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Links Between Illness and Global Warming?

Dr. Paul Epstein is a physician in Boston, and the associate director of the Center for Health and the Global Environment at Harvard Medical School. He's created a niche as an eco-physician, exploring the link between increased illness and global warming. Illnesses such as heatstroke, asthma and allergies are the more obvious outcomes of a warmer and more polluted planet, but Epstein says an increase in infectious diseases such as malaria and West Nile virus may also be linked to the greenhouse effect.


Other segments from the episode on June 26, 2006

Fresh Air with Terry Gross, June 26, 2006: Interview with Brian Cox; Interview with Paul Epstein; Review of Jolie Holland's "Springtime can kill you."


TIME 12:00 Noon-1:00 PM AUDIENCE N/A

Interview: Actor Brian Cox talks about his role on "Deadwood" and
other movies and plays he starred in

This is FRESH AIR. I'm Terry Gross.

Culture is coming to "Deadwood." Last night on the HBO Western series, a
flamboyant theater producer and his troupe arrived in this violent, anarchic
Western town. He plans to transform an old bordello into a theater. The
producer is played by my guest, Brian Cox. In addition to his recurring role
on "Deadwood," Cox is starring in a London production of a new Tom Stoppard
play. Cox is a Scottish actor whose recent movies include Woody Allen's
"Match Point," Spike Lee's "25th Hour," "The Bourne Supremacy," and "L.I.E."
Before Anthony Hopkins played Hannibal "the Cannibal" Lecter in "The Silence
of the Lambs," Cox played Hannibal Lecter in the 1986 movie "Manhunter." Let's
start with a scene from an upcoming episode of "Deadwood." The theater
producer Jack Langrishe is dividing the members of his troop into committees.

(Soundbite of "Deadwood")

Mr. BRIAN COX: (As Jack Langrishe) Civic relations is me and will include
here a subcommittee for the renovation of the bordello. Supervision of the
work subcommittee head, Countess Dunn, with thanks. Civic relations
construction subcommittee, Claudia. Countess is the second.

Unidentified Actor: Hiring laborers.

Mr. COX: (As Jack Langrishe) A truth divinely writ: we make more devotees
of theater engaging 20 laborers at $2 a piece than two of the same at 20.

(End of soundbite)

GROSS: That's a scene from "Deadwood."

Brian Cox, welcome to FRESH AIR. I'm going to ask you to describe your
character in "Deadwood."

Mr. COX: I play a character called Jack Langrishe. He's a character who
actually existed. He's slightly different from the real character. He's
different in this way, that he was actually very, very low-key. He was quite
low-key. He wasn't as flamboyant as perhaps I have, or David Milch has made
him. And he's serving a clear purpose in the story of "Deadwood." But he's an
amazing man because he was a man who toured theater companies all over America
during a particular time, and he was--he set up--he had just lost everything,
and actually kind of like out of the ashes of the Chicago fire, he lost his
company, and within a week, he had everything back on its feet again. He
started off touring with about 15 people. He ended up touring with 115
people. He finally retired, and he died as a senator, I think, in Colorado.
He was a really, really interesting man, and he was the first person to really
bring theater to the West. He actually did in "Deadwood" itself, he did the
American premiere of "The Mikado," believe it or not.

GROSS: Oh, God! Excuse me that has to register on me. To think of the
Mikado in "Deadwood" the way Deadwood is portrayed in the series is really

Mr. COX: Yeah, it is. It's a kind of--so odd really. But it was
fascinating. He was a fascinating character just--and so he comes now to
Deadwood, and basically, I think, you know, we've arrived in the third series,
and you know if you look at the sort of graph and the path of "Deadwood," you
can see that culture, you know--having been through the whores and the boozing
and what have you, and the kind of more basic things that was required in
those mining camps. The miners themselves, of course, sought culture. They
wanted theater. They wanted--you know, they wanted burlesque, but they also
wanted straight theater, so--you know language serves a need.

GROSS: Because your character is a man of the theater and very into theater,
but when he's just having a conversation, he often sounds like he's
proclaiming on a Shakespearean stage. You've performed in Shakespearean
productions. What is the difference between how you actually perform
Shakespeare when you're doing Shakespeare and this kind of Shakespearean sound
that you've given this theatrical producer in "Deadwood"?

Mr. COX: Well, it's to do with the technique of how to speak for a start,
how to sustain a thought on one breath. Shakespeare's all about breath as
thought, but a lot of his cadence is very, very long, you know, the iambic
carries you through, and I mean, there's a whole--you know, there's a whole
structure to how you play verse. But also the idea is that everything is on
the text. You know, the subtextual idea is a very, very 20th century kind of
idea, and it's a kind of thing that pervades American films which is why we
have this kind of Strasbourgian effect, you know, this kind of, I think,
basically, phony, Stanislauskism where the actors scratch and mumble and do
other stuff, and that's supposed to be real, you know.

