more accessible. I learned for the first time how to utilise the incredibly sharp rotating blade which moved at incredibly fast speeds. There I would be, kneeling on a stool so that I could see what I was doing and be able to move the object forward towards the blade at the correct angle. The jigsaw was fastened to the counter and if you didn’t hold the material you were using tightly enough, the object you were holding would escape from you and rattle alarmingly around the teeth of the saw. My fear was one that one day I would get startled and topple off the stool backwards, injuring myself in the process. I felt confined and less mobile kneeling on the stool and I didn’t even want to think about falling forward onto the jigsaw! It just occurs to me now to wonder why I never spoke up. Why didn’t I say something about my struggle that a low stool would have alleviated? Things would have been a lot easier. I think that I’m just so used to getting on with the resources that are already available in all parts of my life rather than go out of my way to get what I need. Get a suitcase down from the top of my wardrobe? No problem. Put a board game back on top of my mother’s wardrobe? No sweat. It’ll be difficult but I get things done. Just don’t ask me how.

Anyway, that was thirteen years ago. The stool-less situation continued until my older sister Aysha glanced at me one day recently and asked me what I had been doing.
“I was washing the dishes,” I replied.
“Yes, but why is your chest wet Fatema?” she wondered curiously.
“That’s what happens when you’re shorter,” I sighed miserably.
My older sister is married and she has lived in her own house for about five years now. The next time I went to stay over at her house after we had this conversation, I noticed something new in the kitchen- a low stool, about fifteen centimetres high. I used it every day. No longer did I have to drag a heavy, solid wooden chair from the living room to the kitchen every time that I wanted to reach ingredients for myself and cook or bake. Everything that I needed to do in her kitchen, I could do more comfortably.

Then, each time I returned home, I would return to a kitchen where even getting a glass for water was sometimes slightly less than straightforward. You see, the tall stool is sometimes moved from the kitchen- I’ve yet to know why the person who removes it doesn’t put it back- so that when I need it, it isn’t there. I would get so frustrated that rather than hunting it down and fetching it back myself, I would place a foot on the washing machine door thereby raising myself to reach a glass from the cupboard. Okay, I’ll be honest, at other times I would just be frustrated at being so small.  At those times, dragging the tall stool across the kitchen annoyed me. To get myself a glass, I would disregard it and place my foot on the washing machine door anyway.
My older brother got irritated when he caught sight me doing this because he thought that I would break the washing machine door over time (I won’t). He told me never to do it again but he never once considered my need for that little black stool. I doubt he even remembers that it existed which makes me furious because I think about it every day. I don’t feel comfortable enough to request that my family leave a glass on the draining board at all times for me to access.
“Sure,” I thought bitterly, “I’ll stop stepping on the washing machine when I stop being so short or when I stop being frustrated about it.”

I hate being so short. It’s one of the reasons why I don’t want to learn how to drive. When I catch the bus, I’m the same as every other passenger travelling alongside me, but the thought of getting into a car especially adapted for me makes me feel embarrassed about myself and different from other drivers in an awfully obvious way that makes me squirm. People think that you get used to being short just because you’re born that way but it’s been more than quarter of a century and I haven’t gotten used to it yet so I’m pretty sure that I never will. I know that I should be more grateful. After all, people need all sorts of accessibility equipment to move, talk, hear, see and even simply to breathe. However, maybe I could take some steps towards being patient. I’m going to stop stepping on the washing machine from now on. I could find a driving instructor to accommodate me…and maybe, just maybe, I’ll even let go of my stubbornness and buy a little stool.


Our World. Without Boundaries Podcast Ep8 In The ‘Inclusive Designer Series’ With Gregory Mann On Dementia (Mini Series Ep2)

 In this episode we discuss dementia with Gregory Mann – episode 2 in the vision mini series. 


Perito:     Welcome to the Perito Podcast Our World Without Boundaries, a Podcast all about creating inclusive environments and about helping us all become experts at identifying exclusion and create an inclusive and accessible world for everyone, everywhere.  Perito believes that we are all designers in some capacity even if we aren’t the Principal Designers like Town Planners or Architects.  This Podcast is out there to help everybody become a community expert in recognising exclusion and someone who can then contribute to a design process and make or create better inclusive design decisions.  The Podcast will help listeners learn from the day to day experiences and challenges of our interviewees and the topics we cover so that we will all have a greater understanding of what can exclude people from participating and what can be done to create our world without boundaries.  Now in our new mini-series we’re looking specifically at vision and we’re joined again by Optometrist, Gregory Mann from Mann and Francis.  This mini-series was conceived as a specific tool to help people understand impairments associated with the eye, but also the impact of temporary issues that can make short but just a severe impact on people’s lives, so in this episode we’ll be specifically looking at dementia.  Hello Greg, welcome back thanks for joining us.

Greg:        Hi thanks for having me back so soon.

Perito:     The last Podcast was particularly useful.  You’ve already done one quick fire round but let’s try another one ready?

Greg:        Go ahead.

Perito:     (1.18) You’ve already done one quick fire round but let’s try another one ready?

Greg:        Go ahead.

Perito:     (1.19) What is the greatest global challenge we face, as say global population?

Greg:        I’m going to say artificial intelligence, closely followed by global warming.

Perito:     (1.30) Is there likely to be artificial intelligence if there’s no one to build it?

Greg:        Well that’s true, good point, I think artificial intelligence will be quicker than global warming.  Your dead right if global warming hits us first then we won’t have to worry about the artificial intelligence.

Perito:     No.

Greg:        Of course, artificial intelligence could get us around the global warming issue so.

Perito:     (1.51) What couldn’t you live without?

Greg:        I’m not too worried about my phone but I must admit I use the internet a lot ever since I first got.

Perito:     (1.59) What’s the best gift you’ve ever given someone?

Greg:        I gave my girlfriend a book called “Quiet” a while ago and it’s a book for introverts and she found it really, really helpful, I’ve heard really good things from it so whilst I’m not particularly introverted so I haven’t read it myself it helped her a lot so yeah I’d Quiet for Introverts, she’s given it to a few other people.

Perito:     (2.20) Your favourite beverage?

Greg:        This is the child in me come through a little bit here, I’ve never been one for hot drinks or fizzy drinks or sweet drinks, I largely just drink water but I’m a big fan of milkshakes.

Perito:     (2.31) You could have water, water’s a good choice for a favourite beverage, that counts.

Greg:        Most frequent would definitely be water but it’s a bit embarrassing really but if I go to a really nice sort of American diner or something and everyone else is having American beers, Budweiser’s and things, I dare say I’m tempted by the ice cream milkshake.  (laughter)

Perito:     (2.52) That’s good enough, since some people might be starting out with this episode can you tell us a little bit about who you are or where you come from and how you’ve come into contact with dementia as an optician as well maybe towards the end of.

Greg:        Sure yeah so in brief I’m an Optometrist, an Optometrist is the person who works in a high street opticians, they’re the people who actually examine your eyes, ask you to read the letters, is it better with the lens, without, establish a prescription for your spectacles if you need them and we screen for eye disease, we look at the health of the eye to make sure the eye is functioning.  So I started out in a high street but since then I’ve been working almost exclusively in domiciliary care, domiciliary is by a home visit care homes and individual homes performing a home visit in service.  Before this Podcast I knew we’d be talking about dementia so I was working out just roughly how many patients I meet in a given year with dementia and if I had to guess just a rough idea I’d probably look at at least 1500 pairs of eyes a year, something like that and off the top of my head between 30% and 50% of those people will have dementia in some capacity or another, so to take a wild guess I’m probably seeing 500 to 1000 people with dementia a year, I’m spending between 15 and 20 minutes with each of those patients.

Perito:     (4.09) That is a huge number of people so we’ll come to the volume of this but what was interesting talking to the Visual Impairment Charity I was dealing with the other day they said 80% of their members are actually people with age related Macular Degeneration and following on from the last Podcast I realised just how important this was, but when the lady who was leading the charity said that I just thought, wow this is, so combine that with obviously the number of people with dementia as well these are really, really, really big problems that are impacting everybody.

Greg:        Yeah, almost it’s not a guarantee thank goodness, but yeah the odds are, I wouldn’t like to take a guess of what percentage of people have some form of Macular Degeneration by the time they get to 90 or some form of dementia by the time they get to 90 but it would be a big number, it could well be between 20% and 30% of all 90 year olds could have both Macular Degeneration and some dementia and of course you may well have both of course, we’ll come to this later, but last time we talked about various eye diseases and really what each eye disease meant and how that affected someone’s vision but there’s nothing to say you can’t have more than one eye disease and there’s nothing to say you can’t have dementia or maybe even multiple types of dementia and eye disease and when you start combining some dementia, some eye disease, some hearing impairment and some mobility issues then you’re really getting someone whose got a real uphill struggle and needs as much help as they can get.

Perito:     (5.34) Now coming back dementia before I started Perito, I’ve got to be honest, I wasn’t really aware of dementia as the catchall term that it is, I kind of had this vision that Alzheimer’s was something that was very separate and dementia was something that was very separate because people seemed to use them, at least my impression, these weren’t interchangeable terms they just kind of would seem very separate.  Just how many types of dementia are there, and can you just tell us, am I right in thinking that dementia is literally the overarching catchall term that it seems to be and Alzheimer’s fit into underneath that?

Greg:        Yes exactly that so dementia is the collective term for degeneration and malfunction of the brain in the context we’re talking about and within the term of dementia there are lots and lots of different types of dementia, in honesty at one point I remember there being about 100 to 120 types of dementia, this was probably 8 years ago or something, we thought there was about 100 to 120 different types or different forms of dementia presented in 100 different distinct ways, well as actually having done a bit of research for this Podcast there are now at least 400 types of dementia, we won’t talk about all those of course but it appears to be such a broad topic and that’s purely because the brain is so vastly complicated that there are clearly 400 different ways in which the brain can deteriorate and present as a form of confusion and dementia.

Perito:     (6.54) And I guess if we harp back to your, we briefly joked about the idea of cost between terminating Futurama but you were talking about the idea of the brain being extremely important for vision, so if this is starting to affect the brain then vision is, at least there seems to be a logical path to the eye as being an issue and if the brain stops doing the calculations in the correct way then I can see why the brain is confusing the eye.

Greg:        Yeah absolutely, so that’s possibly the most important thing to think about when we think about eyes and we think about vision, is that the eyes and the brain work together in order for us to see and we can’t see well unless both of those things are working properly, so last week we talked about how fundamental the eye was for us to see which is fairly obvious, people think that well if the eye isn’t working very well someone’s vision isn’t going to be very well affected but really the eye is if anything the more straight forward part of the seeing process, all the eye is seeing is taking in light which is reflecting off the objects we see around us and converting it into electrical signals, those electrical signals then go to the brain and it’s the brain’s job to decode everything and translate it into the real world that we’re seeing around us and even if the eye is doing a perfectly sublime job if the brain isn’t able to interpret those electrical signals properly then we won’t see very well or we may not see things in the way and the perspective that you and I see things.  So I do want to briefly talk about the different types of dementia, we said earlier there were 400 different types but if I may I’ll just go through sort of 3 or 4 of the main types.

Perito:     Yeah, yeah absolutely Greg, that’s fine.

Greg:        And we can refer back to those a little bit later.  You mentioned Alzheimer’s earlier on, that’s one of the most common and frequently found forms of dementia, this is sort of the text book type that everyone thinks about when they think of dementia, so its gradual decline of the brain and it’s function.  It presents in the fairly text book forms of dementia, it’s the simple forgetfulness, someone trying to talk to you but they can’t think of that obvious word and that word might be cup or fire engine or dog or anything but it just, it’s really quite frustrating for them if they can’t think of that word in that’s early presentations it’s sometimes even diagnosed by someone who can’t make their way home, they drive to the shops like they use to all the time and yet suddenly they find themselves getting quite lost and getting a bit confused on the way home, or often their short term memories quite frequently are affected with Alzheimer’s as well, so they may well be a swimming pool what happened you know 20 years ago or 50 years ago but they really can’t remember what they did yesterday or what they had for lunch or anything like that.  So that’s Alzheimer’s that’s one of the main ones.  The other one which a lot of people have heard of is Vascular Dementia, have you encountered that on the street so to speak James?

