Tuesday, December 30, 2014

LIPOSUCTION AND FRACKING – PAN’S PIPES AND 21st CENTURY EXISTENTIAL SOLUTIONS?



It’s that time of the year in the northern hemisphere, a week or so after the Winter Solstice, when you encourage yourself, using familiar landmarks, to imagine ( knowing it has already shifted a degree or so) that the sunset is not as far south-south-west as it was and when the thoughts of longer days and the advent of spring force a similar degree of separation from the past.  Those thoughts of the present and future coalesce into questions about the road ahead, for you as an individual but also for society in general.

In a most severe consequence of trying to address these questions and with often polar-opposite symptoms, the stress (or genetics, or drugs, or trauma) can cause an at-risk individual to suffer a pathological outcome, where at one end of the clinical spectrum a ‘deep’ despair may result and at the other a ‘high’ euphoria. Both of these severe manifestations result in a psychological inertia, where the questions and the answers become irrelevant. The process itself destroys. This might be termed an existential schizophrenia, a term borrowed from a recent address by Pope Francis to the Curia, the administrative and diplomatic section of the Vatican State, where he berated them for their failings. In between the extremes there is a supposed grounded or surface ‘normality’ where individual coping mechanisms, cope even if those questions remain unanswered.

I’d like to think of myself as a curious philosopher-of-sorts, armed with the tools of mathematical logic; tools honed over a lifetime’s experience to examine, dissect, and conclude upon the big questions. In truth I am not. All these years later, I realise that despite the enquiring curiosity I lack the intellectual perseverance to fully exhaust the analysis, knowing that for every questioned answered another is posed. Avoiding nihilism I escape again and again to whimsy, a coping mechanism that demands little, expects little and perhaps returns little apart from a fleeting moment of respite.

Part of my whimsical approach to the 'big questions'  often involves an association of images rather than specific ideas and a recurrent association in recent years has been a diagrammatic representation in my head of the similarities of hydraulic fracking to extract shale-gas from mother earth and tumescent liposuction to extract fat from humans.



FRACKING

Horizontal hydraulic fracturing (HHF) or “fracking” using high-pressure “slickwater” lateral fracturing of subsurface shale beds to recover hydrocarbon shale gas and light crude or “tight” oil has only been in commercial existence since the early 1990s but already its ability to extract high volume gas reserves has, in particular, revolutionised the North American energy market where some 4,000 HHF wells have been drilled (or old vertical bores re-drilled) and put into operation.

The unconventional gas (UG) HHF methodology has resulted in the commercial extraction of about 3.5 million barrels of tight-oil per day and 9.5 trillion cubic feet of shale-gas per year. This represents approximately 30% and 40% of the domestic US production of liquid fuels and natural gas respectively. In addition the production of HHF derived tight oil and shale-gas over the next 10 years is projected to grow by 30% and 60%.




As a consequence of the success in shale-gas extraction US domestic gas prices have dropped by about 60%, the US is considering building liquid petroleum gas refineries to export gas (up to now the US has been a dominant importer of LPG products and never established a capacity to actually produce and export) for the first time. This sudden and dramatic turn-around in US domestic energy supplies, allied to falling world-wide oil prices due to oversupply, has re-invigorated a fading imperium, both at a commercial and existential level.

Worldwide UG production using HHF technology is set to meet 25% of all energy needs by 2035 and will also alter the international geopolitics of energy exploitation as the geographic distribution of largest shale reserves differs from that of the fossil-fuel reserves. For example Canada and Argentina have some of the biggest reserves in the world.

The downside is sub-stratum destabilisation and the potential for contamination of the water table. HHF is an intensely water-dependent technology and added to the hydraulic drilling water (slickwater) are a number of chemical solvents constituted to maintain the integrity of the boring technology, as well as surfactants and the proppants such as quartz crystals used to sustain the induced fractures to ensure the extraction flow of gas. Currently many of the US drillers store the “de-gassed” slickwater in on-site extraction ponds and allow the water to evaporate. The resulting HHF “mud” contains high concentrations of the chemical solvents used.



LIPOSUCTION

In 1921 Dr Charles Dujarrier, a French Gynaecologist attempted to reshape the “fatty” ankles and knees of a patient of his who was a dancer and did not like their appearance. He used a uterine curette but managed to tear her femoral artery resulting in the dancer requiring a leg amputation. It was not until 1976 that Arpad and Giorgio Fischer, father and son Italian cosmetic surgeons, introduced the modern technique of machine-suction assisted removal of fat with blunt curettes and called it liposculpture. The “dry” procedure was associated with significant blood loss, haematoma and seroma formation and as a consequence marginal cosmetic benefit.