But the interesting thing about somebody like Langrishe is his language and
his training and his craft, and his appreciation of words infects him and you
get that with theatric types. I mean, it's slightly dying out and the way it
was now, but I worked, for instance, with John Gielgud. I worked with Ralph
Richardson. I also worked with Laurence Olivier once, and they had a cadence.
They had an ability to use a phrase in a particularly erudite and
extraordinary way. They were part of that breed of actor, and those Victorian
actors excelled at it. Absolutely excelled at it. It was the way they spoke,
it was the way they thought, how they got up in the morning. That's what they
started with until when they went to bed at night.

GROSS: If you're just joining us, my guest is Brian Cox, and he's one of the
stars of the new season of "Deadwood," and he plays a theatrical producer.

I want to get to another role that you've had, and this is just such a
terrific performance. It was in the film, the "25th Hour"...

Mr. COX: All right.

GROSS: 2002. It was directed by Spike Lee, and I want to play a scene
here. Edward Norton plays someone who's about to serve a long prison term,
and the film is set in the 24 hours before he has to report to prison. And
this is like the last scene of the film. You play his father. You own a bar.
You're driving your son to the prison down a long country road, driving him
from the city to the country where the prison is, and his face is beaten raw.
He's actually had somebody beat him up so that he wouldn't look too pretty or
too weak and innocent when he got to prison. So he's sitting in the car with
his face beaten up. You're driving and then you say to him, `Just give me the
word and I'll take a left turn, and we'll find a nice little town that you can
hide in instead of reporting to prison." So here's some of that scene. We'll
pick up right after you've made that offer.

(Soundbite of the "25th Hour")

Mr. COX: (As father) ...if you want it. If that's what you want, I'll do

Mr. EDWARD NORTON: (As son) No, they'd take your bar.

Mr. COX: (As father) My bar. Jesus, my bar. They can take my bar to hell
and back. You think my bar is more important to me than you, my only child?
Give me the word, and we'll go.

Mr. NORTON: (As son) They'll find me. They'll find me sooner or later.

Mr. COX: (As father) You know how they find people. They find them when
they come home. People run away but they usually come back. That's when they
get caught. So you go and you never come back. You never come home. We'll
drive. Keep driving. Head out to the middle of nowhere. Take that road as
far it takes us. You've never been west of Philly, have you? This is a
beautiful country, Monty. It's beautiful out there. It looks like a
different world. Mountains, hills, cows, farms and white churches.

(End of soundbite)

GROSS: That's my guest, Brian Cox, with Edward Norton in a scene from the
film, the "25th Hour." That is such a beautiful scene and...

Mr. COX: I'd actually forgotten that. It's beautiful.

GROSS:'s as if you're reading a poem with music behind you.

Mr. COX: Yeah.

GROSS: It's so--so can you talk a little bit about doing that scene? Your
monologue there lasts nearly seven minutes. Yeah.

Mr. COX: Yeah. It was an amazing thing. Well, you know, the monologue was
rewritten--it was actually rewritten on the day we recorded it, and we did one
version early on and then we just did this other version because Spike fell in
love with the whole idea of this--of the kind of redemption-regenerative, you
know, thing that could happen to Ed's character. So he wanted more stuff, so
David Benioff, who wrote the script and also wrote the original book, wrote
this, you know. This--I think it's in the end, it's about a 10-minute
monologue, and it was quite amazing, and we just did it. You know, we did the
scene, of course, with Ed and I, and then it goes in and it kind of makes this
seemless change to the monologue. And it's just an extraordinary--I think
it's a truly, truly extraordinary film because it deals with so much. Again,
it deals with--you know, because it was the first film to deal with--directly
with 9/11 in a scene where they--two boys are down in lower Manhattan, and
Spike had the guts to kind of pound through the window, and he looked right
down at ground zero, and it kind of gave the film an edge and a whole--paean
and kind of homage to America. And when I hear that script now and I hear the
fact of the celebrating of what is beyond Manhattan, what is beyond that
place, it's just quite--it's so evocative and so poetic and so of the time
and, you know--I kind of really--I think it's a remarkable piece of work.

GROSS: Brian Cox, you didn't really become well known in the States
until--you're in what? Your 40s? When the film "Manhunter" came out in the
1980s, I think that was a kind of turning point...

Mr. COX: I was just...

GROSS: terms of American recognition.

Mr. COX: Yeah. I was just in my late--I think, no, it came out round
about--I made it when I think 39, and it came out when I was 40. Yeah.

