ASCRS News: EyeSustain update
December 2022

by Margaret Tharp, MS-2

Medical students and physicians today face a career where the effects of climate change on human health must be factored into the patient care model. 

The first time I became aware of the concept of climate change is a flashbulb memory from my pre-kindergarten teacher in Evansville, Indiana, a mid-sized town on the Indiana/Kentucky border, when we learned that temperatures in our world were rising. As the granddaughter of an ophthalmologist who doubled as a farmer and avid backpacker, I grew up considering the outdoors to be part of my identity and was always drawn to protecting our natural world. I did not yet realize how this eco-appreciation might intersect with my desire to pursue medicine. 

When the world went on pause in March 2020, I was a junior at Purdue University wrapping up my early decision application to Indiana University School of Medicine. I decided to direct my newly found free time toward a job as an inpatient pharmacy technician in my college town’s local hospital. It was in the long, solitary pandemic days compounding intravenous medications for our surging occupancy that I realized the sheer amount of packaging waste I produced as a single pharmacy technician in a rural Indiana hospital. As I lugged my huge trash bags at the end of each shift and grew increasingly concerned about recent climate developments, I decided the intersection of climate change and healthcare was something I would explore in medical school. 

Following my acceptance to Indiana University School of Medicine and socially distanced graduation in May 2021, I reached out to the medical student council and was connected with Eashan Kumar, Stella Protopapas, and Taylor Diedrich, then rising second-year medical students. Before taking me under their wing, the trio had spent their first year of medical school applying the efforts of two national environmental entities, the Planetary Health Report Card and Climate Resources for Health Education, at Indiana University School of Medicine through scoring our school’s sustainability practices and introducing climate-related curriculum changes. Together we established the Indiana University School of Medicine chapter of Medical Students for a Sustainable Future, an organization directed toward uniting climate efforts among medical students nationwide. One of the early goals for our chapter included Stella’s suggestion of conducting a medical waste audit. After gaining approval from an outpatient surgery center in my hometown of Evansville, Stella and I dual applied for the 2022 Healthcare Without Harm USA Emerging Physician Leader Award and were granted funding for audit supplies, as well as an opportunity to attend the CleanMed 2022 conference in Kansas City, Missouri. With the assistance of fellow first-year Minka Gill and a collection of volunteer medical students, our audit was successfully completed in June 2022. 

While evaluating the audit data, I noticed that 15 of the 30 surgical cases from that day were phacoemulsifications, providing an excellent opportunity to gauge waste produced by ophthalmic procedures. Already taking part in an ophthalmology research internship at the time, I worked with Stella, Minka, and my research mentor, Louis Cantor, MD, to quickly develop an abstract for submission to the internship-advertised Heartland Vision Science Research Symposium. We were pleasantly surprised and validated when our poster was awarded best clinical research poster.

When I began medical school, I realized the largest environmental impact I could make was through policy, prompting me to run for a position within the Medical Student Section of the Indiana State Medical Association. With the assistance of older, wiser medical students, I drafted my first resolution calling on the Indiana State Medical Association to support AMA-endorsed incorporation of climate change education into medical school curriculum. At the annual convention in September 2022, the Indiana State Medical Association voted to adopt the resolution with amendments to become policy. 

As I begin a position on the Editorial Board for EyeSustain, I’d like to offer advice to other medical students and physicians seeking climate action:

1. We have what it takes. For too long I put off taking action based on the belief that my lack of formal education in climate sciences nullified my credibility. Accredited education in environmental studies is undeniably beneficial, but degree or no degree, anyone can have a voice in this work.
2. You will need help from others, and others will need help from you. Progress toward a livable future comes from combining knowledge, skills, connections, and contributions of individuals to create an effective whole.
3. Listen. Much of this work requires using our voices, but we must also listen in order to effectively reach solutions. 
4. Prepare to be questioned, but resist letting criticism cause you to question yourself. Do your research well and remain firm in your conclusions.
5. Start small and be persistent. Any progress is good progress, and there is no straight path in climate justice. 

I’ve gotten involved in this work because without planetary health there can be no human health. I’m deeply grateful for each person I have been able to work with and am more hopeful because of them.