Dominic: The third one is, don’t piss on my grave when I die.

Speaker 2: This is Dental Leaders. The podcast where you get to go one-on-one with emerging leaders in dentistry. Your hosts, Payman Langroudi and Prav Solanki.

Prav: Oh gosh, haven’t done one of these intros in a long time. Payman’s really good at these.

Payman: It gives me great pleasure to…

Prav: Yeah. Fucking… you’ve just stolen the words out of my mouth.

Payman: Go on, bud, we haven’t got time.

Prav: It gives me great pleasure to introduce Dominic O’Hooley to the Dental Leaders Podcast. So much to talk about in so many different areas of life, be it academic, science, real home life lessons, kids, everything. I think we’re going to have a really deep conversation today because Dom said before this, “You can have anything, guys,” so let’s start from the beginning, Dom.

Dominic: Except my house.

Prav: Except his house.

Dominic: Yeah.

Prav: So, Dom, let’s start from the beginning. Your upbringing, where you were born, where you were brought up? Just a micro history of your upbringing.

Dominic: Yeah, a synopsis. I was born in Leeds, brought up in a little town called Horsforth. Two children, myself and my younger sister, Belinda. Mom and dad, Seamus and Jean. Had a very conventional upbringing, raised a Catholic, but, I’d like to say about from the age of five, but I think it was from probably the age of seven or eight, I decided I was agnostic and had a lot of conflicts with my parents about that because my dad was… to say he was religious was an understatement. I went to a Catholic primary school in Horsforth and I was an altar boy. I had to go and serve mass three times a week, Tuesdays, Thursdays, and Sundays. The high point of that was, nicking a bit of the altar wine. The low point was having to serve for a Monsignor Justice, who sounds a little bit like a Judge Dredd character and he was like that a little bit as well. He was a bit tough.

Dominic: So, moved over to Guiseley when I was ready to enter secondary school, and, then, unfortunately, my relationship with my father started to decline very much so at that point.

Prav: What do you mean by that, Dom?

Dominic: I’m afraid that my dad wasn’t an easy guy. He’s passed away. My dad weren’t an easy. He seemed to find me almost impossible to understand or deal with. You know from what I’ve said before, that I’ve now got a diagnosis of autism. But, at that time, there was no real understanding of that at all. I think the commonest expression he used and my mom used as well was, you’re just odd. Which sounds a bit corny but it wasn’t particularly funny at the time.

Prav: Did you hear that a lot growing up?

Dominic: A lot.

Prav: Constantly.

Dominic: [inaudible 00:03:25], yeah.

Prav: Yeah.

Dominic: By the time I got to do my A-Levels, it got to the point where my dad threw me out. So, I ended up doing my A-Levels living in a bedsit in Headingley.

Prav: What led to that Dom? Just take us back to that moment where you did get thrown out. Was it an argument? Was it, the whole focus around being odd, or was it you rebeling a little bit?

Dominic: Well, I was a rebellious type.

Prav: Yeah.

Dominic: One of the things that I’ve reflected a lot upon since, is that my dad was very authoritarian and I didn’t take kindly to it so I was always extremely resilient and would come back at him and report everything he said. As I got older, it became a physical thing quite a lot. He beat me up a few times. We ended up, as I got bigger… and we’re both six foot tall, we ended up fighting quite a lot in the house, which wasn’t appropriate. I think that really got to the point where I went to school one day, and when I got home that evening, my bags were on the doorstep. I was told to get in the car and they took me down to this bedsit, and that was that.

Prav: Wow.

Dominic: I’d love to tell you that was horrible, but, to be honest with you, despite been a bit of an odd bird, I’ve always been a bit of a… not a ladies man, exactly, but I’ve never had any problem whatsoever when I was a young guy talking to girls, I’ve never been embarrassed or anything like that. I’ve always thought I’m quite funny, whether they [inaudible 00:05:14]. I’ll be honest, I thought it was quite an opportunity rather than a punishment, to be living in student land in Headingley.

Payman: So, Dom, when was the first time where you became aware of, there might be a diagnosis here as opposed to I’m a bit odd. When was that?

Dominic: Well, when I was at school, I had a music teacher called Mr. Mumford, who’s a lovely guy… or was a lovely guy. Unfortunately, he passed away as well. I remember in first year of secondary school, walking around one lunchtime on this… the school had numerous playgrounds, and this was a quiet one down a bit… where there weren’t a lot of kids around. Just walking around on my own, really upset and I couldn’t tell you why but I was. He just said to me… he came over and he said, “What’s up with you?” He said it in such a way that I felt confident enough to open up and I just said, “I don’t know who I am, I don’t know what to do, I don’t know how to think.” I was only 11 at the time. He became a bit of a pal through school to be honest with you.

Dominic: Then, I started to get an inkling that there was something not quite the same about me, as there was about a lot of my compatriots. As I got older, I became very adept at masking my difference and being very good at concealing it. I think being fairly intelligent means I can usually hide it with a combination of being quite amusing, if I want, and also just being quick on the draw so I can judge what people want to say… and I can do that. But, I think as you get to know me, I think, sometimes, the cracks in my armour become very apparent, really.

Dominic: So, as I got a bit older I left school. When I met my wife, Rebecca, I think very early on she realised that I was autistic. For a number of years, we had a conversation where it was a case of, I think you possibly should get a diagnosis and, say, go forward with that, and eventually I did.

Prav: Dominic, it expresses themselves on a sliding scale for different people, doesn’t it, and manifests itself in different ways. For you, personally, how is that expressed in communication, personality, dealing with others, body posture, and then other people that you know? What does that sliding scale look like? Just for whoever’s listening to, really, get a-

Dominic: [inaudible] give you a brief understanding.

Prav: Yeah.

Dominic: My boy, Humphrey, who’s 14, he’s got… I suppose, if you’re looking at sliding scale, he’s very much towards the right side, the severe side. He’s nonverbal. He has never really been able to speak at all. He can say the odd word such as no, or yes, but he can’t say anything else, really. He has unusual behaviours such as self-harm and absconding behaviour. He likes to run free. So, for example, when he lived at home, if he was in the house, he would try and escape all the time. It’s not because he was upset, it’s just because he likes to. Then, he used to do something called garden hopping, which was quite fun, really, which is where he’d been in the backyard with me, I might turn my back for 30 seconds, he’d climb over the garden fence, and within minutes, he’s gone down about 12 houses, across the gardens and over the fences.

Dominic: So, from my point of view, looking at my own personal… I did write a blog about this, I think the way my mind works, it’s constantly going through an incredible number of complex verbal options. I keep running back to these topics and subjects that I like and I have to whack them out of my brain because otherwise, I’d want to say to you, I’ve got a very interesting fact for you, Prav. Did you know that rhodium is actually this and… I particular like metals and things like that. Enough, Dominic.

Payman: I read something where you said you’ve chosen to look at it as an advantage.

Dominic: Yeah.

Payman: The work you’ve done with the [BABD] and the Scientific Committee on… we mustn’t say, Oh, it’s because of this, but, to some extent, you’ve used it to really focus on the evidence for COVID. But in dentistry, is it an advantage? Do you find it an advantage in some ways?

Dominic: I do. It’s a double-edged sword. I think it can be intensely focused. So, if you think about the flow state that, sometimes, we get into, Prav, I’d imagine, sometimes when you’re training, you might get into-

Prav: [inaudible 00:10:22], yeah.

