News & Media Opinion Pieces Neglect of this patient will affect all of us

Neglect of this patient will affect all of us

This article by an SA medical student member of DEA first appeared in Medical Observer.

AS A diligent medical student, I’m reviewing the case of a patient with hyperthermia.

The patient’s temperature is a few degrees above normal, and they have had sustained exposure to excessive heat. Weak and fatigued, the patient also has nausea and vomiting.

I’m relieved to note that the patient is still sweating profusely, which suggests that they haven’t progressed to heat stroke.

What treatment do I expect to be administered at this point? For starters, I remove the patient from the heat. I check for the patency of their airways and I maintain adequate breathing and circulation. I also administer fluids and ensure the patient avoids exertion.

With supportive care, the patient’s inherent repair mechanisms should restore health.

Imagine my consternation that, for this patient, there have been no such attempts to maintain basic life support and adequate hydration, and the patient is not being rested.

Monitoring of the patient’s vital signs has been scant. What is most glaringly wrong is that there has been no attempt to reduce the patient’s exposure to heat.

I believe you know this patient: it’s Earth.

What do we know about Earth’s current state? The average temperature has risen by 0.74°C over the past 100 years and it is projected to rise as much as 6.4°C during the 21st century.

The years 2001–10 all rank in the hottest 12 years on record.

You can’t keep pumping that much extra energy into a system without consequences. And we’re seeing them. While eastern and northern Australia spent the start of 2011 drowning under unprecedented rainfall, record snowstorms paralysed North America and Europe. In the past six years we’ve seen massive storms such as Hurricane Katrina, Cyclone Yasi and Cyclone Monica, the latter being the strongest storm to impact Australia on record.

Think of our oceans as our core heat storage organs, buffering us from thermal change.

They’re also our sweat glands. As they heat, more water evaporates. Earth is sweating profusely, putting extra water into our atmosphere, causing more extreme weather.

Our patient is showing serious signs of weakness and fatigue. Dryland salinity is ravaging formerly arable land in the east and west of Australia, and battered ecosystems can no longer resist infestation by weeds.

The Coorong in South Australia is in extreme peril thanks to acid sulfate soils and low water flows. Even areas that seem relatively undisturbed have not been spared. We’re seeing small mammals and seed-eating birds disappearing across the largely uninhabited north of Australia. And Phytophthora (root rot) is decimating the unique vegetation of Western Australia.

Dissolved CO2 is causing acidification of the oceans, which is harming coral reefs and shell-forming organisms, with consequences for the entire ocean food web. Massive soil erosion and deforestation are not leaving Earth much capacity to metabolise and filter out the toxins. Sounds like liver failure and end stage renal disease.

Our patient might have presented with hyperthermia, but now we’re uncovering a saga of chronic neglect.

Is it reasonable to liken Earth to a human body? Like us, Earth has homeostatic mechanisms that buffer and restore temperature deviations. And, like us, if subjected to extreme disturbance, Earth’s ecosystems can no longer compensate. We know, all too well, that once systems decompensate, it can spell death.

In the case of Earth, death isn’t quite as we know it: living systems will surely continue, but maybe not in a form compatible with human life.

Even if we turn off the heater right now, evidence suggests it could take another millennium to dissipate the excess heat. We’re past the point of completely preventing any damage, but it’s not too late for mitigation.

Our patient is in critical condition. We must act immediately and decisively to stop further heating of our planet. Our own lives depend on it.

Visit Doctors for the Environment Australia at

Dr Mani Berghout PhD

Medical student at Flinders University Medical School and member of the SA subcommittee of the DEA