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Doctor, It’s The Climate · Simmer Down

• 0:02
  Kathleen Biggins: Welcome to Simmer Down, a podcast where I talk to cool heads about what often seems like an overheated topic.
• 0:09
  Kathleen Biggins: Climate change.
• 0:11
  Kathleen Biggins: I'm your host, Kathleen Biggins, founder and president of C-Change Conversations.
• 0:16
  Kathleen Biggins: On this podcast, we're going to be tackling the kitchen table issues from family health to family finances, and ask how climate change is impacting what we value most, including keeping our families safe.
• 0:31
  Kathleen Biggins: Now there was a recent story that really snapped my head back.
• 0:38
  Kathleen Biggins: It was about a father and a son who went for a hike outside of Phoenix, and it was a hot day.
• 0:49
  Speaker: About halfway up, I'd say my legs started to feel hot.
• 0:51
  Speaker: Like my whole body felt hot.
• 0:53
  Speaker 2: Last August, Joey Anzuela and his dad hit the hiking trail in the heat of the day.
• 0:57
  Speaker: By the time I got to the top, I felt a little like dizzy.
• 1:00
  Kathleen Biggins: But the father felt fine, and the son was drinking a lot of water.
• 1:12
  Speaker: I remember nothing coming down.
• 1:14
  Speaker: I remember taking a few steps on the way down and nothing else until the bottom.
• 1:17
  Speaker: And I just remember seeing his car and saying, like, I'm almost there, and then it was just black.
• 1:23
  Kathleen Biggins: The sun fell to the asphalt, fainting against the hot pavement and receiving second-degree burns, and his body temperature has risen to 108 degrees.
• 1:34
  Kathleen Biggins: The father was shocked.
• 1:36
  Kathleen Biggins: He had no idea that his son had been in so much danger because he felt fine.
• 1:43
  Kathleen Biggins: And his young 12-year-old son had been drinking water throughout the hike.
• 1:47
  Kathleen Biggins: But to me, it was kind of a parent's nightmare.
• 1:52
  Kathleen Biggins: How our misunderstanding about the risks of climate change and what it could mean, especially for our younger family members, can put them at risk.
• 2:03
  Kathleen Biggins: So we wanted to talk to an expert who could help us understand how climate change is increasing these levels of risks to our entire families, but especially to our young people.
• 2:17
  Kathleen Biggins: What do we need to be worried about as climate change exacerbates health and safety risks?
• 2:23
  Kathleen Biggins: And how do we begin to protect our families right now?
• 2:27
  Elizabeth Cerceo: You know, even before I started really getting into this work, I was wondering, you know, why do we bundle up our babies in like 10 layers when it's, you know, when it's not, it's 40, 50 degrees.
• 2:40
  Kathleen Biggins: This is Dr.
• 2:41
  Kathleen Biggins: Elizabeth Cerceo, the professor of medicine and executive of climate health at Cooper Medical School at Rowan University.
• 2:48
  Kathleen Biggins: She's a member of more medical associations than I can name, but she also is the mother of six children.
• 2:56
  Kathleen Biggins: I told her the story about the father and son on the hike, and she understood it both as a parent and as a doctor.
• 3:04
  Elizabeth Cerceo: Yes, because we're we're kind of we're projecting on them what we think should um we should do for them.
• 3:10
  Elizabeth Cerceo: But infants, children are not little adults.
• 3:14
  Elizabeth Cerceo: They have unique physiology, they have risk factors that put them in harm's way, both for extreme heat and also pollutants, especially air pollution.
• 3:26
  Elizabeth Cerceo: So with very young children, especially below five, but but certainly um younger children, six, seven, eight, they have an increased metabolic rate.
• 3:35
  Elizabeth Cerceo: They also have a higher sweating threshold, so they don't sweat as easily.
• 3:40
  Elizabeth Cerceo: And because of their size, they have a smaller blood volume.
• 3:45
  Elizabeth Cerceo: And again, because of their size, they have a smaller body surface area to body mass ratio.
• 3:52
  Elizabeth Cerceo: And so this larger area to absorb heat, essentially.
• 3:56
  Elizabeth Cerceo: So there are physiologic reasons why our little ones are going to be predisposed to heat-related illness.
• 4:06
  Kathleen Biggins: So, really, this is the heart of it.