GROSS: Mm-hmm. So you played Hannibal Lecter in "Manhunter." What are some
of the pluses and minuses of getting discovered by Hollywood when you're 40 as
opposed to when you're in your teens or 20s?

Mr. COX: Well, the thing is--I think the obvious plus is that you're there.
I've always wanted to be an actor for the long haul. I've never--I kind of
realized that when I--I mean, I started really quite young. I was 15 when I
started work in the theater, and I went to drama school when I was just 17. I
did my audition when I was 16. I was working as a professional actor from the
age of 19. So, you know, it was very--I was very aware that--and I think it's
my Scottish canniness I think is what stands me in good stead--I was very
aware of the fact that I would be, you know--that while I know it's an
insecure profession, it's something I want to be doing down the road, and the
irony is, of course, as you get older--well, actually it's not ironic, it's a
fact of life, you know, experience comes to you, so the thing that's more
interesting is, as you get older, because you've been dealing with life. So
in a way, your work gets richer and you know more about your job, and you're
able to offer more. And the most interesting work for me is the supporting
work. You know, in the theater, I'm a leading actor, and I will always go
back to the theater and assume that role but I can do it less and less because
it's expensive. But in the cinema, it's knowing where your place is and
knowing that you want to be a supporting actor, so you come in and you give
the color to a movie in a way, you know, because I had--you know, got
colleagues back in England say, `Well, I could never play small parts in
films, you know or anything like that,' and I just think it's a nonsense
really. I mean, Michael Powell once said the great thing about cinema is that
there are no small parts or big parts. There are only short parts and long
parts. You're on a film either for a long time or you're on it for a short
time. But when you're on a film--whatever--you know, when you're there,
that's you. You're doing it.

GROSS: My guest is Brian Cox. He has a new recurring role in the HBO series

We'll talk more after a break. This is FRESH AIR.


GROSS: My guest is Brian Cox. He has a new recurring role on the HBO Western
series "Deadwood" playing a flamboyant theater producer. Cox is in London
now, starring in the premiere of the new Tom Stoppard play, "Rock 'n' Roll."

I know your father died of cancer when you were nine...

Mr. COX: Mmm.

GROSS: ...and your mother had some kind of breakdown and was

Mr. COX: Yeah.

GROSS: For how long was she institutionalized?

Mr. COX: She was institutionalized for about--well, on and off, it was about
two and a half years, two and a half--yeah, two and a half to three years.

GROSS: Was there ever a diagnosis?

Mr. COX: Well, basically, she had--you know, she had a massive nervous
breakdown, and she was--I mean, she did try to commit suicide at one point,
and I think just everything became too much for her, and she just completely
physically and mentally collapsed, and they didn't know what to do with her
for quite a while, and then they finally decided to give her electric shock
treatment, so they gave her electric shock treatment over a period of about, I
think about six or seven months, and then she had to recover from that, so it
was a kind of long, drawn-out process, and you know, it was quite--I think it
was very difficult for her. It was a very painful time for her.

GROSS: So, you must have had it pretty rough. I mean, by the time you were
nine or 10, you were in some ways almost orphaned because your mother was
institutionalized, your father had passed away.

Mr. COX: Yeah. I had these wonderful sisters who--I have three older
sisters and I have a brother as well, a brother who's older than me. There's
a kind of--the war is between us all. My sisters were born--I mean, I've got
sisters who are 16, 15 years older than me. And they're still around. I
mean, they're fantastic women, truly fantastic women. They had--they were
fantastic to me when I was a kid. I mean, they really were. They saved me.
I mean, my childhood was great. I mean, I--you know, in recent times I get a
little bit--I get a little bit concerned because I seem to give the wrong
message about my childhood. Actually, my childhood until my father died was
really pretty amazing. I mean, my mother and father had problems, but they
had problems which had to do with--my father made some--during the war he did
quite well because he had a tiny shop, and he made some very bad building
investments and lost a lot of money, and that was in the background. But,
basically, we were a very happy family. And then my father--though my mother
was always troubled, as a young girl she had gone to Canada into service, and
then she actually came back to marry my father, but I think she always
regretted the fact that she--I think she was really the artistic one of the
family. I think she regretted the fact that she gave up a life to, you know,
have kids. I think it was tough--I think it was a tough thing for working
class women at that time. I think they--you know, my mother was one of
millions, I think.

GROSS: You left home when you were around 15.

Mr. COX: Yeah. I left--I still lived at my home but I was hardly ever there
because I was working at the theater. I really left home when I was 17.

GROSS: And did you leave home because you were unhappy there or because you
wanted to start looking at theater more seriously?

