Scientists sound the alarm over a concerning phenomenon observed in the ocean: ‘This is worrying news’
Stephen Proctor – November 4, 2023
Scientists are worried that the recent extreme ocean warming is a sign we haven’t kept up with how quickly the planet is changing. Countries have reported some of the warmest temperatures in recorded history, and the same can be said for the waters from the North Atlantic to Antarctica.
What’s Happening?
The oceanic heat wave is hitting both sides of North America. Waters off the coast of Florida and the western coasts of the U.S. and Canada are alarmingly warm. The Western Mediterranean, off the coasts of Southern Spain and North Africa, is also warmer than average. The same can be said for the Baltic Sea and the water around New Zealand and Australia.
A recent report showed that the number of these heat waves in ocean waters doubled between 1982 and 2016, noted the BBC, and the heat waves have also worsened considerably.
“This is worrying news for the planet,” said Christopher Hewitt, director of climate services for the World Meteorological Organization, in a news report from the WMO.
Why is the marine heat wave concerning?
Marine heat waves can negatively affect ocean life, the fishing industry, and weather patterns.
These heat waves can cause fish to die on a large scale and coral reefs to undergo “coral bleaching.” The warmer water also changes the behavior patterns of marine life, making it harder for fishermen to locate and catch enough to sustain their livelihood. Alaska was forced to cancel the snow crab harvest in 2022 because the billions of crabs that historically called the Bering Sea home had all but disappeared.
An even more concerning effect of these marine heat waves is the threat they pose to the Atlantic Meridional Overturning Current, which is basically a giant global conveyor belt of ocean water.
Water in the AMOC travels from the tropics to the North Atlantic, where it cools and becomes saltier, then sinks deep into the ocean before traveling back south and repeating the process. The AMOC is crucial in regulating global weather patterns, including the jet stream.
If the water in the North Atlantic becomes too warm, the AMOC could slow down or even stop, resulting in extreme changes to the weather around the world. Scientists say this could happen sometime between 2025 and 2095, reported CNN.
What’s being done about marine heat waves?
A group of scientists from around the world is working to better understand marine heat waves, what causes them, their effect on the climate, and their effect on the environment around them. While there’s still a long way to go, a team in Australia was able to predict a marine heat wave several months out.
Florida voters are ‘hoodwinked’ alright. But not by women seeking abortion access | Opinion
Fabiola Santiago – November 2, 2023
The debate over abortion rights in Florida isn’t, as Attorney General Ashley Moody has alleged before the state’s highest court, too hard for voters to understand.
She underestimates us.
The issue boils down to basics: Who gets to make one of the hardest and most personal decisions a woman has to confront in her life? A choice that affects her physical and mental health forever.
Under the leadership of Gov. Ron DeSantis, Republican politicians decided last legislative session that they have the ultimate say — imposing on Florida’s 10.8 million women a near-ban on abortion, without giving any consideration of the opposition.
For years, the Florida GOP has been inching toward total control of this vital healthcare right, first coming after Planned Parenthood with bogus accusations, then banning most abortions after 15 weeks of pregnancy in 2022, with no exceptions for rape or incest.
With a Republican super-majority in the Legislature in place — and emboldened by the U.S. Supreme Court’s overturning Roe vs. Wade’s constitutional protection — the governor and lawmakers went quite far this year.
They passed, and DeSantis signed in a telling private ceremony in his office, a near ban by instituting a six-week limit on access. The restriction means that by the time many women find out they’re pregnant, they no longer can legally get an abortion in the state — and that any doctor performing the procedure could go to prison.
Now, DeSantis and Moody are trying to keep voters from fighting back, Kansas-style, by putting abortion on the ballot — and winning constitutional protection.
Did Republicans really think women and their male allies would sit back and allow politicians to take over bodily rights, family decisions and healthcare choices — without pushing back?
Now, the 15-week ban is under legal challenge in the state Supreme Court — and it’s not the only one.
A petition to put an abortion rights amendment on the November 2024 ballot that would prevent the outright ban the GOP ultimately wants — ensuring constitutional access against political whim — has gathered an impressive 500,000 of the 891,523 voter signatures needed by the Feb. 1 deadline.
The committee behind the petition, Floridians Protecting Freedom, has raised almost $5 million in six months. Both are strong indicators of voter support.
But, Moody claims, the ballot initiative is an effort to “hoodwink” voters and she calls the all-American democratic practice of activism to secure rights, “war.”
Florida voters are being hoodwinked alright. But it’s not by women seeking access to safe, legal abortion.
It’s by a Florida GOP doing the bidding of the wealthy, ultra-conservative Christian lobby buying political power — and doesn’t care if studies show that the women most affected by abortion bans are poor and dark-skinned.
By going straight to the state’s conservative Supreme Court to ask for a repeal of the petition, Moody shows that she’s running scared of voters’ will and complex points of view on abortion. She’s afraid they’ll exercise their say and vote in favor of constitutionally protecting abortion in Florida — as they did in 2018 when 65% voted to restore the voting rights of felons who done their time.
She has put forth no valid legal argument for seeking to quash people’s right to make their voice heard by unilaterally taking the proposed amendment off the ballot — especially before the committee has completed gathering signatures.
It’s not a democratic move on Moody’s part, but Florida’s autocratic Republicans are beyond caring about democracy and its institutions.
It’s their way or the highway, voters need not opine and neither should Democratic lawmakers. The abortion debate proved there’s no room for bipartisanship or working to reach a consensus.
