November 5, 2025 • 25 mins
Pediatrician and environmental scientist Dr. Deborah Hendrickson joins Dr. Michael Koren to discuss how the environment affects our health. Dr. Hendrickson uses the example of poor air quality from sources such as wildfires and pollution to explain how this impacts children's breathing, from lung development to allergies and asthma. She also notes that the climate is changing due to human causes, which should inspire hope that human solutions are possible. The doctors conclude by discussing how climate change is making things more difficult everywhere and how the risks to our children, in particular, are increasing.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Announcer (00:00):
Welcome to MedEvidence!, where we help you
navigate the truth behindmedical research with unbiased
evidence-proven facts, hosted bycardiologist and top medical
researcher, Dr.
Michael Koren.
Dr. Michael Koren (00:11):
Hello, I'm Dr.
Michael Koren, the executiveeditor of MedEvidence! And I'm
really delighted to have DeborahHendrickson, a pediatrician and
a physician who practices inReno, Nevada, as a guest today.
And Deborah, you're an expertin helping people understand the
impact of climate change on thehealth of our kids.
(00:31):
And not only that, you wrote abeautiful book about it.
I haven't completed it yet.
I've been a third through, butit's a terrific read, and
hopefully it'll share some ofyour thoughts about why you
wrote this book and also whyit's important for people to
know about these issues.
So again, uh Deborah, welcometo MedEvidence!
Dr. Debra Hendrickson (00:47):
Well, thanks very much for having me.
Dr. Michael Koren (00:50):
So let's just start by telling everybody
about your background.
I mentioned you're apediatrician, you're in Reno,
but just tell us where you grewup and why you ended up becoming
a pediatrician and and and someof your passions regarding your
day-to-day.
Dr. Debra Hendrickson (01:03):
Yeah, so I grew up in the Bay Area in
California, um, went to schoolin New England.
Uh so I've lived, you know,both ends of the country and
also briefly in Ohio as well,and in Seattle, Washington.
So I've I've touched all a lotof the corners, not down in
Florida, but a lot of areas ofthe country.
Uh and for uh in college andfor 10 years afterward, I was I
(01:25):
focused on environmentalscience.
I was uh a degree inenvironmental science uh as an
undergrad.
And-
Dr. Michael Koren (01:31):
where was that?
Which college was that?
Dr. Debra Hendrickson (01:33):
At Brown.
I went to Brown in Providence.
Dr. Michael Koren (01:35):
Yeah.
Dr. Debra Hendrickson (01:36):
Um, and I uh worked for 10 years as an
environmental analyst andplanner for uh government
agencies in New England andWashington and uh Washington
State in Seattle in the Seattlearea.
And I worked mainly in floodclaim management, you know,
using big computer models tostudy the hydrology and soils
and how uh changes in urban uhdevelopment in these areas would
(02:00):
affect stream flows and salmonhabitat, because salmon are so
important to the PacificNorthwest.
So, anyway, so I had thisbackground in environmental
science and then um went througha major life event, which you
probably read about in the book,and I had three small children,
and I had really grown to enjoymy visits to the pediatrician
because he would pull outtextbooks and really talk to me
(02:21):
about the science of what he wasthinking.
And I kind of liked thedetective aspects of it, and I
liked the idea of combining someof my science background with
uh caring for kids.
And so when I faced this lifecrisis, I decided to change
direction and went back tomedical school to become a
pediatrician.
Um, and uh, so that's that wasmy background before I became,
(02:44):
you know, and and so climatechange was kind of uh a way that
both of my careers cametogether, that uh that an
environmental issue wasaffecting the health of my
patients.
Dr. Michael Koren (02:54):
Interesting.
So just to help the listenersand viewers understand this
better, you you talk about a lotof things in the book, and the
name of the book is called TheAir They Breathe.
And for that reason, obviously,some elements of uh respiratory
issues in in kids is uh is animportant part of this, although
more broadly you talk about allthe effects of climate.
(03:16):
But um tell tell us a littlebit more about where you got the
title and also um somesomething about childhood
asthma.
How often is it that peoplethat that young kids come into
the emergency room, for example,or come to your office with
breathing problems?
How often is that related toasthma, or what else can it be?
Just so people get a little bitof the medical background of
(03:38):
these type of issues.
Dr. Debra Hendrickson (03:40):
Yeah.
So the title comes from one ofthe major themes of the book,
which is that it's reallyimpossible to separate a child's
health from the health of theenvironment and particularly the
quality of the air that theybreathe.
Um, and so there's a wholepassage in the book about this
in the introduction that you youprobably read.
Um, that uh, you know, forexample, the lungs, uh, you
(04:03):
know, children are born withmost lung development happens
after birth, like 80 to 85%.
So you're born with like 30 to50 million of these saccules
that then differentiate intohundreds of millions of alveoli.
And we know that um kids whoare born or raised in areas with
bad air quality uh are uh theytend to have smaller, stiffer
(04:26):
lungs by the time they reachadulthood because they're there
it impairs the differentiationof the alveoli.
They tend to have um increasedelastance of the lungs, so
stiffer lungs and the immunityof the lungs is affected too.
And that has, of course,lifelong implications.
So um, and also I go into somedetail in the book about how the
(04:46):
brain can be affected by thequality of air we breathe.
We now know that air pollutionis a um a major derailler of
normal development uh in kidsliving in high pollutant areas.
And the reason this is an issuewith climate change, it's not
just that fossil fuels increaseum air pollution and on their
own, even if they weren'tcausing climate change, they
would be having many of theseimpacts, but they have been
(05:09):
another impact, which isincreasing wildfire smoke,
increasing ozone or urban smog,increasing aeroallergens.
So they're having a number ofuh, you know, they're also
looping back and causing evenfurther uh impacts, especially
in areas of the West out herewhere we're so impacted by
wildfire smoke.
So that's so the main point ofthe title was that kids develop
(05:31):
through interaction with theenvironment and particularly
with the air they breathe.
Um, and so that that that's avery important determinant of
health.
Dr. Michael Koren (05:39):
Yeah, fascinating.
Yeah.
Dr. Debra Hendrickson (05:41):
The second part of your question
about um asthma versus otherthings, you know, we often see
small children in pediatricswho, of course, have
bronchiolitis, you know, likeRSV or metapneumovirus.
