Have you ever wondered about your own death? About how you might die, about where, with whom, distressing and difficult, calm and peaceful. You may have had professional experience in emergency or intensive care, managing aggressive cardiopulmonary resuscitation and critically ill people, or working in other caring environments in hospitals or homes, you may have witnessed the dying of family, friends, people you love present in that moment the heart slows and then stops, when life slips to death.
Dying, death and the lives we lead are where my interests intersect. As a cardiologist death comes up in clinical discussions, confronting the fear of death is a part of the therapeutic role of the physician. We talk of risk, approaches to reduce risk, to maximise the time we have with good quality of life, with an often-tacit understanding not adequately explicit, that life will end. Sometimes we move goals of treatment from ‘active’ treatment where prolonging life is the central goal toward palliative care, where meaning and joy are central and the end of life is understood. Most often the honour of discussing death and dying is not offered within a treating relationship until the last hours.
Yet when I think about climate change and health, it is death we seek to avoid. Death of people, children, elderly, animals and plants. Death of species, Death of communities, of towns and places, the dying of culture, the end of humanity. An ultimate death. Extinction. The existential threat.
There are a range of catastrophic and existential threats. Catastrophic threats being the ones that kill a quarter of us, and existential threats those that end all our lives. Loss of biodiversity, food and water security, hazardous contamination of essential elements for survival, climate change, pandemics. And nuclear war. And our understanding and use of information, how we engage with the challenge, communicate with each other. How we care, or not for our future. Threats we understand much more today that we did even a few years ago,
There is debate about the magnitude of the risk of climate change. Is it catastrophic, a threat to life for less than 25 per cent of humanity, or is it existential, potentially causing the end of human civilisation? There are numbers, calculations, modelling and quite heated discussions… Some discuss temperature predictions for this century in a calm manner that suggests life can go on as we know it at 1.8 degrees above the long-term average temperature, at 2, 2.7 or over 3. Life would be warmer they say, but it goes on.
Death from climate change is messy. Not like a coronavirus where the diagnosis is clear, laboratory based, easily counted. Exponential spread is now well understood, our modelling on spreading viruses are refined and understood.
The changing climate impacts across our lives, sometimes leaving a subtle fingerprint, sometimes a forceful boot kicking us to the ground. The changing climate impacts the air we breathe, the food we eat and the water we need to survive. Where we live, and how we live there, emerging as increasingly central to our survival.
In just the last few years more than 50 per cent of our Australian population have been touched by environmental disasters underpinned by the changing climate, with 12 million of us breathing the hazardous air pollution and smoke from the 24 billion hectares that burned through that apocalyptic summer. Lives were lost through fire, drought and heat waves causing illness, injury and death, and most recently unprecedented floods upending more lives, lives forever changed, futures uncertain.
Physical health impacts from the changing environment occur across all parts of our health from childhood to very old age. From heart attacks and strokes, infections and falls, frailty and the mental health impacts not least of which is the growing existential dread that accompanies the realisation of consequences of man-made environmental destruction and the glimpse of what lies ahead.
Existential threats. Threats that disrupt our human future. Threats that change our human future, a planet without us, end of civilisation, end of humanity as we understand. Climate change is existential alone, and in concert with the other challenges, there has never been a more important moment to imagine our human future.
Recognising and protecting biodiversity, seeing the central importance of our natural environment, its water and lifegiving sources of food and shelter. Understanding global pandemics, their risks and mitigation strategies. And at the same time international conflict, the spectre of nuclear war again hanging over our future with increasing clarity.
We worry about artificial intelligence, but it’s how we use information and knowledge that warrants our attention. Do we approach understanding with care and compassion, or careless disregard for our future. This is a central question for how we live, and how we might tackle our future. Our understanding of science is remarkable. Yet we have seen how easy it is to disregard science, particularly that clear relationship between CO2 concentration in our air and the temperature and climate in which we live. So it is how we use our knowledge, how we share and grow our knowledge that commands attention.
And so, a veritable smorgasbord of challenges to our human future. And the associated challenge that we might ‘solve one problem’ without recognising the ‘other problems’ and their interrelated, interconnectedness, might just make things worse…
The balancing act of hope and threat is complex. We see this in both healthcare and in politics and policy. Hope has physical and psychological benefits, we feel inspired, motivated, able to move, to participate and to change. Yet avoiding the magnitude of risk, running away from the panic of the end of our existence we risk delusion, failing to appreciate the magnitude of the risks ahead, failing to understand what’s likely to unfold. This is an optimism bias that helps individuals survive, but that may seriously compromise communities and generations ahead as we fail to appreciate the need for change.
