Courage Has A Face. Her Name Is Hadley.

Posted on | November 8, 2023 | Comments Off on Courage Has A Face. Her Name Is Hadley.

Mike Magee

“Don’t call me a saint,” said founder of the early 1930’s Catholic Workers Movement, Dorothy Day. “I don’t want to be dismissed that easily.” Oddly enough, says Jesuit writer, James Martin, “That quote is probably the biggest obstacle to her canonization…Given that quote, would Dorothy really want to be canonized?”

Today’s election results were a sliver of bright light in what has been a rather dark period. But it is at times like this that quiet heroes emerge. If courage has a face, this morning, as results across the land show a sweeping victory for Democrats, and specifically those advancing the cause of women’s autonomy in managing their own health decisions with their doctors, it belongs to a young woman from Kentucky named Hadley.

In the final weeks of the Kentucky governor’s race, as Politico reported, Andy Beshear gave voice to the woman who directly addressed his opponent on camera. “Anyone who believes there should be no exceptions for rape and incest could never understand what it’s like to stand in my shoes. This is to you, Daniel Cameron. To tell a 12-year-old girl she must have the baby of her stepfather who raped her is unthinkable.”

Absorbing the results of yesterday’s elections with the rest of us are Governor Chris Christie, Governor Ron DeSantis, Ambassador Nikki Haley, Vivek Ramaswamy, and Senator Tim Scott who will take the stage this evening in Miami at the 3rd Republican Primary Debate. No doubt they are surrounded this morning by consultants trying to figure out how best to spin this issue. As Dobbs has played out in states like Kansas, Ohio, Kentucky, Wisconsin and beyond, political scientists are likely reminding their students that in politics, “Sometimes when you win, you lose.”

Court packing on a federal level, and even more importantly by Republican leaders on the state level, has tipped the power of our nation toward minority rule, allowing repugnant leaders to seize control of our legal system. That power has been used over the past decade to allow passage of laws that attack existing rights such as women’s power and autonomy over their own bodies, or construct barriers that obstruct the popular will of the people. Examples include promoting extreme gerrymandering and voter suppression, dead ending the Dream Act, or allowing citizen access to weapons of war and a permitless gun-carry law in Florida.

Understandably, citizens have wondered, “Will our Democracy die?” Hadley’s courageous decision reflects a stubborn and determined stance, by her and many others throughout this land, assuring the answer is, “No. Not on my watch!”

Her image and words will be lasting for three major reasons. They prove that:

A healthy Democracy requires participation and engagement of citizens.
Freedom and autonomy, including access to health professionals, is sacred and personal.
Women will not accept second class citizenship.

Trump no doubt remains unaware that he has lost everything. Many of his most ardent supporters, including Leonard Leo, the mastermind behind the court packing scheme that brought us the Dobbs decision, remain firmly in a state of denial. But even they must admit this morning, as they stare into Hadley’s eyes, and listen to her steady voice, that they have met their match. And she is a young woman who’s message is clear, “Enough is enough!”

Likely channeling another woman’s spirit from a century ago, Hadley’s courage (listen here) was more human than super-human. As Dorothy Day quietly proclaimed, “Don’t call me a saint. I don’t want to be dismissed that easily.”

Picking Up The “Single Payer” Baton From Ady Barkan.

Posted on | November 2, 2023 | 2 Comments

Mike Magee

The Politico headline in 2019 declared dramatically, “The Most Powerful Activist in America is Dying.” This week, 4 1/2 years later, their prophecy came true, as activist Ady Barkan succumbed at age 39 to ALS leaving behind his vibrant wife, English professor, Rachael King, and two small children, Carl, 8, and Willow,4.

His journey, as one of the nation’s leading activists for a single-payer health care system began, not coincidentally, with his diagnosis of A.L.S. in 2016, 4 months after the birth of his first child. His address at the 2020 Democratic National Convention fully exposed his condition to a national audience.

His mechanized words that day were direct, “Hello, America. My name is Ady Barkan, and I am speaking to you through this computer voice because I have been paralyzed by a mysterious illness called A.L.S. Like so many of you, I have experienced the ways our health care system is fundamentally broken: enormous costs, denied claims, dehumanizing treatment when we are most in need.”

With remarkable self-awareness, he told New York Times reporter, Tim Arango, “That’s the paradox of my situation. As my voice has gotten weaker, more people have heard my message. As I lost the ability to walk, more people have followed in my footsteps.”

