Peak Oil Medicine

A blog by Dr Paul Roth exploring healthcare options for a scarce oil future.

Archive for August, 2006

Demonstration of the vulnerability of the health care system to fuel supply disruption (Part 2).

Posted by Paul Roth on 29th August 2006

This is the second of a two-part series on the UK oil crisis that occurred in the September 2000. You can read the first part here.

Implications for peak oil
The blockade and subsequent disruption shows that we have designed our society to be vulnerable to an even short-term decrease in energy supply. It also demonstrates the presence of (sometimes unsuspected) bottlenecks where a few people can create major havoc.

It?s worth noting that this crisis was entirely reversible and consisted of a relative reduction in oil flow for a short period of time. In contrast, peak oil will produce an absolute and permanent reduction. The distinction is important for two reasons.

Firstly, the UK protests caused a TRANSPORTATION crisis only, preventing people and things from moving about. There was still a normal amount of all the things that we currently take for granted (like food and clothing), it was just that they couldn?t get to where they were needed. Even if farmers didn?t have diesel for their tractors and trucks, their crops were in the ground growing and their finished produce was in sheds waiting to get to market.

In contrast, peak oil will not only limit oil-based transportation, but it will disrupt the manufacture of everything containing petrochemicals (ie all plastic, synthetic clothing, kitchen appliances, computers). They will not be sitting in warehouses waiting for normality to resume. They will not be there in the first place. So energy descent will not present a transportation challenge. Secondly, the crisis ended in just over a week, allowing things to get back to normal quickly. Peak oil will be permanent, and there will be no quick fix.

Recommendations

  • Development of a fuel-shortage crisis plan, ready to be implemented quickly when needed. (Rationale: there won?t be time to start from scratch in a real crisis).
  • Real-time simulation of a short-term fuel shortage, once the plan has been completed, to evaluate and refine it (Rationale: A simulation called Oil Shockwavewas run in the US two or three years ago and had a lot of interesting findings).
  • Develop a strategic stockpile of essential medical supplies and the fuel to get them out to hospitals and other health care facilities (Rationale: Can be done quickly and will reduce the impact of a shortage, while longer term options are implemented).
  • Consideration of how essential workers (including health care workers, but also emergency services personnel, SES, electricity workers and others) can have preferential access to fuel in a crisis. Alternatively, how government authorities can transport workers where they are needed (Rationale: Limitation of services due to the inability of people to reach their workplaces was a major factor in the UK crisis).
  • Longer term, consideration of how the health care system can be made less dependent on oil. (Rationale: even if oil peaking is 20 or 30 years away, it will take a long time to achieve a fundamental redesign and reconstruction of our system. If it is closer, then any move in that direction will reduce the impacts of the event).

This concludes my examination of the UK crisis for now. Please leave comments or questions below.

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    Demonstration of the vulnerability of the health care system to fuel supply disruption.

    Posted by Paul Roth on 27th August 2006

    The ability of a short-term fuel disruption to cause a health-care crisis was demonstrated in the United Kingdom in September of the year 2000.

    Background
    What started as a protest by fishermen, farmers and truck drivers about rising fuel prices resulted in a national crisis. The result of the blockade was that petrol and diesel was unable to leave refineries and get to petrol stations, causing an acute fuel shortage across Britain. The crisis was resolved after eight days, following appeals to the good-nature of the peaceful protestors about the effects of their actions on the country.

    Effects
    One of the most severely affected sectors was health care. Although an attempt was made to provide preferential fuel supplies for health care workers, it was not widely successful. The crisis was generally worse in remote and country areas that were heavily dependent on transport. Media reports from the time documented the problems, including:

    • Inability to discharge patients because their relations couldn?t travel to the hospital to pick them up.
    • Closure of outpatients departments.
    • Severe shortages of blood products, drugs, sutures and linen.
    • Cancellation of all elective and non-emergency surgery.
    • Shortages of hospital staff because they couldn?t get to work.
    • Severe limitation of ambulance travel, with activity limited to emergency calls only.
    • Inability of community nurses, general practitioners and other community-based workers to visit their patients. One GP was planning to do home visits on horseback when the petrol ran out.
    • Accumulation of contaminated waste because it couldn?t be collected.

    Commentary
    We should see these events as a simulation of what might happen in other countries if there is a sudden fuel shortage. It should be noted that countries like Australia and the USA are probably much more dependent on oil than the UK, due to their larger size, and the emphasis of car and truck transport over electrified rail.