Dominic: [inaudible] individual. So, therefore, with me, I can find I can get into a flow state quite simply and become almost unaware of time. That’s probably the happiest I can be in my life really, when I’m like that really. I, also, I find it a challenge because… I think I said this in my little thing that I wrote for dentistry magazine. I said, I’ve chosen the worst job in the world for an autistic guy because I’ve got to meet new people all the time. That’s hard. It really is hard. Well, I suppose, it’s a case of sod it if it’s hard, I’ve got to do it. So, I get some satisfaction from that and I get some satisfaction from the fact that I’m, in some ways, able to charm my patients and have very honest conversations with them and get over my communication issues.

Dominic: On the other hand, I think it leaves me very anxious and wrung out. So, I’ll often find at the end of the day, I’m absolutely wrung out. When my son, Humphrey, had perhaps had a, we call, meltdown, because he’s just overstimulated and he just can’t cope with it any more. I suppose, I have the similar… and I used to use my bike as a way of getting around that. So, I’d have my day of patients and I’d be completely at the end of my tether, and I just get on the bike and spend an hour and 15 minutes, hammering it back home. By the time I get home, I’ll be fine. Right now, I haven’t got that anymore.

Prav: What do you use as a substitute? You just talked about your flow state, and that’s when you’re happiest, is that? Is that when you’re mentally in the zone? One of the guys who works for me, has had a diagnosis, and he finds himself… one of the smartest guys I know, and he says, once he gets in the zone, and the zone is a mental zone rather than a physical one, there’s no stopping this guy. He is super intelligent, and just thinks differently. He’ll solve a problem in 20 minutes that will take the rest of the team a week.

Dominic: I suppose, with me, it is a mental thing. When I’m reading papers, for example, and trying to solve complex problems, I do find a [inaudible] way of thinking about things that’s perhaps a little bit different. I think one of the advantages I have is, I can absorb a massive amount of information quite quickly. So, I can look through a lot of papers and I can start to pick on things that perhaps not everybody will pick up on. Then, that means I can collate a lot of information. I suppose, it’s been a geek fest for me to be able to pull papers up that I think they useful on a daily basis.

Dominic: [inaudible] though, insofar as, I have to watch myself because I can go down the rabbit hole very eager. So, if I read a paper that really interests me, then I’ll forget that, actually, I’ve got a bit of a mission that I should be out helping to educate the [inaudible] population on COVID in my little view, that I should be doing that. I go down rabbit holes and end up reading something that’s got very little to do with it.

Prav: So, if I read a paper, I’ll scribble in some notes down. Get some facts down and stuff.

Dominic: Yeah.

Prav: What’s going in your head? Is it a bit like the Matrix? You sit there and then you pull out the bits, but [inaudible 00:13:52], and then you contextualise it and make a relationship with the next paper you read and just pull it all together. Have you got a great memory? Are you able to bring facts together and then formalise them… those facts together, in what you feel is a solid argument. How does that work? Because, for me, I have to write it down.

Dominic: I’m not sure. The thing is, that I don’t look at the abstracts, I tend to go straight to the body of the paper and read the paper.

Prav: Yeah.

Dominic: I have weak points. I’ll be honest with you, at the moment, I find statistics difficult, I always have. It makes a weak point of mine. So, there’s gaps within that quality of my ability to absorb information. What I find interesting, is that I’m able to… and, sometimes, I’ve actually wanted to go back to the office and say, You haven’t seen this connection. Why aren’t you seeing it? I’ve seen it [inaudible 00:14:55]. It’s good, but, as I’ve said, there’s big negatives to it as well. I’ve actually had to catch myself. This happens with patients and it happens when I’m in chats with dentists. I catch myself and I’ve actually been rambling on about someone for 10 minutes and you can see that their eyes are like too hard boiled eggs, because they’re like, Oh, stop, please.

Payman: So, Dom, you’re 17, 18, living alone and self-motivating yourself to do A-Levels and hanging out with chicks, but where did dentistry come into? How did dentistry come into that?

Dominic: Well, dentistry came into it from the fact that I was a little bit led by… my mother kept saying to me, she says you’re so sensitive… I think she saw my oddness as sensitivity because I used to weep quite a lot. I think the weeping was, a lot, due to the fact that I just couldn’t cope with… I felt so out of it. When I was at school, I just felt like this guy was just inside a clean room looking out at everybody else. Do you know those big round circle for clear inflatable circles and you see people playing and rolling down the hills, I felt like one of them. I don’t know what you call them.

Payman: [inaudible 00:16:19].

Dominic: Yeah, that’s it. I felt like I was in one of them all the time. But, my mom took it as sensitivity and she said… I’ve always had a medical leaning. I’ve always found medical facts particularly interesting, and she put me off doing medicine. She said, “You can cope with death.” I think one of my obsessions, all my life, has been death.

Payman: What do you mean?

Dominic: She said [inaudible] talk about it a lot. I don’t think it’s for you. I don’t think you should go down that road. Because, dealing with death, potentially, on a daily basis is just not going to be something that’s good for you. So, I thought, Well, I’ll go for dentistry then.

Payman: Pulp death, instead.

Dominic: Yeah, well, it’s a combination of minutia, so I can look into the material science side, I can get involved in things like that. Secondly, I can control my interactions with patients. So, I felt very early on that I can shut the buggers up if I want because I can tell them to open their mouth and get on with the work. Will you bleep that bit? Yeah, [inaudible 00:17:33].

Dominic: Also, I think, from a fiscal point of view, I thought it’s a good living. When I was a young guy, I went and actually watched the dentist do work in Horsforth and I realised that he had a very nice 911, a red one. A 911 turbo. One of the first ones with the massive wing on it. Then, he owed a restaurant in Horsforth, [inaudible] called Johnny [inaudible 00:17:59]. At the time, I thought, well, you’re doing all right, and yet you always seem to leave five o’clock. So, from that point of view, I though, he’s got a good bang for his buck ratio. I can do good work. I can get him very interested in what I do. But, I can still be out of work at a reasonable time. It didn’t quite always work out like that.

Payman: Where did you study dentistry?

Dominic: Liverpool?

Payman: Oh, good town.

Dominic: Yeah, so I went across the Pennines, primarily, because… I don’t know, really, I just thought, I didn’t fancy Manchester, for some reason. Pay back. I wanted to be able to [inaudible 00:18:43]. It was one of the best decisions I’ve ever made. I absolutely loved it in Liverpool.

Prav: What was dental school like compared to school school, in terms of fitting in and the social side of things?

Dominic: Well, that’s interesting because I started to find the crooks. That was quite a way for me to become more fitting in and there was two sides to that. One was alcohol. So, from an alcohol point of view, I found, that if I drank quite a lot, and I became very funny in my own head. I seemed to get a real circle of friends who were also guys who liked to go out for a drink. The second aspect of it was a geeky side. I was one of these unusual students who seemed to have a friendship base among the geeks and also among the real rogues as well. So, I ended up actually being quite a popular student, really. I know that’s hard to believe, but I did.

Dominic: I think the third aspect was that I decided… I got very fit when I was at home and I decided I was going to go for a selection into an airborne territorial army regiment, so I did that as well. So, I ended up being one of the fittest heavy drinkers in dental school.

Prav: [inaudible 00:20:04].

Dominic: Yeah, so I had a lot on my plate. I was actually doing selection for an airborne TA regiment as I was going towards finals. I’ve always been a bit like that. I love having tongues on my plate.

Prav: Just putting the pressure on. Do you to perform better under pressure? Do you feel like… Yeah.

Dominic: Yeah, I love it.

Prav: Are you a grafter that puts in loads and loads and loads of hours into lots of different things or, no? It just comes naturally to you. You mentioned the fitness as well. I remember speaking to you separately on this point about fitness. I think the words you said to me is, I’ve just got a decent engine on me, I’m just pretty good at it. But, is it something that just came naturally to you?