His was a shared sacrifice, laced with stubborn and very public persistence, under the banner, “Be A Hero.” His passing on November 1, 2023, was bracketed that day by a piece by veteran Healthy Policy guru, and columnist for KFF Health News, Julie Rovner, that certainly would have made Ady smile. In the Washington Post newsletter, Health 202, it read, “The AMA flirts with a big change: Embracing single payer health care.”

The commentary that followed included this, “That leftward shift in political outlook is showing up not just in the AMA, but in medicine as a whole. As the physician population has become younger, more female and less White, doctors (and other college graduates in medicine) have moved from being a reliable Republican constituency to a more reliable Democratic one.”

Ironically, the AMA’s lead journal, JAMA, last week reinforced the need for simplification with an article by luminary KFF health policy pros, Larry Levitt and Drew Altman, titled “Complexity in the US Health Care System Is the Enemy of Access and Affordability.” They wrote, “Health care simplification does not necessarily resonate in the same way as rallying cries for universal coverage or lower health care prices, but simplifying the system would address a problem that is frustrating for patients and is a barrier to accessible and affordable care.”

My friend and colleague at The Health Care Blog, THCB, Kim Bellard took off on the article, writing, “Health insurance is the target in this case, and it is a fair target, but I’d argue that you could pick almost any part of the healthcare system with similar results. Our healthcare system is perfect example of a Rube Goldberg machine, which Merriam Webster defines as ‘accomplishing by complex means what seemingly could be done simply.’ Boy howdy.”

A bit further on, Kim comments, “If we had a magic wand, we could remake our healthcare system into something much simpler, much more effective, and much less expensive. Unfortunately, we not only don’t have such a magic wand, we don’t even agree on what that system should look like. We’ve gotten so used to the complex that we can no longer see the simple.”

As Kim suggests, status quo is hard to crack. But change has been in the air for some time. A KFF supported 2017 survey of 1,033 US physicians by Merritt Hawkins revealed a plurality of physicians favored moving on to a single payer system. Why? The survey suggested four factors:

1. Physicians are seeking “clarity and stability”. They believe “single payer” will reduce “distractions.”

2. There is a generational shift underway. “Younger doctors are more accepting.”

3. Physicians have become resigned that “we are drifting toward a single payer system” – so let’s get on with it.

4. There is a philosophical change occurring that increasingly embraces the societal value of universal coverage.

Around the same time American Public Health Association published a proposal drafted by the Physicians for a National Health Program which currently boasts more than 25,000 physician and medical student members. That proposal echoed some of the five points – universality, single administration, local delivery, health planning, and inclusive transparency – I advanced in 2019 in CODE BLUE: Inside America’s Medical Industrial Complex.

Kim, Julie, Larry, and Drew are right in pointing a finger at complexity. But what Ady understood, more perhaps than any others having waged the good activist fight as a progressive soldier, was that the challenge was greater than that. The challenge was cultural.

That realization was what drove the military’s decision under the Marshall Plan. In the re-build of Germany and Japan, we elected to start with a health plan – in part because we recognized that all other social determinants – housing, nutrition, education, clean air and water, safety and security – would be enhanced in the process leading to a tradition that could support stable democracies. This is essentially the same challenge we as a country (having wandered so far off course as to elect Trump) are facing today.

Changing culture, as health professionals know, is a tall order. It is about compassion, understanding and partnerships. It is about healing, providing health, and keeping individuals, families and communities whole. And – most importantly – it is about managing population-wide fear, worry and anxiety.

What we are asking of the people, and the people caring for the people, is to change their historic culture (one built on self-interest, hyper-competitiveness, and distrust of good government). This is a tall order – something that parents, pastors, politicians and physicians equally recognize. Things evolve, and difficult things take time.

Ady Barkan has run out of time. He has left it to us to complete the task of achieving health care for all through a single payor system.

Category: Uncategorized
Tags: Ady Barton > Code Blue > Drew Altman > Julie Rovner > KFF News > Kim Bellard > Larry Levitt > Physicians for a National Health Plan > PNHP > THCB > The Health Care Blog > Tim Arango

“Some Like It Hot.” – An Old Disease Arrives Anew.

