Bruce Bekkar - From Delivering Babies to Delivering Climate Solutions

[00:00:10] Dominique: Hello. Welcome to Green Champions.

[00:00:12] Adam: Thanks for joining us in a conversation with real people, making real environmental change in the work that they do. I'm here with Dominique, our sustainability expert.

[00:00:20] Dominique: And I'm so glad to be here alongside Adam, the social enterprise extraordinaire. We bring you guests who saw the potential for impact in their job or community, and did something pretty cool about it.

[00:00:28] Adam: From entrepreneurs to artists, scientists to activists, this podcast is a platform for green champions to share their stories and plant new ideas.

[00:00:35] Dominique: Today, Adam and I are pretty excited to be joined by Bruce Bekkar. Bruce is a former OB-GYN, who's now leading conversations around how the medical field can take action on climate change. Through his work with ecoAmerica, and as a co-creator and co-host of the Green Docs podcast, Bruce help professionals become advocates for sustainability and climate smart care.

And today we're really excited to spotlight Bruce as our green champion, and we're gonna dive into how the climate crisis is a health crisis. Thanks for joining us today, Bruce.

[00:01:07] Bruce: It's really good to be here. I am always happy to meet new people that are doing important work in the climate space. So the privilege is mine.

[00:01:16] Dominique: Well, Bruce, I feel like we should first start talking about your history as an OB-GYN. So take us back to early days there, like how did you decide to pursue medicine? 

[00:01:26] Bruce: At the time that I went to college, it just seemed like the people that could would try to get into medical school, it was just kind of considered the pinnacle of achievement in the beginning of an exciting and really demanding and, fiscally beneficial career with a chance to make a difference at the same time. And so I got drawn up in that, I was competitive and I went to UC San Diego, where there was a lot of interest in going to medical school.

[00:01:52] Adam: I think it just I always really respected the doctors that I'd met growing up. And actually the guy who delivered me was a family friend and he would come over from time to time and I always felt that Dr. Shulman knew me a little better than anybody else did because he saw me first. And that's probably a big part of what drew me to medicine and to OB-GYN in particular. So anyway, I was really excited to go to a good medical school and to have a career that felt meaningful and secure and where I really got the chance to connect with people on a pretty intimate level, on a regular basis. How did that start to change? Like at what point did you start to connect that to environmental change and human health?

[00:02:35] Bruce: One of the things that I loved growing up was going to the beach with my family and loved getting in the water. And I learned to surf finally when I started to grow bigger than three and a half feet tall. So my interest in environmentalism really came from my love of the coast and of going surfing. And a couple of years after I moved back down to San Diego, which actually I came back to a town on the north county coast called Del Mar because I just absolutely felt at home there.

And it felt very natural to me that the one of the things I would do in my time off, aside from enjoying going in the water, was also to do stuff around protecting the coast. And so my initial involvement for several years was with a local community group that kind of banded together and we coordinated beach cleanups and put on fundraisers to buy things for the town that would help keep the beaches clean. 

We started lobbying the Surfrider Foundation. We had a connection to them and we actually convinced them after a little bit of effort to let us found the first local chapter of the Surfrider Foundation in San Diego.

And if any of your listeners follow Surfrider at all, you know that there are more than 80 chapters, local chapters now around the world, and Surfrider has, really empowered these people to take on coastal issues without their direct control although they do advise.So I was really happy to be part of the very first local chapter of that organization. And that's kind of the through line. It didn't connect up to climate change until later.

[00:04:08] Dominique: Which I wanna talk a bit about the fact that you focus a lot on maternal and infant health. even going back to your decision with medicine first, why the OB-GYN path? What drew for you the, like, mothers and infants side of the health world in general? And then I wanna unpack how that is so relevant to the climate crisis?

[00:04:27] Bruce: It was not relevant, or at least it was not recognized as relevant initially. The obstetrician who delivered me would show up from time to time, and I had great respect for Dr. Shulman. My girlfriend in college, her father was a prominent OB in South San Diego, and I spent a fair amount of time around him. And then when I went to medical school, it was right when ultrasound was really starting to find its footing within obstetrics. 

Prior to that, all they had were x-rays, and of course x-rays were done very infrequently. Oftentimes, there were big surprises at birth because obstetricians didn't even know that there were two babies in there and not just one. So when ultrasounds showed up and began to just permeate OB-GYN, it was really at a time when a lot of us were going through our initial rotations at USC medical school. And so it was this time of miraculous technological advancement and, I think it was the most popular specialty of our graduating class, probably for that reason.

