As third-year medical students, we recently stepped out of the classroom and onto the wards, eager to provide the quality care we had been working towards for the better part of the last decade. We were, however, quickly met with a stark reminder of how climate change can jeopardize our ability to do so. We entered the ER in the midst of a blistering heatwave to find two patients waiting to be admitted: A woman with asthma gasping for breath and an elderly man starting to wake from a heat stroke. There was a small commotion as the medical team huddled in the hallway deciding which of these two patients would gain admission. The hospital was full, and there was only room for one. Stories that may have once sounded like a far-off dystopia are now commonplace during our rotations: power outages from extreme weather resulting in the loss of thousands of dollar’s worth of insulin and other precious medications, collapsing hospital air-conditioning systems during heatwaves, prolonged allergy seasons driven by rising temperatures. What has already become clear to us in our short time as members of the medical team is how much of patient health is influenced by the natural environment — by factors outside our textbooks, flashcards, and, seemingly, control. We are, without question, entering a medical landscape that is being shaped by an increasingly heated and polluted planet. What has remained less clear to us, however, is our role, and the role of the medical profession, in the climate crisis. Though the health of our future patients will be impacted by a warming planet, the issue has often felt too massive to integrate into an already overburdened medical system. Importantly, we are not alone in these feelings: While the vast majority of physicians agree that climate change is happening and relevant to patient care, many remain uncertain about their role. This year’s recently-released assessment by the International Panel on Climate Change (IPCC) offered a glimpse into that bleak and not-so-distant future. The report’s bottom line is sobering but unequivocal: Climate change is here, and its impacts will be catastrophic without intervention. Temperatures will continue to rise, contributing to increased rates of extreme weather we see today. Moreover, these phenomena threaten everyone’s health, but disproportionately impact vulnerable and disadvantaged populations. Though the situation is dire, it isn’t without hope. The IPCC offers that, with expeditious and dramatic decreases in greenhouse gas emissions, we can avoid the worst outcomes. We hope that we can clear some uncertainty by elucidating the ways we have tried to meaningfully engage in the climate crisis and, in doing so, inspire others in the medical profession to do the same. Talk to your patients about climate change. Physicians are among the most trusted members of the community, and studies have shown that physicians are respected but underutilized resources on the issue of climate change. This does not require clinicians to engage in a complex discussion of greenhouse gasses or politics, but rather direct application by educating patients on medications and conditions that increase the risks associated with heatwaves, apps that track air quality, and locations of the nearest cooling centers. “Green” the practices in your office or hospital. The health care industry is ranked second in its energy use annually. Though much of the waste created and energy consumed is in the name of patient safety, the EPA predicts that the health sector could reduce its emissions by 30% without compromising patient care quality through actions like using reusable and recyclable tools where possible, discussing proper usage of red bag waste in the OR, supporting mass transit, installation of energy-efficient building operations like LED lights or occupancy sensor switches, decreasing thermostat temperatures, and promoting plant-based meals in the cafeterias. Join a medical, climate, and health group. Groups like the Medical Consortium on Climate and Health and Medical Students for a Sustainable Future represent a growing contingent of medical professionals already engaging in the fight against climate change. Join a community of like-minded individuals to learn about what actions are already being taken in various local and professional networks. Encourage your professional societies to put out policy statements on climate change. Physicians and students can find out if their professional societies have a published policy statement on climate change. If not, offer to help draft and propose one. The American Academy of Pediatrics is one such society already leading the way on this front. Discuss climate change with students and in the medical school classroom. The process of incorporating climate change-related education into the already busy medical school curriculum takes time. In the interim, physicians and students can start the important dialogue about how extreme weather, ambient air pollution, and rising temperatures will impact common illnesses. Vote for climate activists. Everyone can put their support and votes behind leaders who will take bold steps towards mitigating climate change. Educate yourself on climate change, its impact on human health, and how to respond. None of the aforementioned goals can be achieved without first learning more about this crisis we face. Current physicians can continue their education outside of the classroom. The Yale School of Medicine now offers continuing medical education credits for courses on climate change and health. Many other schools, including but not limited to, UCSF and UC Berkeley, also provide physicians with CME credits to further their knowledge on climate change and human health. The IPCC report unambiguously states that confusion, hesitation, and silence are luxuries we can no longer afford. We can be certain that a climate warmed by 1.5℃ is far less dangerous than one warmed by 2 or 3℃, and with unified support and swift action, we can avoid the worst of the predicted outcomes. We look forward to a future where discussions about climate and health are commonplace in health care settings and where each of us — whether student or established medical professional — feels confident in our role in the climate crisis. Joie Akerson and Anoush Calikyan are medical students. Source
