Vol. 221 November 15, 2019 “Cassandra Speaking of Climate Change “

November 15, 2019

Cassandra: one who speaks a prophecy that no one heeds.

A friend of mine (actually his wife) was cleaning out his collection of many years of books, cowboy boots, framed certificates, and other cherished stuff when he found three 1996 pamphlets published by The Worldwatch Institute, an independent, nonprofit environmental research organization in Washington, DC. founded in 1974 and still going strong.  My friend thought I might be interested in them.  One of them, “Climate of Hope: New Strategies for Stabilizing the World’s Atmosphere” published in June 1996, prompted me to think about what were their predictions and did they come true? That is the subject of today’s blog.

Quotes directly from Worldwatch Paper #130 “Climate of Hope” June 1996:

  • “Climate change is likely to be erratic, disruptive, and unpredictable. . . The incidence of floods, droughts, fires and heat outbreaks is expected to increase in some regions.”
  • “Recent changes in global climate trends are almost certainly related to the rapid buildup of greenhouse gases.”
  • “Carbon dioxide is a greenhouse gas, letting in visible light from the sun but trapping heat near the earth’s surface.”
  • “Since carbon dioxide is a virtually inevitable product of fossil-fuel-based energy system, efforts to stabilize the climate will at some point have to require a fundamental revamping of that system. Exactly how to do this and at what cost have been subjects of considerable uncertainty and vehement debate.”

There are several greenhouse gases, including methane (hence the “target” on the backs of farting cows) and chlorofluorocarbons (CFCs, HFCs) which are manmade chemicals that have been largely phased out because of their depletion of the ozone layer. Sulfur gas, also from fossil fuel burning, is not a greenhouse gas but does produce acid rain. Stringent emission standards in the 90’s by most industrialized countries have significantly reduced the amount of sulfates in the atmosphere. Carbon dioxide is the largest greenhouse gas by volume in our atmosphere, and carbon dioxide level measurement have become a standard proxy for predicting world-wide temperature increases.

Prior to the industrial revolution in the 1800’s carbon dioxide levels in the atmosphere hovered just below 300 parts per million (ppm). In 1996 the level was 360 ppm. In order to slow global warming the carbon dioxide level will have to be below 500 ppm. Our world-wide carbon dioxide level is currently 420 ppm. “A 450 ppm target means cutting emissions by more than half by 2050. A level of 500 ppm, which would accelerate global warming, could be reached by 2050 if carbon dioxide emissions are not reduced.” (1996) Because carbon dioxide is a “long-lasting” gas in our atmosphere it’s effect on global temperature is cumulative over decades, so that if we (the world) wanted to return to 1996 levels we (the world) would have to go to zero carbon dioxide emissions, an impossible task.

More words from the 1996 Cassandra:
“We are still a long way from stabilizing the global climate, a far more complex challenge than repairing the ozone layer. Even with quick action, some greenhouse gases will linger in the atmosphere for centuries. Still, close observers note that a climate of hope has crept into negotiations recently. Insurance companies, small island nations, and others with major interests in a stable climate have re-shaped the diplomatic playing field. Finally, the time for serious policymaking may be at hand.”

Remember, these words are from 1996. As Yogi Berra said: “It’s like deja vu all over again.”

Meanwhile, as Stephen Colbert says occasionally,
Cause of the Vaping Lung Injury
In my last blog I reviewed a pathological study of lung tissue in 17 patients with the vaping related lung injury which showed no damages indicative of lipoid or oil-caused pathology. The researchers concluded that vitamin E oil was not the culprit, and that the lung injury was similar to that seen from inhalation of a toxic gas and not the inhalation of oil. They did not know what that “toxic gas” was.  The CDC has just released a study of 29 patients suggesting that the offending agent might actually be inhaled vitamin E acetate because they found that in the injured lungs. They also admitted that other unknown agents might be causing the injury.
Meanwhile, hospitals are reporting an increase (one a week in some places) of a hyperemesis syndrome, (persistent, prolonged vomiting), in heavy users of recreational marijuana. First identified in 2004 it can be difficult to diagnose as several other causes have to be ruled out with x-rays and lab tests, but it is increasing in states that have legalized recreational marijuana.



Vol. 66 May 1, 2012 A Medical Business and Marketing Report

May 1, 2012


The price the tooth fairy pays has increased nearly 90% since 1998 to a high of $2.50 in late 2009, but after a 2010 correction in the average price Delta Dental has downgraded its future to “uncertain”. Delta has been tracking how much money kids have been getting for teeth left under pillows for their more than 100,000 subscribers. As illustrated by the graph showing the Dow Jones average and the tooth fairy average price, both took a hit in 2008. (1)


There were more than 9000 whooping cough cases in California in 2010, a level unseen since 1940s. The number of cases in Vermont has gone from 18 to 102 in two years. The number of kindergartener who have been vaccinated against whooping cough (aka pertussis, or the “P” in the DPT vaccine) has dropped from 93% in 2005 to 83% in 2010. In Ashland Oregon the rate of unvaccinated children reached about 30%. Though the link between vaccinations and autism has been shown to be wrong, and it’s author a fraud, the far-fetched rumors on the internet continue to feed the unfounded fears about vaccinations held by many young parents. (2)


A survey of 600 men over the age of 65 who were operated on for prostatic surgery revealed that 27% of those undergoing open-surgery radical prostatectomy still suffered from significant urinary incontinence 14 months after surgery. But, 33% of those undergoing robotic-assisted laparoscopic radical prostatectomy reported urinary incontinence. After the usual caveats about differences between surgeons, the long learning curve for robotic surgery, and the lack of information in the survey about pre-surgical urinary incontinence, the editorial comment casually mentioned that 88% in BOTH groups had “moderate or big problems” with sexual function post-operatively.(3)


