12th December 2023
Many people are terrified by the prospect of imminent social collapse because of the climate and nature crisis. The effects of the crisis are already here and being felt in Britain with heatwaves and floods, while many people in poorer countries are being forced to leave their lands and homes. Yet governments seem incapable of responding adequately.
The result can be sadness, despair, desperation, and doomism, a sense that we are doomed and nothing can be done. Those of us concerned about the climate and nature crisis campaign, demonstrate, write to prime ministers, and try to make changes in our own institutions and lives. We use evidence, logic, words, and data, but we haven’t paid enough attention to the emotional side of the crisis. Emotion can be a spur to action but can also paralyse. In a recent experiment the UK Health Alliance on Climate Change and the Point of Care Foundation came together to use a method called Schwartz Rounds to explore the emotional side of the climate and nature crisis.
Schwartz Rounds were developed in the US and are used in over 200 NHS institutions. Each round lasts an hour, has two trained facilitators, and starts with three people telling personal, emotional stories that related to the issue—in this case the emotional impact of the climate and nature crisis. Afterwards people in the room (real or virtual) react, not asking questions of the storytellers but sharing their own stories or impressions. The meetings are confidential and are not about problem solving. Evaluation has shown that they can benefit both staff and the patients they treat.
Our round was online with forty people. We deliberately didn’t record the round, and I have gained consent from the people whose stories I tell below.
The first storyteller told of the shock she felt as a medical student seeing black deposits in the lungs of a man who’d lived all his life in London.
She’d never been taught about air pollution and thought about what must be in her own lungs. Her experience led her to be a campaigner on climate change. Others shared similar reactions to seeing black deposits in lungs, while one person shared her disgust at learning long after she had installed a woodburning stove just how bad they are for air pollution.
She reflected too that her privilege was doing harm to people much less privileged than herself, a recurrent theme in the climate and nature crisis where the damage has been done by the rich and yet the poor experience the most harm.
The second storyteller, a surgeon, was appalled—like many surgeons—by the waste that was generated every time he did a procedure. He also visited a place in Pakistan where 70% of the world’s surgical instruments are manufactured and was shaken to see the dreadful working conditions of the employees, many of whom were children. Poor children were making instruments for him to discard. He began to campaign on reducing waste from surgery and better conditions for the workers in Pakistan and received abuse as a result; but rather than shut him up the abuse spurred on his campaigning.
On a visit to Madagascar, the third storyteller was enthralled to see humpback whales up close, but on the same day she saw coral that had been reduced to grey sludge by the warming of polluted seas. She related her experience to her own work as a nurse concerned with reducing hospital-acquired infection and thought of the billions of gloves discarded every year by the NHS and other health systems. They are contributing to pollution in the oceans. She was motivated to work to reduce the number of gloves used in the NHS.
All three storytellers had been motivated by their emotional reactions to take action on the climate and nature crisis, but the round heard stories of people reacting to fear of the future with denial and disavowal. People are reacting as they react to a death or any severe loss. One person regretted that he had known about climate change since the early 90s yet had continued to fly around the world. He told the story as well of hearing that his daughter in law was pregnant with his first grandchild just after he had heard an apocalyptic talk on the likely course of the nature and climate crisis. Thinking of the future of the grandchild, he struggled to congratulate his daughter in law. Several people spoke of fear for their children and grandchildren.
One health professional told a story of having to get consent from a young girl who was undergoing medical treatment that might impact her fertility. The young girl told her that she didn’t want to preserve her fertility to allow her to have children in future, because of her fear of what would result from the climate and nature crisis The health professional, who had read the reports of the Intergovernmental Panel on Climate Change, was at a loss for how to respond. The girl’s mother leapt in and said that there was nothing to fear, that the future would be fine. The health professional didn’t want to contradict the mother but nor did she want to offer false reassurance.
Many people became emotional during the round, and that is one of the intentions—to share emotional experiences, help people recognise that they are not alone and that others are having similar emotional responses to the climate and nature crisis.
As I’ve said, using a Schwartz Round in the context of the climate and nature crisis was an experiment. One piece of immediate feedback was that only one person left during the hour, far fewer than is normally the case in. webinar. Of the seven people who completed the evaluation, all agreed that it’s important to pay attention to the emotional impact of the climate and nature crisis and all agreed that Schwartz rounds are a good way to do so. There was less agreement over whether the experience of the Schwartz round would be useful in meeting the needs of patients but more agreement that it would be useful in working with colleagues.
One respondent wrote: “I thought it was so insightful. I was in tears listening to some of the stories as I am so sad at what is happening. I am teaching the topic to undergraduate students and finding it difficult to get a happy medium between the actual truth without making them feel as bad as I do.” Another wrote: “My first Schwartz Round. I was interested to be part of this and I am also interested in (and deeply saddened by) the climate emergency. I found it emotionally useful (validating, encouraging action) and energising to hear the three storytellers.”
I’ve experienced other Schwartz Rounds, even participating once as a storyteller, and they have always proved engaging, causing me to reflect on my own experiences and emotional reactions to those experiences.
The climate round was perhaps the most emotional of the rounds because I do feel that the world is in a dangerous place, and I am particularly concerned about what the climate and nature crisis will mean for my children and grandchildren. When I hear people talking about the “future,” I often fear that there will be no future for them. The climate round released emotional energy that I will channel into ever more actions to do what I can to counter the climate and nature crisis. I recognise that emotion leads to action that leads to more action that leads to an increase in action—and it’s actions not words that we need.
Both UKHACC and the Point of Care Foundation hope to continue to use Schwartz Rounds and other methods to help people address the emotional aspects of the climate and nature crisis.
Competing interest: Richard Smith is the unpaid chair of both UKHACC and the Point of Care Foundation, both of which are charities.