In the spring of 2020, academic medical centers pivoted quickly to adapt clinical care, teaching and research to challenges wrought by the COVID-19 pandemic. Clinical rotations were suspended due to shortages of protective gear and unknowns about the epidemiology of the virus itself. Virtual classrooms and new elective rotations were quickly established. At the Emory University School of Medicine, “The Climate Crisis and Clinical Practice” was one such elective built over the span of a few weeks with the generosity of time from faculty colleagues around the U.S.1 Seventeen live-virtual lectures by guest experts emphasized major themes – emerging challenges, health equity and social justice, disasters and solutions in healthcare, and climate communication. Because of the virtual platform, the live lecture series and recordings were opened to students across the country. Representing over 30 institutions, approximately 230 individuals registered for the four-week series. The registrants reflected the growing community around and burgeoning demand for climate change content in medical education. Many students were members of the group Medical Students for a Sustainable Future (MS4SF) and were already involved in planning climate and health educational initiatives at their home institutions.
Inclusion of education on the climate crisis has been considered essential for all health professions students.2 To this end, MS4SF released a planetary health report card, ranking schools based on several key metrics, including the incorporation of climate change in the curriculum.3 Although the Emory University School of Medicine had implemented climate and health education as part of the core curriculum for first and second year medical students in their pre-clinical years,4 the elective provided a valuable space for students curious for more learning opportunities or considering how climate change and climate justice figure into their MPH activities or even future careers. The small group sessions convened student-leaders, fostered community building, and nurtured student-led initiatives and projects that unfolded in the subsequent months. Students were challenged to think deeply about the climate crisis, even while living the uncertainty of a pandemic.
This form of
curricular involvement serves to combat the seeming dissonance between the existential urgency of the climate crisis and the practice of medicine as reflected in lecture halls, hospitals and clinical settings.
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Such engagement in a crisis likened to “trauma” itself also requires courage and necessitates reflection.5 A writing tool to promote reflection in the healing arts,6 fifty-five word stories were among the final assignments for the elective. This collection of 55-word stories are those of the first cohort of students who completed the Climate Crisis and Clinical Medicine elective. Individually, they express each student's creative processing of learning in a pandemic about another existential crisis whose implications affect not only their profession but every aspect of their future. Together, they speak the resolve and passion of current students and future leaders in climate medicine.
At home, sitting alone as the world collapses. As the flames of fires born of human hands wrap their hungry arms around the planet. Warmth, the kind that makes me uncomfortable. The sticky, humid heat that boils my blood and makes me cry out. Shake the stillness from the smooth pond of ambivalence. Say something.
Polluted air. Flooding lands. Long droughts. Severe famines. Extreme heat.
Vulnerable, marginalized patients suffer.
Seemingly hopeless, a night in Earth's history devoid of stars.
We work together for the shining rays of tomorrow.
Physicians with passion and fire.
The Earth will not die on our watch.
The Earth's citizens will not falter on our watch.
The things this earth has sustained, doesn't make them sustainable.
Sharing this human experience doesn't mean the sharing is equitable.
We cannot miss the train that passes through our windows daily.
Though we've been blind to solutions
And forgot the questions
That doesn't mean there aren't answers.
We can question and change, while maintaining hope.
How has climate change imprinted on our consciousness?
Emaciated bears clinging to a solitary ice float.
Dumpsters drifting through flooded boulevards.
Family odysseys through Aegean islands to makeshift cities.
Urate crystals on microscopy, silica transported across alveoli.
A groundswell, not of water, but doctors, patients, and those who care for justice and a livable planet.
The storm raged. The forecast called for rain and not much more. “There are no hurricanes in May,” they said. She could skip dialysis and go tomorrow, she thought. No power at home, son at work – they called him ‘essential’. She agreed. The toxins built in her body, like the storm surge outside her window.
The earth. Wild, beautiful, fragile. We pass it by and forget to look. To see. What surrounds us, sustains us, and is fundamental to our very being. We are hurting it, and in hurting it we hurt ourselves. Badly. Slow motion now, but not for long. Some already suffer– unprotected and exposed. We must hurry.
Simone Weil once said, “Attention is the rarest and purest form of generosity.” Historically, humans have not been that generous, especially to this planet. Now many people are perplexed as to why our planet's climate is changing so drastically, so rapidly. Fortunately, I think there is a solution. A simple act of generosity: pay attention.
Discussing climate change with my brother. Me, worried about exacerbated health disparities, environmental racism, and declining crop nutrients. My brother, worried about how this impacts the spider species he studies. Feeling irrationally angry at him for only caring about his slice of the world, before realizing that's what we all do. Different motivations, same goal.
The world is changing
1 degree warmer, is that harmful?
Greenhouse gases galore
Fine particulate matter affects the whole body
Asthma, heart attacks, dysregulated immunity
Heat strokes, heavy rainfall, catastrophic storms
Disparate infrastructure, heat islands
We need greenspace, alternative energy, fair housing access,
Nondiscriminatory environmental policy
Everyone on the planet is affected but some more.
The augmenter of all things unequal
It begins the moment you're not but 200 cells.
But you're strong.
Who knew it permeated the air you breath, the water you drink, the food you eat, the school you learn in?
But you are resilient.
Yet, you see, you shouldn't have to be anything other than you
I sit on my porch, birds are chirping, people are walking. The sun is hot but relief is just inside. I can smell only flowers; I sip clean sink water. Snapback to my screen. Cancer. Infection. Cognitive delay. Racism. Disaster. Inaction. Summer is coming, people will die. Will I even hear about it? Will anyone?
“Do your part, stay home” is trending on social media for COVID. Where is the “do your part, save the world/environment/your health/everything/everyone you love” trend for climate change? Does it require models, celebrities, and wealth to promote? Perhaps it can start with someone smaller, a student doctor, to spread the word through her clinical work.
How easy it can be to slip back into normalcy? What's wrong with an easy life?
What's wrong with forgetting?
How can you forget suffering? Can you? Does it create a sufferer?
But, what can you do, live off the grid?
You can fight for others, which is fighting for yourself. Fight for our future…
Our global community is united
By our humanity,
In efforts towards wellness,
With hopes for children, flourishing communities
And fundamental vulnerability to illness—
though colored in myriad ways, unequally weighted by multi-level injustices—
We all depend on our earth and her interwoven systems to sustain, and united we must be in tackling the climate crisis
Declaration of Competing Interest
The authors have no conflicts of interest relevant to this article to disclose.
Acknowledgments
Funding source
No funding was secured for this article.
Acknowledgment
The authors gratefully acknowledge Dr. Perry Sheffield for her encouragement and support to make the climate crisis and clinical medicine elective a reality.
References
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