David Ouchterlony is a coroner who spent 10 years as a full-time palliative care physician at the Temmy Latner Centre for Palliative Care at Mount Sinai Hospital. Here, he compares and contrasts his daily experiences with the suffering of others to the emotional distress he feels when thinking about climate change.
It is hard for me to separate my feelings about bad news, suffering, and death that I developed in palliative care from those I have developed as a coroner. There are physicians who offer conference seminars on identifying and coping with stress in medical practice. I have never felt the need to register for one of these. I have never felt that my experience with dying patients and grieving families has caused me any distress that I take away into my own life. I sleep well, I stay fit, I have friends and a happy marriage, and I have some laughter every day.
On the other hand, I have to recognize almost daily that death is around me all the time. I see dead bodies, talk to shocked and/or grieving family members at the scene of death or by phone and I write reports of my investigations. So I have many more regular reminders of death than most people, even more than most physicians. How does this affect me? It’s hard to say. I would need an identical twin brother as a comparison. Certainly there are sad moments and not infrequently I am moved close to tears, especially when talking to parents, hearing expressions of love and dealing with deaths of infants and children. These moments are brief, however, and soon forgotten in the busyness of the investigation.
The changes I see in myself that I might attribute to this medical work are several. I am more constantly reminded of the fact that death is inevitable than most people are. It remains to be seen if I will be more accepting of death when my own time comes. I am perhaps also more aware of the dangers around me and more fearful of accidental death than others. I drive more slowly than I used to. I always hold on to a railing when descending a staircase. I get my checkups, and my screening colonoscopies. I stopped skiing (never liked it much anyway).
These feelings and actions that come from my work seem trivial when weighed against the effect that the knowledge of climate change has on me. In my view, anthropogenic climate change is a certainty, so uncertainty is not an issue for me. If it is not addressed now — and effectively — life on this planet will be very different and much more dangerous. I know I have contributed to the problem as a person enjoying the energy-dependent lifestyle we know today. But I also know that as one person I can’t make much of a difference.
A feeling of helplessness was my first reaction when I fully understood the situation. I found it very frustrating to not be able to find anything I could do that might help.
My first strategy was to talk to people to try to encourage understanding among those around me. This led to more — and more acute — frustration as I discovered that I knew many climate change deniers whose opinions I could not change. My distress has also come from considering the fate of my children, grandchildren, and subsequent generations of people everywhere around the world. It comes too from recognizing that only large-scale change across international boundaries will make a significant difference to the fate of humanity.
In contrast to my relative equanimity in the face of the distress and suffering of patients and families, I have what seems to be a deeper sense of fear (dread may be a better word) about climate change. I have had nights when sleep was difficult (usually when a climate-denying friend had annoyed me). I am disturbed by what seem to me to be excessive use of gasoline engines, from single-occupancy vehicles on busy highways to the constant hum of gardening machines. I get angry and frustrated to hear of politicians, business leaders and journalists who do not understand the situation, or who say they do, but do not act as if they do.
Each of these reminders stirs up my fear of what is coming in small daily doses. These stirrings add up to make me a more serious person, I think, and I work to not fall into pessimism. I don’t feel depressed and think I would recognize if I was.
Could it be that my professional experience, the years dealing with bad news and difficult times (for patients), somehow improved my ability to deal with my own feelings about climate change? Are climate deniers (some of them) just trying to avoid the fears that arise once they accept the truth of what is coming?
I have for years been advocating acceptance of bad news to people dying of cancer, so that they can make good decisions at the end of life. There seems to be a close parallel with that situation. People can only make good decisions when they have and accept all the facts.