Procedures by plastic-surgeons worldwide in 2010.
Lipoplasty primarily means liposuction. The total number
of procedures does not include procedures done by other specialists
such as dermatologists.


In 1987 – around the time that George P. Mitchell was developing and promoting horizontal hydraulic fracturing for shale-gas recovery – Dr. Jeffrey Klein, a Californian Dermatologist, evolved the 1983 Fournier and Illouz “wet” tumescent or hydraulic technique to constitute a mixture of physiological saline, local anaesthetic and a vasoconstrictor to reduce blood loss. Using this approach most liposuction procedures could then be done as office or side-room procedures. In the years since the volumes of tumescent fluid have increased thereby increasing the amount of fat that could be aspirated at one session. Other promoted advances such as ultrasound or laser probes designed to break down the fat to make for easier aspiration have not surpassed the tumescent technique in overall safety and outcome.

Why such popularity in liposuction?

Where weight reduction is considered morbid obesity in the developed world is becoming a major health problem. Amongst other intervention strategies many people associate liposuction with weight loss and thus consider the procedure. Indeed the results concerning weight loss following liposuction are equivocal with some studies reporting that 50% of patients report a weight gain. An interesting Norwegian study in 2010 showed that the presence of an eating disorder was a significant predictor of an interest in having liposuction performed.

The main drive of course is appearance. We have idealised notions of ourselves and others and what constitutes animal attractiveness. The desire to attain, maintain and regain this “attractiveness” has always been and will always be a part of human existential being.



EXISTENTIAL SOLUTIONS AND PAN’S PIPES.


The last 15 years have seen the introduction and indecently-fast adopted incorporation of two techniques, two solvent driven technologies designed to extract and thereby “shape” our world at an individual and societal level. The supposed – real and imagined – value-added benefits for the individual, geo-political and commercial sense of wellbeing have ensured that the hazards – physical, psychological and geological – are downplayed and marginalised for the greater good.

These are existential questions: For the present autologous fat and shale-gas are the Ambrosia of the 21st Century: there is an expectation that to extract, to consume, to attract is to survive.

George P. Mitchell, the pioneer of shale-gas fracking, was an Arcadian. His parents were immigrants from Arcadia in Greece surnamed Paraskevopoulos, and whose father adopted the name Mike Mitchell. Arcadia in Greek mythology and religion was the principal home of worship to Pan, the ancient lecherous Greek God of the Wild, and inventor of the famous pipes. For the mythological inclined Pan and Asclepius (the God of Medicine) were the only Greek gods to actually die and this is perhaps salutary when we consider the medical and geological futures of hydraulic or tumescent drilling. It is also ironic that it is Pan’s fellow Arcadian who has become the subject of equal veneration all these millennia later.




Have a good 2015.


Saturday, December 06, 2014

Troubadours & Tinsel

THE STREETS OF GALWAY, IRELAND 
5th DECEMBER 2014


Footlights


Puffin Palace


Old Friends



(S)Mitten Chords


Time of Day


Pane Sailing




Order & Chaos



A Rebel Face



Blackboard 


Treasure Trove





Squeezed 1


Squeezed 2



Drunk Decorations





Its around here somewhere!


Sunday, November 09, 2014

The Bâdgirs (Windcatchers) of Galway

The Bâdgir (Windcatcher) of Galway

While reading a recent edition of the Galway Advertiser I was dismayed as much by the report of the council debate on the uncertain future of the new Pálás arthouse cinema at the junction of Merchants Road Lower and Dock Road as I was by the use of the old computer generated design image of the building itself.

The Pálás Arthouse Cinema from the south-east.

A recent ‘real’ photograph, taken from the same angle as you turn the corner on Dock Rd and head towards Jury’s Inn, would have revealed a building and would have revealed a design nuance, that for me at least, is as evocative an architectural feature as any in the city, if not further afield.


The Pálás Cinema behind Longwalk rooftops

In its most profound manifestation architecture as a human endeavour has sought to enable mankind’s dialogue with the Gods, and from the very beginning, has involved creating a structural conversation that reached out to the heavens. I think of the upright carved pillars of the Neolithic hunter-gatherer temple complex in Göbekli Tepe, Turkey from c. 10,500 BC, the ziggurats and pyramids of Sumer and Egypt, the entases of Greek and Roman worship, the high-arched Gothic cathedrals of medieval Europe, to that most modern manifestation of human outreach, the soaring Burj Khalifa tower in Dubai.

