A Planet and A Petri Dish

By S. Todd Stolp MD

©April 2008

The “Green Belt” movement led by Wangari Maathai previously gained credibility as a recipient of the 2004 Nobel Peace Prize in response to the movement’s efforts to raise attention to phenomenon of global warming.  Predictably, this inspired some degree of irritating self-righteous pride from some, and scoffing skepticism from others.  There is, however, no research to indicate that either of these particular behaviors are likely to solve the environmental challenges that face us.  Viewed from space, there are only two options that survive scrutiny: 1) self-serving interests must be minimized in the debate, and 2) the road to lessening our impact on this planet will take personal sacrifice.

“Living Green” has unfortunately become a cliché.  For environmental awareness to suffer the fate of a passing fashionable trend belittles the deep roots of this dilemma.  It is much too easy to recycle our plastic bottles (or even worse, create the illusion of doing so by separating our recyclables but having it end up in the same landfill as other rubbish because of limited local capabilities), purchase automobiles that achieve over 30 miles-per-gallon, and upgrade to water-saving appliances in order to feel that we are doing our parts.  While these steps are worthwhile pursuits, every American will need to change the way we work, live and spend our money.  We will need a different paradigm.

In 1981, Dr. Jonas Salk published a book entitled World Population and Human Values: A New Reality.  Today, with 5% of the world population, the U.S. consumes 25% of the world’s resources.  Today, with a population of 1.3 billion people, China is in the midst of an industrialization modeled after the American experience over the past century, but supercharged by a population more than ten times as large.  Not only will our responsibilities require us to bring conservation principles into the forefront of our own lives, but we will also need to share the lessons of our previous success and indulgence with the rest of the world.  We will need to model this behavior just as we previously modeled our industrial success.

From a public health perspective, a useful example of a successful campaign to modify public behavior has been the campaign against tobacco consumption.  Very little progress was achieved against commercial tobacco sales by public service ads depicting lungs ravaged by cancer and older smokers tethered to oxygen tanks during the early nineteen-seventies.  Success ultimately was attained when the cost of tobacco products was significantly increased through various tax disincentives.  When use of tobacco required palpable sacrifice on the part of smokers, tobacco consumption in California decreased from nearly 40% in 1970 to 14% in 2005.  Consequently, the incidence of lung cancer has fallen by 15%.

Dr. Salk describes the “S-shaped curve” which defines the growth of all living systems.  Growth initially occurs at a slow rate, but eventually gathers momentum as population efficiencies come into play.  During the most rapid increase in population, growth is almost vertical.  Eventually, due to such factors as a limited supply of resources (food, water, energy etc…) and the accumulation of waste, the steep increase in population flattens out, creating an “S-shaped curve.”  What factors will influence the flattening of the world population curve, and how will those factors be distributed among the world’s population?  Will our limits be determined by the tolerance of nature, or will our limits be self-imposed?

How we answer that question will determine the type of world that we leave to subsequent generations.  And whatever we do, we must be prepared to sacrifice convenience.

Frogs, Hot Water and Public Health

April 5, 2010

by S. Todd Stolp MD©

We have probably all heard the description of the allegorical “experiment” in which a frog dropped in hot water will immediately hop out, but a frog in a pot that is slowly heated will recline with hind legs crossed like a vacationer in a spa until succumbing to the heat.  This tale is often told to emphasize the human tendency to ignore slow-paced social change while vehemently protesting the same change imposed rapidly.  Because April 7 through 11 has been designated Public Health Week, perhaps a close look at the “Boiling Frog” experiment will provide some insights regarding the challenges facing the Public Health sector.

Through the magic of the internet, gathering further research about the poor frog in the experiment is actually quite easy.  First, it should be pointed out that, for good reason, animal rights regulations would prohibit the above “experiment” today, and children should be cautioned not to try this experiment at home.  However, it turns out that in the 1880s a future president of the American Public Health Association, Professor William Sedgwick, conducted an extensive review of the excitability of the nerves of frogs and quoted the works of Heinzmann from 1872 who had indeed conducted the above experiment with a very slow incremental increase in water temperature in an elaborate system to measure the excitability of the frog.  The conclusion was that as long as the incremental change in temperature was slow enough, the evasive muscle movements of the frog were absent.  So how does this relate to today’s Public Health challenges, and was it just chance that the reviewer of these studies was a Public Health giant?

To summarize the implications of this experiment, incremental change is ignored if it is slow enough.  Consider the incremental change that has occurred in our world over the past 50 years.  While we often complain of the dizzying rate of social change over time, it seems that each tiny change that occurs over the short term is in fact embraced.  Consider the arrival of fast food restaurants, the ability to purchase a meal at a convenience store for our bodies while at the same time feeding our automobiles, our welcome acceptance of the latest app at work and play and our desire for the latest digital device (think “Roomba”) to avoid exertion.  If we are truly alarmed by the effect these changes are having on our health – and the evidence that this is true is overwhelming – why are these concerns not reflected in our consumer and citizen behavior?  Could it be the “Boiling Frog” effect?

Perhaps.  However, humans receive much more input from and have much more impact upon our environments than frogs.  We can read the news, share and debate philosophical views, watch commercials on T.V., adjust our investments and plan our employment.  We can design our cities with a broad range of options when resources allow, choose our meals when choices are available, and select our careers when education is sufficient.  These variables are called the “social determinants of health,” and influence our health with at least as much effect as our access to clinical care.  Helping communities act upon these opportunities is the greatest challenge to public health we face today.

It is interesting to note that before Heinzmann engaged in his research, an European physiologist, Friedrich Goltz, had conducted essentially the same experiment, but Goltz had conducted his research differently.  Goltz compared normal frog responses to increasing temperature to the responses of frogs with their brains removed.  In his experiment, Goltz used such a rapid change in temperature that the normal frogs actually became irritable and made escape-like movements.  The frogs that were “destitute of cerebral hemispheres” did not.  Humans, of course, have immeasurably greater cerebral capacity to understand the effects of our environment upon our behavior and audaciously pride ourselves in wielding such magnificent thinking powers.  Whether we optimize use of our cerebral resources to use our cognitive and creative skills to keep the temperature in our pot in a survivable range or leap to a new environment will be the ultimate measure of our insight and compassion.