AXSChat Podcast

Soccer Stories and the Cutting Edge World of Prosthetics

November 13, 2023 Antonio Santos, Debra Ruh, Neil Milliken
AXSChat Podcast
Soccer Stories and the Cutting Edge World of Prosthetics
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Have you ever wondered about the intricate world of soccer and the role of play in nurturing creativity? Imagine a heartfelt conversation with Scott Martin, an ardent football coach and storyteller. Listen as he takes you on a nostalgic journey into the authentic days of the North American Soccer League. Scott shares how ethnic backgrounds played a pivotal role in the formation of clubs and how the genuine love for the sport soared high above the allure of money. He passionately advocates the significance of unstructured play in fostering creativity, a lesson he highlights with a nod to the Finnish education system. 

Shifting gears, we enter an essential discourse on the cutting-edge field of prosthetics. Did you know that many disabled veterans lack insurance for repairing their artificial limbs? We discuss how such challenges impact their lives, throwing light on the need for durable, repairable, and culturally fitting prosthetic options. The conversation gets even more interesting as we talk about the importance of user involvement in the design process of these devices, a factor that could lead to more beneficial results.

Finally, we navigate through the intriguing universe of assistive technology, highlighting the challenges and costs associated with it. Ever considered why the price tag on these devices is sky-high, especially in the global north? Or how governmental subsidies can exclude individuals who can't afford to pay? We bring a fresh perspective by comparing the healthcare costs between the US and Portugal. Wrapping up, we share a sense of optimism for the future generation, believing that they hold the power to bring about a positive change in the world. A rich blend of stories, insights, and thought-provoking discussions, this episode is one you shouldn't miss!

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Axschat:

Scott Martin

NEIL:

Hello and welcome to Axschat. I'm delighted that we are joined today by Scott Martin, who is a Podcaster, close to our heart, writer and also, football coach. And that's football in the European sense, not the throwy, wearing body armour, kind of football in the American sense.

SCOTT:

No.

NEIL:

Soccer, for those eon the other side of the Atlantic.

SCOTT:

Yes.

NEIL:

So, welcome Scott. It's really good to have you with us. Debra is in the air on a plane, somewhere and so, can't join us today but sends her love. So, tell us how you came to start working in soccer, football? Because you're in Wisconsin, and I'm guessing that is not a sport that you grew up with necessarily. Because soccer has really taken off in the US over the last couple of decade and I'm guessing that you're not 21 anymore?

SCOTT:

No, slightly older than that. Well, I really came about during the old North American Soccer League days, when back in Bauer and Pillais, and Croif and everyone was getting older, not too old. But they would come here and play. And that, but that was so mismanaged and messed up. I actually, as a player, was caught in between the death of the NASL and waiting for major league soccer to start because back during the days of the NSAL, it was ethnic clubs and such. My coach was German, so, we had a very stronger German heritage. There were the Voratians in Milwaukee, there were the Brits in Madison, Wisconsin. You had different ... you had the English, typically down in St. Louis. The poles in Chicago and they would put their own clubs together and a lot of times it was managed, moneywise because they had their own pubs on site. Those were the good old days, boys. Those were the good old days. So, after a match, you'd end up going to the pub and each club would have of course, their history, through awards and trophies, sitting there to intimidate you, waiting to give a rip. So, yeah, those days are all gone and it's so structured, it's became, I think, far too structured, with how things are done.

NEIL:

So, obviously those are the, you know, MLS now is big money.

SCOTT:

Yes.

NEIL:

Now, Croif and co, they were big stars.

SCOTT:

Oh, huge.

NEIL:

You know, total football, massive international stars, but back in that time, the money, even though they were national figures, the money wasn't so big. So, now, it's really big business. But my guess is that you're also engaged very much in the grass roots, side of things and that's grown a lot.

SCOTT:

Yes, I've seen it and I will have to say, I' m always going to be open and honest, especially when it touches my heart with soccer and football, that the pendulum, I believe, has swung, in the wrong direction and I have found too many kids do not play unless the coach blows a whistle and roles out a ball. I hate that. I actually have been able to do something here in Central Wisconsin, that wasn't being done. I actually have, my team is, half our players are from one large high school and half are from another large high school in our area and, so we combined together and we went out and won the State championship last year over teams out of Milwaukee and Madison and some of the larger areas because they didn't know about us. But, I put together a bunch of soccer rats. Soccer rats are course are kids that go out and play without a coach and just play and play and that's where they pick it up. That's, you know, how the better players have picked it up, by just playing. So, I am doing things old fashioned.