[00:05:22] Dominique: Oh wow. And then why is it so significant to talk about maternal and infant health when talking about the climate crisis?

[00:05:30] Bruce: Well, the climate crisis as we are learning more and more really is an ongoing health crisis. It's not something theoretical, it's something ongoing. And there are a number of vulnerable groups that have been identified in the medical literature as being particularly sensitive to impacts of climate. But initially the groups that were being recognized in the 2015, 2018 or so, we started talking about kids. 

They have much greater sensitivities to many of these adverse impacts of climate change. The elderly, the poor, and uninsured people that are chronically ill and overweight are also in the bullseye. But, it was not recognized initially that pregnancy was a time also of great vulnerability and of course, the thing about pregnancy is it isn't just one person's health that you're concerned about, it's the what's called the pregnancy diet. It's mother and baby. So we find that both of those groups are sensitive and at risk. It was really that the studies were showing up in the medical literature starting in 2010, but increasingly as we get to today, more and more studies around the world showing harm due to some of the really common exposures of climate change, including increased heat, heat waves and lack of nighttime cooling and increased humidity and air pollution, either just from the burning of fossil fuels or from industrial plants and freeways, forest fires which create really, really nasty blends of air pollutants that have a substantial negative effect on developing babies and on moms.

[00:07:00] Dominique: It's really awesome to hear you share a bit of the fact that like these are vulnerable groups. Understanding the fact that it is so important that we are talking about it, thinking about it, creating space for talking about other options for these individuals. But when you think about your communication style around this work, which for listeners, if you have not found Bruce's Ted Talk yet, you really should go find it.

But how do you feel that your background as a physician has shaped the way that you communicate about climate change? And what kind of response do you think that you're getting when you speak about climate change?

[00:07:36] Bruce: Well, it's hard to know what kind of impact you have whenever you give a talk, when you're hoping to get people to take action. But certainly, as I grew more and more concerned about climate change and finally left my practice in 2013 so I could devote myself to focusing on this problem, I just really felt like I had transitioned from taking care of mothers and babies to helping take care of Mother Nature. And so it was really kind of a natural extension.

And the great thing about being in medicine, is that people pay attention when doctors have opinions about things. Doesn't mean we're always right, certainly, but we generally get the benefit of the doubt and people will at least give us a listen. And research still shows that nurses and physicians, nurses actually even more so, are the most respected or trusted voices in society.

First of all, I don't pretend to be a climate scientist because I'm not. But I can speak about what we are learning in the literature from actual researchers. And I should also issue a disclaimer here, I'm not a researcher. I did not have academic training. I'm a mediocre surfer and an OB-GYN who happened to find myself very curious about impacts on pregnancy. And so I put together a team that looked into that kind of the first time and we'll talk about that I guess later. But my speaking style, God knows how in the world I could evaluate that but I had kind of an odd career, 'cause one of the things I did before this light bulb came on about environmental threats and climate in particular, was that I actually studied acting for four years and even did a little bit of standup.

So.

[00:09:05] Dominique: Oh, interesting. 

[00:09:07] Bruce: So I don't know if that comes through at all, but I kind of hope it does. And one of my favorite quotes, which I actually heard from my father, is credited to Mark Twain. He said, "If you're gonna tell people the truth, you better make 'em laugh or they'll kill you." And so I always try to find a little bit of lightness in the presentation and let people know that I'm not some stuffy guy that is gonna put them to sleep.

I wanna hear about your comedy and standup and acting a little bit. When did you get into that and how far did that career go?

Well, I was blessed with two wonderful parents. My father was a very serious aerospace engineer, and my mother was a homemaker back in the sixties and seventies when that's what most moms did. But they were both rather creative people. And I just discovered after being in practice for about five years that medicine is amazing and challenging and is such an honor to do that work. I felt kind of a creative itch that needed to be scratched.

[00:10:01] Adam: And so, I ended up on a whim just signing up for an acting class.And I also loved writing and kind of that's where standup came in was that your writing is absolutely the center of the nexus of all that. It's one thing to put it up on stage, but you have to have the material, and I really enjoyed writing comedy. I love that and it's interesting watching all these different kind of forces coming together in, in your climate work. One, having that medical training and understanding, seeing firsthand,and understanding, "Hey, here's how our environment is being impacted by the people around us and things that we can do to actually stand up and take action."