Dominic: Well, it’s a funny one, because when I was a young boy, my mom was a bit of a feeder, and so I was very restricted with my diet when I was a young lad. That’s not unusual among autistic people. Then, I seemed to find things that I liked and, then, when I was about 11, 12, I got a bit overweight. That was due to big meals and I had my dad making me finishing everything on my plate. Absolutely had to finish everything on my plate. So, I became a little bit… not diet obsessed but became obsessed with aspects of physical health. As we’ve talked about offline, [inaudible 00:21:29], we’ve talked about longevity, the health span of human beings and things like that, I’ve found all that very interesting over the years. When I talk about having a good engine, I think it was that once I discovered cardiovascular exercise, so running, I started getting into running in the fells.

Dominic: So, I used to like fell running. For somebody who’s a bit of a loner, a lot of the time, there’s nothing better really. You’re out in the fells on your own. Beautiful views. Can be very, very arduous, it can be bad weather, you can feel very close to nature, really. Also, there’s an element of fear there, sometimes, because I used to do a lot of very long fell races. Something called a super long races. You’d be really a long way from civilization from [inaudible 00:22:21]. If you broke your leg, you’d be in trouble. So, that appealed to me. I just discovered, I seemed to have very good cardiovascular fitness. I think that’s just a genetic thing.

Payman: Yeah.

Dominic: Funnily enough, since I’ve had my accident, I’ve discovered I’ve actually got bicuspid aortic valve. So, I’ve got an unusual aortic valve where [inaudible 00:22:44]. That was an incidental finding.

Payman: Tell us about your accident, Dom?

Dominic: Yeah, just very briefly, I was going into cycling a lot as well, and I found, as I’ve reflected briefly earlier… I said, I used cycling as a way to deal with being a bit overstimulated. So, it’s a good way for me, at the time, to calm down after a bad day work or get prepared for a day at work. I think getting tired before I start work sometimes helps me mentally. So, anyway, one day in 2018, Friday the 13th of July, beautiful summer’s day, I set off to go to Huddersfield for one of my practises where I place implants, and I got to about halfway on the journey, riding a bike I built up… a beautiful bike. Then, I went through a junction called Hellfire Corner. It’s called that because of the amount of accidents that happen at it. I went through a set of lights at green, and a guy was driving an extended VW craft van, over, up the other direction and he turned right into me. The combined impact speed was about 48 miles an hour.

Payman: Jesus.

Prav: If you take yourself back to that moment, can you visualise it happening in slow motion? Or, is it all a complete blank?

Dominic: I say it’s a blank, I’ve got retrograde amnesia. What that means is, that because I have a moderate to severe head injury, I’ve no memory from about five minutes before it to about three days after it.

Prav: Wow.

Dominic: So, I had two different bleeds on my brain. One of them was towards the posterior part of my brain and the other was in the upper right anterior frontal lobe. I also had something called a diffuse axonal injury, which is a deceleration type injury. So, it’s remarkable that I’ve still got some good cognitive function really. I’m really pleased about that because, I suppose, from a self-worth point of view, being fairly bright… One of the ways I gauge myself is with self-esteem, I think. I think if I’d really lost that or aspects of that, I’d have found that incredibly challenging. I don’t know how I would have found it. Yeah, so I have a memory of going past the school, five minutes before the crash, and then nothing until about three days later, when I’m in hospital.

Prav: Somebody, obviously, mapped out what happened in that 5, 10 minute window, or whatever it was, at that time, and then what happened since. So, what happened? Who came to the scene?

Dominic: Well, the craft van had two different cams on it. He had a frontal cam, and it actually shows me [inaudible] them. I’m wearing the brightest orange top you’ve ever seen in your life with black and white Chevron’s across the chest. You can see it from a mile off, so you think, you can’t be looking, mate, because I’m really obvious. A lot like an angry wasp coming down the road. Then, actually, the second dash cam is actually of the driver. When you see him, you actually see him jump at least three inches off his seat and you see the whole cab… and that’s me hitting the cab.

Payman: Oh, Jesus.

Dominic: Then, you see him start off and he parks around the corner. Then, you see him get out of the cab. An abiding memory of that, is the amount of builders cleavage he was showing as he climbed out of the cab. Half his backside are running out. Always remember that, for some reason. But anyway, what happened is, the air ambulance came from Leeds Major Trauma Centre, so the Archer Air ambulance. One of the people on board was a consultant in emergency medicine. So, she obviously assessed me at the time. She picked up my bike helmet, took my bike helmet off and it hadn’t cracked. It was very flat on the front, which she made the assessment that I didn’t have a severe injury at that time.

Dominic: I was giving ketamine because I was in acute pain because I’d had the [inaudible] forearm. So, my right forearm had [inaudible 00:27:11]. I think it was a partial [inaudible] glove and it was still attached. I had multiple compound fractures in my right forearm. My right index finger was almost amputated in an open fracture dislocation. My left wrist had an explosive compound fracture of several bones. I had a C7-T1 fracture in my neck. Had an orbital ethmoidal fracture of my left orbit which had allowed air into my [inaudible] cranial vault.

Payman: Wow.

Dominic: So yeah, and a bit of facial trauma as well, which is improved me.

Prav: So, fast forward to the point where you come around three days later, or whatever it is, when did you come to realisation of the enormity of what had happened? That alone, obviously, you mentioned that, out of everything you want to hold on to your faculties upstairs, right. That’s more important to you than anything else.

Dominic: Oh, yeah.

Prav: But, for someone who’s an athlete, who gets their buzz off… Look, I’m far from an athlete, but back injuries, wrist injuries, just the tiniest little injuries set me off mentally. How did you compute all that, and what was going through your mind at that point?

Dominic: Well, it was a funny one because I’d had an atypical reaction to ketamine. It was a combination of that and something called… it was almost a form of delirium due to my head injury so I became very agitated. So, they gave me something called an atypical anti-psychotic medication called olanzapine. So, I had some unusual symptoms from that. So, went I came around, I was rocking back and forth all the time. I didn’t know I was doing it.

Dominic: So, Rebecca, my wife, was looking at me and… I think another side effect of it was, that I was exceptionally happy. I felt fantastic. I think a combination of opiate analgesia and that, meant that I felt on top of the world, to be honest. I felt very relaxed. I felt almost transcendental in some ways. I felt like I’d escaped death and I was amused by the fact that I had this thing called a vac pack on my right arm where they were using negative pressure to stop the separation and everything. I felt amused by it all.

Dominic: So, it’ll be very wrong to say, that when I came around, I was devastated, I wasn’t. I almost felt like, Wow, I’ve got a really good excuse not to train. I can’t train. So, there’s no point worrying about it because I can’t train. There’s no way I can think I’m going to do it.

Prav: Is that because you were high and dosed up, or even when you came off that, was your mind set, that’s how you felt afterwards? That, actually, I’m just accepting what’s happened, and I’m going to say the positives from it.

Dominic: A bit. I think that the whole time in hospital everybody was so nice to me. My health anxiety, which is another side effect of my autism, hadn’t kicked in. So, the cardiologists, for example, didn’t come and see me when I was in hospital and say, Oh, by the way, when we looked at your full body CT, your aorta is slightly enlarged and we think you might have a bicuspid valve. They didn’t say that to me, so I wasn’t worried about that. The healing seemed to be happening quite quickly and I thought, well, it’s unlikely I’m never going to do dentistry again here. Because, one, I can’t move left hand at all, two, I can’t feel my left hand at all. So, [inaudible 00:31:09].

Dominic: It was only once I came out of hospital, and it was only when I got home, that it hit me like a tonne of bricks, and I just felt devastated. I had something called atypical PTSD which is where you don’t have flashbacks to the event because I can’t remember anything. But, I have very unusual night terrors, and I used to wake up… I had something called Early Morning Awakening syndrome so I used to wake up every morning at about half one, and that was it, I couldn’t go back to sleep. After a few weeks of that, you start getting a bit… it’s hard to explain how low I felt really.