    Although the focus of this article is on oil peaking, it should be noted that there are many other potential causes of a short-term fuel shortage, similar to that experienced in the UK:

    • Terrorism.
    • Industrial action.
    • Natural disasters (storms or bushfires).
    • Accidental emissions, equipment failures or explosions (for example at a large oil refinery).
    • International events (for example Middle East military action or terrorism, SE Asian piracy, accidents in the Strait of Hormuz etc).

    It also highlights the dependency of our current system on transport. These events should be taken as a warning of what could happen in other countries at any time - our systems have evolved to be similar to that in the UK, and are just as vulnerable.

    Coming Next…
    During the week I’ll publish the second part of this article. It discusses the implications for peak oil, along with some ideas for moving forwards from here.

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      What are the consequences of modern medicine?s oil addiction?

      Posted by Paul Roth on 23rd August 2006

      Modern medicine has evolved in the age of cheap and abundant oil, and is addicted to it. I have previously identified eight categories of petroleum use in medicine, and list them here for convenience:

      1. Transport
      2. Direct Content
      3. Embodied
      4. Energy Production
      5. Processes
      6. Roads and Buildings
      7. Emergency Services
      8. Organisational and Political Systems

      I discuss them in much more depth HERE. The addiction developed because market forces kept the price of petroleum products low (although the market does not consider costs like environmental and social ones), while other options were more expensive. Due to our frequent focus on economic issues over humanitarian and environmental ones, the system evolved to be run as cheaply as possible (as we have made a value judgement that money is more important than compassion). Using oil and its derivatives was therefore a no-brainer.

      There is really only one fundamental feature of the current system from which all else flows. That fundamental is MOVEMENT. Because it is so cheap and easy, modern healthcare is characterised by the easy movement of people, equipment, supplies and waste. There are three primary outcomes arising from this, and many secondary ones that are derivatives of the primary ones:

      1. Centralisation
      2. High complexity
      3. Linear flows

      1. Centralisation
      The combination of economic rationalism and easy movement has promoted the establishment of large scale and centralised institutions. Modern healthcare systems are one of them. Centralisation allows organisations to capture economies of scale and therefore reduce running costs, as well as making them more amenable to government planning, budgeting and control. The flipside is that it may be disempowering for the average individual due to bureaucracy and inertia, non-responsive to local needs, and destructive of local institutions and infrastructure. These problems may be present to a greater or lesser extent in most settings. Even the primary care setting (general practice in Australia) is often encumbered by centralised regulatory and fiscal restrictions, meaning that they are not truly localised, but controlled from a distant location. Distance is a corollary of movement, and a by-product of the great experiment of suburbia is a discounting of distance: because travel is easy, cheap, reliable and ubiquitous.

      Many components of the current system are distant from their point of use. These include:

      • Governance and political control ? centralised health care has developed as a component of centralised governance. Decisions are made to make administration easier or for political convenience, usually without serious consideration of local issues and opinions.
      • Technology - For the many countries that are not ?technology sources?, purchases and maintenance of high-tech medical equipment puts a significant strain on national budgets and balances of payments. Additionally, they are more or less distant from the source of the technology, increasing the embodied fossil fuel content as well as making it more likely that they will be cut off during energy descent.
      • Large hospitals ? New hospitals are often built on the suburban fringe to service new suburbs (sometimes displacing farmland) but then older hospitals (which are often conveniently situated right next to population clusters) are closed and sold off for ?redevelopment?, making nearby residents drive to the new facilities. Of course there?s no public transport out there, but don?t worry because there?s plenty of parking?
      • Patients ? New large-scale healthcare facilities are often built a long way from population clusters, as discussed in the previous point. An additional issue is that, with the super-specialisation of medicine (discussed below), patients routinely travel large distances to see an expert in ?their? problem.
      • Healthcare staff ? Staff often live distantly from the facility where they work and the populations they serve. There are several possible factors at work: (i) at older facilities, staff quarters have been bulldozed to make way for new carparks or sold off for apartment redevelopments, thereby displacing healthcare workers; (ii) new facilities on the suburban edge may not have nearby housing; (iii) staff may choose to live distantly from facilities situated in poorer or crime-ridden locations.

      As transport reliability, speed and range has increased, the diameter of the circle centred on each large regional hospital has increased, making the problem worse rather than better, and ensuring that energy descent will have a major impact. As a mental exercise, compare the number, size and distribution pattern of hospitals now to when horses where the main form of transport: one hundred years ago, there were many small hospitals of only a few beds each (even in country towns) located right next to normal houses. Unfortunately this phenomenon has changed, and most small towns are now lucky to have one hospital (ie centralisation in miniature). As a society evolves over time, centralisation usually occurs in parallel with the phenomenon of increasing complexity, with the two processes supporting each other in a positive feedback loop.