In appreciating architecture however, particularly the architecture of the profound, both religious and secular, there is generally an onus placed on us as mortals to experience a designed harmony of the whole and to participate in and submit to the unity of that vision of engagement. What really excites me though, in architecture, are those occasions often at the periphery to the grand vision, to the worship, when a chanced-upon structural nuance, created either accidentally or by design, exists where functionality and flamboyance suddenly fuse and surprisingly confuse.



The ventilation vents at south-east corner of Pálás cinema.

Every time I turn the Dock Road corner and draw close to the Pálás site, but most particularly in the morning sunlight, one such architectural nuance always makes me reflect, always makes me engage with the building more. The nuance? The cold mundane steel ventilation grills that you can see on the south-east back wall of the Pálás arthouse, which both in function and design remind me so much of the Bâdgirs of Yazd, a city in Iran that I had the pleasure of visiting about five years ago.


The Rooftops of Yazd, Iran

Four Bâdgirs cooling a domed Ab-Anbar water reservoir


A Bâdgir in Yazd

Bâdgirs or Wind-catchers (from Persian bâd “wind” and gir “catcher” ) are an ancient architectural feature of the hot and arid central Iranian plateau, and in the simplest single-sided version are designed to draw in the main prevailing wind creating an airflow through the building, sometimes passing over columns of wetted curtains, and by allowing the air to exit on the leeward side, cool the interior. In the city of Yazd in Iran traditional wind-catchers are often engineered to be used in combination with the qanat underground water systems that bring cool snow-fed waters from the surrounding high mountains to establish almost a refrigeration effect. In modern times the engineering principles underpinning Bâdgirs have become a feature of Sustainable Architecture in many parts of the world.


Bâdgir engineering principles

In an e-mail conversation with the architect of the Pálás arthouse cinemas ( there are three cinemas contained within the building on three levels), Tom dePaor  (who must be equally frustrated by having his beautiful building lie fallow) he explained his design for the ventilation grills as, 

My intention was only to express, if not exaggerate the air intake and extract of the building – something which is normally supressed in contemporary construction.

Returning to my original declaration of love for the nuances of function and flamboyance in architecture this is the reason I find the wind-catchers of Galway’s Pálás cinema so appealing. And to further emphasise this attraction Tom dePaor also detailed another feature of his ventilation design when he explained, that the air intake for the lower cinema comes through the carved-out letters of the cinema itself.


Air Intake for ventilation is through the Pálás lettering

I do hope the future of this iconic and sustainable building will be sorted out soon. In a sad way a sign on the site somehow sums-up the current impasse.


Sign in rubble tip on Pálás site


Monday, October 27, 2014

From Black Death to Ebola; from Ragusa to New York: Commerce, Civil Liberty and the return of the Trentina



"among those who escaped from Caffa by boat were a few sailors who had been infected with the poisonous disease. Some boats were bound for Genoa, others for Venice, and to other Christian areas. When sailors reached these places they mixed with people there, it was if they had brought evil spirits with them: every city, every settlement, and their inhabitants, both men and women, died suddenly...We Genovese and Venetians bear responsibility for revealing the judgements of God."

Gabrille De"Mussi, A Genovese Lawyer writing in late 1348

In the same year, 1348, that De’Mussi wrote his commentary a Report of the Medical Faculty of Paris, commissioned by King Philip VI of France, examined the probable causation of the outbreak of Bubonic Plague in Europe and came to a very different conclusion. The august members of the Faculty blamed the ‘Black Death’ on the celestial conjunction of Saturn, Jupiter and Mars that had occurred on the 20 march 1345!!! 

Venetian Plague-Doctor's mask with Jani Beg and the 
depiction of Mongol mangonels in action.

The real explanation for the lethal pandemic which ravaged Europe and decimated half the population of the Mediterranean basin (estimates of 75-200 million) of course was the presence of plague-carrying rats that had devastated the Mongol armies under Jani Beg, Khan of the Golden Horde, which had besieged the Genovese port of Caffa (Feodosia) in the Crimea in 1345. Jani Beg, in frustration at having to break off the siege, ordered the catapulting with mangonels of the rotting corpses of his dead soldiers into the city. Escaping Genovese ships, loaded with grain, people and rats brought the Yersinia pestis bacillus (Plague) first to Constantinople, then Sicily and then to all ports beyond from Mid-October 1347 – mid-March 1348, thereby rapidly accelerating the spread of the disease beyond the lands of the Golden Horde.

