Dartmouth-Hitchcock Medical Center was one of the earliest health-care organizations in the country to go "green," more than 15 years ago. DHMC's commitment to environmentally conscious operations hasn't wavered since, and it's now poised to be the first hospital in the nation to calculate its carbon footprint.
Dr. Diane Riley grew up steeped in good, old-fashioned New England parsimony— the kind that extends from saving leftovers in the kitchen to preserving the region's natural resources. Now married to a conservationist and living in the Upper Connecticut River Valley, Riley, a 1989 graduate of Dartmouth Medical School, still lives by the precepts of her childhood: if something breaks, for example, you fix it and keep using it as long as possible. The couple's laundry room boasts super-efficient appliances; they buy local, organic produce to reduce their impact on the environment; and they reuse their shopping bags.
But Riley found applying ecological principles at work a good deal harder. She is a hand surgeon who practices at two hospitals near DHMC—Alice Peck Day (APD) Memorial Hospital in Lebanon, N.H., and Mt. Ascutney Hospital, a member of the Dartmouth-Hitchcock Alliance in Windsor, Vt. For quite a while, she lived "an almost split existence," as she puts it, tolerating copious amounts of waste on the job while she industriously reduced, reused, and recycled at home.
That disconnect came into sharp relief one morning several years ago, as Riley watched three full bags of trash being hauled out of an APD operating room where she'd just completed a procedure that she does about 150 times a year—a simple, 10-minute operation under local anesthesia to improve the mobility of a finger with an inflamed tendon. Among the discards was a stack of unused plastic drapes, an untouched gown several sizes too big for Riley, and reusable towels that would never be laundered. Riley reached what she calls her "cracking point" when she saw those three bags. "For all I do at home," she says, "it's not going to [amount to] anything if I open thousands of pieces of plastic and throw it all out in the garbage."
The United States generated nearly 250 million tons of garbage in 2005, and hospitals alone accounted for over 2 million tons of it—enough to bury the 10 square miles of Washington, D.C., in a pile of trash nine feet deep. Every year. Health care currently represents 16% of the gross national product, a number expected to blossom to 20% by 2016. And the industry is about to embark, analysts say, on a $200-billion building campaign in preparation for the expected tsunami of demand from aging baby boomers.
Combine those trends with growing concern about climate change, environmental degradation, and energy independence, and it's no surprise that environmentally friendly health care has found its way into the national dialogue.
The Wall Street Journal has made the business case, Time magazine has profiled the architects and activists leading the charge, and National Geographic's electronic "Green Guide" has ranked the nation's most ecologically friendly hospitals. Health Care Without Harm, a global pollution-reduction nonprofit, boasts more than 460 member organizations worldwide. Closer to home, nearly 200 American health-care organizations have embarked on—or completed—construction of facilities that incorporate a host of green features, from low-toxicity building materials to mercury elimination programs to on-site composting of kitchen scraps.
DHMC got in on the act early, setting ambitious energy-conservation and site-preservation standards for its 220-acre,
Freelance writer Sharon Tregaskis hails from Ithaca, N.Y., one of the top 10 green cities in the U.S. She specializes in covering the environment, health care, and higher education and has written for other publications about the effects of environmental contamination on prenatal development, an eco-friendly skyscraper in New York City, and a diesel engine that runs on discarded french-fry oil. Kelley Meck, a DC '08 and Dartmouth Medicine's spring-term editorial intern, also contributed to the reporting for this article.