Um they'll come in wheezing,coughing, and it'll seem and
sound a lot like asthma, but umyou can sometimes tell just from
the exam because it's morecoarse and uh, you know, the
(06:03):
slightly different presentation,or or they'll be positive for
RSV on the on the lab test thatyou have in the office.
You'll know that it's it'sbronchiolitis and not asthma,
although those kids are going tobe a little bit more prone to
asthma afterward.
Um, so the there are, you know,and and sometimes kids will
just come in during a smokeevent and be short of breath.
Or, you know, I've had patientsend up in the hospital during a
(06:25):
smoke event in our town,because we have that's what's
been the biggest impact ofclimate change here.
Well, we're 10 miles from theCalifornia border, so we get a
lot of wildfire smoke from justwest of us.
Um and they may never haveanother episode, but but the
smoke was the cause.
It was a you know anenvironmental trigger, uh, not
that they have asthma underlyingit.
Dr. Michael Koren (06:45):
Interesting, interesting.
So one of the things thatoccurred to me as we're talking
about things is that 100 yearsago you would read in novels and
other pieces of literature thatpeople move from New England to
warm climates like Arizona fortheir health, particularly
respiratory illnesses.
Dr. Debra Hendrickson (07:01):
Yes.
With the concept being thatit's warmer and drier.
But maybe that's differentnowadays with climate change.
Uh yeah, and the the second chapter of
the book is actually all aboutPhoenix, and I go into some of
that history because um, yeah,and it was it was interesting
because there was a whole fieldof medicine at that time called
climatology, which of course hasa very different meaning now.
But it was this idea that youcould prescribe people a place
(07:24):
to move to and that a differentclimate would improve their
health.
And a lot of people did improvewhen they moved to Arizona, but
it was probably in many casesjust because they were getting
out of some of the 19th centurytenement conditions in some of
these cities.
Um uh so yeah, that is a bigpart of the of the history of
the Southwest.
Dr. Michael Koren (07:44):
Um so writing this book is a huge endeavor.
Um, I'm always impressed by myguests that have put the time
and effort.
It's it's it's not easy,especially when you're still
practicing and you you have lotsof other parts of your life.
So so tell me a little bit moreabout what drove you to write
this book.
Was it you one incident,multiple uh incidents, what what
(08:05):
was it that made you decide toliterally spend the time to put
together such a nice piece ofwork?
Dr. Debra Hendrickson (08:11):
Oh, thank you.
Yeah, um, I had, you know, asas I was seeing more and more
impacts of the smoke in theoffice, I I really wanted to to
help parents understand uh boththe urgency of the moment that
we're in right now with climatechange uh and their own agency
to do something about it.
I kind of think parents are thesleeping giant in the climate
(08:31):
fight.
And I was kind of hoping to tapinto that fierce protectiveness
that anybody in pediatrics hasseen in their interactions with
parents in the clinics andhospitals and help them be as
concerned about this as they arewith any other aspect of their
kids' health and give them someguidance about what to do about
it.
And it was also, I reallywanted it to be kind of a moral
call to action.
(08:52):
You know, I wanted it to evokepowerful emotions and wake up
people to the implications ofwhat's happening to the people
we love most in the world.
Um, because I do think thatclimate change is a crime
against children.
I think this is the greatestmoral crisis that humanity has
ever faced, and it's up to allof us as individuals to do
something about it.
And um there was one specificincident that triggered me
(09:14):
writing the book.
I don't know if you wanted meto talk about that too, that you
read about it.
Dr. Michael Koren (09:17):
Absolutely.
Dr. Debra Hendrickson (09:18):
Yeah, so it was um it was about 12 years
ago.
It was uh the first of the wewe had a we've had a series of
major, uh we call them smokecrises here, where we just get
um weeks up to months of smoke.
Um, where we, you know, thatit's very um it's very
overwhelming and and oppressive.
(09:38):
Um, but the first one of thesereally was in 2013.
Uh it was called the YosemiteRim Fire.
And I was seeing a little girlin my office uh who had already
had some respiratory issues,some asthma symptoms, and she
was only about 10 months old.
And uh outside the windows ofthe hospital that day, uh ash
was raining from the sky likesnow, and it was just swirling
(09:59):
around the building.
Uh, and uh it was just anapocalyptic scene.
And uh her mom brought her inbecause she just couldn't get
her symptoms under control, andshe'd put this damp baby blanket
over the car seat to try tokeep her protected, and it was
covered with little flakes ofash when she came in.
Anyway, I had this baby on thetable and I was listening to her
(10:19):
lungs, and she was just lookingup at me with these big brown
eyes, struggling to breathe.
And that was really the momentthat I realized that I was
seeing things that I had learnedabout in my environmental
education and career in terms ofthe forests uh burning at much
higher rates.
And we didn't realize it at thetime because that was a really
unusual event at the time, butit became a very routine event
(10:42):
over the subsequent decade.
Dr. Michael Koren (10:45):
Interesting.
That, you know, having aninteraction with a patient like
that can be incrediblymotivating for us physicians and
uh and to your point a call toaction.
And this gets into a little bitof the controversies around
climate change.
And again, we're not politicalhere.
We just like to report thefacts and let people make their
(11:06):
own decisions.
But there are some debatesabout how much of climate change
is man-made and how much of itis from other sources.
And um you can weigh in alittle bit on that, and uh I
think that's important forpeople to hear.
Is it is it something that, inyour view, is entirely man-made?
Is it something that it's othersources and and how does that
matter for protecting yourpatients at the end of the day?
Dr. Debra Hendrickson (11:28):
Oh, yeah, no, this is this is a man-made
problem, and you know, 98% ofscientists in the world agree.
You'll you'll always found findsome outliers uh in any
question of science.
But uh no, the the issue isthat the green greenhouse gases
in the atmosphere have beensteadily increasing in
concentration since the dawn ofthe industrial age, and those
(11:49):
gases trap heat that wouldnormally radiate back out into
space.
And you can uh they have thethe models that predicted what
would happen as CO2, which isthe most important greenhouse
gas, as CO2 rose and what weexpected, have been almost
exactly on the nose.
And in fact, you you probablyknow that uh the oil companies
(12:10):
themselves knew this.
In in 19 the 1970s and early1980s, Exxon, for example,
devoted millions of dollars ofresearch to uh investigating the
alarms being raised by some oftheir own scientists about what
their products would do.