ANTONIO:

Yes, quite recently, I think there was some, I don't remember the name, a German coach, complaining for the fact that because there are so many, let's say soccer or football farms for kids.

SCOTT:

Ah, yes.

ANTONIO:

Those players will sometimes play by themselves or just learn and play it in the street.

SCOTT:

Mm hmm.

ANTONIO:

They don't get into those places anymore. So, it's almost like that soccer is losing creativity because all the players are born in a kind of a farm.

SCOTT:

Exactly. And they have to do things structured. So, from too many discs, the coaches use too many disks and say run from here to there, and I'll mention something about where I really started seeing a disjoint. I used to do evaluations for the Olympic development programme, with US soccer and they asked me to come in and look at kids and make suggestions on who should be brought into the group and maybe work their way up the ladder. I tended to focus on kids that had colour because to me, the white kids were coming in, you could tell, that they went to so many high price clinics and they were too structured. I think that yes, we all know, the game is a beautiful game and it's about creativity and working together and blending. While, I never was asked to come back again to do any evaluations and what they ended up having on the roster was a bunch of white kids that were so structured and this was 40 years ago. So, look where US soccer is now, not a whole lot further. So, they didn't listen to what I said at the time and I wish they would have, so.

NEIL:

So, and I think that, you know respecting creativity and play and not structuring people and allowing people to learn through play and acquire skills, through play, is extremely valuable and in so many different spheres. You just look at the world's most successful education system, it is not the most structured because that's the Chinese one. And they are pretty successful. But, the world's most successful is the Finnish one. They get the best results. They start later. They spend less time in lessons. They basically allow kids to run wild and climb trees and fall out of things, get scabby knees and learn. And learn through play. And, so I think that when we restrict that, we are losing out something. And I think that even as adults, adulting is bad. Yes, sometimes we have to be responsible. We have to keep roofs over our heads, hold down a job and all the rest of it, but losing our sense of fun and play and our sense of discovery, means that we are all poorer and that society is poorer, as a result. How does that connect to our themes as a Podcast? Axschat has always been about creativity and diversity. Particularly focused on disability diversity and talent and how including people with disabilities generates innovation and you know, uncovers talent that is unconventional. And I know that you have done work in the disability space around disability sport as well. So, maybe you can tell us a bit about that particular aspect of what you do?

SCOTT:

Well, I haven't, well I guess I have, but in my own way. So, we are looking at 30 years now, since I contracted Group A strep, with Necrotizing Fasciitis and the media always liked calling it the flesh-eating disease. I woke up from a one-month coma to learn, we had to remove your hands and parts of your feet to keep you alive and the first thing that ran through my mind was, I guess I'm not playing any longer. And I was coaching at the university level. But, I just continued to try to be myself and not change, even though and this is what always ticked me off and I think it led me to doing my Podcast, is that I ran up against discrimination many times on how, especially from males because I think, because of my disability, I think I scare males too much that they have to look at their own mortality. And I actually use that to my advantage before matches and stuff. But I don't go out, I was asked by not US soccer, National Soccer Coaches Association of America, to work with them on doing presentations and education but it never really went anywhere. But I just, am myself. I talk to players. When they first meet me they think, oh, you know, who is this? He has no hands. And yet, and we end up working together and winning. Just to get past that stigma of things that we can't do because of a disability.

NEIL:

Yes. So, and that's hugely important, we need that role model behaviour and generations coming up behind, need that role model behaviour. So, you know, I, the company that Antonio and I work for, does a lot of work with the Olympic movement and the Paralympics. So, we are the team for the Olympics and Paralympics, so I have spent a lot of time around people, with some really advanced prosthetics, you know. So how, I mean, having had your condition and woken up, are you a, how have you seen prosthetics over the years, improve? Because I mean they are very different now to where what they were 30, 40 years back.

SCOTT:

Oh, I've got a story for you guys, back in 2013, here in the United States, so many of our soldiers were coming back missing limbs and Congress, threw millions of dollars, towards trying to solve the problem because it made them look bad. And one of the groups, which was John Hopkin's University very well-known research hospital and group, contacted me and asked me to fly out to Baltimore and meet with them they looked me up on what they were trying to design were prosthetics hands with individually moving fingers, we see them now. So, I was able to make these things work. It was just on computer at the time before they took it out into the real world and tried to make these things work. Well, when I sat down with them, I told them that guys, my hands break down every six months and they cost a bunch and they are more simplistic to have repaired. What do you think is going to happen, when you have so many more moving parts, which is going to increase repair costs and also frequency of repairs and how were these disabled veterans going to have the insurance, truthfully, to repair them.

