by J. Matthew Sleeth, MD
God created the earth. He made it to be self-sustaining and renewing. Throughout history, the natural world has fulfilled its role. It has carried a thousand generations largely without the help or consideration of humans.
When I speak in a church, I bring along a case of efficient lightbulbs to give to people. I refer to the Energy Star Web site (www.energystar.gov) which urges us to consume less energy. Formed by the Environmental Protection Agency under George Bush Sr.’s administration, the Energy Star program appeals to our sense of patriotism, logic, and brotherhood. It says that if every household changed its five most used bulbs to compact fluorescent lightbulbs, the country could take twenty one coal-fired power plants off-line tomorrow. This would keep one trillion pounds of poisonous gases and soot out of the air we breathe and would have the same beneficial impact as taking eight million cars off the road.
A decrease of soot and greenhouse gases in the air translates into people who will be spared disease and death. Some sixty-four thousand American deaths occur annually as a result of soot in the air. Throughout my childhood, I knew of only one schoolmate with asthma. Now on a hazy day, dozens of kids in every school reach for inhalers to aid their breathing. God did not design the air to make us short of breath. It was meant to sustain us.
The Harvard School of Health looked at the impact of one power plant in Massachusetts and found that it caused 1,200 ER visits, 3,000 asthma attacks, and 110 deaths annually. Nationally, the soot from power plants will precipitate more than six hundred thousand asthma attacks. These are just numbers, albeit large ones. For me, those numbers boil down to one young girl early in my medical training.
It was a triple “H” day in the nation’s capital—hazy, hot, and humid. A dome of smog hung over the city and extended far beyond the capital beltway. The weatherman told those with illnesses to stay indoors, but eight-year-old Etta Green and her brother went to a neighborhood playground. I began my afternoon shift in the ER wing of the children’s hospital while Etta and her brother were running through a sprinkler to cool off. As Etta exerted herself, her airways began reacting to the smog. The muscles that line the bronchioles of her airways involuntarily contracted, while the mucous cells began a pathologic overproduction of thick fluid. Within a few seconds, this fluid buildup became what we call an asthma attack.
Etta’s brother ran back home for her inhaler, and bystanders called 911. Within a few minutes, a rescue unit was on-site and began treating and transporting Etta. They radioed ahead that things were not going well. To one side of the ER, we had a room with eight beds set aside specifically for asthma cases. On that afternoon fifteen children occupied the area—receiving oxygen treatments, inhaler treatments, and IV medicines. The growing anxiety of the EMTs in Etta’s ambulance made it clear that she was too ill for this area. A nurse flipped on the lights in a trauma room, and we assembled there.
The doctor in charge of the team called out what he wanted everyone to do. I was given the job of intubating Etta, if needed. The ambulance crew arrived. She was being “bagged,” meaning that the paramedic was trying to oxygenate her with a mask over her mouth and nose and an Ambu bag that forced air into her lungs. Her thin, limp body was quickly transferred to our trauma gurney.
“Matthew, go ahead and intubate. Tammy, get an art [arterial] line in; I want her paralyzed too,” the leader called out. I lifted Etta’s small hand and held a few endotracheal tubes next to her little finger. Then I selected the one closest in diameter to her finger, a trick I’d been taught for quickly getting the correct size. I paused a second to lean down and whisper in Etta’s ear, which is the only way to communicate with a patient in a crowded, noisy room.
“Etta,” I whispered, “I’m Dr. Matt. I’m going to put a tube in your mouth and get you breathing right.” I looked into her frightened eyes. “I’m not gonna let anything bad happen to you, sweetheart,” I promised. Her left hand still rested in mine, and I thought I felt a weak squeeze.
Two images from that scene still haunt me. The first was her little finger held next to those plastic endotracheal tubes. That hand was so small and vulnerable in my oversize palm.
The second image came thirty seconds after I intubated Etta. The team leader yelled for quiet. He held his stethoscope on her chest. “Give her a breath,” he ordered, and I squeezed down on the bag. Etta had on a bathing suit the color of a fluorescent green hula hoop. Pictured on its front was a happy, smiling whale blowing a spout of water into the air. Etta must have loved that bathing suit. One couldn’t help but smile at the frolicking whale. Trying to lift that whale by forcing air into her lungs is my second haunting memory. Despite the rescue squad, and despite the best efforts of an entire pediatric emergency department, I broke my promise to Etta. She died of air pollution on that summer day.
It is tempting to point to a self-serving lobbyist or a power-hungry elected official and blame him for one of the sixty-four thousand annual deaths from airborne soot. But what about me? What about us? Remember the lightbulbs? By changing lightbulbs, hanging clothing on the line, taking fewer trips to the mall, carpooling, and owning more modest homes, Christians can save lives—not statistical lives but little children like Etta. They can save their own grandchildren and, just as importantly, the lives of people they will never meet.
Love thy neighbor as thyself—one cannot claim to be a Christian and ignore the Golden Rule. It isn’t a suggestion or a guideline; it is a commandment from God. What is the connection between the parable of the Good Samaritan, the Golden Rule, and the environment? Isn’t our choice of homes, cars, and appliances just a matter of lifestyle, and therefore not a moral or spiritual matter? Does God care whether I drive an SUV, leave the TV on all night, or fly around the world skiing?
The Bible doesn’t mention any of these things. They didn’t exist in Jesus’s time. Yet Jesus taught the spirit of the law, not the letter. From the spirit of the law, and from the example of his love, we can determine the morality of our actions.
Energy—electricity, wood, coal, gasoline, propane, and oil—is like food. It is a blessing, and it sustains us. Our relationship to God’s gifts can be one of entitlement, ignorance, and gluttony or one of praise, thanks, and temperance.
From Serve God, Save the Planet: A Christian Call to Action by J. Matthew Sleeth, MD