Posted on | October 25, 2023 | 2 Comments

Mike Magee

Naomi Orestes PhD, Professor of the History of Science at Harvard, didn’t mince words as she placed our predicament in context when she said, “If you know your Greek tragedies you know power, hubris, and tragedy go hand in hand. If we don’t address the harmful aspects of human activities, most obviously disruptive climate change, we are headed for tragedy.”

At the time, as a member of the Anthropocene Workgroup, she and a group of international climate scientists were focused on defining and measuring nine “planetary boundaries,” environmental indicators of planetary health. At the top of the list was Climate Change because, one way or another, it negatively impacts the other eight measures.

Not the least of these “human perturbations” is the effect of global warming on access to clean, safe water, and the impact of violent weather cycles and rising sea levels on concentrated urban populations along coastal waters.

A less recognized, but historically well documented threat, is exposure to migrating vectors of disease as they contact unprepared human populations beyond their traditional camping grounds. The threat of avian flu among migratory birds has been well covered. Equally, over the past decade, North America has seen a range of novel infections, especially along our southern borders, from dengue, to chikungunya, to Zika.

The southern United States and its coastal populations are firmly in the cross-hairs. Their seas are rising at an alarming rate, and fouling fresh water supply with invasive sea water. Their soaring temperatures are only exceeded by record setting atmospheric river rainfalls and flooding events, and their “extreme poverty throughout Texas and the Gulf Coast states, where inadequate or low-quality housing, absent or broken window screens, and a pervasive dumping of tires in poor neighborhoods,” as reported in this weeks New England Journal of Medicine, assures a reemergence of one of this countries most significant, but now long forgotten killer diseases.

In 1853, the disease killed 11,000 in New Orleans, some 10% of the population. Twenty-five years later, it overwhelmed Mississippi Valley cities killing 20,000. Its latest major foray in the United States was in 1905 with 1000 deaths. Its’ absence over the past century is credited to public health and structural and engineering advances. But that was then, and this is now.

The disease is Yellow Fever, and red lights are blinking in a range of southern coastal cities from Galveston, TX, to Mobile, AL, to New Orleans, LA and Tampa, FL.. Experts say they may soon be in the same boat as Brazil was between 2016 and 2019 when it experienced a threefold increase in the historic prevalence of the disease among its population.

Public Health sleuths have uncovered that the 1878 epidemic in the Mississippi Valley was triggered by an El Nino spike the year prior. The warmer and wetter conditions are believed to have supported a large increase in Aedis aegypti mosquitos, the vector for the Yellow Fever virus.

Are we prepared? Recent experience in fighting Dengue fever in the southern states is not encouraging, with WHO chief scientist Jeremy Farrar warning that Dengue might soon “take off” absent better mosquito eradication and screening prevention. U.S. Public Health experts say a Dengue foothold is nearly secured and the disease is fast on its way to becoming endemic in southern coastal states.

As for Yellow Fever, there is an effective vaccine, but it is also associated with rare but serious side effects. Antivaccine activism post-Covid would be a significant barrier now say experts. Adding to the challenge, no Yellow Fever vaccine is currently available from the U.S. Strategic National Stockpile. Mosquito surveillance programs are currently marginal, and response capabilities for mass vaccination in affected areas are severely limited.

The Anthropocene Workgroup is fully aware of these human instigated crises. In the prior Holocene Epoch of 11,700, we prided ourselves with being able to co-exist with other lifeforms and in equilibrium with a healthy planet. But beginning in 1950, the new Anthropocene Epoch has aggressively chipped away at planetary health, disrupting stabilizing cycles, and critically raising the temperature and acidity of oceans that cover and buffer 70% of the planet.

The return of Aedes aegypti, and the Yellow Fever virus it carries, is a dramatic harbinger of additional challenges to come if we are unable to limit “human perturbations” of our planetary cycles.

Category: Uncategorized
Tags: anthropocene epoch > anthropocene working group > chikungunya > dengue > global warming > halocene epoch > Yellow Fever > Zika

Agents of Democracy

Posted on | October 19, 2023 | Comments Off on Agents of Democracy

Mike Magee

In the Age of “Doomscrolling,” Doctors and Nurses Need To Stay Focused On Their Primary Mission.

Exactly 1 year ago, mental health experts alerted the medical world to their version of an assessment scale for yet another new condition – “doomscrolling.”

