SURGEONS AND GLOBAL WARMINGDr. Shah Suril Atulkumar - October 23, 2019
Do surgical specialists stop to think about their impact on Global Warming?
Are modern doctors fighting for a good cause like our great predecessors?
What is the positive impact of being connected, are we truly international?
Do we even think that way during our busy schedules?
I am an Orthopaedic Surgeon from the Republic of India and when it comes to the most crucial topic of our era, global warming, I ask myself; 'am I responsible'?
My answer; 'As surgeons we are responsible for at least a part of the climate issues on our planet, just as we are equally affected by it. We should be part of the solution as well'.
Perhaps you’d rather ignore what you’ve just read, but that might put you in the same category as the selfish businessmen running the industry.
Let’s for a second assume that we as highly educated professionals believe we need to step up. Where would we start?
Most of us have similar basic needs and we have similar daily habits. Among us we use every type of transport available and we use high tech devices to connect to people as well as to market ourselves. While these habits are beneficial to our personal development, it is a double edged sword. Everything we undertake is driven by electricity. In our everyday lives we use up a tremendous amount of earth’s energy to achieve our goals.
Greenhouse gas emissions have been calculated using grid intensity (emission per kilowatt) provided by local power utilities. The increase in human caused greenhouse gas emissions have undeniably led to health, ecological and humanitarian crises.
Urbanising Marketing in Healthcare
Around the world there’s a tendency to believe the best healthcare is found only in big cities. Not a strange thought, because there’s a powerful marketing machine driving those ideas.
It’s often clever business people running large urban hospitals and we ourselves are keen to be stationed in one of them. At the end of the day, good marketing rubs off on your status too.
However, investing mainly in urban areas directly promotes global warming. This strategy simply means healthcare has become a business. I wonder if the founding fathers of modern surgery wanted it to be this way.
Having a better system in place that separates doctors from hospital marketing would mean we would be able to identify all highly qualified doctors. Our peers working in rural areas included. Creating proper individual qualification profiles enables us to change the way we think as a species. And perhaps a deeper wish to move away from urban areas. Though it would require a broad understanding with actual human connections.
Communities would benefit more from such a direct identification set up than our current set up initiated by government driven hospitals and business oriented clinics. Of which the vast majority is based in smart urban cities causing a lot of annihilated nature for their mere existence.
Imagine being able to separate our profession from business driven strategies. Think about the extended impact this adjustment would have on where we’d live, our commute to work or the effect of nature on a global scale. In a world where healthcare is less concentrated in urban areas, patients would get quicker and easier access to it. Decreasing patients transporting time to sooner reach better healthcare would also add an indirect, but positive effect on our ecosystem’s burden.
To achieve such an independent qualification system we need to look at the ground work.
Today, ninety per cent of the institutions associated with surgical field are operating solely for their economic advantage. You can’t deny that these advantages often surpass concerns about the environment.
But if every doctor would have a direct connection to the community, there will be a more responsible execution of what we do.
Most of the food on the menus when we are attending conferences has an impact on climate change. More and more voices are raised against the intensive meat industry because of their large emission of green house gasses. With political parties emerging around the globe that strive for better protection of the world’s fauna and better animal rights, there’s definitely room for improvement towards the food served at congresses. Especially when it’s so easy to combine our daily nutrition with an eco-friendly diet.
I personally eat a healthy diet according to Shraman tradition (Jain Vegetarianism, red.) in which any form of violence against nature is minimised. Our nutrition consist mainly of grains and pulses. In addition we eat fully plant based, but never any root vegetables to respect even the tiniest creatures. Growing up on such a diet has made me a strong and healthy man, needless to say I’ve never had any nutrition related issues.
Now I’m not saying you should eat the same as I do, but would it hurt any of us when we demand eco-friendlier food during a conference? After all, we are the ones advising our patients to eat healthy and go for food with higher nutritional value. The impact of such a simple change would be enormous if done on a global level. It could easily represent a turning point for our community as a whole.
For us as a professional group to initiate this change would have an even bigger positive impact on the world. As doctors we have already earned the respect and admiration of our communities and we are seen as role models. When a group of role models start a movement, it will be followed.
We would lead by example. We would be a true inspiration to our patients if we show courage to fight global warming by forcing a change. It would most certainly be an inspiration to the world. We’d be able to add it to our profession as the noble milestone of our time by taking a joint action.
And while breeding animals used for biomedical research may not weigh as high on global warming as the meat industry, we may want to raise some global questions on the ethics of animal research while we are at it.
I for one would be keen to learn how my peers on a global scale feel about their daily diet and learning methods. And especially whether or not we are taking our personal impact to global warming into account.
Our natural resources are limited. It begs the question of whether or not our conferences are worth the damage it’s causing our environment. Surgeons are amongst the highest educated people in the world. We sure should be able to see the correlation between situations that have unfolded and our daily habits. Humans in general are taking much more than we give when it comes to our planet. And we should acknowledge the need to set a better example by initiating a change in our own ways.
Surgery is not a business
Lastly, we should reconsider the dependance of our medical system. A dependence that’s thriving on a lack of trust within our community which finds its origin in the insurance system. A system that’s been created by the corporate system. That system is less concerned about our environment and more about profits. It's merely a business.
Every now and then we are awoken by scandals of industry created epidemics. Take the latest scandal with purposely inflicted opioid addiction that we are now becoming aware of for example. It’s been made possible by large corporations that are still able to continue their business. How is that even possible? And who truly takes responsibility for it?
Scandals like these are not just about companies anymore. We, as doctors, should be a part of the change that is needed.
A change can be made when the brightest of doctors start to put their heads together and create policies for a global health system. Such a system would provide so many advantages for our kind, beginning with the much needed care for the earth we live on and the air that we breath.
Why don’t we start by putting our concerns for global warming on the agenda’s of our next conferences? Joined minds are able to find new ways, solutions even or at least come up with practical actions to minimise our own impact. Are we even aware of the impact we can have as a large group of professionals?
Surgery, our theatre and hospital
Volatile anaesthetics are halogenated compounds suspected to be destructive to the ozone layer. The widely used anaesthetic gas, nitrous oxide best known as Desflurane, is an established greenhouse gas. Recent reports suggest that nitrous oxide is an important ozone-depleting gas. Carbon-dioxide, methane, and nitrous oxide are all powerful greenhouse gasses, and together they are the main cause of climate change.
Wasteful surgical output can be segregated as hazardous waste, fluid waste, sharps, cytotoxic waste, black box waste (any material being both infectious and toxic, red.), recyclables and reusables. Operating theatres in general and surgical waste in specific are an appreciable source to contribute to greenhouse gas emissions.
We can initiate the move towards eco-friendly operation theatres as an international body by connecting our minds on one platform. Emission reduction strategies have the potential to lessen the climatological impact of surgical services without compromising patient safety.
Waste incineration technology and the practice thereof can be implemented under conditions that meet applicable and proposed emissions limits and other environmental regulatory constraints.
The development and adoption of continuous emission monitoring technology should be encouraged.
With this, I have laid some basic points before you to initiate a discussion, to decided what we can and need to do. As humans our planet is struggling and therefor our lives are in danger.
Didn’t we pledge to care for those who need us, to heal whenever we can, or at least to not make things worse?
It’s time we recognise that we are needed more than ever before and that we can’t do this individually. For only if we get connected and start acting now, we won’t have to regret our past in the future.
We owe it to future generations to be better doctors by being environmentally aware and by teaching our children that if you support the wrong causes, the effects will become serious someday.
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