      2 High Complexity
      A highly complex system (like a city) is usually composed of lots of members, with many interactions between them. It develops when there is plenty of energy available to drive it, thereby allowing easy, cheap and frequent movement of people and information. Systems like these with lots of linkages need lots of energy to keep themselves going, because their members tend to self-organise into groups of various types and sizes (like businesses and professional organisations). These groups in turn need their own energy supply to maintain them, as well as some form of governance, financial system, utility service, etc. By the way, centralisation is one way that such systems attempt to decrease their energy needs.

      The multiple interactions and energy exchanges in complex systems like our modern society create multiple niches. In another model of a complex system, a tropical jungle, the energy flows are also so high that multiple niches are created, driving evolutionary processes toward the specialisation that allows a highly diverse ecosystem to develop. Note that many species are so specialised that they can only survive within a very narrow band of parameters (like temperature or altitude), and there is often a limiting factor that puts a natural control on population numbers (like nesting sites). Compare this to the polar regions, where energy flows and species numbers are much less, and most successful organisms (like polar bears) are adaptable generalists, able to eat a variety of foods and survive a wide range of climatic conditions. In nature the currency of energy interaction is food and nutrient exchange, while in human societies it is money (and what money can buy, including food).

      Our cities resemble the world?s jungles (in terms of energy flows, the number of niches, and the presence of specialisation), while rural towns resemble the Arctic. Comparing health care systems in the two locations, rural towns usually have a few general facilities that provide primary care. Cities, in contrast, have a relative overabundance of healthcare facilities, and there are many subspecialists who can provide secondary and tertiary level care. Rural towns often tend to be an island within a sea of farmland and wilderness, and while they have a large catchment area, it is characterised by a very low settlement density. In contrast, cities tend to serve areas of very high settlement density, and often have very large catchments for specialist services (including the surrounding country towns that need access to those services).

      Another feature of complex systems is sophistication. Consider the sophisticated but fragile feeding strategy that hummingbirds have evolved (ie they exploit a small but viable niche in a complex forest system with high energy flows and lots of viable niches to be exploited). Now consider the polar bear strategy: catch and eat whatever you can. The hummingbirds of our healthcare system are medical specialists and subspecialists. They can exist in cities because there are enough people within the (expanded) catchment zone who need their services to justify their existence on economic grounds, even if they only treat an uncommon and esoteric illness: people will travel to see them. The polar bears (like me) are the general physicians, family doctors and general surgeons.

      The phenomenon of medical specialisation has paralleled the increasing sophistication and complexity of society in general. Complex systems tend to develop during periods of relative stability, because it takes time for interactions between the system members to develop. In the case of our civilisation, the availability of a stable and abundant high-density energy source has promoted its complexity. So what happens when systems become too complex? According to Joseph Tainter (author of The Collapse of Complex Societies), they collapse. The reason is that when a system passes a certain threshold, the amount of energy needed to maintain its complexity is so much that it is basically not worth it (ie it gets harder to advance and so there is an eventual decline). I like to think of it as ascending the stairs to get to the tenth floor and then jumping out of the window when you get there (ie a society slowly builds itself up step by step until it gets to a certain point where it plummets rapidly down). Our society is currently dangling by a fraying rope from that tenth floor, just like a piano in a cartoon: when it drops there?s going to be a crash, a big mess, and no more sweet music. Thinking about crashes brings us to the third primary consequence of oil-dependence: the spectacle of the open system.

      3. Linear Flows
      Under our current model, it is cheaper to keep a constant flow of new things coming in and dispose of the waste than it is to recycle and re-use (also new and modern is valued over used and old). These are features of an open (or linear-flow) system. So what are the characteristics of an open system? Well I?m glad you asked because we all have intimate knowledge of a certain open system that we can use as a model: I like to call it the gastrointestinal tract. The GIT system has an entry point where you feed in new materials; it processes that material and extracts something useful from it (in this case proteins, lipids, carbohydrates, and other nutrients); and then it excretes the waste. The waste is not recycled back to the input point (unless it is processed by earthworms and plants back into food but that?s another story) and it is lost to the system, even though it may contain valuable substances that could be useful, and mean that less fresh new input is needed.

      Now consider the modern healthcare system. Raw materials are fed into the system (all the fossil fuel derivatives, paper, electricity etc); something of value is extracted (in this case the delivery of the ?service? of healthcare); and waste materials are generated and transported off site for disposal. Little is recycled or reused, and the percentage of waste that is ?clinical? or ?contaminated? requires even more energy for safe destruction. The costs of the system are tolerated because it delivers a ?societal good?.

