Letters to the Editor

Editor’s note: The following comments were received regarding a recent article published in the Bulletin.

Letters should be sent with the writer’s name, address, e-mail address, and daytime telephone number via e-mail to dschneidman@facs.org, or via mail to Diane Schneidman, Editor-in-Chief, Bulletin, American College of Surgeons, 633 N. Saint Clair St., Chicago, IL 60611.

Letters may be edited for length or clarity. Permission to publish letters is assumed unless the author indicates otherwise.

Climate change article presents only one side of the story

Mr. Fox’s article on climate change (“Climate change: What does it mean for the future of surgery?”) in the September 2019 Bulletin of the American College of Surgeons* is not accurate and does not meet the standards of the American College of Surgeons.

The initial point made in the article was: “Perhaps the health effect that most directly affects surgeons is the increase in extreme weather events.” Yet there is little evidence that this is happening.

Chapter 2 of the Fourth National Climate Assessment states, “Observed trends and projections of future changes in severe thunderstorms, tornadoes, hail and strong wind events are uncertain…tornado activity in the United States has become more variable, particularly over the 2000s, with a decrease in the number of days per year with tornadoes and an increase in the number of tornadoes on these days…there is only low confidence in observations that storms have already become stronger or more frequent.”1

From the Fifth Assessment report of the Intergovernmental Panel on Climate Change (AR5), chapter 10, page 5:

In land regions where observational coverage is sufficient for assessment, there is medium confidence that anthropogenic forcing has contributed to a global-scale intensification of heavy precipitation over the second half of the 20th century. There is low confidence in attributing changes in drought over global land areas since the mid-20th century to human influence owing to observational uncertainties and difficulties in distinguishing decadal-scale variability in drought from long-term trends. {10.6.1, Table 10.1}

There is low confidence in attribution of changes in tropical cyclone activity to human influence owing to insufficient observational evidence, lack of physical understanding of the links between anthropogenic drivers of climate and tropical cyclone activity and the low level of agreement between studies as to the relative importance of internal variability, and anthropogenic and natural forcings.2

Again, from organizations that many (with reason) believe are partial toward the manmade climate change ideology, there is minimal endorsement of Mr. Fox’s statement about an extreme weather events increase.

Mr. Fox says, “Climate change is increasing the amount and severity of extreme heat events around the world, with the number of people who experienced extreme heat increasing by more than an estimated 125 million from 2000 to 2016.” Such a calculation needs to be analyzed in terms of how world population has increased over that interval, especially in hotter environments. Many of the countries with hotter environments are low-income countries with a higher population growth, and such population growth could logically and simply be responsible for the statistic Mr. Fox cites.

Concern over the fatal effects of extreme heat are mentioned. However, a recent article in The Lancet documents the far greater lethality of cold weather rather than hot weather: “Can we sustain success in reducing deaths to extreme weather in a hotter world? In an incredible story of human adaptation, the aggregate global risk of mortality to extreme weather declined by over two orders of magnitude over the past century.”3,4

Mr. Fox’s mention of air pollution serves only to confuse the purpose of the article; certainly air pollution is a legitimate health concern, but not directly related to the question of “manmade climate change” in terms of the decarbonization crusade.

Mr. Fox’s concern about rising global temperature increasing some diseases, as referenced by the Lancet article, is speculative, with “model projections suggest” that “vectorial capacity” will increase. Apparently, there is minimal firm evidence at present that that is the case.

Probably the fundamental health and economic issue here is “decarbonization”; that is, the purported necessity to reduce carbon dioxide in the atmosphere. The massive uncertainties in the reasoning that decarbonization is necessary and has a favorable cost-benefit profile is not closely examined in this article, and in fact, there is good reason to believe it will cause more harm than good, especially in poorer countries.

Unfortunately, Mr. Fox’s article endorses an ideology, and is not a careful and critical appraisal of the facts at hand concerning “manmade climate change.” Just as in the operating room, careful and critical thinking is essential in matters of public policy.

George Chovanes, MD, FACS, FAANS
Allentown, PA

I read with dismay the September 2019 Bulletin article “Climate change: What does it mean for the future of surgery?” I was trained in meteorology and earned a bachelor of science degree in physics prior to becoming a general surgeon. Although that doesn’t provide me the credentials to be a climatologist, it provides me with critical thinking skills.