Republicans assume that Florida is a blindingly red state, and people will keep voting for them in support of an increasingly intrusive, extremist agenda. That’s how it’s been in recent elections, but in the case of abortion restrictions, families are experiencing what it’s like to live under someone else’s choice when it’s their daughter, wife or girlfriend’s life on the line.
That’s when the public debate becomes deeply personal — and choice matters.
If Moody — or any other woman, for that matter — doesn’t want an abortion, she doesn’t have to get one. Under restrictions, women and families have no choice.
It is that simple.
No party, no politician should be making the decision for the woman who feels that having one more child may kill her. Or, for the teen swept away by hormones and false promises of eternal love whose future suddenly is a question mark.
With extremist DeSantis vying for the GOP presidential nomination and the privilege of leading the nation, Florida’s abortion rights debate becomes a matter of national importance.
DeSantis, who as Trump did nationally has stacked the courts with conservatives — at least two critical appointees, highly inexperienced — only serves a narrow sliver of the population. In other words, his view of governance is minority rule over the diverse majority.
If Florida’s attorney general prevails with the state Supreme Court and silences voters’ voice on a topic as crucial as abortion, she will have set a dangerous precedent.
Dead bodies litter Mount Everest because it’s so dangerous and expensive to get them down — and 2023 could be the most deadly season yet
Hilary Brueck, Ashley Collman and Maiya Focht – November 2, 2023
Scroll back up to restore default view.
More than 310 people have died climbing Everest since exploration first started in the early 1900s.
It’s dangerous to retrieve the bodies, so many litter the mountain to this day.
Many have blamed overcrowding for deaths in recent years, and 2023 saw a record number of climbers.
Dead bodies are a common sight on top of Mount Everest.
On average, six people die climbing the world’s tallest peak each year. The year 2015 was the mountain’s deadliest in recent history, when an avalanche killed 19.
Including sherpas that accompany climbers, that means about 900 people tried to summit the mountain from the South side during the main 2023 climbing season, which only lasts about eight weeks, each April and May
When people die on Everest, it can be difficult to remove their bodies. Final repatriation costs tens of thousands of dollars (in some cases, around $70,000) and can also come at a fatal price itself: Two Nepalese climbers died trying to recover a body from Everest in 1984.
Lhakpa Sherpa, who is the women’s record-holder for most Everest summits, said she saw seven dead bodies on her way to the top of the mountain in 2018.
“Only near the top,” she told Insider in 2018, remembering one man’s body in particular that “looked alive, because the wind was blowing his hair.”
Her memory is a grim reminder that removing dead bodies from Mount Everest is a pricey and potentially deadly chore.
These days, tourists spend anywhere from $50,000 to well over $130,000 to complete a once-in-a-lifetime Everest summit. It’s difficult to know for sure exactly how many people have died trying to get up and down, and where all those bodies have ended up.
Recent fatality estimates are as high as 322 after an especially deadly 2023 season. A BBC investigation in 2015 concluded “there are certainly more than 200” corpses lying on Everest’s slopes.
Some hikers are blaming the surges in deaths in recent decades, in part, on preventable overcrowding.
As May temperatures warm and winds stall, favorable springtime Everest climbing conditions sometimes only last a few days. These brief climbing windows can create conveyor-belt style lines that snake toward the top of the mountain.
Mountaineers line up as they make their way up a slope on Mount Everest on May 31, 2021.LAKPA SHERPA/AFP via Getty Images
Climbers can be so eager to reach the peak and stake their claim on an Everest summit that they develop what’s called “Summit Fever,” risking their lives just to make it happen.
Other Everest climbers complain about risky human traffic jams in the mountain’s “death zone,” the area of the hike that reaches above 8,000 meters (about 26,250 feet), where air is dangerously thin and most people use oxygen masks.
Even with masks, this zone is not a great place to hang out for too long, and it’s a spot where some deliriously loopy trekkers may start removing desperately-needed clothes, and talking to imaginary companions, despite the freezing conditions.
Getting bodies out of the death zone is a hazardous chore.
“Even picking up a candy wrapper high up on the mountain is a lot of effort, because it’s totally frozen and you have to dig around it,” Ang Tshering Sherpa former president of the Nepal Mountaineering Association, told the BBC in 2015. “A dead body that normally weighs 80kg might weigh 150kg when frozen and dug out with the surrounding ice attached.”
Mountaineer Alan Arnette previously told the Canadian Broadcasting Corporation that he signed some grim “body disposal” forms before he climbed Everest, ordering that his corpse should rest in place on the mountain in case he died during the trek.
“Typically you have your spouse sign this, so think about that conversation,” he added. “You say ‘leave me on the mountain,’ or ‘get me back to Kathmandu and cremate,’ or ‘try to get me back to my home country.'”
For years, Everest climbers often referenced one particular dead body they called “Green Boots” who some spotted lying in a cave roughly 1,130 feet from the peak. It was the body of Tsewang Paljor, a 28 year-old Indian climber who died on the mountain in 1996, during the same storm that inspired Jon Krakauer’s bestseller, “Into Thin Air.”
Pemba Dorjee Sherpa, who has climbed up Everest 20 times, at camp three on the mountain in Nepal, May 20, 2019.Reuters/Phurba Tenjing Sherpa
But in recent years, Everest’s most infamous corpse has been tougher for hikers to spot, leading to widespread speculation that the body was either moved, or covered by rocks, as climber Noel Hanna told the BBC.
Nepalese Sherpas generally consider it inappropriate and disrespectful to their mountain gods to leave dead bodies littering their holy mountain. In 2019, at least four bodies were taken down from the mountain by Nepalese trash collectors.
