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It’s the end of the world as we know it, and I feel fine

Still practising

Chris Preece

Tuesday, 24 September 2019

AdobeStock_164989122_global_blog.jpgThe last few days have served me up a heady cocktail of nostalgia for the past, and concern for the future. I’ve been looking back on where things have come from, and wondering precisely where they’re going to end up.

One ingredient in this cocktail came with my Medical School reunion on Saturday. I’m not sure what I had expected, but any anxieties I had about the event evaporated pretty much on arrival.

Almost everybody was immediately recognisable, as if we’d been carefully stored away in Tupperware containers, only now released for this one event. Personalities seemed broadly the same too, but details had changed. Perhaps unsurprisingly quite a few had left medicine in search of other, happier pursuits, whilst others had a passion for the job that seemingly far exceeded their grudging attendance at lectures 20 something years before. Collectively we had scattered ourselves far and wide, started families, found new lives - yet nonetheless could fall back into old jokes and routines as if no time had passed at all. We all change, it seemed, yet we all stay the same.

It felt comfortable, reassuring.

The other ingredient meanwhile, came just the day before, with the Global Climate Strike. Roughly 4 million people striking in an attempt to shake the rest of us out of our collective complacency. Children throughout the world, desperately warning that we’ve doused their home in petrol, and begging us all to put down the matches.

Which didn’t feel comfortable or reassuring at all.

I’ve been trying to find a way to reconcile those two conflicting emotions – the soothing nostalgia of revisiting my past, with the horrifying predictions of a future we seem perilously reluctant to change. I found myself wondering what the Medical Student version of myself would have been doing. I like to imagine he would have gone on a protest, although I fear he would have only done so having received “permission” first. (I may have looked like a ginger version of Neil from the Young Ones, but I was a conformist at heart.)

Such permission might not have been forthcoming. On the other side of the world, Australian Education Minister Dan Tehan took time out of his busy day to warn medical students in Melbourne not to join the Climate Strike, presumably because the Australian Government is of the opinion that what their country needs is to get a whole lot hotter.

Some people, it seems, feel that a couple of hours of lectures are much more important than preventing the literal and figurative meltdown of human civilisation. So, with my past self in mind, I’d like to offer the following for any medical student or doctor considering going on the next batch of Climate Strikes. It’s a suitably difficult quiz all about healthcare and Climate Change to take on the next strike, thus delivering education and protest in one package…

NHS Climate Change Quiz.

(Worth 2 CPD points, or 2,000 if you actually prevent the apocalypse)

1) What percentage of England’s Carbon Footprint comes from health and social care? (1 mark)

(Answer – As of 2017 it’s 6.3%, or 27.1 million tonnes of CO2. Which is an awful lot, although it did reduce by 18.5% over 10 years)

2) How many miles of road travel was attributed to the NHS alone in 2017? (1 mark)

(Answer – 9.5 billion miles, which is about 3.5% of all road travel. Releasing 7,285 tonnes of nitrous oxide and 330 tonnes of particulates.)

3) What are the likely global health impacts of climate change? (4 marks)

(Answer – Excess deaths due to extreme temperatures. Variable rainfall is likely to result in a lack of safe drinking water. Rising sea levels will likely cause damage to homes and facilities. Increased air pollution will exacerbate respiratory and cardiovascular diseases. Flooding will increase levels of water born disease, disrupt services, and increase risk of drowning. Food production may well diminish. There will be significant mental health implications. Collectively expected to cause an estimated 250,000 deaths every year between 2030 and 2050. Though if you’re desperately looking for something positive, mortality in the winter in the UK may fall.)

4) How many cases of asthma can be attributed to Nitrous Dioxide air pollution annually? (1 mark)

(Answer - 4 million new cases of asthma globally can be attributed to NO2 every year, which is about 13% of global incidence.)

5) Given all this, how many pages into the NHS Long Term Plan do you need to get before there’s any reference to addressing climate change, reducing carbon footprint or pollution? (1 mark)

(Answer - 120.  It isn’t mentioned until the appendix.)

In fairness to the NHS there have been improvements over the last decade or so. The Long Term Plan may have unforgivably relegated the subject to the appendix, but it does at least note that water consumption is down by 21%, and that 23% of waste is recycled. It also notes however that the NHS’s reduction in CO2 is well short of the 34% target set for 2020, with no terribly convincing plans provided for getting to the planned 51% drop by 2025.

So what good do all these protests do anyway? Well, a recent YouGov poll suggested that 27% of voters regarded the environment as one of their most important concerns – second only to the NHS and Brexit. (It was the seventh most important issue just six months ago).  As such it appears that the chief aim of the strikes – increasing awareness - is working, and starting to translate into political pressure; so perhaps the next lengthy Government document on the future development of the NHS will spend a little more time looking at how we can move it towards no longer creating the health problems of the future.

At one point over the weekend I stood on the balcony of the hotel hosting our reunion, discussing the subtle changes to the city’s skyline, and imagining how it might change again over another 20 years. So, here’s hoping that the answer to that question isn’t “well, to start with, it wasn’t all underwater…”

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Chris Preece

Chris has worked as a GP Partner in North Yorkshire since 2004, and still relishes the peculiar challenge of never quite knowing what the next person through the door is going to present with. He was the chair of his local Practice Based Commissioning Group, and when this evolved into a CCG he joined the Governing Body, ultimately leaving in April 2015. He continues to work with the CCG in an advisory capacity. When not being consumed by all things medical, Chris occupies himself by writing, gaming, and indulging the whims of his children. He has previously written and performed in a number of pantomimes and occupied the fourth plinth in Trafalgar Square. Tragically, his patients no longer tell him he looks too young to be a doctor.
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