Mr. COX: No, no. You know my--when I left, it was really because I had a
very strong accent. A very, very strong accent, a strong Hungarian accent. I
had to go to drama school, and I wanted to go to drama school. And you
really, in order to learn the craft of acting, and I wanted to go to London
because I didn't want to go to Glasgow. I really, you know--I needed
somewhere where I could learn how to speak, you know, what they call standard
English, which I've never been able to speak.

GROSS: What do you think your accent is sounding like now?

Mr. COX: Well, my accent is a sort of hybrid of so many things. You know, I
think that--you know, I've lived in England, you know, on and off most of my
life but I've also lived in America. I mean, it's been very difficult because
I've got this line in this play--I'm doing this Stoppard play in London--and
I've got this line where I say to the woman who plays my wife, just--you know,
who's had cancer--I say--she's had a breast removed--and I say, `Just don't
lose half your bum, that's all.' And I keep saying `butt.' (Unintelligible)
`It's not butt, it's bum.'

GROSS: What about the accent or the dialect that you're using in "Deadwood"
as the theatrical producer?

Mr. COX: Well, that was originally--you know, it was so odd, because I
originally was going to play him American, but then I realized that he was
indeed Irish. And there was a wonderful actor called Micheal MacLiammoir.
Micheal MacLiammoir was the man who gave Orson Welles his first job. Him and
his lover, who was called Hilton Edwards, ran the Gate Theater in Dublin in
the '20s, and Orson Welles auditioned there when he was 16, and then Orson
Welles finally cast Michael as Iago when he did the film of "Othello." But
Michael became this sort of grand dame because he was gay, but he was this
very sort of--he always wore full makeup, and he wore a black toupee, and
actually the irony was he wasn't really Irish but he pretended to be Irish
because he loved the Irish cadence, and he loved that way of speaking, that
wonderful way of speaking in that Irish voice. And so I kind of thought that
was--this was a very good kind of template for Jack Langrishe. So I kind of
used him for that.

GROSS: So you used the sound of somebody trying to sound Irish.

Mr. COX: That's right. He was the--yeah, I mean, I'd seen Micheal
MacLiammoir. He used to do this show--because, you know, Oscar Wilde was an
Irishman--called "The Importance of Being Oscar," which basically gave him the
opportunity to play Lady Bracknell, but he always played Lady Bracknell with a
very educated Irish accent.

GROSS: Now, I've read that you've said that you don't like to watch your own
movies. You don't like to see yourself on screen because it makes you feel
like the elephant man. You said, `I come across as a sort of creature. I
never seem like a human being.'

Mr. COX: Right.

GROSS: And I'd like to hear more about that.

Mr. COX: Well, it's funny. I've just been doing some ADR for "Deadwood"
this morning...

GROSS: ADR. What is ADR?

Mr. COX: A--looping. You know, doing some extra--`Additional Dialogue
Required' is what ADR is. It's where, you know, where you dub yourself on a
screen. You know, like they might change a line and you have to, you know,
you have to watch yourself on the screen, and there's a little white line goes
across and you play the line. So I had to see myself, and I--yeah--I mean, I
just go, what--you know, it's just so odd. I think your own--you know, when
you're in the mirror, you know, if you pass yourself in the mirror, you're
still. Or you see a photograph, you're still. But when you see yourself in
motion, all kinds of--your face does all kinds of odd things and takes on odd
shapes. And I get kind of spooked by it. I really do. My wife, she keeps
saying, `Oh, you must watch your work, you know. You really must.' And I did
when I was younger. I did because I was vain. And I think it's still vanity
that makes it goes and goes, `God this guy is so ugly.' You know, it is the
elephant man.

GROSS: You know--and what you're saying is true in your mind but so untrue in

Mr. COX: Yeah, I know.

GROSS: But the reason that I'm interested in this is you're dealing with this
as an actor, but I think like so many people just deal with this looking in
the mirror in the morning.

Mr. COX: Yeah.

GROSS: You know, that it's just such a reaction that I think many of us have
just looking in the mirror, like, `That?'

Mr. COX: Exactly.

GROSS: `That's how I look?'

Mr. COX: Well, at least in the mirror, you're still, but, you know, on
screen, you're moving.

GROSS: Right, right. You even get to see how you look behind your ears and
stuff like that.

Mr. COX: That's right, you know. And you see...

GROSS: Yeah...(unintelligible).

Mr. COX: ...angle.

GROSS: Well, Brian Cox. I wish you good luck in the new play that you're in,
and I look forward to seeing more of you in "Deadwood." And thank you very
much for talking with us.

Mr. COX: Thank you, Terry. It's been a delight.

GROSS: Brian Cox is in London, starring in the new Tom Stoppard play "Rock
'n' Roll," and he now has a recurring role on the HBO series, "Deadwood." He
plays theater producer Jack Langrishe.