As defined in the article, “Constant exposure to negative news on social media and news feeds could take the form of ‘doomscrolling’ which is commonly defined as a habit of scrolling through social media and news feeds where users obsessively seek for depressing and negative information.”

No one can deny a range of legitimate concerns. Faced with continued background noise from the pandemic, add global warming, renegade AI, and the Republican Congress. And now, the devastating attacks on Israel and growing instability in the Middle East. It is no wonder that we can’t turn off the Instagram feed.

With real challenges like these, our troubled world needs her doctors and nurses to stay focused more than ever on their primary professional missions – managing health and wellness, sickness and disease, fear and worry, and yes, now “doomscrolling.”

John J. Patrick PhD, in his book Understanding Democracy, lists the ideals of democracy to include “civility, honesty, charity, compassion, courage, loyalty, patriotism, and self restraint.” The 4.2 million registered nurses and 1 million doctors in America are agents of democracy.

Regrettably, they are already being drawn away from patients by three powerful forces.

Corporate Dislocation – To assure maximum reimbursement, doctors and nurses are routinely asked to prioritize time and contact with data over time and access to patients.
Health Technology and AI Substitution – Rather than engineering solutions to expand real-time patient contact, most innovations are further distancing patients from healthcare professionals.
Legislative Intrusion – Complex medical decisions, long entrusted to the patient-health professional relationship to negotiate, are being transferred to ultra-conservative legislators.

We live under a constitutional and representative democracy, as do two-thirds of our fellow citizens in over 100 nations around the world. The health of these democracies varies widely. The case for democracy emphasizes its capacity to enhance dignity and self-worth, promote well-being, advance equal opportunity, protect equal rights, advance economic productivity, promote peace and order, resolve conflicts peacefully, hold rulers accountable, and achieve legitimacy through community based action.

One of the challenges of democracy is to find the right balance in pursuing “the common good” which has dual (and often competing) arms. One arm is communitarian well-being and the other, individual well-being. Blending personal and public interests is complex. In health, one might argue, this tension has led to our dual system – one, largely profit driven, interventional and science discovery based, and the other largely public, preventive and focused on communitarian public health.

Both nursing and medicine have embraced professionalism, and launched new graduates by voicing “oaths” or promises to themselves, their colleagues, and our society as a whole. These lists of promises or pledges, their language and priority ordering, helps reveal both the history and intent of these noble professions.

Of course, the most famous oath in Medicine is the Hippocratic Oath reaching back some 2000 years to Greece. In pledging to a grouping of ancient deities, it recognized that interventions should “do no harm,” and that confidentiality was paramount.

By 1964, this oath was sufficiently out of date that many medical schools embraced an updated version written by Louis Lasagna, MD. The oath includes a communitarian connector: “I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.”

The Penn State College of Medicine’s Oath in 2022 offered a counter-balance by giving top billing to the patient, with the oath to the patients, not to Greek gods: “By all that I hold highest, I promise my patients competence, integrity, candor, personal commitment to their best interest, compassion, and absolute discretion, and confidentiality within the law.”

The Geneva based World Medical Association, in the shadow of the Nuremberg Trials, provided a list of pledges in their 1946 Declaration of Geneva in order of appearance including:

the service of humanity
patents first
patient autonomy and dignity
respect for human life
absence of bias or prejudice on any basis
commitment to patient privacy
guided by professional conscience and dignity
honor the noble traditions of the profession
respect and gratitude to teachers, colleagues and students
share knowledge to advance health care
commit to personal health and well-being
never violate human rights.

Nursing has also relied on professional Oaths. The first was the Nightingale Pledge, created in 1893 by the Farrand Training School for Nurses and named after Florence Nightingale. It is believed to be based on the Hippocratic Oath, and was modernized in 1935. In the 1950’s, the American Nurses Association (ANA), created a formal Code of Ethics, including Nursing’s 9 Provisions (or Pledges) committing to: compassion and respect, patient-focus, advocacy, active decision making, self-health, ethical environment, scholarly pursuit, collaborative teamwork, professional integrity and social justice.

As health professionals, we need to be laser focused during these troubled times on our patients. Doctors and nurses, day in and day out, by managing fear and worry, reinforcing community and family bonds, and championing hopefulness, guard against a true “doomsday scenario” – the destruction of our Democracy from within. The patient is our primary concern, and deserves our full professional attention.