“There’s sort of this idea that there’s only one mountain that really matters in the kind of Western, popular imagination,” filmmaker and director Jennifer Peedom told Insider when her documentary, “Mountain” was released in 2017.
Peedom had climbed Everest herself four times as of 2018, but said the thrill of summiting Everest is largely relegated to the history books, and for “true mountaineers,” it’s just an exercise in crowd control these days.
“There seems to be a disaster mystique around Everest that seems to only serve to heighten the allure of the place,” she said. “It is extremely overcrowded now and just getting more and more every year.”
This story was originally published in May 2019. It has been updated.
US EPA needs to phase out food waste from landfills by 2040 -local officials
Leah Douglas – October 31, 2023
FILE PHOTO: Workers use heavy machinery to move trash and waste at the Frank R. Bowerman landfill in California
(Reuters) – A group of local U.S. government officials from 18 states on Tuesday urged the Environmental Protection Agency to phase out food waste disposal in landfills by 2040 to cut emissions of the potent greenhouse gas methane.
Food waste causes 58% of the methane emissions that come from landfills, the EPA said in an Oct. 19 report that calculated those emissions for the first time. The U.S. is lagging on a goal to halve food waste by 2030, and the EPA has been criticized for under-investing in the issue.
“Without fast action on methane, local governments will increasingly face the impacts of warming temperatures, sea level rise, and extreme weather events,” the officials, including the mayors of Seattle and Minneapolis, said in a joint letter to the agency.
They also asked the agency to update landfill standards to better detect and mitigate methane leaks.
More than one third of food produced in the U.S. is wasted, and methane emissions from landfilled food waste are growing, totaling more than 55 million metric tons of CO2 equivalent in 2020, according to the EPA.
Landfills are responsible for about 14% of U.S. methane emissions, according to the EPA. Methane is 28 times stronger than carbon dioxide as a greenhouse gas over a 100-year period.
Some cities and municipalities have voluntary household composting programs for food waste. Residents of New York City, which was not among the cities that signed the letter to EPA, will soon be required to separate food scraps from the rest of their household trash.
The EPA provides resources on its website for household food waste management and has a program for businesses to commit to cutting their food waste, though the agency does not verify their progress.
Food waste will be a priority at this year’s United Nations climate conference, to be held at the end of November in the United Arab Emirates.
(Reporting by Leah Douglas; Editing by Marguerita Choy)
Americans are still putting way too much food into landfills. Local officials seek EPA’s help
Melina Walling – October 31, 2023
Shredded organic materials are piled up before being taken to a anaerobic digester at a GreenWaste Zanker Resource Recovery Facility in San Jose, Calif., Friday, Oct. 27, 2023. For the first time since the 1990s, the EPA updated its ranking of preferred strategies for waste reduction, ranging from preventing wasted food altogether (by not producing or buying it in the first place) to composting or anaerobic digestion, a process by which food waste can be turned into energy in the form of biogas. (AP Photo/Jeff Chiu)A truck loaded with organic material exits a GreenWaste Zanker Resource Recovery Facility with the generators that will convert biogas into electricity at rear in San Jose, Calif., Friday, Oct. 27, 2023. For the first time since the 1990s, the EPA updated its ranking of preferred strategies for waste reduction, ranging from preventing wasted food altogether (by not producing or buying it in the first place) to composting or anaerobic digestion, a process by which food waste can be turned into energy in the form of biogas. (AP Photo/Jeff Chiu)Generators that will convert biogas into electricity sit at a GreenWaste Zanker Resource Recovery Facility in San Jose, Calif., Friday, Oct. 27, 2023. For the first time since the 1990s, the EPA updated its ranking of preferred strategies for waste reduction, ranging from preventing wasted food altogether (by not producing or buying it in the first place) to composting or anaerobic digestion, a process by which food waste can be turned into energy in the form of biogas. (AP Photo/Jeff Chiu)
CHICAGO (AP) — More than one-third of the food produced in the U.S. is never eaten. Much of it ends up in landfills, where it generates tons of methane that hastens climate change. That’s why more than 50 local officials signed onto a letter Tuesday calling on the Environmental Protection Agency to help municipal governments cut food waste in their communities.
The letter came on the heels of two recent reports from the EPA on the scope of America’s food waste problem and the damage that results from it. The local officials pressed the agency to expand grant funding and technical help for landfill alternatives. They also urged the agency to update landfill standards to require better prevention, detection and reduction of methane emissions, something scientists already have the technology to do but which can be challenging to implement since food waste breaks down and starts generating methane quickly.
Tackling food waste is a daunting challenge that the U.S. has taken on before. In 2015, the U.S. Department of Agriculture and the EPA set a goal of cutting food waste in half by 2030, but the country has made little progress, said Claudia Fabiano, who works on food waste management for the EPA.
“We’ve got a long way to go,” Fabiano said.
Researchers say the EPA reports provide sorely needed information. One report found that 58% of methane emissions from landfills come from food waste, a major issue because methane is responsible for about a quarter of global warming and has significantly more warming potential than carbon dioxide.
With the extent of the problem clearly defined, some elected leaders and researchers alike hope to take action. But they say it will take not just investment of resources but also a major mindset shift from the public. Farmers may need to change some practices, manufacturers will need to rethink how they package and market goods, and individuals need to find ways to keep food from going to waste.
So for the first time since the 1990s, the EPA updated its ranking of preferred strategies for waste reduction, ranging from preventing wasted food altogether (by not producing or buying it in the first place) to composting or anaerobic digestion, a process by which food waste can be turned into biogas inside a reactor. Prevention remains the top strategy, but the new ranking includes more nuances comparing the options so communities can decide how to prioritize their investments.
