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Pediatrics and safeguarding the environment don't usually go hand-in-hand. But Children's Hospital Boston resident Ari Bernstein, MD, is making a career of combining the two.
For his new book, Sustaining Life, written with Eric Chivian, MD, director for the Center for Global Health and Environment at Harvard Medical School, Bernstein spent more than five years interviewing scientists and ecologists around the world and found that Earth's biodiversity (the variety of life on the planet) directly impacts our health in ways that most of us aren't aware of. "We're at a point in human history when people have become so detached from the natural world and so convinced that we can live without nature that we aren't aware of how our health is so incredibly tied to the health of the natural world," Bernstein says. "As a pediatrician and someone interested in making the world a place that's as healthy as the one I grew up in, I want people to understand that tie."
In Bernstein's talks about the topic, which he gives around the world, he illustrates how biodiversity loss, driven by climate change, habitat loss, pollution and over-exploitation of natural resources, poses a threat to human health. He points out that 50 percent of America's 100 most prescribed medicines are based on compounds made from plants or animals. "Almost all antibiotics are derived from natural products and so are many anti-viral drugs," he says. "We're relying on them more now than ever." Yet the pace of current biodiversity loss is the greatest it's been in 65 million years. "The last time we lost species this fast was when an asteroid hit the earth and the dinosaurs went extinct, along with 50 percent of all species alive at the time," he says. The difference between then and now is that humans are now largely driving the extinctions—and the pace is accelerating. "We're losing species 100 to 1,000 times faster than what would occur without human influence," Bernstein says. "And when we lose a species or an ecosystem, it's gone forever."
In his book, Bernstein describes groups of species that are at risk of extinction and also crucially important to medicine, such as amphibians. The first pregnancy test was based on a frog; if the frog ovulated after being injected with a woman's urine, the woman was told she was pregnant. Amphibians continue to be invaluable to scientists, as several new medicines, including a new, more effective kind of anesthesia, are being derived from chemicals found on frog skins. But amphibians are disappearing. "They're one of the most endangered groups on Earth," Bernstein says. Since they live in water and on land, they're doubly exposed to contaminants and pollution, and they're sensitive to ultraviolet radiation as tadpoles, so they're affected by the ozone hole. Climate change also plays a part, since frogs are cold-blooded and quite sensitive to temperature.
Another species that could continue to contribute to medicine is the horseshoe crab, which is endangered due to coastal development and pollution. "They're evolutionarily spectacular," Bernstein says. "They're millions of years old and have outlived the organisms that gave rise to them." Horseshoe crabs have ancient immune systems, and their blood, when exposed to bacteria, clumps. "It's the most sensitive test known to humanity for bacteria," Bernstein says. "It's said that horseshoe crabs can detect the equivalent of one grain of sand in an Olympic sized swimming pool." Their blood is now used in the gold standard test to detect contamination in childhood vaccines and implantable devices like hip joints and heart valves.
Another profiled group are the venomous cone snails, which live in endangered coral reefs. Scientists are studying the fish-eating snail's ability to instantaneously paralyze prey with their powerful toxins. By studying how their venom works, scientists are developing treatments for chronic pain—one of which has been FDA approved—and there are many more drugs in development. "It's good for us all to remember that we're living in a country that uses more greenhouse gas per capita than anyone," Bernstein says. The increasing temperature of the ocean kills coral reefs, and once the reefs are gone, so are the animals that live in them.
So what can we do? "Sometimes the size of the problem is its own worst enemy," Bernstein says. "People hear this and become horribly depressed and shut down. But there are simple things we can do." One is acting on the old adage of reduce, reuse, recycle—most importantly reduce. "Own energy-efficient cars, use less energy use at home and buy appliances that have good energy star ratings," he says. "If you can, use public transit, walk or bicycle instead of drive and encourage the towns you live in to facilitate public transit, bike paths and sidewalks." Bernstein also suggests city dwellers advocate for green space. "I want to help people in cities see that the urban landscape makes a difference to the quality of the air they breathe," he says.
Ultimately, Bernstein hopes that readers will see the big picture: that we must live in sustainable ways to protect the natural world. "Think of what a parent might do if they knew that reducing their carbon footprint, cutting down on waste and protecting green space could affect their child's treatment options," he says. "If people understand what's at stake for their health, and especially their children's health, they'll find it within themselves to act in ways to preserve the world that we all need in order to live healthy lives."
Sustaining Life is available at amazon.com.
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