Friday, December 23, 2011

Stopping Keystone XL is the Best Policy for Energy Security.

Like a crazed heroin addict suffering through withdrawal, America is frantically tapping on its antecubital vein in eager anticipation of the next fix. Of course, Keystone XL hasn't been presented in this way. They say it's a bid for energy security, and that it will reduce our dependence on Venezuelan or Iranian oil. Lets just call it what it really is: giving more heroin to the addict. Building Keystone XL will be proof that America isn't ready to find help to get over its oil addiction, and it will be proof that we don't care about energy security, nor do we care about future generations.

Oil is traded on a global market, so any suggestion that Keystone XL is going to stick it to the Saudis by allowing America to import Canadian oil instead is absolutely ridiculous. In fact, the only way that Keystone XL will impact OPEC at all is if it significantly increased the global supply for oil - which it won't. The pipeline will bring in another 900,000 barrels per day. Considering that global production is about 85 MILLION barrels per day, excuse me, but whoop-de-fucking-do.

In fact, if I was OPEC I would WANT the Keystone XL project to come on-line. OPEC produces 30 million barrels per day and they are under intense international pressure to keep up unsustainable levels of production. They are using methods of oil extraction, because they are in such a rush, that will cause their wells to dry up more rapidly than they would if they could take things out a bit slower. Keystone XL will take the pressure off of OPEC. OPEC can just drop its own production by 900,000 barrels per day, global supply remains the same, the price doesn't budge, and OPEC sacrifices a tiny bit of income now for higher-endurance production in the future.

American politicians always harp about two things: energy security, and watching after our children. What could be more secure than leaving a giant untapped oil field in North America? What would be a better gift to leave our children? The truth is, global oil production right now is quite stable, and our economy is starting to turn around. We don't NEED the oil that Keystone XL would deliver right now, but it would allow us to continue our addiction. What if someday there is a world war of a geologic catastrophe? What if oil flies over 300 dollar per barrel, threatening even access to our military and basic civilian functions? Having a giant reserve in Canada waiting for us is the ULTIMATE energy security. It is a giant piggy-bank that our children could break in a dire emergency.

Even if Keystone XL went straight to American oil markets (it won't), and even if it could all be used for any purpose (it can't), it would only satiate 4.5% of American demand for oil. Another way to achieve energy security, which would be exactly equivalent to making Keystone XL, is to DECREASE our oil consumption by 4.5%. We can (actually, will be forced to whether we like it or not) build an economy that is less reliant on oil. Currently our development is a model of inefficiency. Our cities sprawl ever outward, fueled by cheap gasoline. Government continues to subsidize roads and highways, to connect every random distant suburb to its nearby strip-mall. Why not encourage more dense urban development? Why not push our cities to rely more on the foot, the bike, light rail, or trains - and away from the car? Why not encourage Americans to carpool more?

Well the real answer is this: we don't need to encourage any of these things because the market will do it for us. As long as oil prices remain high, we will begin to shift to a post-petroleum economy. Again, this is an inevitable transition. It makes no sense to me to delay that shift when world oil production is so stable right now. It makes no sense to raid a secure deposit of resources that our children may have a vital need for in the future because we want low-hanging fruit now.

On Traveling, Surgery Residency, and the Intensity of Experience

In his recent book "Thinking, Fast and Slow", Daniel Kahneman expands upon an interesting concept. He describes two ways that human beings perceive reality: the experience of the present and the remembrance of the past. He calls them our "experiencing selves" and "remembering selves" and shows that they often fail to come to a consensus, as illustrated by a beautiful experiment with absurd results:

Participants are subjected to two forms of torture. In one form, the participant's hand is immersed in painfully cold water for 60 seconds. In the other, the hand is immersed in the same painfully cold water also for 60 seconds, at which point the water is warmed 1 degree Celsius and the participant must now endure 30 more seconds of slightly less painfully cold water, for a total of 90 seconds.