• 4:08
  Kathleen Biggins: Our kids and their future.
• 4:10
  Kathleen Biggins: How can you understand what's at stake and make an informed decision to protect them and your entire family?
• 4:18
  Kathleen Biggins: When I spoke with Dr.
• 4:20
  Kathleen Biggins: Cerceo, who said I could call her Lisa, about the health risks of climate change, we focused on these very personal questions from her perspective as a parent and as a medical doctor.
• 4:32
  Kathleen Biggins: So, Lisa, one of the things that I've read over and over again is that most major medical institutions call climate change a major threat to public health, if not the number one threat to public health.
• 4:50
  Kathleen Biggins: Help us understand why they say that.
• 4:53
  Elizabeth Cerceo: I love to share an infographic from the CDC.
• 4:58
  Elizabeth Cerceo: It's now been taken down off of the official CDC website, but it's this climate change and health impact wheel.
• 5:06
  Elizabeth Cerceo: And it goes through what are some of those impacts.
• 5:09
  Elizabeth Cerceo: So we talked about extreme heat, but it also extends into changes in infectious disease patterns and worse allergies.
• 5:18
  Elizabeth Cerceo: I mean, allergies affect almost everyone.
• 5:20
  Elizabeth Cerceo: You know, as we have higher CO2 concentrations, we actually have higher pollen, that the plants produce more pollen and it's more allergenic when they do produce that pollen.
• 5:31
  Elizabeth Cerceo: It impacts our water quality and our food supply.
• 5:35
  Elizabeth Cerceo: And also on a more macro scale, it impacts sociologic cultural structure.
• 5:42
  Elizabeth Cerceo: So when we think about war and migration and mental health writ large, it has impacts on all of these different areas.
• 5:53
  Elizabeth Cerceo: So there's really no area of health that is not touched by the impact of our environment.
• 6:00
  Elizabeth Cerceo: You know, so often, because we spend a lot of our lives between four walls, we tend to forget that we are part and parcel with the natural world around us.
• 6:11
  Elizabeth Cerceo: We are inextricably linked.
• 6:13
  Elizabeth Cerceo: And it really is a false barrier at these walls and windows that separate us because the cells, the molecules in our body are nature.
• 6:24
  Elizabeth Cerceo: And so we need to increasingly recognize just how intrinsically linked we are and really and take seriously the impacts on the environment.
• 6:36
  Kathleen Biggins: So one of the things that I personally feel is that it's getting more dangerous to go outside.
• 6:43
  Kathleen Biggins: Um I'm more nervous to walk my dogs in the park because the ticks are so bad and the new diseases that are popping up that are really concerning.
• 6:52
  Kathleen Biggins: I'm worried about playing tennis in the middle of the summer because it's too hot.
• 6:56
  Kathleen Biggins: I worry about my nephews who are football players who are practicing in the summer and all that heavy gear.
• 7:02
  Kathleen Biggins: Um, and sometimes when I see a cloud burst on the on the horizon, I get nervous about driving my car because I know these rains are getting so much more ferocious and so often people are safe in one moment and washed away in another.
• 7:17
  Kathleen Biggins: Am I right in feeling that climate change is increasing my safety risk and my medical risk in some ways, as a doctor and as an expert?
• 7:29
  Kathleen Biggins: Do you see that as well?
• 7:31
  Elizabeth Cerceo: It's a yes and.
• 7:32
  Elizabeth Cerceo: We need to accept that there are increasing risks to our health because of extreme heat, because of air pollution, because of these vector-borne illnesses increasing and encroaching in areas where they don't belong and extreme weather.
• 7:48
  Elizabeth Cerceo: And we also need to still continue to live our lives and be active to try to remediate the problem and be part of the solution.
• 7:57
  Elizabeth Cerceo: So we do at the same time need to take necessary precautions.
• 8:02
  Elizabeth Cerceo: So for your nephew who's out there playing sports, you know, we have to be acclimated.
• 8:08
  Elizabeth Cerceo: It takes the human body at least seven to 14 days to be acclimated to the heat.
• 8:13
  Elizabeth Cerceo: So, you know, as we're thinking about going into the summer, sometimes those first really bad uh days of heat in the summer can be super deleterious to health.
