Fracking has become the rage for natural gas production in the lower 48. It is a practice that is realtively new and the extent of conseqences of the process remain a matter of debate. People being able to set water on fire makes it clear there is a problem. The sensationalism of that image has become a tool of the environmental left to frame the argument.
People should be allowed to ask questions. And if dangers exist there should be investigation. That does not mean the industry will necessarily shut down. It may mean that oversight needs to take place. There are fine lines between regulation and overregulation but no regulation is not an acceptable answer if problems exist.
Medicine sometimes moves forward when a set of cases presents. It is what happened with HIV. In 1981 homosexual men started showing up with Kaposi's Sarcome and Pnemocystis carinni pneumonia. The questions were asked and the etiology was uncovered.
The same thing happens every day when outbreaks of a disease are traced back to a food item. E-coli 0157 and hamburgers or Hepatitis A and strawberries from Mexico are great examples. There are minor examples as well. Most gastroenterologists can tell you when a C. Difficile outbreak is underway.
Dr. Amy Pare, a plastic surgeon in McMurray, PA, recently saw a number of patients with inflammatory skin lesions. She noticed they were clustered around a natural gas fracking site. Two toxic hydrocarbons were found in patient urine samples and when the patients stopped drinking water the lesions improved.
Pennsylvania law now requires gas companies to make physicians aware of any substances patients to which patients may have exposure. Previously, that information had been protected under corporate secrecy laws. Doctors are not allowed to use the information given to them for any purposes other than treating patients.
This poses ethical problems for physicians. Patients being exposed to harmful chemicals present a public health issue. Recognizing that issue and taking steps to prevent further cases is part of the practice of medicine. The biggest step in this case would be to sudy the epidemiology and figure out how fracking is or is not playing a role.
Physicians have to report many different diseases to government databases. Just recently I saw the summary of sexually transmitted diseases diagnosed in Alaska in the last year. Confidentiallity is mostly maintained but states use the data to try and treat patients and control outbreaks.
One would hope the medical community would always be so forthright in exchanging information and solving problems. It does mean enlisting the help of the public while maintaining confidentiality.
It is not always the case. I have been in a number of institutions over the last 22 years from medical school to private practice. I have also heard a number of stories from other physicians. Some of the things that you hear can make your skin crawl. It is like a bad trip through the kitchen on Bar Rescue.
Does the public always find out about the issues in the hospitals? The surgery centers? The offices? No. Sometimes it makes the news or becomes an expose on a news magazine. Often it is buried and physicians are willing partners.
I was at a hospital once that had a major breakout of Legionnaire's Disease due to a contaminated water supply. That made the news. Most media observers in this town likely remember a few infection control and medical waste issues at some local hospitals. We all heard about the kidney that was thrown out recently.
Many major breakdowms in process do not make the news. A big part of that is the medical community, like most people, is afraid to be honset with the public. That has a lot to do with the legal system that will quickly add many questionable cases to legitimate ones. And when something does make the news it often leads to an overreaction and defensive medicine being practiced.
Physicians love to get on their high horse about bicycle helmets, seat belts, smoking in bars, and now apparently "fracking." They are far less likely to jump out and get after the institutions in which they practice. In fact, they act extra hard to help those institutions keep the issues out of the public eye. It is always better to stir somebody else's pot.
It is great that Dr. Pare and other physicians want to get the word out about "fracking." It is great that physicians work to identify diseases and their causes. It is great that they do not want a gag order to stop them.
But what happens when there is an outbreak of infections in a hospital? What happens if there is major equipment malfunctions causing issues? What if there is a series of medication errors? The physician and the hospital usually do look to identify and solve the problem. The problem may even be reported to regulatory agencies. Then there is sometimes a self imposed gag with regards to making it public and warning other patients. Patients can be part of the solution if given knowledge just like a helmet on a bike.
After 22 years in hospitals I am skeptical about the data that 150,000 people a year die because of mistakes. That is roughly the same number of people who are diagnosed with colon cancer every year. If 150,000 people were really dying I should be seeing at least some of it and I do not. It is the difference between hard and estimated data.
Over the years there have been issues with the cleaning of endoscopic equipment identified in hospitals and surgery centers around the country. It has given manufacturers the opportunity to modify cleaning devices. It has given institutions a chance to improve processes.
Here's the thing. It is a lot easier for a gastroenterologist to make sure his scope is being cleaned than to wonder whether fracking is causing colon cancer. Neither is a bad question but only one is easy to answer and enact immediate meaningful change if needed.