NEIL:

Mm hmm.

SCOTT:

What's going to happen? You better make them durable. Left Baltimore and never heard from them again. I did use one of those hands, a Prosthetists let me use, within two weeks it fried, the electronics fried. So, there is ... it's another thing that just upsets the heck out of me, with you know, politicians trying to make something out of it to make them look good but, it's not realistic so, what I have, I've had for 30 years, and again, they breakdown every 6 months. I actually have one not that's working properly now that I'm waiting to get a loner, so I can send it back, yet again to make things more functional. So, it's difficult. But things need to be done more and again, that's why I am, I do my Podcast and what I'm now, I just rewrote my book to try to make that more promotional for the disability community.

NEIL:

Yes. So, I absolutely hear you on the complexity of some of the prosthetics and assistive tech. It's really hugely expensive. And you know, whilst everybody wants to create features and give someone the next Luke Skywalker arm, and it's alluring, the cost of maintenance is still really significant. So, yes, it's great if you're sponsored by, you know, one of these companies or you happen to be in the global north and happen to be wealthy and closely located to the factory or whatever. But that's not the reality for most people. So, there does need to be that sort of appropriateness and durability and cultural context, when we are creating products and services for people with disabilities because quite often we over egg the technology and don't think about the long term and the durability and the repairability and the impact on people's life. I know Antonio has got a question?

ANTONIO:

When I was a kid, my mother, worked in an orthopaedic hospital that I had to be in because I had to use orthopaedic boots. And at the time most of the people working and making those boots and making some prosthetics, they are all people with disabilities.

SCOTT:

Mm hmm.

ANTONIO:

So, I was about, you know 6- or 7-year-old. And I went there and for me that was normal. You know, I was not able to establish any difference between individuals.

SCOTT:

Sure.

ANTONIO:

You know, you were telling us that you know, you were telling them about your needs in relation to the prosthetics and then you never heard from them anymore?

SCOTT:

Yes.

ANTONIO:

I don't think there is an excuse not to involve people who have needs for prosthetics, in the designing processes, you know. The information is everywhere. And there are good cases where the engagement happens. But, why do you feel that they didn't call you back again? What is missing there? What do we need to do to make sure that next time they do call you back?

SCOTT:

I think I would have slowed down the process and the process had to go quickly so they could get money from the Federal Government. Because if you weren't, I'm assuming that there were benchmarks that you had to meet, in order to receive this funding. And you better meet those benchmarks, and if there's a guy like me coming and saying, and warning them about potential problems, that's going to change them. They are not going to reach the benchmark. There is a gentlemen in Paris that reached out to me, God, over a dozen years ago now, that he was developing prosthetics that were very simplistic and he was making these things with what is the copy machines that spits out, you can make things with them, 3D?

NEIL:

3D printers?

SCOTT:

Yes, he was using a 3D printer and trying to make these things work and he was going to different seminars and conventions and things promoting what he was doing. And we had a discussion about it and you got to be careful that somebody doesn't knock you out and do something, so you weren't viewed as being respectable or whatever because, so, for the major prosthetics companies that are building all this equipment, if someone is going to come out and knock them in half, or more on pricing, what is going to happen? I mean we have seen that throughout history, with so many different inventions and things. When somebody builds a better mousetrap, especially if it's half a price, well, they are going to get the market share. And if someone else doesn't want that because they are going to lose their business, then there is a problem. So, what you're saying, you're asking me Antonio, money, it's all about money, and it's not about people and it's so unfortunate. It's ridiculous.

NEIL:

So, I think that there are definitely market forces at play within and significant, I wouldn't necessarily call them monopolies, because they are not necessarily monopolies, within and I'm loathed to use the word,'cartel,' not without using the word,'allegedly,' a few times first.

SCOTT:

Yes, cover your ass.

NEIL:

Yes, but definitely there are, you know, groups of organisations that are providing these services. What was interesting was we have seen this also in other areas, with the blind community. So, braille displaces, also, massively expensive, hugely complex, loads of little moving parts, really difficult to maintain and repair, especially if you're users accidentally spill yogurt in them or crumbs and so on. And you know, maintain them over the years. They are really expensive and out of reach for most people that don't have government funding and so on. So, there was a project run, initiated by the former Chairman of the RNIB, to create a different type of braille display and they created like a braille notetaker, with less cells. And it used a different technique. So, less moving parts. And they were doing it for a tenth of the price.

