Maryland Motor Vehicles Agency Wants To Know About Your Sleep Apnea (nbcwashington.com) 155
"Man goes to the doctor for a sleep apnea diagnosis, a few months later he gets a letter from the state of Maryland about his sleep apnea -- and they won't tell him how they found out about it," writes Slashdot reader schwit1. NBC4 Washington reports: Dr. David Allick, a dentist in Rockville, was diagnosed with mild sleep apnea in June 2022. Months later, he received a letter from the MVA requesting additional information about his diagnosis in order "to determine your fitness to drive." The September 2022 letter noted failure to return the required forms, which included a report from his physician, could result in the suspension of his license. Allick said he isn't clear how the state learned about his medical diagnosis. But more importantly, he said he was previously unaware of a little-known Maryland law requiring people to report their sleep apnea diagnosis to state driving authorities. Allick said he still has questions about what prompted the ordeal. "Everybody I talked to -- nobody's heard of anything like this," he said, also acknowledging: "I'm sure they want to keep the roads safe." schwit1 adds: "How is this not a HIPAA violation?"
The investigation team at NBC4 Washington found that Allick is one of 1,310 people whose sleep apnea diagnoses "have led to medical reviews by the Maryland MVA." The state department didn't have data on how many of these Maryland drivers have had their license suspended.
The investigation team at NBC4 Washington found that Allick is one of 1,310 people whose sleep apnea diagnoses "have led to medical reviews by the Maryland MVA." The state department didn't have data on how many of these Maryland drivers have had their license suspended.
Standard practice in Canada sadly (Score:5, Informative)
I had my license suspended for 4 months after being diagnosed with pretty bad sleep apnea. My own family doctor reported it to the ministry of transportation.
Took that long for follow up sleep studies and to finally get my CPAP machine.
Sucked but at least now I am rested after sleeping, but they still get remote reports of my CPAP usage.
Re: (Score:2)
Well, to be fair you've got socialized healthcare in Canada so they kind of expect you to take care of your medical needs. Here in the USA, who knows what a sleep apnea diagnosis and treatment entails in terms of financial obligations. You'd probably have to check your insurance and see what your deductibles are, and that's assuming you even have health insurance.
Re: (Score:2)
Just got a quote the other day. I have full employer provided insurance and I was quoted $4k total price, $2k of it was my responsibility.
Re: (Score:2)
I'm in the US by the way.
Re: Standard practice in Canada sadly (Score:3)
We could tell from the insurance prices.
Re:Standard practice in Canada sadly (Score:5, Insightful)
This is beyond stupid. It creates a huge disincentive for people to find out what's causing their sleep issues. If you didn't have accidents before the diagnosis what difference does it make that you have it diagnosed now? At the bare minimum they should just give you a warning that you need treatment. But either way it's still an invasion of privacy. Should we suspend the license of any frail or diseased people? Or people who are too old? Disgusting.
Re: (Score:3)
Re:They don't have a need to know. (Score:5, Informative)
But OTOH, how many people become apnic while driving?
Even with my mild apea, before I got it under control, I had near misses and microsleeps. Rest breaks are essential
Also see:
https://jamanetwork.com/journa... [jamanetwork.com]
Drivers With Untreated Sleep Apnea -- A Cause of Death and Serious Injury
Re: (Score:2)
It's not about becoming apnic behind the wheel, but narcoleptic. Which is a common sideffect of untreated sleep apnea
Re: (Score:2)
If it's untreated, then the state won't know, they know only if it's diagnosed and treated.
Your logic needs work.
Re: (Score:2)
Sorry but your logic does.
Diagnosed does not equal treated. So it could still be diagnosed, reported, but untreated. (And treatment does not mean getting a CPAP-machine. It means USING it regularly, too.)
Re:They don't have a need to know. (Score:4, Informative)
Re: (Score:2)
Did you get your heart checked too? Could have been quick bouts of Atrial Fibrulation.
Re: They don't have a need to know. (Score:2)
Who the hell gets their heart checked? Heart disease is one of the leading causes of death, but when have your heard a doc say: "we're going to do a routine stress test and see if your VO2max is optimal"...
Docs have no interest in this. It's about keeping you just barely healthy enough to pay their bill, not about keeping you optimal. (Or else there wouldn't be an overweight/obesity epidemic.)
