Read the full transcript of women’s health physician and climate crisis expert Dr. Bruce Bekkar’s talk titled “The Climate Crisis Is Not Your Fault But It Is Your Problem” at TEDxNewRiver 2024 conference.
Listen to the audio version here:
TRANSCRIPT:
A Life-Changing Discovery
One October evening, way back in 2006, I had just come home from another long day seeing patients in clinic, and I was going through my mail. I happened to read the UC San Diego alumni newsletter that night, and there was an article that caught my eye. It was called “The End of the World as We Know It.” Now aside from being the title of an REM song, this was about research being done at Scripps Institution of Oceanography, which is part of UC San Diego, about this thing called global warming that I’d heard of, but I knew virtually nothing about. Now you have to understand that Scripps Institution of Oceanography is one of the really preeminent research centers of its kind in the country, if not the world.
And after I finished reading this rather long article, I physically felt the foundation of my life crumble beneath me. All the people and the patients and the places that I care the most about, including this magical stretch of coastline in North San Diego, full disclosure, I’m an enthusiastic but very mediocre surfer, were at risk to a degree that I couldn’t have imagined. Now all of us in medicine have had patients that have very suddenly and tragically crossed a tipping point beyond which we can’t get them back. And it dawned on me that night that it was very possible that nature had that same catastrophic vulnerability. And nobody knows better than an obstetrician that we’re part of nature.
There’s no separation.
Taking Action
I was figuring out ways to green up my life. Within a couple of weeks, I was going to city council meetings. I got invited to serve on an environmental board. Full disclosure, our first assignment was to help the city pick out a new sewage pump. Lots of poop presentations.
But I kept showing up, and I kept meeting people, and I kept learning. And after a few years had gone by, making time whenever I could with my practice, finally in 2013, I gave up my practice to do this work full time just with the hope that I could somehow help prevent nature from crossing one of her own tipping points and taking all of life down, including ours with it. Now in a couple of minutes, I’m going to talk about reasons for hope, but we’ve got to be real. Right now, we know how this crisis is going. And just a brief Google search for extreme weather events in the first half of 2024 is basically going on a worldwide disaster tour.
The Global Climate Crisis
In the Middle East, Pakistan, Iran, the United Arab Emirates have had severe flooding. Record-setting temperatures in Southeast Asia, in the Philippines, in India, and Thailand. Canada had a springtime early start to its fire season after 2023, which was its black summer, its worst year of fires ever. Back home in the US, Texas had yet another severe flooding episode, which knocked out power for tens of thousands for weeks. In the Midwest, more than 850 tornadoes were recorded in the first half of the year, put it in the top ten percent of all time.
You might remember hearing about the heat dome that was so massive, it covered 27 states and put over 150 million Americans at risk from high temperatures. And in California, we’ve got our own particular brand of climate crisis. We have accelerating coastal erosion. We have a nonstop fire season, and we have this phenomenon during our rainy season now called atmospheric rivers. I was a kid growing up in LA in the sixties and seventies.
I never heard about a single one of these. We had 51 of them this year. And right here in Florida, there was so much rain from a tropical depression in June that Miami-Dade, right down the road, had to declare a state of emergency, and so did Fort Lauderdale right here. But it’s not just the fires and the floods and the heat. It’s ongoing air pollution.
It’s ocean impacts, more violent storms, coral and sea life die-offs, sea level rise, and its economic impacts. Because as it turns out, not surprisingly, all that heat trapped in our atmosphere, all that energy correlates very well with billion-dollar weather disasters. And if all that stuff doesn’t get your attention, maybe this number will. This is a heat index. It’s heat plus humidity, so it’s probably only 130 degrees Fahrenheit.
This was recorded at Persian Gulf International Airport a year ago in July. We are seeing more and more days on the surface of this planet that are literally unlivable for our species. And we have to remember, we’re the most adaptable species on earth. If you actually care about animals, think about what they’re going through. So the inescapable conclusion is through our collective actions over the course of many, many decades, we’ve given nature a fever, and the signs of her illness are becoming increasingly frequent and severe all around the world all the time.
And if you’re not really worried about this, you’re not paying enough attention. Now many people throw up their hands when they hear about this stuff, and they say, well, it’s not my fault. But a lot of us in health care are noticing that the ongoing impacts of various parts of climate change are hurting our patients. And it’s not just the extreme weather events because although those can cause injuries and deaths and often do, it’s the ongoing heat and the air pollution. It’s the growing scarcity of fresh, healthy food and clean water.