• 8:24
  Elizabeth Cerceo: And we always think, you know, the very young and the very old, but our young student athletes are at risk too.
• 8:31
  Elizabeth Cerceo: So uh certainly we need to exercise precaution.
• 8:35
  Elizabeth Cerceo: I usually tell my patients to download the airnow.gov app, um, which will let people take a little bit more agency so that when they see that the air quality is poor, you know, maybe you don't go for the walk that day, or maybe you do it early in the morning.
• 8:51
  Elizabeth Cerceo: Or I would have my patients download the OSHA NIOSH app, which is a heat app.
• 8:56
  Elizabeth Cerceo: Um, these are both free and and um government run so it they can access where is the dangerous heat because you know sometimes we underestimate our risks.
• 9:07
  Elizabeth Cerceo: And I think that's one reason that these kind of conversations are so important to both normalize what's happening around us, but also help us to take those necessary precautions.
• 9:18
  Kathleen Biggins: And is there a magic number when we have to be worried, like a temperature where at a certain point we know that we have to protect our kids or not play tennis?
• 9:29
  Kathleen Biggins: Or is it um dependent on other factors like humidity or or as you said, how acclimated we are?
• 9:35
  Elizabeth Cerceo: Yeah.
• 9:35
  Elizabeth Cerceo: There's a lot of factors that go into the heat risk.
• 9:39
  Elizabeth Cerceo: And you know, that's one of the reasons that heat warning systems get so complicated because the risks are different for different people.
• 9:46
  Elizabeth Cerceo: You know, your 80-year-old mother who's on 10 different medications has a different risk than you know, someone who's in their 30s, 40s, 50s, and you know, relatively active.
• 9:57
  Elizabeth Cerceo: So those risks are different, but even above 80 degrees Fahrenheit, we start to see an inflection point where morbidity and mortality starts to increase.
• 10:08
  Elizabeth Cerceo: And that's pretty much across the board.
• 10:10
  Elizabeth Cerceo: And a lot of us think, you know, oh, 81, 85 degrees is you know, pretty comfortable still, but it it creates physiologic stress.
• 10:19
  Elizabeth Cerceo: And so we do see that there are impacts there.
• 10:22
  Elizabeth Cerceo: Certainly, you know, once you get above 90, 95 degrees, then we start to worry even more about outdoor workers, about you know, people who um are working in kitchens, people who are delivering mail, all of these populations that that are going to be at increased risk.
• 10:40
  Elizabeth Cerceo: But pretty much anyone could be at risk.
• 10:43
  Elizabeth Cerceo: And so that's a really important message to get across that you have to know what your personal risk factors are and then adjust.
• 10:51
  Elizabeth Cerceo: And that might mean modifying your life.
• 10:55
  Kathleen Biggins: So I read that in many parts of the world we are hitting heat and humidity levels that would kill even the healthiest human being if they were outside for an extended period of time, and that it had been measured in tiny bits of time, um, even along our own Gulf Coast, and that it would get worse as climate change gets worse.
• 11:16
  Kathleen Biggins: So that means outdoor workers or even people maybe out doing sports, not realizing how dangerous it is, could hit these thresholds.
• 11:25
  Kathleen Biggins: Can you describe how it feels from the inside?
• 11:28
  Kathleen Biggins: Like how would you recognize as someone who's having these heat problems that you are in danger?
• 11:35
  Elizabeth Cerceo: Yeah.
• 11:35
  Elizabeth Cerceo: You know, when it starts off, it can be very subtle.
• 11:38
  Elizabeth Cerceo: So it can be a little bit of dizziness, a little bit of nausea, maybe even vomiting, some headaches.
• 11:44
  Elizabeth Cerceo: Also, as you get dehydrated, you can lose electrolytes, and that's certainly not good.
• 11:50
  Elizabeth Cerceo: Your blood can also become more viscous, more thick because you're losing some of that fluid.
• 11:56
  Elizabeth Cerceo: As your body progresses down that pathway, eventually you will hit hydromyosis where you stop sweating, and that can lead to heat collapse.
• 12:05
  Elizabeth Cerceo: When we cut off the sweating, the only thing we have left is phasodilation.
• 12:10
  Elizabeth Cerceo: So the blood vessels close to your skin try to dilate to bring more of that hot core blood out to the periphery to cool it down.