Category: Uncategorized
Tags: declaration of geneva > doomscrolling > hippocratic oath > John J. Patrick > Louis Lasagna > nuremberg trials > patient-healthprofessional relationship > patient-physician relationship > penn state college of medicine > world medical association

Is Your University President An “Intentional Peacemaker?” This One Is!

Posted on | October 12, 2023 | 6 Comments

Mike Magee

Two days before Hamas launched its barbaric attack on Israel, a U.S. based university president delivered a Keynote Address at an International Peace Conference in South Korea. Here were his opening words:

“In the contemporary world that is somehow both entirely interconnected and increasingly divided, the need to develop peacemakers has never been more pronounced. As a university president, I feel especially responsible to fulfill this need – to develop peacemakers is as noble an endeavorer for our institution of higher learning as I can imagine. Colleges and universities are where young minds evolve, perspectives are broadened, ambitions are shaped. If these institutions are intentional about their work, they can create in the hearts and the minds of young people the building blocks for peace around the world, strong ethical foundations, intercultural understanding, radical empathy, and the skills to solve complex problems and make change. They have the power to shape the values, ambition, and intentions in the next generation of global leaders and citizens.”

“This university was designed with a mission in mind – to develop problem solvers, entrepreneurs, and wise leaders from around the globe and to weave them together as a community committed to a more peaceful, sustainable, and equitable future for all. We’ve created an institution where training global citizens isn’t an afterthought, but the foundation of our work. It’s at the heart of everything we do. Our students come to us from over 100 nations, are accepted based on talent and character, rather than economic background and status. So what does this look like for us? Developing global responsibility is a combination of global exposure, intercultural understanding, lessons in civil discourse, and proximity to a global community.”

Take a moment to view his whole address here: https://www.youtube.com/live/sIsDrWJLlcw?feature=shared&t=13374

And read an interview that followed in the Korean press here: https://koreajoongangdaily.joins.com/news/2023-10-05/national/kcampus/Universities-must-do-more-to-cultivate-futures-problem-solvers/1883894

How does your president, faculty and student body stack up to his when it comes to the intentional creation of “peacemakers?”

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Full Disclosure: The university president noted above is related to Mike Magee.

Category: Uncategorized
Tags: highly selective universities > innovative universities > intentional education > Kimdae Jung Peace Forum 2023 > Mike Magee PhD > peacemakers

Can An Intense Dialogue Between Science and Religion Be Fruitful?

Posted on | October 4, 2023 | 4 Comments

Mike Magee

By all accounts, they were mutually supportive. He was three years older and the chief scientific adviser to the world’s most powerful religious leader. The Scientific American called him “the greatest scientist of all time,” and not because he won the Nobel Prize in Chemistry a decade earlier for explaining the nuts and bolts of ozone formation. It was his blunt truthfulness and ecological advocacy that earned the organization’s respect.

Paul Crutzan is no longer alive. He died on February 4, 2021 in Mainz, Germany at the age of 87. What attracted the 86 year old “Green Pope” to Paul were three factors that were lauded at his death in the Proceedings of the National Academy of Sciences (PNAS) – “the disruptive advancement of science, the inspiring communication of science, and the responsible operationalization of science.”

It didn’t hurt that Crutzan was pleasant – or as the The Royal Society in its obituary simply described him: “a warm hearted person and a brilliant scientist.”

In 2015, he was Pope Francis’s right arm when the Catholic leader, who had purposefully chosen the name of the Patron Saint of Ecology as his own, was briefed on the Anthropocene Epoch. Crutzen had christened the label five years earlier to brand a post-human planet that was not faring well.

Crutzen was one of 74 scientists from 27 nations and Taiwan who formed the elite Pontifical Academy of Sciences in 2015. Those selected were a Who’s Who of the world’s scientific All-Stars including 14 Nobel recipients, and notables like Microbiologist Werner Arber, physicist Michael Heller, geneticist Beatrice Mintz, biochemist Maxine Singer, and astronomer Martin Rees.

On May 24, 2015, they delivered their climate conclusions to the Pope, face to face. The Pope heard these words, “We have a collection of experts from around the world who are concerned about climate change. The changes are already happening and getting worse, and the worst consequences will be felt by the world’s 3 billion poor people.”

