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By Jim Cochrane with Gary Gunderson

This trip began amid the historic California fires and will end in the still sandy flood plains of Wilmington, still wet from the unprecedented hurricane. Stakeholder Health includes the Adventist hospital in Paradise where friends and relatives friends who have lost everything. Jerry Winslow, Stakeholder Health Chair, shared an iPhone video from a couple he married walking amid the ashes. Who can miss the story of changing climate.

There’s another kind of fundamental climate shift we’ve seen, the one that is changing the relationship between credentialed experts in highly specialized fields and the working collaborative practitioners. This is mostly for the good, unless you’re an inflexible academic who can’t adjust to the humility required to be useful–not to mention survive the new climate.

Mostly I want to talk about changing the climate in our castles of expertise and our cathedrals of science. I’m an academic, one with a long activist history to be sure, but still. Academics, like professionals more widely, are known for being smart and well trained; “experts” we like to say. Mostly we are, sometimes rather narrowly, sometimes more expansively. So we carry authority of a kind. And we have something to offer. We live off that, get paid for it, and gain prestige or status by it.

The more we journey and hear—and see, the real reason for a road trip like this!—how people on the ground express their extraordinary, purpose-built, socially aware, and culturally embodied intelligence, the more I, the academic, am confronted with how easily my expertise fools me into thinking that what we do in research and training is adequate to the reality when it is not. I’m not talking about engineering or computer programming or anything like that (though we can fool ourselves even then) but about anything and everything to do with the ambiguous, liquid dynamic that is the life of persons and of communities.

In a meeting today Gary noted that “every institution or program either builds trust or uses it up.” Which it is, is hugely important. A deep web of trust can only be built on the back of intensely held respect, itself dependent upon credibility, and that resting on experienced integrity, humility and transparency lived over time (no quick fixes are possible).

With even a bit of humility a great deal works. Without it almost nothing. We know this but it’s hard to live by it. Grant conditions, institutional barriers, guild constraints on what counts as “method” or “evidence,” the asymmetrical relationship of “authoritative” power vested in the expert, and more, all get in the way. It’s been fascinating so far on this road trip to notice just how powerful those initiatives are that do not rest on any expert institution or group of people but on the grounded, dynamically connected intelligence of people rooted in the communities they serve. I’m thinking of the cardiovascular initiative in Southeast San Diego, Produce Good food initiative in Vista (CA), Chicanos Por La Causa in Phoenix, TOVA Coffee Shop hub in Lubbock, CitySquare in Dallas, and others we have seen on the way. If the “experts” are there—they often are—it’s on terms set by those with whom they work. The last shall be first and the first …. should … be last.

That’s a point about researchers like me and other experts. But going to the ground is not irrelevant to understanding the human dynamics of climate change either. At a meeting of public health policy advocates at the APHA in San Diego someone on the panel noted that very little is happening in public health to address what the future will mean in this regard, and that this must change if we are not to be found to fail the very point of public health. It’s obviously not just about weather extremes and what they do to people and environments. Far more changes than that—just think of how disease vectors are likely to shift. And it’s those who have least access to existing formal health facilities and services that will be most hard hit as usual (though accepting it as “usual” cannot be grounds for taking it for granted).

Back to where we started; the smoldering embers and floods that signal fundamental change already here. It is surprising that we haven’t heard much about that in our meetings, except on the edges. The people in Lubbock spoke about how they were trying to build for the future and noted the irony of doing so surrounded by gas flares burning in miles of industrial oil driven cotton plantations. We suspect that since we ourselves were seen as visiting health experts, they didn’t think that climate was part of what we were curious about.

We have heard intimations of what’s to come indirectly. Most obviously—in Southeast San Diego, in San Bernardino, in Phoenix, in El Paso, in Lubbock, in Dallas, and in Little Rock (you can expand this to include anywhere you live on any continent)—in patterns of internal and external human migration and what they mean for families, communities, towns and cities, regions, nations, in fact for all of us, and for how we react to that reality alone (see this notable example).

We’ve got a way to go and not just on our See2See road trip. But change is already here—fundamental and dynamic, changing the air we breathe and the way we think about ourselves.