William M. Briggs

Statistician to the Stars!

“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.

Fourth Horseman of the Global Warming

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.


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.


  1. “a leading ED killer”

    Must be that other ED. The one immediately coming to mind is rarely fatal except perhaps socially.

    Of course the change will be gradual — and small. I wonder how many people could distinguish a one or two degree change even if the spacing was only one day let alone a century.

    The paper’s “hypotheses” could be tested by examining the changes that occurred between 1998 and the surrounding years as that year has a remarkable spike in global temperature. “The warmest year of the entire series is 1998, with a temperature of 0.546°C above the 1961-90 mean” according to this paper

  2. The authors neglect what is certainly the worst medical consequence of global warming — or I should say, the FEAR of global warming: increased insanity in the human species. It is already strikingly evident with only a statistical three tenths of a degree warming since 1980. The authors themselves provide a hefty example of the effects of this contagion.

    “And he said unto them, Ye will surely say unto me this proverb, Physician, heal thyself.”

  3. And let’s not forget that the dominant greenhouse warming theory says that the warming will be greatest during winter, nights, and at high latitude, because at the low temperatures under these conditions, there is very little water vapor, so each increment of CO2 provides a greater radiation-trapping increase. And you could easily interpret the temperature histories of the last century to be in support of this.

    So very cold conditions are warmed much more than very hot conditions are. Thus, it is really important to examine the possibly beneficial effects of this moderation of temperature extremes.

  4. Briggs

    September 17, 2009 at 4:48 pm


    This is the danger of writing these kinds of papers. I pointed some, and other similar facts, out to the paper’s authors. I offered them space for rebuttal. Nothing heard yet.

  5. Actually the water vapor issue is more complicated. Climate models say that the dominant warming is due the large cloud-water vapor feedback, not the direct effect of the increased forcing of CO2. Without water vapor, and without an increase in water vapor, the warming is quite small.

  6. Very nice piece, Mr. Briggs. I’ll add you to my bogroll, ummm, blog roll.

  7. This is the danger of writing these kinds of papers. I pointed some, and other similar facts, out to the paper’s authors. I offered them space for rebuttal. Nothing heard yet.

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