It's muggy and rainy outside an unassuming, multi-building government building in Lakewood. Inside, a group of about two dozen people are preparing to enter another world.
They don hats and gloves and wander into a giant freezer, where the shelves are packed with long, shiny, cylindrical tubes.
This is the National Science Foundation's ice core facility, but these people are not climate scientists, researchers or government officials. They are doctors, nurses and other health care workers.
“We have ice exhibits that people can look at, including ice from Greenland,” said Richard Nunn, the museum's associate curator. “The temperature in this room is about minus 38 degrees. It's so cold your nose hairs freeze in an instant.”
Kevin J. Beatty/Denver Site Richard Nunn, assistant curator at the National Science Foundation's Ice Core Facility at the Denver Federal Center in Lakewood, holds an ice sample in a frigid freezer on Aug. 14, 2024.
Ice core facilities store and study ancient ice from glaciated regions around the world, providing a library of atmospheric carbon concentrations and telling the story of Earth's changing climate over thousands of years.
“It's pretty amazing that miles of ice are being stored in that building for scientific research,” said Dr. Robin Richard, a physician in Shiprock, New Mexico.
Richard said he stepped back from full-time practice as a doctor to speak out about climate and health because “climate change is the biggest public health crisis we face today.”
Drought and the drying out of the region have increased the amount of dust in the air, taking a toll on the farmers and ranchers she treats, causing respiratory illnesses and breathing difficulties.
“It comes with anxiety, depression and general stress,” she said.
Kevin J. Beatty/Denver Site Tubes containing ice samples line a frigid freezer at the National Science Foundation's Ice Core Facility at the Denver Federal Center in Lakewood, Aug. 14, 2024.
Diploma in Climate Medicine
She and dozens of other health care workers, from across the U.S., are here as part of the University of Colorado School of Medicine's Climate Medicine Diploma Program, which trains clinical leaders on climate change and its health impacts.
It will start with a crash course on the basics, said Dr Bhargavi Chekri, director and family physician.
“What is climate change and what are the health problems it may cause or is already causing?” she asks.
Colorado is a good place to explore these questions because it’s home to many federal agencies that deal with climate issues. In the foothills of the Rocky Mountains in Boulder, the group meets at the National Center for Atmospheric Research (NCAR).
Scientists participating remotely via computer screens will provide detailed explanations of climate models, international reports, national forecasts and the impacts on agriculture, transportation and more.
John Daly/CPR News Dr. Bhargavi Chekri, family physician and continuing medical education director for the Climate Medicine Diploma, speaks with health care workers at a program at the National Center for Atmospheric Research in Boulder.
Cechri said doctors and nurses are well-positioned to learn and discuss a range of information, from air quality to extreme heat and mosquito-borne diseases.
“At the end of the day, I think health care workers are trusted because we want to help patients and we want to build healthy communities,” she said. “That's always our number one priority.”
Beyond Science
The focus isn't just on hard facts. Everyone has their own story to share during the narrative medicine exercise, summarizing their thoughts in 55 words. Group members take turns reading what they've written. “Back then, kids were laughing and playing on the beach. Now the ocean is warming and sea levels are rising,” one member said.
“The summer scent of pine needles under my feet, wildflowers dancing in the breeze. And then I'd lose my favourite spot,” said another. “That evening I saw him on my way to the shelter. His cracked lips were dry, his cheeks were red, and his confused eyes met mine. He was standing on the corner, the sun beating down on us, the air was filled with car exhaust, the driver looked away,” said a third.
The key, Cechli told the group, is to help health care workers talk about what they're seeing. “We can tell the truth about what's going on with our patients, our communities, our families, and we can tell the truth about where the science is pointing,” she said.
The diploma is a 250-hour continuing education program that includes five one-week certifications. You'll learn about topics such as environmental justice, decarbonizing the health care system and reducing energy use, and surviving disasters.
To date, 60 people have completed one or more Climate Medicine Diploma Certificate trainings – most of them doctors, but others nurses, paramedics and physiotherapists.
The program continues the spirit of its founder, Dr. Terry O'Connor, who died in an avalanche in Idaho in May at age 48. Cechli called O'Connor a visionary leader. “He relentlessly pushed the boundaries of medicine and environmental protection,” she said.
Frontline healthcare workers
A warming planet is having a huge impact in Colorado, across the U.S. and around the world, with reduced snowpack, more extreme weather and worsening wildfires — and health care workers are on the front lines.
John Daly/CPR News Emergency physician Dr. Mary Meyer led Kaiser Northern California's disaster response for six years after the Tubbs Fire devastated the city of Santa Rosa in 2017.
“We've evacuated Kaiser Santa Rosa Hospital twice because of wildfires,” says Mary Meyer, an emergency physician in the program. She helped direct disaster response for Kaiser Northern California, a large health system, for six years, during which time wildfires in the state became more frequent and severe. “It's been six years of disasters,” she says.
In 2017, she and her colleagues rushed to evacuate 200 patients from Kaiser Santa Rosa Hospital after the Tubbs Fire, which at the time was the deadliest fire in California history, killing 22 people and destroying more than 5,600 structures.
