Day: August 10, 2010

Categories
Carrying Capacity Environment Global Climate Change

Beware of Technology

Beware of Technology—6-2010

© Richard Grossman MD, 2010

The chief cause of problems is solutions.

(Eric Sevareid)

I once sat on an airplane next to an engineer specializing in failure analysis. I told him about my “rip-stop” condom invention, which I hoped would be less likely to tear. “I’ve never had a condom break,” he said. Then his face clouded and he added: “Well, just once. In Thailand.”

As a physician I am used to things not working out as planned. There is so much variability among people it’s unreasonable to anticipate the same level of success with every patient. However, people’s faith in technology is such that we expect a perfect cell phone connection every time and spill-free offshore drilling. We are shocked when our expectations are disappointed.

I will not write about how BP grossly underestimated the amount of crude oil spilled into the Gulf of Mexico with the Deepwater Horizon disaster. Neither will I dwell on the executives’ culpability in this catastrophe, nor the dishonesty that allowed industry and watchdogs to make an incestuous agreement about safety. Nor will I highlight BP’s reckless decisions and actions. I will write about the risk of our overdependence on technology.

I know a few of the local BP executives. They are intelligent, well meaning and honest. Like you and me, they are just trying to earn a living. It is not their fault that BP has taken advantage of our social and legal structure that allows large corporations to run roughshod over the environment and the rights of people.

Engineers don’t assume that their projects won’t fail. Rather, they estimate the “time to failure.” For some highly refined mechanisms, that may be many years. For complex new technologies it may be impossible to estimate the time to failure. Don’t ever believe a claim that anything is entirely reliable.

One of the ways to increase safety is to have redundant systems. This is a bit like what we have in a car. There are brakes to avoid an accident. If the brake fails (or if you fail to use it in time) the seatbelt will keep you from going through the windshield. Air bags offer a second level of safety.

Every gas well drilled in La Plata County has redundant systems in case of a blowout. There are annular valves to squeeze the pipe, and rams if the annular systems fail. If any one valve type were perfect, a second set wouldn’t be needed.

There were valves at the Deepwater Horizon drilling site that failed. Perhaps the failure was because the explosion cut the control cables—we don’t know yet what caused the problem.

BP won’t tell me if there was an “acoustic switch” on this drill rig. This type of valve is triggered to shut not by wires but by an acoustic signal. It is required in some areas, but apparently not for rigs in the Gulf. An acoustic switch has the advantage that it can still be closed if the wires to the drilling platform are cut.

This oil spill is a tragedy, but I can think of much worse. What if there were a nuclear accident instead of one with petroleum? As bad as crude oil is to the environment, it is far better than spreading highly toxic radioactive isotopes over the Atlantic!

I view the Deepwater Horizon tragedy as a wake up call: any technology can fail. Large, complex technology can fail disastrously. Even with “failsafe” precautions, disasters happen.

Coal and petroleum fueled the industrial revolution and revolutionized the way we live. Fossil fuels have also allowed our population to grow enormously over the past two centuries. Regrettably, growth cannot continue indefinitely. Continued growth and dependence on fossil fuels are major issues that our society is just beginning to examine.

Renewable energy is one way to avoid large disasters. Most of the electricity for our home comes from solar panels on our roof. Our generating system is small, safe and doesn’t burn fossil fuels. We depend, however, on natural gas to cook and keep us warm.

I draw several conclusions from the Deepwater Horizon experience. We shouldn’t allow any more nuclear power plants. Consideration of drilling in the Arctic Ocean must be stopped. Any further offshore drilling must be carefully supervised by governmental agencies that are also carefully monitored. There must be contingency plans laid out ahead of time for dealing with an emergency such the Horizon’s blowout. Perhaps the most powerful lesson is that we must become less dependent on fossil fuels.

This article may be copied or published but must remain intact, with attribution to the author. I also request that the words “First published in the Durango Herald” accompany any publication. For more information, please write the author at: richard@population-matters.org.

Categories
Hope Medical Women's Issues

Feminize Medical Care

Feminize Medical Care—4-2010

© Richard Grossman MD, 2010

May God bless you with discomfort at easy answers, half truths, and superficial relationships, so that you may live deep within your heart;

May God bless you with anger at injustice, oppression, and exploitation of people, so that you may work for justice, freedom and peace;

May God bless you with tears to shed for those who suffer pain, rejection, starvation, war and loss, so that you may reach out your hand to comfort them and turn their pain into joy;

May God bless you with enough foolishness to believe that you can make a difference in this world, so that you can do what others claim cannot be done;

May God bless you with God’s comforting presence now and in your journeys through each day.

Franciscan blessing

Read by Reverend Ginny Brown at Dr. Leanne Jordan’s memorial service

My first year medical school class had 125 students in it; only six were women. Now half of medical students are women.

I did my specialty training at the University of New Mexico and was surprised that several other residents in obstetrics and gynecology came from medical school in Denver. The former chair of the OB-GYN department excluded women from his program. Imagine not letting women learn to care for women! Fortunately that has changed; now only two of thirty-six OB-GYN residents at the University of Colorado are male.

A friend studied the culture of operating rooms for his doctorate in sociology. He noted a huge change from the 1960s to the present. Men initially dominated—both figuratively and literally—and many OR nurses lived in terror of the behavior of surgeons. As more women became surgeons the ethos improved. The OR became a kinder, gentler place, and patients benefited as well as the staff. Worldwide, empowerment of women is one of the most important steps we can take to slow population growth.

Women in medicine often take off time to have children and to raise their family, so female doctors may take longer to finish their training. I am proud of our daughter-in-law, Dr. Stephanie Shrago, for excelling in med school and family practice residency and having two wonderful daughters. Of course, I also have to thank our son Dave who does a lot of our granddaughters’ care.

Another remarkable physician with whom I practiced for almost twelve years just died. Dr. Leanne Jordan’s memorial service was held earlier this month with an overflow crowd of admirers. Speakers at the service recalled Leanne’s talents: an amazing athlete, empathetic friend and an outstanding doctor. When we worked together in the operating room I felt as though I were energized with a second cup of coffee, because she was always so quick—but careful—during surgery.

One friend said that Leanne’s smile would light up a whole room. I knew about many of her accomplishments and numerous athletic skills that were mentioned during the service. I will never forget the story of her skinny-dipping with a friend after rowing practice when some guys moved their clothes away from the river’s bank.

Leanne died of the breast cancer that she fought valiantly for years. I admire her for being the “poster child” for cancer treatment. She did not hide the fact that she was battling the disease. This openness was a source of solace for others with serious illnesses, and an encouragement to get screened for cancer.

Early detection of breast cancer is key to its cure, as with many other diseases. Breast self exam is good, but mammograms can detect disease long before it can be felt.

Mercy has just opened its state-of-the-art Breast Care Center. It has the latest equipment for the diagnosis of breast problems. In addition, it is beautiful. Stunning art, a fireplace and the dragonfly motif help to soften the usual medical atmosphere.

In the past I heard complaints about pain caused by mammograms, but I don’t any more. That may be because the new digital machines are faster. They are safer, too, since they use less radiation.

Regrettably, not all women have health insurance to cover mammography. There are programs to help women older than 40, so finances shouldn’t be a reason to avoid this important test. The criteria are confusing for the different programs, so it is best to call B.J. Boucher at the American Cancer Society local office, 259-3527.

We have benefitted from more women participating in medical care. It is sad that we recently lost one of the finest, Dr. Leanne Jordan.

This article may be copied or published but must remain intact, with attribution to the author. I also request that the words “First published in the Durango Herald” accompany any publication. For more information, please write the author at: richard@population-matters.org.