      Compare that model to a historical example of a closed system. In the book Farmers of Forty Centuries, the author (F H King) describes the sustainable practices of farmers in China, Korea and Japan over several thousand years. One essential practice was returning the nightsoil (faeces) to the soil as fertiliser, thereby closing the ?nutrient loop? and drastically reducing the need for new nutrient inputs.

      Systems that are open are vulnerable to supply disruptions. Because they require constant inputs to keep running, any reduction in the amount of materials entering the system can quickly cause a chain-reaction of cascading failures that causes it to implode, rendering it more or less useless, sometimes very quickly. An example is the consequence of the UK fuel protests of a few years ago; several hospitals nearly ran out of linen, while some emergency departments temporarily shut their doors, all within a matter of days.

      Because it has historically been cheaper to buy new inputs for the health care system (and society in general), recycling and reusing waste products has generally not been pursued with any vigour. It is obvious that this must change somehow, and systems need to be redesigned to be more sustainable under this system conception of energy flows.

      I?d like to specifically discuss the role of plastics. Because plastic is so cheap, it has developed as a substitute for glass wood, metal and natural rubber. It has also become a substitute for human labour (for example single use instruments rather than the labour required to resterilise them). Plastic is also quick and easy (as opposed to the older materials and methods that took more time and effort to use and clean). Remember that plastic only seems cheaper because the true environmental costs have never been included in its price. Any change in the health system will need to address the issue of plastic: it will be a daunting task, whether new feedstocks are found (eg plant-derived plastics) or new processes and materials are implemented (such as a move back to glass).

      One final thought about systems. If a closed system suffers a disruption and suddenly becomes ?opened?, it can cause big problems. Consider what happened to Native Americans once their large but essentially closed system was opened by European discovery. Or what happens when an artery is cut.

      Conclusion
      Let?s focus on the idea of movement again. David Holmgren, co-originator of permaculture, says that we take movement for granted in our society. So what is the opposite of movement? The idea of relocalisation is emerging as one important response to the challenge of energy descent, and we must keep in mind that it means a contraction of movement. A second idea is decentralisation. To me, the connotations of the two words are different. While relocalisation implies a localising of decision-making, energy, food, healthcare and other essential services, it also suggests a certain local independence from other areas. In contrast, decentralisation implies that the networks remain (although in a lower energy state than before), allowing the exchange of information, if not physical goods. Finally, we must come to terms with the fact that most people will be unable to move very far, and that many items and raw materials will never be available in the same abundance again.

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        Peak Oil Grief

        Posted by Paul Roth on 16th August 2006

        So why do people go into a type of shock when they first hear about and accept the implications of peak oil? It’s the same as when you break bad news to someone - in both cases a grief reaction is initiated as they begin the process of dealing with their loss (by the way, nowhere is the journey more important than the destination than when healing grief - the journey IS the process of healing).

        A grief reaction happens in response to an actual or perceived loss. Grief is the way that a biopsychospiritual being makes sense of the pain of loss, eventually resolves it, finds some sort of meaning, and move on with life despite what has happened.

        You can define loss widely as any threat, either real or perceived, to the integrity of that same biopsychospiritual being. So a person goes through a grief reaction after the death of a loved one, but also after a limb amputation, moving house, losing a job, or experiencing a spiritual crisis [for example a religious person may mourn the loss of their relationship with God if they lose faith or feel that they have been abandoned, etc].

        Pretend for a moment that your spouse gets a job in a new city, and you decide as a family to move to the new location. If you are ATTACHED to where you currently live-the people you know and the lifestyle you lead-then you are likely to experience a grief reaction, beginning once you accept that the move will be ‘real’. From the existential viewpoint, the energy that you have invested beginning and maintaining the attachment that you have formed must be released when the attachment ends - you feel the absence of the reciprocal energy loss as the emptiness of grief.

        Another aspect of the pain of a grief reaction is that your subconscious mind is saying that it doesn’t know how it will cope once the thing is gone. The grieving process allows the subconscious to heal over the hole left by the lost thing, by coming to terms with the loss and working out ways that it can repair its “intactness” and regain safety and normal function.

