The Air They Breathe

I’m used to thinking about climate change from a physics perspective: what technologies can we use to reduce the amount of carbon dioxide and methane going into the atmosphere. Even when I consider the health effects of climate change, I tend to focus on the technical aspects (as you might expect from an author of a book titled Intermediate Physics for Medicine and Biology). Moreover, I often consider the long-term risks of climate change, and how it will harm future generations.

The Air They Breathe, by Debra Hendrickson.

In her wonderful new book The Air They Breathe: A Pediatrician on the Front Lines of Climate Change, Debra Hendrickson has a different perspective. She explains how climate change is harming her young patients today. Specifically, she highlights four ways they are in danger.

1. Bad air from burning fossil fuels and from forest fires caused by climate change hurts children, particularly those with breathing problems like asthma. Here in Michigan, sometimes climate change seems a distant threat. But I remember the summer of 2023, when the air in the Detroit area was filled with smoke from fires in Canada. Hendrickson often makes her points by examples of specific children, such as a young girl named Anna, whose asthma was worsened by a forest fire burning near her home in Reno, Nevada in 2013. In The Air They Breathe, Hendrickson writes

Since Anna’s visit to my clinic that afternoon, thousands of other wildfires have raged through California, just a few miles to our west. They have grown bigger and more explosive, devouring not just forests, but towns. Every summer and fall now, waves of smoke pass through my city, and more of my young patients cough and wheeze. In 2018, the Mendocino Complex wildfire would become the largest California had ever seen, darkening the skies for weeks. Only two years later, in 2020, the August Complex fire would shatter that record, becoming the first to burn more than a million acres. And in 2021 we spent not just days breathing smoke, as we did in 2013, but months, as both the Dixie and Caldor fires raged a few miles away.

When I look back today, I see that the Rim Fire was not an isolated event, as it seemed to us then; it was the beginning of a trend. It was a sample of the world we are creating for our children.

2. Excessive heat can cause heatstroke in children, particularly in infants left in hot cars and high school football players who practice in the extreme heat. Children are especially sensitive to overheating. Heat waves can kill. Hendrickson tells the story of Joey Azuela, a child who almost died when hiking on a hot summer day near Phoenix, Arizona, saved only after being rushed to a hospital where he was covered with ice and injected with cold saline. She writes

Heatstroke is treated with extreme urgency; minutes make the difference between life and death. Joey Azuela is alive because he was cooled so quickly. Yet as the world watches temperatures climb, we drift, and delay; we risk pushing the planet to tipping points of rapid and uncontrollable changes, from which we cannot recover. The speed of our response is everything. It will determine not just the type of future our children have, but whether they have a future, at all.

3. Trauma and post traumatic stress disorder can occur in children who experience disasters caused by climate change, such as a hurricane, flood, or forest fire. Hendrickson examines in particular how in 2017 hurricane Harvey dumped as much as 40 inches of rain on Houston, Texas. One boy, Lucus, had to escape the rising water with his mother and siblings from their neighbor’s roof, saved by a passing boat. She writes

Natural disasters have always plagued us; the events themselves are nothing new. But a warming world is turning up their dial, and with it, the potential for trauma. Though some years are better than others, weather-related catastrophes are clearly trending worse over time: becoming more frequent, more powerful, and more destructive. Globally, natural disasters have increased fivefold over the last half century. Extreme weather events—the worst examples of these disasters, like 100-year floods and Category 4 hurricanes—are growing steadily more severe, and more common.

4. Infectious diseases, such as an increase in malaria caused by a greater range for mosquitoes, are becoming more common with global warming. Hendrickson tells us about Darah, an infant born in New Jersey who got the Zika virus from her mother while in the womb, and who suffered from microcephaly: an underdeveloped brain. She explains

To understand the connection between climate change and Darah’s case, we have to zoom out from her small New Jersey apartment and see that she shares this planet with trillions of other living things. That her body is linked to the Earth not just by water and air, but by a rich sea of organisms, friend and foe, living within and around her. Many of them are being affected by rising temperatures and shifting rains; by changes in habitats and seasons.

One point this book makes clear is the health care and climate change are not separate issues. The two are intertwined. Another point is that this is not merely a problem that we will all face in the coming decades. It’s happening now, as described by the horrific stories of these children. I found this book to be a call to action. It motivates me to make an even greater effort to address global warming, because—as Hendrickson warns us—“The only heroes our children have are us.”