Maybe we all should ask, no, demand to get our hearts checked for AF and every other possible condition.
Re: (Score:3)
I directly asked my doctor about getting a routine stress test. He told me they only order that if they suspect there is a problem, or have a history where heart issues have been diagnosed. This is concerning to me, as my great grandad died of a heart attack, my granddad died of a heart attack and stroke, my dad had the "widowmaker" heart attack in his 50's (survived). It seems really likely to me that I will have a massive heart attack in my late 40's or 50's, and I sure as hell would like to know
Re: (Score:3, Informative)
Re: (Score:2)
Even if you have it, it's not going to suddenly knock you unconscious during the DAY when you're awake.
Yes. Yes it will. That's kind of a big part of the problem with it.
The fact that there are "MANY OTHER THINGS THAT COULD CAUSE" the effects of a particular problem isn't really an argument for not addressing that problem. Even in just this context, the logical conclusion of that is that driving while intoxicated, violating traffic signals, and driving on the sidewalk should all be legal. After all, there are "MANY OTHER THINGS THAT COULD CAUSE" impaired driving, traffic collisions, and pedestrian death
Re: They don't have a need to know. (Score:2)
"I was just enjoying some ethanol, officer. It was my damned liver's fault for not metabolizing it fast enough!"
Re: (Score:2)
With sleep apnea, you stop breathing occasionally when you're asleep. You'll probably wind up tired but, you are not in any danger of randomly falling asleep at the wheel.
Wow. Were you trying to sound fantastically stupid, or did you manage to stumble on it by pure accident?
Re: (Score:2)
Re:Standard practice in Canada sadly (Score:4, Insightful)
It is not a invasion of privacy for a doctor to notify the DMV that you might not be safe to drive. In fact, they have both an ethical, and a legal obligation to do it. It endangers both the patient and everyone else. The same reason doctors need to report contagious illnesses.
Saying they should wait until something happens is like saying people should be able to drive drunk unless they've actually gotten into an accident when drunk before. Also, if the person had a condition where they should've known it effected driving, than kills someone while driving, and the police find out that the person knew or should've known beforehand, it puts them in a very bad legal position.
They do suspend the license of frail, old, and diseased people if they can't safely drive.
They also didn't suspend his license, he needed to show that it was safe for him to drive, despite having a condition that commonly makes driving dangerous.
Anyone can report someone to the DMV if they think they can't safely drive for one reason or another.
Re: (Score:2)
It is not a invasion of privacy for a doctor to notify the DMV that you might not be safe to drive. In fact, they have both an ethical, and a legal obligation to do it. It endangers both the patient and everyone else. The same reason doctors need to report contagious illnesses.
Absolutely right. And if everything went accordingly to those legal and ethical obligations, the MVA is able to notify where and how they got this information.
If the can't, it needs to be examined if all the legal and ethical requirements were met. This is what this is about. No more, no less.
Re: Standard practice in Canada sadly (Score:2)
If you take a genetic test and it says you are predisposed to addictive behaviors like drinking, should the genetics company be obligated to report to the DMV and force you to have an interlock device installed?
Honest question. Maybe yes?
Re: (Score:2)
Arguably we should, other people on the roads have the right to live also.
But we constructed everything where not having a car is close to being subject to house arrest. Public transit wastes your time, taxis and rideshare is expensive.
Re:Standard practice in Canada sadly (Score:4, Interesting)
Do you not already? My dad's parents both lost theirs for medical reasons (Alzheimer's and heart condition, respectively) and relied on taxis for their last few years. Where I live I have to have a medical check every 10 years when I renew my licence, and I believe it will go down to every 5 years at a certain threshold (probably 65 or 70 years - not close enough to need to check the details yet).
That's without even considering insurance. At age 70 you're unable to hire a rental car in some countries because there's no-one who will insure it.
Re: (Score:2)
Not just licences. Try to get life insurance or travel insurance if you have a medical history, especially mental health. Seeking help and getting a diagnosis means paying higher premiums forever, or just not having any insurance because you can no longer afford it.
Re: Standard practice in Canada sadly (Score:2)
Even a vision test is "medical evidence"......... take another attempt at making the roads unsafe.
Re:Standard practice in Canada sadly (Score:5, Insightful)
If you didn't have accidents before the diagnosis what difference does it make that you have it diagnosed now?