And then, your acting career really helping you develop that voice to communicate that. That's really interesting watching all those pieces fit in. We're gonna discuss your advocacy more in the next episode. But you've described the climate crisis as being less like a chronic illness and more like a cancer. Can you explain a little bit more what that means?

[00:10:52] Bruce: Yeah. When we talk about the climate crisis, there are a number of things that we need to do to protect people, and these are generally put in the bucket of adaptation. But adaptation is not going to resolve the climate crisis. And the reason I came up with this analogy is because to me there's a danger in being seduced by adaptation, if we just build sea walls or if we just, get better at clearing out forests and putting out fires more quickly. The problem is that we're talking about the balance of nature here, and she looks increasingly like she's getting out of balance to a dangerous degree where we're not going to be able to adapt sufficiently where at the tremendous cost of putting up seawalls, they're going to be inadequate after 10 years.

So we have to look at this problem really straight in the eye and realize that it's not something that we can adapt our way out of. It's more like a cancer, which means that we have to stop it because if we do not, it's gonna get to a point where adaptation's not gonna work and we're going to see consequences that we can't even imagine. We're already starting to see signs of this.

So, in a way it's a call to the public to clarify that point, but it's also speaking to health professionals, which I do a lot. We have to make sure that we understand that this is mother nature, mother nature's our patient, and we would never allow an illness in any of our patients to go untreated, a particularly one that was life-threatening.

We're part of nature. This is not something distant to us. There's no environment, that we could decide, we care about our golf course or maybe we just go play on another one.

 Nature is all around us and we are a part of it, and we are a reproducing species. And that's absolutely vital. The connection is not voluntary. The connection is absolute. Nature has to be okay.

But I wanna flip it around the other side too and just remind everybody of how glorious it is when we're surrounded by nature that is doing well. If you remember the early days of the pandemic when we stopped flying and driving and doing so much in industry, how glorious it was to see, as soon as we got our knee off nature's neck within a couple of weeks, there's just amazing and wonderful things that, that were happening all around us with wildlife and nature in general.

And I don't know about you guys, but that's the kind of world I wanna live in and that's what I want to pass on. I want to be proud of what we're producing and what we're leaving for the next generation, and I wanna enjoy it myself, and I'm not settling for less than that.

[00:13:19] Dominique: I really appreciate you sharing that and I think that image of us having a knee on nature's neck is not gonna leave my brain for a while, but I think that you're right. And right now, this episode's gonna release when we're experiencing so much extreme heat.

I don't know how many things have to happen from a nature standpoint for us to start being more practical across the board about what all these floods and extreme heat events are linked to. 

Why else do you potentially think the other physicians or other professionals you've spoken to maybe are not always drawing these connections?

[00:13:54] Bruce: I want to be careful because I'm not a social scientist and I have to sound like one for a moment, but I think we live in a very short term focused society. We just wanna get through today and this week, or get to our vacation a week from now or something like that. And that's kind of human nature.

I think that there are two sides to us. If we live in a democracy, which is a participatory form of government, we have not only our personal individual wants and needs, but we're also members of the town that we live in and the state that we live in, and the country that we live in, and really, the world.

And I think there has been a gradual but very, very significant atrophy of that part of our personality that sees ourself as part of that bigger whole. And it's not only a do-gooder kind of a thing to bring up. I think also that has a heck of a lot to do with why we are so short term in our thinking because if you don't connect to a broader, more bigger purpose in life than just yourself and your number of gold toilets that you have, that's a very purposeful knock by the way. You guys are laughing even though it's quiet and here I can see it.

If you don't see yourself as part of something bigger, if you don't have larger goals than just yourself and your family, I think you lose out on joy. There's incredible happiness to be gained, real joy to be gained from connecting. And I happen to think the more different we are from the people that we are working with and for, the better it feels. And that's personal experience.

And it's not just, we're a whole bunch of do-gooders who can't stand not meddling in other people's affairs. It's really different. We're doing what we're doing in order to make a difference, and it also makes us feel a whole lot better.

[00:15:26] Adam: It's interesting because like one, you talk to a lot of healthcare workers and they tend to be extremely busy. What do you say to somebody that says, "Hey, healthcare workers are just too busy to engage in this"?

