Tesser Well

By: | November 19, 2014

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It was a dark and stormy night.

In her attic bedroom Margaret Murry, wrapped in an old patchwork quilt, sat on the foot of her bed and watched the trees tossing in the frenzied lashing of the wind. Behind the trees clouds scudded frantically across the sky. Every few moments the moon ripped through them, creating wraithlike shadows that raced along the ground.

The house shook.

Wrapped in her quilt, Meg shook.

______

The opening lines of the children’s classic A Wrinkle in Time are never all that far from my mind. As a kid, I loved the book so much that given the chance, I would have crawled inside it and stayed. And this time of year—especially at night, when the wind is blowing and branches are scratching across the windows—I often think of Madeleine L’Engle’s archly purple curtain-raiser and its creepy, cozy promise.

Snuggle in, it says, and listen. Continue reading →

Winter Blooms

By: | November 18, 2014
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The stinking hellebore.

Winter is settling in: the air is nippy, branches are bare, and wearing open-toed shoes is now out of the question. During a recent visit to a horticulture centre, though, I was impressed to see that many flowers in their gardens still bloomed. Cheery red blossoms, gold-centered asters, and frilly magenta petals popped against a bleak backdrop of dead stems and grey skies.

As someone who has trouble keeping plants alive under the best of conditions, I’m intrigued by flowers that thrive even in frigid weather. The white blooms of the Christmas rose, for instance, emerge in December. A related plant, less attractively named the stinking hellebore, has pale green, purple-tinged flowers that also grow during the winter.

It turns out that the stinking hellebore relies on a curious mechanism to warm itself up. Inside the plant’s nectaries — the compartments that hold nectar — live thousands of yeast. These microorganisms busily break down the sugar in the nectar, producing heat. Continue reading →

Guest Post: Affair of the Heart: VII: $64,000 Questions

By: | November 17, 2014

3022618543_9ab124cc98_bI spent about seven hours in the operating room at Johns Hopkins Hospital being worked on by a highly skilled surgical team, followed by a day in intensive care and five days in regular care. I also had a battery of pre-op and post-op tests and consultations to investigate the aortic aneurysm that put me on the operating table.  When I asked friends to guess how much all that cost, not one estimated less than $100,000.  I probably will never know who came the closest.

I know exactly how much Johns Hopkins and some two dozen surgeons, anesthesiologists, radiologists, cardiologists, and assorted other specialists billed Medicare, the government-sponsored program that provides most of my health coverage: just under $64,000.  And I know how much Medicare paid.  But those sums aren’t the actual costs of the care I received.  Nor do they reflect how much an uninsured patient or a private insurance company would have been billed, though it almost certainly would have been much more than $64,000. Welcome to the bizarre and confusing world of American medical price setting, in which health care providers strive at least to balance their overall costs and payments–and in most cases make a profit–and in which charges vary according to who’s paying. Continue reading →

The Last Word: November 10-14, 2014

By: | November 15, 2014

DavidKingham_8199741707More imaging, more problems: Colin Norman’s medical troubles began with his heart. But in this week’s post, an MRI of Colin’s heart shows that his pancreas is wearing a cyst ominously called an intraductal papillary mucinous neoplasm. These cysts may be an early sign of pancreatic cancer, but using them to screen for the disease . . . well, that’s tricky.

Why does Christie love elk hunting? Maybe because you do it in the dark. “Something magic happens in the woods when the sun goes down. Without sight as a guide, the other senses become more vivid, in the way that I imagine a blind person must become more attuned to sound or touch.”

Lava smothers everything in its path, but eventually life returns. Craig goes to Hawaii to see succession for himself. “The force of the living seemed more cunning and unstoppable than any devastation, ready to explode onto whatever it touched.”

Countries can’t seem to come to any agreements on climate change. But maybe megacities could lead the charge, says Jess. “City governments are used to down-and-dirty infrastructure tasks and practical decision-making – the kind of pragmatic thinking we need to follow through on carbon commitments.”

And if you’re looking for action on climate change, don’t look to Congress, says Richard. Politicians aren’t scientists. They’re not farmers or teachers either. “Don’t expect any votes on agriculture or education,” said one House member, speaking on background.” They aren’t experts on . . . well, anything.

***

Image: La Veda Pass at night by David Kingham via Flickr.

 

Both Our Houses

By: | November 14, 2014
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All those in favor.

The congressional session that begins in the New Year, according to the incoming leaders of both the U.S. Senate and House of Representatives, will do nothing to address anything.

Although Mitch McConnell of Kentucky, the presumptive majority leader of the Senate, and John Boehner of Ohio, the Speaker of the House, did not make that promise explicitly, it is implicit in arguments each candidate articulated during the recent campaign season. In a meeting with the Cincinnati Enquirer’s editorial board in early October, Sen. McConnell was asked whether he believed climate change is real. “I’m not a scientist,” he replied. Responding to a similar question, Rep. Boehner said, “I’m not qualified to debate the science.”

The dual declarations that a lack of expertise disqualifies lawmakers from gathering facts, making informed decisions, and voting their consciences has led many Capitol Hill observers to predict an end to the era of gridlock in Washington. In its place, congressional insiders say, will be a prolonged period of inaction.

