Dr. Temperance "Tempe" Carbonic doesn't exist, but she should. If she did, you'd find her in the emergency department of a mid-sized hospital in Denver, where she's spent the last eight years watching climate change walk through the doors on two legs. What started as idle curiosity about heat-related admissions has evolved into something approaching obsession—a detailed tracking system that reveals uncomfortable truths about the industry she's devoted her life to.
How did you start noticing the connection between climate and your patients?
It was 2019, during that heat dome that hit us in late June. We had this elderly man come in with heat exhaustion, and while I'm hooking him up to IV fluids, he mentions it's the third time that month he'd felt dizzy from the heat. Third time in June! In Colorado! That's when something clicked.
I started keeping a little notebook, just jotting down patterns I was seeing. By 2021, the notebook had become a spreadsheet. Heat-related admissions, respiratory distress during wildfire season, injuries from extreme weather events, mental health crises that seemed to spike with temperature. The data was undeniable. Climate change wasn't some abstract future threat—it was my Tuesday night shift.
What does your tracking system look like now?
laughs My colleagues think I've lost it. I've got color-coded charts, weather correlation graphs, seasonal admission patterns going back six years. I track everything from obvious stuff—heat stroke, smoke inhalation—to the subtler connections. Kidney stones spike during heat waves because people get dehydrated. Domestic violence calls increase when it's too hot to think straight. Even car accidents go up when wildfire smoke reduces visibility.
The really disturbing part? I started tracking our hospital's emissions too. We're pumping out about 15,000 tons of CO2 annually while treating people harmed by emissions. It's like being a firefighter who moonlights as an arsonist.
How do you reconcile working in an industry that contributes to the problem you're treating?
That's the question that keeps me up at night. Healthcare accounts for about 10% of U.S. emissions1, and hospitals are the worst offenders—all those single-use devices, energy-intensive equipment, pharmaceutical manufacturing. Every time I order a CT scan or use disposable surgical instruments, I'm contributing to the very conditions that bring patients to my door.
I've calculated that our emergency department alone generates about 4.2 tons of medical waste per month. Meanwhile, I'm treating kids with asthma exacerbated by air pollution, elderly patients with heat-related illness, people injured in climate disasters.
The cognitive dissonance is professionally devastating, honestly.
Have you tried to change anything at your hospital?
Oh, I've become the annoying doctor who brings up sustainability in every staff meeting. I proposed switching to reusable gowns for non-sterile procedures, installing solar panels, buying renewable energy credits. The response is always the same: "That's nice, Tempe, but what about patient safety? What about costs?"
And they're not wrong! When someone's having a heart attack, you don't pause to consider the carbon footprint of the defibrillator. But we could be doing so much more during non-emergency situations. We could reduce pharmaceutical waste, optimize energy usage, choose lower-emission suppliers. Instead, we act like sustainability and patient care are mutually exclusive.
What's changed in your patient population over the years you've been tracking?
The baseline has shifted. What used to be unusual—heat exhaustion in May, respiratory distress from wildfire smoke in March—is becoming routine. I used to see maybe two or three heat-related cases per summer. Last year, I logged forty-seven between June and September.
The mental health component is huge too. Climate anxiety isn't just affecting environmental activists anymore. I'm seeing farmers worried about drought, parents asking if it's safe to let kids play outside during air quality alerts, elderly people who can't afford air conditioning during heat waves that last weeks instead of days. The psychological toll of living in an increasingly unstable climate shows up in our ER every single day.
Do other healthcare workers share your concerns?
More than you'd think, fewer than we need. A recent survey found that 60% of healthcare workers say climate policies would influence their job decisions2, which suggests people are paying attention. But there's still this weird disconnect between individual awareness and institutional action.
I've got nurse colleagues who bike to work to reduce their carbon footprint, then spend their shift generating bags of medical waste. Respiratory therapists who worry about their kids' asthma while working with equipment that contributes to air pollution. We all see the contradictions, but the system makes it nearly impossible to resolve them.
What would meaningful change look like?
Start with the obvious stuff—renewable energy, waste reduction, sustainable procurement. But the real change needs to be cultural. We need to start thinking about environmental health as public health, not some separate issue. Every medical decision should consider both immediate patient outcomes and broader health impacts.
Imagine if medical schools taught students to calculate the carbon footprint of common procedures alongside their clinical effectiveness. Or if hospital administrators had to report emissions data alongside patient satisfaction scores. Right now, we're optimizing for individual health while undermining population health, and that's ultimately self-defeating.
Any hope for the future?
sighs Some days. I see younger doctors who get it instinctively—they understand that you can't have healthy people on a sick planet. And the data I've been collecting is starting to influence our emergency preparedness planning. We're finally acknowledging that climate change isn't a future problem—it's a present reality that requires immediate adaptation.
But honestly? Most days I feel like Cassandra, cursed to see the future but unable to convince anyone to change course.
I'll keep tracking, keep advocating, keep treating the casualties of our collective inaction. Because what else are you going to do—quit medicine and become a climate activist? Someone's got to be here when the next heat wave hits.