I'm Terry Gross, and this is FRESH AIR.

(Soundbite of music)


* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

Interview: Dr. Paul Epstein of the Center for Health and the
Global Environment at Harvard Medical School discusses connection
between increased illnesses and global warming

This is FRESH AIR. I'm Terry Gross.

Allergies getting to you? Well, there's evidence that increasing levels of
carbon dioxide in the air may be making some pollen-related allergies worse.
Global warming may also be contributing to an increase in mosquitoes and
mosquito-borne diseases and the growth of poison ivy. Here to explain the
connection is Dr. Paul Epstein, associate director of the Center for Health
and the Global Environment at Harvard Medical School. The center's goal is to
promote a wider understanding of the health consequences of global
environmental change. Epstein is a physician who has specialized in tropical
diseases and public health.

Let's start with the connection between climate change and worsening allergies
to ragweed and pollen.

Dr. PAUL EPSTEIN: This is something that in the 1990s we did not imagine.
We thought carbon dioxide, OK, one of the side effects is it could increase
the forests and agriculture and green the Earth. In fact, many of the
skeptics about climate change touted carbon dioxide from burning fossil fuels
as something that would boost photosynthesis and brighten up the Earth and
generate more nutrition.

What we've found is that the weedy species are responding disproportionately.
The opportunists, just as in the animal kingdom we see some of the mosquitoes
and bugs and rodents responding, we see opportunistic species in the plant
world, like poison ivy, responding to carbon dioxide, making more of itself,
growing and also making more toxic chemical within it that's more allergenic.
We did experiments with carbon dioxide and ragweed here at Harvard, and they
were repeated by the US Department of Agriculture. We doubled CO2 two times,
CO2 and we--what we found was that the ragweed went up about 10 percent but
the pollen went up 60 percent. We're seeing ivy and weeds and plants that are
opportunistic seize on this disturbance of more CO2, make more of themselves
and make more toxicity, and this is something that is happening in the plants,
it's happening in the animals. It's happening in the oceans with more algae
and jellyfish. And these are the ones that are seizing on the multiple
stresses that the environment is undergoing because of human activities, be it
habitat change or extra chemicals or climate change itself.

GROSS: So, if you follow the rising CO2 levels in the air, do you also see a
rise in pollen that correlates with it, like in the last 10 or 20 years?

Dr. EPSTEIN: Yeah. And we have data for the last 15 years or so, and people
are seeing this as they brush off their cars or see it on their lakes. We're
seeing the seeds in pollen. But--we're seeing it but, in fact, we're seeing
very unusually high counts. And some of this is the carbon dioxide. What's
interesting is there are synergies, so the carbon dioxide is affecting plants,
but we're also seeing early flowering of plants, and in Washington and in New
York, in--up here in Boston, we had flowering of plants in January, and I
think actually that was one of the turning points in awareness about really
how disturbed the seasons were and our weather was. Another one being, of
course, before that, Katrina. But, at any rate, we're seeing early flowering
of plants, we're seeing synergies among the diesel particles that come out of
trucks and buses, so very high rates of asthma along bus and truck routes in
Harlem and in Roxbury and so on. Turns out diesel particles are the delivery
system for these pollen and spores. They help deliver it...

GROSS: How can that be? What can they do to deliver it?

Dr. EPSTEIN: They deliver it deep into the lung sacs, and they actually
irritate--they have nitrate in them so they irritate the immune cells so they
increase the allergic reaction. But the...

GROSS: The particles from the diesel fuel get inhaled and the allergens
attach themselves to those particles?

Dr. EPSTEIN: That's right. We've known that diesel particles themselves
affect the lungs and can irritate them and cause allergic symptoms. Now it
looks as if there's this--they glob onto these aeroallergens and help deliver
them and sensitize the lungs to their impacts.

GROSS: One of the things doctors have been investigating is why are we seeing
such increases in the rates of people who have asthma.

Dr. EPSTEIN: Sure.

GROSS: Are--do you think there's a connection between global warming and

Dr. EPSTEIN: Well, I believe there is, and there are--so there are several
ways in which these various components are working. You've got the
aeroallergens just from CO2. You've got diesel particles from burning fossil
fuels as well. Then you have the change in the season, so climate change is
affecting the seasons, and we're seeing early arrival of asthma and allergy
season. Then there's another issue, which is ozone, ugly ozone, the ground
level photochemicals smog, and that's a reaction between tailpipe emissions
that sped up with warming, so we're seeing warming counteract some of the
attempts to reduce ozone.