And there's a very famous graphthat they produced that
predicted almost to a tenth of adegree exactly where we are now
(12:30):
in terms of CO2 concentrationand the temperature of the
planet.
Uh so this is a man-madeproblem, which means that we can
also do something about it, youknow, that we we need to cut
back these gases dramatically inthe next few years, which is
you know more challenging nowbecause of the administration in
the US.
Um, but it's a problem, it'sit's technologically feasible to
(12:51):
do what we need to do.
It's uh entirely a politicalproblem.
Dr. Michael Koren (12:55):
Yeah.
And again, uh I I would say Ipersonally agree with most of
what you're saying, not 100%.
I think there's certainly roomfor looking at the the course of
CO2 concentrations in theenvironment over time, literally
millennia, and bigfluctuations.
So with all things in inresearch, there's room for
interpretation, but no doubtthere's a there's a major
(13:16):
contribution from man-madeactivities.
I think we anybody with areasonable uh look at the
literature and a reasonable lookat uh the data would would come
up with that conclusion.
Um but that gets into the wholeconcept of what can we do about
it.
And of course, we have the theshort-term issues are how to
protect our kids, and then thethe longer-term issues is how do
(13:36):
we change our economy so thatwe can hopefully have a more
sustainable long-term trajectoryfor our kids, kids, and our
kids, kids, kids, and our kids,kids, kids, kids, kids.
So maybe uh you can jump intothat a little bit because uh you
made a super interestingcomment about medical
climatology being its ownspecialty, and maybe we still
(13:57):
need to be thinking in thoseterms to some degree.
Dr. Debra Hendrickson (14:00):
So uh the good news is that there's
actually been an explosivegrowth of solar energy around
the world and battery storage.
Um China's uh growth in solaris so astounding that they're
meeting their Paris goals aheadof schedule, and they're likely
to become the first electrostatethat is powered entirely by
renewable energy and batterystorage.
(14:21):
Um so there's a lot of good,hopeful signs around the world.
Uh I this is, you know, and andthese energies are cheaper,
faster to create.
And um, you know, a lot of thebarriers right now are just how
to connect them to the grid andtechnological issues like that,
but but those can be overcomewith the with the right funding
and governments in place.
Um so it's it's it's entirely aproblem we can solve.
(14:46):
And there's a lot of hopefulsigns on the horizon.
The issue is how fast it'shappening in countries like
ours, you know, wherever we havea very limited window of time
to avoid the most catastrophicwarming.
Uh, the modeling has shown thatwe're supposed to cut the
greenhouse gas CO2 emissions inhalf by the end of this decade
(15:08):
to avoid going over 1.5 degreesum centigrade centigrade warming
in the trend line of warming.
So um it's uh, you know, andthat's obviously a window that's
rapidly closing.
So we're probably going toexceed it, but every tenth of a
degree matters.
And so we need to just work asfast as we can to make this
transition happen.
Dr. Michael Koren (15:28):
Well, if I'm not mistaken, the models also
would suggest that if we stoppedall CO2 production tomorrow by
some miracle, we're still goingto see warming in the
environment.
So there's certain, there'sgoing to be a certain period of
time we're going to have to dealwith this, which gets into this
whole issue of how do weprotect our kids in the short
run.
And so I'm curious about yourthoughts about that.
Dr. Debra Hendrickson (15:51):
Yeah, the modeling shows that warming,
well, the most recent modelingthat was done on this anyway,
showed that warming would stopin three to five years if we
completely stopped CO2 tomorrow.
Um so in terms of how toprotect kids, there's there's
kind of two avenues parents cantake.
One is adaptation.
That's what do we do to protectour kids right now from things
that are happening right now.
And the other is, you know,mitigation or sustainability.
(16:13):
What do we do to keep uh thisproblem from getting worse?
And in terms of adaptation, itdepends which issue you're
talking about, whether it'swildfire smoke, you know, or air
quality or heat waves orhurricanes, you know, and
there's a list ofrecommendations I go through in
the book for each of those forhow to protect uh our kids.
And then for sustainability,you know, it's uh I usually tell
(16:34):
people to think of your ownlife as being in the center of a
series of spheres, you know,and um your child is in a home
with a family and uh and that'sthe center sphere.
The next sphere out might betheir school and your job and
then your neighborhood, yourcity, your county.
And take an inventory of yourown greenhouse gas use in each
of those, or or the the of yourcommunity's use in each of those
(16:58):
spheres, and just pick onething to work on.
Um, it might be electric schoolbuses for your kids' school or
help or helping the schoolconvert to a heat pump uh with
solar panels instead of astandard HVAC system.
And getting kids involved inthose kinds of projects can
really help them with um howthey're feeling about this issue
as well.
So um I think you know thosethat those are the two avenues
(17:21):
that parents of action thatparents can look at.
And um, and like I said, I wentinto more detail this at the
end of the book.
Dr. Michael Koren (17:27):
That's terrific.
So are you recommending peoplemove to different places if
they're growing up in a desertenvironment and there's
wildfires and they're beingsubject to the ash?
Should they be moving someplaceelse back echoes of what
happened 100 years ago whenpeople are moving to warmer
climates?
Dr. Debra Hendrickson (17:45):
Yeah, well, um it I think with climate
change, it's kind of an issueof pick your poison because you
know, yeah, if you're inArizona, the the temperature
projections for Phoenix are it'shard to imagine living there uh
if if these bear out, um, thatwe're gonna see temperatures in
the 130s by mid-century.
So yeah, so so even just goingoutside and those kind of
(18:06):
temperatures, and obviouslythat's just for the hottest
parts of the year, but thelength of periods where they're
seeing over 100 degrees isgetting longer and longer every
year, too.
So if you're somebody who'svery sensitive to the heat, like
an older person, that may notbe a place that you can live
anymore.
If you have a if you're aperson with a lot of respiratory
problems, living in the West isgonna cause some issue.
(18:27):
But of course, wildfireparticles now spread across the
country.
The New York area and Chicagohave been experiencing the the
upper Midwest of have beenexperiencing smoke from
wildfires in Canada for severalyears now.
Um, so I and you know, ifyou're in Florida, it's
hurricanes that you have toworry about or the Gulf states.
So uh there's there's no placethat will be untouched by this.
(18:51):
Um, and so that's uh it's it'shard to say where people should
move, but I guess it depends onyour own uh susceptibilities and
fears.