Payman: Dom, did you go in to, Dom mode, and fully research everything and try-

Dominic: Oh, yeah.

Payman: Yeah.

Dominic: I did. I’ve done that on so many different… unfortunately, it became very unhealthy. So, one of the things I did is, I did discover I had a congenital heart issue. I must have spent about six hours a day researching aortic dilation, bicuspid aortic valves, all the rest of it, long-term sequelae of it. [inaudible 00:32:32]. Then, I became the absolute expert on it, there’s no doubt. I could have a very detailed conversation with any cardiologist you want and I can discuss papers with them at great length. However, that’s not good. That’s not good at all.

Prav: Does it help your health anxiety a bit?

Dominic: Not at all. But, I suppose, I think, in a way, because I’ve become a little bit more accepting [inaudible 00:33:00]. I felt almost immortal before this happened. I felt like I’m doing everything I can to live forever. I’m going to have the longest health span of anybody because I take supplements hardly anybody bugger knows about. Secondly, I trained so well. Thirdly, my diets fantastic. And, fourthly, I sleep well. All these things. So, I’m really optimising everything here. Then, I got smashed to bits. I realised, it don’t matter what you do, because it can just happen around the corner. [inaudible] all taken out of your hands. That sense of being immortal is gone and I’m trying to, a little bit, more, these days, thinking, every day has got to have a better meaning for me.

Prav: Dom, this has been a common theme throughout this conversation, which is the topic of death. So, you mentioned it very early on in the conversation when you mentioned your mom, and she said you can’t cope with it, with medicine. Then, you’ve talked about being immortal. Then, you’ve talked about escaping death. Is there a theme there in terms of this been throughout your life, in terms of mortality or wanting to live forever? And, that’s why you invest in these supplements and all the rest of it. What’s the theme there?

Dominic: Well, I think from a scientific point of view, we’re almost on the cusp of proper health span elongation.

Prav: Yeah.

Dominic: I think that we’re near there. I think that, perhaps, we’re a little early, or, perhaps, our generation will benefit. It’s hard to know. But, I think we’re close to it.

Prav: Yeah.

Dominic: So, from my exciting scientific point of view, I feel like if I can persevere for a bit longer, I might benefit from that. Secondly, I think on a… not a sadder note, but it is sad, quite oddly, I was the person who was holding both my parents when they died. So, when my mom died of recurrent breast cancer, for example, in Cookridge Cancer Hospital, as it was called at the time, I was at the foot of a bed and then I just noticed her breathing changed and went and cuddled her. She died in my arms. Then, only 2017, my father who I’ve had such an awful relationship with, I was in his final room in hospital in Bradford, and he died in my arms, again, as well.

Dominic: And, being from an Irish Catholic family, uncles who died, we did something called awake, which meant that the corpse was presented to the family and we used to sit around all night. So, the dead body is not something that bothers me in the slightest and the transition from life to death is something that I’ve become a bit obsessed about from a young age. I don’t know, I think it’s an obsession with not conquering the fear of death, exactly, but just… I don’t know, it’s hard to say. I just think about it a lot. [crosstalk 00:36:21]-

Payman: You said you were agnostic, but do you have any spiritual belief about life after death?

Dominic: Well, I’ve gone through phases in my life of being agnostic when I was a young boy and then becoming a very strong atheist and becoming quite combative with people. I’m sure, you’re probably aware, I’ve done that on Facebook and the rest of it. I’ve been combative with people who’ve got faith. I’ve almost had, in some ways… I’ve wanted to get an argument going because I want to try and convince people and I want to try and… But lately, I’ve started to become, in the last few years, agnostic. The limits of human understanding is such, that how dare I say I’m an atheist. Do you know what I mean? It’s like a priest his atheist. Well, what the hell’s it got to do with anything.

Dominic: So, I think it’s a more pragmatic view, but who knows? Will we ever be able to comprehend what’s really happening? Who knows? Will we use artificial intelligence to augment what we’ve got, to allow us to have the cognitive function to comprehend things we just have no ability to at the moment. So, I think it’s fascinating but I also think, at the same time, I’ve tried to soften my outlook towards other people who have got faith because I think it was remarkably, almost, unemphatic of me. It’s almost the psychopathic side of autism where your empathy switches off and you’re just very black and white, and you don’t really appreciate the feelings involved in other people’s thoughts. You just say it how it is. I think I’ve come a cropper with that a lot in my life.

Prav: Has that changed post-accident, Dom? Was that a turning point for you in terms of the way you looked at things, in terms of both being combative, and religion?

Dominic: Not religion. I think the agnosticism had been happening for years before the accident, and nothing’s really changed there. But, I think that the accident did allow me to reflect on my own persona and my own shortcomings. I think one of the things that I did notice was, I saw the best in the very worst of people after my accident, and, by far, the majority was the best. All these friends of mine who just stepped up and just did [inaudible 00:39:00]. Going to my practises and finishing my cases and doing it for no price and just labs doing the work for nothing. All those people were my medical indemnity… not medical indemnity, [inaudible] helped me out.

Dominic: I just realised, [inaudible 00:39:23], why do we deserve that? What have you done to deserve this amazing outpouring of love? Then, I, also, in some cases… I won’t go into this, but I saw the very worst of people as well. I don’t know, it’s hard to explain. I started to think, Well, I’ve got to be a bit more forgiving of myself. Because, sometimes, I think that it’s my own incredibly high standards that I’ve got for myself, and my, really, almost pathological perfectionism that comes across in such a negative way to other people and I judge them by my standards, and it’s disgusting, really. So, I decided, the best thing to do, is to stop being like that. And, start trying to take a breath a bit more. Take a breath and not be such a-

Payman: A lot of times in life, your biggest strength ends up becoming your Achilles Heel as well.

Dominic: Yeah.

Payman: It’s being aware of it, I guess, is the clue for that. [crosstalk 00:40:26]… Go ahead.

Dominic: No, I was just going to say, you’re very right there. I think it’s the awareness of it that’s become better since my accident. I don’t know whether my autistic brain has been slightly rewired and I’m more self-aware than I was. Perhaps.

Prav: Tell us about… its Humphrey, isn’t it?

Dominic: Yes.

Prav: So, from the day he was born right up to now, not living at home. Is that right?

Dominic: No. Humphrey born, second to last child. Jemima’s my youngest child.

Prav: Mm-hmm (affirmative)-

Dominic: Humphrey was born, he was very small for [inaudible 00:41:05], but then he caught up very quickly. When he was born, he was only five pounds. A little lad. He had a couple of physical issues at birth. Something called Hypospadias, which is a congenital abnormality of the ureter. He had to have that fixed when he was a toddler, young lad, now he’s a little boy. But, even from the age of about three, we started to know that he was different. They say, in autism, sometimes, they reach their milestones, then they seem to regress, and that happened with him. When his speech started to go and he didn’t gesture. We call it the blank face of autism where he had a neutral expression all the time.

Dominic: You’ll often say, old artistic people are not wrinkled much because they [inaudible] but I do. But, it’s weird. But, anyway, as he got older… it’s been the greatest thing in my life and my wife, Rebecca’s, life without a doubt, but also the hardest thing in our life without a doubt as well, because a combination of different things. I think, the degree of his disabilities, his hyperactivity, severe learning difficulties and nonverbal autism, and this predilection for self-harm and very disturbed sleep, very difficult for him and also for us. When he started, then, becoming quite violent towards his siblings and to his mom, it became harder.