The next month, with his release of the encyclical on the environment, Laudato Si’, Pope Francis began by embracing science, with these words, “I am well aware that in the areas of politics and philosophy there are those who firmly reject the idea of a Creator, or consider it irrelevant, and consequently dismiss as irrational the rich contribution which religions can make towards an integral ecology and the full development of humanity. Others view religions simply as a subculture to be tolerated. Nonetheless, science and religion, with their distinctive approaches to understanding reality, can enter into an intense dialogue fruitful for both.”

Further along, he celebrates scientific progress with these remarks, “We are the beneficiaries of two centuries of enormous waves of change: steam engines, railways, the telegraph, electricity, automobiles, aeroplanes, chemical industries, modern medicine, information technology and, more recently, the digital revolution, robotics, biotechnologies and nanotechnologies. It is right to rejoice in these advances and to be excited by the immense possibilities which they continue to open up before us”

But then comes the hammer: “Any technical solution which science claims to offer will be powerless to solve the serious problems of our world if humanity loses its compass, if we lose sight of the great motivations which make it possible for us to live in harmony, to make sacrifices and to treat others well.”

Laudato Si’ and the Pope’s personal intervention in climate deliberations in 2015 are widely credited for the successful December 12, 2015 draft Paris Agreement. The final draft was signed four months later by 126 parties at the UN Climate Change Conference (COP21).

Now eight years have passed, and Pope Francis has decided that “enough is enough.” This week he released a condensed update of the original 180-page Environmental Encyclical, now just a 12-page apostolic exhortation.

In the piece, titled Laudate Deum, Pope Francis was especially critical of the U.S. and other developed nations, writing, “If we consider that emissions per individual in the United States are about two times greater than those of individuals living in China, and about seven times greater than the average of the poorest countries, we can state that a broad change in the irresponsible lifestyle connected with the Western model would have a significant long-term impact.”

Paul Crutzen’s spirit quite obviously was still stirring in the aging Pontiff’s soul. He raised again the mischief that man had unleashed in triggering the unprecedented ecological Anthropocene Epoch, and suggested worse times lay ahead if humans do not course correct. Specifically he sees humankind, now amplifying our mistakes with new AI technology, in dangerous territory. Specifically, to “increase human power beyond anything imaginable,” he says, is “a failure of conscience and responsibility.”

Those who know Pope Francis well, like fellow Jesuit priest David McCallum SJ say his brand of direct and confrontational “servant leadership” is just what the world needs at this moment. McCallum, is a professor of business and leadership, and expert on “restorative justice” at the Jesuit’s LeMoyne College in Syracuse, NY.

But for now he is based at the Vatican building a leadership curriculum that he says “is intended to create space for diverse people to participate in the church, listen to one another’s needs, and then discern a way forward together with the bishops – but not the bishops alone. In church terms, it is a call to synodality. In business terms, it would be like a flattening of the organization with less hierarchy, more teamwork, and more consultation.”

The Green Pope remains controversial, especially among deeply conservative Catholic bishops. But in him, admirers like McCallum see “a servant leader, (who) has to let go of immediate satisfactions, and might even have to embrace failure to accomplish a greater, long-term goal…people at times experience leadership in terms of sacrifice and a certain amount of loneliness. Those are two of aspects about leadership that can be a little bit challenging…This requires living, loving, and leading in a spirit of hope, with a sense of possibility for the future.”

We all need to hope and pray for his success.

Category: Uncategorized

We’re All In The Hot Seat Now.

Posted on | September 27, 2023 | 2 Comments

Mike Magee

It’s not that easy living in the “Big Easy” these days and co-existing with a world dominated by water concerns. When Times-Picayune gossip columnist Betty Guillaud (as the folklore goes) “coined New Orleans’ undisputed nickname” in the 1960’s, it was a lifestyle eponym meant to favorably contrast life in “The Big Easy” with hard living in “The Big Apple.”

That was well before August 23, 2004, when the levies failed to hold back the Gulf waters, and 1,392 souls perished leaving two names to last in infamy – Katrina and Brownie, of “Brownie, you’re doing a heck of a job” fame.

Now it’s not as if it’s been all smooth sailing for New York City and water. I mean, look at the history. When the British overran the Dutch in 1667, one of the first priorities was to dig the first public well and include a marvelous technologic advancement – a hand pump. That was in front of an old fort at Bowling Green, near Battery Park.

