Stanford Medicine magazine looks at how health and the environment interact — and ways to counter negative impacts

Stanford Health Care anesthesiologist Praveen Kalra, MD, was surprised to read a few years ago that a commonly used anesthetic, desflurane, had an outsized negative environmental impact compared with other anesthetic gases that work equally well. 

He convinced his anesthesia colleagues to drop desflurane in favor of more environmentally friendly anesthetics, and in doing so, became part of a green movement now sweeping health care. Desflurane has been eliminated in all Stanford Health Care operating rooms.

The new issue of Stanford Medicine magazine, featuring a special report on the environment and health, includes articles describing efforts by Kalra and others toward green health care. With about 8.5% of all U.S. greenhouse gas emissions originating from the health care industry, many in the field feel a responsibility to reduce that contribution. 

“We’re at a moment of realizing that all this research says climate change impacts the patients we take care of, and we have to start doing things differently,” Christy Foster, director of sustainability at Stanford Medicine Children’s Health, said in an article about innovations to reduce the environmental impact of conducting surgery. 

Also in the report, Health on a planet in crisis, are stories about ways to reduce the health impact of environmental hazards, including wildfire smoke in California, dust storms in sub-Saharan Africa and lead poisoning in Bangladesh. 

The report includes:

• A roundup of initiatives addressing environmental health — from quantifying, modeling and optimizing water use for hospitals; to formulating an ocean-friendly sunscreen made from a virus; to overcoming climate dread.
• A story about a high-tech hunt for the source of dangerously high lead levels in pregnant women in Bangladesh. The article describes how research scientist Jenna Forsyth, PhD, and professor of medicine Stephen Luby, MD, used chemical analysis and detective work to discover the origin — a yellow colorant being used to make ground turmeric look more appealing.
• A Q&A with environmental advocate Catherine Coleman Flowers, in which she discusses what she calls “America’s dirty secret”: failing sewage and septic tank systems, particularly in marginalized, rural communities. The Q&A is based on a Minor Consult podcast with Lloyd Minor, MD, dean of the Stanford School of Medicine.
• An article about what it will take to make California’s schools climate resilient. The piece, featuring Lisa Patel, MD, clinical associate professor of pediatrics, describes the creation of a Stanford Medicine-led white paper on the topic, its recommendations and its impact.
• A report on attempts across Stanford Medicine to make operating rooms more sustainable, including the project Kalra led to reduce greenhouse gases due to anesthetic gases; switching to more reusable devices such as blood pressure cuffs; and right-sizing supply packs — the collection of tools and supplies needed for a surgery, such as surgical blades, clamps, drapes, sutures and swabs. 
• The story of a medical student who channeled her anxiety about climate change into a campaign to weave material about the environment into the medical school’s curriculum. The student, Ashley Jowell, is graduating with her medical degree this spring and is featured in a video conversation with Kalra about physicians tackling climate change. 
   

Beyond the theme package, the issue also features an article about the unexpected importance of the sense of smell — and a faster, more successful treatment for the loss of the underdog of senses; a story about drug delivery strategies that could reduce side effects from mRNA vaccines; and a perspective Q&A about self-compassion from a physician well-being expert and emergency medicine doctor who works the night shift.

Stanford Medicine magazine is available online at stanmed.stanford.edu as well as in print. Request a copy by sending an email to medmag@stanford.edu.