An interview with Dr Diana Warner: looking beyond the presenting complaint
In October 2018, then working as a GP in Bristol, Dr Diana Warner was conducting a baby clinic, assessing 6 week old infants. One of the problems she was looking for was congenital hip dysplasia, which, if not spotted immediately, later causes considerable pain and disability, requiring hip replacement surgery sometimes as early as when the patient is in their 20s. While examining one of these babies, Diana was suddenly hit by a sense of “missing the point”. She was screening for a condition that could affect this young girl into her 3rd decade, but what would the world look like then? She made a pledge then and there to do everything she could to change the prognosis; to work towards ensuring that the world in 20 years’ time will be live-able, breathable, bearable. Six months later, Dr Warner retired as a GP and dedicated herself to climate activism.
Diana is no longer a GP, but she is still a doctor. She considers the work she is doing now to be as, or even more, important to the health of our communities as her 35 years in the NHS. Why? Because the climate crisis, according to the Lancet no less, is the greatest threat to human health in the 21st century (1). Heatwaves, extreme weather events, flooding, food insecurity, pollution – all directly affect physical and mental health, as well as reducing access to healthcare. These effects are summarised below.
Before her awakening of sorts at the baby clinic, Diana had been no stranger to the ecological emergency – she had spent a lot of time researching and reading up on it, and had stood twice as Green Party candidate for her home constituency of Filton and Bradley Stoke in the 2015 and 2017 general elections. But it was now clear that the system could not be changed from within. She joined the Extinction Rebellion splinter group “Burning Pink” (AKA Beyond Politics) which advocate for drastic changes to the way our society is run. Economic decisions are driven by an uncontrollable “urge to increase our GDP”. This is the status quo we rarely question, but which is unsustainable and incompatible with any attempts to heal our planet and its people. GDP is based on finance alone and does not take into account factors such as public health and the environment, known as “externalities”. In economics, an externality is “a cost or benefit caused by a producer that is not financially incurred or received by that producer” (2). Ignoring externalities allows big business to continue exploiting the earth’s natural resources in the name of GDP.
Currently, Diana is acting independently of any particular organisation and wants above all else to bring diverse communities together to work for a common goal. She describes her two main aims as follows:
Establishing Citizen’s Assemblies. This is a tried and tested way of using normal people to make governmental decisions. Citizen’s Assemblies have been used successfully around the world, for example in Ireland when they were used to discuss the historically divisive issue of abortion. One member of the Irish assembly described feeling “empowered and informed – it gave me the language and skills to have difficult discussions” (3). How does it work? Around 100 ordinary people are randomly selected and spend three months learning about an issue. This is often done by bringing them all together and then splitting into smaller discussion groups (nowadays, this translates as Zooms with breakout rooms). Experts from all sides are invited to speak to the assembly, ensuring representation of the political spectrum. Participants listen, discuss and ask questions, and are also encouraged to interact with their communities, meaning that 100 people are selected, but the net of engagement is cast even wider. The groups are selected to be fully representative of the population, including 50% women, people from ethnic minority backgrounds, the LGBTQIA+ community. They are rich, poor, fat, thin, black, white, right-leaning, left-leaning, religious, atheist and everything in between. They acquire over this time as much, probably more, knowledge than the politicians who we are used to entrusting with these decisions; all that they lack are the inflated egos. Once the 12 weeks are up, a question list is constructed, usually by the assembly themselves, and recommendations are made. Importantly, with the recommendations come reasons: “you not only see what the decision was, but why that decision was made” (4). Burning Pink believe that Citizen’s Assemblies should be used for a wide variety of issues, including the climate, health, economy… issues which, as Diana points out, are intrinsically interlinked
Protesting the government’s attempts to outlaw Non-Violent Direct Action (NVDA) through necessity. Diana describes the “slow erosion of the independence of the courts and judicial systems”. Part of this erosion is due to the gradual dismantling of the plea of necessity, “the argument that the defendant did what they did in order to prevent a greater harm”. This is relevant to climate activists such as Diana who have taken part in NVDA in an attempt to warn against the undeniable suffering that the climate emergency has brought and will bring. An example of this is the Stansted Airport Case, where in 2017, 15 activists blocked an aeroplane from carrying asylum seekers away from the UK and to their native countries. Since then, 11 of these passengers prevented from being deported “have now been given legal status in the UK” (5). AKA, the 15 human rights activists prevented the wrongful deportation of people who had fled their home countries to find safety in the UK. In November, their plea of necessity will be argued in a landmark case in the Appeal Court.
Since her eureka moment two years ago, Diana has been involved in a number of protests, and has found herself more than once at the mercy of the police force. She’s been arrested multiple times, including for blocking entrances, gluing her hands to a train, throwing paint at Liberal Democrat and Conservative party headquarters. Most recently, she was arrested at home on Monday 24th August, along with 4 other members of Burning Pink, charged with “conspiracy to cause criminal damage”. Diana spent 4 weeks in prison on remand. Asked what kept her going during this time, Diana returned to the commitment she made to the baby she met two years ago. “I made a pledge to make her life good and bearable. It was a deep pledge, a sort of life-changing pledge”. Another motivation she talked about was a sense of repayment for the persecution her ancestors faced as German Jews. Her grandmother was killed in a gas chamber at Auschwitz. “Who was speaking out for my grandmother? Who was helping her?”. In a sense, Diana feels compelled to act from both sides – from the new generation and the old, from the injustices of the past and those of the future.
It is easy to feel despairing when we know that our planet is in such danger, and the government seems not only to be ignoring the problem but to be outlawing the activists who are trying to make a difference. But there is hope when we work together and refuse to accept that society cannot change. According to Diana, first and foremost we need to educate ourselves so that we can take action. As students or healthcare professionals at the beginnings of our careers, we are part of the system, but not yet so blinkered that we cannot question how things are done. It is essential that we “put [our] work in context”, and never forget that our responsibilities to our patients extend beyond their presenting complaint.
Fig. 1 - https://www.facebook.com/healthdeclares
Fig. 2 – William Watson