Editor's Note
Minimizing the Mess
Wednesday is garbage day at our house. At 7 a.m., before I leave for the hospital, I wheel the blue, 68-gallon container, which is usually full, to the curb for pickup and frequently wonder how two people can generate so much trash every week. Most of our drinks come in recyclable containers. We rarely buy prepared meals in Styrofoam keepers. And, until the recent visit of our granddaughter, we haven’t seen a Pamper in our house in 25 years. Yet there it is … 68 gallons.
And then I go to the hospital. With the rise of MRSA and C. Diff, sometimes half of the patients I see are in isolation, requiring me to don a yellow disposable gown, latex disposable gloves, and a paper disposable mask before stepping in the room. As I talk to them, I watch lab techs use and dispose of needles, syringes, and tubing. Those supplies, along with Foley catheters, incentive spirometers, and IV bags make up just a short list of throw-away-ables I see in today’s hospital, and I don’t even get into the operating room. When walking through our office, I pass numerous red hazardous waste containers that get emptied at least once weekly.
As a consuming society, we generate huge messes. In medicine, we are among the messiest. Yet as society advances, we get better at hiding our messes. I don’t know where my 68 gallons of garbage goes every week. With visions of syringes floating off the New Jersey coast, I’m not sure I want to know where the contents of those red containers goes when it leaves our office, although Richard Broderick’s article tells a part of the story. The fate of waste was a little more obvious when everybody had a town dump. Most summers, our family travels to Copper Harbor at the northern tip of Michigan’s Upper Peninsula. Until recently, Copper Harbor, like many remote small towns, had a dump where what you threw away was on display and the remains of last night’s dinner got recycled by a cloud of seagulls and a battalion of bears.
But the more hidden our messes are, the more potentially nefarious they are. Long after the bugs are killed, pesticides linger in our environment, triggering some well-documented medical consequences and prompting fears of as-yet undiscovered physical effects, particularly in the young. Recently, physicians have discovered that our standard recommendation to “flush it” for patients with unwanted medications didn’t eliminate the drugs, as trace amounts have turned up in water supplies. Messes can be dangerous, and getting rid of them for good is tough to do.
Yet some of the stuff that adds to waste has made the practice of medicine safer. Since the discovery of HIV, no one wants to return to the era of resharpening hypodermic needles or autoclaving syringes. And medicine certainly is becoming more aware of the hazards of its waste. Twenty years ago, we didn’t have red containers, nor did we have programs to collect unwanted drugs.
Medicine and society will never eliminate their messes, but we can keep working at minimizing the jetsam. I sometimes fantasize about a waste-less life, waving cheerfully at the garbage man on Wednesday morning and crowing, “Nothing today.”
I can always dream.
Charles R. Meyer, M.D., editor in chief
Dr. Meyer can be reached at
cmeyer1@fairview.org