        So when someone hears about peak oil for the first time, and begins to understand the implications and possible future events, a grief reaction can very easily occur. Why? Because we have become attached to this life that we live - its comfort, convenience, relative safety and luxury. And suddenly we discover that a plausible and near threat exists. And that we could possibly lose a lot of the things we have grown used to. And it could happen within our lifetime. Maybe very soon. In effect our subconscious has been woken from its somnolence and harpooned with the hard reality of the massive losses that could follow oil peaking, including:

        • Loss of life (self, loved ones, friends, co-workers, pets)
        • Loss of health
        • Loss of the future (for self and especially children - both born and unborn)
        • Loss of dreams and ambition
        • Loss of purpose (why bother if the world is going to end?)
        • Loss of control (especially of life events)
        • Loss of lifestyle and material goods
        • Loss of comfort and laziness
        • Loss of faith in God (depending on ideology and point of view)

        No wonder people experience a grief reaction. But it is only those people who understand the implications and ACCEPT them that really have the reaction. Which brings us to coping styles and the stages of grief. DENIAL is a very effective (and commonly used) strategy: just look at our politicians. SELF-EXCLUSION is a subtype of denial (”I could never get lung cancer, even though I smoke.”). Denial is, according to Elisabeth Kubler-Ross (author of the book “Death and Dying”) the first phase of grief. Her stages are:

        1. Denial and Isolation
        2. Anger
        3. Bargaining
        4. Depression
        5. Acceptance
        6. Hope

        In a previous posting on Peak Oil Medicine, Jim Barson also quoted the work of Kubler-Ross in his article on people’s reactions to peak oil. Her ideas about the stages of grief have proven themselves invaluable when counselling the bereaved, and I think that they will also be very important for us to understand how people might react to the implications of peak oil. They should also allow us to design educational strategies that anticipate and subsequently overcome the denial stage of grieving, thereby helping ever larger numbers of people to understand and prepare for peak oil.

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          People?s response to news of peak oil

          Posted by Paul Roth on 10th August 2006

          Health care professionals have long respected the work of author Elisabeth Kubler-Ross for her extensive insights into the processes of death, grief and loss. The idea of loss can be extended to a wide range of people, places, events and objects, anything in fact that we are ATTACHED to. Many of us have become attached to our modern oil-fueled lifestyle, and will grieve its passing. This idea of attachment helps to explain the way that some people react when they first hear about peak oil. Expecting a type of grief reaction when explaining peak oil to those ignorant of it, and examining some strategies to help deal with it, can help you to get your message across. These ideas will be explored here in more depth, starting today: In the article that follows, Jim Barson returns for an encore performance, this time explaining his reactions to the idea of peak oil. -Paul Roth.

          People’s Response to News of Peak Oil

          By Jim Barson

          Dr Samuel Johnson once said in reviewing a manuscript ?Sir, your work is in parts both good and original, however the parts that are good are not original and the parts that are original are not good?. This is doubtless true of the following. It is a patch work of the wise thoughts of many others stitched together with a few of my own. These ideas have come in large measure from attendance at one of ?The Heart of Peak Oil? workshops run by Gaiavic at Ceres in Melbourne and the ?Local Solutions Conference? in New York and off the web.

          We are not as rational as we like to think we are, large areas of human behaviour are the result of emotional and instinctual actions which are rationalised after the fact.

          Our brains are designed on the ?Get More Energy? Operating System, it has been patched and upgraded countless times, but the source code is still intact. The crisis of Peak Oil is an inevitable, unwelcome, unintended and unexpected consequence of this operating system.

          Down in the basement of our skulls, there is a hard wired set of instructions contained in our brainstem, basal ganglia and limbic system, these are structures which have changed little in millennia and are features that we share with all vertebrates to some degree. The basic instructions which run the unconscious routines of daily life are found here, as are the default response sequences that protect us from immediate danger and drive us to push our genetic endowment forward in time through to the next generation and on to immortality. We don?t instinctively respond to slowly evolving long term threats. How to survive in the long term? Don?t die in the short term, repeatedly. And ?Get More Energy.?

          Every single one of our ancestors was able to survive long enough to find a mate and have at least one child. We all had good ancestors. Our emotional and instinctual behaviour is the recipe that produced the survival of these untold thousands of ancestors. There have been just six generations of humanity that have lived through the exponential crescendo of oil induced success and excess. The last 150 years have been grossly abnormal ones for us and our interaction with the planet, we are too many and we have overshot the earth?s capacity to carry us. What we now see as normative civilised behaviour is really very aberrant. Our attempt to defy the laws of thermodynamics has put us in grave peril.

          Living things function by extracting energy from the environment. For the first few million years of our history this meant food. ?Food is energy and it takes energy to get food.?

          With the advent of agriculture and later the abundant cheap energy from oil, fewer and fewer of us have had to work in the business of providing food. Currently, in our culture, 2% of the population can produce food for the remaining 98%. We in the privileged western world no longer have to hunt and gather or grow our own food.