Dominic: Then, we’ve had a bit of misfortune with the fact Rebecca was also diagnosed with a pituitary tumour [inaudible 00:43:02]. For years, before that, she’d been having something called atypical migraine [inaudible] atypical migraine. But, actually, we think now that they were tumour headaches from a growing macroadenoma of the anterior pituitary glands. So, we had a lot on our plate, really. Then, when Humphrey started, before he was just getting to puberty… he’s a big boy, and his self-harm and his aggression to his family got to the point where the best idea for him, really, was to go into a residential school. So, he’s been there three years, down in South Yorkshire.

Dominic: What happens is, before lockdown, we went to visit him every week and, just in the last year, he was starting to come back and visit us as well for day visits. We haven’t had an overnight one yet. [inaudible] so hard, I can’t tell you. Taking down on the 18th of December for the first time… I took him down with my son, Gabriel, who’s 21. We took him down in the car. That was the hardest thing in my life, that.

Dominic: Then, I went to visit him. Rebecca was very ill with a migraine, one of these atypical migraines on Christmas Day. He’d been down a week and I went to visit him on my own. So I drove down, visited him and, I always remember, he was absolutely full of cold and he;d obviously got a cold meeting new people. I sat there with him and he ate his Christmas dinner with me. I’ll be honest with you, I think, when I left there, it’s the one time in the life, rather than just be obsessed with death, I actually had proper suicidal ideation and pulled up and thought, I’m going to top myself, I can’t bare with it. I [inaudible] obviously. It got to eight o’clock that night and got a call from where he was and he’d absconded, and he’d managed to escape.

Prav: Gone garden hopping.

Dominic: Yeah. It’s really quite difficult. It’s beautiful grounds, very tall fences and he’d escaped and he was going [inaudible] in the dark, middle of the countryside. They had to get dog teams out and police helicopters to get him. That was the same night, Christmas night.

Prav: That you were having those thoughts.

Dominic: A tough time.

Prav: Yeah.

Dominic: Well, I’ll be honest, let’s look at the bright side, his school there is 10 yards from his front door. We don’t have any more of the problems we used to have where he used to have a different bus driver taking him to the special school where we live. If he had a different driver and they hadn’t been told, that was the whole day ruined. He’d be completely utterly bereft and these little things such as that, where it was a different bus driver or he didn’t have his teacher at school, same one, or even such stupid little things to me or to anybody else… the bus driver’s shoes were different, they’d bother him. They’d bother him so much that, he’d not only have a bad day at school, but when he’d get home, he’d very aggressive and self-harm as well. Hard times.

Payman: Did you find you had to balance Humphrey’s interests with your other kids interests?

Dominic: Well, this is it, very much so, because a big boy and he did hurt his older brothers a couple of times quite badly. Particularly, Rufus once. Threw a boot at him and hit him right in the face with it really hard. Things like that are not… it didn’t break his nose but it could have broken his nose. Then, he went for his little sister a few times. It got to the point where I had to physically restrain him and he was almost impossible to restrain. He was a young boy, but I called him a bag of snakes. He was so strong. It got to the point where… he didn’t feel physical pain like we do, perhaps, because one of his self-harms was biting his nails off and then he’d laugh. So, he’d bite a nail off, and he’d laugh and just smile. Mentally, it’s a very tough thing. So, it got to the point where that was the best decision for everybody.

Dominic: One of my ambitions in my life, after all the accident and everything, I can do what I was going to do before the accident, which is move to a bigger place, with the grounds enough for me to have an annex built, that eventually, hopefully, that Humphrey can come over and have an annex, and we can have him back home. Whether that happens or not, I’m not sure. Well, it’s an ambition. So, let’s hope.

Prav: What’s the communication like at the moment? Is there any, at the moment, during lockdown or anything?

Dominic: Well, he don’t like telephone so he won’t [inaudible] on the phone. So, he’s got used to Skype a little bit now. So, the first Skype call was about eight seconds. The second one was about 30 seconds. Now, he’ll do about five minutes, and it’s great.

Prav: It’s progress, isn’t it?

Dominic: It certainly is. It’s actually exponential progress if you think about it. We’re allowed to go down and see him again now. So, there was a spell during lockdown when we couldn’t. So, we go down and see him now. We have to wear PPE, and he thinks that’s very amusing, which is a good thing. He finds it funny so that’s great. If he found it distressing, that would be a problem. What he doesn’t like, is that we can’t go in his house anymore. We just got to stay outside. So, he finds that difficult. So, the visits are a little bit shorter at the moment. We drive down, it’s good a 70 mile. Then, the first visit was only 15 minutes because he wanted to go inside and when he does, he wants to go in and we can’t. Not with that. But, it’s still 15 minutes. But, the last one was a good hour, and it’s fantastic.

Dominic: Well, it’ll get all right again. I’m full of hope for that. The main thing is, that he’s found lockdown not too difficult at all. It’s been a very same existence. Every day is very similar-

Prav: It’s what he needs.

Dominic: It’s perfect.

Prav: Yeah.

Dominic: Perfect. So, who’s to argue with that?

Prav: Yeah. So, going back to just health optimization and life extension, Dom, I’m sure, loads people are interested in it. What are your five top tips to push people towards living forever? What five things would you say… look, I’ve done my research, I’ve geeked out on all this stuff, whether it’s supplementation, lifestyle adjustment, diets, whatever it is. If you could just give five bits of advice, what would they be?

Dominic: One, I’m going to do few that aren’t chemical at first. So, one, to have a good circle of friends.

Prav: Mm-hmm (affirmative)-

Dominic: I think it’s really important. I think that from a psychological and from certain physical points of view, having friends, throughout your life, is important. Doing physical exercise. I think doing physical exercise tailored to your age. So, I think, that trying to be a marathon runner, when you’re 49, for the first time, is probably not a good idea. Also, look at your lifetime exercise total, as if it’s a bucket full of sand, and you’ve done a lot of exercise and you’re filling that bucket up. Once it’s full, and you’ve done 19 marathons or something, don’t just keep doing it because you’ll just get atrial fibrillation. It’s because you’ve basically got micro fibrosis in your heart muscle because you’ve [crosstalk] exactly, you’ve just overdone it too much.

Dominic: I think from a dietary point of view, don’t do what my dad told me. [inaudible 00:52:01], don’t finish your plate, even if you full. It’s a bad idea. I think, leave the table slightly… I won’t say hungry, but leave it with the ability to eat more. But, at the same time, don’t be a complete disciple of a very limited diet. I’m not saying that because you’re here.

Payman: No.

Dominic: I’m not. I’m saying it because I think a little bit of what you fancy, does you good as well.

Payman: Of course, it does.

Dominic: I think it’s important to keep that in mind, because I think that if you lose the pleasure from eating, you can tend to find that you can lose the value of eating as well. So, I think that it’s important. I think, believe it or not, micronutrients that you get from a wide variety of foods, it’s surprising. One of the things I have changed is, that I really believe that supplements are great and I still do, but I think that what you get from whole foods are very important as well. I think that there’s things that we don’t know yet and it’s the combination of the different chemicals within the whole food, that’s providing us with a sum of its parts that we’re not getting from supplements. So, I think that’s important.

Dominic: Another one is sleep, I can’t overestimate it. I think if you can just try and get into good sleep hygiene pattern. I wouldn’t use sleep apps. The reason I won’t use them is, because I think they make you anxious. I think a sleep app can be a double-edged sword. For people who like to quantify every behavioural parameter in their life, it can be a nice thing. But, if you get anxious and you find that your parameters are not where you want them to be, that can then be a self-fulfilling prophecy where you start going down a spiral of insomnia. So, it’s important to try and do that. On the sleep thing, try not to eat after about six o’clock or nine if you can, maybe seven. Just don’t be scoffing food before you go to bed.