Dr. Michael Koren (18:59):
Yeah, because you mentioned something about
uh air pollution being adeterminant of even development.
And um is there a better placeto live uh with that concept in
mind?
Dr. Debra Hendrickson (19:11):
Um yeah, I mean, the the West is
definitely most impacted bywildfire smoke.
Like I said, you can do thingsto protect your kids.
Like what we do here is um youcan even just something as
simple as weatherizing yourhome, which is a low-cost thing
to do, makes your home moreenergy efficient, it uh can seal
out pollutants pretty well too.
And then a lot of us here havefreestanding air purifiers.
(19:33):
You can um uh you can buildthem from instructions online as
well.
Uh, if you use a high-gradefilter in your central air
conditioning system, that canhelp.
You know, going when you gooutside, wear masks or do other
things to protect yourself.
So there are things you can doto reduce the exposure, but if
you have a young child,especially one with a lot of
respiratory problems, uh itwould be an issue to think
(19:55):
about.
So you're not recommendingpeople move to Iceland quite
yet.
No, no, I think uh I don't think there's
any place you can guaranteeyourself you won't suffers
experience some other impact ofthis.
You know, and one other impactthat I just wanted to mention
too, and I think this isrelevant for everybody in
medicine, that, you know,because of the threat that
(20:17):
climate change poses tohealthcare infrastructure, you
know, um this is an issue thatthreatens really every area of
medicine.
Um, but it is a particularissue for children because, and
this has been in the newssomewhat lately because of
what's going on at HHS.
You know, uh the fact that wewe expect our children to
survive to adulthood, that is afairly recent phenomenon, you
(20:39):
know.
Um throughout most of humanhistory, uh, you know, the odds
of a child surviving toadulthood were about 50-50.
And that it was up until thebeginning of the 20th century.
Uh, you know, in 1900, 40% ofall deaths in the US were
children five and under, andthat was mainly from infectious
diseases.
So a lot of the improvementwe've seen in that is because of
(21:00):
vaccines, which have of coursebeen in the news, but also clean
drinking water, uh, sewagetreatment, um, milk
pasteurization, mosquito controlprograms, you know, all the
aspects of public health andhospitals and clinics where we
can get the supplies we need.
You you probably um saw in thenews or experienced when
Hurricane Helene hit WesternNorth Carolina, uh, the factory
(21:22):
that made 60% of the IV fluidsin the United States was badly
damaged.
And so we had a nationwide IVfluid shortage.
And that's just one example.
There's some from everydisaster of hospitals that never
reopen, of supply chains thatare interrupted.
So everyone in medicine isgoing to be affected by this.
Uh, and but but children,because they've they benefited
(21:45):
so much from public healthimprovements as those, if as
those start to unravel becauseof a warming environment, a
warming climate, um, and all thechaos that that's going to
unleash, that's a you know big,big threat to the next
generation.
Um and if I could just make oneother point, it's that the
healthcare system itself is acontributor to uh greenhouse
(22:07):
gases.
Four to five percent of allgreenhouse gas emissions
globally, and between eight andten percent in the US are from
the healthcare sector.
So if physicians are listeningto this and want to get
involved, just getting involvedin your own hospital's uh waste
and emissions profile and tryingto do something about that uh
can be helpful.
Dr. Michael Koren (22:26):
Well, Deborah, this has been an
absolutely fascinatingdiscussion.
Thank you so much.
Um any final words for theparents out there that I know um
your your focus is isdefinitely on some public health
elements and public policyelements, but I do think a lot
of people that are listening tothese things also want to make
sure that they're doing whateverthey're possible for their kids
(22:48):
and their grandkids to protectthem.
So any uh final recommendationsfor that?
Dr. Debra Hendrickson (22:53):
Yeah, so in terms of adaptations parents
can take to, for example, a heatwave, you can go to
heatheatrisk.gov or the um theheat risk advisory system for
CDC.
It will tell you if there areany heat advisories for your
county uh that week.
Um, obviously do your errandsearly in the morning, uh, drink
plenty of water, take shadebreaks if your kids are in
(23:14):
sports.
Uh, be sure the coach is awareof the risk of heat illness and
of the signs of heat illness,especially in for football
players, uh, because they'remore at risk because of the
padding that they wear.
So football coaches aresupposed to have a tub of water
on the field uh for kids to bedunked in if they get too hot,
and they should have a wet globeuh thermometer device, um, wet
(23:37):
bulb globe thermometer uh on thefield to tell them the full
risk, not just from thetemperature but all the other
conditions.
Uh and you know, there areadaptations like this for for
air quality as well.
So one other thing in your bookthat I found interesting was
about insect-borne illnesses.
Can you make a comment on that?
That's a some like a practicalthing that people would take
away.
(23:58):
Uh yeah, so for vector-borne illnesses in
the spring and summer, uh, youwant to use um uh uh good uh
insect repellent.
If you go to the AmericanAcademy of Pediatric site for
parents, which is calledhealthychildren.org, they have a
table there of insectrepellents that are safe for
children of various ages thatyou can use to repel uh
(24:18):
mosquitoes and ticks, which areboth uh the risks from both of
those insects are rising uh asthe climate warms and the and
the environment changes.
Uh and then you can use uh bedscreens if you're gonna be out
camping in an area with a lot ofuh mosquitoes, uh, and um also
uh hats that have uh somenetting sometimes can be used to
(24:38):
help uh older kids.
Dr. Michael Koren (24:39):
Well, we so much appreciate your passion.
We so much appreciate yourexpertise, terrific.
Uh if you haven't looked at ityet, please take a look at this
book.
I think it's a very valuableread.
And thank you very much foreducating, informing me, and our
listeners and viewers ofMedEvidence! Thank you so much.
Dr. Debra Hendrickson (24:58):
Thank you very much.
Announcer (24:59):
Thanks for joining the MedEvidence Podcast.
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Welcome to MedEvidence!, where we help you
navigate the truth behindmedical research with unbiased
evidence-proven facts, hosted bycardiologist and top medical
researcher, Dr.
Michael Koren.
Dr. Michael Koren (00:11):
Hello, I'm Dr.
Michael Koren, the executiveeditor of MedEvidence! And I'm
really delighted to have DeborahHendrickson, a pediatrician and
a physician who practices inReno, Nevada, as a guest today.
And Deborah, you're an expertin helping people understand the
impact of climate change on thehealth of our kids.