[00:15:36] Bruce: I say, "I know. You are too busy. And now I'm giving you more to do." But before you throw your shoes at me, I wanna point out the fact that this is already part of your life, both as a professional because of the patients that you take care of and because personally, you know too much to ignore this. So it's already weighing you down. It's already giving you more work to do, and it will give you progressively more problems to solve. But it's also weighing you down because every time you get reminded of the climate crisis, you understand science and biology and nature well enough to know that this is not okay. We can't let this go on.

This is not the world we want to live in, nor to leave behind.

So, what I'm doing is giving you a focus to address this that will instead of it taking energy away from you and making you feel more overburdened, it will actually start to make you feel better.

And you don't have to completely give up your practice like I did. I happen to be in a good spot to be able to do that. But the more you do about this, the more it will make all of your life feel more manageable and the happier you will be as a person.

So I don't mind asking people, I just have to duck the first few shoes that get thrown at me before this sinks in.

It's gonna take a while to stop the climate crisis. But the health benefits accrue literally overnight. They're immediate and so yeah, we can do this stuff and we have to wait for the temperature to come down. But in the meanwhile, we can make people's lives better and those benefits are there right away.

And they're not just, again, health benefits, they're economic benefits and community benefits, they're on multiple levels. And I don't know about you, but I like win-win stuff and climate action is win-win.

[00:17:15] Dominique: Yeah. And that delayed gratification I think in sustainability can be hard to navigate of working for something that you don't get to see. So I like that you've shown us something that we can see and something that does produce benefits in the short term.

When you're educating these health professionals and sharing a bit about climate change, or you watch the light bulb go on for them, what is a common misconception or learning that you feel like you can impart with healthcare professionals? Or maybe is like one of the early light bulbs that you find, just like kind of begins a chain reaction with them?

[00:17:51] Bruce: I think one of the most important ones is that they find out that they can make a difference. I think that's one of the big reasons people don't get engaged is because the problem feels global and massive, and it is. However, because health professionals are such trusted voices in society, they can begin to make a difference literally just by showing up to the decisions that are being made in their community.

It's about getting outta your silo, but then there's work to be done educating other people in healthcare as well, and getting healthcare itself to become more sustainable.

But one of the misconceptions that healthcare professionals, I think actually really need to be reminded of more than once is that as soon as they show up to things because of who they are in society, it immediately makes an impact. And that is the kind of thing that keeps 'em coming back for more.

[00:18:40] Adam: Now, you don't just speak to healthcare professionals. You speak to a wide range of groups, including lawmakers, other people. You've had a great TED Talk called, "The climate crisis is not your fault, but it's your problem." For those of you who are listening, I encourage you to go check it out 'cause it's really great.

But how do you tailor your message depending on the audience?

[00:18:57] Bruce: It's not really that different. There's just a bit more of a focus on the science, health science, stuff with healthcare professionals because that's what they're tuned into. But that message also resonates with virtually any audience. So I might be a little bit more data-driven. I gave a talk for Harvard Medical School just a week and a half ago, which is always an honor. I presented results of studies 'cause they wanted to hear about heat and its impacts on pregnancy. And so I gave them an update and I talked about what we're learning specifically regarding impacts on fertility and birth defects and maternal health, hypertensive disorders during pregnancy. So I nerded out a bit on the data around that stuff and then went into some detail about what we know about impacts on fetal growth and development and newborn's wellbeing and all.

 Whenever I talked to an audience, I feel like the first two thirds of my presentation is just demonstrating my bonafide so they know that they're with me and they're going to listen to what I have to say. 'Cause what I'm really there to do, regardless of the audience, is to talk about what we do with this problem. And the title of the TED Talk came from a buddy of mine, my best friend and a very good speaker on his own. But it was very purposeful. The point of the matter is that regardless of where you are, this is a problem that is in your life already. It's already having an impact. And there's only one way to turn that around. So it actually makes it feel like a source of inspiration and connection in your life, and that is to get involved.

[00:20:27] Dominique: Bruce, before we ask you what we could be doing today, you don't actually like the word environment. Can you tell us why?

[00:20:34] Bruce: I think it suggests a false choice. The environment is a thing over there that we could decide to care about or not to care about or to worry if it's breaking down. But in fact, I think, again, as I, I think I mentioned earlier, we're part of nature. Really environment is just another way to say the state of nature around us, whether you're talking about the coast or the mountains or a golf course or whatever. But I don't want people to think about it as a choice. It is a necessity that nature, however, whatever condition nature's in, our lives will be the result of that.

[00:21:05] Adam: All right, so for those who are listening, like what can people actually do today?