That's now how risk works. I've never been hit by a car while j-walking, that doesn't mean I'm special, it means I'm lucky.
Should we suspend the license of any frail or diseased people? Or people who are too old? Disgusting.
Well. Yes. Wait what? Do you guys not already do this? Maybe that goes to explain your insanely high death rate from motor vehicles (in all metrics) compared to other western countries.
Re: (Score:2)
Does this automatically qualify someone for full disability since they can no longer work without a way to get to work?
Re: Standard practice in Canada sadly (Score:2)
If the real problem is that CPAPs cost an arm and a leg for what is essentially a blower, pressure sensor, and microcontroller, maybe patents should be invalidated or something? (In the name of public health. Like they did for COVID when companies tried to protect their intellectual property on, coincidentally also, CPAPs/BiPAPs....)
Re: (Score:2)
Re: (Score:2)
Re: Standard practice in Canada sadly (Score:2)
That DMV agent should have been drawn and quartered, horrifically. For acting so corrupt after the DMV agents treat others so poorly. (Please wait in line 6 to 8 weeks for the next agent.)
That Maryland (Score:2)
Re:That Maryland (Score:4, Funny)
"Welp, hon, the gub'mit knows about my 'apnea, time to sell de house and move downy shoar..."
Re: (Score:3)
He legally has to notify the new state.
And if he tries to transfer his license to a new state, he likely won't be successful to begin with because states share information.
Almost all but a few states are part of the Drivers License Compact, and they share information.
There need to be regulations for common safety (Score:5, Insightful)
Re: There need to be regulations for common safety (Score:5, Interesting)
Your medical files should never used against you if you voluntarily seek medical help.
This is a huge reason why people, particularly veterans, are reluctant to seek mental health attention; there have been more than a few documented cases of gun rights being revoked as a result of seeing a mental health professional. It was overturned [netdna-cdn.com] but the damage was done.
Re: There need to be regulations for common safety (Score:5, Insightful)
Well I suppose valuing guns more than your mental health would be a mental health issue...
Re: (Score:3, Insightful)
Well I suppose valuing guns more than your mental health would be a mental health issue...
This is the USA you're talking about. We don't even require any sort of proof of firearms proficiency to purchase a gun. You just have to pay for the gun, pass a criminal background check, and it's yours. The 2A was written with the assumption that most people would've had some familiarity with firearms as part of day-to-day life in Colonial times, not from Hollywood [getyarn.io], as is the case today.
Re: (Score:3)
Re: There need to be regulations for common safety (Score:4, Interesting)
Re: (Score:2)
For the CCW process, you actually had to shoot a bit at the end, so that's something.
Wait, wasn't this article about sleep apnea?
Re: (Score:2)
Re: (Score:2)
Re: (Score:2, Insightful)
All rights have limits and having mental health limits on gun rights is not at all inappropriate.
And I I mean really, I see you in another post under my thread praising the idea of mandatory training being required so don't get all high end mighty with me on limiting rights.
Re: There need to be regulations for common safet (Score:2)
Re: (Score:2)
Well we don't allow felons to own guns so I don't think it's too outlandish to not let people legitimately diagnosed with violent mental instability to own them either.
Makes a hell of a lot more sense than revoking someone's driver's licence for sleep apnea to me at least.
Re: (Score:2)
On the other hand it's one hell of a lot more important to the average American's life than a gun is.
If some one were to be found mentally unfit to own a gun it would have almost zero effect on the day to day lives of 99.9% of Americans. Losing their ability to drive though? That would be a hell of a lifestyle change for most.
Re: (Score:2)
If we don't don't let convicted felons own a gun why are we letting those who are mentally unfit?
Re: There need to be regulations for common safet (Score:2)
By those sorts of slipperly slope arguments, who says that a convicted felon is not redefined for gun rights? Maybe someone who was given a traffic ticket should also have them taken away? Maybe someone who cuts in line at the store? Maybe someone who even just thinks a negative thought? Maybe someone who even just resists the government for one millisecond?
Re: (Score:2)
The problem is that so many of you believe that wanting to own a gun or enjoying shooting sports is a mental illness to begin with. You aren't serious people and cannot be trusted,
Oh and you can thank fellow gun owners for creating that atmosphere. "You can have my gun when you pry it from my cold dead hands" is not an uncommon gun rights phrase. Only in America is that phrase not associated with mental instability though.
