Things have been busy here at Permintic. In the past 6 months there have been many changes. I was recruited as a clinical instructor at my alma mater, which was followed shortly by a move from Illinois to Ohio, starting work as an NP at an integrative medicine clinic, getting married to Ms. LF, buying the most eco-friendly car available (of necessity so that I could start another NP position in geriatric medicine while minimizing my environmental impact), attending my brother-in-law’s wedding, continuing the house search and, finally putting an offer in on a property with enough acreage to support the initial unfolding of our vision…. all the while working 60+ hours a week to make it all possible. Whether or not we become the proud new “owners” of a century home on over 8 acres, I anticipate things becoming even busier with the anticipation of our first baby in November. Nevertheless, I haven’t forgotten about you all, and have been looking forward to continuing our conversation about how to restore, sustain, and improve the health of the Earth and everything She supports (including humans). Thus, we continue our conversation, as promised, about the Ultimate Disease of Civilization.
The diagnostic criteria for metabolic syndrome are not set in stone, but basically consist of at least three of the following:
- Central, abdominal obesity (e.g., >102 cm for men, or 88 cm for women)
- High triglycerides (e.g., ≥ 150mg/dL) – or being treated for hypertriglyceridemia
- Low HDL cholesterol (< 40mg/dL for men, and < 50mg/dL for women) – or being treated for dyslipidemia
- High blood pressure (≥ 130 mmHg systolic [top number], or ≥ 85 mmHg diastolic [bottom number]) – or being treated for hypertension
- High fasting blood glucose ≥ 100 mg/dL – or being treated for type 2 diabetes
The diagnosis is relatively easy to make in our current world with an abundance of fossil-fuel-produced and procured materials and services, such as a tape measure, a blood pressure cuff, a stethoscope, and a tube of blood sent to the lab. But in the future world of fossil fuel scarcity how easy will it be? We will probably have enough rulers and tape measures lying around initially to either use directly, or to make our own measuring devices out of other materials. But what if we lost ours and couldn’t just go to the store to buy a new one? Blood pressure cuffs also exist in abundance now. But what if the gauges need to be recalibrated? Where would we get the tools, and, even with the tools, what if we don’t know how? Or what if the bladder gets punctured somehow and can no longer hold air? What if the diaphragm of the stethoscope breaks? Where would we come by replacement parts? I suppose some ingenious permaculturist could fashion a cuff and stethoscope out of materials taken from the natural environment, or we could improvise with tourniquets and palpation of the brachial pulse as we gradually loosen it, in order to get very rough estimations of blood pressure. But how on earth would we find out what a person’s triglycerides, HDL and glucose levels are? Without the industrial processes that are hopelessly dependent upon cheap fossil fuels, who will make the plastic vacuum sealed tubes? Who will make the 23 gauge butterfly needles needed to draw the blood? Will we have a stockpile of needles that we use and sterilize repeatedly? Although needle sterilization and reuse is not uncommon at all in developing countries, I can feel other health care providers trained in our single-use disposable model of infection control cringing along with me at the thought. How will we run the tests without expensive lab equipment, the production and operation of which is entirely dependent fossil fuel energy inputs? Personally, despite years of working within the system, I wouldn’t even know where to start.
This decline scenario characterized by scarcity may not be the most realistic. But whether or not we live in a world in which we miraculously design fuels to seamlessly replace fossil fuels while preserving the status quo, permaculturists can’t help but engage in systems thinking focused on building resilience. It is almost impossible for us not to think of the energy inputs required to keep our healthcare system moving; impossible for us not to question its resilience; and impossible for us not to start thinking about how we can either redesign resilience back into it or to sustainably recreate it from the ground up.
Next time, we’ll compare and contrast the conventional allopathic and the permintic treatment options for metabolic syndrome…