Perito:     (9.32) Yes I think Vascular’ s becoming more noticeable isn’t it because I think people are beginning to work out that with the heart disease and also I think it’s something to link to plaque as well isn’t it, plaque on your teeth if you’re not brushing your teeth properly can impact in older age on vascular.

Greg:        Interesting a lot, I have to admit I wasn’t aware of that, a lot of forms of dementia are visible under brain scans by examining the brain and you could find plaques build-up of deposits and waste products on parts of the brain, certainly that’s more common with Louis Body Dementia which we’ll come to a bit later, so I didn’t know it was correlated to poor dental hygiene I must say, but Vascular Dementia everyone always worries about what they can do to not get dementia because obviously everyone wants to avoid getting it, a lot of dementia is bad luck and coded in our DNA I’m afraid, however Vascular Dementia is something that we can control a little bit, everyone’s familiar with a stroke, a stroke being a bleed of the brain which then starves the brain of oxygen and that affects the brain, Vascular Dementia in a way works in quite a similar way so if the blood supply is affected to your brain and we look at what causes blood supply to be affected so that’s diabetes, blood pressure, cholesterol, obesity all those other sort of other factors that we can control, if the blood supply to the brain is affected and it’s much slower than a stroke of course, it doesn’t happen overnight, it happens gradually over years then our brain is slowly dying off and that presents in poor brain function and therefore that’s a form of dementia.  So in many ways it presents in a similar way to the Alzheimer symptoms we talked about before, the forgetfulness, getting lost on the way home, poor short term memory but it is in some ways it presents in a similar way but it is quite different but the mechanism by which Vascular Dementia is caused is quite different, if we’re looking at the systemic factors that we would call the whole body factors, blood pressure, cholesterol, diabetes all that sort of stuff they are contributing to the increased chance of Vascular Dementia.

Perito:     (11.26) That’s good Greg thanks, anymore for, you mentioned Louis Body is that a big one as well?

Greg:        Again we’re only talking about 3 or 4 today but this is one of the more common one as well and Louis Body its main reputation are hallucinations, really quite prone to causing hallucinations and of course this isn’t the eye allowing us to see hallucinations or triggering hallucinations this is the brain that causes the hallucinations and hallucinations can be visual or they can affect our hearing, they can be auditory as well.  So often people with Louis Body Dementia will have really quite severe periods of confusion and it can also really affect their sleeping pattern as well, it’s not unusual for Louis Body to fall asleep most of the day and be up and about most of the night.

Perito:     (12.06) That just sounds very distressing perhaps more than the others.  That’s seems like it’s going to impact physically on your sleep and life as well so it’s quite interesting.

Greg:        Yeah absolutely, I wouldn’t like to say which forms of dementia were the best or the worst to have but definitely a lot of, some forms of dementia don’t trouble the patients quite as much, they more trouble the family members who find it very upsetting, whereas Louis Body Dementia if these hallucinations are distressing for the patient that can really work them up.  The final form of dementia I wanted to talk about which is Frontotemporal Dementia this again is another one of the more common ones and this can affect again some of the text book characteristics of dementia that people think about can really affect their behaviour, their personality changes, their ability to speak and sometimes these patients with dementia they lack tact so the text book form of someone with Frontotemporal Dementia they may well be really quite in your face, they may be quite aggressive, despite being a very quiet and peaceful individual who never swore in their daily life before and now suddenly their speaking all sorts of blue language and they may also struggle to speak and comprehend what you’re saying to them.  So those are probably the four of the most common forms of dementia and we’ve put them in these categories but of course just because someone has a certain type of symptom it doesn’t mean they have that type of dementia it’s all up to the professionals to establish this.

Perito:     (13.26) If we turning back to eye issues so we briefly mentioned that moments ago how does dementia then impact on a person’s vision?

Greg:        That’s a really good question and it’s one that I’ve been trying to figure out for the past 10 years, so going back to what I said earlier the first thing to stress is that even if the eyes are working perfectly someone could have dementia at the age of 82 and they could have the eyes as good as any 40 year old, they’re eyes could be absolutely fantastic but if the brain isn’t interpreting what the eyes are seeing then they will perceive, their vision will appear to be really quite badly affected and there’s been quite a lot of research on it but because the brain is so broad and so easily affected in many, many different ways and with 400 different types of dementia all affecting the brain in different ways it’s really hard to be certain how that person may interpret the world.  However we can talk about some general rules of thumb or things that we do often find are affected and it might help us sort of thing about how someone generally might see, so what I would say is when people ask me this, what it is like to see if someone has bad dementia, I often say it’s a bit like being really, really drunk on alcohol, or perhaps even heavily under the influence of psychedelic drugs, now I don’t about you James but I’ve never taken psychedelic drugs and I’m not a big drinker either.

Perito:     No nor me no.

Greg:        So I’m not suggesting for the research purposes only family members with dementia start taking LSD or some really strong psychedelic to try and emphasise with their family members.

Perito:     (14.53) I think we’ve seen it recreated on television enough times haven’t we in various movies and stuff.

Greg:        Yeah we have, absolutely and I have, when I’ve seen those I’m trying to think of a show where it has but when I’ve seen those, it’s a movie star or something, they’ve been a James Bond type villain, a person has been drugged with some kind of, in their whiskey or something and then they wake up and their really confused and delusional for a while I often think god I bet that’s what it’s like to have dementia.  So if you think of it a bit like that then you can sort of look around your room or wherever, or your car or wherever people are sitting listening to this and think about what would I be looking and seeing if I had bad dementia or if I was on a psychedelic form of drug.

Perito:     (15.35) Well I’d be feeling scared and vulnerable I suspect.

Greg:        What instantly yeah, straight off and you would probably be aware that something wasn’t quite right but you might not know what, and is it you or is it everyone else around you whose not, people with dementia often to note are fairly cautious or nervous or easily scared because things seem new to them but a few symptoms or a few ways of thinking about how someone with dementia may see, well we talked about Louis Body Dementia they may well have hallucinations, so the hallucinations could be triggered by something, so they may for example see a shadow on the floor and even though it’s the shadow of a chair or a vase their brain may well reinterpret that into looking something completely different, they may think it’s a dog on the floor, they may think it’s a hole in the floor or an earthquake has just suddenly happened and the floor is separated, or it may not be even triggered by an object at all it might be completely out of the blue.  I’ve had patients who will see a double decker bus parked outside in the garage and there’s nothing out there at all so hallucinations are quite a big thing, I suspect again that their perspective on size and distance very likely to be quite far off.

Perito:     (16.41) Well it’s often noted already certainly in inclusive design circles that any dark carpet or any kind of lift shaft, so for instance if there’s a black floor in a lift it appear to people that there’s no floor to the lift and therefore it’s just a lift shaft so that’s why people with dementia often are concerned about going to lifts.  The same with bathrooms as well, so the floor coverings thinking back to this has reminded that actually floors, walls, anything that looks like it could be a void is to be avoided.

Greg:        Yeah avoided, good pun, yeah, no your dead right that’s absolutely true and I was gonna come a bit later on to a story along those lines actually but yeah shadows and the brain can try and interpret things as best it can and come up with completely the wrong solution, so it may well be that cup of tea that you’ve given your family member, you’ve given that patient it might be well within arms reach but it might look like it’s completely across the room or the light switch that isn’t completely across the room they may try to find themselves trying to touch towards it because it looks like it’s really close there.  I often see people with dementia who will at something on the floor and they lean forwards to try and pick it up and it’s either not there or it’s a lot closer or a lot further away than they think.  So perspective and size can be really thrown off and like you say when you talk about shadows and dark areas in a room that can really distress someone with dementia.  I don’t know if you remember the sort of childhood toys kaleidoscopes.

Perito:     Yep kaleidoscopes, yeah I do too.

Greg:        They’re sort of telescope type things you’d look through and you’d twist them and it would create all these bizarre shapes and patterns but I think to think of someone who has dementia might be like looking through those a little bit, some weird perspective on colours and shapes will suddenly change as you rotate the kaleidoscope and it may well be similar to that for dementia.  Light is another big one, sun and glare will frequently cause people with dementia to be quite dazzled, we talked about different types of glare last time in the previous Podcast, it’s known that people with dementia their pupil response is slower so therefore a little more prone to glare anyway.  Television we talked about the lack of perspective it may well look like the television is either closer or further away or even worse it may look like it’s really people if you have bad dementia, they may well look at the television and think they’re talking to another person but it may just lack the perspective and lack the fact that it’s not a 3D image.

Perito:     (18.53) Well I’m guessing as well because the bigger the television the bigger people’s heads are on the screens must be reinforcing that message as well.

Greg:        Yeah absolutely.

Perito:     (19.01) If they had TV’s on the wall more above perhaps there are other things you could do that.

Greg:        Yes I suppose that one could say that it might be a situation in which technology perhaps hasn’t given people with dementia a real helping hand, people with dementia probably remember the televisions they had when they were in their 40’s, you know in the 60’s or 70’s they may well have had a small television but it’s the size of a small microwave and then when we put modern televisions which are 50” or 60” on the wall they may not recognise that as a television, it may be even easier to confuse with a real image or something.  Other factors towards dementia which could trigger a bit of confusion for someone, and I think we need to be a bit careful about over stimulating someone with dementia, if they’ve got the radio on and a TV on, it’s very bright, they’ve got a busy window scene and there’s people around the room as well that well be too much stimulus for that person, it might be quite overwhelming if we think that their vision isn’t very good or their vision sometimes struggles processing the right image if it’s been over stimulated so their brain is busy listening and paying attention outside and having to deal with other forms of stimulation that well be that that’s a bit overwhelming for someone with dementia.  We’re also aware that their colour vision is affected with dementia as well so their brain may well either not see so much colour or it may see the wrong colours and again if you talked about dark patterns and dark colours that well look like a void, my personal opinion is that a really quite a complicated or intricate pattern on a carpet, you know some of them are almost psychedelic just to look at them and it may well feel if you have dementia and your looking at a really complicated pattern on a carpet or even just a simple one but very bright one, almost like if someone had a chessboard style kitchen lino for example that well trigger some kind of a peculiar surface like that.

Perito:     (20.38) Stripes and colour patterns is an issue for many people and they just actually remind me of when you talking there about, certainly with tinnitus, what tends to happen with tinnitus which is an audio problem and the tinnitus operates on different frequencies for different people so it will eliminate voice for some people, high pitch, low pitch, and the humming and the constant noise in the ears will cause that sort of essentially lack of distinction between the noise that you can hear hence essentially making you deaf, but if we apply that to a similar sort of logic to like coloured patterns if we’re thinking of the kaleidoscope and these coloured patterns maybe the coloured patterns are simply forming an extension of the vision through the kaleidoscope, so if you’ve already got these multi patterns and this relatively very unpredictable vision system anyway and then you’ve got an extension of that which is appearing in the real world then I can see why that might be a problem, and they essentially sit over each other.

