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

 

 

 

 

 

 

 

 

 

 

 

Historical perspective

"Those who cannot remember the past are condemned to repeat it" (George Santayana, 1863-1952)

After 200 years of industrial economic growth, most people have come to believe that economic growth is a normal and indeed essential state of affairs and that it will continue indefinitely.  A historical perspective suggests that on the contrary, economic growth is a temporary phase during the development of a civilization and that it is unsustainable.  We can deduce this in three ways: from archaeological records, from contact with other living civilizations and from basic arithmetic.  Let's look at each of these in turn.

Archaeological records

Archaeological records tell us that no previous civilization has ever achieved perpetual economic growth.  If they had, they would still be here today.  Most past civilizations have eventually failed through war, resource depletion or other factors which are examined in detail in Jared Diamond's book "Collapse: How societies choose to fail or succeed" (2005).  Examples of civilizations which have failed include, in approximate order of appearance, the Sumerians, Assyrians, Medes, Babylonians, Persians, Greeks, Romans and Carthaginians.  Their surviving records suggest that none of them foresaw their own collapse, and all of them thought their society was stable and would continue indefinitely.

Contact with other living civilizations

During the Age of Discovery, from the late 1400s to the late 1700s, European explorers sailed the world making contact with, trading with and/or conquering other civilizations.  None of the living civilizations they encountered had achieved, or had an expectation of, perpetual economic growth.  All the civilizations encountered had achieved an approximately steady state or zero growth economy, with the exception of Easter Island which was in the final stages of collapse due to resource depletion.

Basic arithmetic

A brief consideration of basic arithmetic will show why perpetual economic growth was just as impossible for early civilizations as it is for us today.  Let's take as an example, the Romans.  The Western Roman Empire (that part of the Roman Empire centered on Rome) was founded around 753 BC and expanded until around 117 AD with the death of the emperor Trajan.  His successor, the emperor Hadrian, was a man ahead of his time and decided that it was neither possible nor desirable for the Roman Empire to continue to expand.  He therefore attempted to stabilize the Empire at its then current size, it continued in a steady state until around 180 AD with the ascent to power of the emperor Commodus, then began a long slow decline until 476 AD when the last Western Roman emperor was deposed.

Let's suppose that instead of stabilizing in 117 AD, the Roman economy had expanded at 1% per annum until the present day.  This very modest rate of economic growth would be viewed as sluggish by most modern economists.  Eighteen hundred ninety three years of economic growth at 1% per annum would result in a Roman Empire which produced and consumed over 166 million times the amount of goods and services in the year 2010 as it did in the year 117.  Of course this amount of growth isn't possible: there aren't the resources on the planet to sustain it.  So if Roman economic growth had not been voluntarily stopped by Hadrian, it would have been compelled to stop by natural forces when it bumped up against the physical limits of the environment.

And just for fun, let's calculate how much the Roman economy would have grown if it had enjoyed a 3% growth rate until the present day - a rate which most modern economists would consider to be normal.  I have no idea what the answer is because the compound interest calculator I am using can't handle numbers that big.  If any economist reading this knows the answer, please tell me, and then tell me how he or she thinks that would be possible to achieve.

So archaeological records, contact with other living civilizations and basic arithmetic all point to the same conclusion: perpetual economic growth was impossible in the past, it is impossible now and it must at some point stop.