SCOTT:

See.

NEIL:

And they distributed them in Africa, with books preloaded on them. Now, there was no incentive for them. So, they were doing it because they weren't there to create a business. They were there to meet a need. But then it didn't become really a business. So, they are not sold in the global north. So, they are not the threat to the established hierarchy of organisations that are still selling these devices. But they ought to be because there is no reason why people should be paying $6,000,$7,000, $8,000, for a device, where you could have a similarly functional thing for $500.

SCOTT:

Well, I had a guest on the show a couple of months ago and we got into talking about their company. He works in a think tank and they come up with ideas on what can help the disabled community. And they are, they currently are producing very low numbers, right now, wheelchairs that are less than 20% of the cost. He told me about what would happen to the price, if it came to the United States or to the UK and such, it would just boom. It would just explode. You can't get around that and we were really talking about, how, you guys have to be able to get around it. But in places like Africa, where it needs to be done, they are able to market it at that lower respectable price in countries like that. But why can't they still do the same thing over here because, man, there are so many people that rely on government funding. You know, us here, in the United States, with the way our insurance group, oh my God, it's so ridiculous because anyone who comes up with the idea or the push to try to get universal healthcare in this country, just gets nailed.

NEIL:

By the economists, yes.

SCOTT:

It's just crazy. Wild Trump. Anyway, it's just not happening. So, for example, here's another one. So, I had a guest on the show from Canada, we were talking about braille and money. They went in and changed their printing presses and things, to be able to aid braille, to let you know, so that people with disability, you know, vision issues are able to read what their money is. Now, in the United States, you don't know. We just don't think things through and it's so stagnant and old fashioned and not thinking progressively or proactively towards disability community. It has to change.

NEIL:

Yes. Yes, I mean the US approach to health and I use the word,'care,' in quotes, it is something that from outside, we can't really comprehend the insurance system. But, what we do see, where there is a lot of governments subsidy of devices and services for disability; is that that tends to inflate prices.

SCOTT:

Yes.

NEIL:

And it creates a market where if the individual is not paying, then who cares what it costs. And this is how you have ended up with these gold-plated devices that if you aren't able to get access to the system, then you're completely unable to afford it at all. So, and I saw this when, ten or 15 years ago, I was working on products where we were wanting to integrate text to speech, into mobile products, to build something to support people with dyslexia.

SCOTT:

Okay?

NEIL:

And the components, literally the same components, were a tenth of the price, if we were going to integrate it into a game, than if we were to use it for assistive technology. So, they would licence it through us for ten times as much because we said we wanted to use it as assistive tech?

SCOTT:

Humans can be so stupid and selfish.

NEIL:

So, there you go.

ANTONIO:

I was recently reading a blog about an American who had moved to Portugal. And he was comparing the cost of access to some healthcare services that he needed, was comparing with the United States and what was he paying in Portugal and he started to realise that in Portugal, he was paying about €120 for a procedure that he was paying $5,000 in the United States. So, it and then you start to realise, how is it possible that this procedure can cost €5,000,it doesn't cost. It is everything that is on the top of it, saying that it's costing that money.

SCOTT:

My wife right now, as we are talking guys, is working in the emergency room at our local hospital and since they were bought out a few years ago, from a corroboration, there are doing things for example that, there are beds in the emergency room and those are for people that have emergencies, that are seen by doctors and they have to wait in order to go up to a surgery or to go up to a room instead. No, they are not doing that anymore. Those rooms tend to be filled with, because they are cutting back, there are so many nurses, that are saying screw you and leaving because of the poor wages and they are cutting back on the floors, on the beds that are available on the floors, that they are now placing patients in her emergency room instead of going up because it's cheaper. And they don't have as many doctors, they are pushing out the doctors, because the PA's are less expensive. So, it all comes down to the bean counters talking about how we can ... oh my God, I'm going to pound my head against a wall when we are done here guys, or else I am going to go to a pub at about 11 o'clock in the morning. So, I don't know which way to go.

NEIL:

So.

ANTONIO:

Scott, you know, we were earlier also talking about, you know, your Podcast and your work, what actually motivates you to bring guests to your blog and to have open conversations about this?

SCOTT:

You know, I was a little kid in 1968, and I remember when Martin Luther King, Junior and Bobbie Kennedy were assassinated and everything that was going on in Vietnam and so many things were going on in this country and all the protesting. And I watched Walter Cronkite on CS News, every night and how honest he was and it hit me and it has always stuck with me about, when there is a problem we need to talk about it and action needs to be done. And there is nothing wrong with that. So, the more I've gotten into the show and doing the show, the more I've been in search of and finding, people that are more expressive and have a bit of a chip on their shoulder and wanted to do something about it or at least express their views. So, you know, we just go from there.

