When I first started working at Michaels, still in my 20s, my workdays usually ended around 5:15, and since I was allergic to rolling out of bed before 6:00 AM, I would run after work in La Crosse. I started running the trails of Hixon Forest, a very nice park on the edge of town with steep traverses and varying terrain that was sometimes easy on joints and in other places treacherous. One night I tripped on a tree root that protruded from the surface of the trail. I did a face plant and got something between a scratch and a cut on the palm of my hand with soil jammed into it. Once I got home, I washed it to within my pain threshold, not getting it totally clean – which I could have done with a healthy dose of morphine. I thought, it will scab over, fall off, and I might have a slight scar. Big deal.
A few days later while at work, I noticed a red streak running up the anterior (I’m trying to sound smart here) forearm. One of my coworkers said, paraphrasing, “You have a blood infection. You better get that looked at.” I had been gashed by chisels, machetes, pencils, knives, gravel, teeth, claws, crushed limestone, glass, fish gills, and other things a million times (I have scars to prove it). I learned to ride bike without training wheels, on gravel, with no helmet. Perhaps this explains some things.
Ok. Well, I had never seen this red-streak phenomenon before, so I took the advice. Turns out she was absolutely correct. I had no other ill effects of the sepsis, and with a week or two of antibiotics, it disappeared faster than it appeared.
The illness was accurately diagnosed by an ordinary citizen and confirmed by the doctor who prescribed run of the mill antibiotics to take care of the problem. All the magic was in the little pill.
Compare the prescription of penicillin to pulling wisdom teeth or replacing a knee joint.
Penicillin – Doctor: “Do you have any allergies?” Me: “No.” Scribble, scribble. Drop this off at the pharmacy and wait 15 minutes, pop the pills, and it’s over.
Wisdom teeth / knee joint – anesthesia, which can kill you. Teeth are burrowed into your skull, which is home to your brain, which is very important and sensitive and at risk while the surgeon is muscling these things out of your head. Knee replacements require pliers, hammers, chisels, scalpel, grinders, muscle, finesse, touch, and a good eye.
Is there any energy efficiency here? What’s the point?
Glad you asked.
If A=B, and B=C, then A=C. Remember that? Ok.
If medicine=energy efficiency, then lighting=penicillin, and everything else=surgery.
I really get fired up when I hear grousing about our industry, our state, our utility, this, that, and the other ate my homework. Wait. No. “…has captured all the low hanging fruit” – that phrase I also despise. No, you’ve got the infections taken care of, and in fact, you have virtually perfected that, like the eradication of polio. But that’s all. Shall we just live with the crippled knee and searing pain of bad teeth?
If malady=polio, then lighting=vaccine, which has been perfected. Polio has been nearly wiped out worldwide with the exception of about three third-world countries under dictator rule. The vaccine is a drop in a child’s mouth, and even a dufus like me can administer it. Fortunately for me, children can’t cry with their mouths closed. Since I always make them cry, I would be perfectly suited for polio vaccinations, or changing light bulbs for that matter.
Since we are on the topic of healthcare and lighting, let’s consider a hospital. According to my reliable database, lighting consumes 29% of a hospital’s electricity. Lighting does not consume natural gas, at least in a hospital. If we take 30% savings for lighting energy use on a complete upgrade of lighting, we have about 7% savings for the entire facility. This is generous. I would argue that for most hospitals, over a 20-year span, there is at least 30% additional savings potential from a combination of operational optimization (retrocommissioning and operations and maintenance) and smart design and selection of major equipment as it reaches the end of its useful life or as the always-evolving healthcare facility morphs and grows.
Just as an ordinary citizen can spot sepsis, they can also identify a CFL, T12 lamp, T8 lamp, T5 lamp, tail light, gas lantern, a candle, the sun, and even an LED. An ordinary person is not likely to differentiate between a torn meniscus or ACL, or a joint that’s full of scar tissue needing replacement. They sure as heck aren’t going to be allowed to dig into my knee with a kitchen knife.
So I ask, why would anyone think infection control is the end of the road for medicine? Why would anyone think lighting and better widgets are the end of energy efficiency?
 Skipping cogen because the sliver of electricity generated by cogen, especially in the Midwest, is miniscule.