by Dr. Plastic Picker

Its 4:21am and I showed up. I showed up on this blog because I’m having a hard time doing my part as co-author for this very important paper. We’re on a tight deadline simply because the six authors are busy and normal people, that have multiple other projects and things to do. Advocating and writing about climate change, doesn’t pay the bills. We all have to work and do other things, and this is all extra. The extra love and extra attention to we pay to this work, is so important because no one is showing up. But that’s not true because the three reviewers showed up for us. They showed up and the Yale Journal of Biology and Medicine Editorial Board showed up to accept our paper. They made really good suggestions and to be honest, it’s suggestions that we need to take and to incorporate and it will make the paper better.

It’s really an act of love, isn’t it? All those long-winded reviewer comments. They actually read the paper and asked us to add more. So what they asked of me (or what I took on for my part) was.

“I believe that it would benefit from incorporating more attention-grabbing elements to better engage readers. I encourage the authors to bolster their arguments and critiques, and to provide a more balanced approach by weighing both the benefits and challenges of divestment. For instance, while the manuscript includes a list of organizations committed to divestment, it would be beneficial to also address the challenges these organizations have faced, and to provide examples of successful case studies. Additionally, relevant evidence to support the arguments presented would be helpful. “

Okay. So let’s add more attention-grabbing elements to better engage readers. The introduction is kind of bland and I can add some pizazz! Just like I do when I go onto the news. Let me pretend I’m on the local news station in my addition to the introduction!

Climate change poses an existential threat to children’s health. The Lancet has described CC as “the greatest global health threat facing the world in the 21^st century,” and also calls it “the greatest opportunity to redefine the social and environmental determinants of health.”  Increasingly, pediatricians are caring for patients with illnesses directly and indirectly related to climate and the environment, including allergies and asthma; heat-related illnesses; premature birth; injuries from severe storms and wildfires; water-, tick- and vector-borne diseases; and mental health problems. The threat to human lives is here and increasingly recognized by mainstream media. For example, the last two summers the Pacific Northwest was encased in a heat dome. What was supposed to be a 1 in 10,000 year event happened in two sequential summers. Summer of 2021, 800 died in the Pacific Northeast heat waves of 2021 [https://www.scientificamerican.com/article/deadly-heat-dome-was-a-1-in-10-000-year-event/]. The following summer of 2022, for a 5 day period a heat dome enveloped the Pacific Northwest and 11 million were placed under excessive heat warnings and 12 million under heat advisories. Ninety six people died in Oregon who were mostly home alone without air conditioning. [https://www.opb.org/article/2022/09/28/pacific-northwest-heat-wave-2021-oregon-summer-weather-heat-dome-climate-change/] . And then further south in California, what we now understand as climate whiplash where the wets are wetters and the dries or drier [Precipitation regime change in Western North America: the role of atmospheric rivers A Gershunov, T Shulgina, RES Clemesha, K Guirguis… – Scientific reports, 2019] – the west experienced extreme rain events with the landing of atmospheric rivers that caused historic flooding in California and Nevada.  200,000 were left without power, and 22 deaths including a 5 year old that was swept away in the floodwaters gaining national media coverage [https://www.npr.org/2023/01/10/1148094527/california-flood-boy-swept-away-montecito-evacuate].

Okay wow. That was super helpful. I’m going to put this in now into the track changes document. I added it to the track changes document. Can I tell you how I hate how ugly the track change document looks! It’s hard for me to follow what it actually reads like. But oh well, this is what I’m learning as I venture into more academic writing. I’ll be honest. Some of the stuff I got from Wikipedia which actually is legit, because I followed the citations back to the original reference articles. There are some smart people writing in Wikipedia! LOL.

Okay the next part is reviewer 2 wanted “I encourage the authors to bolster their arguments and critiques, and to provide a more balanced approach by weighing both the benefits and challenges of divestment. For instance, while the manuscript includes a list of organizations committed to divestment, it would be beneficial to also address the challenges these organizations have faced, and to provide examples of successful case studies.” So I need to incorporate two more paragraphs which I’ve been struggling with for the last two days because it’s hard to try to incorporate it into a very long document already. But if I can try to explain it to you dear readers, than it will make sense. Because the readers of these journals are just people as well, but they just need more “smart language” with some ivy league flourishes!

I had started this already so here I go.

The Challenges and Benefits of Divestment

We understand that in most institutions, fossil fuel divestment will be difficult and sometimes seem daunting. Within each healthcare sector organization, both professional organizations and health systems, there are complex systems in place that control finances. It’s often hard to figure out who has influence and responsibility for directing where money is invested. Organizations have complicated structures of who manages retirement plans, and who gets a say in how these plans are selected, and often it’s a handful of individuals on committees or those who hold financial positions who make the decisions despite overwhelming support for divestment/climate safe investments from the rank and file health care providers. The word divestment and ESG has now also become increasing partisan, and now included in the culture wars. When divestment or climate safe investments have been raised by physician climate and health advocates, the response from others has sometimes been founded in fear that climate safe decisions are in conflict with fiduciary responsibilities despite recent clarification by the Department of Labor that ESG investment guidelines are in line with fiduciary roles. There is the real threat that fund managers and retirement committee members can be sued for violating fiduciary roles, and organizations and individuals have had to purchase insurance to cover for this remote possibility. There is usually also not cross institutional lines of communication yet in terms of retirement fund managers and climate and health advocates in this space.

We understand that there are challenges to divestment, but there are precedents and success stories that can be examples. In May 2020, The University of California system became the largest public university in the country to divest from fossil fuels, and as the flagship system for California became a bright example of how divestment can occur. With it’s own complicated structure of governance, it was a combined effort from multiple groups within the university system that accomplished this. It was the UC Green New Deal, UC Academic Senate, and UC Board of Regents all involved in accomplishing this work. There were key professors and student leaders that represented a ground-swelling of support from faculty and students that were displayed in multiple protests throughout the different campuses. In the end the UC system was able to accomplish divestment, and gained moral authority and greater leadership and security in their academic reputation as a leader in climate science and advocacy.

Okay. That was really helpful actually! I think I’m done. I’ve added my part and just send a text to my friend about who to send the next document to. Sometimes writing a paper is like soup. We add bits and pieces and hoping it melds into something delicious. Everyone who is part of this paper poured their heart into it. It’s hard to work as a group and to coordinate, but there really is no other option. We have to work together. We have to try. This paper is really really important because the pediatric associations need to lead the way, and then family practice and emergency medicine and the rest will follow.

So it’s 551AM and it’s been a production 90 minutes. I had been thinking about this paper the entire weekend and just couldn’t get anything on the actual paper. But realizing that I’m imperfect but my part is important has helped. I’m not an academic. I do like writing. And I’ve added my part and my perspective, and I’ve reached out back to my academic friends because the track changes and citations scare the beejeebers out of me! But being able to type and realize if I can explain things to you, dear readers, and more importantly to myself – than maybe I can explain it to the academic pediatric world. I need this publication so that I can come back to the retirement committee head and my current nemesis, and just hand him a copy of this paper with a co-authorship. That way I can push our organization to divest a multiple billion dollar pension and funds. I may be cursing him and another person in my brain, but I’ll smile when I hand him this paper. Because I went to Crimson University.