In June, a woman in her 70s showed up at an emergency room in western Canada dehydrated and suffering from asthma and diabetes.
But it was a record heat wave in the region that prompted Dr. Kyle Merritt to admit the woman to the hospital in Nelson, British Columbia, citing climate change as the underlying cause for her condition.
The woman, whose name has not been made public, lived in a trailer with no air conditioning as temperatures climbed past 100 degrees. Combined with heavy smoke from wildfires raging in Canada and the United States, emergency rooms throughout British Columbia quickly filled up.
The soaring temperatures created a heat dome, breaking records and killing nearly 600 people in British Columbia. The crushing heat was followed in November by deadly flooding that killed four people in the province and more than 100 in Washington state.
Because Merritt noted in the woman's medical chart that climate change was responsible for bringing her to the hospital, many inside and outside the profession perceived it as a first-of-its-kind diagnosis.
“I think that we’ve learned that climate change is essentially required in order for it to get that hot where we live,” Merritt said in a recent interview. “Without the heat, she would not have been admitted to hospital. So I thought it was accurate.”
The U.N. World Health Organization estimates 150,000 deaths a year are caused by climate change, a topic of discussion among world leaders, scientists and others last month at the U.N. Climate Change summit in Glasgow, Scotland.
The conference coincided with the first public mention of Merritt’s diagnosis in a news release about a rally the physician-activist group Doctors for Planetary Health was planning in Victoria, British Columbia. A second rally was held in Nelson, Merritt’s hometown.
Merritt, a member of the group, was interviewed by Canadian TV networks and Yahoo News, drawing international attention, including in Glasgow.
Summit attendee Dr. Jay Lemery, an emergency medicine physician and co-founder of the climate health program at the University of Colorado School of Medicine, said he was struck by Merritt’s boldness.
“It’s a provocative action, but certainly the science is there to substantiate it,” said Lemery, who’s focused on bringing “climate and health data to the bedside.”
Merritt, whose patient was successfully treated, unaware that her diagnosis had drawn headlines worldwide, said he received some negative phone calls and emails for treating climate change “as a real thing,” but most of the reaction has been positive.
He said he isn't aware of any other doctor making such a diagnosis, but he feels certain that others have made the connection between climate change and a person's health.
“It’s clear to me this could not be the first patient where a doctor considered climate change as an underlying factor,” he said.
Dr. Linda Thyer, an emergency medicine and family doctor in Vancouver, B.C., and a founding member of Doctors for Planetary Health, organized the rally in Victoria, to coincide with Glasgow and to capture the attention of lawmakers.
“I feel as health care professionals, as physicians, we need to carry our voice to the policymakers, saying that the climate emergency is a health emergency,” she said.
In an era when Covid-19 vaccinations ignite fierce political debate, the E.R. and exam rooms are probably not the best places to broach the subject of climate change, Lemery said.
“I don’t have a political agenda,” he said. “I absolutely have a scientific agenda, and the data is there. We know what is happening. We know its impacts.”
Thyer said she is seeing more patients who are experiencing the adverse effects of global warming, mostly involving respiratory ailments and mental health.
She said some of her young patients suffer from eco-anxiety, which the Journal of Climate Change and Health describes as distress caused by climate change in which people become anxious about their future.
Indigenous peoples, children and young adults are considered the most vulnerable.
“This can involve loss of sleep or appetite, difficulty concentrating, low energy and panic attacks,” said Thyer, a mother of three.
“What do you tell them when they say, ‘Mom, what’s the world going to look like when I’m trying to start a family?’”
Just as smoke from U.S. wildfires blew into Canada this summer, climate change ignores borders. Smoke from California wildfires traveled as far as Boston and New York over the summer.
Marshall Burke, a professor of earth system science at Stanford University, said satellite images showing the path of toxic wildfire smoke have enabled researchers to “link up health data we have on the ground to see how many people go into the hospital on a given day.”
“We need to expand our notion of where climate change is going to be important,” he said.
The issue is gaining traction among doctors and academics. Lemery’s climate and health program at the University of Colorado includes five physician fellows, believed to be the first of their kind in the U.S. The department plans to offer a diploma in climate medicine next year, said Lemery, co-author of the textbook “Enviromedics: The Impact of Climate Change on Human Health.”
“The key is to share and have a health care workforce that is ready for what is coming down the pike,” he said.