If I was going through this torture, at the end of 60 seconds I would obviously prefer to just take my hand out of the water instead of endure another 30 seconds of still very cold water! And most people, if given that option at the time, would do the same. Remarkably, if the participants are later asked which form of torture they prefer, they actually choose the 60 + 30 instead of just the 60. They are voluntarily willing to subject themselves needlessly to an additional 30 seconds of pain!

Why does this happen? Kahneman explains that while the duration and aggregate of an experience might matter to our experiencing selves, those details are easily glossed over by our remembering selves. In fact, our remembering selves focus disproportionately on the beginning, end, lows, and highs of an experience. Another question is posed by Kahneman: would you bother to go somewhere on a vacation if you would have complete amnesia of the entire trip? I'm not sure I would. At that point, relaxation is the only thing that matters (and maybe sun exposure). I might opt for Florida instead of the Bahamas or somewhere more exotic, if I was going to go anywhere at all.

The conflict between our experiencing and remembering selves was an interesting subject for me to read, because it neatly explains a paradoxical trend I had noticed: I remember some situations as being better than I know they actually were at the time (if I am thinking of the sum of the entire experience in aggregate). For example, one of my favorite semesters as an undergraduate was the spring of my junior year, but I also know with certainty that I was insanely busy, studied harder than I ever had, and went out very infrequently. I remember my social life being significantly better than average that semester, which I know empirically is not actually true (I even went to bed early on my 21st birthday because I had a physics test the next week, to the chagrin of my roommates at the time).

In light of Kahneman's book, it makes perfect sense. I didn't go out as frequently, but when I did, it was a much more intense experience. Going out after two weeks studying is just a different feeling than going out for the fourth night in a row. In fact, I remember having significantly MORE fun in medical school than I did in undergrad. Frequency matters less than intensity of experience.

I've noticed this paradox about traveling as well. Traveling is by definition not a relaxing experience (that would be vacationing). Right before medical school I went on a 6 week trip through Europe with some friends. It was a mad rush, to fit in as much as possible, stopping at places sometimes for only 1-2 days before moving on. The trip was exhausting, I remember thinking on more than one occasion. Yet, my remembering self recalls more easily the positive experiences - which were many, and noteworthy, and easily forgets the baseline exhaustion of the grind of intense traveling. This phenomenon can be explained graphically, with the spikes representing the intensity of experiences while the baseline is the quality of life day-to-day. When traveling, there is an obvious sacrifice of short term conveniences, habits, and luxuries for the opportunity to have heightened experiences:

I chose to go into surgery, which as a career has a reputation of being brutal. The long hours and the daily grind mean that I know my experiencing (present) self is, while maybe not completely miserable, certainly wishing I had chosen a more relaxing life. There is a conflict, because when my remembering self recalls the last six months, it think it has been one of the best times of my life. My experiencing self thinks surgery residency is tough and often painful, but my remembering self thinks its great and not so bad. I remember the interesting surgical cases, complex patients, and funny stories - not the long hours.

Like is the case when traveling, I've sacrificed my experiencing self for the sake of the remembering self, in this instance the sacrifice being ample sleep, free time, etc. I am compensated by doing really neat things on occasion. Finally, recall the anecdote from my junior year in undergrad: in residency, when I do get time off, its much more high impact. The fact that I only get every other weekend off on average is more than compensated by the fact that each weekend has 2-3 times the impact that they used to.

I suppose this is something to think about, whether traveling or choosing a career path. Perhaps the difference maker for me is that I am too willing to make decisions based on the preferences of my remembering self. Still, for a person choosing whether or not go to into medical school, or whether or not to go into surgery, "long hours" is something I am glad I never put too much weight on (because hours are essentially forgotten by the remembering self). Like a person who subject themselves to 30 seconds of needless pain in Kahneman's torture experiment, I would choose surgery residency all over again, even if my experiencing self would prefer a more laid back profession. Absurd results, indeed.

Tuesday, December 06, 2011

How Doctors Die

Loved this.

Its a shame that Sarah Palin so completely poisoned the well with her "death panel" comments. A conversation about how we should approach patients at the end of life is something that this nation badly needs.