Post Peak Medicine

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Introduction

PART 1: FRAMEWORK AND BACKGROUND

Three possible futures

Peak what?

Historical perspective

Awareness and denial

Medical literature review

Legal and ethical issues

Financing a practice

Armed conflict

Peak population and dieback

Personal preparation

Further reading

PART 2: SPECIALTIES

Anesthesiology

Dentistry

Dermatology

Emergency medicine

Family medicine

General surgery

Internal medicine

Midwifery

Nursing

Obstetrics and gynecology

Optometry

Orthopedic surgery

Otolaryngology

Pediatrics

Pharmacy

Psychiatry

Psychology

Public health

Radiology

Urology

 

 

 

 

 

 

 

 

 

 

 

Awareness and denial

"Professor Luis Garicano, director of research at the London School of Economics' management department, had explained the origins and effects of the credit crisis when (the Queen) opened the £71 million New Academic Building.  Prof Garicano said: 'She was asking me if these things were so large how come everyone missed it'.  He told the Queen: 'At every stage, someone was relying on somebody else and everyone thought they were doing the right thing.'" (Andrew Pierce, The Daily Telegraph, United Kingdom, 5 Nov 2008)

"The Commons Treasury committee said male banking chiefs became caught up in a 'group think,' where they failed to challenge decisions which led the entire banking system to the brink of collapse 18 months ago." Rosa Prince, The Daily Telegraph, United Kingdom, 3 April 2010.

When people first become aware of peak oil, the impossibility of endless economic growth and everything which follows on from that, the first question they are likely to ask is "How should I prepare?"  The second question they are likely to ask is "Why can't everyone else see what I can see?"  When someone understands that the supply of oil is finite, our economy depends on oil, and that perpetual economic growth is just as impossible as a perpetual motion machine, they often feel compelled to pass on this news to family, friends and co-workers, and are surprised when the response is less than enthusiastic: in fact, the usual response is anger, denial and accusations that the person bearing the news has taken leave of their senses.  Even if evidence and arithmetic are presented to support the case, many people don't believe it and often don't even want to look at it.

A belief in perpetual economic growth and denial of evidence to the contrary does not seem to be correlated with intelligence, educational level, age, sex or cultural background.  Many highly trained and highly intelligent economists, often working for national governments and central banks, believe in perpetual economic growth, or appear to believe in it.  This phenomenon is difficult to explain on rational grounds.  In this chapter I am going to offer an explanation based on genetics and evolution.  I don't claim that this is the best explanation, or even that it is correct, but it does offer a model for explaining something which many peak oil aware people find difficult or distressing to deal with. 

The explanation I am going to offer you is based on our innate herd instinct.  In this age of individualism, the terms herd instinct, groupthink or conformist are often used in a mildly derogatory sense, but it is important to realise that the instinct to do as the group does is an important part of the survival toolkit which evolution has bred into us.

You can see the herd instinct in action by watching a shoal of fish, a herd of buffalo or a flock of birds.  At the approach of a predator, all the animals start moving in a coordinated manner away from the perceived danger.  The animals at the front of the shoal, herd or flock may not even be able to see or smell the danger, but they move anyway.  This movement away from danger protects both the herd and the individual animals within it.  If an animal decides to move in a different direction, it may be trampled by the herd and/or eaten by the predator, and so doesn't pass on its genes.  In this way, evolution reinforces the herd instinct and discourages individual thinking.

You don't often see human beings moving in large herds, except in artificial situations like airports or sports stadiums, but the herd instinct is still there - it just expresses itself in an intellectual rather than physical form.  People share a common set of beliefs about the appropriate way to behave towards family, neighbours and enemies, the nature of birth and death, communal rituals and the origin and destination of their society.  We call these things culture and religion.  People who deviate from the core set of beliefs may be marginalised or ostracised, and may have just as hard a time as the buffalo who decides to make a left turn when all the rest are charging straight ahead.

This all works well for 99% of the time, when things are going smoothly and the herd is moving in the right direction.  But what happens if the herd starts moving in the wrong direction?  We can see some examples of this in the animal kingdom.  Fishermen can herd fish into nets by making noise to drive them in the desired direction.  A famous fictional example can be found in Thomas Hardy's 1874 novel "Far from the Madding Crowd" in which an insane sheepdog drives a herd of sheep over a cliff.  In both of these cases, the herd instinct causes the herd to move into danger, not away from it, and the maverick animal which heads in a different direction is the one most likely to survive. 