[00:21:09] Bruce: Participate at any level that feels right for you. how do I get started? The truth of the matter is that you very possibly through your place of work or the industry that you're in, can find a connection to do climate work through environmental groups that are part of that industry or part of that organization.

A lot of hospitals have green teams, and so nurses and doctors and other people that work in the hospital can sign up and participate with a green team who might be working on reducing the use of disposable plastic packaging and things like that or cleaning up the supply chain or figuring out ways to use reusable instruments and not disposable instruments all the time in the OR.

But outside of healthcare and actually for people in healthcare as well, it's as easy as just Googling or asking ChatGPT what are some really good environmental organizations that are working on climate near me? And you will, regardless of where you are, find a bunch of options. And so just by finding out where these organizations are and being willing to put some time and energy into showing up to things, you'll probably find your footing.

And it isn't necessarily a straight line, people. Like initially when I got involved with climate, it was around my concern about what was happening to the coast and sea level rise and coral reefs and sea life die off and all kinds of things that were just horrific for me to think about. But it morphed into really focusing on the health aspects, both because I have a voice in healthcare that I can use more easily than I can as a mediocre surfer.

And by the way, I'm being very generous when I call myself mediocre. 

[00:22:43] Dominique: You have more surfboards than I do.

[00:22:45] Bruce: Which apparently doesn't mean anything, but I try. But there are ways for people to get involved that they're willing to show up. And it could be as simple as just going to the next city council meeting and sitting in the audience and finding out what they are talking about that has some kind of environmental impact or specifically relates to the rollout of renewable energy since the federal government has decided to ignore the risk of climate change, which I think is the polar opposite of leadership. Local and state governments have become increasingly important. And there's a lot going on and a lot to be done. And again, it's in this win-win category.

We did some work with building electrification in San Diego, and you'd be amazed that when one city picks up the ball and starts to say, "Okay, we're going to make it easier for people to use non-gas appliances at home." There are all kinds of ways for people to get involved with things like that and to voice their opinion. And you oftentimes will find out within the city that you live in that there's already a group doing this kind of climate work.

Thank you, Bruce. I appreciate so much getting the chance to share your story, to hear how much you know in this space, but also I appreciate you walking us through how being an OB-GYN also wove into a standup acting career and you really meet everybody where they're at. I think when doing any kind of comedy, you have to really deeply understand how people receive information. it comes through in all that you do, which that's why I think it is so cool, and I'm glad you mentioned that.

[00:24:08] Dominique: But I appreciate you giving us actionable steps that we can see wherever we are, no matter our community or what stage we're at or what we're good at. 

And I appreciate seeing the fact that when we improve the climate and take care of the climate, we get returns in advance when it comes to our health. So thank you so much for sharing that and educating our audience.

[00:24:28] Bruce: It's my pleasure and I don't think we can say often enough that if people switch from being a little concerned or really concerned about this to becoming engaged with it, I'll give you a money back guarantee, you will feel better doing that. When you find some kind of agency, the moment you find you have some kind of an impact and that you're around other people that do this work, who are wonderful people by the way, because they're working primarily for people they'll never meet and maybe, and nowhere near them. It is wonderful and inspiring to be around people like that, and it feels a whole lot better than just trying to ignore this problem as it continues to grow.

[00:25:02] Adam: How can people connect with you and support the work that you're doing?

[00:25:05] Bruce: The podcast is on hiatus because my partner in crime, Nathaniel DeNicola, who's a senior author on our paper in JAMA. We've done so many talks together, but they just had a baby, and so we're waiting for him to resurface after that.

But I'm on Instagram @greendocsd, sd for San Diego. 

[00:25:23] Dominique: And we'll definitely add your TED Talk to the show notes as well.

[00:25:26] Bruce: Thank you.

[00:25:27] Adam: Well, thank you so much for joining us today.

[00:25:29] Bruce: It's been great. You guys are a great audience.

[00:25:31] Adam: Well, as always, our guests have found a unique way to champion sustainability. We're here to put real names and stories behind the idea that no matter your background, career interests, you really can contribute in the fight against climate change.

[00:25:42] Dominique: You can find our episodes at thegreenchampions.com. If you wanna stay in the loop, give us a review and follow us if your podcast platform. If you have questions about climate change or sustainability, you can reach us on our website, thegreenchampions.com. Music is by Zayn Dweik. Thanks for listening to Green Champions.

We'll dig into the second half of Bruce's success story in our next episode.