Dominic: The last one is, for me, I think, if you want a good life, get a pet. Go cuddle your dog. [inaudible] coming through. It’s not just about cuddling your wife and kids and everything, we [inaudible] get those [inaudible] microdosing, going as many times as you can a day. What do you reckon?

Prav: Good advice. Loads of great advice there. I think, although, you started off with saying, I’m going to start with some non-chemical ones, I truly believe they’re all chemical.

Dominic: Well, they are.

Prav: In one way, shape or form, having a great group of friends around you and being happy is firing all sorts of chemicals off.

Payman: I think I’m breaking every one of those rules apart from the friends one. Let’s hope the friends one’s the most important one.

Dominic: If you looking at chemicals, perhaps BCQ and [inaudible] mononucleotide, are two that I’d consider quite seriously if you’re trying to life extend.

Prav: They’re expensive. They’re bloody expensive. Dom’s cost me a fortune with his advice.

Payman: How much is your monthly supplement bill?

Dominic: Oh, I’m not telling you.

Payman: Prav?

Prav: I don’t add it up, mate, deliberately. Dom’s seen my cupboard.

Payman: Is that what you call it?

Prav: Sometimes you’re shoving this stuff down you and you don’t know what it’s doing. But, I was just speaking to Payman about this. We talk about, you need the break and you need to enjoy yourself and all the rest of it, and exercising age appropriately. Every bit of advice you’ve just dished out, Dom, I’ve just broke. So, I was going hell for leather on my thingy bike… what’s it called, Airdyne.

Dominic: Oh, yeah.

Prav: Doing a flip into batter on there, trying to murder myself on it, came off it screaming. My legs was so full of blood, I’d rather chop them off. Then, I had this incredible knee pain. Then, I’m hobbling around. This is six, eight weeks ago or something like that, right. I’ve torn my sartorius. Hobbling around, gone for an MRI, confirmed it had been torn. A tiny tear in my meniscus.

Dominic: Ouch.

Prav: Yeah, ouch. Then, started feeling really sorry for myself. So, I thought, fuck this, I’m going to stop training. Even though I could do upper body stuff and that. I just thought bollocks to it. So, I stopped training. I still ate fairly well, but I stopped taking my supplements as well. It’s funny, your mindset… the tablets are all in one of these right? Okay. When you’re going to take them. I just couldn’t be assed. I thought bollocks to it, I can’t be bothered. I carried on with a diet because my wife sorts that out for me. I’m quite lucky, in that sense, so I don’t need to worry about that. I’ve put 10 kilos on, right. 10 kilos on. My foot pain has started coming back, I don’t feel as mentally sharp, I definitely don’t feel like Superman anymore.

Prav: That’s made me realise a few things. One of them is, probably, the pills that I was taking, were having a good effect, anti-inflammatory and all the rest of it. But the other thing is, I think, my mindset, really, in terms of the way I look at it, you either turn around and say bollocks to it, I can’t be assed anymore and you go into self-destruct mode, which is what I’ve been in for about six weeks. Or, you say, let’s have it, I’m going to stay positive, screw you all. Yeah. Come at me, I’m going to win. I flipped between those two modes. There’s no half measures for me. I’m either, all the one direction or the other.

Prav: But, the one thing that has come out of this is, the Domino’s Pizza that I had was awesome when I had the break from it all, but more importantly, actually, the supplements I’ve been taken, I do feel that they’ve been having a positive… and starting taking them again. I don’t think it’s placebo. I do think they do have a profound effect on well-being and the way you feel.

Dominic: Yeah, I think you’re a little bit like me in some way, insofar, as you, not bipolar, but you’re bipolar with regard to you all or nothing, with regard to your training profiles. But, I think you might be like me, insofar as, if you do let yourself go, you’re almost excited about the fact you’ve got to come back.

Prav: Do it properly.

Dominic: So, you got to do it properly. So, it’s almost like it’s a mission. It’s the fact you’ve got this mission, that you [inaudible] again.

Prav: What’s more detrimental is, because you know you can come back, you let yourself go a little bit further and it’s a bit of arrogance. Do you understand where I’m coming from?

Dominic: Oh, yeah.

Prav: That, itself, is-

Dominic: Then, you just [inaudible 00:59:15]. So, I’m suddenly getting more injuries than I used to get. So, I’m getting things like grown strains, and then I’ve got a calf strain. I’m thinking, I can come back, I’m a glutton for punishment, I’ll run this mountain, I’ll run till I’m blue in the face.

Prav: Yeah.

Dominic: Then, I’ve got this calf strain at the moment, and I can’t. So, I’ve got into cowbells at the moment. I’m using that as a way of trying to [crosstalk 00:59:43]. Yeah, I’ve forgotten how hard kettlebells are, actually. [inaudible 00:59:48].

Payman: Dom, we’ve been asking everyone about their clinical errors, in the hope that we can all learn from them.

Dominic: Yeah.

Payman: Can you think of a clinical error that you want to share with us?

Dominic: Absolutely. Yeah. First implant ever placed. I placed it on a young female doctor. I left it four millimetres super crustal because I bottled it. I didn’t screw it in enough. So, that was a combination of hubris, insofar, as I thought I was better than I was, even though it was my the first implant I’ve ever placed. Two, it was not being aware of the fact that when I was in the middle of the surgery, that I’d get deep fear that would come from nowhere. Thirdly, I wasn’t able to control the ability to take a breath and relax into the surgery and get into the flow.

Dominic: For me, one of the biggest lessons I’ve ever learned in surgery is, going slower than you think you need to. So, rather than thinking, right, this is the surgery, I need to get it done, I need to get it finished. No, this is the surgery and I need to enjoy every little bit of it. Obviously, I don’t want to cause excess morbidity of my patient by taking too long. But, I definitely want to reflect twice on everything I do. That’s a lesson that I didn’t learn in that case and it stuck with me for the rest of my implant career. Because, I was very lucky. The patient has good biotype and never shown any issues with that, and has got no problems. But, I think it might be to do with… it was an Austrian plant and they do keep the bone well as well. So, the fact that the super crustals [inaudible] or there. But, on the other hand, that could have been a nightmare around the beginning of my implant career.

Payman: How long ago was that when you put your first implant in? How many years were you into dentistry?

Dominic: About 13 years ago now. Yeah.

Payman: So, you’d qualified a good 10 years or something?

Dominic: 13, the number that follows it. No, I’ve been qualified 27 years. [crosstalk 01:01:55]. [inaudible] that I’m 50, but I am nearly 51.

Payman: So, you’re not going to be working under Boris’s new scheme? You’re going to be one of the over 50s who’s going to stay at home?

Dominic: Well, I’m not because I’ve got the biological age of a 21 year old athlete. [inaudible 01:02:17]. He can come and try and stop me if he wants and then [inaudible 01:02:22]. The old aggressive Dom might come out again then.

Payman: Dom, you know that reading your stuff…

Dominic: Yes.

Payman: The English is superb. Where did that come from? Was that that Catholic school? Or is it that you read a lot?

Dominic: I started reading very young. I read a lot. I’ve got, I suppose, not an obsession, but it’s one of the things I do love is, language. I think language is a beautiful thing. Words, themselves, are beautiful things. Just big vocabulary. I think that, sometimes, it’s wrong to dumb stuff down. So, the fact that we live in a generation where it’s all WhatsApp and Twitter feeds and all the rest of it, and we’ve gutteralized our language a little bit, doesn’t mean that you should do that when you’re writing. For me, I think you should write and I think you should challenge your readership to… if they don’t know a word, go and bloody [crosstalk 01:03:22].