Dubrovnik (Ragusa) – Approaching from the South

Early Quarantine Stations for Republic of Ragusa 1377

In 1377 the Republic of Ragusa (Dubrovnik), a rich maritime state which depended almost entirely on the flow of commerce through its city, to try and prevent outbreaks of plague in the city, introduced as a public health initiative the Trentina Ordanance which mandated that all ships and their crew, goods and passengers from plaque infected areas must lay-up at the islands of Mrkan and Bobaro (off Cavtat) for thirty days. A similar facility for land-based arrivals existed outside the city walls and for these a period of forty days, the Quarantina was imposed. Ragusa established its first purpose-built quarantine facility or lazzaretto for maritime traffic on the island of Mljet in 1397 and this subsequently moved to a land-based facility on the Danče peninsula to the west of the city in 1430.




"Be it therefore determined that our Provveditori al Sal shall by the authority of this Council cause a hospital (locum) to be built on the Vigna Murata (Sant’Erasmo), as they see fit, and those who have left Nazareth (Lazzaretto Vecchio) after being cured must go to this hospital and remain there for forty days before they return to Venice."

Venetian Senate Decree 18 July 1468

Ragusa’s overlords since 1205, the Most Serene Republic of Venice (when the returning Venetian fleet of the IVth Crusade and the new Patriarch of Constantinople Tommaso Morosini took control) established its own quarantine facility on the small island of Santa Maria di Nazareth (renamed the Lazzaretto Vecchio) off the Lido with a Senate decree in 1423 and a further convalescent facility, the Lazzaretto Nuovo in 1468 on the island of Sant’Erasmo. The finance for the building of these came from the commercial Proviveditori al Sal (Salt Office) and were then subsequently overseen by the Health Office who could issue their own ordanances.

Venetian Quarantine and Isolation Facilities

In practice the lazzaretto vecchio was run as an isolation (from isola or island) unit, where infected people were brought, and people who had died from the plague both on and off the island were buried. An individual could only be transferred to the Lazzaretto nuovo, a true quarantine facility i.e. where non-infective or cured people were detained once his cure was confirmed. The management of plague outbreaks was aggressive and highly proscribed. A cure was determined if the individual had survived the disease and had had his buboes or abscesses lanced and healed. Once this was determined he would be transferred to the lazaretto nuovo but could take no goods with him, and had to spend fifteen days in the pra part of the facility, then fifteen days in the sanita part before being let go home where he had to spend another ten days in quarantine under a ban on outside movement. At the height of the plague outbreak in 1575 some 6000-8000 people languished and died in the lazzaretto vecchio.

Pieter Bruegel-the-Elder's depiction of the Black Death attendants 
and their modern Ebola equivalents. 
The white shrouds have not changed much!!!

The difference between quarantine as a preventative measure and isolation as a treatment measure continues to be blurred. In the US, the Centers for Disease Control and Prevention (CDC) define isolation as “separating ill persons who have a communicable disease from those who are healthy” and quarantine as “separating and restricting the movement of well persons who may have been exposed to a communicable disease to see if they become ill.”

On the 24th October 2014 the Governors of New York and New Jersey, Andrew M. Cuomo and Chris Christie in response to the case of a medical doctor returning to the US with established Ebola infection, imposed a mandatory quarantine of 21 days on all medical workers returning from West Africa if they had had contact with Ebola patients. The first person detained under this edict, a nurse Kaci Hickox, who is asymptomatic and has tested negative for Ebola, has been detained in an unheated tent on the grounds of the University Hospital in Newark, New Jersey.

This resurrected Ragusan Trentina edict of the two Governors has created an enormous ‘civil liberties’ outcry but does, because two States have made a conjoint decision, have a basis in Federal Law but only it appears if the US Secretary of the Treasury has given the go-ahead.



Article I, section 8 of the US Constitution (the so-called Commerce Clause) grants Congress the power to “regulate Commerce” with foreign Nations, States and the Indian Nations. Using the remit of the Commerce Clause the US Congress passed its first federal quarantine law (to contain Yellow fever) in 1792. The law did not allow federal authorities to promulgate quarantine procedures of their own but allowed those authorities to assist State officials, upon request, in enforcing their own quarantine measures. The Act was repealed in 1799 to be replaced by slightly more robust measures and transferring authority for its implementation to the Secretary of the Treasury (Act Feb 25,1799, ch 12, 1 Stat 619).