NEIL:

I think that's interesting because I maybe disagree on some of these things.

SCOTT:

Go for it man.

NEIL:

Some of these things, politely. So, I think it's absolutely essential to bring people to the conversations that are not afraid to voice their opinion. I think that sometimes that we, as a community, can do ourselves no favours by clearly having that chip on our shoulder and it's a delicate balance between advocacy and rebel raising. And I think that you know, I can't tell you which side of the line to walk, on that one because I think that sometimes we need the rebel raisers. We need the people that are going to occupy the buildings and do the walk.

SCOTT:

Sure.

NEIL:

And all of that. But, also we need the negotiators and the calm heads that move these things forward. But what I do agree with you on is that we need people that are going to be truthful about the problems and not just brush them under the carpet.

SCOTT:

Exactly, I guess that's really, you just made the fantastic ... that's the bottom-line Neil. Just people that are open, honest and not afraid of maybe knocking on the door, not just, you know, kicking it in. So, I hear you and I respect what you have to say about that aspect of it, as well. There are ways when one thing works better than the other and you know, they can work in unison together, as well.

NEIL:

Yes. So, I think because we live in such a polarised world.

SCOTT:

Oh gosh.

NEIL:

And you know, people have both you know, compassion fatigue from being you know, shown horrible things all of the time and also, fatigue with the conflicts and the confrontation that we are constantly seeing. So, how do you think we can take forward the conversation? How you know, who is the next you know who is the next Walter Cronkite that's going to, you know, shine a light on these things and bring forward the conversations or are they multiple?

SCOTT:

I think it starts with the youth. I used to teach high school social studies in history before I went on to coaching college soccer, football. And now, I've tried to get back into my own classroom but I don't even get interviews but that's a different issue. But I do substitute teach. So, I do get into classrooms and the kids respond to me, for example because I am respectful of them and they are respectful of me and I tell them that I have responsibility as an elder and things that I've had for life lessons to pass on to them but they also have responsibilities, as they're maturing about trying to gather thoughts and to promote positive actions. The kids nowadays have so many things tugging and pushing and pulling and doing all of these things to them that they will react to just common sense. I think this generation that I am talking about high school age, so 16 through 18. I think that they are looking for common sense. For example, on so many days when I am working, it's just busy work, while, I'll play music and 70's, 80's rock, Tom Petty and John Mellencamp. The kids react to that positively. It's not just their new stuff. I think they want to go back. They want to experience those days that we had gentlemen that we look back and say, oh my God, those were so much more calm. They want that and they are not getting it and I think that, as they mature, they might start carrying us back to those days, to some calmness, to some thoughtfulness and maybe actually get some things done that we always and our governments always talked doing, about common sense for humanity. And I think, I think that they might be able to pull it off. Things that maybe our generations didn't do because, so many people got into you know, the great dollar or the pound, that I think, I have hopes. These kids might be able to do something about it.

NEIL:

Yes. I think I am still an optimist. When I was growing up, we grew up under Margaret Thatcher and she led the famous saying,'There is no such thing as society,' which has left us with a terrible legacy, of you know, everybody is thinking selfishly of you know, of their own benefit and that collectivism, I think that binds or did bind people together. I start seeing that in the values of the younger generations that are coming through. You know, when we are trying to recruit within our organisations. Actually, it's not money that is actually attracting the younger people. Once you get beyond the hygiene factors of can it pay for me to be able to afford to live. That's not the main motivator. It's, you know, is this organisation is doing good stuff for the planet? Is there a social purpose? You know, these are things that you know, from our generations which you know, famous movie line,'Greed is good,' you know. That was, I think that that is set the tone for several decades. So, I hope that like you, the younger generation and I am hopeful that the younger generation are going to do things differently and that some of us that have tried to carry the flame, can pass on that flame to, you know, to an empowered and educated and empathic generation coming forwards. It's been a real pleasure talking with you, Scott. We are at the end of our allotted time. But I really look forward to continuing this discussion later on, on social media.

SCOTT:

Sounds fantastic guys, great. Thanks, Antonio. Thanks, Neil.

Creativity, Play, and Disability in Soccer
Improving Prosthetics and Engaging Users
Assistive Technology Challenges and Costs
Passing the Flame to Youth