Robert Tighe didn’t take a typical path to his medical degree, which is likely why he approaches and discusses health and climate problems in original ways. How many medical doctors do you know who double majored in political science and history?
Industry, nonprofits, government, religious groups – all these communities play a role in addressing the impact of climate on our health. We can create infrastructure leading to meaningful connections to make real impact – that’s the commitment.
“I came into science backwards,” Tighe says, “I didn’t get a PhD. I’m an MD. But I am an MD who has a lab that does basic research. That’s not weird in and of itself. But there aren’t many MDs out there who then do basic research on air pollution. I can probably count them on two hands. Most MDs study along disease lines, not the causes or worsening of disease from environmental pollutants like air pollutants.”
Tighe is an Associate Professor of Medicine and Associate Professor in the Division of Environmental Natural Sciences at Duke. His main clinical interest is in pulmonary fibrosis, a progressive scarring disorder in the lung, which is often fatal. He has worked to understand links between pulmonary fibrosis and air pollution exposure. Research on pulmonary fibrosis suggests there is some type of ongoing irritation or injury, that leads to pulmonary fibrosis. Several groups have tried to find specific causes of this injury. Tighe proposed that this could be in “the air we breathe,” suggesting that pollutants in the air worsen pulmonary fibrosis via specific mechanisms. “This idea just wasn’t in the literature on fibrosis.”
Solving this problem on his own was a nonstarter for Tighe. He realized that the questions couldn’t be solved by one approach. It would take many approaches, many kinds of expertise – basic lab science, epidemiology, policy, communications – to address the impact of air pollution on our lungs and to apply directly to the individuals and communities who need the help. The research needed to go beyond the walls of the campus to understand both the causes and the effects. He has broadened that approach to how climate affects human health. He’s now in charge of Duke Medicine’s strategy on climate and health, a significant component of the university’s Climate Commitment.
“What I love about Duke is this consistent belief in the value of transdisciplinary approaches. Not just the contributions of academic disciplines, but of different communities inside and outside of the university that have valuable perspectives on problem solving. Industry, nonprofits, government, religious groups – all these communities play a role in addressing the impact of climate on our health. We can create infrastructure leading to meaningful connections to make real impact – that’s the commitment.”
Unfortunately, Tighe feels that the academic world hasn’t done a great job historically of communicating about that impact. “We started with ‘there’s this weird gas, and it’s killing fish and plants, we don’t really understand it, it might be making things hotter, but what we want you to do is consume less, build things that will likely just raise your electrical bill, and do this all altruistically.’ We make too many assumptions that people will understand why we are making these choices,” Tighe said.
This is where Tighe’s work as a medical doctor informs his approach to climate work. “Health is a much more personal thing. I can say there’s a threat to your health, and then it makes it easier to make the jump to, oh, and this is why and how that threat is happening and how I might be able to do something about it.”
“With high blood pressure, you can take medicine. Beyond that you can exercise, you can change your diet. Our approach to climate shouldn’t be much different – we need to say ‘this extreme heat is affecting you and here’s what you can do about it. Here are some strategies.’”
Tighe also stresses that we have to listen to people in communities to understand what they care about. They might not think they have a “climate problem” but it is likely they do. “I met with a pastor group who told me ‘we respect your climate work and that’s all fine and dandy but what we are really concerned with in our communities is gun violence.’ I took the opportunity to explain that physiologic stress drives anger and violence during times of extreme heat and humidity. I realized we could partner on their terms, and address what they really care about.”
“We at universities are used to just producing information but we don’t always connect the dots. We need to take our observations and move them quickly into a space where it will have impact for an individual. And we can’t wait 30 years to come up with meaningful solutions to impacts of climate change on health,” says Tighe. “The cat will be way out of the bag at that point. How do we accelerate the path to discovery? We need to think on five-year scales to make real change possible.”
Photos courtesy of Robert Tighe.