(00:31):
And not only that, you wrote abeautiful book about it.
I haven't completed it yet.
I've been a third through, butit's a terrific read, and
hopefully it'll share some ofyour thoughts about why you
wrote this book and also whyit's important for people to
know about these issues.
So again, uh Deborah, welcometo MedEvidence!
Dr. Debra Hendrickson (00:47):
Well, thanks very much for having me.
Dr. Michael Koren (00:50):
So let's just start by telling everybody
about your background.
I mentioned you're apediatrician, you're in Reno,
but just tell us where you grewup and why you ended up becoming
a pediatrician and and and someof your passions regarding your
day-to-day.
Dr. Debra Hendrickson (01:03):
Yeah, so I grew up in the Bay Area in
California, um, went to schoolin New England.
Uh so I've lived, you know,both ends of the country and
also briefly in Ohio as well,and in Seattle, Washington.
So I've I've touched all a lotof the corners, not down in
Florida, but a lot of areas ofthe country.
Uh and for uh in college andfor 10 years afterward, I was I
(01:25):
focused on environmentalscience.
I was uh a degree inenvironmental science uh as an
undergrad.
And-
Dr. Michael Koren (01:31):
where was that?
Which college was that?
Dr. Debra Hendrickson (01:33):
At Brown.
I went to Brown in Providence.
Dr. Michael Koren (01:35):
Yeah.
Dr. Debra Hendrickson (01:36):
Um, and I uh worked for 10 years as an
environmental analyst andplanner for uh government
agencies in New England andWashington and uh Washington
State in Seattle in the Seattlearea.
And I worked mainly in floodclaim management, you know,
using big computer models tostudy the hydrology and soils
and how uh changes in urban uhdevelopment in these areas would
(02:00):
affect stream flows and salmonhabitat, because salmon are so
important to the PacificNorthwest.
So, anyway, so I had thisbackground in environmental
science and then um went througha major life event, which you
probably read about in the book,and I had three small children,
and I had really grown to enjoymy visits to the pediatrician
because he would pull outtextbooks and really talk to me
(02:21):
about the science of what he wasthinking.
And I kind of liked thedetective aspects of it, and I
liked the idea of combining someof my science background with
uh caring for kids.
And so when I faced this lifecrisis, I decided to change
direction and went back tomedical school to become a
pediatrician.
Um, and uh, so that's that wasmy background before I became,
(02:44):
you know, and and so climatechange was kind of uh a way that
both of my careers cametogether, that uh that an
environmental issue wasaffecting the health of my
patients.
Dr. Michael Koren (02:54):
Interesting.
So just to help the listenersand viewers understand this
better, you you talk about a lotof things in the book, and the
name of the book is called TheAir They Breathe.
And for that reason, obviously,some elements of uh respiratory
issues in in kids is uh is animportant part of this, although
more broadly you talk about allthe effects of climate.
(03:16):
But um tell tell us a littlebit more about where you got the
title and also um somesomething about childhood
asthma.
How often is it that peoplethat that young kids come into
the emergency room, for example,or come to your office with
breathing problems?
How often is that related toasthma, or what else can it be?
Just so people get a little bitof the medical background of
(03:38):
these type of issues.
Dr. Debra Hendrickson (03:40):
Yeah.
So the title comes from one ofthe major themes of the book,
which is that it's reallyimpossible to separate a child's
health from the health of theenvironment and particularly the
quality of the air that theybreathe.
Um, and so there's a wholepassage in the book about this
in the introduction that you youprobably read.
Um, that uh, you know, forexample, the lungs, uh, you
(04:03):
know, children are born withmost lung development happens
after birth, like 80 to 85%.
So you're born with like 30 to50 million of these saccules
that then differentiate intohundreds of millions of alveoli.
And we know that um kids whoare born or raised in areas with
bad air quality uh are uh theytend to have smaller, stiffer
(04:26):
lungs by the time they reachadulthood because they're there
it impairs the differentiationof the alveoli.
They tend to have um increasedelastance of the lungs, so
stiffer lungs and the immunityof the lungs is affected too.
And that has, of course,lifelong implications.
So um, and also I go into somedetail in the book about how the
(04:46):
brain can be affected by thequality of air we breathe.
We now know that air pollutionis a um a major derailler of
normal development uh in kidsliving in high pollutant areas.
And the reason this is an issuewith climate change, it's not
just that fossil fuels increaseum air pollution and on their
own, even if they weren'tcausing climate change, they
would be having many of theseimpacts, but they have been
(05:09):
another impact, which isincreasing wildfire smoke,
increasing ozone or urban smog,increasing aeroallergens.
So they're having a number ofuh, you know, they're also
looping back and causing evenfurther uh impacts, especially
in areas of the West out herewhere we're so impacted by
wildfire smoke.
So that's so the main point ofthe title was that kids develop
(05:31):
through interaction with theenvironment and particularly
with the air they breathe.
Um, and so that that that's avery important determinant of
health.
Dr. Michael Koren (05:39):
Yeah, fascinating.
Yeah.
Dr. Debra Hendrickson (05:41):
The second part of your question
about um asthma versus otherthings, you know, we often see
small children in pediatricswho, of course, have
bronchiolitis, you know, likeRSV or metapneumovirus.
Um they'll come in wheezing,coughing, and it'll seem and
sound a lot like asthma, but umyou can sometimes tell just from
the exam because it's morecoarse and uh, you know, the
(06:03):
slightly different presentation,or or they'll be positive for
RSV on the on the lab test thatyou have in the office.
You'll know that it's it'sbronchiolitis and not asthma,
although those kids are going tobe a little bit more prone to
asthma afterward.
Um, so the there are, you know,and and sometimes kids will
just come in during a smokeevent and be short of breath.
Or, you know, I've had patientsend up in the hospital during a
(06:25):
smoke event in our town,because we have that's what's
been the biggest impact ofclimate change here.
Well, we're 10 miles from theCalifornia border, so we get a
lot of wildfire smoke from justwest of us.
Um and they may never haveanother episode, but but the
smoke was the cause.
It was a you know anenvironmental trigger, uh, not
that they have asthma underlyingit.
Dr. Michael Koren (06:45):
Interesting, interesting.
So one of the things thatoccurred to me as we're talking
about things is that 100 yearsago you would read in novels and
other pieces of literature thatpeople move from New England to
warm climates like Arizona fortheir health, particularly
respiratory illnesses.