“We realized that climate change is really here and it's going to impact how we organize and function in healthcare and our ability to deliver care,” she said. “Climate change is a health crisis.”
Over time, they learned how to plan ahead and essentially pre-evacuate and spread patients across multiple facilities, Meyer said. The bright side of the disaster is that they “got better and better at evacuating the hospital as we did it more and more.”
Moving the evidence of climate change
The next day, on a bright, clear morning, the program group headed out to the Marshall Mesa trailhead.
John Daily/CPR News Dave Gustafson, an open space ranger with Open Space Mountain Park in the city of Boulder, talks to members of the University of Colorado's Climate Medicine Diploma Program near a trailhead on Marshall Mesa, not far from where the December 2021 Marshall Fire began.
Open Space Ranger Dave Gustafson was in the area to give a talk on fire ecology and behavior on December 30, 2021, the day the Marshall Fire broke out, during an unseasonably dry and windy day.
The earthquake killed two people and destroyed approximately 1,000 buildings, making it the most destructive earthquake in Colorado's history.
Gustafson helped fight the fires in a community that was already dealing with a pandemic and a mass shooting at a King Soopers grocery store.
“I think a big part of it is the emotional impact it has on everyone involved in the community: emergency responders, people who have lost their homes,” Gustafson said. “All of that adds up and causes stress for emergency responders.”
As medical workers walked through forests dotted with charred trees, they gave hourly updates on the fire, something Dr. Lauren Brave knew all too well.
John Daly/CPR News Pediatrician Dr. Lauren Brave lost her Louisville home in the 2021 Marshall Fire.
“I never thought my home in Louisville would burn down. It really took me by surprise,” said a pediatrician who took the tour.
After her home burned down in the Marshall Fire, she decided to volunteer and lobby for state funding for wildfire prevention and mitigation. “I think just the intersection of what I do and what happened communicates. That was kind of how I dealt with it after the fires started.”
Health leaders as climate communicators
Some health care workers may not feel comfortable being out there as advocates, especially on an issue that has been heavily politicized. Their voices matter, said Ed Maibach, a professor in the Climate Diploma Program who specializes in public health and climate communication, standing just a few steps from where the Marshall wildfires began.
“Health professionals are on the front lines of climate change, and educating them on how to best do that job really opens up all kinds of new possibilities for waking up as a country and as a human race to the reality of climate change,” he said.
The diploma program also teaches about decarbonizing the health system, aiming to conserve energy through energy efficiency and the use of renewable fuels, and ultimately becoming fossil fuel-free.
John Daily/CPR News Dave Gustafson, an open space ranger with the City of Boulder's Open Space and Mountain Parks, told students in the University of Colorado's Climate Medicine Diploma Program how a combination of high winds, lack of snow and tall, dry grasses sparked the Marshall Fire.
“We all go into medicine wanting to help people and cure illnesses on an individual level,” said Dr. Beth Gillespie, an internal medicine hospitalist at Denver Health and one of the program's instructors, “and as we start to learn more about how climate impacts health, we realize that the health care system is contributing to the problem.”
She said Denver Health aims to reduce its climate emissions by 50 percent by 2030 and then by 2050. “It's really important that the institution is mitigating emissions while also trying to protect people, patients, from local hazards, environmental hazards, like poor air quality and extreme temperatures,” she said.
Expectations for the program
Dr. Christine James, an allergy and immunology physician at San Diego Health, said she has seen the effects of climate change firsthand as rising temperatures make allergy season happen earlier and last longer.
“Especially in San Diego, we recommend some measures, like keeping windows closed to avoid exposure to pollen, but a lot of people don't have air conditioning,” said James, one of five people who attended the Climate Medicine Diploma Course through the fellowship program.
She hoped the program would provide her with a better understanding of challenges and solutions.
“I don't know what (the program) will do for me personally, but I think being a nurse is very important,” said Lauren Kelly, an Albuquerque nurse who teaches at the University of New Mexico and has worked with tribal communities.
Kevin J. Beatty/Denver Site Shanna Tarter, managing director of the University of Colorado's Climate Medicine Diploma Program, photographs tubes inside a freezer during a visit to the National Science Foundation's ice core facility at the Denver Federal Center in Lakewood, Aug. 14, 2024.
She wanted to help the nursing profession become involved in climate health activism and advocacy through interdisciplinary and interprofessional collaboration.
“There's historical precedent in our profession for the nursing profession to focus on the environment and environmental health,” she said, “and that's the catalyst for building on that and saying, 'The current situation calls for us to do more and take more political action in that area.'
The hope of the program is that as word of their work spreads, more health care workers will get involved and educate them about the burgeoning health risks.
“The climate health movement — medical professionals looking at the threats that climate change poses to health — has been developing over the last 15 to 20 years, but it's really gaining momentum now,” Maibach said. “The people being trained here today are helping to spread this movement into their communities, because there are still a lot of communities that don't have medical professionals looking at these things.”
