“I don’t believe in climate change.”

I’d just got back from Darwin in early October, and I and many of my GP colleagues had been closely following the news of the bushfires in New South Wales. We’d had our first warning of high fire danger in late September. As I returned to work in Campbelltown, in south-west Sydney, a grey haze of smoke hung in the air. Each breath I took left a metallic reminder of the bushfires at the back of my throat. My patients were coughing more than usual. Those with asthma were getting through more inhalers. On behalf of patients, I’d been writing letters to the Department of Housing asking for modifications to keep people healthy and safe in the weather extremes they were experiencing. It was what had been predicted. It was what was happening. So I was surprised to hear my patient say it.

“Oh,” I said. “I definitely do.” We’ve known each other a while, and I know her daughter, granddaughter and great-grandson well, too. We’d gone through quite a lot of medicine together, revealed enigmatically in small episodes like a slow-moving TV drama. This could become another storyline.

As I asked a bit more, and we discussed it for a short time, I realised that it wasn’t that she didn’t believe in climate change, it was that change in climate as we tend to hear about it wasn’t a thing she experienced. Bushfire smoke and unseasonable weather definitely were. And they did affect her in numerous ways.

If I said I was going to write about climate change now, you’d expect me to write about carbon dioxide and other greenhouse gases, of concentrations in parts per million. We might mention farting cows, and have a little chuckle before getting back to the serious business of the perils of allowing average temperature to rise more than 2 degrees. We’d talk about sea-level rises and debate whether these would be measured in centimetres or metres. We would talk about glaciers and Greenland, polar bears and parasites. And my essay could be confined to the environmental (green-coloured) pages of the newspaper, where it can do no harm to the parallel worlds of business or politics.

My patient’s experience is very different. She’s experiencing the smell of the air, and her lungs are bringing back up the fine particles of smoke blown across from the Blue Mountains. Her skin feels the change in temperature of 10 degrees from one day to the next, and the pain in her joints tells her this is an unpleasant and undesirable phenomenon. Her jangling nerves still remind her that she slipped on her steps at a time of heavy rainfall, suffering a nasty fracture of her arm.

Perhaps it’s not that she doesn’t believe in climate change. She’s suffered the effects of it more than I have. Perhaps it’s that there are no polar bears to be worried about in Campbelltown. There are no glaciers, shrinking or otherwise, in Queen Street. Almost no one ever experiences the actual average global temperature. The way climate change is talked about just has no bearing on her life.

“For those stuck in the middle of an environmental emergency, it’s not helpful.”

If I am honest, it doesn’t on mine, either. To a lesser degree, I experience some inconveniences. My trains are delayed because of bushfires and I’ve had roads near me blocked by floods, both of which have prevented me from making it to work. I observe changes in the timing of blossom coming out in our garden. I choose to link this to climate change, though, and I choose to worry about it on behalf of my children and their children to come. I am in a privileged position, being paid above average, having a house in working order, and having no concerns about where my next meal is coming from. What else do I have to worry about, apart from climate change? Contrast this with my patient. She has some very real fears about affording the cooling at home, and she worries about her granddaughter’s health problems after getting out of a violent relationship. This doesn’t leave much room to worry about polar bears and ice sheets. The irony here is that those, like my patients, who will be most affected by the changes in the climate, those least able to adapt, are those who are already struggling and therefore not worrying much about climate change as we conventionally talk about it.

What’s going on here? Those of us who talk, write and campaign about climate change are often dismissed as being out-of-touch, latte-sipping, inner-city types. After all, the inner city is where the Greens have most of their support. In his book The Lucky Culture, journalist Nick Cater describes this familiar bogeyman for the Right wing — the university-educated, left-wing elite — talking to itself through the ABC. The stereotype is designed to dismiss these views and make them seem irrelevant, and to ensure that the political and economic changes needed to reduce the effects of climate change don’t find traction in the wider community.

It’s easy to rebut the stereotype. I don’t drink lattes and don’t live in the inner city, but I am passionate about doing something about climate change. However, I wonder if there is a kernel of truth in this stereotype. The truth isn’t in the claim that there is a new left-wing ruling elite who think they are morally superior, as Cater claims. In fact, I’d suggest that the Left are more riven with self-doubt than the Right, who may see themselves as the rightful rulers. The truth is in the language we use. You can almost guarantee that anyone talking about climate change in the terms I’ve described — sea-level rises, ice sheets, average temperature rises, greenhouse gasses — is not in the groups who will suffer most of the effects, either now or in the future. Those affected now talk about bushfires. They talk about floods, hurricanes, drought, crop failure, increasingly salty water, rising food prices. “Ah, yes, you see,” we shout back. “Climate change. I told you so.” For those stuck in the middle of an environmental emergency, it’s not helpful.

This big-picture language distances us from those most affected. And it’s a pattern of behaviour. We see it in the way we talk about the so-called social determinants of health. I’ve never heard my patients talk about social determinants. I’ve never heard them mention the term “food security” either. But I’ve witnessed the tears after another racial bullying episode at work. I’ve heard people reluctantly admit that they’ve not eaten for a few days so the children can. I’ve seen stress that makes people sick from constant arguments with the housing department about getting repairs for the draughts through the house. I can go home, though, and have a sip of chardonnay, debrief with my wife, perhaps write another article for Croakey about the social determinants of health. My patients, meanwhile, have no escape. No need for the words when you live inside it.

*Read the rest of this article at Inside Story