Greg:        Yeah it could well be that like you say, some areas are almost eliminated, other colours or other shapes are massively over estimated and over stimulated into the brain.  Other things how dementia affects peoples vision well it can affect their ability to track eye movements and motion so a really busy scene, imagine if you are sitting on a high street having a cup of coffee, people watching outside, lots of people walking past, if you had dementia you would struggle to track all those people walking past, your ability to look at someone as they walk across and track them with your eye movements there’s actually quite a sophisticated mechanism to track someone there, you’re not consequentially using your eye muscles it’s a sub-conscious thing, that is affected with dementia so people with dementia it’s often thought that if it’s the sort of dementia that affects their eye movements, it’s often thought that they don’t see the world in a fluid moving way, they almost see it as a series of still photographs.  So yeah eye movements are bad or are often affected, so a busy world or an over stimulated world is far more overwhelming for someone with dementia anyway, certainly when it comes to their eye movements it is.  They may well struggle with contrast a little bit so that a poorer contrast environment makes it harder for their brain, their eyes and their brain have to work harder to see in an environment with poor contrast and you talked about Macular Degeneration, well there is evidence to say that another eye disease we talked about, Glaucoma which causes tunnel vision or reduced peripheral vision, there is evidence to say that people with dementia irrespective of whether they have any eye disease will also have reduced peripheral vision, similar, it will feel a bit so the world around them as their brain has fewer and fewer resources it seems to me that their brain starts shutting off what it considers less important vision, it shuts down the periphery just so that you’re really concentrating and doing your best to interpret the world right in front of your eyes.

Perito:     (23.26) That’s brilliant Greg thank you for that, so how do glasses play into dementia?

Greg:        That’s a great question and obviously one that I ask myself multiple times a day just about every day, there’s definitely a real decision to make when it comes to someone with dementia and whether glasses are appropriate for them, and there’s a real balance to be had between is giving someone with dementia glasses going to cause more problems or is it going to fix them more problems than it’s going to cause, and there’s definitely a middle ground between how much better can we make their vision versus how inconvenient or distressing or distracting or another thing for that person with dementia to have worry about, think about or lose to the glasses cause.  However if we’re talking, we’ve talked earlier on about how the brain is struggling to interpret the world around it if we can give it a bit of a helping hand by making sure that the eye is doing its part as best as well possibly can, then with the help of glasses if needs be then to me it makes a lot of sense to give the brain the biggest head start if we can really.  Generally depending on how strong those glasses are and what they’re for, we may well think, we may well decide that glasses are appropriate perhaps for general use because if they make everything in front of that person’s face clearer and they’ve just got one pair of glasses they need to wear them all the time and the person’s quite happily wearing glasses because perhaps they’ve worn them for the past 30 years and it’s not unusual for that person, they’re quite use to having something on their face, we may well think well that’s perfectly appropriate let’s give them some glasses and make life easier for them.  If on the other hand they don’t need glasses for general use but they do need glasses like most people with age just for some close work that becomes perhaps a bit more of a complicated decision because is that person going to end up wearing the glasses for the wrong thing, if their wearing them all the time when they should only be wearing them for reading then it may well mean that their going to, more likely to fall over, the vision around them half the time will be worse than it is better.  So that’s a bit of a tricky decision to make but it’s one best done with the carers or the family members having factored in what that person likes to do, what their hobbies and how confusing and distracting for them to have spectacles, but as a rule of thumb we’re trying to minimise the symptoms and make the eye do the very best job it possibly could and when we start factoring in, did they wear glasses when they were young, are they quite happy with wearing glasses, it is going to reduce the chance of them falling or do they think that they’re 35 years old and they didn’t wear glasses at 35 so they’ll keep saying, “well those aren’t my glasses, what are they doing, they’re not mine, they’re not mine” is that going to cause them more distress than its going to fix.

Perito:     (25.51) What’s becoming very clear to me Greg is just how important the eyes are for people with dementia, not only can they be an avenue for pain and distress and worry because of the way things appear but also there’s a conduit out so if glasses are needed to help that and shape the, and I suppose optimise the perception with the eye/brain combination than it’s vital.  Do you agree with that?

Greg:        Yeah, there’s almost always to be had a discussion on is it worth the extra hassle because they are a bit more hassle.  If I have a patient with, if we go through a few scenarios, so I may well have a patient whose been wearing glasses most of their adult life anyway and their very familiar with the type of spectacles they have, they recognise that it’s their spectacles so if we decide well we can improve that person’s vision, we can hopefully make the best possible job we can in the hope that then the brain is going to make things a little bit easier on the brain, we may well decide okay well what colours does that person like, what sort of frame are they wearing at the moment, do we want to give them a frame quite similar so that it’s a very easy transition for that person to have new spectacles.  If they’re use to wearing perhaps a Bifocal lens or a Varifocal lens and they’re use to that and it doesn’t cause them any trouble, I may well keep them in the same style of spectacle lens because it’s just less of a transition for someone.  If on the other hand I have another patient who really needs glasses for reading, they cannot see anything if it’s right in front of them but they can walk around the room, they can see the television, they can recognise people from across the room without spectacles that might be a situation on which we may decide, well does this person have the attention span and the interest levels to be able to look at things close up and if they really have, if they’re never much of a reader, they really are interested at looking at photographs or pictures or they’re old wedding albums or whatever it is, we may well say well giving them spectacles is probably more hassle, they’ll probably end up losing them, or wearing them for the wrong thing or they may well think they’re 32 years old and they don’t need glasses as you do, so leave them alone they’re not theirs, or it might be that we give someone some glasses for purely close work because once a week a family member comes round and sits down and spends time with them going through some old family photographs, and that’s a really important part of dementia is stimulating the memory and trying to keep people’s memory and attention active, so if they’re doing activities most of the week and then they have a dedicated time when they’re perhaps doing some family time looking through photographs, it may well be that we give them a pair of glasses but 9 hours of the day they’re kept in a drawer or perhaps the family member looks after them and it’s only when they’re doing a specific task that then the glasses come out just for that one task.

Perito:     (28.21) So does eye disease come in here as well with dementia is that going to be a problem because that’s going to be a negative I guess isn’t it immediately, we talked briefly about that at the beginning?

Greg:        Yeah absolutely so when we’ve talked about the eye, even if the eye does a perfect job, someone with dementia may well have quite poor vision because of the reason we’ve discussed above, when we start factoring in eye disease it can really make life difficult, they can definitely exacerbate all the above and unfortunately if someone has, for example, cataract, a really common eye disease, that may well mean that the eye isn’t doing a perfect job so the signals that are going to the brain are already impaired as a result of the cataract.  We talked about eye disease in the previous condition but very briefly about cataracts and how that can reduce the contrast, reduce someone’s ability to see clearly and make someone more prone to glare, so when we factor in the fact that someone’s pupil isn’t responding quite as well because they’ve got dementia, they’re more prone to glare anyway.  If we think about perhaps Macular Degeneration that’s poor central vision, if someone has bad dementia and people or the carers feel that their peripheral vision is very likely affected they tend not to notice you when you walk into a room, until you start walking in front of them and then they notice you, then it may well be when you combine that with Macular Degeneration they have poor central as well.  It may well be that their vision is really quite poor indeed and ultimately it’s going to exacerbate a lot of the above, when it comes to dementia and eye disease there’s a really complicated discussion to be had with the patient, their carers or family members, and the profession or as to whether what can we do to minimise the eye disease, can spectacles help things a bit, can they improve someone’s vision and do we need to think about operations, or seeing a referral and attending an appointment at the eye hospital as to whether we can alleviate that eye disease so that means a cataract operation, perhaps that means eye drops.

Perito:     (30.05) Does the same sort of thing replace hearing?

Greg:        That’s a great question and I won’t talk too much about hearing because I’m not an Audiologist and I’m sure an Audiologist wouldn’t talk too much about eyes but my personal suspicion is that much like vision if someone’s hearing is impaired then that will really exacerbate their ability to interpret the world around them.  We’ve talked that certain frequencies can be affected more than others, it may well be the case that a certain person has real trouble with a certain tone of voice so they may not be able to hear their wife, the gentleman may not be able to hear his elderly wife talking if she’s got a higher pitched voice but he may well be able to hear deeper tones and octaves of individuals or frequently gentlemen who have got a deep voice, so definitely hearing is a really key part of making someone’s brains job easier, reducing the strain on the brain so that the brain can interpret things the best it can.

Perito:     (31.04) Greg, that’s really useful classic information because you’ve got such a wealth of knowledge on the subjects.  What would be interesting is to share that knowledge with people in a way maybe more a story way so it’s easier to understand exactly how people are experiencing dementia, do you have any stories you’d like to share that would be good examples for people?

Greg:        Yeah sure I’d love to, so some of these are eye related, some of these are just things that I’ve picked up so I should stress that I’ve had very, very little formal training on dementia, so I try not to talk too much about general ways to deal with dementia but I can talk about what’s worked for me in practice and when I’ve worked in a care home or with some carers who have really, really top end and really, really fantastic with dementia, I pick up the odd story or I see the odd thing and I do pick up a few things from them.  The first one I wanted to talk to you was about a gentleman who wanted to have a wee and every time he wanted to have a wee he would stand 3’ away from the lavatory.  He didn’t like sitting down to have a wee, he wanted to stand up like all gentleman do of course but he would not walk right in front of the lavatory and as a result of course it was really quite a messy job and after some weeks the carers are starting to get really, really frustrated that every time he wanted to go to the bathroom there was a bit of a mess and some cleaning up required.  However, one person, a carer who had a lot more experience with dementia, went in and had a look at this person’s bathroom and their set-up and they find that the person’s bathroom was well lit, it was very appropriate for the patient, however he had a very large and dark bathroom mat, and this is probably going to trigger off something you said earlier on James.

Perito:     Yes, yes.

Greg:        He decided that persons’ vision was such that he saw that dark bathroom mat, I don’t know what style it was a dark purple or something and to him it looked like a hole, so why would he stand close to the bathroom, the lavatory because otherwise he’d fall down the manhole.  All they had to do was remove the bathroom mat, put a lighter colour bathroom mat in front of it and suddenly there he was standing 3” away from the lavatory like you and I would.  So it sounds silly.

Perito:     Great story.

Greg:        But trying to see the worlds through someone’s eyes and interpreting it as the best they can, can instantly reflect in a complete change in their behaviour, I’ve got another story.

Perito:     But it was so logical for the guy not to want to do that, so despite all his situation, the stress his under, the logic and the self-preservation element was still there, so I need to go to the toilet but there’s no way I’m going over that bit and just like you would.

Greg:        Yeah well absolutely and you have to be a bit careful saying this but my opinion is that people with dementia often exhibit behaviours and patterns that are quite, I don’t want to mean primitive but they’re definitely quite primal, almost childlike or animalistic, so what are children afraid of, they’re afraid of falling, they’re afraid of loud noises, they’re afraid of busyness, they’re afraid of distress, they’re afraid of anything different, any kind of change and I often find that people with dementia are the same thing, those fundamental things that we’ve evolved to be afraid of, they still maintain so falling, you know falling down a hole, that’s a primal and basic fundamental thing that we all try and avoid and that’s what that gentleman was trying to do, so in a way he was far more logical than everyone else was about it and if you try and think about the world through his eyes, could he have seen that as a form of distress, could he have seen that as a risk or a hazard, eliminate the safety hazard, improve the lighting if needs be and suddenly the problem goes away.  The next story I had and this isn’t particularly about eyes but it’s a great one is there was a gentleman who presented in a care home, fairly new to the care home and as it frequently is the case he didn’t have an awful lot of history, he didn’t come with a lot of information and this man was up at 5 o’clock every morning really quite worked up, he’d always try and get out, he’d be pacing up and down the corridors, really quite worked up wanting to do something and they couldn’t work out what it was, did he want a cup of tea, did he want to go to the lavatory, no he just wasn’t happy.  Anyway the carers put a lot of time in trying to work out what was going on and after talking to the family and doing some research they found out that this gentleman, at one point in his life, was a semi-professional rower, which will probably remind you of some echoes of 5am starts and rowing first thing in the morning James.

Perito:     Yeah often unhappily early starts yes.  (laughter)

Greg:        Well this gentleman unlike you, this gentleman was raring to go so they did a bit more research and felt that he was so use to the routine of getting up at dawn, the crack of dawn every day and going for a row, they then felt well what can we do to alleviate that gentleman’s symptoms so they decided that they can get him a boat, so I think they ended up with a canoe of some kind or perhaps just a small rowing boat and they put it in the garden for him.  It was a bit of a feature for other residents to look at, it wasn’t really any kind of a trip hazard and immediately, under supervision of course so he wouldn’t fall, this gentleman was thrilled to bits, he’d go, he’d sit in the boat, he’d mock row through the oars and either though to you and I we may look at that and think well that’s demeaning that’s irresponsible, why are we feeding this gentleman’s delusion.  The principal behind it is what does that man need to make his life more pleasant, how can we alleviate the stress, it’s not up to us to judge what’s demeaning or what’s appropriate, if it fixes the problem and it’s safe why don’t we encourage it, so I just thought that was a lovely story about a gentleman who was so distressed and they got to the solution by looking through the man’s history and taking time to look at what that man did with his life.