And so our future hangs, balanced between risks, threats that are existential, and our capacity to find hope in our best future, pragmatic and without delusion.
Sometimes at night we might hear our heart beating, loud in the surrounding silence. The heartbeat of worry, anxiety, or panic is faster. It’s insistent, it wants us to act. We find ourselves concerned about all sorts of things, including when the end might come, when the beating might stop, when the sudden cardiac arrest with its random timing, could it be now… Fear is paralysing, adrenaline saturates our muscles, including our heart, breathing is hard, panic rises. For some collapse comes to break this circuit.
Panic, it’s not so helpful. Calm thought, peaceful mediation. Slowing breath, slowing heartrate, not stopping, just calm. Slowing from the race of stress, toward the calm of our future, finding the mantra for our life. Its this process of rest, relaxation and reflection that gives us strength to contend with serious challenges, to answer the major questions and to move forward.
A delicious balance between tachycardia, the racing heart, and bradycardia the slow resting beat, is where we find action. Being ‘in the moment’, this is how we move forward from incapacitating panic, how we contend with the challenge, how we create our best future.
I tell my children, ‘You’re in for a wild ride’. Climate change (and scope three emissions), catastrophic and existential risks. Political disruption alongside environmental change that may undermine our survival.
How can we avoid the paralysis of panic? To embrace life, to celebrate life and death, to avert extinction, we need to ask what it is that matters in our lives. What might bring us together, what we want, desire, what we hope to create? What can our human future be?
There isn’t ‘one solution’, one grand theory that will make everything alright. One engineering design that solves climate change, preserves biodiversity and prevents nuclear war. The origin of the electron is not what matters, it’s the value we place on its creation, it’s worth and our future.
Recently, in a book on globalisation, Anthea Roberts and Nicolas Lamb offered a compelling argument for integrative thinking, whole of system, interdisciplinary approach to complex problems – a move from our tendency to pursue Ockhams’ Razor – the assumption that the simple unified explanation is the answer – toward an understanding that solutions are often more like Ockham’s quilt, complex interrelated, interdependent elements that form a dynamic surface, not a straight line.
Perhaps we need a compass not a map. A compass that helps us find the values that guide and unite us, the compass that shows us the way through a future landscape that will offer unprecedented challenges and events. Is a compass a glimmer of hope that comes from the dark confrontation of existential risk?
What would be the elements for such a tool? We need to talk about this. Talk together, as communities and as a nation. And while our politics are not currently inspiring in these discussions, there are glimmers of hope. Hope from community consultation, kitchen table conversations, hope from the politics of genuine representation and hope from the great work already underway with many groups are already facilitating and encouraging these conversations, learning and sharing as they go.
My friend Millie Rooney, and her organisation Australia remade, spent the past two years talking with a range of people around Australia about what it is they care about, what might be our Public Good. They found that across the political spectrum we value housing, healthcare, education, jobs, access to nature and access to the internet.
But we also all yearn for something deeper.
Connection: Humans are social, we value connection to others, to our places. Connections through physical infrastructure like paths and shared spaces, and through vitual spaces on-line and through community connection.
Contribution: We all aim to contribute. Paid work, unpaid work, contributing to our community and to our nation.
And Care: We want ability to care and to be cared for. To care for ourselves, our families and communities and our places, our environment, our planet.
So what if we use care as a primary goal? What if our approach to education, healthcare and aged care were defined by the value of care? What if we consider existential threats such as climate change through a lens of caring – caring for people, communities, ourselves, our environment and our future.
Our human future, death, dying and life. Our future contains our past, our current decisions may determine our longevity. Appreciating science, using our imagination and seeing the intergenerational view are all keys to our human future.
As we find and celebrate these common threads, as we weave the quilt that supports our humanity now and toward the future, our confidence in survival grows. From panic, distress and disabling anxiety, hope comes from joy, connection, collaboration and play and our horizon extends again toward a better future.
Dying well at the end of a life well lived is a gift. A gift that reminds us of the power and privilege of living. There are however a great spectrum of ways in which we can die, of way in which those we love and care about will die, of how our communities will die and of how our planet will change over the years ahead. We are at a crucial moment for our human future, and the compass we choose to use to determine our direction now is key.
‘Life, Death and our Human Future’ was part of Provocations #4: ‘“Hope” is the thing with feathers’, a symposium presented by the J.M. Coetzee Centre for Creative Practice at the University of Adelaide on 28 April 2022.