Dr. Debra Hendrickson (07:01):
Yes.
With the concept being thatit's warmer and drier.
But maybe that's differentnowadays with climate change.
Uh yeah, and the the second chapter of
the book is actually all aboutPhoenix, and I go into some of
that history because um, yeah,and it was it was interesting
because there was a whole fieldof medicine at that time called
climatology, which of course hasa very different meaning now.
But it was this idea that youcould prescribe people a place
(07:24):
to move to and that a differentclimate would improve their
health.
And a lot of people did improvewhen they moved to Arizona, but
it was probably in many casesjust because they were getting
out of some of the 19th centurytenement conditions in some of
these cities.
Um uh so yeah, that is a bigpart of the of the history of
the Southwest.
Dr. Michael Koren (07:44):
Um so writing this book is a huge endeavor.
Um, I'm always impressed by myguests that have put the time
and effort.
It's it's it's not easy,especially when you're still
practicing and you you have lotsof other parts of your life.
So so tell me a little bit moreabout what drove you to write
this book.
Was it you one incident,multiple uh incidents, what what
(08:05):
was it that made you decide toliterally spend the time to put
together such a nice piece ofwork?
Dr. Debra Hendrickson (08:11):
Oh, thank you.
Yeah, um, I had, you know, asas I was seeing more and more
impacts of the smoke in theoffice, I I really wanted to to
help parents understand uh boththe urgency of the moment that
we're in right now with climatechange uh and their own agency
to do something about it.
I kind of think parents are thesleeping giant in the climate
(08:31):
fight.
And I was kind of hoping to tapinto that fierce protectiveness
that anybody in pediatrics hasseen in their interactions with
parents in the clinics andhospitals and help them be as
concerned about this as they arewith any other aspect of their
kids' health and give them someguidance about what to do about
it.
And it was also, I reallywanted it to be kind of a moral
call to action.
(08:52):
You know, I wanted it to evokepowerful emotions and wake up
people to the implications ofwhat's happening to the people
we love most in the world.
Um, because I do think thatclimate change is a crime
against children.
I think this is the greatestmoral crisis that humanity has
ever faced, and it's up to allof us as individuals to do
something about it.
And um there was one specificincident that triggered me
(09:14):
writing the book.
I don't know if you wanted meto talk about that too, that you
read about it.
Dr. Michael Koren (09:17):
Absolutely.
Dr. Debra Hendrickson (09:18):
Yeah, so it was um it was about 12 years
ago.
It was uh the first of the wewe had a we've had a series of
major, uh we call them smokecrises here, where we just get
um weeks up to months of smoke.
Um, where we, you know, thatit's very um it's very
overwhelming and and oppressive.
(09:38):
Um, but the first one of thesereally was in 2013.
Uh it was called the YosemiteRim Fire.
And I was seeing a little girlin my office uh who had already
had some respiratory issues,some asthma symptoms, and she
was only about 10 months old.
And uh outside the windows ofthe hospital that day, uh ash
was raining from the sky likesnow, and it was just swirling
(09:59):
around the building.
Uh, and uh it was just anapocalyptic scene.
And uh her mom brought her inbecause she just couldn't get
her symptoms under control, andshe'd put this damp baby blanket
over the car seat to try tokeep her protected, and it was
covered with little flakes ofash when she came in.
Anyway, I had this baby on thetable and I was listening to her
(10:19):
lungs, and she was just lookingup at me with these big brown
eyes, struggling to breathe.
And that was really the momentthat I realized that I was
seeing things that I had learnedabout in my environmental
education and career in terms ofthe forests uh burning at much
higher rates.
And we didn't realize it at thetime because that was a really
unusual event at the time, butit became a very routine event
(10:42):
over the subsequent decade.
Dr. Michael Koren (10:45):
Interesting.
That, you know, having aninteraction with a patient like
that can be incrediblymotivating for us physicians and
uh and to your point a call toaction.
And this gets into a little bitof the controversies around
climate change.
And again, we're not politicalhere.
We just like to report thefacts and let people make their
(11:06):
own decisions.
But there are some debatesabout how much of climate change
is man-made and how much of itis from other sources.
And um you can weigh in alittle bit on that, and uh I
think that's important forpeople to hear.
Is it is it something that, inyour view, is entirely man-made?
Is it something that it's othersources and and how does that
matter for protecting yourpatients at the end of the day?
Dr. Debra Hendrickson (11:28):
Oh, yeah, no, this is this is a man-made
problem, and you know, 98% ofscientists in the world agree.
You'll you'll always found findsome outliers uh in any
question of science.
But uh no, the the issue isthat the green greenhouse gases
in the atmosphere have beensteadily increasing in
concentration since the dawn ofthe industrial age, and those
(11:49):
gases trap heat that wouldnormally radiate back out into
space.
And you can uh they have thethe models that predicted what
would happen as CO2, which isthe most important greenhouse
gas, as CO2 rose and what weexpected, have been almost
exactly on the nose.
And in fact, you you probablyknow that uh the oil companies
(12:10):
themselves knew this.
In in 19 the 1970s and early1980s, Exxon, for example,
devoted millions of dollars ofresearch to uh investigating the
alarms being raised by some oftheir own scientists about what
their products would do.
And there's a very famous graphthat they produced that
predicted almost to a tenth of adegree exactly where we are now
(12:30):
in terms of CO2 concentrationand the temperature of the
planet.
Uh so this is a man-madeproblem, which means that we can
also do something about it, youknow, that we we need to cut
back these gases dramatically inthe next few years, which is
you know more challenging nowbecause of the administration in
the US.
Um, but it's a problem, it'sit's technologically feasible to
(12:51):
do what we need to do.
It's uh entirely a politicalproblem.
Dr. Michael Koren (12:55):
Yeah.
And again, uh I I would say Ipersonally agree with most of
what you're saying, not 100%.
I think there's certainly roomfor looking at the the course of
CO2 concentrations in theenvironment over time, literally
millennia, and bigfluctuations.
So with all things in inresearch, there's room for
interpretation, but no doubtthere's a there's a major
(13:16):
contribution from man-madeactivities.
I think we anybody with areasonable uh look at the
literature and a reasonable lookat uh the data would would come
up with that conclusion.
Um but that gets into the wholeconcept of what can we do about
it.