Perito:     (36.46) Excellent and have you got anymore for us because it’s very good so far Greg?

Greg:        Yeah a couple more, I had another gentleman also, and a couple more but before we do just going back to that rowing gentleman, other applications for that very similar story it could well be that you’ve got a patient who was a postman, it could well be you had a patient who was a milkman, it could well be you had a patient who was a builder or an accountant, giving the patients anything that allows them to compete in their routine and feel like their contributing or doing some work it may well provide some form of comfort for that person, so a milkman, some empty milk bottles, if he goes around every morning, if it he calms him down and he wants to do it, putting milk bottles at the base of every single door and the whole building it doesn’t cause anyone any harm, as long as their plastic bottles of course.  Another story I wanted to talk about was, this is a bit sad, is I had a gentleman who came up to me, I tested his eyes, we got on well, and he obviously had some dementia but he presented really quite well, he said to me, “there’s a conspiracy going on here” and I think sometimes if you’re dressed well and you’re clearly a visitor a care home often patients will confide in you in environments where they wouldn’t otherwise, you look quite different, you’re not in uniform, they definitely respond in a slightly different way sometimes.  So he wanted to confide in me in something, obviously sort of whenever you hear this you go on full alert and he said to me, “don’t you dare lie to me young man but tell me why am I in the women’s area?” and so I said, “what do you mean?” and he said, “well if I’m not in the women’s area where are all the men?”, now this was a care home, a fairly typical care home it’s probably 25 residents and he was the only male resident in the entire care home, we all know that women live longer than men and that was perhaps a bit unusual to have only just the one gentleman but it does happen from time to time and so I was now faced in a position where what do I tell him, do I tell him well, do I give him a long speech about well men live less longer than women therefore statistically unfortunately most men have passed away that’s why they’re not in care or do I try and say something to him that relieves his symptoms, alleviates his concern and worry but at the same time not wanting to upset him or lie to him, so I said to him, “that they were all at work” and that seemed to make him quite happy, I said to him, “Bob you’ve retired but the other gentleman will be back later, they’re all at work” now I knew he had short term memory so he’ll probably be asking me the same question in an hour, if I knew that he’d be worrying at 6 o’clock why no one was home from work I probably wouldn’t have said it because then that fear would have caused an additional further complication but knowing he had short term memory problems it was less distressing for him to think that he wasn’t in the women’s section the men would be back later.

Perito:     (39.32) So what happened to Bob in the end did he, is he still alive and is he still asking the same questions?

Greg:        I have to admit I haven’t seen Bob for some time but he was, I think, after that he was quite happy with that answer and went back along with his daily business reassured that he wasn’t in the women’s section, he wasn’t in the girl’s section, that generation quite frequently separated gender and how they spent their time.  I think we often find with dementia that as the brain degenerates, patients definitely present with different, they go through phrases of quite a lot of confusion and then they suddenly settle down again and then sometimes they can become more confused and deteriorate and decline a little and then they can settle down again, so I think Bob was, when I met Bob he was definitely in a more agitated state and then a month or two later it is very likely he would have settled down and calmed down and been less concerned that he was in the women’s section, or just eventually accepted the world around him for what it was and not really worried about it too much.

Perito:     (40.32) Okay brilliant thank you Greg anymore from there or shall we move onto the next question?

Greg:        Yes I’ve got one more story, this is not dissimilar to Bob actually and it’s a bit of quandary for your listeners to think about and how they would choose to deal with this situation.  I had a patient who requested a home visit and on visiting there she had two daughters with her, both daughters were very nice really looking to after their mother but they had a really quite different approach to how they would deal with their mother’s dementia.  The mother was constantly asking where her husband was, now the husband sadly had passed away 5 or 10 years before this and we often find with dementia that their short to medium term memory is really badly affected, so whilst the mother recognised her daughters and knew she was with her family she didn’t know where her husband was and it was a really awkward situation because one daughter wanted to tell her mother the truth, she didn’t want to lie to her mum, she felt that her mum should just accept what she said, she wanted to tell her that her husband had died.  However they’d done this before and it had led to real genuine distress from her mother, literally screaming because if you’d found out that your nearest and dearest had just died you’d respond in the same way.  The other daughter preferred a more, a lying approach, a deceitful approach but one that managed that patient’s symptoms arguably in a much calmer way, she would just tell the mother.

Perito:     (41.54) Well it sounds like a white lie doesn’t it, yeah?

Greg:        Yeah, yeah a white lie, that’s a great way, it’s a white lie and she would tell her mother that the husband was at work and he’d be back later to calm her down, so I’m not saying there’s a right or wrong answer here and I think we’ve got to be really careful when it comes to deceiving and lying to our nearest and dearest family members and it may well be that sometimes they can remember that lie and then they’ll challenge you 5 hours later, well why aren’t they back from work yet, so you’ve got to be quite careful but it was just to raise a bit of a dilemma for our listeners is to how do we best deal with these patients and the answer is to how we best deal with these patients and the answer is probably whatever works for them, whatever works for them is a way but consider what works for that person, not what you think is best or what you would like to hear, what makes things most comfortable for that person and achieves your goal of making that person happy.

Perito:     (42.50) You’ve mentioned about the individual and designing for the individual needs, if we come back to the postman and canoe situation, that’s all very well, so that’s very bespoke, have you got any tips, rules of thumb our listeners can do to design better or just understand how to engage with a person with a dementia on a general basis, so are there things that the majority of people can do to help the majority of patients or citizens who might access or interact with their services or design?

Greg:        Yeah sure great question, I’ll definitely keep this mostly to do with eyes but a few little tips that I’ve picked up in the past in general I definitely suggest getting their ears and eyes looked at and examined properly and preferably in a domiciliary setting.  You’ll often find that people who specialise in the home visits will encounter dementia far more frequency than those in a high street, so a home visiting Audiologist and a home visiting Optician is more likely to be experiencing dementia but don’t be afraid to ask that when you’re booking the appointment.  Of course getting as much information as you can from your doctor, your consultant about the nature of your family members particular type of dementia, do they have one type, do they have multiple types and how that’s likely to present and knowing whether they have a form of dementia that causes hallucination, whether they are possibly gonna have their visual fields affected or lose their peripheral vision.  Knowing that information will mean that you can customise the world around you, around that patient far better.  Don’t be afraid to do a bit of trial and error, don’t be afraid to think, come up with a theory oh are they behaving in that way because of X, Y or Z, let’s try and eliminate X, look at Y and work on Z just seeing if that helps that person.  Yeah so a few little tips and tricks for the eyeballs as a rule of thumb it’s quite a good idea to think a bit, to approach things in a similar way to if someone has lost their vision as a result of their eyes, we talked about some of these in a previous episode but similar principles to as if they’re losing vision or they’re registered as blind.  So improving the contrast in the world around you, that’s generally with lighting, eliminating shadows, keeping things quite simple so for example if you imagine someone had blind would you feed them mash potato on a white plate, probably not.

Perito:     No I don’t think I would now, no.

Greg:        No I don’t think you would.

Perito:     I might have done before you just said though.

Greg:        Yeah, yeah you may well have done, in the words of Alan Partridge use a sausage as a breakwater.  (laughter)  So you may well choose to have different colours plates and objects to make life easier for that person, so a dark plate, so if you’re serving a lighter coloured food is much easier for that person to see, if you’ve got a pale cup it might be beautiful but if you’ve got a pale cup on a pale tablecloth again it’s much, much harder for them to see especially if its just full of water, or milk or something pale as well.  So working on your contrasts of the objects in the world around you, try to eliminate glare and reflections just like if someone’s registered as blind, being aware that general lighting can be your friend but lighting and glare can be your enemy, eliminating shadows with lots and lots of lamps so that they don’t shine directly into the person’s face but they do cause generally good lighting.  Keeping things familiar is really important of course, changing the bedroom or the layout of someone’s room if they have dementia is really quite distressing for them but don’t be afraid to jiggle things around a little bit if it improves the lighting and removing, as you said any really complicated patterns on the floor or the walls, complicated or confusing pictures, carpets or rugs.

Perito:     (46.23) So have you got any further general tips Greg which would really effectively for people?

Greg:        Yeah these are just general tips that I’ve found work for me in general practice and I think as a rule of thumb they may well be worth your listeners thinking about, so remember that the brain controls almost everything and dementia can affect almost any part of the frame therefore almost anything can be affected but as general rules of thumb being slow and calm.  I often think of people as mirrors, people with dementia as mirrors, they are essentially products of their environment, so if you’re agitated, if you’re busy, if you’re loud, if you’re worked up, if you’re stressed so will they be, however if you aim to be calm, friendly, smile and go back to real basics with body language, touch is a really good one, where you touch someone is really, really important, touch can be very reassuring for someone anyway between the elbow and the upper arm is a really good gentle way of approaching someone especially with a smile and especially if you approach slowly, that can really reassure someone.  I probably touch.

Perito:     (47.20) And I guess from the front as well, so you mentioned that before but also thinking back to the previous Podcast with vision impairments, locating and touch on someone and approaching them in a way that they can still view you from periphery and everything was really important.

Greg:        Yes absolutely great point, you may well approach them from the front when you’re doing that and you may well of course use another sense that you have available to you sound, you may introduce yourself or make sure that you’re talking when you’re doing it so that they can hear that someone’s approaching as well as seeing, as well as feel, so you’re stimulating all those senses so that it’s less of a shock to someone.  Other things to do with dementia, I often find people with dementia quite like to be called by their first name, we may think of the older generation as liking the formality of surnames but firstly if you’re dealing with a female remember that they may have had more than one surname in their past, if they were only married at the age of 70 under Mrs Jenkins it may well be that they don’t remember that, they remember being Mrs Smith so if you call them by their first name it’s a much easier and more familiar and friendly way to approach someone and eliminates the chance of them not recognising themselves as a different name.  Also be aware that a lot of elderly people will have more than one name, so they may be christened Joan but from the age of 5 they may have been called Betty, so if you call them Joan they won’t recognise as their own name, so being aware if you’re dealing with someone you don’t know very well make sure you find out how they like to be addressed, more often than not, or very frequently surprisingly so it will be a different type of name.  Be sure to work on your body language and keep calm and rely on the base indicators like smiling and being aware that people with dementia will mirror you.  If I think back to my time in practice I’ve been punched and head butted by patients in the past, more than one of those have been female believe it or not however, with hindsight most of the time it’s been my fault, I’m pleased to say it hasn’t happened over the last 4 years or 5 years so I must be getting better are reading patients body language, calming and controlling my own body language and knowing when to take a step back or when whatever methods and techniques I’m using are not working.  We’ve talked about touch a little bit and it’s towards the upper arm and the elbow.  Another strange story is don’t be afraid to go with it, I had a patient who would insist on wearing their pyjamas for breakfast and the family member who was caring for them really didn’t like the idea of it, it was always got up dressed and first thing in the morning being smart and well presented from when they were first married and the family member really wasn’t in on this person still wearing their pyjamas for breakfast.  So I do think routine and a regular stable environment is really important for someone with dementia but at the same time is it worth causing a really big argument over getting someone out of their pyjamas in time for breakfast.  Consider the option that it might not be, it may not be worth causing that person that distress just to get them out of their pyjamas.  So we may look at it and think that looks a bit silly, that looks a bit unconventional but does the patient, does it may the patient’s life easier, is it more pleasant for that patient.  Another really interesting.