Re: (Score:2)
Hahaha, I see what you did there. Well done, you can never lose an argument if you just make up a worst case scenario (an incredibly unlikely one in fact!) and claim with no evidence that is what is being proposed.
Not an honest tactic of course but I feel like this is par for the course in talking to you on Slashdot so I suppose I shouldn't expect better.
Re: (Score:2)
Re: (Score:2)
Re: (Score:2, Funny)
The solid in question is lithium.
Comment removed (Score:5, Insightful)
Re: (Score:2)
Re: There need to be regulations for common safet (Score:5, Insightful)
Bullshit. The fears expressed might be real but the facts are a different matter. You'll always find a small group that thinks they will be medicated against their will, given secret tracking devices, and watched 24/7.
The VA is a trusted health provider that is invaluable in providing specialized medical care that the average health provider doesn't have any experience in. PTSD, Agent Orange, chemical exposure, musculoskeletal injuries caused by carrying heavy packs, loss of limbs -- these are all areas where the VA is a leading research and treatment provider.
Sure, you will always find bad physicians in any healthcare system, but overall the VA provides medical care that is targeted and necessary for vets specialized requirements. Perpetuating myths that the VA experiments with untested, involuntary medications just degrades the public's perception of the need for the VA and puts support for veteran's healthcare at risk. The VA is sometimes the only healthcare available to veterans and does a damn fine job for the majority of their needs. The few horror stories you hear about ANY healthcare system (long-term healthcare nurses "helping" patients to pass on, operating rooms in children's hospitals with mold, oxygen systems contaminated with machine lubricants, etc) are outliers and don't suggest ALL healthcare should be shut down. It just means more open and transparent investigations must be held when problems are found.
A vet and VA patient
Posting AC to preserve mods
Re: (Score:2)
Re: (Score:2)
Re: (Score:2)
Cost vs Benefit (Score:5, Interesting)
So any time medical data is going to be used, as in this case, it makes sense to find out the benefits for the large cost in privacy. How many additional deaths per year are the result of people who have sleep apnea driving, and how does that compare with an estimate of lives lost due to other medical privacy issues? If the statistics on deaths from driving with sleep apnea don't exist, then there is no justification for this law whatsoever.
Re: (Score:2, Insightful)
The US places an extremely high value on medical privacy.
Unless you're a woman in a state run by batshit God-botherers.
Re: (Score:2)
Certain diseases like seizures, are reportable to the DMV (and FAA). Because being a driver or a pilot is a responsibility not just to yourself but to others. If you have a seizure you are not allowed to drive a car for at least a year, due to the risk of having another one if not properly medically managed. Severe OSA if left untreated can cause someone to nod off at the wheel, it's like narcolepsy. So there IS a justification in this instance.
Re: (Score:3)
How many additional deaths per year are the result of people who have sleep apnea driving
CDC says that the primary symptom of sleep apnoea (drowsiness) causes close to 100k crashes a year causing many 10s of thousands of injuries and killing between 500-1000 people a year.
and how does that compare with an estimate of lives lost due to other medical privacy issues
Lives lost due to medical privacy issues? Like what? The government agent coming to your house and stabbing you because you were diagnosed with sleep apnoea?
If the statistics on deaths from driving with sleep apnea don't exist, then there is no justification for this law whatsoever.
Laws don't get created in a vacuum. Quite a few places in the world have laws against driving if you have sleep related issues precisely because inattentiveness when drivi
Standard for CDLs and other professional licenses. (Score:2)
This seems crazy to us because it hasn't been applied to personal-vehicle licensing before, but people who drive big trucks or operate heavy equipment that could kill someone if they had a medical emergency are typically required to take a "DOT physical" every couple years as part of their licensing process. I had to take one because I operated a quarter-ton hoist at work that could drop 500 pounds on somebody's head if I suddenly nodded off.
I don't know if the highway safety people dig into things beyond
Re:Standard for CDLs and other professional licens (Score:4, Interesting)
Re: (Score:2)
Thanks for doing stuff most of us, me as well, don't want to do.
People don't give enough credit to long-haul truckers.
Why would diabetes be bad for driving?
