I was in my third year of medical school and midway through my general surgery rotation. That afternoon, I was working with an experienced acute care surgeon who was removing a young man's inflamed appendix. We hoped the operation would relieve the searing pain that had brought him to the hospital
The surgeon skillfully navigated his way through the procedure. He didn't hesitate or make any unnecessary movements. He didn't make any mistakes. As the final stitch to close the wound was thrown, I glanced up at the operating room's clock. Without compromising the patient's safety, the surgeon had completed the case faster than anyone else I had seen do it.
As I walked over to the trash can to remove my gown and gloves, I noticed that it was full. It was huge—commercial-sized, in fact. Just minutes ago, it had been empty. As I peered in, I realized just how much we had wasted. I saw unused surgical tools, heaps of paper, and plenty of plastic wrap. No effort was made to recycle anything.
A family of four might have taken a week to fill one of those trash cans. We took less than an hour. Operating rooms generate an enormous amount of waste: A 2016 study found that a single surgical department at the University of California, San Francisco, for example, wasted $968 worth of disposable medical supplies during every operation.
But this phenomenon is not limited to ORs. No matter which rotation I was on in medical school, from family medicine to obstetrics, waste was the only constant. The normal rules of conservation did not apply. President Trump's recent decision to withdraw from the Paris climate agreement was a sobering reminder that the world has much work left to do in its fight against climate change. Whiles some local governments and companies have sought to claim a leadership role in this arena, the response by American hospitals has been muted.
More From Tonic: Young Blood
Hospitals have obvious reasons to use a lot of energy. They're constantly buzzing with activity and use complex, energy-guzzling machines to treat patients. Lights have to shine, monitors have to work, and vents have to hum.
This all happens non-stop. Day in and day out, hospitals cannot cease to function. As a result, hospitals are the second-most energy-intensive commercial buildings in the United States. Only food service facilities rank higher. This has consequences: Using energy releases greenhouse gases into the atmosphere, contributing to climate change. A 2013 study found that American hospitals were responsible for 3.5 percent of the country's total greenhouse gas emissions. Their energy use alone accounted for 36 percent of this total.
But climate change is not the only area where hospitals come up short. That same 2013 study found that the American healthcare system was responsible for emitting 12 percent and 10 percent of the pollution that contributes to acid rain and smog formation respectively, and 9 percent of particulate matter. Hospitals were responsible for about a third of each figure.
Unfortunately, acid rain wreaks havoc on delicate aquatic ecosystems, and smog and particulate matter negatively affect lung function. All told, that study found that the total damage from hospital emissions may exceed 100,000 disability-adjusted life years annually. In other words, America's citizens may be losing over 100,000 years of life every year to early death, disability, or illness.
Compounding the problem, many hospitals don't even try to go green. Even simple measures to save energy are often ignored. Many, for example, are not using light-emitting diodes (LEDs) despite large potential energy and financial savings. A 2014 study, for example, found that a hospital that installed LEDs decreased its energy costs by 59 percent.
They also generate an enormous amount of waste—perhaps as high as 16,000 tons per day, according to a 2010 estimate. The constant fear of contamination have pushed hospitals to increasingly embrace disposable products. The use of paper is still widespread and recycling is rarely prioritized.
Hospitals would be wise to change course. Minimizing their collective environmental footprint would help fight climate change and improve human health. It could also save a tremendous amount of money. In fact, 2012 research from the Commonwealth Fund found that the savings could exceed $15 billion over a decade.
There are several steps hospital administration can take to cut down on energy use, reduce pollution, and minimize waste. They can retrofit old buildings and install more solar panels and energy-efficient light bulbs. They can better incorporate occupancy sensors to shut down equipment when no one is around and adopt more reusable products, especially in ORs. And they can also discourage excessive paper use and promote a culture of recycling. These efforts won't stop environmental destruction, but they're a good start.
Some hospitals may balk at the required upfront investment. But the costs of inaction, and the potential savings from going green, make these steps worthwhile—it's the right ethical and financial decision for hospitals to make. We live in an era in which federal inaction towards the environment is the new reality. It is now more important than ever that individual actors step up to do their part in the fight against climate change. Hospitals can and have to do better.
Kunal Sindhu is a resident physician at Beth Israel Hospital in New York.
Read This Next: Science Committee Wants to Restrict the EPA's Use of Science