And of course, we have the theshort-term issues are how to
protect our kids, and then thethe longer-term issues is how do
(13:36):
we change our economy so thatwe can hopefully have a more
sustainable long-term trajectoryfor our kids, kids, and our
kids, kids, kids, and our kids,kids, kids, kids, kids.
So maybe uh you can jump intothat a little bit because uh you
made a super interestingcomment about medical
climatology being its ownspecialty, and maybe we still
(13:57):
need to be thinking in thoseterms to some degree.
Dr. Debra Hendrickson (14:00):
So uh the good news is that there's
actually been an explosivegrowth of solar energy around
the world and battery storage.
Um China's uh growth in solaris so astounding that they're
meeting their Paris goals aheadof schedule, and they're likely
to become the first electrostatethat is powered entirely by
renewable energy and batterystorage.
(14:21):
Um so there's a lot of good,hopeful signs around the world.
Uh I this is, you know, and andthese energies are cheaper,
faster to create.
And um, you know, a lot of thebarriers right now are just how
to connect them to the grid andtechnological issues like that,
but but those can be overcomewith the with the right funding
and governments in place.
Um so it's it's it's entirely aproblem we can solve.
(14:46):
And there's a lot of hopefulsigns on the horizon.
The issue is how fast it'shappening in countries like
ours, you know, wherever we havea very limited window of time
to avoid the most catastrophicwarming.
Uh, the modeling has shown thatwe're supposed to cut the
greenhouse gas CO2 emissions inhalf by the end of this decade
(15:08):
to avoid going over 1.5 degreesum centigrade centigrade warming
in the trend line of warming.
So um it's uh, you know, andthat's obviously a window that's
rapidly closing.
So we're probably going toexceed it, but every tenth of a
degree matters.
And so we need to just work asfast as we can to make this
transition happen.
Dr. Michael Koren (15:28):
Well, if I'm not mistaken, the models also
would suggest that if we stoppedall CO2 production tomorrow by
some miracle, we're still goingto see warming in the
environment.
So there's certain, there'sgoing to be a certain period of
time we're going to have to dealwith this, which gets into this
whole issue of how do weprotect our kids in the short
run.
And so I'm curious about yourthoughts about that.
Dr. Debra Hendrickson (15:51):
Yeah, the modeling shows that warming,
well, the most recent modelingthat was done on this anyway,
showed that warming would stopin three to five years if we
completely stopped CO2 tomorrow.
Um so in terms of how toprotect kids, there's there's
kind of two avenues parents cantake.
One is adaptation.
That's what do we do to protectour kids right now from things
that are happening right now.
And the other is, you know,mitigation or sustainability.
(16:13):
What do we do to keep uh thisproblem from getting worse?
And in terms of adaptation, itdepends which issue you're
talking about, whether it'swildfire smoke, you know, or air
quality or heat waves orhurricanes, you know, and
there's a list ofrecommendations I go through in
the book for each of those forhow to protect uh our kids.
And then for sustainability,you know, it's uh I usually tell
(16:34):
people to think of your ownlife as being in the center of a
series of spheres, you know,and um your child is in a home
with a family and uh and that'sthe center sphere.
The next sphere out might betheir school and your job and
then your neighborhood, yourcity, your county.
And take an inventory of yourown greenhouse gas use in each
of those, or or the the of yourcommunity's use in each of those
(16:58):
spheres, and just pick onething to work on.
Um, it might be electric schoolbuses for your kids' school or
help or helping the schoolconvert to a heat pump uh with
solar panels instead of astandard HVAC system.
And getting kids involved inthose kinds of projects can
really help them with um howthey're feeling about this issue
as well.
So um I think you know thosethat those are the two avenues
(17:21):
that parents of action thatparents can look at.
And um, and like I said, I wentinto more detail this at the
end of the book.
Dr. Michael Koren (17:27):
That's terrific.
So are you recommending peoplemove to different places if
they're growing up in a desertenvironment and there's
wildfires and they're beingsubject to the ash?
Should they be moving someplaceelse back echoes of what
happened 100 years ago whenpeople are moving to warmer
climates?
Dr. Debra Hendrickson (17:45):
Yeah, well, um it I think with climate
change, it's kind of an issueof pick your poison because you
know, yeah, if you're inArizona, the the temperature
projections for Phoenix are it'shard to imagine living there uh
if if these bear out, um, thatwe're gonna see temperatures in
the 130s by mid-century.
So yeah, so so even just goingoutside and those kind of
(18:06):
temperatures, and obviouslythat's just for the hottest
parts of the year, but thelength of periods where they're
seeing over 100 degrees isgetting longer and longer every
year, too.
So if you're somebody who'svery sensitive to the heat, like
an older person, that may notbe a place that you can live
anymore.
If you have a if you're aperson with a lot of respiratory
problems, living in the West isgonna cause some issue.
(18:27):
But of course, wildfireparticles now spread across the
country.
The New York area and Chicagohave been experiencing the the
upper Midwest of have beenexperiencing smoke from
wildfires in Canada for severalyears now.
Um, so I and you know, ifyou're in Florida, it's
hurricanes that you have toworry about or the Gulf states.
So uh there's there's no placethat will be untouched by this.
(18:51):
Um, and so that's uh it's it'shard to say where people should
move, but I guess it depends onyour own uh susceptibilities and
fears.
Dr. Michael Koren (18:59):
Yeah, because you mentioned something about
uh air pollution being adeterminant of even development.
And um is there a better placeto live uh with that concept in
mind?
Dr. Debra Hendrickson (19:11):
Um yeah, I mean, the the West is
definitely most impacted bywildfire smoke.
Like I said, you can do thingsto protect your kids.
Like what we do here is um youcan even just something as
simple as weatherizing yourhome, which is a low-cost thing
to do, makes your home moreenergy efficient, it uh can seal
out pollutants pretty well too.
And then a lot of us here havefreestanding air purifiers.
(19:33):
You can um uh you can buildthem from instructions online as
well.
Uh, if you use a high-gradefilter in your central air
conditioning system, that canhelp.
You know, going when you gooutside, wear masks or do other
things to protect yourself.
So there are things you can doto reduce the exposure, but if
you have a young child,especially one with a lot of
respiratory problems, uh itwould be an issue to think
(19:55):
about.
So you're not recommendingpeople move to Iceland quite
yet.
No, no, I think uh I don't think there's
any place you can guaranteeyourself you won't suffers
experience some other impact ofthis.