But reducing waste requires a big psychological change and lifestyle shift from individuals no matter what. Researchers say households are responsible for at least 40% of food waste in the U.S.
It’s a more urgent problem than ever, said Weslynne Ashton, a professor of environmental management and sustainability at the Illinois Institute of Technology who was not involved with the EPA reports. Americans have been conditioned to expect abundance at grocery stores and on their plates, and it’s expensive to pull all that food out of the waste stream.
“I think it is possible to get zero organic waste into landfills,” Ashton said. “But it means that we need an infrastructure to enable that in different locations within cities and more rural regions. It means we need incentives both for households as well as for commercial institutions.”
With the problem clearly defined and quantified, it remains to be seen whether communities and states will get extra help or guidance from the federal level — and how much change they can make either way. The EPA has recently channeled some money from the Inflation Reduction Act toward supporting recycling, which did include some funding for organics waste, but those are relatively new programs.
Some local governments have been working on this issue for a while. California began requiring every jurisdiction to provide organic waste collection services starting in 2022. But others don’t have as much of a head start. Chicago, for instance, just launched a city-wide composting pilot program two weeks ago that set up free food waste drop-off points around the city. But prospective users have to transport their food scraps themselves.
Ning Ai, an associate professor of urban planning and policy at the University of Illinois Chicago, said the report could be bolstered by more specific information about how different communities can adopt localized solutions, since preventing food waste might look different in rural and urban areas or in different parts of the country. But she was also impressed that the report highlighted tradeoffs of environmental impacts between air, water and land, something she said is not often as aggressively documented.
“These two reports, as well as some of the older ones, that definitely shows up as a boost to the national momentum to waste reduction,” said Ai, who was not involved with the EPA’s research.
Associated Press climate and environmental coverage receives support from several private foundations. See more about AP’s climate initiative here. The AP is solely responsible for all content.
SC wastes more food than any other state, new study shows. Here’s why and how much
Sarah Claire McDonald – November 1, 2023
With the coming months bringing seasonal food fads and festive holidays, food waste has the potential to be much more prominent around this time of year.
After Cherry Digital, a communications agency, surveyed 3,200 Americans to find out how much was thrown away this past year, it was discovered that U.S. households waste about $907 worth of food annually.
Food waste comes in to Re-Soil, near Elgin, and is composted over a 15 day period.
As for South Carolina, the reported estimation was much higher than the nation’s.
Residents in households around the Palmetto State were reported to waste over $1,300 worth of food each year, according to survey data from the study.
After the findings were broken down state-by-state, the survey found that South Carolinians were the most wasteful overall, getting rid of $1,304.68 worth of food each year.
The least-wasteful state in the U.S. is West Virginia, the study states. This state’s residents reportedly only throw away $404.90 worth of their annual groceries.
Although this could in part be due to wasted leftovers, there could be another issue afoot.
The survey shows that only one-quarter of people know what the “use-by date” actually means for peak product quality.
According to the findings, the survey displayed that 30.4% of individuals believed that this date means the last date the product was edible, 22% thought that it meant that it was the last date the food product could be displayed and sold in a store and 21% believed that it meant the date that the product would be at its best flavor and quality, which is the meaning behind a “best-by date.”
According to the United States Department of Agriculture Food Safety and Inspection Service (USDA FSIS), examples of commonly used phrases and their meaning include:
A “Best if Used By/Before” date indicates when a product will be of its best flavor or quality. It is not a purchase or safety date.
A “Sell-By” date tells the store how long to display the product for sale for inventory management. It is not a safety date.
A “Use-By” date is the last date recommended for the use of the product while at peak quality. It is not a safety date except for when used on infant formula as described below.
A “Freeze-By” date indicates when a product should be frozen to maintain peak quality. It is not a purchase or safety date.
The survey also discovered that, for food wasted, 51.1% of people believe that best before dates on fruits and vegetables should be ignored as “it’s easy to tell if something has gone bad,” as detailed by its findings. The study also discovered that the foods Americans would most likely throw away are dairy products at 46.6%, 22.3% for meat, fish at 19.2%, bread at 5.1% and vegetables at 8.5%.
Discarded rotten fruit left for waste after a market.
For those who don’t want their uneaten or unused food to go to waste, your local community may have several food drives, food banks and community help centers that will take all kinds of donations, especially around the holidays.
Although there could be several others, Feeding America’s website lets its users search for nearby affiliated food banks to donate. This website can be found online at https://www.feedingamerica.org/find-food-bank.
More than 50 officials call on the EPA to help local governments cut food waste in their communities
Joy Saha – November 1,2023
Person Throwing Pizza In Garbage Getty Images/Andrey Popov
On Tuesday, more than 50 local officials penned a letter urging the Environmental Protection Agency to phase out food waste disposal in landfills by 2040 to cut emissions of the potent greenhouse gas methane, Reuters reported.The letter came in the wake of two reports from the EPA that spotlights America’s food waste crisis and its detrimental environmental consequences. More than one-third of the food produced in the U.S. is never consumed. Much of that waste ends up in landfills, where it generates astounding amounts of toxic methane.
Food waste causes 58% of the methane emissions that come from landfills, the EPA said in an Oct. 19 report that calculated those emissions for the first time. The U.S. Department of Agriculture and the EPA set a goal in 2015 to cut food waste in half by 2030. But very little progress has been made and the EPA has been criticized for “under-investing in the issue,” Reuters said.