Then there's another one that's really hit us by surprise. We're seeing dust
storms come off of Africa from where the deserts are forming that are the size
of the continental US, and the desertification is due to overgrazing but also
to the warm sea surface temperatures that you've heard so much about. So
we're seeing climate affect Africa. It's affecting actually China in ways
that's sending dust storms to the West Coast, and in the Caribbean...

GROSS: The West Coast of America?

Dr. EPSTEIN: West Coast of America...(unintelligible).

GROSS: So the dust from the dust storms travel that far?

Dr. EPSTEIN: They do, they do. And they--in terms of the Atlantic, they are
seeming to be swept across along the same pathway of warm salty sea surface
water that's sweeping these hurricanes, like Katrina and Rita and so on, is
also accelerating the pathway of these dust storms. So they're reaching
Barbados and Trinidad and also Florida--kids in Miami. And in these islands,
asthma was unheard of. It was less than 1 percent, and that's why those of us
from the north that could afford to would go there for clean air and so on.
What we're seeing now is 25 percent of the kids have asthma on islands like
Trinidad, studied by a woman pediatrician there, and they peak during these
dust storms. The dust storms also introduce organisms that infect the coral
in the Caribbean, the fan coral. So here's another dimension of climate and
global change that's affecting our air quality. So we've got the carbon
dioxide itself from burning fossil fuels. We've got the particles from fossil
fuels. We've got the climate changing from fossil fuels. We've got the ozone
from fossil fuels. And now the aggregate of climate change that's been
created by this blanket of carbon dioxide and other heat-trapping gases is
contributing to the various components of bringing on seasonal change, as well
as the photochemical smog.

GROSS: You mentioned these dust storms from Africa being swept across the
ocean and coming to the--you know, the coast of the United States. Who's
actually tracking where that dust is coming from?

Dr. EPSTEIN: These are tracked by NASA, our space agency, so we see them in
satellites, and where they're also being tracked now is in the deep oceans,
where we see fan coral being infected by fungi that are soil fungi from
Africa, and we've traced them with DNA and so on. So it's very clear that
this is where they're from, and we're seeing, in terms of the clinical
picture, the epidemiology that they peak--where the asthma peaks during these
dust storms. So the whole connection with disease, as well as the diseases of
coral, is a clear one, and we see it from space first off.

GROSS: My guest is Dr. Paul Epstein, associate director of the Center for
Health and the Global Environment at Harvard Medical School.

We'll talk more after a break. This is FRESH AIR.


GROSS: If you're just joining us, my guest is Dr. Paul Epstein. He's
associate director of the Center for Health and the Global Environment at
Harvard Medical School.

You know, before we get deeper into some of the health problems that you think
are being caused by global warming, let me just ask you a basic question, why
are you so convinced that we're actually experiencing global warming?

Dr. EPSTEIN: The oceans have warmed much more than the atmosphere. It turns
out that over the past century, the oceans have warmed 22 times more than the
atmosphere, and the oceans, as Andy Revkin called them, are the "heat bank."
They are storing heat, and that is what is changing the water cycle. The
oceans are warming, ice is melting, water vapor is rising. This is what's
affecting our ecological systems and our health more than the warming itself.

GROSS: More than the warming of the atmosphere?

Dr. EPSTEIN: Well, it is the warming of the deep oceans that is what
generates the--not just one storm, but the sequences of storms that then lead
to clusters of outbreaks of disease. It's the warming of the ocean that is
helping to melt the ice at rates not conceived of just five years ago.
They're accelerating and going twice as fast as they were, some of the outlet
glaciers in Greenland. This is what has us all alarmed is the pace, the
magnitude, the rate of change, the volatility and variability of weather, and
the key is the heat that's accumulated in the deep ocean, which we missed. We
missed when we looked just with satellites, and it wasn't until the science of
the late '90s revealed with submarine data, etc., what was happening in the
deep oceans. That's where the heat is.

GROSS: I've spoken to scientists and science journalists who are confident
that we're experiencing global warming, but they say that if you look at the
pattern of events around the world, you could say this pattern is an example
of the consequences of global warming, but you can't look at any one hurricane
or any one event and say with certainty whether that one event is directly a
consequence of global warming. Do you feel that you can look at the health
issues that we've been talking about, like, you know, the increase in pollen
levels, the increase in the number of people who are suffering with asthma,
can you look at any of these one things and say, `This is definitely a
consequence of global warming'?

Dr. EPSTEIN: Well, the--I think, in terms of asthma described a number of
ways that I do believe that climate change and the fossil fuel emissions are
contributing to this disease. If one looks in the mountains of Africa, Latin
America and Asia at what's happening with malaria and dengue fever, is--we're
changing to another type of disease, but there there's a clear signal, because
there, just where the glaciers are retreating, where plant communities are
migrating up, where the permanently frozen ground, the permafrost is receding,
we're seeing mosquitoes circulated high altitudes. And this means that
malaria is circulating in Nairobi. Dengue fever is up in the mountains of the
Andes, etc. So it's in the mountains that we can see the clear signal that
warming is affecting the range of infectious diseases.

