I am deeply appreciative of the miracles of modern medicine. I cannot help but feel grateful, in particular, for being able to participate in a clinical trial of a new drug that might help me avoid open heart surgery. Few living creatures can escape a certain level of selfishness when it comes to the desire to stay alive.
But as we all should know by now, our miraculous technologies come at a cost. In her fascinating book "Lightning Flowers," Katherine Standefer investigates the ecological and human cost of the computer that lives inside her chest -- and mine -- in the astonishing expectation that it will bring us back from the dead if necessary. That cost is measured, among other ways, in Third World mines that destroy forests, rivers, and communities of human beings.
How much collateral damage is acceptable as the cost of saving a geriatric life? I fear that modern medicine has largerly failed to properly consider the broader cost of many of its interventions.
Case in point: Every month, my clinical trial requires me to go to the hospital in Ann Arbor for some tests and to be given my new month's dosage of the experimental drug or placebo. It's important that they take back any pills I have left, and give me all new pills, because the ghost in the machine at the heart of the study may have changed my dosage for the month.
Unfortunately, one month I couldn't hang around long enough for the new pills. I could have come back, but they offerred to send the pills by courier. It seemed a little decadent, but they offered, so I said yes, and the pills were promptly delivered. What was delivered was 30 ordinary sized pill capsules. They did not need refrigeration, and were not toxic to touch like chemotherapy drugs. Perfectly ordinary capsules, probably containing nothing but sugar. For some reason, they put them in two bottles, either of which would be big enough for all of them:
They put each of these little pill bottles inside a larger pill bottle:
Despite the fact that the medicine is not toxic to touch and does not require refrigeration, they included a mask and gloves, and an electronic temperature monitor that documented the temperature in transport:
They put all this inside an 8" x 8" cardboard box, "protected" by 12 Koolit gel packs:
They then put that box inside another cardboard box, this one 9" x 9" with lots of styrofoam glued onto it, rendering it unrecyclable. They then put that box inside a 17" styrofoam cooler, specially shaped to fit around the styrofoam glued onto the 9x9 box and immobilize it. Before closing the top on the styrofoam box, they threw in four more Koolit gel packs, each of them 3 times as large as the previous 12. The styrofoam box was then placed inside a final cardboard box, 17.5"x17.5", and proudly labelled "KoolTempGTS Excel Qualified Shipping System"
I'm 63 years old. It would certainly be nice to have a couple more decades, but modern technology has already made that pretty likely -- the heart surgery that would fix my problem is astonishingly invasive, but the mortality is less than 1%, and the serious complication rate under 4%. This new medication is being developed not so much to save my life as to do so more *conveniently*.
I'm not fishing for compliments when I say that I don't think destroying habitats, rivers, watersheds, and the entire cultures of some ancient communities we dismiss as "primitive" can possibly be justified by it making my path to a longer life more convenient.
Fortunately, I really don't believe it's an all or nothing game. The whole point is how unnecessary this waste is. For 30 pills, they sent me four plastic bottles, an electronic temperature monintor (disposable, apparently), twelve POUNDS of gel pack at God knows what environmental cost, three cardboard boxes, one of them bristling with non-recyclable styrofoam, and a styrofoam cooler big enough for two dozen beverage cans.
They could have delivered me these pills in the smallest size of plastic bag the supermarket sells. I'm deeply grateful that so many people are doing research and studies that could extend and enhance my life. But couldn't they think about the planet at the same time? Shouldn't the professional vows that doctors take, which are focused on the welfare of the patient, take into consideration the longer-term well-being of the patients and their descendants?
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