 I have done a lot of international work. I've been to Haiti following the earthquake. I've been to the Philippines following the super typhoon. I've been to Sri Lanka following the tsunami. I've seen a lot of destruction and hurt people and communities disrupted. But I've always been moving through. I've been there knowing that in a few weeks time I would be going home. I would be going home to my family, to my bed. And what I thought now was, I don't have a home to go to. I don't know when I will have a home to go to. My shift starts at 11. The hospital was already feeling the impact of smoke. And we're starting to see some complaints related to the smoke and even some people saying that they had escaped some flames. And every time the paramedics bring patients in, their radios are always chirping with the activity in the community. And I was hearing about structure fire here and grass fire there. And at one point, one of the paramedics looked at me and he said, every fire asset in the county is deployed right now. And that was the first time that the hair went up on the back of my neck. And I thought, this is gonna be a different night. So I called my wife and I said, you know, it's a little bit weird out there. Why don't you get some things ready? Just in case. It was around 1.15 that I was in, seeing a patient and my personal phone went off. And it was my neighbor, Mike, and he's just yelling at me, get out, get out, get out. And he doesn't know that I'm at work. I run out of the patient's room and I immediately call my wife's cell phone back. Only it's my 15-year-old daughter Sophie who answers the phone and she's just screaming. That's all she can do is scream. It seemed forever, but it wasn't probably about 30 seconds until I hear my wife getting back into the car. Okay, we're in the car, we're in the car, we're driving. And they're driving through walls of flame and burning branches that she said, okay, we're out, we're out. It was around 3 a.m. that the fire team came in and they said to me, we're making our last stand. There is a trailer park just adjacent to our property on the north with a dry creek bed in between. And they were gonna use the last two rows of trailers to try and hold the fire off of our property. And I said, okay, time to evacuate. And the firefighters actually said, we're not making that recommendation, we're recommending shelter in place. And I said, time to evacuate. And that's when we decided to evacuate the hospital. It's a big deal to make that decision to evacuate a hospital. And we had 122 patients. And that included at least one patient on the ventilator, a couple patients in the NICU, and of course med search patients and emergency patients. That morning on the 9th, it looked like a bomb had gone off. All that was left of the homes were chimneys and the shells of cars. The impact after the fires and the immediate days that followed, we had to deal with the emotional impact of our community being devastated. We have 170,000 plus people who call Kaiser Permanente, Kaiser Hospital and the clinics their medical home. People still needed medications and they needed appointments and they needed procedures and they needed to have babies. So we pulled together to set up systems to continue delivering that care. In our community, there were tens of thousands of people who were displaced who were now in shelters and they needed medication refills and they needed to be evaluated for their breathing problems and they needed to be evaluated for their anxiety and their loss. The result of the fire was obviously substantial impact to the air quality in the area. I've heard numbers like 50 packs of cigarette smoking equivalent for people who were breathing the air for the week that followed the fire and I walked around a lot without a mask and I still wonder what that impact will have for the years to come. For many many months, we saw an increase in respiratory illness. I've heard a number close to 40% increase in emergency department visits for respiratory illness as far out as March of 2018. And what researchers still don't know is what the impact will be to children born around that time and to heart disease. We certainly know that people who have had ongoing respiratory illness exacerbations of COPD and asthma, but also anxiety and depression and we have seen a substantial rise of psychiatric visits to our emergency department since the fires. The stress that it puts on people and on their families is substantial and people continue to feel it two plus years later. Climate change clearly has an impact to health on many levels. From my perspective as a physician, what I see is that as we have more heat, we have more fires, we're gonna deal with those respiratory illnesses. We can also, I think, expect to see more heat-related illnesses, or we're gonna use more and more electricity for air conditioning. And so we're gonna have to figure out ways to address that. Food is clearly a part of medicine. As we move into more arid periods of our existence, we're gonna find food challenges that much greater. When I've been to other countries where food and food supplies are much more challenged, if people aren't healthy because they're not getting the foods that they need, then they're more susceptible to diseases. We have seen the rise in mosquito-borne illnesses. Whether it's food, whether it's heat illnesses, whether it's smoke-related as we see more fires, that's gonna become more and more the part of the picture as we move forward. Kaiser Permanente has been very forward-thinking and progressive in trying to address this problem. We're gonna be carbon-neutral in 2020. And on my own campus, I continually see new solar panels going up over parking lots and on buildings. And we have a new building that went up recently that is a low-use building. So I'm really proud to be a part of the organization. Every story deserves a happy ending. And we did have a happy ending in our story. I managed to make it up to our property. And I had sort of held out hope that I might find our house there, but it wasn't there. And my wife had left the house with not being able to find our cat. And we also have two goats on the property. And as she left, she just kind of looked at the goats and couldn't do anything, couldn't stop. And so I get up to the house and I'm there with a friend of mine and I'm calling for my cat and I'm crying. And behind me, I hear, baaah, baaah. And my two goats had somehow managed to survive the fire. We don't really know except to think that the, they did what goats do. And so their grass was mowed down in their pen. And I think the fire just flashed over them. They were a little bit singed, but then their fence burned down and they probably just hopped over that. And then they said, you know, here are all these grapes. I have grapes on my property. All these grapes we've been trying to eat for all these years and now. So they were just sitting there chewing on the grapes and doing okay. And they are now living with some friends in the East Bay and looking forward to moving back up and we hopefully have our house back by the end of this year.