GROSS: Are insects particularly sensitive to climate change?

Dr. EPSTEIN: Insects are very sensitive to climate change. We see this in
the--when we do fossil records. They move faster than grasses and shrubs and
trees and bears that are considered the "paleothermometers," as they're
called, that respond to changes in temperature. We see beetles moving much
faster. We see this in terms of insects that are affecting forests, and
they're moving, from Arizona up to Alaska, overwintering--some of these
beetles are overwintering, moving to higher altitudes, moving to higher
latitudes, and even sneaking in extra generations a year, just as the trees
become weakened from drought because it's the rosin in the trees that drowns
out the beetles as they try to bore through the bark.

I'm telling you more than you want to know, but the point is that insect and
plant life is just as important as the battle between insects and humans. And
in fact, millions of years ago, it was that battle between insects and plants
that resulted in the fossil fuel that we burn today, and it's a battle that is
going to play out in terms of agriculture, in terms of forestry and so on in
ways that may be more important than just malaria and human disease.

GROSS: You've done fieldwork over the years in developing countries. Do you
feel like in your fieldwork you ever directly observed epidemics or increases
in illnesses that were correlated to global warming?

Dr. EPSTEIN: Well, in the 1990s the huge storms were hitting Honduras,
Hurricane Mitch. Mozambique was having floods. Venezuela. These are places
I visited. As we move into the 2000s, we're seeing the same kinds of storms
hit the US, Japan and Europe, so the picture has magnified as it were and hit
insured populations. But I've been to Mozambique, lived in Mozambique and
seen the aftermath of these extreme events. They leave malaria epidemics.
Malaria went up fivefold after the six weeks of floods in 2000 in Mozambique.
In Honduras, after Hurricane Mitch, dengue fever, malaria, rodent-borne plague
and other types of viruses that rodents carry and water-borne disease. So
again, it's these clusters that I've observed in developing nations and now
we're seeing this affect us in developed nations.

GROSS: So have you been trying to involve the insurance industry and various
businesses, trying to convince them that they will have to pay consequences if
global warming continues unchecked? And is your hope that if you involve them
and if they see the consequences that they'll try to contain global warming,
they'll become part of the larger cause?

Dr. EPSTEIN: That's what I've been doing. I've been sitting down with
executive boards of Swiss Re, meeting with Munich Re...(unintelligible)--these
are the re-insurers that insure the insurers--with AIG and large insurers that
have now become more aware of the full range of risks of climate change and
the biological, as well as the physical. The disease and climate change are
stalking our health and the natural systems we depend upon. These risks are
being perceived in the corporate sector in both industry and the financial
sector. They are now beginning to look for how to develop their investments
into healthy sustainable solutions. This can now turn around and help us
towards how we get away from fossil fuels, how we do not go down the nuclear
path, I would say, and replace carbon pollution with radioactive pollution.
These are the discussions we have to have now as to how public health can be
front and center in terms of the new path of development.

GROSS: Is it ever frustrating for you to, instead of working with patients to
be working with, you know, business and insurance companies, trying to
convince them that they need to get on-board and make changes, you know, and
support changes that will help prevent the further global warming trend?

Dr. EPSTEIN: Working with the business community right now is exhilarating,
and all of finance and the corporate sector are buzzing right now. We see
venture capitalists putting money into this. The raiders, like Standard &
Poor's, begin to evaluate it. So I'm excited with this new patient, and I
think that it's--one would do a PET scan on the brain of the global economy,
it's all buzzing, the different parts of it, and it's getting ready to make
some moves. It needs the enabling incentives and regulations to make the move
at a scale that's commensurate with the pace and magnitude of climate change.

GROSS: Have you succumbed to any of the health problems that you talk about
that you think are connected to global warming--more allergy problems, asthma,
problems with mold, that kind of stuff? No, not malaria, I hope.

Dr. EPSTEIN: Not--well, I've had some of these things, but the other day, I
got poison ivy cleaning in my backyard and fighting back this enormous
regrowth of poison ivy and the toxicity, and I was suited up as if I was
fighting Ebola.

GROSS: Bring a hazmat suit.

Dr. EPSTEIN: It was totally--stripes and strips of--and so on, and then
decontamination was a horrible--I had to get rid of this stuff and put it in
the--so it made me really think about fighting Ebola and getting rid of that
waste. It made me think about nuclear and getting rid of that waste. So I
got some poison ivy, if you must know, and I realize that a roll in the hay,
if you're thinking of a roll in the hay these days, you've got to think of
more than a condom.