Re:Standard for CDLs and other professional licens (Score:4, Informative)
Diabetes is a problem because if your blood glucose level is either too high or too low, it introduces the possibility of impairment in judgment, reaction time, or the possible loss of consciousness - similar issues to that which alcohol can cause. The FAA has similar restrictions for pilots with diabetes - there is ongoing testing and evaluation necessary to keep your pilot's license, with extra paperwork if you're taking anything other than insulin to keep your sugars under control.
Re: Standard for CDLs and other professional licen (Score:4, Interesting)
This could be an excellent opportunity for any automaker with level 3 autonomous capabilities to come up with a way to detect and react to seizures, like taking control and bringing the car to a stop along the side of the road. If they did that, they could make a strong case for getting a car with level 3 driving classified as "durable medical equipment" (or at least, the marginal cost of the level 3 capabilities) for epilepsy patients, because it would give them back their ability to safely drive once they were at a point where a seizure was"unlikely, but not inconceivable".
Maybe they could implement some variant of "dead man switch" where the epileptic driver has to squeeze alternating sides of the steering wheel every few seconds to prove they aren't having a seizure... If they have an actual seizure, it's unlikely that they'll be able to deliberately, let alone accidentally, continue to squeeze left, right, left, right, etc. Though in all likelihood, if the car is doing eye tracking, I think it could detect the seizure just by monitoring the driver's gaze.
Seriously, though... Tesla Autopilot is already so good, there's really no reason to turn someone into a homebound shut-in by taking away their drivers license now that cars *could* actually pull over safely and automatically if they had to, if not*literally* drive them to the emergency room. And yes, in America, losing your driver's license IS basically equivalent to de-facto house arrest for most people in most parts of the country.
Re: (Score:2)
"Please select all the pictures with traffic lights to continue driving."
HIPAA does not apply (Score:3, Informative)
https://www.hhs.gov/hipaa/for-... [hhs.gov]
Re:HIPAA does not apply (Score:4, Informative)
https://www.hhs.gov/hipaa/for-... [hhs.gov]
Why doesn't it apply here?
If they didn't get it from the patient, they got the information from his health care provider, which seems to be explicitly forbidden from sharing it without permission.
https://www.healthit.gov/faq/w... [healthit.gov]
https://privacyrights.org/cons... [privacyrights.org]
Re: (Score:2)
HIPAA has exceptions for public health (e.g. if someone tests positive for Ebola, the health department is notified), law enforcement (e.g. gunshot wounds, child abuse) and serious threats to health and safety (e.g. patient has homicidal delusions, patient has seizures and refuses to stop driving, or has untreated severe OSA or narcolepsy and has a job driving tanker trucks).
Re: (Score:2)
Yes, but if that's the case, why doesn't the MVA simply point to such an existing exception?
Rules like this reduce doctors visits (Score:2, Troll)
Interestingly in the last few ye
Epilepsy (Score:2)
An epilepsy diagnosis results in an immediate driver's license suspension and has for decades AFAIK. Doctors are required by law to report them. This is nothing new.
https://www.epilepsy.com/lifes... [epilepsy.com]
The only question is how much risk a person's medical condition is to others on the road. Driving is a privilege, not a right.
Re: (Score:2)
An epilepsy diagnosis results in an immediate driver's license suspension and has for decades AFAIK. Doctors are required by law to report them. This is nothing new.
https://www.epilepsy.com/lifes [epilepsy.com]...
According to your own citation doctors are not required to report in Maryland.
Driving is a privilege, not a right.
The difference between privilege and right is illusionary.
Re: (Score:2)
If you read further down, "While Maryland law does not provide for the mandatory reporting by a physician of a person who has been treated for epilepsy, it does provide for the discretionary reporting to the Motor Vehicle Administration of persons who have “disorders characterized by lapses of consciousness.” MD. CODE ANN., Transportation 16-119 (2020)."
By law the responsibility for reporting seizures is on the driver, not the doctor, i.e. the DRIVER is the one who is prosecuted if they have a
Re: (Score:2)
Driving is most definitely a right. The courts have has ruled that it is a right multiple times, at least in the USA.
A privilege is something your not entitled to and the government isn't required to allow.
You are legally entitled to drive a vehicle on public roads, the government can set certain reasonable limits, requirements, and restrictions just like with guns and protests, but like with guns/protests, there are strong limits on what the state can do.