Health Impacts
It’s the infectious diseases we never thought we’d see. And it’s mental health impacts that can affect any one of us given the wrong circumstances. Now any one of these impacts by themselves or as they usually occur in combination can aggravate preexisting conditions. But as we’re learning with childhood asthma and air pollution, they can cause those illnesses as well. Now not everybody’s equally vulnerable.
You probably have heard that the most vulnerable amongst us are the elderly, the poor and uninsured, the chronically ill and overweight, minorities, and then two patient groups, which really sit at the nexus of my practice and yours, pregnant moms and newborns. Our study in JAMA in 2020 and many others that have followed since then have highlighted what appears to be a very strong cause and effect relationship between heat and two types of air pollution tied to the burning of fossil fuel and preterm birth, low birth weight, and stillbirth. And I don’t have to tell this audience just how serious those birth outcomes are. As far as newborns are concerned, even I know that those little people are not just small adults. And the World Health Organization told us that, this was back in 2022, that one out of every ten early childhood deaths was due to air pollution, and 20% of newborn deaths are related to air pollution probably by way of their connection to preterm birth and low birth weight.
Impact on Healthcare Facilities
And it’s not just our patients that are suffering. It’s also our facilities. It’s the clinics and hospitals where you work that are seeing more patients who are more sick, and they’re seeing them more often. And that puts added pressure on staff and on supply chains. And it makes it harder and harder to deliver high-quality care.
And then you have to throw in the added specter of an extreme weather event because a fire or a flood or a big storm can cut off access to your hospital. It can damage the hospital. It can cut off power. It can even force emergency evacuations. And you don’t even have to be in the bull’s eye because if another hospital that you depend upon in your network is knocked out, guess who gets overwhelmed taking care of their patients?
And it goes beyond that because it’s not just our patients and our facilities. It’s also our own communities and our families. If you’ve got kids, if you have elderly parents, if somebody has a chronic illness, it probably falls on you as the doctor in the family to make sure they get the kind of care that they need. So added to that list of vulnerable groups that I mentioned, we have to put you on there because whether or not you think the climate crisis is your fault, it is most certainly your problem. Now there is hope.
Reasons for Hope
The fact is this problem is fairly simple. We have to stop the mass quantities of burning of fossil fuels. The good news there is we have viable alternatives. They’re getting better and better every year. Their prices are coming down, and their uptake is accelerating around the world.
You can see how quickly solar panel production and battery production is going up all around the world. Those charts are really impressive. But it’s also electric vehicles. It is projected that in California this year, one out of every four new cars sold will be electric. That’s up from 3% just a few years ago.
And, of course, it’s not just a California phenomenon. Certain experts tell us that the number one selling vehicle is either the first or the top three in the world last year was electric. It was a Tesla Model Y. Now there are a number of reasons why experts continue to under call how fast we’re taking on these new technologies. Again, this is good news.
Now one of those reasons is certainly people’s concern and government’s concern for how the climate crisis is going. But another thing that I don’t think gets talked about enough is the fact that these new technologies, these alternatives are just way better than what we’ve had. If you electrify your ride, I don’t know if any of you have driven an electric car, but once you get in it, you find you’re in something way quieter, way smoother, and much quicker than virtually anything that burns gas. And if you electrify your home, if you power it with the sunlight hitting your roof, and you put a battery in the garage, the prices of those technologies keeps falling, and you can get yourself largely disconnected from an expensive and really pretty unstable grid. You can even do what I did in my kitchen, which is to swap out my old messy gas stove with an induction cooktop.
And so when I boil water to make pasta, instead of seven or eight minutes, it takes less than two minutes. It’s my Tesla of the kitchen. The bottom line here is that the alternatives that we have to fossil fuels are not some horrible sacrifice. They’re actually way better than what we’ve already got. We’re also finding out that our patients are benefiting.
There was a study in 2018 by Casey’s group that looked at the rate of preterm birth for women pregnant nearby electricity generating plants that burn fossil fuels. And in the decade following the closure of those plants, the preterm birth rate dropped by over 25%. And if you’re familiar with our data, that’s a big decrease in preterm birth. Another bit of good news is a little bit counterintuitive. It comes in at a different direction, but I think it’s important to realize we’re not up against some massive army that just wants to continue burning fossil fuels.
