I feel like I have a fairly unique perspective on the Deep Water Horizon incident (it is not an accident) in the Gulf of Mexico. First, because I have lived for 45 of my 50 years on the Gulf Coast. Second, because of the 5 years I was not on the Gulf coast, 4 of those were spent in the diving Navy. Third, because as a physician I feel qualified to comment on the health effects of the incident.

Louisiana has always had a love-hate relationship with the water of the Mississippi as well as the water of the Gulf, and control through levees has led to significant wetlands loss. Based on my time in Louisiana and now in the Alabama coast, I can report Louisianans also have a love-hate relationship with Big Oil.  Those of us on the coast have learned to co-exist with energy extraction technology (lots of jobs) but have not demanded care and caution be taken by those companies over time.  In Drawing Louisiana’s New Map: Addressing Land Loss in Coastal Louisiana the National Academies point out that the oil and gas companies in the past dredged canals for exploration which led to significant wetlands loss. There are currently 10 major navigation canals and 9,300 miles of pipelines in coastal Louisiana serving about 50,000 oil and gas production facilities. These canals, which are perpendicular to the coast, have created new open water areas, drowning wetlands and allowing salt-water intrusion into freshwater ecosystems. The result—land loss hot spots. “There is also evidence,” the report says, “that extraction of large volumes of oil and gas has exacerbated the problems of inundation and saltwater intrusion”—that is, withdrawing oil and gas along geologic faults seems to exacerbate subsidence in coastal Louisiana. Former Governor Blanco, in fact, cut a deal with the federal government to allow deep water exploration in exchange for revenues to fix the wetland loss caused by such infrastructure development.

From my experience in the diving Navy, I can tell you that the federal government does not have any better technology than BP does when it comes to working a mile down. The depth limits of human beings going down to fix something is about 330 feet of sea water (fsw). The depth limit for people going down in a saturation environment to fix something is around 1500 fsw. Beyond that and you have teeny remote controlled robots trying to use a wrench to fix things. In the Navy we learned not to drill a hole we can’t plug and we learned you can’t plug anything easily below 1500 fsw. That still seems to be the case.

The medical aspect of this incident is more uncertain. We know people will suffer acute illnesses from exposure no matter how protected they are. We know that for the workers there will be excess cancers due to exposure to hydrocarbons. We also know that for people who eat seafood there will be ingestion exposures for years to come. For the rest of Americans, though, the exposure to hydrocarbons is more likely to be lethal in a different way. Thanks to our love affair with the car (40% of all oil consumed in this country, average commute 104 minutes) we are not expending enough energy and consuming too many calories to boot. Could it be that 70% of Americans are obese for a reason? If Americans were to rearrange their lives to spend less time in the car and expend more energy in other activities we would be a much healthier nation. In addition, maybe the Louisiana wetlands (and other more be-soiled places) would eventually recover and we might not feel compelled to punch holes in the bottom of the ocean we can’t close up.