Between 1993 and 2006 over 4000 in the U.S. were affected in 121 infectious outbreaks from raw (unpasteurized) milk or cheese. Two-thirds of those affected were children who had more hospitalizations for these illnesses than adults. Most of these outbreaks occurred in states where the sale of raw milk and milk products is legal. (4) “Advocates of raw milk hold that pasteurization kills enzymes that make food digestible and bacteria that contribute to a healthy immune system….it tends to be richer and sweeter, and, sometimes, to retain a whiff of the farm – known to connoisseurs as ‘cow butt’.” But, raw milk is profitable. The largest raw milk diary in the world, with 430 cows in Southern California, produces 2400 gallons of milk a day which retail at $16 a gallon.(5)


A four-year study of over 34,000 adults interviewed about 18 variables revealed that the “most satisfied” patients had a 12% higher hospital admission rate, had 9% more drug prescriptions, and a death rate 26% higher than the “least satisfied” patients. The correlation between higher mortality and more patient satisfaction seems to contradict the adage that “more is always better.” (6)


In response to an on-line petition with 6000 signatures Starbucks has announced it will stop using cochineal dye to color its strawberry and raspberry products. Cochineal dye is widely used in the food industry and is extracted from a tiny beetle. The petition against the bug-based dye was started by a South Carolina woman who “wanted to inform customers that the chain’s strawberry drinks weren’t vegan-friendly.” (Now THAT’S an “angry vegan”) (7)


Partners Health Care is building a new rehab hospital across the harbor from Boston on the edge of the Charlestown Navy Yard. The architects assume the building will have a 80 year life span, and that with global warming the worst storm within 80 years might cause floods up to 5.5 feet above previous flood levels. “Looking at long-term risks, benefits, and costs the Spaulding Hospital design team decided it would be a prudent investment to put the hospital generators on the roof… And 61% of Americans don’t think global warming will pose a serious threat to them or their way of life in their lifetime.” (8)


In February the US Food and Drug Administration began requiring that drugs that lower cholesterol, statins like Lipitor and Zocor, carry a new warning that cognitive side effects such as memory loss and confusion can occur while taking statins. About 10% of statin takers already suffer from muscle ache side effects from the drug. People take statins to prevent heart disease, of course, but a 2011 Cochrane review of 14 trials of statins found that 1000 patients need to be treated for a whole year to prevent one death. (9)


Having sex does not help you lose weight. Twenty minutes of running burns about 261 calories, swimming about 182 calories, jogging about 159 calories, while twenty minutes of vigorous sexual activity for a 150-pounder burns a paltry 35 calories. It may be aerobic, but it won’t make you lighter. (10)


Nine medical specialty groups have developed a list of 45 “routine” tests  and procedures they consider unnecessary, a waste of money, and can expose patients to some risks. The list includes annual electrocardiograms for healthy people, CT scans for low back pain, chest X-rays before surgery, giving antibiotics in the first week of a cold, brain MRIs for headaches in healthy patients, and CT scans or antibiotic treatment for sinusitis . The physicians involved in the groups project (“Choose Wisely”) think that patients do play a role by asking for tests or procedures they have heard or read about, but don’t need. The groups also think that the list may help reduce the amount of “defensive medicine”, performing tests out of fear of malpractice if something is missed. (11)


A recent Avoiding Avoidable Care Conference reported that the $10 Billion a year is paid to medically injured patients (and their lawyers, of course), and that another $46 Billion is spent on “doing more than we should because we want to reduce the threat of litigation”. The total of $56 Billion represents about 8 days or only 0.02% of our annual health care spending. “It is not clear to me that [medical malpractice reform] is really going to be the thing that changes the cost curve.”said Amitabh Chandra, an economist and Professor of Public Policy at Harvard. (12)


Pitchers elbow” in Little League pitchers used to be attributed to their throwing the curveball, and its use was severely curtailed for the youngsters, but it is now making a comeback as new studies indicate that it is total number of pitches thrown rather than the type of pitch that causes the inflammatory condition. As is common in predicting future values, the range of maximum pitches allowed per week to avoid the development of “pitchers elbow” is from 150 to 300 depending on the source. Some orthopedic surgeons still feel that the curveball should remain banned from Little League play. Dr. Lyle Micheli, director of Sports Medicine at Children’s Hospital in Boston, recommends that young pitchers learn how to throw the knuckleball instead. (13)

1. Boston Globe, April 24, 2012, G 13, Rachel Zarrell
2. Boston Globe,  April 22, 2012, editorial page
3. N Engl J Med 2012 Mar 15;366 and Journal Watch General Medicine April 1, 2012;vol.32,7,p.54
4. Emerg Inf Dis 2012 March; 18:385 and Journal Watch General Medicine April 1, 2012;vol.32,7,p.56
5. New Yorker Magazine, April 30, 2012, p.32, Dana Goodyear
6. Arch Int Med 2012 Mar 12;172 and Journal Watch General Medicine, April 1, 2012;vol. 32, p.59
7. Cape Cod Times, April 20, 2012, C5
8. Boston Globe, April 20, 2012 Opinion, Joan Wickersham, A 11
9. Boston Globe, April 16, 2012, G 12, Deborah Kotz
10. Consumer Reports on Health, May 2012, p. 12, “Tip of the Month”
11. Boston Globe, April 4, 2012, B 11, Liz Kowalczyak
12. Boston Globe, April 20, 2012, B 6, Chelsea Conaboy, “White Coat Notes”
13. Boston Globe, April 1, 2012, C 2, Kevin Paul Dupont, “On Second Thought”


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