“Without fast action on methane, local governments will increasingly face the impacts of warming temperatures, sea level rise, and extreme weather events,” the officials said in their joint letter to the agency. They also called on the EPA to update landfill standards to “require better prevention, detection and reduction of methane emissions,” per ABC News. Landfills are responsible for about 14% of U.S. methane emissions, the EPA also found. Reuters added that compared to carbon dioxide, another powerful greenhouse gas, methane is 28 times stronger over a 100-year period.
New tool reveals swaths of American coastline are expected to be underwater by 2050: ‘Time is slipping away’
Brittany Davies – October 31, 2023
If you ask Climate Central — which has a coastal risk screening tool that shows an area’s risk for rising sea levels and flooding over the coming decades — Texas’s coastline is in trouble.
The new map-based tool compiles research into viewable projections for water levels, land elevation, and other factors in localized areas across the U.S. to assess their potential risk.
The predictive technology indicates that, under some scenarios, many of Texas’s coastal areas, such as much of Galveston Island, Beaumont, and the barrier islands, will be underwater during floods by 2050.
What’s happening?
Coastal areas face threats from rising sea levels caused by melting ice caps and warming oceans, as well as flooding from storms intensified by changing temperatures. The Environmental Protection Agency (EPA) estimates more than 128 million people live in coastal communities, many of which will be severely impacted by the effects of higher tides and dangerous storms.
CNN reports that coastal flooding could cost the global economy $14.2 trillion in damages, not including loss of life and well-being, by the end of the century. The loss of land due to sea level rise is also detrimental to the entire ecosystem, disrupting important wetlands and freshwater supplies.
Why is this concerning?
The coastal risk screening tool provides startling insight into how many areas will likely be affected by rising tides and floods, especially if nothing is done to mitigate Earth’s rapidly rising temperatures. As 2050 quickly approaches, time is slipping away to prepare and protect communities and ecosystems from the rising waters.
Planning, approving, and implementing new infrastructure and other major projects to keep communities safe can take years to complete. Because the wheels of bureaucracy turn slowly, cities need to start planning now before they find themselves in too deep.
What’s being done to reduce the risk?
Many of the most vulnerable regions are densely populated and people are already dealing with personal and economic damages from intensified flooding. While some may be able to move or make changes to their homes and communities to prepare for rising waters, not everyone has the means or desire to make these changes.
Several actions may be taken by individuals, organizations, municipalities, and the government to reduce the impacts of coastal flooding. The first step is understanding where the vulnerabilities are, indicates Peter Girard of Climate Central. Protecting existing wetlands and utilizing nature-based solutions such as living shorelines or sand dunes can lessen the impacts of flooding, storm surges, and erosion.
Community developers are encouraged to consider those most vulnerable when implementing coastal resiliency strategies such as shifting populations or building flood walls. Individuals living in flood zones should learn about the risks and obtain insurance protection if available.
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How a Lucrative Surgery Took Off Online and Disfigured Patients
Sarah Kliff and Katie Thomas – October 30, 2023
A binder holds up Sandy Aken’s stomach closer to her body at her mother’s home in Anaheim, Calif., on Sunday, Oct. 22, 2023. (Gabriella Angotti-Jones/The New York Times)
The bulge on the side of Peggy Hudson’s belly was the size of a cantaloupe. And it was growing.
“I was afraid it would burst,” said Hudson, 74, a retired airport baggage screener in Ocala, Florida.
The painful protrusion was the result of a surgery gone wrong, according to medical records from two doctors she later saw. Using a four-armed robot, a surgeon in 2021 had tried to repair a small hole in the wall of her abdomen, known as a hernia. Rather than closing the hole, the procedure left Hudson with what is called a “Mickey Mouse hernia,” in which intestines spill out on both sides of the torso like the cartoon character’s ears.
One of the doctors she saw later, a leading hernia expert at the Cleveland Clinic, doubted that Hudson had even needed the surgery. The operation, known as a component separation, is recommended only for large or complex hernias that are tough to close. Hudson’s original tear, which was about 2 inches, could have been patched with stitches and mesh, the surgeon believed.
Component separation is a technically difficult and risky procedure. Yet more and more surgeons have embraced it since 2006, when the approach — which had long been used in plastic surgery — was adapted for hernias. Over the next 15 years, the number of times that doctors billed Medicare for a hernia component separation increased more than tenfold, to around 8,000 per year. And that figure is a fraction of the actual number, researchers said, because most hernia patients are too young to be covered by Medicare.
In skilled hands, component separations can successfully close large hernias and alleviate pain. But many surgeons, including some who taught themselves the operation by watching videos on social media, are endangering patients by trying these operations when they aren’t warranted, a New York Times investigation found.
Dr. Michael Rosen, the Cleveland Clinic surgeon who later repaired Hudson’s hernias, helped develop and popularize the component separation technique, traveling the country to teach other doctors. He now counts that work among his biggest regrets because it encouraged surgeons to try the procedure when it wasn’t appropriate. Half of his operations these days, he said, are attempts to fix those doctors’ mistakes.
“It’s unbelievable,” Rosen said. “I’m watching reasonably healthy people with a routine problem get a complicated procedure that turns it into a devastating problem.”
Hudson’s original surgeon, Dr. Edwin Menor, said he learned to perform robotic component separation a few years ago. He said he initially found the procedure challenging and that some of his operations had been “not perfect.”
Menor said that he now performs component separations a few times a week and that, with additional experience, “you improve eventually.” He said he had a roughly 95% success rate. In Hudson’s case, he said, the use of component separation was warranted based on the complexity of her hernia and her history of abdominal surgeries.