• 12:19
  Elizabeth Cerceo: But as you can imagine, that blood is needed to deliver oxygen to critical organs like the brain, like the heart, like the GI tract and the kidneys.
• 12:28
  Elizabeth Cerceo: And so that has a lot of negative downstream impacts as well.
• 12:33
  Elizabeth Cerceo: So our body does it the best it can to try to compensate, but only up to a point.
• 12:39
  Elizabeth Cerceo: And from an evolutionary perspective, we're actually much better at dealing with the cold than we are dealing with the heat.
• 12:48
  Kathleen Biggins: So one of the things that we haven't yet talked about were kind of that physical risk of heat, as in what happens if it's so hot that things around you can start to burn you?
• 13:01
  Kathleen Biggins: And there's a whole season out in the Southwest called burn season where people go to the ER because they fall off their bike or touch their mailbox.
• 13:09
  Kathleen Biggins: I don't think that's something we recognize as a threat, and yet it's a growing one.
• 13:13
  Kathleen Biggins: Can you talk a little bit about that?
• 13:15
  Elizabeth Cerceo: Yeah.
• 13:16
  Elizabeth Cerceo: So, you know, Phoenix is really an epicenter for this.
• 13:19
  Elizabeth Cerceo: They've had to triple the size of their burn units because you know, people would fall down on the hot asphalt and come in with third-degree burns.
• 13:29
  Elizabeth Cerceo: And, you know, it it's it seems anathema to us, but you can have almost instantaneous tissue damage when the temperature is above 158 degrees Fahrenheit.
• 13:39
  Elizabeth Cerceo: Now that that seems really high.
• 13:42
  Elizabeth Cerceo: It is really high.
• 13:43
  Elizabeth Cerceo: But we should remember that inside cars in the summer can get to 160 degrees Fahrenheit, and that black asphalt can get up to 170, 180 degrees Fahrenheit.
• 13:54
  Elizabeth Cerceo: So, and even at lower temperatures, around 110 or so Fahrenheit, you can begin to have burn injuries at the basal epidermis, kind of more the superficial layers of the skin.
• 14:08
  Elizabeth Cerceo: So, yes, you know, certainly the southwest is the epicenter, but it could potentially happen in other areas as well.
• 14:16
  Elizabeth Cerceo: Um, so uh so yes, that is a huge concern.
• 14:19
  Elizabeth Cerceo: And and you know, a lot of times we'll focus on things like heat stroke, um, which is incredibly dangerous.
• 14:26
  Elizabeth Cerceo: It has a 20 to 80 percent mortality depending on the population you're you're looking at.
• 14:31
  Elizabeth Cerceo: And that's where you have an increase in your core body temperature, but also mental status impacts.
• 14:38
  Elizabeth Cerceo: Certainly heat stroke is the most dangerous, but there are all of these other impacts from heat as well.
• 14:44
  Elizabeth Cerceo: We mentioned the risk to pregnant women.
• 14:47
  Elizabeth Cerceo: If heat happens at certain points of gestation, because there are these critical developmental um cycles in the fetus, it can actually lead to congenital defects, like congenital heart defects or cataracts.
• 15:01
  Elizabeth Cerceo: There are other physiologic impacts, though, um, as well, with the lungs and with the heart rate being more rapid.
• 15:09
  Elizabeth Cerceo: One of my colleagues who runs a nonprofit that is dedicated to gardening and tree planting was herself hospitalized last summer because she was overdoing it around 11 o'clock or so in the morning, not even the peak time of heat.
• 15:27
  Elizabeth Cerceo: And she was in you know her late 40s, early 50s or so, you know, otherwise healthy.
• 15:33
  Elizabeth Cerceo: But we just under-recognize how this is going to impact us in our everyday, daily living.
• 15:46
  Kathleen Biggins: Extreme heat is just one of the threats being made worse by climate change.
• 15:50
  Kathleen Biggins: One of the other things that's happening as the temperature is rising is that our oceans are getting hotter.
• 15:55
  Kathleen Biggins: As they get hotter, more water evaporates.
• 15:58
  Kathleen Biggins: And because the air is warmer, it can hold more water vapor.
• 16:02
  Kathleen Biggins: So it simply means that when conditions are right, we're getting more of these cataclysmic showers instead of the more restorative kind that we really need.