The author of this article failed to provide readers with primary source verification of climate data, which has been uniformly corrupted. The resultant public hysteria has now reached the American College of Surgeons. To wit:

  • Extreme heat events: The author writes, “Climate change is increasing the amount and severity of extreme heat events around the world.” False. See Figure 1. Although this graph only represents weather conditions in the U.S., our nation has the most comprehensive record, and data after the 1970s accurately reflects raw satellite data before it was manipulated. Extreme heat and cold events are a false metric for climate change.The author states, “A primary driver of climate change is the increased global burning of fossil fuels and coal, which emits a high amount of carbon dioxide.” False. The sun is the primary driver of climate change. If the author took the time to look at solar cycle 24 (see Figure 2), he would understand the cyclical nature of climate and be concerned. This shows the nearly identical pattern to the one prior to the mini-ice age, which started in 1645. Do not conflate climate change with pollution. CO2 is not a pollutant; it is essential for plant life, and plant life is essential for animal life.

Figure 1. 

Figure 1.

Figure 2.

Figure 2.

  • Climate-sensitive diseases: The author writes, “The rising global temperature has changed the capacity for the transmission of some insect- and water-borne illnesses, such as dengue fever, Lyme disease, and malaria.” False premise. As Figure 3 shows, global temperatures have not been rising. The only anthropogenic warming is by the corrupted data manipulation, raw actual data versus reported data. No plausible reason is given for the manipulation, and more than 60 percent of reported data are now calculated (unmeasured) by the computer models.

Figure 3.

Figure 3.

  • The author refers to “extreme weather events, such as prolonged, severe drought.” False premise. Contrary to every prediction by the “experts,” the U.S. has record low drought (see Figure 4).

Figure 4.Figure 4.There is no reason to offer solutions to a nonexisting problem. The real problem is junk science, incompetent journalists who fail to provide primary source verification, and a poorly educated public with limited capacity for critical thinking, placing them at risk for indoctrination and hysteria. Consensus is not science. True scientists understand the nobility of their profession, would never claim that “the science is settled,” would encourage robust debate, and would not engage in ad hominem attacks directed at those with an opposing viewpoint. Those who debase themselves in junk science to increase federal grants to their academic institutions at the expense of the truth deserve nothing short of expulsion from academia. The politicization of junk science results in junk policies and more than 50 years of false, apocalyptic forecasts (ice age, melting sea ice, ice free arctic, polar bear extinction, receding glaciers, and so on) do not serve the public interest. I am arrogant enough to challenge every “climate expert” in the world to a debate. I have a 23-slide, 15-minute presentation that would embarrass and humiliate them off the stage. This is serious because it is affecting public policy that will harm the middle class. First, do no harm.

Razi Saydjari, MD, FACS
Casper, WY

*Fox, M. Climate change: What does it mean for the future of surgery? Bull Am Coll Surg. 2019;104(9):12-20. Available at: http://bulletin.facs.org/2019/09/climate-change-what-does-it-mean-for-the-future-of-surgery/. Accessed November 20, 2019.


  1. Hayhoe K, Wuebbles DJ, Easterling DR, et al. Chapter two: Our changing climate. In: Reidmiller DR, Avery CW, Easterling DR, et al. Impacts, Risks, and Adaptation in the United States: Fourth National Climate Assessment, Volume II. Washington, DC. U.S. Global Change Research Program; 2018:72-144. Available at: https://nca2018.globalchange.gov/chapter/climate. Accessed November 6, 2019.
  2. Bindoff NL, Stott PA, AchutaRao KM, et al. 2013: Detection and attribution of climate change: From global to regional. In Stocker TF, Qin D, Plattner GK, et al. Climate Change 2013: The Physical Science Basis. Contribution of Working Group I to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge, U.K., and New York, NY: Cambridge University Press; 2014.
  3. Gasparrini A, Guo Y, Hashizume M, et al. Mortality risk attributable to high and low ambient temperature: a multicountry observational study. Lancet. 2015;386(9991):369-375.
  4. Mehrabi Z, Donner S, Rios P, Guha-Sapir D, Rowhani P, Kandlikar M, Ramankutty N. Can we sustain success in reducing deaths to extreme weather in a hotter world? World Development Perspectives. Available at: www.sciencedirect.com/science/article/pii/S2452292918301449?via%3Dihub. Accessed November 6, 2019.

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