But by the early 1700s, the absence of a sewage system and saltwater intrusion from the Hudson and East Rivers, plus a crushing population explosion, had overwhelmed the clean water supply. The solution – temporary at best – haul in fresh groundwater, in limited quantities, from Brooklyn.

It was hard to tell in that century what was worse, the regular cholera outbreaks that claimed 3,500 lives in one single year, or the catastrophic fires burning without response like the one that destroyed a quarter of the city structures in 1776. So much for Independence Day celebrations.

The city’s response was to form a regulatory and operational agency, the Manhattan Company, under one Aaron Burr, to build out infrastructure with public funds. Excess funds were used to start a bank, whose name may be familiar to you – the Chase Manhattan Bank. As you might imagine, the leaders of the bank were better at making money than providing citizens with clean safe water.

But by 1837, with disease rampant and supplies dwindling, the city went all in on a technologic solution. With the help of 4000 immigrants beginning in 1837, the city built a dam six miles above the link between the Croton and Hudson Rivers, creating a five mile reservoir on 400 acres containing 660 million gallons of water. As the water collected, they also build the 41 mile Old Croton Aqueduct from the reservoir to the Great Lawn in Central Park, gravity driven, falling 1/4 inch every 100 feet. Just five years later, on July 4, 1842, the first drops arrived accompanied by fireworks.

Nowadays, water engineers constantly test and repair a system that now delivers 3.8 billion liters of drinking water to over 9 million New Yorkers each day. They also work to structurally address, in this age of global warming, encroaching salt water intrusion on the city’s shores. But if they are ever tempted to feel sorry for themselves, or utter the words, “It’s not easy,” they need only turn their gazes southwest to “The Big Easy.”

Let’s begin in Plaquemines Parish on the southern edge of the state. An intense and prolonged drought and massive evaporation during a long hot summer have promoted saltwater intrusion of the Mississippi River, and led to drinking water advisories since June forcing the state to provide bottled water to residents of the parish. There’s not much room for error where the Mississippi meets the Gulf. Chronic dredging of the river has left the mouth below sea level. Add to this that the river’s flow is down to 130,000 cubic feet per second, close to the lowest flow ever recorded.

The salt water is on the move north, detected now 66 miles upriver. Professor Mark Davis at Tulane’s Center for Environmental Law has been raising the alarm for several months. He says, “The amount of river it takes to push the Gulf of Mexico back and keep economies going needs to be appreciated, not just along the river, but nationally. This river does not have lots of water to share. The power of the river is what keeps salt water out,”

Up a ways, at West Feliciana Parish, a sandbar became so obstructive to the river on July 21 that tugboats have been required to allow barges to negotiate the narrowing pass. The “salt water wedge”, as it is termed, has now led Gov. John Bel Edwards to ask for a federal emergency declaration. The encroaching sea water not only fouls drinking water, but also destroys piping infrastructure due to its corrosive effects, and the raised salinity levels undermine the effectiveness of water treatment plants. It also harms crops and sickens live stock.

The dense “saltwater wedge” travels below fresh water above. This is the basis of the Army Corps of Engineers temporary solution – a strategically placed underwater levee anchored to the rivers bottom to obstruct upward advancing sea water. But the continued drought means the levee will be breached in days, not months. A second temporizer is to add up to 36 million gallons of fresh water a day to water treatment plants to dilute the briny water influx and allow the facilities to work effectively.

Pulitzer Prize winning social philosopher, Philip Kennicott, offers scant reassurance in a comprehensive review of how “the dark future of climate change” has undermined “the dream of air conditioning.” Chuck full of unintended consequences, he disturbingly reminds his readers that “Making internal spaces cooler for humans means making external environments hotter for all living things…” Drawing on images of Mars colonies that are “dependent on perpetual sources of oxygen and water,” he dares to “remind us of our frailty…as the danger zone for excess heat creeps into once clement zones, (and) the air conditioner joins the furnace as an essential system for ever more people.”

Kennicott’s closing line uncomfortably mirrors those of the Army Corps of Engineers and Governor John Bel Edwards. And whether you’re dealing with “saltwater wedges” in “The Big Easy”, or Canadian fire-driven, orange skies in “The Big Apple,” citizens everywhere best heed his warning that we’re in hot water now.

He writes, “We want to live beyond or without weather, because the weather we made is killing us.”