          We still seek to ?Get More Energy? but do so now through the medium of money. Money is the means to buy energy, not just food and fuel but also cars, houses and luxury goods etc. with high imbedded energy. The abundant cheap energy of oil provides us with all of what we take for granted as good and desirable, not only food but shelter, comfort, ease, entertainment etc.

          We waste so much of our lives: ?Spending money we don?t have, to buy things we don?t want, to impress people we don?t like.? We do this because it is the getting of things, not the having of them that gives us the buzz in the brainstem. This buzz is achieved by the release of dopamine. The surge of dopamine in our brains is the essence of pleasure and it is the final common pathway of positive behavioural reinforcement. Our urge to consume has become insatiable. In a very real, biochemical sense we are addicted to oil, addicted to what oil gives us.

          Why do we do it? Because when all of these things other than food are reduced to their essentials they boil down to status symbols, high energy things and it is our ability to obtain them that declares our fitness and desirability as a mate. We don?t care how much we have, because we are programmed to ?Get More Energy?. We want it because it brings status (dopamine) and sex (dopamine & fun).

          A tall, strong, intelligent male with a GSOH, as sought in the personal ads in the newspaper, is someone who can, at least at the level of the female brainstem, win battles, solve problems, work in a team and by dint of all these ?Get More Energy? for her and their offspring.

          A strong, voluptuous, intelligent, female with a GSOH can likewise, at least at the level of the male brainstem, do all of the above, lactate into the bargain and ?Get More Energy?.

          If we try to run a program written using the recently developed and still experimental ?Use Less Energy? Operating System, most people?s brains will not respond.

          When speaking for the first time to someone to whom the idea of Peak Oil is a revelation, it is important to see it with their eyes.

          Accepting Peak Oil and the subsequent energy descent means accepting real or imagined loss: Loss of home, wealth, car, job, freedom, independence, safety, security, loss of potential or loss of the long imagined future. This is not something that can be dealt with as an intellectual exercise it requires emotional engagement and an emotional response.

          Dealing with such fundamental challenges is analogous to rewiring our brains, we have to learn to think differently, to think in different ways, not to just think a few different thoughts.

          To rewire our brains to run this new ?Use Less Energy? Operating System we must confront change which is as threatening as news of a potentially fatal illness.

          It undercuts the core of our normal lives.

          The response to life threatening illness has been described by Elizabeth Kubler-Ross as following the sequential stages:

          Denial > Anger > Bargaining > Acceptance.

          Many people will go through a sequence like this as they come to terms with Peak Oil.

          When you introduce the dark clouds of Peak Oil into someone?s world for the first time don?t be impatient if they don?t seem to ?get it?. It doesn?t matter if it is the kid who mows your lawn, a family member or one of the movers and shakers from the business or political realm. They will each have to cover some emotional mileage before they can really understand and react appropriately.

          Don?t feel uncomfortable about asking ?How does that make you feel?? and sharing your own reactions when you first started to come to terms with the vision of the post Peak Oil world. Acknowledge that it is a scary concept but point out that it won?t go away just because it is ignored. Men, in particular, seem to need an initial nudge or invitation to engage their emotional awareness, women sometimes seem to find this first step easier.

          Not everyone will follow the Kubler-Ross road map but emotional acceptance is probably a prerequisite for getting on with life in the Peak Oil world. Not everyone however will be able to start their journey right now, it has been said: ?It is very hard to get someone to believe something when their job depends on them not believing it.?

          They might not start their journey to acceptance until after Peak Oil has trashed their job.

          Some of those who will not accept the idea may react with hostility, see this for what it is, an expression of fear and anxiety. It doesn?t mean that you should back off, you can still aim to get them thinking. Try to at least send them away with ?a small stone in their shoe?, that will make them have to think about it later. One response might be to say ?I found it really hard to believe it at the start too, but then I learned that????. Here you can insert one or more points such as these two that, in my opinion, pack the maximum impact:

          1) Oil discoveries peaked in 1964.
          2) That if the globe of the Earth were a sphere 8 metres in diameter, our original 2 trillion barrel endowment of oil would be a sphere the size of a pea.

          Our collective chance of survival and a positive response to Peak Oil is improved as the level of community awareness increases. Peak Oil is a non negotiable fact of our collective future and not wanting to know about it is an unacceptable example of the sort of self indulgence that we can no longer afford.