Perito:     (50.13) I guess it might be the one thing, sorry Greg, it might be one of the few things that they actually recognise, maybe one of the few things that they look at and go like a child with their blanket or a favourite teddy, perhaps an element from the clothing item stand.

Greg:        Yeah that’s a really, really good point, very probably actually, that frequently explains, I have one patient I can think of them now actually, names Dennis and he likes to wear a bobble hat indoors, all day, even in the summer and exactly that he probably use to wear it 20 years ago or a bobble hat 20 years ago when he was walking the dog and so he thinks that he knows it’s his, he remembers it’s his and I think if people have dementia and they’re aware that the world around them is slipping away from them and they’re aware that something’s not quite right, they’ll very frequently grab on and clutch onto something they recognise or they know is theirs and that brings me nicely onto another point and that’s stealing.  We often find that people with dementia steal things, and they not stealing, they’re taking things and they often hide them away, the reason they do that is they look at something like keys or a picture or a wallet or a purse and they think god that’s important I do not want to lose that, that’s really important and they’re aware that things aren’t quite right for them, the world around them is slipping away a little bit and they think what I can do with that really important thing, I know I’ll put it somewhere safe, I’ll put it under my bed, I’ll put it in my drawer and that’s why we often find people with dementia take things because they think that it’s theirs and they think that it’s important and they want to put it somewhere safe because they don’t want to forget where it is.

Perito:     (51.40) How’s this working going forward, are we making progress with this, I mean I’ve found this particular whole conversation to be massively enlightening but also its concern is there’s a concern here that we may be not doing enough to help people with dementia particularly as this is a huge, huge issue going forward as we get older population and the whole idea of an inclusive environment which obviously is excluding people simply because they can’t interact with anymore or maybe we simply don’t understand how to help them interact with it anymore, whether they become, have dementia.  What are your thoughts on the future and the way this is moving forward?

Greg:        I just don’t think dementia was really even thought about 30 years ago was it, it was more just that they’re, “oh my crazy old aunt she’s going crackers, she’s going crazy don’t worry about if she starts talking about the war, it’s perfectly normal” it’s definitely becoming better than that, we are more aware of dementia but you’re dead right it’s such a broad and complicated issue it’s obviously massively underfunded of course and answer generally I think is time and a tailored approach to individuals.  The more time we can spend learning about someone learning about their history, learning what works for them or what doesn’t work for them betterer and more inclusive environment we can make for people, but I think your dead right it’s going to become more of an issue over time and although things are moving in the right direction it feels quite slow and I’m not sure how you’re listeners can really tailor their environment if they’re shopkeepers or if they own practices and buildings that are going to be visited by people with dementia it is quite difficult to tailor someone’s environment in terms of a physical environment I think being aware of over stimulation is a really good one and I’m sure that would help lots of other disabilities, thinking about contrast and design and layout is a really good one and again that will help people with other disabilities probably.

Perito:     (53.22) You also mentioned it a second ago Greg about the idea of we’re people mirrors, so as long as everybody when their designing projects to think of people as mirrors they are directly reflecting what we produce for their products, their environment like you said.

Greg:        Yes exactly that.

Perito:     (53.35) Which is amazing in terms of this really struck for me is the tool so no matter you do if you have a crazy world that you’ve created for a shopping experience and don’t be surprised if people react in the same way to it, whereas if you’ve got a perfectly normal pro-generic then go for it.

Greg:        Yeah, no absolutely if it’s a high energy, all guns blazing casino or shop selling computer games for youngsters it’s going to be such high energy, it’s going to be massively over stimulating, massively confusing and intimidating for anyone with dementia, as you say they’re products of their environment.  I’ve just thought about this idea now but if I had a shop and I wanted to tailor specifically for people with dementia as well as a lot of staff training I would really consider having a protocol in place where I would, and a template where I would tailor that shop for two hours a week for people with dementia to come and visit and that might involve removing an awful lot of the stimulation from the walls, changing the lighting to make it a calm environment, changing the background music, making sure that my staff know, oh well we’ve got this dementia window between whatever it will be 10 o’clock and 12 o’clock on a Thursday, this is a calm and generally relaxing environment, our staff are aware that some of the patients may have dementia so they’re changing their body language, they’re picking up on non-spoken queues about what that person seems to respond to, changing the lighting in the environment, maybe even changing the colour of the background lighting to sort of create a more calm and relaxing environment.  Perhaps that will be a way in which things could move forwards.

Perito:     (55.16) Now there are quiet hours and things out there but one of the issues I’ve got from an inclusive environment expected with this is we’re turning around to people and saying you’re only welcome here during these predefined tolerated types and I think everything that you’ve mentioned and particularly with dementia patients and customers isn’t actually that far off what they’d quite like as a shopping experience, certainly during Covid I’ve noticed how much easier the Co-Op at the end of my road is because it’s almost like a personal shopping, there’s fewer people in there, you can queue patiently outside, everything’s so much more relaxed and overall it’s a much more positive experience for me.

Greg:        Yeah absolutely and a one-way system which has been brought through for Covid, certainly my Co-Op’s got a one-way system, that definitely makes it easier for a patient with dementia if everyone’s sort of shuffling and moving in the same direction.

Perito:     (56.04) Some vision impairments as well.

Greg:        Absolutely, absolutely, I can see that the other way to look at it is you’re only welcoming in people for narrow window a day, I guess perhaps the free market might solve it if someone thinks that there’s a demand for a permanently calm and relaxing environment that all the introverts and everyone who likes that environment will take their business there and that may be the way forwards, but I do feel that we’ve got a long way to go, it’s such a broad topic, it’s so hard to generalise and we’ve talked an awful lot about various rules of thumb and general traits.  I think we’ve got a long way to go, but like you say hopefully some of the principles tie in with other disabilities that make life harder, so if we can work on things for some people who are blind it will very likely improve people’s dementia as well.

Perito:     (56.56) And before I ask you about any final things, topic, question, what I’d like to just ask if you’re happy to talk about it is everything that we’ve talked about today is very emotive, you’re dealing with people who are in a stressful situation often towards the end of their life, how does this impact on you and what did you, what impact does it have emotionally for you as an optician to see people in this and do you find that you’re kind of just having to work through it or do you often think about these things and how do you manage that for yourself?

Greg:        First thing to understand with most forms of dementia it’s more upsetting for the family members than it is the patient, very often.  The patient frequently, they may go through phases of getting quite distressed or knowing that’s something’s not quite right and getting very upset about it but the vast majority of people that I see with dementia are pretty content, they’re quite relaxed, they’re quite happy, they may have gone back to basics a little bit in what they like and don’t like and what they’re doing with their time but 9 times out of 10, more than 9 out of 10, 97 times out of a 100 they’re actually fairly content, fairly relaxed, it’s the family members who find it really, really difficult because they’re seeing their loved one change, they’re seeing their loved one decline and become less of a person that they remember and that’s really hard for them.  So I think remembering that if the patient is happy, you’ve done your job well and that’s the most important thing, I think that’s really important to think about and also just thinking about the funny side of dementia, I mean people with dementia do really, really funny things, we’re talked Frontotemporal Dementia and how one can lose their inhibitions.  Frequently people with dementia can be incredibly honest, it’s almost childlike in how naïve and honest they are and that’s really refreshing in a world where everyone tries to save each other’s feelings so I’m trying to think of some situations really I mean I’m luck enough not to have a bald patch but if I did I can guarantee it would be pointed out at least once a day by someone (laughter) so certainly I can have someone’s, more than once I’ve had someone saying, “that’s shirts far too small for you”, “good god look at the colour of that tie”, “she’s far too pretty to be your girlfriend” as they point at a carer whose talking to me.  Something hilarious like that so I think it’s really important to sometimes be prepared to laugh at the funny side of dementia and as long as the patient’s happy I think that’s the most important thing.

Perito:     (59.07) Any final things you’d like to add on any topic at all, so this is a chance for you to say what you’re thinking or what’s that’s come up new technology or anything at all?

Greg:        Yeah sure lovely, two things really the first one which is what I really wish I’d mentioned last week we talked about Macular Degeneration and how it’s extremely common and can cause some real impairments in peoples’ central vision, there was one thing I wanted to talk about and it was hallucinations and Macular Degeneration, there’s a condition called Charles Bonnet Syndrome and it’s a situation in which the scarring at the back of the eye caused by Macular Degeneration sends random electrical signals to the brain and the brain doesn’t know what to do with them so it does its best to interpret them, very often can cause a completely random hallucination and the reason I wanted to bring it up was it was thought some years ago that this was really rare, only 5% of people with bad Macular Degeneration had these occasional hallucinations and then there was a study in which actively consultants at an eye hospital, and I can’t remember which hospital it was, started asking people, every single person they had with Macular Degeneration, “do you hallucinate, it’s perfectly normal if you do, we think it’s more common than we realise” and the results eventually came back that up to 50% of people with advanced Macular Degeneration hallucinate a bit and see things that aren’t there, and those patients were afraid to tell anyone because they thought they were going mad, they thought they were going to develop dementia and actually they weren’t it was just the scarring at the back of the eye triggering these hallucinations so I do want to say who listened to the previous Podcast who had Macular Degeneration or a family member and they were worried about getting hallucinations it may well be that it’s the Macular Degeneration causing it, so don’t be afraid to have an eye test and get that examined further because it could well be that it’s Charles Bonnet Syndrome their suffering from.  The second thing I did want to mention and again I haven’t sort of managed to quite find a way to sneaking in this so far was a completely random and very small nugget of information is very often you’ll find people with dementia will ask for their parents, they’ll very often say, “where’s my mum” or “where’s dad” and this person’s 84 years old so obviously very distressing for the family members and the children saying, “well your dad died 40 years ago”, to understand why they do that it’s not unusual for someone with dementia to think they’re a lot younger than they are, so they have very poor short term memory or even medium term memory so a person with dementia may well think they’re 45 years old.  We talked about that, that man who was very distressed because he wanted to go to his rowing first thing in the morning that he was probably doing in his 20’s, he thought he was in his 20’s, so he may well at certain times have asked where his parents were, or asked for his mother for some reassurance and so understanding that people with dementia will often think they’re considerably younger than they are, that explains why they ask for their parents and it also explains where they can find mirrors quite distressing, they look in a mirror and they don’t recognise that person, if you think you’re 40 years old and you look in the mirror and you see an 87 year old in the reflection that’s really distressing for someone, so be aware that mirrors and even reflections on television can be distressing to someone with dementia and that’s why they’re asking for their mum.

Perito:     Brilliant summary there Greg, thank you very much.  So thanks for joining us today Greg it’s been really interesting to hear about your work and if listeners want to find out more about the versatility of domiciliary opticians please check the Podcast notes on the website blog or head over to Greg’s company website which is and that’s also going to be listed on the page too.  Now thanks for joining us Greg.

Greg:        Pleasure thanks for having me.

Perito:     Now you have been tuning into the Perito Podcast Our World without Boundaries, thanks for listening everyone, everywhere.


Our World. Without Boundaries Podcast Ep6 In The ‘Inclusive Designer Series’ With Gregory Mann On Vision Impairments (mini series ep1)

In Episode 6 we find out about vision and impairments from Gregory Mann in this, the first part of our mini series about optics and the human eye.


Perito:     Welcome to the Perito Podcast Our World Without Boundaries, a Podcast all about creating inclusive environments and about helping us all become experts at identifying exclusion and creating an inclusive and accessible world for everyone, everywhere.  Perito believes that we are all designers in some capacity even if we aren’t the Principal Designers like Town Planners or Architects.  This Podcast is out there to help everybody become a community expert in recognising exclusion and someone who can then contribute to a design process and make or advise on creating better inclusive design decisions.  The Podcast will help listeners learn from the day to day experiences and challenges of our interviewees and the topics we cover so that we will all have a greater understanding of what can exclude people from participating and what can be done to create our world without boundaries.  In this mini-series we’re looking specifically at vision so we’re joined Optometrist, Gregory Mann from Mann and Francis Mobile Opticians and the mini-series was conceived as a specific tool to help people understand impairments associated with the eye, but also the impact of temporary issues which can make short but just a severe an impact on people’s lives.  Hello Greg thanks for joining us.

