The Big Picture

Not long ago, at two-forty in the morning, I was staring intently at a young man’s eye. His lid was swelling like a pale balloon, and when I touched it, I could feel air crackling underneath. A thin, bloody ooze trickled from its corner and pooled in the hollow next to his nose. I pressed on the eye again; perhaps I was trying to get a sense of how bad it was. It should have been painful. It wasn’t, of course, because this young man, with his strapping young body – muscles and tan-lines and a few scars from the extraordinary experience of living – had just arrived back into the trauma bay after his CT scans, which showed that his brain was a smooth opalescent grey. No bumps or furrows, no ventricles left; even blood was no longer permitted inside the white vault of his skull, confirmed by angiography, with his cerebral tonsils squeezing south as fast as they could herniate. While decisions and weighted options and logistics and aggressive care were all in solemn conference amongst us, the team, I kept coming back to look at the eye. This small detail. In a short while I would have to ring the boy’s mother, who knew nothing yet of the crash – a woman taking a long anticipated holiday up the coast, quite confident her son was safe at home.

It was a thin line my mind was walking. Focus on the series of details, or be overwhelmed by the whole? Tired and psychologically spent from managing the trauma, aware of the unpleasant hour on the clock, with images of my own children asleep at home, I felt perilously close to being subsumed by the horror of the big picture. This daily horror. So I went back to the eye for a little while. It made it easier, musing on it; it being something to focus on, a detail, a leaf on a tree in the woods.

I only bring this up, because at this juncture in history, there is a lot of this going on. Attention to the little detail. A deckchair moved, an online petition signed, a solar panel installed, small specifics, all while our planet ignites.

As guilty as the next citizen, I have moseyed through this last decade, believing the science like you all do, watching the evolution of understanding of what is going on with our climate: from global warming, to climate change, to now climate breakdown – when 99 out of 100 scientists agree on something, you know it must be as close to truth as truth can be – but I have managed to merrily carry on living this entitled life. I am, as many of us reading this are, coddled, comfortable, well-travelled, drunk with choice.

Yeah, I do my bit – don’t we all – solar panels, recycling, that lovely keep-cup, strongly worded tweets.

I have also believed that ‘science’ figured it out in the first place, so ‘science’ will find a solution. Carbon sinks, renewables for every energy requirement, geoengineering. Surely, the derailment can be averted by smarts.

But it’s not only that now, is it? Species extinctions coming at us at the rate of meteors, oceans awash with plastic, populations of vulnerable humans with as much right to oxygen, safety, health as you or I, people being displaced, burning, starving. And it’s not just degrees of temperature rise, it is the vast catastrophic destruction of our planet. Habitat loss and poisoning are the vile cousins of this inexorable temperature climb. Our exquisite blue-green wonder, scorched, bare, polluted.

Still too abstract? Borders will no longer save us, if they ever did, except in our minds, in the privilege we believe we are owed by the accident of our birth. Look at Australia already. Brittle coral bleached pallid, trickled out mud brown rivers sludgy warm with the stench of dead fish, cracked desolate salt plains littered with crumbling white rib-cages and skulls, whole species blinking out overnight unnoticed, marine life choked to death on plastic vomiting from their slit stomachs on their demise. This is our home. Our planet of majestic beauty and history, its archives stretched way beyond our little wants and needs of today. Earth is on track to be destroyed, and soon; a possibility as real as sunset.

So what do we do? Do we accept our fate, knowing we – you and I – will be dead and decomposing by the time the real horror sets in? Or do we love the land under our feet enough, the sparkle of cool water, the colour of a billion birds and insects, and, of course, our fellow humans – including our children – enough to want to be part of the solution, not part of the cataclysmic problem. Can we be part of an existential answer when we are not present to witness it? Yes, of course we do, and can. And thus there is no looking away from the big picture. We are all in this. If we want to breathe the oxygen, then we must face this issue every, single day. Each one of us in all our guises: political, corporate, community, occupational, individual, must look it not just in the eye, but in its whole. It must influence how we vote, how we speak, how we make choices, how we live. We all must do the small things, as well as the large. We must vote and we must lobby. It must be part of our every, single, day. This is no longer a choice. But, if every single human could pull in the same direction – well, just imagine. This is not the plea to turn us all monk-like, but to all take part in the sensible understanding of the things we can do at each of these societal levels. Do not turn away, people. Yes, live, love, embrace the wonder of the world, but face this huge picture, and face it daily. Do not shy from reading articles written by experts. Do not vote for small men who prefer ego and baseless power to honour, integrity and a climate policy. There is no more time for looking at the tiny details, and only when we please. It is big picture time, or it is nothing at all.

Practicalities. What can I do?

  1. I can understand what changes I can make at an everyday level [The most effective ways to curb climate change might surprise you ]
  2. I can actively look at who I vote for, and what their climate policies are
  3. I can lobby the organisations that represent me: eg ACEM, ACEP, AMA.
  4. I can join and donate to the groups who are parting the waves in front of me such as:
  5. I can read about others who are searching for solutions
  6. I can make the important actions a natural part of my day (active transport – walk/cycle – to reduce vehicle use, dietary changes to include less reliance on red meat/dairy, use of renewable fuels where possible, use my money – shop and support places committed to divesting of all fossil fuels. Money, of course, is the most powerful voice of all)
  7. I can never stop speaking about it, and I can support those making active change.

Emergency physician. Lives for teaching and loves clinical work, but with social media, she is like the syndromic cousin in the corner who gets brought out and patted on the head once in a while | Literary Medicine | @eleytherius | Website |


  1. Thanks Michelle, what a post to start my day🧐 I will pass it on those those I know. Primum non nocere

  2. Sadly I am yet to encounter a colleague who is willing to give up flying, as I have. Just an embarrassed foot shuffle, and a quick change of subject. But as wealthy individuals (on a global scale) it is the biggest personal sacrifice we can make. A pity so few are willing to do so.

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