It is literally a handful of C-suite executives, their lobbyists, and the politicians who’ve sold their souls to them that we’re up against. And I think it is perfectly reasonable for you and I to be angry at those people who are so willing to sacrifice everything you and I want out of life, including our well-being, just to satisfy their boundless greed. But let me be really, really clear. It doesn’t matter how you feel about it. Frankly, it doesn’t matter what you think.
I don’t care that much if you agree with everything I’ve just said, if you trust the science. It really doesn’t matter to me that much if you recycle everything in sight and bring your own bag to Whole Foods virtually every time. The scope and the urgency of this problem are such that our personal small actions won’t cut it. They’re simply inadequate in the face of this moment that we’re in. We need rapid, large-scale social change, and so all that matters is what you and I do to enable that.
Becoming an Activist
Nothing else. People that work to catalyze social change are known as activists. And I’m going to tell you something you might not realize about yourself. You actually are already an activist. Because every time you improve the efficiency of care delivery where you work, every time you urge patients to eat less processed food and meat and walk and bike more and drive less, and frankly, every time that you shorten the course of an illness or speed the healing of an injury and thereby decrease the resource needs of that patient, you are doing some of the work of a climate activist.
I told you a few minutes ago that regardless of whether you think it’s your fault, this is your problem. And now I’m telling you you’re already doing some work on it. My last question to you is, do you want to do more? Well, this picture is just one of many I could have brought. There’s a big wave of people in health care that are coming into the climate fight.
Doctors and nurses and various other people in health care are doing this. There are a couple of reasons why some people have not yet shown up to this problem. Certainly, two of them are. People don’t know how to start, and they’re not sure they can make a difference. Turns out starting is really easy.
If you’re drawn to helping reduce the carbon footprint of health care, there are nonprofits like Health Care Without Harm and Practice Green Health nationally coordinating these efforts, but your hospital likely has a green team already, and they would love to hear from you. If you’re drawn to advocacy, the kind of work I’ve been doing for more than fifteen years, there are also lots of nonprofits doing this work. There’s EcoAmerica. There is the Medical Society Consortium on Climate and Health. But you can also just Google “climate change orgs near me,” and you’ll find your local Sierra Club or your 350.org or other local groups doing this work, which brings me to, can you make a difference?
Thankfully, it’s still true that doctors and nurses are among the most trusted voices in society, period. So literally by you just showing up to things, you make a very significant impact. Probably the biggest reason that people haven’t gotten involved is that most of us in medicine feel a little bit overworked and maybe a bit stressed, and they can’t imagine taking on the world’s problems in addition to everything else that you all do. I get that, but I think you are perhaps not noticing something, which is that every time you are reminded of this climate crisis, it takes energy away from you to suppress your uncertainty and your anxieties and your fear about it. And I will tell you from my own experience for many years now and from doctors I know all over the country, that as soon as you plug into this problem and engage with it, no matter how polite, and work and feel like you’re beginning to have some agency and you’re part of a solution, you will find a strange experience relating to this problem.
You’ll actually start to feel hopeful. And guess what? Hope brings energy. This is not a sacrifice to do this work. I am so heartened every single time I hear from a doctor who’s doing this work somewhere in Chicago or on DC, and you see the smiles on their faces.
They’re very real. This makes their life feel more manageable. And finally, I’ll tell you, there are two questions I got asked an awful lot as an obstetrician. One of them was, “How many babies have you delivered?” To which I finally ended up saying, “I don’t know. All of them.” And the other was, “How many kids do you have?” I wasn’t lucky enough to have any kids. It just didn’t work out. But in a way, I have a really big family because every single baby that I had the privilege of delivering, that I got to be the first one to hold, that I watched as they figured out how to take a breath, that I got to comfort in some small way.
It was a bond that was instantly connected that I can’t possibly put into words except to say that it felt like family. I feel an obligation that goes beyond just assuring them a safe delivery. And it’s been said, you can’t have healthy people on a sick planet. And to this group, I would say, what really is the work of all the incredible work you’re doing and all the technology and all the innovation if we rescue these young lives and then turn them out into a planet that’s falling apart around them? My commitment is I’m going to do everything I can for as long as I can to help stop the climate crisis so that these babies have a chance at a healthy life.
And if you share that commitment, and I think it’s pretty likely that you do, I’m here to tell you that we need you. It’s time to show up to this problem. It will give you back more than you put into it, but I’d like you to do it anyway. I hope you’ll join us. Thank you.
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