          Acceptance involves a degree of maturity and a departure from childish self absorption. It requires taking responsibility, being able to delay gratification, engaging with others and realising that the long term collective good is more important than the selfish me, here and now.

          Living with the reality of Peak Oil and energy descent requires us to behave like adults, to say ?OK, that?s the way it is going to be, let?s make the most of it?.

          Advertising, consumerism, and our narcissistic culture have led to a dumbing down and infantilising of our culture, to paraphrase J H Kunstler. ?We need to grow up and relearn how to behave like citizens, we can be so much more than just a bunch of wasteful, weak, whinging, infantile consumers obsessed with the idea of getting something for nothing?.

          For those who can get there, arrival at the stage of emotional acceptance of Peak Oil signals completion of the rewiring necessary to run the new ?Use Less Energy? Operating System. Once this new system is up and running we can learn new sustainable ways to get our brains to release dopamine. We can all learn new ways to achieve status within the tribe. ?No one can do everything, but everyone can do something?.

          The first output of this new way of thinking is a sense of wonder at the magic of what we have achieved in our mad energy consuming binge and a keen appreciation of its weakness, vulnerability and transience, the knowledge that it can?t last.

          The essence of the joy and sense of beauty one feels when one beholds a flower, a child, a rainbow or a sunset is the knowledge that this beauty can?t last and will be gone before you know it.

          There is much that is wrong with our world, stuff that deserves to be swept away, but there is much that is wonderful and will be missed and mourned if we can?t save it.

          When filled with this sense of wonder and joy, tinged with anxiety and dread, it is easier to find the resolve within ourselves to work hard, to do all that is within our power to save what we can, to make the transition work, to make the best of what we have, to get it to last as long as we can and to keep as much as we can of what can be sustained, for our children and all our descendants. The rules have changed, but we too can still be good ancestors.

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            Hirsch Report Update Part 3 - The Shape of World Oil Peaking: Learning from Experience.

            Posted by Paul Roth on 8th August 2006

            This study profiled a solo Robert Hirsch?s examination of the possible shape of the world?s peak-oil curve. He started by saying that world conventional oil production before, during and after peaking is almost certainly not predictable, because it depends on so many variables, including:

            • Oil price changes in the 10 years before peaking
            • EOR technologies
            • Oil field damage from previous mismanagement
            • Supply-demand expectations and oil company decision-making
            • Government incentives, political events and stability in oil-producing regions
            • Geology of major oil-producing regions

            He stated that modeling all these factors is probably so complex that any such estimate would be of questionable value. (POM: It would also need to include an inherently inaccurate guess about Saudi reserves that would introduce so much uncertainty that the exercise is probably futile).

            Because Hubbert used a bell-curve to model US peaking, the same type of curve has been applied to the problem of world oil peaking. Hirsch showed in this study that a bell curve may not be the best shape to use. He explained that Deffeyes fitted a bell curve to the US-48 peaking data and generated a broad and gently-sloping curve that showed that peaking occurred very slowly and gently over a 10 year period.

            In this study, Hirsch set out to examine the validity of a bell-curve in modeling oil production peaking. He looked at the data from four oil provinces that had already peaked (Texas, North America, Norway, and the UK) in order to gain some insights into what might happen.
            He selected these areas because they:

            • Are large and geologically varied
            • Had significant peak oil production (minimum 1MMbpd)
            • Had accurate long term data
            • Were managed for maximal oil production (ie they were unconstrained by cartel production quotas etc)

            Hirsch found that peaking was not obvious just one year before it occurred; that each peak was sharp and triangular rather than a smooth and gently-sloping bell curve; that post-peak declines were up to 13% in the first year; and that three of the four regions showed a pre-peak spike.

            POM Comment: This study highlights the probable folly of trying to accurately predict an exact date for the peak. I think that Hirsch showed incredible originality and drive to conceive and publish his ground-breaking report in 2005, and has continued to do so with this study. He once again provides incredibly useful information, suggesting as he does that peaking might appear suddenly, occur quickly, and be associated with a significantly faster drop-off than the 2% per year estimate used in his first study.

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              Hirsch Report Update Part 2 - Economic Impacts of Liquid Fuel Mitigation Options

              Posted by Paul Roth on 8th August 2006

              This study was done by Bezdek, Wendling and Hirsch, and published by the US National Energy Research Laboratory in April 2006. It looked solely at the US situation, and was a follow-up of the Hirsch Report (2005). It emphasised the dual issues of energy security and balance of payments problems as justification for implementing mitigation options now.

              It examined the four strategies (of the six in the Hirsch Report) most available to the US: improvements in vehicle fuel efficiency (VFE); coal-to-liquid conversion (CTL); oil shale; and enhanced oil recovery (EOR). It excluded gas-to-liquids and oil sands.