“The Speaker is right,” said one senator, who asked not to be identified. “Why should I feel qualified to vote on the Keystone XL pipeline? Do I look like some kind of geologist?”

Continue reading →

Urban Allies May Save the World

By: | November 13, 2014

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A friend of mine, a fund manager, described his experience of the financial crisis of 2008. His fund was based in one of these mid-town Manhattan office towers they call a Hedge Fund Hotel. In those early days when the crisis set in, my friend could arrive at work relaxed, but then he’d be in an elevator with all those other people who run money, and the panic would spread from eye to eye in that elevator. By the time he walked into his own office he was an emotional wreck.

The global climate crisis has failed, in many instances, to generate the same kind of emotion that the global financial crisis evoked on Wall Street. The people with a common stake in climate catastrophe have yet to ride in that elevator together and exchange eye contact. They don’t communicate their fears face to face.

Climate change is not so much a technological or scientific problem as it is a social and political one. We may have hoped for international cooperation on carbon emissions in the way that we succeeded on CFCs regulation for ozone layer protection, but instead we’ve seen the big players dealing in spectacularly bad faith. Even this week’s big climate deal announcement looks like it might not survive domestically.

One possibility is that the nation state is not the level best-suited to tackle climate change. A couple of years ago, I was giving a talk in London about Arctic oil extraction, and a guy called Mark Watts approached me afterward. He runs C40, a network of 69 megacities taking leadership on climate change, and hosts bi-annual Mayoral conferences (climate change panic elevators, for our purposes). Each city has made a public commitment on carbon reduction and resilience, and the C40 group has sub-networks for mentoring and assistance with the nitty gritty.

Aside from climate change being a largely urban problem – the sites of both its exacerbation and the bulk of its human victims – cities are better placed politically to take action. Municipal politics is a strange beast, sometimes comical in its corruption and local bickering, but it doesn’t face the same diplomatic hurdles to cooperation as the nation state does. War and trade disputes are more distant prospects, and city governments are used to down-and-dirty infrastructure tasks and practical decision-making – the kind of pragmatic thinking we need to follow through on carbon commitments.

For real action on climate change, my hope is no longer with the big international climate conferences. C40 has hit on a leverage point in a complex system. After a few years of tracking any baby steps their member cities chose to report, C40 has stepped it up this year. Accountability and transparency are the watchwords going forward, and cities will be judged on their performance and fidelity to carbon commitments. If mayors want to boast their successes among their peers, they have to pony up the evidence. It’s peer pressure at its best. That’s the way social innovation actually happens.

 

Outdoors After Dark

By: | November 11, 2014

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It’s 6 am on an early November morning, and I am tiptoeing up a juniper hillside with a rifle slung over my shoulder. I’m following Adam, my friend and guide, when suddenly he stops. “Listen.”

It’s still completely dark, except for the sea of stars above us, which I gaze up at as I stop and listen to the elk, my mind focused on pinpointing its whereabouts. He’s just west of us, and now we’re sneaking through the darkness toward his call.

If you’re a regular LWON reader, you already know how this story ends, and you also know how my three outings earlier this month fanned my passion for elk hunting. As I tried to explain my new obsession to a friend, I realized that one of the most enjoyable parts of elk hunting was the time I spent outdoors in the dark.

Something magic happens in the woods when the sun goes down. Without sight as a guide, the other senses become more vivid, in the way that I imagine a blind person must become more attuned to sound or touch. The sounds of a forest contain so much information, but these signals can become drowned out among the textures of sight. Tracking elk without vision for reference, I became hyper-aware of the auditory cues all around me. As I focused on locating elk calls, I also noticed an owl hooting in a nearby tree and the sound of a racoon, scurrying through the brush.

I’d never really thought about it before, but some of my fondest memories in the outdoors have happened in the dark. Continue reading →

Guest Post: Affair of the Heart: VI. An Incident in the Pancreas:

By: | November 10, 2014

PancreasIn early February this year, a few days after a magnetic resonance image confirmed that an aneurysm at the root of my aorta had reached a worrisome size, I received a phone call from the office of my primary care physician.  The MRI had picked up an “incidental” finding, unrelated to the aneurysm; could I come into the office to discuss it?

The incidental finding turned out to be a type of pancreatic cyst called, ominously, an intraductal papillary mucinous neoplasm (IPMN).  It’s probably nothing to worry about, my doctor assured me, but it would be prudent to have a high-resolution MRI of the abdomen and the pancreas to get a better look at what we’re dealing with.  The MRI confirmed that the cyst was an IPMN, about 2 centimeters (almost an inch) long.  The recommendation: repeat the MRI in 3 months to make sure nothing has changed.

At that point, I was in full reporter mode, having just learned that my aortic aneurysm, which I had basically dismissed for 12 years, could no longer be ignored.  I set out to learn all I could about IPMNs.  It’s an interesting story that raises hopes of early detection of more cases of pancreatic cancer—one of the deadliest cancers—and some tricky questions about the benefits and costs of screening for these and similar lesions.  It would be an even better story for me if I were not in the middle of it. Continue reading →