Dominic: Don’t change your style if you can. I suppose I’m a verbose person with regards to my writing. So, my style is a little bit verbose as well. I do try and reflect on it and think, I don’t want to come across as a total smart ass here as well, just using the big words, because I know one. But, at the same time, sometimes they just seem to fit the moment. So, that’s what I’ll use.

Payman: Is your style of writing… does it just flow? Like you said, you’re in that flow state. Would you consider it-

Dominic: I can write 1000 words of pro’s in three hours and just do it. Sometimes, I don’t need to change it, hardly, at all afterwards. It’s easy. It’s almost edited as I go.

Payman: There’s definitely a novel in you somewhere or a book in you somewhere. Have you ever thought about that?

Dominic: I’m 60,000 words into a [inaudible 01:04:19]-

Payman: Oh, are you?

Dominic: Yeah.

Payman: Oh, I didn’t know that.

Dominic: Originally, the title was going to be Orange is the New Black because of my orange top that I had. Also, because Orange is the New Black was on Netflix at the time. My cycling [inaudible 01:04:35]. I’ve changed the title, I won’t tell you what it is at the moment. But, I’m 60,000 words in. It’s a combination of the year since my accident and reflections on everything from my upbringing. A lot of what we’ve talked about here. I’ve had a few people read it including a couple of people who… one person is quite a big publisher in London and she says it’s wonderful. I’m hopeful something will come from it. But, I stopped writing it at the beginning of lockdown and I started reading the papers. So, I just started writing a little bit of it again.

Dominic: I think it will be… to use a phrase from Chris Sparrow, it’s a bit marmite. [inaudible] it. It’s very, very candid. Very candid, indeed. But, the style will either grab you or it won’t. I think it’s the style I use in my writing generally. There’s a lot of shorter sentences… Quite a lot of descriptive [inaudible 01:05:42]. There’s things that will stay with you hopefully. Not, perhaps, always for the right reasons.

Prav: I think what you wrote in dentistry about the accident, the way it was written, it was almost as though we you could visualise it. I could relive that moment on your bike with you. It was that well written, do you know what I mean? It just sucked me right in.

Payman: [inaudible] really well.

Prav: Also, the feelings about… that surrounded the individuals who were there for you, and those that weren’t.

Dominic: Yeah.

Prav: And, how that… it was just so beautiful, Dom. It was so well written. It was really nice.

Dominic: [inaudible 01:06:29]. To be honest, I was please with it myself. Normally, I’m all right with stuff, I read it and I thought, that’s pretty good.

Payman: Dom, when lockdown happened, we were all asking ourselves questions about the virus and aerosol and then you really took that on and we’ve kind of talked about some of that. But, as the biggest expert we know in this area, how do you see things panning out? Do you see a second peak? How do you see the aerosol question panning out?

Dominic: Yeah, when you look at aerosol infectivity, I think you’ve got to be a lot more detailed in the way that you look about-

Payman: The nuance, yeah.

Dominic: And, think about this virus is a bit of a rascal, really. In very individual circumstances, it can be infective in an aerosolized form, in my opinion. However, those occasions are remarkably prescriptive. So, in the vast majority of the aerosols that we create on a breath by breath basis, I don’t feel it is a primary effective factor in the slightest. So, I think that, where we’ve got to be careful, and we see this with super spreader events, is things such as choir practises. So, where people are, perhaps, not quite as social distanced as they should be and where they’re vocalising loudly, for an extended period of time, usually inside, perhaps with unusually static air flows in quiet buildings, things like that. Perhaps, where you’re in a meat processing plant, for example, where you’re standing with your colleagues in front of a conveyor belt in a very cold, humid environment. You probably turning and chatting to them and shouting over the noise of the machine or in the background, things like that.

Dominic: With regard to a second wave, I don’t believe there is a second wave at all at the moment. I think we never really escaped from a first wave with regard to certain parts of the geography of the UK. I think there was a certain number of cases, it never really went away there. So, I don’t think we’re seeing that. I think we’re seeing a complex political situation where, perhaps… I hope I’m wrong here, but I think that perhaps, because we’re in a fixed-term Parliament act and the government are thinking, well, it’s coming up, well, we’re going to have to get voted in or out again, the very obvious fact that, with hindsight, we can pick bits out of the way that the government have responded to this incredible crisis, means that they’re now using, perhaps, a politicised way to try and take our eye off that ball. So, I think that, in a way… maybe, I’m being cynical here, I think the second wave thing is slightly… I’m not convinced at the moment about that.

Payman: Are you not convinced about the other countries? Spain, and all of that.

Dominic: I think that there’s a few things happening. One is, it’s a slightly different demographic. So, I think it’s a younger, more healthy demographic. I think that the level of death rates compared to infectivity is different than it was in the first wave. I think, secondly, the more testing you do, and this isn’t to quote Donald Trump… the more testing you do, the more cases you find, but that’s true as well. I know that it’s not a static relationship between the two. I think you can’t just describe the death rate being lower, as due to better treatment. I think that that’s wrong to say that. I think it’s because it’s a different demographic of people who are getting it now. I think there’s a level of cross-immunity between SARS-CoV to another coronavirus. Colds and things like that. Perhaps, it’s those individuals now.

Dominic: So, for me, I’m not as worried as I was at all and I could be very wrong. I also think the virus could still attenuate and I’m not convinced it hasn’t slightly attenuated even now. That could be a reason where we’re seeing infectivity, but we’re not seeing as much morbidity and mortality.

Payman: So, you’re quite optimistic, it sounds like?

Dominic: Yeah, I am.

Payman: That’s good. That’s good news. I know what you were doing over lockdown, but, did anything happen to you as far as you’re going to live differently going forward because of what you learned in lockdown?

Dominic: No, not really well.

Payman: Oh, I like that. The first time I’ve heard that.

Dominic: I think the accident had made me change things in my life before lockdown, but the lockdown, itself, wasn’t this fundamental existential self-evaluation exercise where I’ve decided I’m going to now be a disciple of veganism or anything like that. I’ll be honest, nah.

Payman: The last time me and you spoke privately, I asked you, do you feel the weight of it? Did you ever feel the weight of it because, in a way, everyone was looking to Dom for a while there? Did you ever feel responsibility?

Dominic: A bit, yeah. [crosstalk] background. Yeah, for several reasons. I think one of them is that I’m a general dentist with no form of neurology training whatsoever. So, my absolute formal scientific qualifications to be any form of arbiter of advice are very spurious. Two, I think that I am able to captivate people with my scientific utterances. So, people think, oh, he seems to be on the ball, on the money. So, therefore, there’s a responsibility there to be actually sure you are actually on the money. You don’t want to be saying things that are a load of rubbish. So therefore, there was an element of that, is that you set the bar high for yourself. I think I had because my first webinar… I’ll be honest with you, I’m quite proud of that because some of the stuff then was way ahead of this game. I think, Wow, you did well there. You really picked up on some stuff very early on then.

Dominic: When you set the bar high, on one level, you have to keep up with your research to a very high level. But secondly, you have to be open to criticism as well. That’s something that I, in a previous life, I would have found very difficult. So, getting challenged, I used to find it really difficult. I used to think, What the hell do you know? [inaudible 01:13:27]. Well, now, [inaudible 01:13:35]. [inaudible 01:13:35], let’s debate it, let’s discuss it, and let’s try and come to an outcome that’s even better.

Dominic: At the end of the day, we’re still very early doors with this thing, we really don’t know. It’s thrown some real curve balls at us. We’ve gone from this thing where we thought, let’s just ventilate everybody and build a million ventilators, to realising that, actually, ventilating the majority of these patients in the way we were ventilating them was probably killing them. Because, we were high flow ventilating them and we were actually creating a situation where they were ending up far more ill than they would have been.