A US Supreme Court judgement in 1886 ( 118 U.S. 455) in Morgan’s Steamship established that quarantine in the maritime context was to be subject to the federal Commerce Clause and in 1890 an Act to Perfect the Quarantine Service was passed which granted the Secretary of the Treasury power to develop regulations beyond just the maritime context. Further and further court decisions re-enforced the federalisation of quarantine and in 1921 New York State was the last state to transfer its quarantine facilities to federal control.

In a 1942 decision in Wickard v. Filburn (317 U.S. 111 [1942]) the US Supreme Court determined that any activity that would have an economic effect on inter-State commerce was subject to the Commerce Clause. Two years later the Public Health Service Act (PHSA) was passed invoking these powers. The segment of the Act devoted to civilian quarantine and isolation is codified at 42 U.S.C. § 264 (d) (1) and states:

Regulations prescribed under this section may provide for the apprehension and examination of any individual reasonably believed to be infected with a communicable disease in a qualifying stage and (a) to be moving or about to move from a State to another State; or (B) to be a probable source of infection to individuals who, while infected with such a disease in a qualifying stage, will be moving from a State to another State.

The PHSA thus legislated for the potential of any individual to disrupt directly or in a far more draconian fashion, vicariously inter-State commerce, by having quarantine regulations enforced. In most decisions since 1944 the US Supreme Court has been consistent in holding that the quarantine provisions in the PHSA as enabled by the Commerce Clause are constitutional but they do imply a volition or activity on the part of the individual that could disrupt that commerce.
  
The notion of activity, inactivity and compulsion as defined by the threat to inter-State commerce have yet to meet the challenge to constitutionality presented by a recent Supreme Court in National Federation of Independent Business v. Sebelius (2011) which held that the Commerce Clause does not regulate for “inactivity”. According to the decision, and to use a rather broad example, Congress and by extension the Federal authorities under the Commerce Clause cannot legislate for ‘breathing’ but only for breathing in certain places.

New York and New Jersey States have decided to go their own way for now and not wait for a federal mandate. New Jersey has decided to allow quarantine at people’s homes for 21 days but this leaves Kaci Hickox, who lives in the State of Maine in limbo. Under Commerce Clause authority New Jersey has decided to quarantine her, as a non-resident and therefore a risk to interstate commerce, in a tent on a New Jersey medical facility. The mere fact that she might make the effort to go home means that her actions are no longer considered ‘inactive’. You can be sure that State lawyers are already preparing for a constitutional challenge with this authority in mind. Unlike Kaci Hickox, in 1664 the famous Turkish traveller Evliya Çelebi was very impressed with the conditions and management of the quarantine facility he visited in Ragusa (Dubrovnik).

Piri Reis' Dubrovnik

From Ragusa, Venice and France in the 1370s, to New York and New Jersey in 2014, from Black Death to Ebola, the management of pandemics are certainly a public health issue and in our ever shrinking world requires a world-wide response which does not certainly include punishing volunteer medical and non-medical staff for responding to that need. The basis for the quarantine of the well, the legality or illegality of detention, is not a medical issue but a commercial one. Quarantine has always been driven by commercial concerns and used law as a tool to protect those concerns.

Now that the Trentina has been re-entrenched in New York and New Jersey 650 years after it was first introduced in Ragusa, and 220 years after the powers to institute quarantine began to be removed from State to Federal control, perhaps those States are now determined to re-establish some quarantine facility on an offshore island. To be renamed the lazzaretto cuomo-christie no doubt! Guantanamo Bay in Cuba would probably suffice as such a site, given that its current quarantined detainees under the War Against Terror powers of the Patriot Act, are already governed by the constitutional provisions of the Commerce Clause!!

UPDATE: 27th OCTOBER 2014



The New York and New Jersey State threat to Federal control of quarantine provisions has forced the Obama administration and the CDC to issue guidelines and by extension regain that control. 

Kaci Hickox has gone home to Maine where she has also run into conflict with the Maine Governor's quarantine regulations. New Jersey Governor Chris Christie said that if she wishes to sue him for infringing her civil rights, she should "Get in line." 

    

References:

http://www.cdc.gov/quarantine/specificlawsregulations.html
http://www.huffingtonpost.com/2014/10/27/un-ebola-quarantine_n_6054592.html
http://www.nj.com/politics/index.ssf/2014/10/chris_christie_to_maine_nurse_go_ahead_sue_me_over_ebola_quarantine.html#incart_story_package

http://www.nytimes.com/2014/10/30/us/kaci-hickox-nurse-under-ebola-quarantine-threatens-lawsuit.html?