Palliative Care for Planet Earth?
In medicine, there are few specialties that can hold a candle to the work of palliative care. Anyone who has lost a loved one that was cared for by palliative care can attest to this. When a patient is transferred to palliative care there can be a sense of relief for the patient, provider and family as the harsh treatments, the frequent scans and the medicalisation of their lives can finally start to unwind. At this point, the patients’ immediate needs and wishes, rather than the diagnosis and prognosis, become the fulcrum of all decision making. No other specialty addresses the spiritual, medical, cultural and emotional needs of patients so holistically. And when the patient, along with family members and the treating team, accepts the finality of the situation, care is not deescalated; pain is anticipated and treated when needed, and at all times dignity is of paramount importance. There are no further carefully worded descriptions of scans that have “multiple shadows” , no further guarded diagnosis with enough hope included to keep going, just acceptance, honesty and dignified care.
For decades now the IPCC, the UN Intergovernmental Panel on Climate Change, has been the consultant who has collectively taken us into a side room and told us that the investigations have shown worrying irregularities and that we will have to urgently modify our lifestyle, now and not later. Yet, we have not changed. We have not gone to the surgeons either, we have not sought treatment. We sat on it, hoping for the best.
Today’s IPCC report is not a further warning, it’s that follow-up scan we were dreading. Reading between the lines, alongside recent reporting e.g., the pending collapse of the gulf stream, the pending loss of summer arctic ice, raging American, Siberian, European wildfires, all while our emissions continue to increase globally, today’s IPCC report is that consultation; “please take a seat, it is regarding your results. Would you like to have a family member or a friend with you?” Our inaction, our mass distraction and our set behaviours are the malignancy. UN Secretary General Antonio Guterres recently stated that “Humanity is waging a war on nature”. A retrospective analysis of how we have dealt with the climate crisis in the coming decades will be damning. We will no longer be able to say we were uninformed. Our reaction, or lack thereof, to today’s IPCC report will be telling. It is time to be referred to the surgeons, to chemotherapy, to radiotherapy — to accept the harsh reality of what needs to be done.
If we miss this chance, it will be palliation only. Continually fighting for a sustainable future is mentally and physically exhausting. Without a rapid reduction in our global carbon emissions, it may now be time to accept that we can’t change and that our addiction to cheap energy (and the cheap food, cheap aviation, cheap clothing that it provides) is locked in. Perhaps our efforts towards sustainability from here on should really be reframed as palliative measures. Or is there time yet for radical surgery and treatment?
Agri-Food is turned up to eleven
In the classic rockumentary “Spinal Tap” the lead guitarist of the aging and out of touch band explains how his amp is louder than others because the dial goes up to 11, as opposed to 10. When the interviewer challenges him with “well why not just make 10 louder?”, he considers this, then pauses before doubling down with “but these go up to 11”. This rhetoric chimes true when proponents of the Agri-Food model purport that Ireland has the greenest and most sustainable form of ruminant farming because our grass is the greenest, our rain is the softest and our latitude-island combination the goldilocks envy of the rest of the world. When presented with the objective evidence that Ireland’s leading source of greenhouse gases emissions are from beef and dairy, ammonia air pollution is beyond safe limits, our fresh waters polluted and biodiversity decimated the reply is “but grass…but hedgerows…but rain” “but our grass goes up to 11 is the greenest”. Perhaps our greenhouse gases do smell sweeter than most?
The Agri-Food committee is heavily represented by business interests such as Musgraves, Bord Bia, IBEC, Ulsterbank etc., all multimillion-euro businesses that are informing government strategy. Is this any different than Exonn Mobil advising on green energy policy? Independent and objective environmental commentators (Pillar) have left the Agri-Food 2030 Strategy Committee due to the indifference to their objective analysis of the literature and the measures of the Strategy being “woefully inadequate to meet the social and environmental challenges we face.”
You don’t need to be a climate scientist to know what is going on. The executive summary of the Agri-food strategy says it all: “much of the developed world, there should be a move towards more plant-based diets in the interest of public health. But this does not mean that Ireland should make radical changes from its role as a producer and exporter of safe, high quality and sustainably produced livestock products: this would not make sense from an economic, environmental or global nutrition perspective.” The square peg of ramping up Irish food and drink exports and the round hole of carbon neutrality is now government policy. Big business and Big Ag is very much the tail that wags the cow when it comes to Ireland’s climate policy.