Dominic: So, like anything else, we’ve become so much more nuanced over the month. So, going back to your question, yeah, I did feel a responsibility. It’s been nice to not feel quite as much of that at the moment. So, I’m glad there hasn’t been Dom’s 19th COVID webinar.

Payman: Then, you wrote that other piece about how, as a profession, we’ve been let down.

Dominic: Yeah.

Payman: It got quite a lot of support. I remember talking to you to about it at the time. It was right about the time that that practises opened again, and you were saying, the momentum’s gone because people are so focused on going back to work now.

Dominic: Yeah.

Payman: Where do we sit with that?

Dominic: Yeah, that was [inaudible 01:14:49]. I remember writing that.

Payman: Yeah.

Dominic: I remember writing it. It took me about 10 minutes to write that. I was furious when I wrote that. I think that property comes across a little bit in it, really. I thought, we’re at a crux here. We’re at a crux point. Almost, like a pivot point where we’ll do what we always did before, which is that we’ll have all these voices and all this anger and all the rest of it. It’s like when the RF went up to nearly a grand, everybody was, [inaudible 01:15:22]. Then, the next minute, we’re all back at work, and we’re just bending over and accepting it like we did before.

Dominic: So, I was furious because I thought, we’re all just going to go back to work and we’re all going to be bothered about the day-to-day, and we’re all going to end up getting basically taken advantage of by quangoites, managers, people who don’t have a clue how difficult dentistry is on a clinical basis, people who have accepted this liability culture of the norm and [inaudible] for everything not. That’s somehow, civilizationally, a step forward. For me, it’s one of the greatest retrograde steps of being civilised that we could have. That we’ve gone from a thing where we can have a good relationship with a patient after a problem, to one where you end up in litigation and vicarious liability, all the rest of it, and it’s just hard.

Dominic: So, there was a lot of anger when I wrote that little piece, and it did appear to trigger a few reactions, mainly positive ones. But, I still feel anger. I feel anger towards the GDC. I feel anger towards the way that they’re dealing with my freedom of information request. I feel that, the fact that they’ve got one standard for us, which is a very high standard indeed, and they’ve got, it appears, a different standards for themselves with regard to their duty of candour. So, for me-

Payman: Yeah, for someone who doesn’t know about the freedom of information request-

Dominic: Yeah.

Payman: Could you summarise what that was about?

Dominic: Yeah, well, there’s a few of them. One of them was about the minutes of the council meeting where they had, basically, decided not to revisit the ARF. So, the annual retention fee. They decided not to revisit that, unanimously, as council members. Despite the fact that, obviously, the profession, as a whole, was in lockdown, our income was massively devastated. Many of us were thinking that our dental practises may not even survive. Yet, they weren’t even willing to revisit the ARF with regard to doing a direct debit option. So that-

Payman: Their reason for not releasing the minutes of that meeting, was that it was a closed meeting.

Dominic: Yeah, so they basically wanted the freedom of information request… I wanted to know what the written communications between the council members and the Board were, where this decision was made, and they basically have said, to divulge that information to me would inhibit the council members from being free to discuss these things in the future. So, the duty for public disclosure was outweighed by the fact that they had to feel free and uninhibited to speak candidly with regard to these topics. I was almost gobsmacked with that, to be honest.

Dominic: So then, I went on and did a second freedom of information request regarding their second [inaudible] which was in Birmingham, where they’ve now got a very prestigious office in the most… well, the most prestigious office block in the middle of Birmingham. I’ve tried to find out some information about that as well, and I’ve, so far, received very little accurate data, so I’m taking that one further as well. It just makes me a little bit cross that they’ve ended up in such a prestigious office building when they’re not willing to revisit our ARF, and, as a profession, we’re struggling at the moment, financially. I think it sets a precedent, which means that we’re even more… in some ways, perhaps, there were the slightest green shoots showing that the GDC might be listening to us again, and all that appears to have been entirely devastated in recent weeks by what they’re doing there.

Dominic: So, to me, they’ve a lot of hard work to do. I hope that if I do end up having a fitness to practise case for my candour… I’m not going to say anymore, I’m digging a hole here. I can see I’m digging a hole.

Payman: Our time’s nearly over, guys. I’ve got one more question for Dom and then Prav has one more question. My last question, Dom, is, what would you have been if you weren’t a dentist?

Dominic: A philosopher. I think I would have liked to have been a philosopher, with hindsight. A lot of time thinking, writing, being on my own, and irritating a lot of people with my writing. That would have a nice job. Perhaps, the education side of that as well, because, I think, I have got some great benefit from the educational side of my knowledge that I didn’t think I was going to get and I have got that. Okay.

Prav: So, Dom, my final question for you… You know what’s coming next.

Dominic: I don’t.

Payman: He’s never listened.

Prav: Oh, right, fair enough. Listen, mate, you’re 251 years old, and it’s your final day on the planet. You’ve got your kids by your side, and two things-

Dominic: Are they in their coffins because they don’t have longevity like me.

Prav: No, because you’ve given them the supplements, mate.

Dominic: Fair enough.

Prav: You’ve been funding them in this massive estate that you created that’s part of the ambition, remember.

Dominic: Yeah.

Prav: So, you’re 251 years old, they’re all next to you, and there’s three pieces of advice that you can leave them to stroke the world with. The next question is, how would you like to be remembered?

Dominic: All right, so the first one is the three pieces of advice.

Prav: Yeah.

Dominic: Male or female, any age, if somebody bullies you, punch them in the face. Okay.

Prav: Yeah.

Dominic: Especially when you’re young and at school. Don’t take it. Don’t hurt them, insofar as, when they’re down, do something, but punch them in the face. Then, whatever repercussion you’ll get, it’ll be worth it.

Prav: Love it.

Dominic: For various reasons, that will enable you in a lot of ways in your life. Two, [inaudible 01:22:09], get a pet, look after it, and be kind to it. Remember that many pets are more sensitive than you think. So, treat them with love and affection. The third one is, don’t piss on my grave when a die. You don’t have to put flowers on it because I’m not half-fussed about that.

Dominic: And, how I want to be remembered. Perhaps as, who was that COVID geek? He used to be a right asshole, him, but he was all right when he got a bit older. At the end of the day, when I met him, I realised he was actually quite kind. That’ll be good.

Prav: Lovely. Beautiful. It’s really nice, Dom. It’s been a great conversation, mate.

Dominic: I hope so. Thank you very much.

Prav: It’s been brilliant, mate. Thanks for sharing a lot of that depth that you did with us. It can’t have been easy. But, it’s pretty powerful stuff.

Payman: Thank you so much, Dom. I really enjoyed it.

Dominic: I really enjoy speaking to you both. So, I hope it’s onwards and upwards now with the rest of your conversations today.

Payman: We look forward to the book.

Dominic: Oh yeah, well, if you want, I can always send it to you, as long as you don’t facilitate it anywhere. I’ll send you a little preview if you want.

Payman: Yeah, for sure.

Prav: Love to.

Payman: Thank you very much, buddy.

Dominic: All right.

Payman: Thank you.

Prav: Thank you.

Speaker 2: This is Dental Leaders. The podcast where you get to go one-on-one with emerging leaders in dentistry. Your hosts, Payman Langroudi and Prav Solanki.

Prav: Thanks for listening, guys. If you got this far, you must have listened to the whole thing. Just a huge thank you, both, from and Pay for, actually, sticking through and listening to what we had to say and what our guest has had to say, because. I’m assuming, you got some value out of it.

Payman: If you did get some value out of it, think about subscribing, and if you would share this with a friend who you think might get some value out of it, too. Thank you so much for listening. Thanks.

Prav: And, don’t forget our six star rating.