GROSS: Well, Dr. Epstein, thank you so much for talking with us.

Dr. EPSTEIN: Thank you, Terry.

GROSS: Dr. Paul Epstein is the associate director of the Center for Health
and the Global Environment at Harvard Medical School.

Coming up, Rock critic Ken Tucker reviews Jolie Holland's new CD "Springtime
Can Kill You."

This is FRESH AIR.

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

Review: Rock critic Ken Tucker reviews new CD "Springtime Can Kill
You" from singer Jolie Holland

Jolie Holland's new collection of songs is called "Springtime Can Kill You." A
former member of the rock band, the Be Good Tanyas, Holland has spent the past
few years making music that rock critic Ken Tucker says moves farther and
farther away from anything resembling conventional rock or pop. Here's his

(Soundbite of music by Jolie Holland)

Ms. JOLIE HOLLAND: (Singing) "I'm flying with the birds. I'm talking to the
weeds. Look what you've done to me. I'm starstruck..."

(End of soundbite)

Mr. KEN TUCKER: Jolie Holland sings in a slurry murmur as though you know
the words she's going to sing before she sings them, that you share her mood
and her point of view. And so why should she bother to enunciate when she can
just talk softly into your ear and confirm your feelings. But chances are,
you aren't feeling nearly as downbeat as Holland is throughout her new third
recording. You have to be pretty down to call your album, "Springtime Can
Kill You," don't you think?

(Soundbite of "Springtime Can Kill You")

Ms. HOLLAND: (Singing) "Feeling my blues I tear myself away. He will never
have to hear what I had to say. My little words are lost in the wind. With
nowhere to go, and I'm just like them."

(End of soundbite)

Mr. TUCKER: If you're not tuned into Jolie Holland's wavelength, she can
seem mannered and forced, all these songs about being misunderstood, ignored
by the person she's in love with, the self-pity and accusation in a simple
line like "Look what you've done to me." Holland has the blues, and she sings
them as though she's staggering aimless down the street.

Most singers of sad songs want you to think they're moaning from deep in the
night, but there are a lot of birds in Jolie Holland's compositions. She's
clearly a daytime depressive, an observant one, who looks up to the sky to
confirm the worst, rather than navel-gazing or staring at her shoes. This is
good for her work. It gives her a store of imagery and a sense of purpose
that keeps her mannerism in check.

(Soundbite of "Springtime Can Kill You")

Ms. HOLLAND: (Singing) "The sun too bright, and the mountains are too far,
and there's nowhere in town I can get to in my broken car. I've got nowhere
to go but to sleep. I would shut my eyes but I've got promises to keep."

(End of soundbite)

Mr. TUCKER: Holland, in her 30s, a self-taught player of guitar, piano,
accordion, fiddle and banjo, has an affinity for self-mythologizing
singer-songwriters like Tom Waits, and as such she can be pretty insufferable
in interviews. When she makes music, however, what she calls her sullen
songs, they take on the right edge of anger and self-righteousness.

(Soundbite of "Springtime Can Kill You")

Ms. HOLLAND: (Singing) "But like a stubborn beast while the barn's on fire I
might resist you when you try to save my life. I might resist you when you
try to save my life. While the flames rise around us, and I can see that
door, this is still my home and it has never burned before. Oh, this is where
I've taken my solace and my peace. The walls are caving in but I'm still a
stubborn beast. Why don't you take me when I'm willing?

(End of soundbite)

Ms. TUCKER: Jolie Holland manufactures the best kind of phony baloney
bluster. She constantly claims to regret having a perpetually broken heart,
even as the greasy, glowing gleam in her voice tells you that she gets off on
her sadness. She's that rarity, an insensitive singer-songwriter. She acts
as though she doesn't care what you think, and then in the process, makes you
care intensely about her moaning and whining.

GROSS: Ken Tucker is editor at large at Entertainment Weekly. He reviewed
"Springtime Can Kill You" by Jolie Holland.

I'm Terry Gross. We'll close with a classic arranged by Arif Mardin, a
producer and arranger who was with Atlantic Records from 1963 to 2001 and
helped create their sound. He died yesterday.

(Soundbite of music)

Unidentified Singer: (Singing) "You're no good, heartbreaker. You're a liar,
and you're a cheat. And I don't know why I let you do these things to me. My
friends keep telling me that you ain't no good. Oh, Lord, they don't know
that I'd leave you if I could. I guess I'm a tack, and I'm stuck like glue,
'cause I know I ain't never, I ain't never, I ain't never loved a man the way
that I love you."

(End of soundbite)


Transcripts are created on a rush deadline, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of Fresh Air interviews and reviews are the audio recordings of each segment.

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