This essay, by Veronica Goveas, is one of three winners of the 2024 Sustainability Writing Awards hosted by the Office of Sustainability. You can read more about Veronica here.
I grew up in a village in Wisconsin, where summer heat was mild and fleeting. We measured storms by the inches they left on the sidewalk, not by the wreckage they caused. Then, last summer — one of the hottest on record — I interned at a health clinic on the edge of Milwaukee, working the front lines of public health in an unrecognizable season. The heat hammered relentlessly, pressing against the clinic windows by midday, turning the waiting room into a steamy, suffocating chamber of labored breaths and tired sighs. Even with air conditioning, the air hung heavy, sticking to our skin. It felt as if the sun had crept into our sterile hallways — uninvited, unapologetic.
That summer, I witnessed climate change up close and personal. The patients who filed in weren’t just battling their usual chronic illnesses — they were confronting new, heat-fueled struggles. I remember one man, Carl, in particular. He shuffled in wearing a faded Brewers cap and a thick, blue work shirt, his movements slow and heavy. He dropped into the chair across from me with a wheeze, his skin flushed and slick with sweat, beads pooling at his temples. ‘Can’t seem to shake this,’ he muttered, tapping his chest as if the problem were lodged beneath the fabric, a stubborn issue that could be solved with a simple, well-placed touch.
Carl’s chart indicated that he had chronic obstructive pulmonary disease (COPD), a condition that makes breathing difficult. His breathing had always been labored, but this summer was different. The heat trapped his lungs like a vice, tightening with every breath. He told me he’d worked as a construction worker most of his life, spending countless summers outdoors. ‘But it never got like this,’ he said. He looked at me, searching for an answer, as if I could explain why the world he’d known was suddenly turning against him. I felt the weight of his question, but all I could offer was a gentle nod and a prescription refill. I didn’t have the words to tell him it would likely only worsen.
Each day, as the sun climbed higher and the clinic filled with patients like Carl, I felt the fragility of our healthcare system more acutely. We were trained to treat people, diagnose ailments, and offer solutions. But how do you treat heat itself? How do you shield people from an environment changing faster than our treatments can adapt?
In the waiting room, I met people who had journeyed hours from distant rural towns, some living without air conditioning in their homes or cars. They sat, slumped and sweating, fanning themselves with crinkled pieces of paper, their faces flushed, eyes dull with exhaustion. One woman, Anna, had driven nearly two hours with her three kids in tow. ‘The youngest,’ she murmured, nodding toward her toddler in the stroller, ‘she’s got asthma. It’s always worse in the summer, but this time…’ Her voice trailed off as she glanced outside, where heat waves shimmered off the asphalt, warping the air like a living thing. Her toddler slept fitfully, breaths coming in quick, shallow bursts, punctuated by the soft hiss of the inhaler tucked into Anna’s bag, it’s sound as fragile as the child’s labored breathing.
As Anna told her story, I realized that climate change wasn’t just a series of statistics or headlines — it was here, a third presence in the room, actively pushing people to their limits. For Anna and her family, every rise in temperature wasn’t just uncomfortable; it was a looming risk, a threat to her child’s next breath. I saw the worry etched on her face, a worry I knew I’d carry with me long after I left the clinic that evening. Each interaction drove home a painful truth: public health and climate weren’t parallel issues. They were colliding, right before me.
Back home, I’d call my mom and try to explain what I was seeing. She’d listen, a bit skeptically, reminding me that “we’ve always had hot summers” and that “people are just more sensitive now.” It was a familiar refrain, one I’d heard from others who shrugged off the urgency of climate warnings. They didn’t see the people I saw, the patients with conditions they couldn’t manage, driven to us by forces they couldn’t control.
I’d tell her about Carl, about Anna and her kids, about the young man who came in with sunstroke after working three back-to-back shifts in construction, his skin nearly blistering with heat. “It’s different now, Amma,” I’d insist, picturing the crowded waiting room, the steady hum of fans struggling against the warmth. But she’d just chuckle softly and say, “Well, you’re seeing the worst of it, kanna. Out here, things are still fine.”
I felt a knot in my chest each time I hung up, torn between the reality I witnessed and the disbelief of someone I loved. That’s the hard part about climate change: it splits our worlds, leaving some people on the front lines while others stay insulated in places where it’s still ‘fine.’ But how much longer would ‘fine’ last? How many more summers would pass before even the skeptics could feel the heat?
I think about what it takes to keep people like Carl, like Anna’s child, safe as the world warms. Beyond individual care, we need systems built for resilience — clinics designed to handle heat, emergency plans that consider climate extremes, and policies that prioritize the health of those most vulnerable to environmental changes. We need doctors, nurses, and public health workers trained to recognize the subtle fingerprints of climate in the illnesses we see. But more than anything, we need a shift in mindset — a commitment to treating climate change not as an external issue but as a core part of healthcare.
That summer, as I finished my internship, I carried the quiet stories of every patient who walked through our doors. I thought of them during lectures about public health, realizing that each slide on climate’s health impacts wasn’t just academic — it was a roadmap to the lives we’d be caring for. I knew then that the path I had chosen wasn’t just about medicine; it was about advocating for a future where climate doesn’t compromise health.
In Madison, I still hear Carl’s persistent cough and see Anna’s anxious glances at her child. Each patient taught me more about what it means to live in this new reality, where health and climate are forever entwined. As I envision a future in medicine, it’s clearer than ever: the work ahead isn’t just about healing — it’s about building a resilient system strong enough to protect people from a world changing, degree by degree, day by day. In that fragile balance, between health and heat, lies the future of medicine — and our shared reality.