• 16:12
  Kathleen Biggins: And the mayor of Shreveport told me something a few years ago that I found really poignant.
• 16:18
  Kathleen Biggins: He talked about as a child how he used to love the sound of rain on his rooftop.
• 16:23
  Kathleen Biggins: But now, as a mayor, waking up to the sound of rain filled him with dread because he wasn't sure that his community could handle the type of rain volumes we are now experiencing so much more often.
• 16:39
  Kathleen Biggins: And so it turned a childhood pleasure into a professional challenge.
• 16:45
  Kathleen Biggins: And I thought this was just so evocative about how nature has changed really in our lifetimes, from something that seemingly felt benign more often to something that suddenly feels more dangerous more often.
• 17:02
  Kathleen Biggins: It's almost as if we've pushed nature out of the boundaries that we thought circumscribed her for all of our lifetimes and the lifetimes of our grandparents and past ancestors, and really for the last 10,000 years.
• 17:19
  Kathleen Biggins: And now, through our actions, we're pushing her past these boundaries to new terrain that are much more dangerous for our species on so many fronts.
• 17:28
  Kathleen Biggins: Another is in the types of diseases that we are being exposed to, in part because other species are moving into new areas.
• 19:14
  Celine Gounder: With climate change, you have an expansion of hospitable geographies for mosquitoes, for ticks, for various different animals that carry infections.
• 19:24
  Celine Gounder: And so that means that the likelihood of people coming into contact with those also increases.
• 19:30
  Kathleen Biggins: This is Dr.
• 19:31
  Kathleen Biggins: Celine Gowder.
• 19:32
  Kathleen Biggins: She is a CBS News medical contributor and KFF editor at large for public health.
• 19:39
  Kathleen Biggins: She is also a clinical associate professor at NYU's Grossman School of Medicine and cares for patients at Bellevue Hospital.
• 19:49
  Kathleen Biggins: Dr.
• 19:49
  Kathleen Biggins: Gownder studies infectious diseases, which are changing with our climate.
• 19:55
  Celine Gounder: With warmer temperatures and shifting rainfall patterns, you have longer breeding seasons, you have expanded habitats where mosquitoes and ticks live, and you also have changes in their biting behavior.
• 20:09
  Celine Gounder: So all of those things, the longer seasons, the expanded habitats, the changes in their biting behavior increase the risk that you will be exposed and bitten yourself.
• 20:19
  Celine Gounder: And because mosquitoes and ticks carry various different infectious diseases, it also increases your risk of acquiring one of those diseases.
• 20:26
  Celine Gounder: So whether you're talking about mosquito-borne infections like West Nile or dengue, or it could be tick-borne infections like Lyme disease, we're seeing Lyme disease taking over more and more of the country.
• 20:40
  Kathleen Biggins: So this means that the changing climate is really forcing animals and insects out of their old niches, which means we are more at risk of being exposed to diseases we've never experienced before.
• 20:51
  Celine Gounder: All of this increases the probability that you'll have a new infectious disease emerge.
• 20:56
  Celine Gounder: You know, historically, new infectious diseases, pandemics, come from something that's circulating in an animal population and then spills over into the human population.
• 21:07
  Celine Gounder: And that's in fact what we think happened with COVID, that it was something that was circulating in an animal population.
• 21:14
  Celine Gounder: We're still not entirely sure which, certainly infected bats and somewhere along the way also infected humans.
• 21:21
  Kathleen Biggins: So clearly, this is a really big problem.
• 21:23
  Kathleen Biggins: We have to protect ourselves on the individual level, but we also need to create really strong public health policy.
• 21:32
  Celine Gounder: For example, the public health department that does the surveillance to see what the mosquitoes or ticks in a particular area are carrying in terms of infections, where they should be putting larvacide or insecticide to curb the populations, letting people know what's happening in terms of infections being transmitted in the community so that they can also be aware and take appropriate precautions.
• 21:56
  Celine Gounder: Part of what health departments also do is draining standing water in certain areas, certain kinds of trash, like old tires, for example, are well known to allow for standing water where mosquitoes can breed.
• 22:10
  Celine Gounder: And then educating uh clinicians to be aware of what might be circulating in their community so they know what to be testing for.
• 22:19
  Celine Gounder: I think finally, um, what can we do to protect ourselves against infection, even if we do get bitten?