Greg:        Hi, pleasure to be here.

Perito:     Before you tell us a little about who you are what we’ll do is a quick-fire round, a bit of a special treat for you.

Greg:        Okay.

Perito:     And just answer the questions off the top of your head and see how you feel, so first question (1.19) ambition or talent?

Greg:        A bit of both of course it instantly made me think of Gary Player the Golfer, he always said a phrase I’d always thought of was the more eye practice the luckier I get. A fantastic quote but shows you also that you need a bit of both.

Perito:     (1.33) If your teenage self could you see you now what would he think?

Greg:        I think the teenage self would see a middle aged optician and think it was quite boring.  Yeah not much to say about that really, you just think… oh.

Perito:     (1.44) Do you listen to music whilst you work and if so what’s often on the playlist?

Greg:        In truth I don’t actually, occasionally a bit of Classic FM after a long day but for the most part I just listen to Podcasts.

Perito:     (2.00) Socks with sandals?

Greg:        I love it when I see it, if you can pull it off then you’re really special. If you can’t then you’re making everyone else smile inside.

Perito:     (2.10) Seaside or mountainside.

Greg:        Ahh that’s a tough one, I love the ocean, I grew up near the ocean but I do like the view that a mountain gives you so I’ll say the ocean and seaside but preferably high up on a cliff so you can get the best view.

Perito:     Yeah that sounds good, okay brilliant.

Greg:        That was a cheap answer really (laughter).

Perito:     (2.28) There’s no right or wrong answers.

Greg:        Having my cake and eating it on that one I think, yep.

Perito:     (2.33) Tell us a little about who you are and a bit of your background, you obviously like having your cake and eating it but what else is Gregory Mann about so everyone can get an idea of who you are and where you come from?

Greg:        Okay so I’m an Optometrist, I work for a mobile opticians firm called Mann and Francis Mobile Opticians. I’ve been practicing the domiciliary build, domiciliary meaning the home visiting or the mobile service for about 8 or 10 years now, prior to that I was an independent practice in the high street.  An Optometrist is a term sort of used interchangeably with Optician or Assistant Dispensing Optician, Ophthalmologist and they are all a bit different really.  So the Optometrist is the individual who when you go and have your eyes assessed in a high street optician there are others within the optical industry which are similar but not quite the same, so alongside an Optician, as an Optometrist you often have Dispensing Optician and they are well qualified. The term Optician is sort of a bit more of generic term, it can describe either of us although it is a protected title so not anyone can call themselves them an Optician.

Perito:     (3.42) So it’s kind of like an Architect isn’t it you can’t be an Architect in the built environment and the body can take legal action.

Greg:        Yep absolutely yeah, it is a protected title as is the word Optometrist as well so if you see the word Optometrist or Optician it is a protected title.  There other work that is often heard is an Ophthalmologist and an Ophthalmologist is an Eye Surgeon so they’re a consultant, so there background is really different, they start off as Doctors, go to medical school and then specialise.

Perito:     (4.12) Did you ever want to do that, was that always in the plan or was it a case of you?

Greg:        What eye surgery?

Perito:     (4.18) Yeah did you want to go through the field because I guess that’s really super niche isn’t it.

Greg:        It is super niche but in truth the channel is totally different, those who wish to become an Optometrist will go to University and study Optometry.

Perito:     (4.28) Now what I particularly like about what you’ve done with your business is you’ve turned it into essentially a fully accessible Optometry unit isn’t it, you are in your car most of the time, you go around to see people’s houses so if someone can’t go to a high street optician you can go to them. Is that why you set it up?

Greg:        Yes exactly that yeah, so home visits and a domiciliary sector of eye care was always considered very niche, as you’ve said, a very small part of it and in truth most people who are in their comfortable warm rooms in the high street really didn’t want to get involved in domiciliary care and it was neglected for a long time really, however if you’re entitled to an NHS eye test in a normal opticians and you’re unable to attend the high street unaccompanied, that’s the terms that are used, either due to a physical or a mental disability then you’re entitled to an NHS eye test in your own home.

Perito:     (5.22) That’s really useful thanks Greg.  When I conceived this podcast the idea was that this would be the first Podcast in the mini-series about vision, blindless, eye care and helping people to kind of understand more about how this can impact on people’s lives and when your designing, when your creating, when your organising things to build this sort of stuff into and what really matters to the user.  Can you tell us about some typical visual problems that people have I’m thinking maybe if we look at generational issues so from child to as you get older, am I right in thinking that age of the body also means the eyes age with us?

Greg:        Yes absolutely yep, shall we start with the young and work our way through the ages so to speak?

Perito:      Yeah sounds good.

Greg:        Yes so children, a lot of people don’t realise that when a baby is born their vision is appalling, much like the back of head isn’t fully formed you have to be really careful not to damage the back of their head and their vision is really very poor, a new born baby will not recognise its mother how their mum looks, they will primarily recognise their mother through the sound of voice, her smell, her touch and because they have a large amount of contact with her.  A child’s vision develops gradually but over the years and as a result it’s really critical that nothing is going to impede that child’s vision.  Generally it’s a really good idea to have your child’s vision assessed by an Optometrist generally between the ages of 2 and 4, it depends a little bit.

Perito:     (6.38) So how do we know that babies can’t see very well?

Greg:        Good question, obviously you can’t show the dictionary and ask them to read it out, there’s lots and lots of various methods but generally they work on the principle of preferential looking so generally one would hope that are interested and curious and prefer to look at something rather than nothing, so if you hold up a card with a letter on it and then right next to it another equally sized white card with just a blank on it you would hope that more frequently than not the child will look at the card with the letter on and of course if you make that letter fainter and fainter with poorer and poorer contrast and smaller and smaller you can get an idea of just how much detail that child’s sees.

Perito:      Okay cool.

Greg:        Yeah that might well be how an infant’s vision is tested initially but perhaps the most important thing when you’re assessing an infant’s vision is do they appear to have any significant squint, that’s a bit of a slang turn but essentially it’s a turn in the eye, not uncommon to think a child has a turn in the eye and actually the skin between the nose and the eye children don’t have particularly developed bridges of their noses so the skin is closer to the inside of their eye and it looks like that they a squint but they don’t, so an Optometrist will look at that and look at the health of the eye, look at the back of the eye to ensure there’s no obvious obstruction to the child.

Perito:     (7.54) So how many children are born into the world with eye problems, is this going to be one of those things that only affects 1 in a 1000 of us or is this as common in children as it is in adults.

Greg:        I’m afraid I don’t have the exact stats for you on that, certainly very few babies and infants have visual problems, have real squints or any real diseases of the eye but it does happen and the sooner it is diagnosed the better.  Provided that your infant hasn’t got any strong family histories of any squints or anything, short sightedness comes generally in the later children’s years or the very early teens.

Perito:     (8.39) Probably another question you’re going to struggle to answer Greg but I’ll ask it anyway, when it comes around to glasses I mean you’ve worked in a high street optician, when children come in are we designing spectacles and optical products, I don’t know what the earliest age you can have contacts is, but are designing for kids with sight and vision problems already, is there a kind of a big active proactive market out there for it or is there some real room to be made here?

Greg:        Do you mean in terms of the design and the layout of the optical practice in children or do you mean in terms of optical products and spectacles?

Perito:     (9.10) I was thinking more of the product side but if there’s going to be a gap there.

Greg:        Well it’s a good point, I mean the world around is designed for adults so although we don’t particularly struggle with the set up in a practice for children it’s not unusual for me to have to ask a child to perhaps kneel on a chair rather than sitting on a chair for them to be able fit on the machines, it’s a good question actually, I would hope that paediatric specialists in low vision departments in the hospital would probably have higher chairs and equipment that would fit them a bit more appropriately.  As to spectacle frames and fashion and design of things well it’s amusing but Harry Potter has done absolute wonders for his glasses, in the 80’s they were extremely uncool to wear glasses and actually the glasses that you got from your high street practice were pretty awful really however, Harry Potter has made children really want glasses.  In part that it’s not unusual to have a child pretending they can’t see the board, convincing their parents that they can’t see the board and they need an eye test just so they want some cool glasses like their friend or Harry Potter and fortunately fashion has caught up with children’s vision and you can spectacle frames in almost any style or shape or design now, so it’s looking a lot cooler with their glasses.

Perito:     (10.16) Are there any magic frames or more Muggle frames Greg?

Greg:        Excellent question for the moment we’re stuck with Muggle frames but who knows that could be the next area of development.

Perito:     (10.29) Brilliant thank you, so are there any other typical eye issues that are worth mentioning to people who are listening?

Greg:        Yeah for children, so I think leave it to your Optometrist to check for squint and development of the eye, the eye does most of its developing in the first 7 or 8 years of life so far less beneficial if you wait until your child’s 10 then saying they have problems and that has a huge impact on their development during school, it’s a big cause. During school it’s not clear to see the board or if they can see the board they may well be able to see everything clearly but it is harder for their eye to do that, it is far more fatigued for them to look at something then it is you or I.

Perito:     (11.07) Have you noticed schools being a bit more approachable about these sort of technical issues that you’ve just mentioned or is opticians kind of ahead of the game when the schools have yet to catch up.

Greg:        The teachers are pretty good in general, I think if they think that the child’s struggling then they’ll just suggest that child goes to an optician and has an eye test, we do find they’re pretty good.  There’s one other condition that I need to be a bit careful of talking about but there is another condition of the eyes, well not the eyes, it’s a condition of the brain really, visual stress or Meares Irlen Syndrome, I’ll put the spelling of that in the show notes, and this is a situation in which a child will find looking at certain coloured letters, the black and white text is really quite distressing on the eye, feels quite distracting, quite bright, sometimes they will describe it as the words on the page are moving or they may describe it as when they look at a page of writing either the words are moving, shimmering around or they can’t really focus on the words and they just see patterns in the gaps between the words.  This isn’t actually a condition of the eyeball it’s a little like Dyslexia, it’s not the same as Dyslexia although people correctly refer to it as Visual Dyslexia or Visual Stress, think of it as a cousin of Dyslexia its sort of slightly similar in that it’s the brain struggling.  Some specialist opticians and Optometrists can screen for this and we do find that some teachers have heard of it.

Perito:     (12.23) That’s interesting because as a dyslexic I think this whole kind of coloured transparent material thing came in while I was at school in the late 90’s.

Greg:        Did you try that before?

Perito:     (12.33) Well I did but it made absolutely no difference, I mean the yellow colour, the pink colours and it was just, I suppose there was a clarity benefit to a degree but it’s interesting that you are isolating that there is a particular syndrome that may be confused with Dyslexia and as a Dyslexic for it not to, I was always concerned as to why it never made any impact to me and apparently this was the bee’s knees, but obviously it was never going to because I obviously didn’t have the specific syndrome this required.

Greg:        Exactly it’s not the same as Dyslexia, I believe it is correlated with Dyslexia so you’re probably more likely to not specifically benefit from this if you have Dyslexia, but I have plenty of patients who found this beneficial, found these colour sheets beneficial and there’s probably an argument for that but I had patients in that I had University student who doubled their read speed purely as a result of this coloured sheet of paper and it wasn’t cool blue I think it might even have been pink, it is worth looking into and I do find teachers are quite frequently handing these coloured sheets out which is perhaps unadvisable without it being looked at but a lot of high street opticians will not be able to investigate this and some may even mock and not consider feasible.

Perito:     (13.41) Moving through a very typical person’s life and we’re heading into middle age now we’re approaching the Harley Davidson and the sports car type era, are we seeing huge differences in the individuals eyesight now or are we still seeing kind of issues that were picked up in the 20’s and 30’s that have been carried through or are these new things that are developing?