Same way freedom of speech is a right, but I can't g
Actually quite common... (Score:3)
Many states have laws requiring doctors to report to state DMVs for most diagnoses of sleep disorders. The reasoning is sound, if you have a disorder that causes you to fall asleep at the wrong time, you could cause a serious injury while driving.
Unfortunately there are folks who know that a sleep disorder diagnosis may result in the loss of their driving privileges so they will often skip actual medical treatment and try to self medicate (caffeine or other drugs) so the DMV won't find out.
nice in theory, but dishonest policy (Score:2)
If we are going to say that anything that impairs drivers should be reported to the state and result in pulled licenses, then we need to be consistent, otherwise we're implementing some other agenda and "transportation safety" is just the cover story.
Some of the same states handling sleep apnea [which contributes to very few annual accidents] this way are busy legalizing pot and are not treating pot use this way, even though there's plenty of data on pot and driving now, and it's just what the critics of le
Re: (Score:3)
this way are busy legalizing pot and are not treating pot use this way
Citation needed. I don't know of any stated that allows you to legally drive impaired by anything, and that's the reason your argument is a strawman. You're talking about the legalisation of taking a substance while your post is attempting to compare it to driving a motor vehicle while impaired. They aren't the same thing.
Many people take drugs and don't even own cars.
Many people take drugs responsibly.
Many people take drugs and it doesn't affect them.
Many people take drugs and drive their car while impaire
Sleep apnea != narcolepsy (Score:2, Insightful)
This is ridiculous. If we're going to suspend driving privileges because of lack of (or poor) sleep, why are any medical residents still driving?
I can maybe see being worried about people with narcolepsy. Sleep apnea isn't the same thing by a long shot.
Re: (Score:3, Insightful)
No it's not. Deaths aren't exclusively caused by falling asleep at the wheel. Sleep apnoea universally makes a patient incredibly drowsy, it's one of the main reasons they seek medical attention in the first place. Drowsiness is a huge driving risk that causes 100k accidents a year in the USA alone, and no the overwhelming majority aren't people asleep at the wheel.
You raise a good point about medical residents. Where I live there are legal requirements to manage fatigue in the workplace. My employer is obl
HIPPA (Score:2)
HIPPA. It's not what you think.
Re: (Score:2)
Is it a female hippo? Certainly it's often confused with HIPAA, which is a heavily watered down GDPR.
Perhaps Viagra Usage Should Be on Licience (Score:2)
Interesting (Score:2)
Orwell strikes again (Score:2)
From the original article: “But they should be aware that Maryland requires, if you are diagnosed with sleep apnea, to voluntarily submit that information.”
That will discourage people from doing sleep studies and other treatment, at least in Maryland.
Drowsy driving is very common (Score:3)
When I started using BiPAP a few years ago, my quality of life went way up.
This is one way to force people out of cars and in (Score:2)
Re: (Score:3)
HIPAA allows exceptions like when states require reporting of some diseases to the government, like Ebola or child abuse or OSA.
Re:He should kill his doctor (Score:4, Informative)
Correct.
That's why the agency needs to disclose the source of the information like "this information has been provided by Dr. Nick as required by and in accordance to state law number-whatever that defines an exception to HIPAA" Case closed.
If the MVA can't provide that, it is correct to assume a HIPAA violation and investigate accordingly.
Re: (Score:2)
Well, picked that because it is no difference if I was referring to him or his inspiration...
Re: (Score:2)
Re: (Score:2)
As was picking the name Dr. Nick as example. No offense taken. I just wanted to point out that there are not one, but two well known quacks of that name....
Re: He should kill his doctor (Score:2)
Zero tolerance for breaking medical secrecy for something which can be kept under control with some personal judgement.
If he's forced to report it fine, but if he has so little faith in personal judgement to volunteer to break his medical secrecy for a mild case I wouldn't want them as a doctor.
Doctors reporting apnea is pretty much unheard of in my country. Even when people stop driving during treatment no one is going to report it, it just causes needless red tape.
Re: (Score:2)
What a dumb take. Certain medical conditions have ALWAYS been reportable to the government. Testing positive for Ebola, people with gunshot wounds, airline pilots with seizures, young children with evidence of sexual abuse, to name a few. These are the exceptions to patient privacy laws, because they pose a risk to themselves or others that is far greater than catching a cold. Don't be hyperbolic.