Today is the third class in your current four class set. We will begin class with a casual conversation. Our reading today is about pharmaceuticals. Our listening material is about anesthesia. Please listen and enjoy. I have included a transcript. Read and listen at the same time.
Click HERE for the reading
AILSA CHANG, HOST:
Many people try different ways to reduce their carbon footprint. Perhaps they drive less, or they recycle more. One Oregon doctor focused on a little-known medical fact. The anesthesia gasses patients breathe in before surgery - many are greenhouse gases. Kristian Foden-Vencil of Oregon Public Broadcasting has the story.
KRISTIAN FODEN-VENCIL, BYLINE: A woman lies on the operating table at Providence Hospital in Portland. Surgeons are about to remove a tumor.
BRIAN CHESEBRO: So here comes the one that's really going to get you off to sleep, OK? And this one stings sometimes.
FODEN-VENCIL: Dr. Brian Chesebro, the anesthesiologist, holds a mask over her face as she goes under.
CHESEBRO: So now I'm breathing for her with this mask. And I'm delivering sevoflurane to her through this breathing circuit.
FODEN-VENCIL: Sevoflurane is one of the most commonly used anesthesiology gases. The other big one is desflurane. Whatever gas they get, a patient breathes it in, but only about 5% is actually metabolized. The rest is exhaled. And to make sure it doesn't knock out anyone else in the operating room, it's sucked into a ventilation system, and then it's blown out the roof to mingle with other greenhouse gases.
The two gases are actually fairly similar. Unless there's a medical reason to use one over the other, anesthesiologists tend to just pick one and stick with it. Few understood that one is much worse for the environment, and that bothered Chesebro. He grew up on a ranch in Montana that focused on sustainability. He now lives in the city with his three kids, and he gradually started to worry about their environmental future.
CHESEBRO: I got depressed for a while, and so I hit the pause button on myself and said, well, what's the very best that I can do?
FODEN-VENCIL: He spent hours of his own time researching anesthesiology gases, and he learned desflurane is 20 times as powerful a greenhouse gas as sevoflurane and that it lingers in the atmosphere much, much longer. Opening a big black notebook filled with diagrams and tiny writing, he shows how he computed the amount of each gas the doctors in his group practice used. Then he shared their carbon footprint with them.
CHESEBRO: And all I'm doing is showing them their data. It's not really combative. It's demonstrative (laughter).
FODEN-VENCIL: His colleague, Dr. Michael Hartmeyer, was stunned when he learned his desflurane use was the equivalent of driving a fleet of 12 Hummers each operation. It's half a Hummer if he uses sevoflurane. And outside the OR, Hartmeyer drives a Prius.
MICHAEL HARTMEYER: I wish I had known earlier. I would have changed my practice a long time ago.
FODEN-VENCIL: It turns out sevoflurane is cheaper, too. Over the last two years, Chesebro's convinced Oregon's Providence Health System to make the switch at eight hospitals at a savings of a half million dollars a year. Jodi Sherman is an assistant professor of anesthesiology at Yale.
JODI SHERMAN: This is a new way of thinking.
FODEN-VENCIL: She says other hospitals have tried to force doctors to use one gas over the other but got a lot of pushback. She thinks Chesebro succeeded because he chose to persuade using data. He showed doctors their choice of gas plotted against their greenhouse impact. And it helped that he showed them over and over so doctors could compare their progress to their peers.
But what about gas manufacturers? I asked one of the biggest, Baxter International, which makes both of these gases. The company says the gases have a climate impact of .01% of fossil fuels. Dr. Chesebro says it's a fair point.
CHESEBRO: My counterargument is if it's there, it's bad. And if I can reduce my life's footprint by a factor of six, why wouldn't you do it?
FODEN-VENCIL: Now Chesebro's hospital bosses are hoping other doctors will follow his lead, research their own pet peeve and maybe solve a problem no one's even thinking about. For NPR News, I'm Kristian Foden-Vencil in Portland.
CHANG: This story comes from a partnership between NPR, Oregon Public Broadcasting and Kaiser Health News.
(SOUNDBITE OF NEON INDIAN SONG, "SLUMLORD")