Greg:        A bit of both, if someone has been given spectacles in their younger years, especially when they were teenagers and beyond it’s very likely they still be requiring them but to your middle age question the most common phrase here when we have someone in their mid to late 40’s and above is my arms aren’t long enough, so the typical condition that affects the middle age is a condition known as Presbyopia, everyone refers to it as long sightedness but it isn’t quite the same as long sightedness it’s a different condition, this is a situation in which the lens within our eye is now struggling to focus to read up close.  Generally hits us in our mid to late 40’s, generally it’s an age related deterioration of the ability of the eye to focus, so the analogy I always use is imagine, this is the old fashioned camera, the eye works in a very similar way to a camera really, have a lens in the front of the eye much like a camera that focusses and that’s really quite straightforward for us to fix with spectacle lenses.  The eyes are focussing as well just with spectacle lenses.  If however the film in the camera or if this was digital camera about the electronics of the camera was starting to deteriorate or anything else was going wrong with the camera then you can’t fix that just by refocussing.  One would think that was, generally in your middle age most common problem is Presbyopia but almost anybody needs glasses at some point or another.

Perito:     (15.18) I’m just thinking from a work side of things now so if people are into their 40’s and 50’s in a job, maybe a manual job is there already a thing where organisations, business corporations saying you have to provide these safety glasses, safety gear with prescription to combat that sort of thing cos if you feel that your visions out of sync I suppose does that cause more accidents?

Greg:        Yeah your dead right health and safety’s always on the increase and the need for spectacles for you to do your job properly and employer is required to provide an eye test. If you just need glasses for general use then the employer is legally obliged to provide that however the two main examples that spring to mind are if you require glasses and you’re also required to use safety glasses, so if you have a manufacturing job and your required or obliged to wear safety glasses and you wear a normal prescription pair of glasses for whatever job that is then your employer is obliged to pay you to have an eye examination and were issued with a pair of safety glasses to allow you to do your job properly.  Many of your listeners will probably be able to relate to using a computer, if you need glasses for general use and you also wear those for a computer then your employer is also responsible for that.  However, if you need glasses that are unique for a computer and useless for anything else and you need a computer to work then your employer is obliged to pay for those.

Perito:     (16.35) That’s interesting so it maybe if you were working on a factory floor and there were digital displays overhead that were requiring you to view information on the process say car manufacturing plants that would technically still count do you think?

Greg:        I think if you struggle to see that in general you may well be wearing glasses for driving etc. and therefore.

Perito:     It’s gone beyond that, okay.

Greg:        Safety glasses absolutely but I’m not so sure on office I think the office generally it’s just a screen.

Perito:     (16.59) One of the things it will be interesting to get your view on this actually, one of the things that’s quite important for me, I’m looking at two monitors at the moment actually which both have blue light filters built-in and blue light is an interesting thing that if your staring at a screen all day, and I remember this from the first screen that I ended up having in my first job was a CRT and I transferred to an LCD very quickly after that and my eyesight literally plummeted because of the dryness in the room and things and I sometimes wonder if blue light is the thing that people are designing for at the moment, is it something that’s on your radar?

Greg:        I have to admit I haven’t seen much research distinguishing between CRT and LCD screens, as a general trend we’re doing a lot more close work as a nation than we use to, as a result there are far fewer manual jobs even if it’s just looking at our mobile phones and close work is a stimulus or inducing short sightedness so we are finding short sightedness is increasing in the population as a result.  Whether a screen is slightly worse than hard print or paper remains to be certain but it’s fault that it probably is a little bit, primarily because even though your screen looks flat your eyes are actually looking at a flat image.  The depth of a screen and the depth that your eye has to focus is a few fractions of a millimetre deep and that constant refocussing and adjustment has to do, even without you realising or noticing it is thought that that may be a slightly bigger factor in short sightedness progression.

Perito:     (18.24) Well that kind of flips up as a question on, if you have a population that’s going to be computer focussed so we’re coming into rooms, we’re going to be, well I suppose in the post-pandemic era it’s less likely we’ll be together but are we going to see more automation, more computer use, so in maybe 50-100 years is it possible that the computer screen may completely mutate our eyesight into something completely new because of this external stimulus and humans will either have to adapt or there’ll be health issues are a result of that?  Is that far-fetched or is that a possibility?

Greg:        It’s far beyond the scope of a humble optician I fear (laughter), I’d say that computers can certainly become our friends or our enemy when it comes to low vision the ability just to increase or decrease the size of the print, to increase or decrease the contrast and to change the font colours and the background colours for a combination that works really well for that patient.  I think that has the capacity to make life so much easier for those who are bothered. I do wonder whether our eyeballs and perhaps the rest of body are purely vehicles to the brain so if we’re talking really 50 to 100 years I can imagine that if the signal to the brain the weak link is probably the eyeball, if you could plug your brain with a cable then the brain is what does half the seeing, the brain and the eye work very closely together to see, the eye picks up the signals but it’s the brain that decodes and descrambles everything, so if someone’s eyesight’s deteriorating there would be nothing to stop plugging that persons brain into a computer and then they will either see through a seeing eye, an electronic eye or they may not even need to see because they can plug it into a computer and the computer will send the signals, the brain will decode it and it’s as if they’re watching TV, not through an external device but just plugging it straight into the brain, so perhaps we’re in a bit of an intermediate stage at the moment where the eyes are becoming the weak link but we may be able to completely bypass that.

Perito:     (20.10) That’s kind of a potentially frightening combination of terminators and futurama which is a bit worrying across the board (laughter), hopefully we’ll be somewhere in between that.

Greg:        Yeah artificial intelligence is a bit scary but yeah I definitely think that language is a really good example of how incredibly inefficient it is, for me to get an idea in my brain over to your brain has to be translated from my brain to my mouth then you decode it from your ears back into your brain it’s a dreadfully inefficient slow process so I think eventually bypassing these external things like the eyeballs, like our mouths and language going straight from one brain to another, a fibre cable rather than the slow biological cables that we’re using at the moment. That’s a long way off, for the moment we’ve still got a generation or two of using current vision devices and more straightforward.

Perito:     (20.59) So going back to our gradually decaying human if we’re heading out towards old age and we’re coming out of middle age are we seeing any further deterioration in eye health, is there any other typical diseases that people might be interested in hearing about that will impact on these before we get to old age?

Greg:        Yeah so I think if we’re leaving our middle aged period we’re very likely wearing reading glasses and we may well be requiring spectacles for other tasks towards the end of middle age, television, driving, distance, by the time you get to the older person’s eyes the first thing to understand is that their eye has very little ability to focus so whatever they want to look at generally they may need a different pair of spectacles for it, so some of these patients may need various spectacles one for far away so that’s driving and television, one for computer use sort of arms’ length away maybe even knitting and then a third pair for really close work reading, telephone, mobile phone anything close up but going back to analogy of the camera in middle age and beyond we do start about not just being able to fix this problem with spectacles, we’re getting to the stage where the eye is wearing out just like the rest of our body does and then eye diseases start to become more of an important impact, much of our time we are prescribing spectacles and refocussing the eyeball but a big part of an office job is screen based. disease and if it’s detected triaging it and managing it either in practice or with a referral to work with  the consultant.

Perito:     (22.20) A really useful chapter of this human’s life – we’re hitting old age now and I’m vaguely familiar with macular degeneration because my mum’s got it but is this something that you come across often in older people, just tell us about this later stage life of this individual.

Greg:        Sure, okay you mentioned macular degeneration and your dead right it’s the most common cause of sight loss in the UK, the full term for macular degeneration and its used interchangeably is age related in a generation so as you said, it’s not unusual for people, for the elderly to have this, but it is age related, almost everybody gets it to some extent or another eventually but it’s as broader term as arthritis for example, so you can have some patients who are elderly and they have a little bit of discomfort in their finger, you know on a cold day even though their 84 and that may well be classed as arthritis, on the other hand patients who were largely confined to a wheelchair as a result of arthritis in most of their joints.  Having said that there were various factors that contribute to macular degeneration along with age, some we could do something about, what we would term modifiable and that’s only part.  Biggest modifiable cause or contributing factor to macular degeneration is smoking, it’s terrible for the whole body of course but it really does increase the chance of getting it. If you do have it you get younger, earlier if you smoke. There are other smaller factors as well diabetes, blood pressure, cholesterol, obesity all of which I’d class as modifiable but obesity of course and exposure to ultraviolet light.

Perito:     (23.56) Now we’re looking at providing some examples of this aren’t we Greg in our notes for every listener whose interested in getting a vague idea of what it’s like to exist with these impairments and these are things that are going to really hit people’s day to day experiences aren’t they, I remember doing a survey actually in Basildon, I happened to run into this older chap who clearly had no vision in the centre of his line, he was looking through peripheral and it turned out he had age related macular degeneration as well so he had a long cane and it impacted directly, it wasn’t blindness by any means but it was very much a visual restriction he was simply looking through a black spot in the centre of his eye.  These things affect people mentally, they affect their wellbeing don’t they as well as they’re, I suppose their social and their ability to get out and confidence to get out and engage with the community and world is that true?

Greg:        Yeah absolutely, you mentioned the black spot in the middle of one’s vision, I probably should have described this earlier, the main symptom and disability that macular degeneration causes is it causes very poor central vision, only the very middle of your vision but if I could ask your listeners to perhaps look at a piece of writing, if they look at just one word they can probably see a letter or two of that one word really easily, whilst they’re looking at that first word they can’t read anything even two or three centimetres or two or three words ahead of what they’re looking at, the macular is our central vision so macular degeneration is the degeneration of centre of the eye.

Perito:     (25.24) Huh so it’s self-explanatory yeah okay.

Greg:        It is entirely, yeah absolutely.  We rely almost entirely on that central vision but the most daily tasks in the modern world, our peripheral vision is really useful for navigating around and walking around and walking round and catching things in the corner of our eye but if we ever want to look at something in any detail at all, almost any form of reading or close work or electrical device or buttons on the microwave we use our centre of our eye that’s deteriorating through age it’s really quite unfortunate.  You mentioned that a gentleman you were speaking to didn’t really look you in the eye and if you imagine that your very central vision is quite poor and it’s just a blur and a blob in the middle of that, patients with macular degeneration they develop either through coaching or through picking it up themselves peripheral looking and essentially it relies on looking to the side of someone’s face so the black bob is to their side over their shoulder, to the right or to the left of them, which then means that although they can’t see that persons face they’re talking to in detail at least they’re aware of them more than looking straight at them and having that big black patch right above that persons face, so if you’re talking to someone who may have a visual disability they may not look you right in the eye and it seems rude, it seems like they’re ignoring you or looking off somewhere or not paying attention but actually they will be that that for them, their eyesight is better if they look off to the side.

Perito:     (26.47) Yeah because essentially that’s the only place where the peripheral vision is able to pick the shapes and light I guess and so it’s the only way of doing it.

Greg:        Yep exactly that, if your listeners wanted to try and replicate this imagine putting a great big finger print or a bit of masking tape or opaque tape right in the middle of their spectacles, right in front of their eyeball and then trying to look around they may well find that god they’re either moving their eyes and cheating to try and look around it or if they look straight ahead at all times and its really in the way they may well find god that’s going to drive me mad, I can’t look at anything I want to right in the middle of my vision and it’s really debilitating especially in a world now where we rely so much on our central vision to be able to operate electronic devices.  Other common eye diseases cataracts are the leading cause of blindness in the third world. Glaucoma again more common with age although it does have a genetic component, but Glaucoma affects the vision in the exact opposite way from macular degeneration.  So when it’s untreated and ignore causes tunnel vision, imagine looking through a toilet roll or screw your hands up to make, as gripping a broom handle and then looking down it that would be advanced Glaucoma.  Those are the three most common eye conditions that are age related which you are likely to suffer.

Perito:     (28.03) We were joined on a previous Podcast by activists Caroline Casey, I think you probably listened to the episode with her in?

Greg:        Yes.