Component separation must be practiced dozens of times to master it, experts said. But 1 out of 4 surgeons said they taught themselves how to perform the operation by watching Facebook and YouTube videos, according to a recent survey — part of a broader pattern of surgeons of all stripes learning new techniques on social media with minimal professional oversight.
Other hernia surgeons, including Menor, learned component separation at events sponsored by medical device companies. Intuitive, for example, makes a $1.4 million robot known as the da Vinci that is sometimes used for component separations. Intuitive has paid for hundreds of hernia surgeons to attend short courses to learn how to use the machine for the procedure. The company makes money not only from selling the machines but also by charging some hospitals every time they use the robot.
Many surgeons — even some paid by device companies to teach the technique — haven’t learned how to properly carry out component separation with the da Vinci, the Times found. In fact, at times they are teaching one another the wrong techniques.
The robot comes with a built-in camera that makes it easy for doctors to record high-resolution videos of their surgeries. The videos are often shared online, including in a Facebook group of about 13,000 hernia surgeons. Some videos capture surgeons using shoddy practices and making appalling mistakes, surgeons said.
One instructional video, paid for by another major medical device company, showed a surgeon slicing through the wrong part of the muscle with the da Vinci. Experts said the result could have been devastating, turning the abdominal muscles into what one described as “dead meat.”
Peper Long, a spokesperson for Intuitive, said the company hired “experienced surgeons” to lead its training courses. “The rise in robotic-assisted hernia procedures reflects the clinical benefits that the technology can offer,” she said.
In interviews with the Times, more than a dozen hernia surgeons pointed to another reason for the surging use of component separations: They earn doctors and hospitals more money. Medicare pays at least $2,450 for a component separation, compared with $345 for a simpler hernia repair. Private insurers, which cover a significant portion of hernia surgeries, typically pay two or three times what Medicare does.
Repeat Billings
Fixing the torn muscles of a hernia is like closing a suitcase: It’s usually not too difficult to bring the two sides together and zip it up. But a large hernia, like an overstuffed bag, doesn’t have enough slack to bring the muscles back together.
Around 2006, surgeons adapted a technique from plastic surgery, called component separation, to close large hernias. On each side of the torso, they carefully cut the muscle to create slack, resulting in something like an extra zipper in expandable luggage.
Other hernia surgeons were initially afraid to try it. They would have to make incisions that ran from the sternum down to the pelvic bone and would have to distinguish between three parallel planes of muscle, each just millimeters wide. And while making tiny cuts, they would have to carefully avoid bundles of nerves and blood vessels. Cut a bundle, and the muscle becomes useless.
Despite its difficulty, the procedure took off — and with it, the opportunity for doctors to make more money.
The federal government assigns a value to everything a doctor does, from an annual physical to a complex surgery, in order to determine how much Medicare should pay. These values — known as relative value units, or RVUs — are also used by private health plans, and therefore dictate most doctors’ earnings. Many hospitals require their doctors to ring up a minimum number of RVUs. Some doctors get bonuses if they exceed that goal or have their salaries docked if they fall short.
Component separation has a high value. A traditional hernia repair earns between 6 and 22 RVUs for the surgeon, which for Medicare patients translates to $200 to $750. Tacking on a component separation for both sides of the torso brings in an additional 34.5 RVUs., or about $1,200 more for the surgeon. (Medicare also pays the hospital for each procedure.)
When the RVU system began, in 1992, component separation was part of a billing category that consisted of plastic surgery procedures such as reconstructing a patient’s torso after a traumatic accident. Because the procedure demanded a high level of skill and took so much effort, it was given a high RVU.
But since 2006, its use for hernias has soared, Medicare data shows.
Part of the rise reflects the fact that some people with small hernias, who don’t need complicated surgery, are nonetheless getting component separations. A study by Dr. Dana Telem, a hernia surgeon at the University of Michigan, found that was happening in about one-third of cases.
Another factor is that some surgeons have been billing insurers up to four times for a single procedure. In 2017, the American College of Surgeons warned them to stop, saying they could bill twice, at most — once for each side of the torso.
Robots on Facebook
As hernia surgeons were dabbling in component separation, a larger shift in surgery was underway: using robots to operate.
Intuitive debuted its da Vinci robot in 2000, with the idea that more precise surgery would shorten recovery times. Surgeons could remotely control the robot’s tiny clamps and scissors, allowing them to carry out complex operations with small incisions.
The company marketed the robot to a variety of specialties, including cardiology and urology. It found notable success in gynecology but faltered in 2013, when an influential study reported that robotic surgery for hysterectomies was no better than a more standard technique.
Around that time, Intuitive made a big push with general surgeons, offering training events around the country where doctors could test out the da Vinci for surgeries like gallbladder removals and simple hernia repairs, one of the most common surgeries in the country.
By 2017, Intuitive brought in more than $3 billion in revenues on the da Vinci, and was trumpeting the largely untapped potential of the hernia market. “We believe hernia repair procedures represent a significant opportunity with the potential to drive growth in future periods,” the company said in its 2017 annual report.
The marketing was “masterful,” said Dr. Guy Voeller, a hernia surgeon in Tennessee and former president of the American Hernia Society. “They made it explode.”
Beyond traditional sales tactics, Intuitive also made inroads into the growing Facebook group, a lively forum where hernia surgeons discussed everything from troubleshooting tricky cases to complaining about their pay.