• 22:25
  Celine Gounder: And that really comes down to vaccines and then other medications that can help prevent an infection.
• 22:32
  Celine Gounder: So, for example, if somebody has gotten a tick bite, you can give them a dose of doxycycline, which is an antibiotic, to reduce their risk of developing Lyme disease.
• 22:41
  Celine Gounder: But if you're somebody who's getting tick bites and mosquito bites on a frequent basis, that may not be a practical approach.
• 22:47
  Celine Gounder: And that's where a vaccine would be really handy to have because once you're vaccinated, you would have immunity that reduces your risk of the infection.
• 22:57
  Kathleen Biggins: So let's drill down a little bit more on some of these emerging diseases.
• 23:02
  Kathleen Biggins: Because one of the things that has kept me up at night is learning that there are viruses and bacteria up in the permafrost that are being exposed as the permafrost begins to melt.
• 23:14
  Kathleen Biggins: And as we may know, the Arctic is melting and kind of very quickly because it's one of the fastest warming areas of the globe.
• 23:21
  Kathleen Biggins: How serious is that threat?
• 23:24
  Kathleen Biggins: Help me sleep better at night, please.
• 23:27
  Celine Gounder: Well, it's real.
• 23:28
  Celine Gounder: And it's hard to say how serious that threat is without doing better surveillance, knowing what's actually in the permafrost is where you need to start.
• 23:39
  Celine Gounder: And I think the concern is these are likely to be infectious diseases to which we have no immunity because we would have never seen them before.
• 23:48
  Celine Gounder: So it's a bit like what happened with COVID.
• 23:50
  Celine Gounder: When a brand new infection comes into the population, it makes a lot of people sick, it can be deadly.
• 23:57
  Celine Gounder: And then as the population develops immunity, the severity of infections, the mortality rate drops.
• 24:05
  Celine Gounder: But it means you have to go through this transition that is really horrible for a population.
• 24:11
  Celine Gounder: So that is what we worry about is that one of these frozen viruses could come back and that it's something that we just don't have immunity to.
• 26:47
  Elizabeth Cerceo: And so it's triggering oxidative stress, it's triggering inflammation.
• 26:52
  Elizabeth Cerceo: In some cases, it's triggering mutagenicity because we know that particulate pollution, regardless of whether it's from fossil fuel combustion or from wildfires, can lead to lung cancer, particularly lung adenocarcinoma, which is the type of lung cancer that we see more in non-smokers.
• 27:11
  Elizabeth Cerceo: Now we know that it's associated with type 2 diabetes and hypertension and dementia and chronic kidney disease.
• 27:19
  Elizabeth Cerceo: And as an internal medicine physician, these are things that I see every day.
• 27:25
  Elizabeth Cerceo: I'm not an OBGne, but there's also significant impacts for pregnant women, whether it's with particulate matter air pollution, especially when you have particulate matter pollution and heat, that combination is really bad for pregnant women.
• 27:42
  Elizabeth Cerceo: So that's associated with stillbirths and with preterm births.
• 27:46
  Elizabeth Cerceo: So uh so all of these downstream impacts are things that, you know, we we might see it in our neighbor or in our family.
• 27:56
  Elizabeth Cerceo: And, you know, oh, they have some diabetes and hypertension.
• 27:59
  Elizabeth Cerceo: We just kind of chalk it up because it's so common to it the way things are now.
• 28:03
  Elizabeth Cerceo: But we need to remember that that there are environmental impacts to these common conditions that we see all the time as well.
• 28:11
  Kathleen Biggins: The medical profession is in a unique position because you are still seen as trusted messengers within society, something that is getting a position harder and harder to obtain in today's world.
• 28:27
  Kathleen Biggins: How is the medical community accepting this responsibility?
• 28:31
  Kathleen Biggins: And how are they preparing to educate their patients and the population at large about this major health risk?
• 28:40
  Elizabeth Cerceo: I think right now a lot of physicians understand that there's risks and they're not sure how to necessarily bring that into the office visit or bring it into a patient encounter.
• 28:51
  Elizabeth Cerceo: We are increasingly including this content in our medical school curricula so that our medical students being trained now understand how this impacts health and they'll have a better understanding how to treat patients and how to include these types of questions when they're interviewing patients.