When asked the serious questions of how the leading cause of greenhouse gas emissions in Ireland will not only become net zero in our lifetimes but do so whilst also increasing exports from €14bn to €21bn by 2030 a Father Ted scene springs to mind.
Fr Ted: Did you bring the travel scrabble Dougal?
Father Dougal: I brought the normal scrabble and the travel scrabble, Ted. The travel scrabble for when we were travelling, and the normal scrabble for when we arrived!
Father Ted: Good man!
Father Dougal: Ah, no, wait a minute… now that I think of it I didn’t bring either of them.
At the time of this grave IPCC report, our Agri Food policy plans to vastly increase exports and achieve 50% reductions in emissions in 10 years, neutrality in 30, whilst restoring biodiversity and correcting ammonia air pollution. The Dougal-esque “ah, no, wait a minute” punchline will come in 10 years, except no-one will be laughing.
Underwater cycle lanes
Recently we had a High Court judge rule that a temporary cycle lane in Sandymount could not go ahead. Yet we know that on current projections this cycle lane will be underwater like the rest of Sandymount unless we take urgent action now. Ironically part of the reasoning for the judgement was that an environmental impact assessment for the cycle lane had not been performed. Yet in Ireland between 1990 to 2018 we had an increase in the number of registered cars from 800,000 to 2,130,000 and no environmental impact assessment was required.
We are the weather, we are Cheltenham
Stuck in the middle of today’s IPCC report are car commuters and farmers taking the rap. Commuters remain trapped in their cars due to grossly underfunded and inadequate public and active transport infrastructure. Farmers remain trapped in beef and dairy farming by an outdated CAP system, sunk equipment costs and a gargantuan lobby that is advising government policy. Despite having world-renowned standards, they are routinely vilified yet they are the custodians of the land that we must depend on. Farming and farmers are not the problem; they are the solution. For you see, we already live in a circular economy, but today’s IPCC report suggests it isn’t one that favours the survival of civilisation.
It is rare that government policy can be reduced to one word; “Cheltenham”. One of the lasting images of 2020 was of the masses attending the Cheltenham racing festival while the first COVID wave had begun in earnest. While this event appeared in real-time, and more so retrospectively, as reckless it was in fact endorsed by government approval despite overwhelming scientific evidence to the contrary. If those who attended had a chance to do so again with the benefit of hindsight, would they still make that journey?
Unless the conversation in the news cycle changes and begins to address the root cause of climate breakdown, as well as COVID-19 (and also the next pandemic threat), then are we as a society akin to the masses at Cheltenham in 2020? The major geological event of our planet’s history, the human driven melting of polar ice, is happening in our lifetime yet collectively we are not acting in accordance with the overwhelming scientific advice to stop and act. Is the Cheltenham festival a microcosm of our global response to climate and biodiversity breakdown? The COVID-19 vaccines will undoubtedly be remembered as one of our greatest achievements, but if they are used to accelerate a return to business as usual then business as usual is what we can expect, i.e., wildfires and pandemics.
What do we need to do?
Simple really; don’t fly, transition to and endorse plant-based diets, use active or public transport and consume less (gadgets, clothes, accessories). After that, to quote George Monbiot, all we need to do is to change everything. If we do not, we are akin to the cachectic smoker outside the hospital, determined to smoke until the bitter end. We all have our role to play and there are things that we can do. Irish Doctors for the Environment and the Irish College of General Practitioners have created an infographic showing what we can do in our daily practice, but it will be different for everyone. These small daily changes, along with more green spaces, wildflower meadows, plastic cutlery bans and so on, are welcome.
However, without systemic radical treatment enacted by governments — as with cancers, cut away what you can and treat what you cannot — these individual changes are nothing beyond palliative care. These changes in our daily lives and routines can serve the spiritual, medical, cultural and emotional needs of our planet, but they will not be enough to save it (or, indeed, save us). Current government policy and public attitude, in light of today’s IPCC report, is akin to whistling in the wind.
The scalpels are in the hands of the governments, our and international. We hope they use it like every good surgeon: fast and precise. Otherwise, palliation it is.