“Hand me that ice pack, stat! He has global warming sickness!“, Or, The ED and the Coming Heat Wave
Warning: I don’t write the headlines of stories that link here.
First, I checked. Nobody uses “stat” in emergency rooms anymore. A chief told me that he couldn’t remember the last time he said it in a non-joking manner. And nobody claims that there is such a thing called “global warming sickness.” But doctors Jeremy Hess, Katherine Heilpern, and colleagues come close in their “Climate Change and Emergency Medicine: Impacts and Opportunities,” just published in Academic Emergency Medicine, a top journal.
We can understand that Hess and his pals are worried that a vengeful Global Warming is on its way (ever coming, not yet arrived), because the media and many journals are saturated with (not always sober) warnings. Global Warming thoughts and fears are in the air (forgive me), so its only natural that conscientious souls will publicly ponder “What does it mean to me?”
Let’s see what Hess et alia say will happen when global warming finally hits. Heat stroke, exacerbations of heat-sensitive illnesses like acute coronary syndrome. Injuries from all those extra hurricanes and storms. Intentional injury associated with violent crime! Gastroenteritis (stomachache). Urolithiasis (kidney stones from dehydration; and there’s nothing funny about that). More zoonotic disease, of course. Add to these, increased cases of asthma, COPD and other respiratory infections, various bacteriological nasties, allergies, renal colic, poison ivy, burns (from wildfires, natch), cocaine overdose, and, as ever, the Big D.
When I read this list, I thought I had stumbled upon a related passage of St. John’s:
And when he had opened the fourth seal, I heard the fourth beast say, Come and see. And I beheld, and lo a pale green horse; and he that sat on him was called Death, and Hades followed with him. And power was given to them over a fourth of the earth, and that they should kill with sword, and with hunger, and with death, and with the beasts of the earth.
There have been a lot of claims about the evils that are imminent (they’ll start soon, soon), but my favorite is “Intentional injury associated with violent crime.” Presumably, this refers to the increasing frequency of fistfights that will surely break out over arguments of who is greener, thee or thou. But, no. When it’s hot, blood really does boil, and with increasing temperature comes increasing anger, angst, and rage. Hess even supplies a vague and foreboding hint about those who take “certain antipsychotic medications.” Remember to tell your pals—you read it here first—global warming causes irksomeness! We have all heard of rampant brawling in warm and sunny Florida, so look out!1
The story of Katrina (the windstorm) is retold. This literary device is used wisely, and the reader is left to infer that it could happen again! But we still haven’t heard the worst of it. Now, if you’re as experienced as I am at reading these kinds of papers, you know a version of the old headline “World Ends: Women and Poor Hardest Hit” cannot fail to surface. And so it does here, because we learn that all these fell winds will affect the “socially and economically marginalized” more than any other group.2
With that out of the way, the paper really hits its stride and the full reason for the concern becomes clear to us: Emergency Departments will need more money and resources! Naturally, all those extra emergently sick people will need to be cared for, and lest they burden EDs excessively, actions must be taken now, mostly by applications of large amounts of money. Our authors sternly warn us that ED docs might lose their jobs as global warming maliciously fiddles with the GDP. Prepare now!
What can we do to help? Green Up! First recognize that emergency services are “fundamentally petroleum dependent” (all those ambulances and air conditioners). Second, “model carbon literacy.” Did you know that “physicians are major consumers of energy”? And that they are “well-suited to affect public attitude”? Well, now you do. The solution: let the doctors tell us how to fix everything.3
Sadly, in the entire paper, not a hint, not a glimmer, not even a whiff of a possibility of a rumor, is given that there might be a chance that increasing temperatures (which themselves are uncertain) could improve health conditions. Fewer cases of hypothermia (hyperthermia is plugged)? Fewer deadly cases of pneumonia (a leading ED killer)? Fewer flu cases? Fewer asthma cases (some asthma is exacerbated by flu, and there is often a spike in cases in winter, as well as summer)? Less stomachache caused by the increased food supply (in turn caused by extra CO2 and longer growing seasons)? It’s easy to go on and on and on.
But our authors did not make the attempt. Which makes you suspect that their paper is a polemic and not research. The AEM editors thought so, too. They took the extraordinary step of including a two-page explanation of why the Hess paper was allowed. And in it, uniquely, they cite—twice!—global warming skeptics. They consider that all might not be as bad as some claim. They also openly say that, even if global warming occurs as predicted, “the changes discussed in most forums will likely be gradual enough to allow us to adapt and overcome—which, after all, is what emergency physicians do best.”
You can’t say fairer than that.
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1Recognition of this perhaps explains why Monsieur Sarkozy wants to count happiness as part of France’s GDP.
2Since you know this is coming, you feel a growing tenseness until the relevant passage appears—are they going to forget?—then relief sets in and you can enjoy the remainder of the paper.
3Let me say something nice about Hess, and acknowledge that their Figure 2, showing the theoretical changes to distributions of continuous measures for shifts in mean, variance, and both is very well done. But then they spoil it by including a Figure 3, which purports to show a positive shift in ground-level ozone. The Figure is a forecast of what it might be like in the years 2031-2039. Yeesh.