When you think about the association between climate change and disaster, some of the links may seem obvious. For example, it makes sense that as the climate gets warmer, there will be more drought leading to less food and increasing famine, and starvation. But, did you know that increased temperatures are also associated with increased violence and thus linked to civil unrest? In this episode we will discuss the many links between climate crisis and both natural and manmade disasters with Dr. David Calloway who, in addition to being an emergency medicine physician is also the Chief Medical Officer for Team Rubicon, A member of the nineth class of Presidential Leadership Scholars during which time he evaluated the US health systems impact on the environment.

-Home - Team Rubicon (teamrubiconusa.org)

-Callaway Climate Insights | David Callaway | Substack

-How climate change worsens heatwaves, droughts, wildfires and floods (bbc.com)

-How Health Care Leaders Respond to Climate Change (nejm.org)

Have you ever thought about the impact that repeatedly experiencing destruction and human suffering has on the people who respond to disasters? Although every person responds to traumatic events differently, being exposed to the mental trauma of an intense experience like a disaster has been correlated to increasing levels of depression, anxiety, and PTSD. While it is one thing for people who purposefully signed up as disaster responders and presumably understand that risk, what about the effects on people who did not sign up and just happened to be in jobs where they are, by default, disaster responders. By this I am talking about professionals like medical techs, residents, and nurses—people who happen to be in positions that require them to experience the suffering of others. Should we be warning new residents or medical or nursing students of the emotional and physical dangers that their future jobs may hold if they are called upon to respond to an event like… a pandemic? Today, Dr. Tom Kirsch, an emergency medicine doctor, who recently retired as the Director of the National Center for Disaster Medicine and Public Health, will talk to us about some of the topics that he is most passionate about: moral injury and duty to respond. We will discuss what obligation medical professionals have to place themselves and their families at risk of harm, and what some of the effects of those experiences can be.

Join me as I talk with Dr. Joelle Simpson about the importance of developing disaster plans and responses that specifically target the needs of our country’s pediatric populations. Dr. Simpson is a pediatric emergency medicine physician with Children’s National Health System where she serves as the Division Chief of emergency medicine and the Medical Director of emergency preparedness.  She is also a nationally recognized expert on all topics related to disaster pediatrics and participates on high level panels to ensure that the needs of the pediatric population are represented in disaster all national planning and response efforts. Stick around and learn about why the peds need special consideration.

Resources:

• Emergency Medical Services for Children Program
• Pediatric Pandemic Network
• ASPR Pediatric Disaster Centers of Excellence

When I think about austere medicine, I tend to think about wilderness medicine, but it is not actually limited to the wilderness arena at all. Technically, the practice of austere medicine is just medicine in resource constrained environments and who goes into resources limited situations more than the military? Today we will discuss military and austere medicine, and in particular disaster planning in those environments with Dr. Laura Tilley.

Dr. Tilley recently separated from the Army as a Lt. Colonel and in her time in the military she served as a battalion surgeon in Khost, Afghanistan during operation enduring freedom. After separating from the Army she joined the faculty at George Washington University as an emergency medicine attending physician.

References:

• Health Professions Scholarship Program
• Uniformed Services University
• To Ma’am with Love: USU’s Graduating Class Celebrates a Memorable Teacher and Mentor
• Prolonged Casualty Care Clinical Practice Guidelines

While the world’s increasing dependance on technology has, in many ways, improved our quality of life, in other ways, it has created problems that 50 years ago the average person could not have imagined. In fact, I would argue that it has created a whole new category of disaster. Cyber disaster. In this episode of The Disaster Project, we talk with two people who by virtue of being both physicians and computer hackers, have a level of knowledge about cyber security that the average person does not possess and have dedicated this unique skill set, towards the goal of improving healthcare cyber security. It is my pleasure to introduce you to Dr. Jeff Tully and Dr. Christian Dameff, both doctors at UC San Diego, and founders of CyberMed, a yearly conference which brings together the different stake holders in healthcare cyber security towards the goal of improving the protection of our healthcare system. This episode made me think about how fragile a hospital’s cyber security really is, and how one misstep by anyone in an organization could not only compromise the security of personal information but could quite literally endanger lives.

• CIA triad: Executive Summary — NIST SP 1800-26 documentation.
• C Dameff, J Tully, T Chan, et al. Ransomware Attack Associated with Disruptions at Adjacent Emergency Departments in the US. JAMA Netw Open. 2023;6(5):e2312270. Ransomware Attack Associated With Disruptions at Adjacent Emergency Departments in the US | Emergency Medicine | JAMA Network Open | JAMA Network.
• M Thompson. Iranian Cyber Attack on New York Dam Shows Future of War. Time. March 2016. Iranian Cyber Attack on New York Dam Reveals Future of War | Time.
• CISA: Home Page | CISA.
• Articles on healthcare system hacking:
  • The growing threat of ransomware attacks on hospitals | AAMC
  • The latest cyberattack on health care shows how vulnerable the sector is - The Washington Post
  • As data breaches surge, your medical info is vulnerable to hackers (usatoday.com)
  • Hackers post detailed patient medical records from two hospitals to the dark web (nbcnews.com)

• Digital Health Roundtable
• Capabilities Required for Pandemic Response
• Identifying, Collecting and Analyzing Actionable Intelligence in an Outbreak Event