• 29:11
  Elizabeth Cerceo: We're also working on, from a medical society perspective, how do we educate physicians who have been in practice for 10, 20, 30 years, who might not have ever had to deal with this?
• 29:21
  Elizabeth Cerceo: How do we help to educate them so they can educate their patients?
• 29:25
  Elizabeth Cerceo: There was a great study in a pediatric practice uh out in the Midwest where they they just had a short script and it was built into a well visit about um how you know just as they counsel their families on wearing seat belts or wearing helmets when they're on bicycles, similarly, they need to counsel on issues around climate health.
• 29:50
  Elizabeth Cerceo: And when they when they delivered this 30, 40 second blurb on climate health, the understanding not only increased in the families that heard that, it was bipartisan.
• 30:04
  Elizabeth Cerceo: So whether it was Democrat, Republican, Independent, across the board, people appreciated the information and recognized that there were things that they could do and things that they would do going forward.
• 30:16
  Elizabeth Cerceo: So I so yes, physicians definitely have to be more active.
• 30:22
  Kathleen Biggins: And I think a major point here is when we feel that we have skin in the game, that it can actually impact us personally, we begin to care more.
• 30:31
  Kathleen Biggins: And physicians creating that link, explaining how our health and safety is at risk is just such a critical part of this equation.
• 30:39
  Kathleen Biggins: So it is exciting to see your profession really embrace this role because it's not all gloom and doom.
• 30:47
  Kathleen Biggins: There is a lot that we can do to mitigate the risk and to become more resilient and to become safer in the future.
• 30:55
  Kathleen Biggins: It's important to have hope.
• 30:58
  Kathleen Biggins: So can you share with us how you keep your own hope up and how you continue to reach out to new people and what keeps you going?
• 31:09
  Kathleen Biggins: Any tips for those of us who are trying to do the same?
• 31:15
  Elizabeth Cerceo: So, you know, I am very fortunate because I have been leaning into the advocacy piece of it.
• 31:20
  Elizabeth Cerceo: And so I have found a wonderful community of like-minded physicians who similarly are leaning into the work.
• 31:29
  Elizabeth Cerceo: And so we all buoy ourselves.
• 31:32
  Elizabeth Cerceo: And so that community is so valuable.
• 31:34
  Elizabeth Cerceo: And I think, you know, turning to other structures of wisdom outside of science, you know, science is one facet of the diamond, but we also have to approach it from literature, from religion, from philosophy.
• 31:46
  Elizabeth Cerceo: You know, there's 40,000 years of knowledge that have accrued.
• 31:52
  Elizabeth Cerceo: And so, how can we apply that to what's happening right now?
• 31:55
  Elizabeth Cerceo: Because there have been catastrophes, there have been disasters throughout human history.
• 32:01
  Elizabeth Cerceo: And so applying some of that wisdom to what is happening now and also how we can move past it, because there will be a moving past and a working through.
• 32:12
  Elizabeth Cerceo: And we might not see it the path clearly right now, but it is there, and and we will see it one day.
• 32:38
  Kathleen Biggins: Lisa Cerceo and Celine Gownder, both for their wisdom and their work.
• 32:43
  Kathleen Biggins: You can find more information about climate change, how it affects you, and how you can make a difference and maintain your hope at C-ChangeConversations.org.
• 32:55
  Kathleen Biggins: There you can find all sorts of information about climate change, but also about our outreach.
• 33:01
  Kathleen Biggins: We travel all around the country to talk to groups about the risk of climate change and what we can do about it.
• 33:09
  Kathleen Biggins: If you are interested, please reach out.
• 33:12
  Kathleen Biggins: Did you enjoy this episode?
• 33:16
  Kathleen Biggins: Perhaps you learned something new?
• 33:19
  Kathleen Biggins: If so, think about others who might benefit from learning about climate change in a cool-headed way and pass it along.
• 33:26
  Kathleen Biggins: Zimmer Down is produced by Hans Buetow and Rebecca Fishkin.
• 33:31
  Kathleen Biggins: A special thanks to Carrie Dyckman, our creative director, and to Nicole Curnan and Margaret Koval for their ongoing contributions.
• 33:40
  Kathleen Biggins: We hope you'll listen to our other episodes and bring the climate conversation to your kitchen table.