At first, the group’s members weren’t keen on the robot, questioning whether the flashy new tool was worth its steep price tag. “A lot of added expense with what perceived benefit to the patient?” one surgeon wrote on the Facebook group’s page in 2014.
Around that time, an Intuitive representative placed a phone call to Dr. Eugene Dickens, a general surgeon at a community hospital in Tulsa, Oklahoma.
Dickens had grown up playing video games and was immediately comfortable at the da Vinci’s remote controls, which he used for dozens of gallbladder, appendix and simple hernia surgeries. Intuitive was paying him to be a consultant. (Since 2013 he has received about $1 million.)
Now the company wanted him to jump into the Facebook fray and win over the naysayers, he said.
“We are getting decimated by this little hernia group,” Dickens recalled the company representative saying. “Can you join and help defend us?”
He and other robot enthusiasts began to sing the da Vinci’s praises in the Facebook group, he said. (He said that Intuitive did not pay him for his Facebook posts.)
Over time, the group warmed to the robot, not just for simple hernia repairs but also for more complex operations like component separations. Surgeons began posting videos showing off the new procedure, drawing dozens of positive comments.
Surgeons used the da Vinci for more than 1.3 million hernia repairs between 2016 and 2022, Long said, or about 15% of the total procedures by the company’s robots. Only about 13,000 of those hernia repairs were component separations, she said.
Intrigued by the hype, Dickens taught himself component separation by watching online videos. His first operation went well, he recalled, but a later patient developed a serious complication, necessitating an additional surgery.
Then, at a dinner meeting in Houston, he presented a video of one of his own surgeries to a group of about 50 other doctors, Dickens recalled. A more experienced surgeon interrupted to say he was operating on the wrong part of the muscle. The rebuke felt like a “red flag,” he said, and he stopped doing the procedure, although he is still a proponent of the da Vinci for other operations.
An academic study in 2020 found that “unsafe recommendations often go uncontested” in the Facebook group and warned that “surgeons should be cautious” about using the page for clinical advice.
Dr. Brian Jacob, the hernia surgeon who founded the Facebook group, said that after the study was published, he made an effort to not let bad advice go unchallenged. He said that surgeons have described performing component separations on small hernias. When he sees those posts, he said, he typically comments to say, “That’s not how I would have done it.”
Trashing the Abdominal Wall
In June 2021, W.L. Gore & Associates, a medical device company that makes surgical mesh used in hernia repairs, posted a video tutorial on its website. It promised to be a step-by-step guide to component separation surgery.
A surgeon narrated as he cut the patient’s abdominal muscles, releasing tissue so he could close a hernia. But he was operating in the wrong place and likely created a new hernia, according to four surgeons who reviewed the video.
“It absolutely trashed the abdominal wall,” said Jeffrey Blatnik, who directs the Washington University Hernia Center. “It was so offensive to the point that we reached out to the company and told them, ‘You guys need to take this down.’”
Jessica Moran, a spokesperson for W.L. Gore, said that after surgeons flagged the error, the company removed the video; it had been online for 10 months. “We have investigated what happened here to avoid this happening again in the future,” Moran said.
Dr. Rodolfo Oviedo performed the faulty surgery. Moran said the company had paid him $4,400 for it.
Oviedo acknowledged that he had made mistakes but said he had improved. “At some point I was doing it wrong, and nobody’s perfect,” he said in an interview in June, when he was the director of robotic education at Houston Methodist, a major hospital in Texas. He said it was only at some point after the surgery that he learned of his potentially serious errors.
Four months later, Oviedo offered a new explanation. He said that he had learned of his mistake in real time and had repaired the damage while the patient was still on the operating table. He said the patient, with whom he followed up for 18 months, had not experienced complications. (Oviedo left Houston Methodist for another job in July.)
W.L. Gore’s video had plenty of company: A study of 50 highly viewed hernia repair videos on YouTube found that 84% did not follow all safety guidelines.
In addition to relying on online videos, surgeons also learn new techniques at training sessions paid for by device companies, which typically cover travel and a one- or two-day course. But the companies do little vetting of their instructors, experts said.
Earlier this year, Blatnik fixed a bad component separation surgery where the original surgeon had cut into the wrong muscle plane. The patient’s intestines were bulging out of her sides, another Mickey Mouse hernia.
Blatnik said he immediately recognized the name of the surgeon who had operated on the patient because he had seen that surgeon teach component separation at a course sponsored by a device company. The surgeon has received more than $130,000 in payments over the past decade from companies including Intuitive and Bard, which manufactures hernia mesh, the Times found.
Looking Pregnant
Academic research is only now starting to quantify the complication rate of component separations for hernias.
In 2019, researchers analyzed five studies of patients who underwent the procedure and found that only 4% developed another hernia. But a newer study from the Cleveland Clinic, which followed patients for two years to see if a new bulge had developed, found the number was 26%.
Seven years ago, Sandy Aken said, she had a hernia the size of her fist. A surgeon in Huntington Beach, California, performed a component separation. Three months later, her belly was still protruding, and she felt like her guts were spilling out. She saw another doctor.
“This patient has a significantly compromised abdominal wall with damaged muscle due to the history of component separation,” that doctor wrote in a summary of the visit. Another hernia surgeon told her he could not fix the bulge, she said.
Aken, 64, now looks nine months pregnant. She cannot bend over without pain, a limitation that forced her to leave her job as a caregiver.
In 2018, Dr. Willie Melvin performed a component separation with the da Vinci on Jennifer Gulledge, whose large hernia made her a good candidate for the operation. But he cut into the wrong part of the muscle, leaving new holes on each side of her body and too little slack to close her original hernia, another surgeon concluded after reviewing her case.