You know, and one other impactthat I just wanted to mention
too, and I think this isrelevant for everybody in
medicine, that, you know,because of the threat that
(20:17):
climate change poses tohealthcare infrastructure, you
know, um this is an issue thatthreatens really every area of
medicine.
Um, but it is a particularissue for children because, and
this has been in the newssomewhat lately because of
what's going on at HHS.
You know, uh the fact that wewe expect our children to
survive to adulthood, that is afairly recent phenomenon, you
(20:39):
know.
Um throughout most of humanhistory, uh, you know, the odds
of a child surviving toadulthood were about 50-50.
And that it was up until thebeginning of the 20th century.
Uh, you know, in 1900, 40% ofall deaths in the US were
children five and under, andthat was mainly from infectious
diseases.
So a lot of the improvementwe've seen in that is because of
(21:00):
vaccines, which have of coursebeen in the news, but also clean
drinking water, uh, sewagetreatment, um, milk
pasteurization, mosquito controlprograms, you know, all the
aspects of public health andhospitals and clinics where we
can get the supplies we need.
You you probably um saw in thenews or experienced when
Hurricane Helene hit WesternNorth Carolina, uh, the factory
(21:22):
that made 60% of the IV fluidsin the United States was badly
damaged.
And so we had a nationwide IVfluid shortage.
And that's just one example.
There's some from everydisaster of hospitals that never
reopen, of supply chains thatare interrupted.
So everyone in medicine isgoing to be affected by this.
Uh, and but but children,because they've they benefited
(21:45):
so much from public healthimprovements as those, if as
those start to unravel becauseof a warming environment, a
warming climate, um, and all thechaos that that's going to
unleash, that's a you know big,big threat to the next
generation.
Um and if I could just make oneother point, it's that the
healthcare system itself is acontributor to uh greenhouse
(22:07):
gases.
Four to five percent of allgreenhouse gas emissions
globally, and between eight andten percent in the US are from
the healthcare sector.
So if physicians are listeningto this and want to get
involved, just getting involvedin your own hospital's uh waste
and emissions profile and tryingto do something about that uh
can be helpful.
Dr. Michael Koren (22:26):
Well, Deborah, this has been an
absolutely fascinatingdiscussion.
Thank you so much.
Um any final words for theparents out there that I know um
your your focus is isdefinitely on some public health
elements and public policyelements, but I do think a lot
of people that are listening tothese things also want to make
sure that they're doing whateverthey're possible for their kids
(22:48):
and their grandkids to protectthem.
So any uh final recommendationsfor that?
Dr. Debra Hendrickson (22:53):
Yeah, so in terms of adaptations parents
can take to, for example, a heatwave, you can go to
heatheatrisk.gov or the um theheat risk advisory system for
CDC.
It will tell you if there areany heat advisories for your
county uh that week.
Um, obviously do your errandsearly in the morning, uh, drink
plenty of water, take shadebreaks if your kids are in
(23:14):
sports.
Uh, be sure the coach is awareof the risk of heat illness and
of the signs of heat illness,especially in for football
players, uh, because they'remore at risk because of the
padding that they wear.
So football coaches aresupposed to have a tub of water
on the field uh for kids to bedunked in if they get too hot,
and they should have a wet globeuh thermometer device, um, wet
(23:37):
bulb globe thermometer uh on thefield to tell them the full
risk, not just from thetemperature but all the other
conditions.
Uh and you know, there areadaptations like this for for
air quality as well.
So one other thing in your bookthat I found interesting was
about insect-borne illnesses.
Can you make a comment on that?
That's a some like a practicalthing that people would take
away.
(23:58):
Uh yeah, so for vector-borne illnesses in
the spring and summer, uh, youwant to use um uh uh good uh
insect repellent.
If you go to the AmericanAcademy of Pediatric site for
parents, which is calledhealthychildren.org, they have a
table there of insectrepellents that are safe for
children of various ages thatyou can use to repel uh
(24:18):
mosquitoes and ticks, which areboth uh the risks from both of
those insects are rising uh asthe climate warms and the and
the environment changes.
Uh and then you can use uh bedscreens if you're gonna be out
camping in an area with a lot ofuh mosquitoes, uh, and um also
uh hats that have uh somenetting sometimes can be used to
(24:38):
help uh older kids.
Dr. Michael Koren (24:39):
Well, we so much appreciate your passion.
We so much appreciate yourexpertise, terrific.
Uh if you haven't looked at ityet, please take a look at this
book.
I think it's a very valuableread.
And thank you very much foreducating, informing me, and our
listeners and viewers ofMedEvidence! Thank you so much.
Dr. Debra Hendrickson (24:58):
Thank you very much.
Announcer (24:59):
Thanks for joining the MedEvidence Podcast.
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Ruthie's Table 4
For more than 30 years The River Cafe in London, has been the home-from-home of artists, architects, designers, actors, collectors, writers, activists, and politicians. Michael Caine, Glenn Close, JJ Abrams, Steve McQueen, Victoria and David Beckham, and Lily Allen, are just some of the people who love to call The River Cafe home. On River Cafe Table 4, Rogers sits down with her customers—who have become friends—to talk about food memories. Table 4 explores how food impacts every aspect of our lives. “Foods is politics, food is cultural, food is how you express love, food is about your heritage, it defines who you and who you want to be,” says Rogers. Each week, Rogers invites her guest to reminisce about family suppers and first dates, what they cook, how they eat when performing, the restaurants they choose, and what food they seek when they need comfort. And to punctuate each episode of Table 4, guests such as Ralph Fiennes, Emily Blunt, and Alfonso Cuarón, read their favourite recipe from one of the best-selling River Cafe cookbooks. Table 4 itself, is situated near The River Cafe’s open kitchen, close to the bright pink wood-fired oven and next to the glossy yellow pass, where Ruthie oversees the restaurant. You are invited to take a seat at this intimate table and join the conversation. For more information, recipes, and ingredients, go to https://shoptherivercafe.co.uk/ Web: https://rivercafe.co.uk/ Instagram: www.instagram.com/therivercafelondon/ Facebook: https://en-gb.facebook.com/therivercafelondon/ For more podcasts from iHeartRadio, visit the iheartradio app, apple podcasts, or wherever you listen to your favorite shows. Learn more about your ad-choices at https://www.iheartpodcastnetwork.com
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com