              It assumed the following strategies were crash implemented:

              • VFE: 50% increase after 8 years.
              • CTL: Three new 100,000 bpd plants developed each year with a four year lead time.
              • EOR: 175,000 bpd increase per year after four year preparation time.
              • Oil Sands: None.
              • Gas-to-liquids: None.
              • Oil shale: Three new plants producing 100,000 bpd completed each year with an eight year delay.

              Their modelling found that the costs will total several trillion dollars, and that the relative cost will be least for EOR and most for VFE. Benefits will increase continuously over the 20 year time-frame of the study. They will be relatively small in the first few years, and maximal in year 20. The strategies have widely different impacts, with CTL providing the most liquid fuel and VFE the least. They will create 1.4 million jobs. The character and timing of the jobs varies. Design and construction predominates in the first few years, progressively giving way to operations, maintenance and support as plants are completed and come on line.

              There should be very significant economic benefits, including capital investment, import replacement, company profits, and government taxes. (POM: Not to mention the avoidance of a possible economic collapse if peak oil is imminent). If a crash program was initiated in 2006, it would produce 14 million barrels of liquid fuel per day in 2026. If implementation was delayed until 2016, there will only be 5 MMbpd in 2026. The strategies could decrease total US oil imports from the current 13 MMbpd to 5 MMbpd in 2026. The problem (apart from the fact that a crash program has not started yet) is that initiating them all now doesn?t even satisfy half of US liquid fuel requirements pre-2026.

              They summarised by saying that if world oil production peaks before 2026, then the US will not have a choice about initiating these strategies. They also reiterated that such a program will cost trillions and take decades to have a significant impact.

              POM Comment: More great research from Robert Hirsch et al. The most striking thing for me was the scale at which we currently use oil - despite a massive mitigation effort we would not even get close (for the US alone) to replacing current consumption, not to mention allowing for future demand growth in the US (and lets not forget skyrocketing demand from China, India, etc).

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                The challenges of healthcare relocalisation.

                Posted by Paul Roth on 3rd August 2006

                By guest contributor Dr Jim Barson - an anaesthetist in Victoria and convenor of the health sector working group of ASPO-Australia. What he writes about in the following article is of central importance to our response to peak oil. Feel free to leave your comments and ideas.

                The relocalisation of healthcare is going to be a huge challenge. In the early 1900s local hospitals were dotted all over the map, each at the centre of a circle the radius of which was the length of a hurried trip by horse drawn transport.

                When mobility is restricted and if regional/rural areas see their populations start to increase again, the role of the rural doctor is going to have to change greatly. How to plan to relocalise healthcare is just one of many questions that arise from the impact of peak oil on healthcare.

                What level of complexity will we be able to sustain 2, 5, 10, 20 or more years into the period of energy descent that will follow on from Peak Oil?

                What will be the appropriate level of complexity that balances cost effectiveness with the best possible outcomes?

                Almost all drugs are petroleum derived, they represent an extreme case of value adding and without doubt will continue to be made, but at what cost and in what volume? How strong and how stable will the international logistical chain be that delivers them? How many drugs do we need? What can we dispense with? What can we make locally?

                What sort of equipment is indispensable? Can it be maintained without recourse to exotic spare parts? What is the minimum needed in an operating theatre?

                Is there a case to be made for surgical teams to move around to perform elective surgery in smaller hospitals? If so what can we pack up and move from place to place as required? Should we look at the robust, combat zone/disaster relief surgery/anaesthesia kits that have already been developed?

                The present trend to throwaway almost everything is unsustainable. What reusable equipment can we manufacture that will safely do the job of disposable products? What operations and treatments are no longer going to be possible or affordable or justifiable?

                We will need to manage risk and accept risk-benefit trade offs that might be currently unacceptable. Is legally driven decision making still going to be a viable response to risk minimization? We can’t really eliminate all risk now and will be much less able to do so in the future.

                Will GPs, particularly in rural areas, find that they are called on to do much more and more complex procedural work for patients who can not travel to large centres? How will they get the required training?

                We need to counter the dangerous and na?ve assumption that natural and holistic therapies will be able to simply take over when conventional medicine starts to fail, with no diminution in health or safety. Some natural therapies that actually work will find a place, but we must fight to defend the enlightenment and insist on scientifically proven treatments.

                We must try our hardest to keep the system functioning and adaptable for as long as possible. I am trying to get my head around these issues and would appreciate input from others who are thinking about the problem.

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