Let my Patients Go Surfing

I have just finished reading Yvon Chouinard’s outstanding book titled, “Let my people go surfing…the education of a reluctant businessman.” In Chouinard’s world, there is a constant battle of escape vs. committment. His early days of forging pitons for personal use in climbing blossomed into a small business in which mail order was only for those climbing buddies that couldn’t get to the back of his car in Yosemite or the Tetons. His early employees were fellow climbers and surfers who took off as soon as they had enough money to fund their next trip. At which point, they returned to blacksmithing, or packign boxes or innovating new designs to save up enough money for their next adventure.

Central to these adventures, of course, is an environment in it’s natural state…clean water, flowing streams, healthy salmon populations, non-scarred rock faces. Chouinard’s first-hand witnessing of the irreversibly scarred rock faces of Yosemite from his very own forged Pitons spurred the “clean climbing” revolution of removable chocks that did not leave indelible marks on the rocks. An essay appearing in Chouinard Equipments 1972 catalog changed the face of climing forever…and also began Chouinard’s committment to environmental causes.

Reading his book stirred up my deep, now buried thoughts, about how man and the environment should interact. Ethics begun by my early exposure to hunting, fishing & camping, and carried on by my involvement as an Outward Bound Instructor after college. In the many years that have passed, however, I have had other things ot occupy my time, like learning anatomy, physiology, pharmacology, and jumping through the myriad of hoops to get liscensing and DEA approval for the prescribing of addicting narcotic medicines. Not really what I’d set my mind to when I first dipped a paddle into the clear, cold waters of the North Country Boundry Waters 15 years ago.

My first reaction to reading the book was to quit medicine and get a job with Patagonia…but what would I be qualified for? Well, as a former “dirtbag” outdoorswoman, I would be at least as qualified as most of his initial employees. But Chouinard’s unwavering committment to the environment in the face of trying to run a profitable consumer business is inspiring. COuld I not do the same thing in medicine? Is it possible for a physician to support the environment, not just by actions and monetary donations in her free time, but to really practice medicine in a way that encourages “sustainable” energy consumption and minimal environmental impact?

What are the environmental costs of every prescription for Albuterol that I write? For every xray, CT or MRI that I order? Are there pharmaceutical companies that are environmentally responsible the way Patagonia is? Companies that try to reduce their environmental footprint on the world? Companies that adhere to these ideas through product research, development, clinical trial testing and evenual manufacturing of the drugs? If these companies exist, what drugs do they make? What drugs are they researching? Is it possible for me to only reccommmend to my patients those drugs made by such environmental responsible companies? WOuld they be mainstream drugs, or only drugs that could be used by a minority of patients? COuld a pharmaceutical company like this even exist in today’s pharaceutical, research and drug approval environment?

I don’t know the answers to these questions, but I want to find out. Call me naive. I prescribe only the drugs that I know, based on my understanding of current medical research, to be unequivically helpful or necessary. I recommend over the counter and generic drugs whenever possible. But beyond these basics, I’m sure there is a lot I am blind to.

In a very short search, starting with Patagonia’s web page, leading to the Grist, I discovered the Consortium for Conservation Medicine

The Consortium for Conservation Medicine is a unique collaborative institution that strives to understand the link between anthropogenic environmental change, the health of all species, and the conservation of biodiversity.

This sounds like good start for my research, but if you have any other thoughts, please let me know. How far can I go with these ideas? Can I charge into a new direction? Can I earn a living doing it? Can I pay off my student loans? Or will I have to go back to being a “dirtbag” climber/kayaker and declare bancrupcy just so I can “go surfing” on a clean beach while working for an environmentally responsible organization? Will Yvon Chouinard even consider giving me a job???

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