Unfortunately, a herd of human beings can also move in the wrong direction intellectually, and history provides numerous examples of this.  We call these mass delusions, mass psychosis or mass hysteria.  For reasons which I cannot explain, many (although not all) of the examples involve irrational economic beliefs.  Some are relatively harmless, causing a few people to lose a moderate amount of money.  Some have resulted in the deaths of tens of millions of people.  My main criteria for describing something as a mass delusion or mass hysteria are that a large number of people believed in it, it ought to have been possible to see at the time that the belief was false, and that subsequent events did in fact prove it to be false.

One of the earliest documented examples of financial mass hysteria was the tulip bulb mania in Holland in the 1630s in which the contract prices for bulbs of the recently introduced tulip reached extraordinarily high levels and then suddenly collapsed.  At the peak of tulip mania in February 1637, some single tulip bulbs sold for more than 10 times the annual income of a skilled craftsman. The people participating deluded themselves into believing that the tulip bulbs were worth far more than they actually were. It is generally considered the first recorded speculative or economic bubble.

In the Salem witch trials of 1692-93, 150 people were arrested and imprisoned for witchcraft and 19 hanged, on the flimsiest of evidence.  The delusional belief in witches died out in Western culture soon after this episode.

In Europe in the 1930s and 1940s over 60 million people were killed.  One principal underlying reason for the deaths was a mass delusional belief that Germans were the master race and that all other races were inferior.  After the war, many German people had difficulty coming to terms with their former delusions, and tried to resolve this using denial (we didn't know, we feared for our own safety, we were only obeying orders and so forth).  This is inconsistent with the evidence of enthusiastic mass public participation in, for example, the persecution of Jews and the atrocities committed by the German army against the Russian civilian population on the Eastern Front.

The "dot-com bubble" was a speculative bubble covering roughly 1995–2000 (with a climax on March 10, 2000) during which stock prices in Internet based companies rose rapidly to a level far in excess of what those companies were worth. This was followed by a collapse of Internet company stock prices in 2001 as investors realised that they had paid too much for the stock and that most of these companies had not and never would make any profit.

Following the collapse of communism in Eastern Europe, there was a spate of economic Ponzi schemes - notably MMM in Russia, Caritas in Romania, Jugoskandic and Dafiment Bank in Serbia, TAT in Macedonia, and VEFA Holdings, Xhafferi, Populli, Gjallica and several others in Albania.  Over time, approximately 80% of the Albanian population was drawn into these pyramid schemes, often selling their only real property in order to invest and then depending on the pyramids for all their income. When the inevitable happened, the vast majority of the population was completely dispossessed: http://theautomaticearth.blogspot.com/2008/11/debt-rattle-november-26-2008-from-top.html

The US house price bubble which peaked in 2005 was due largely to a delusional belief, in the face of historical evidence to the contrary, that house prices could only go up and never down, and the house price inflation could be used to fund consumer spending.  The subsequent collapse of US house prices was foreseeable and was a significant cause of the 2008 global economic collapse.  In a rare moment of insight, the part played in this by the herd instinct was acknowledged in a UK newspaper (top of page). 

So the lessons we learn from all this are that human beings are prone to mass delusions, that these occur frequently throughout history, they often involve delusional financial beliefs, they are difficult for most people (even intelligent people) to see at the time they are happening, but they can be seen clearly for what they are after the bubble has burst and the delusion is dispelled.

Some individuals seem to have a natural resistance to mass delusions, in rather the same way that some individuals have a natural resistance to disease.  These people have an enhanced ability to see the delusion for what it is in advance of their peers and to take early mitigating action, but they have a hard time persuading their peers to do the same.  In a limited sense they are able to see the future, which can be both a blessing and a curse for the person afflicted.  They have always been among us, and have been called among other things mavericks, doomsayers, oracles and prophets.  Perhaps they are evolution's Plan B, for when the herd instinct isn't working out.

I believe that our society's current belief in perpetual economic growth falls into the category of mass delusions, and that this will become apparent in due course with the longer perspective of history.