Perito:     (28.11) Now she was greatly influenced by her ocular albinism, I think I’ve got that right, so much so though that she started the Valuable 500 which is out there to help get disability onto the corporate agenda.  It made me start thinking about how bad does someone’s vision need to be considering all the things we’ve talked about, now in my head I’m even thinking age related macular degeneration could be a blindness because of the restriction of vision, how bad does things have to get to be considered blind?

Greg:        The word “blind” is thrown around a lot now and it’s really really confusing, in order to be registered as blind you don’t have to blind, still have some vision and still be registered as blind.  The politically correct and modern term for blind is to be severely sight impaired, obviously they changed it because they felt that word “blind” was a bit misleading in that you had to sort of actually be walking around with a blindfold in order to be classed as blind but generally someone who is considered severe sight impaired they will have some form of deteriorated vision to a point where it’s really really bad.  Consultants at the eye hospital it is those who register someone as blind. It has to be a consultant but therefore they do have some discretion of what is classed as being blind.  So I’m afraid it’s a bit vague because there are lots of grey areas and with a consultant various eye diseases will affect the way they approach it but when you meet someone whose blind it’s really quite unlikely that they are completely blind, it’s far more likely that they have some level of vision but that vision is so poor that’s the cause of real disability.  Generally it might be they can only see shapes or bright lights, dark lights, perhaps movement, if someone walked pass them close by they’d see a flicking of light, a shadow, so just enough for them to not need any help but clearly enough but still important for them to remain and retain their sight.

Perito:     (29.46) So would it be fair to categorise several different levels then, escalating levels, so would we start with partially sighted, perhaps sight impaired, then severely sight impaired and then blind, would that be official terminology, is it there that staggering or is it more than that and what sort of category of problems fall into this, so would cataracts be just a sight impairment and age related macular degeneration would be a severely sight impaired?

Greg:        Great question, the answer is there are only two categories for the moment, you can be blind or as more commonly politically correctly referred to as severely sight impaired or partially sighted and again the more modern term is sight impaired.  There are only two current categories at the moment, largely but the only reason someone would categorise someone and put them in one of these boxes is really to ensure they’re getting the best help from the services and the best help from local charities, but the worst your vision the more you entitled to.  Incidentally if there’s anyone out there who feels that they are entitled to be registered, the first stage is to have an eye test with your normal Optometrist, if your Optometrist feels your vision is likely to be poor enough they will refer you to an eye consultant, the Ophthalmologist, and it’s the Ophthalmologist who will register you as blind.  So back to the eye diseases that you mentioned mild macular degeneration, mild cataracts, mild Glaucoma won’t be registered as anything at all, there are lots and lots of people out there with mild eye conditions they might not even know they have much of a problem, if they do have a problem it’s very mild, it’s quite easy to fix with good lighting but if it gets bad enough then they may well end up being registered as partially sighted or blind.  If there’s no operation or spectacles or anything else.  The only other thing to remember is you have to be, it’s based on the vision which is in the worst eye, the best eye you have, so if you have one eye which has been blind since you were a youngster from an air rifle pellet or whatever it was but your other eye is perfectly fine it’s very unlikely that you’ll be eligible to be registered blind or partially sight impairment.

Perito:     (31.41) I think what’s been really useful about this for me Greg is this idea that by designing and by appreciating peoples different experiences with the various impairments, just because someone might have an eye impairment does not mean that they are, sounds like very similar at all to someone else who might be standing next to them with an eye impairment, because they might be seeing things completely differently so their view outlook onto the world and their ability to engage and contribute to the world could polar opposite to the person standing literally next to them, would that be fair to say?

Greg:        Yeah that’s a really really good point, what we’ve talked about all afternoon has been really varied visual material so what I’d like to do is put some photographs on your website and show notes to try and give some kind of a visual demonstration to what it’s like for someone to have these eye conditions but as you say some of them are complete opposite to each other and there are many many others which we haven’t discussed, some of which will affect children or some of which affect us in our early 20’s, early 30’s, early 40’s and so just because some is registered as blind or clearly has a sight impairment of some kind or another it’s very hard to know how they see.  As a general rule of thumb they’re the experts on how they see and what works for them and what helps and hinders them and what works for one person who has poor vision may well not work for another, but the one thing I do want to talk about that’s really important, really means a lot to me generally people with poor vision they find themselves in a situation where some of their other senses are quite amplified so a person who has very poor vision they may well be really quite attuned to sound, however without the accompanying use of their vision more than one noise or more than one person talking at point or another at the same time is really very distracting so being aware that a gentle touch on the elbow to say which side you are and perhaps being a bit quieter when you approach them as you start to talk them and introducing yourself, just because you know who they are, they may not know who you are, it’s really to put yourself in that persons shoes but as you say varies hugely from person to another.

Perito:     (33.37) So following on from that then, if we’re starting to, well let’s use your experience then, how can the listener start designing for problems in everything they do, so we’re talking about daily life product design, decision making at work, the choices that we have to engage like you said about touching someone on the arm to show which direction you’re coming from, seems really important to, and that’s the choice people can make to engage in the right way, tell us a little bit about what people can start doing?

Greg:        If I had a regular customer or a regular client who came into my shop or my hairdressers or my local shop or whatever it was I don’t think I’d be afraid to ask them what they liked or what they didn’t like, how they liked the work, what helped them what didn’t, so that if you trained your members of staff to expect that same person every month the haircut or whatever it was, it may well be that you can tailor their experience to make it the best possible for them.  However, as a general rule of thumb, like I said earlier, patients who have poor vision they generally rely much more heavily on their other senses, sound and touch being two really good examples.  They may well struggle to see perhaps a light switch or a door handle but if they know they are touching a door handle you can make that easier for them with either touch or colourant contrast so if you have a door handle and you’re talking about a flat glass, so it’s not really a handle, if you envisage they’re trying to press the door but they’re pressing in the middle of the door and so it’s far less leverage, it’s much harder for them to open the door wouldn’t be difficult for you to put a brightly coloured border on the edge where the most sufficient place to push is and you could put a textured surface on there and you could put a sandpaper type surface or a rubber mat type surface just so that they could instantly touch that and know oh that’s where the door handle is if I push here it’s gonna be much easier for me to open.  So as a rule of thumb working with higher contrast, putting borders of brighter colouring or brighter sticky tape or something to highlight hazards on the floors, walls, hazards to touch around the head or to the wall or anything like that and then they’re trying to interact with anything perhaps a screen or a light switch or anything that they need to touch then as well as colourant contrast don’t be afraid to texture as a surface.  You’d be surprised how even a very elderly person who is losing their vision it is surprising how many times these people come and tell me there’s a tiny rough point on their spectacles, I look at their spectacles and they look fine to me and then I touch and I find a tiny, tiny, rough part on the side of their frame and it’s because they’re so reliant on touch and hearing that to get around their disability that we can harness this to make their lives easier.

Perito:     (36.06) Is there anything else Greg that you wanted to add in relation to those kind of design challenges people have, I guess cos TV screens must be a major pain for people, I know if you’re watching TV you have to pull the curtain to stop the sun shining on it otherwise you can’t see anything is that something that affects everybody?

Greg:        Yes absolutely it does, your describing glare and generally when it comes to low vision likely someone’s friend or it could be their enemy.  General diffuse lighting the ageing eye or the eye that has a visual symptom or a visual problem very frequently greater light and greater specific light on what they’re trying to look at will almost very frequently and almost always improve their vision and make their life easier.  However light can be your friend or your enemy so if you’ve got light increasing the contrast and shining onto what someone’s trying to look at that will make their life easier unless it’s a screen of course in which case it doesn’t, but if it’s any kind of written work or a light switch or anything they need to interact with or a button or something, a good task lighting to put a light onto what you’re asking them to look at will almost always improve it.  However light can be your enemy when it comes to glare and generally there are two types of glare, there is disability glare, there is discomfort glare. Discomfort glare is a situation in which glare is shining straight into your eye, the light source is going straight into your eye, so a really good example of that as you said is if you have a bright window, you’re facing the window and just in front of the window that you’re trying to look at is the television screen, that’s an example of discomfort glare, as you’re trying to focus on the TV you’ve got all that light surrounding it causing a hallow and silhouetting the screen that’s a great example of discomfort glare.  You may well find if you’re running a shop or a practice of some kind and you have adverts or some kind of interactive screen or TV you’ve really got to be careful to make sure that there’s no discomfort there and members of the public with poor vision will also find that quite difficult. Also all your staff they have to look at this all day, it will cause them visual discomfort.  Disability glare is less direct, that’s not like going straight into your eye that’s reflecting off an object and then going into your eye that’s causing the problem.  The most common cause of that is looking at a computer screen, we reverse the situation with the bright window, you now have a bright window, your back is to the window then you’re looking at a computer screen in front of you, if you turn that screen off there’s a good chance you’ll see the reflection of the window that’s a disability glare and that again is really quite distracting for us all especially someone who has vision impairments. There is a general rule of thumb if you wanted to ensure that your customers and your members of staff weren’t suffering from disability glare turn the screen off and you can’t see any kind of a reflection on the screen of any kind then you’ve got a good chance that it’ll be okay.  If you can it’s worth changing the angle of the screens or adjusting the lighting conditions, the overhead lights or the windows.

Perito:     (38.58) Lovely thanks for that summary that’s brilliant, any final things you’d like to add essentially on any topic you like, anything that kind of means something to you, you like to tell people about it it’s down to you.

Greg:        Yes lovely, yeah we’ve gone in quite deep into various subjects here the most important thing I’d say is that just cos you have some of the symptoms I’ve described it doesn’t necessarily mean you have any of these eye diseases please don’t panic too much just attend your normal high street Optometrist and have them examine your eyes and see what they can do for you.  A few little nuggets which we’ll scoot about topics in various points if you have any visual problems whether you’re registered as blind or partially sighted or not at all don’t be afraid to contact your local charities the RNIB and your local low vision team at the eye hospital and ask for a referral from your Optometrist if it’s considered appropriate they can refer you on, there’s a lot of charities that do a lot for you, some are prepared to perform a home visit in your home and have a look at your set up and have a look at your house and needs to be loan or give you any low vision equipment and give you a few tips on how to make your life within your home.  I do say that you have to be a bit careful when moving and rearranging your house if you’re elderly and you have poor vision because people with poor vision will rely on everything being where it was the day before however a really free and easy way of making the television to see, sounds so obvious, bring it closer, bring your computer half the distance towards or make the same difference as me buying a television twice the size, new televisions are expensive bringing it closer even if it interrupts the set up and the symmetry of the room may well be important.

Perito:     (40.30) Yeah, the aesthetic isn’t I think of all the cables that will suddenly be appearing in everyone’s front room but it’s a very good point Greg.

Greg:        Yeah either bring the TV closer or bring your sofa so that your sofas in the middle of the room and the TV’s tucked away so you don’t have the risk of cables.  I find a lot of resistance from especially the elderly who have things a certain way for about the past 25 years in their house and they don’t want to change things but provided they can get used to sort of objects being moved around as a one off it’s a great way of giving someone better vision.  As a rule of thumb if you improve the general lighting or specific lighting on what someone’s trying to see, you improve the contrast with table colours or simplify the machines and devices if the elderly are trying to use radios and ??41.15, and Podcasts, they can listen to your Podcast James then please do it as best they can but be aware that texture, colour, contrast, good general diffuse lighting with task lighting, specific lighting whatever you want to see, cost a bit more on electricity but it’s a free uplift to someone’s vision and I dare say does reduce the chance of falls for the elderly as well.

Perito:      Thanks for joining us today Greg it’s been really interesting to hear about your work and for kicking off the mini-series on vision in such style, now if listeners want to find out more about the versatility of domiciliary opticians please check the Podcast notes on the website blog or head over to Greg’s company website which and that’s also going to be listed on the page too.  Now thanks for joining us Greg.

Greg:        Pleasure thanks for having me.

Perito:      Now you’ve been tuning into the Perito Podcast Our World without Boundaries.  Thanks for listening everyone, everywhere.