Less than a week later, he performed an emergency surgery to close the original hernia. But the side tears remained.
Melvin declined to discuss Gulledge’s case. He said he had a lot of experience with complex hernia cases that other surgeons have referred to him and that he and his partner performed about three component separation surgeries a month. Intuitive paid him more than $25,000 last year to demonstrate his technique to other surgeons and to check the work of doctors who are new to robotic surgery.
In February 2020, Dr. Ajita Prabhu, a Cleveland Clinic hernia surgeon who has studied the frequency of failed component separation, operated on Gulledge. Prabhu told her patient that she would try her best, but that the damage from the original surgery was probably irreparable.
She was right. Even with her abdominal muscles sewed back together, Gulledge lived with intense pain. Routine tasks were difficult: When she changed her granddaughter’s diaper, she had to remind the 2-year-old not to kick “grandma’s bad belly.”
In August, Gulledge drove 700 miles to Cleveland for a follow-up appointment. She spent four days on the road, sometimes stopping every 30 minutes because it hurt too much to remain behind the wheel.
When Prabhu examined her, she confirmed Gulledge’s fear: Another hernia had opened up.
My centenarian dad lived to be 101. Here are his lifestyle tips I’m following to live a long life, too.
Louisa Rogers – October 29, 2023
My centenarian father lived a very healthy life but recently died at 101.
His practices mirrored Blue Zone principles: eating in moderation, exercising, and reducing stress.
I hope to live as long as him, so I’ve incorporated these habits into my life to be healthy.
For as long as I knew him, my father, who died a year ago at 101, lived a very healthy, active life. He ran every morning until he was 70, kept his stress level to a minimum, and enjoyed close bonds with family and friends — three of the principles described by Dan Buettner in his book “The Blue Zones: Lessons for Living Longer From the People Who’ve Lived the Longest.”
The author with her father.Courtesy of Louisa Rogers
Because I also hope to live to become a centenarian, I’m following his example. I’ve incorporated many of the practices I saw him live out — and a few others — into my life.
Eat and drink in moderation
“Breakfast like a king, lunch like a prince, and dinner like a pauper,” Daddy used to intone. He always ate his smallest meal in the early evening. At mealtimes, he followed another rule of Blue Zoners: Stop eating when you’re 80% full.
While I have a history of overeating, I’ve learned to eat healthily and moderately most of the time — I eat a 90% plant-based diet with occasional fish, and I indulge in junk food sparingly. I do tend to have my main meal in the evening, but it’s typically a simple one-pot dish.
As for alcohol, many centenarians do enjoy a glass of wine, but they don’t overdo it. My father, however, was a heavy drinker until the last five years of his life, when, after serious catheter surgery, his doctor ordered him to stop drinking. I have two glasses of wine at night, and I think of it as my guilty pleasure.
Exercise frequently
My father was a hiker, backpacker, and runner, starting in his college years. At 70, he switched from running outdoors to using an exercise bicycle and a treadmill.
I began running during college with my dad and slowly expanded into loving exercise of all kinds; I call myself an “adult-onset fitness lover.” Being physically active, especially outdoors, gives me great pleasure, whether I’m walking long-distance routes in different parts of the world (my husband, Barry, and I walked the 540-mile Camino de Santiago), riding my bike, or paddleboarding.
I also find ways to incorporate physical activity into my daily routine, like many centenarians, who often don’t exercise in the modern sense but incorporate movement into their daily lives. And unlike my dad, who lived in the suburbs, I live in walkable communities — I split my time between Mexico and California — so I rarely drive, and it’s easy to get a lot of walking in each day.
Reduce stress
While my father had a great deal of loss in his life — he outlived not only my mother and two later wives but also two of his five children — he was very resilient. He kept marrying, which was not always easy for me, but now I realize it helped him avoid loneliness, which a surgeon general advisory says is about as deadly as smoking.
As for me, a few years ago I told a friend, “I don’t do Christmas stress.” Gradually, that attitude has expanded into the rest of my life. It’s not always that simple, of course. Naturally, I sometimes experience stressful events, but I’ve learned to mitigate it through walking or other exercise, talking to a friend, journaling, and meditating.
Have a sense of purpose
Centenarians know why they want to get up in the morning. I never asked my dad what his purpose was, but he was very engaged in life. After 9/11, for example, he joined an interfaith group made up of Christians, Jews, and Muslims, and later went to the Middle East on a peace delegation. When he was 80, he volunteered to build houses in Honduras.
I love connecting with people, learning, and being creative. I write, cook, and paint. During the parts of the year when we’re living in Mexico, I also speak Spanish and spend a lot of time volunteering.
Maintain strong connections with family and friends
My dad lived in Pennsylvania. Though none of his children lived in the same state, we visited often and were in frequent contact by phone.
For 30 years, he met with a group of friends every month, and they all shared about their lives and reflected on current issues or a book they’d read.
I don’t live near my family members, either, but I’m in regular touch with them. And while I have friends in both communities where we live, I also regularly “prospect” for new ones because I’ve seen that close connections can unexpectedly end through moves, irreconcilable differences, or death.
Nurture a sense of spirituality
Unlike most centenarians, my dad did not have a strong faith. I’m not a traditional believer, either, but I act as though I am. Call it the placebo effect. I write notes to God and ask for help when I’m struggling, and somehow, it works.
There are no guarantees, of course. Plenty of fit people die young. Still, there’s no harm in improving my chances, especially since I enjoy these activities anyway and they add to my quality of life. What have I got to lose?
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