Cli-Fi—helping us manage a crisis
BMJ 2024; 387 doi: https://doi.org/10.1136/bmj.q1734 (Published 03 October 2024) Cite this as: BMJ 2024;387:q1734The great Indian heat wave broke all records. It scorched a vast swath of the country, from Gujarat and Rajasthan in the west, eastward across Uttar Pradesh and Bihar to West Bengal. In rural areas and in the megacities of Delhi and Lucknow, the temperature climbed above 40°C and the humidity above 60%; they hovered there for days, with little relief at night. Power plants and water systems stopped functioning. The combination of heat and dehydration killed hundreds of thousands in just a few days. In one city in Uttar Pradesh, thousands of people had sought refuge in the water of a shallow local lake. But the water was hotter than their body temperature. When the heat wave finally subsided, one of the most grisly tasks was removing thousands of corpses from the lake.
This scenario unfolds in the opening chapters of Kim Stanley Robinson’s The Ministry for the Future (2020). It is fictional. And it is unforgettable.
Reading fiction is one of the sublime ways to experience art. Stories engage us, absorb us, and stay with us.1 The reader may be transported cognitively and emotionally, and experience images more vivid than those in real life.2 This can be transformative; a compelling narrative may change a reader’s point of view.3 Fiction is “the mind’s flight simulator,” according to novelist and psychologist Keith Oatley,4 helping us understand both our own minds and the world’s complexity.
Indeed, stories are an integral part of all cultural traditions. “The human mind is a story processor, not a logic processor,” writes moral psychologist Jonathan Haidt.5 “Everyone loves a good story; every culture bathes its children in stories.” Stories shape collective memories, define social identity, and—importantly in the context of contemporary crises such as climate change—frame the possibilities people perceive for the future.
In recent years, the genre known as climate fiction—or “cli-fi”—has blossomed. “We decide what to do based on the stories we tell ourselves,” says Robinson, “so we very much need to be telling stories about our responses to climate change and the associated massive problems bearing down on us and our descendants.”6 Dozens of authors have answered the call.
Cli-fi varies widely. Some stories and books centre on the climate crisis; in others, conventional plots unfold, with climate change forming the background. Some accounts are set in the next decade or two, others in the more distant future. Some cli-fi is dark and feeds despair; other works are hopeful, depicting pathways to human survival and even thriving. Much cli-fi is just plain good storytelling.
Why should health professionals care?
Cli-fi may be important for our patients as they come to grips with the looming climate crisis—a hyper-object too vast to grasp, a threat too frightening to confront directly, a challenge that can feel paralysing. Indeed, health professionals may find cli-fi helpful in the same way. Cli-fi may function in at least three relevant domains: cognitive, emotional, and behavioural.
It can help us understand the climate crisis, including its health dimensions. While climate science relies heavily—and appropriately—on modelling and forecasting, these quantitative methods tell no stories. No numerical tables or coloured maps can pack the punch of the infectious diseases in Sherri Smith’s Orleans (2014) or TC Boyle’s Blue Skies (2023), the drought in Paolo Bacigalupi’s The Water Knife (2015) or Claire Vaye Watkins’s Gold Fame Citrus (2015), the rising sea levels in Kim Stanley Robinson’s New York 2040 (2023), or the wildfires in Sarah Ruiz Grossman’s A Fire So Wild (2024). The vivid imagery in these books stays with you long after you finish reading, in ways that scientific papers rarely do. Simply stated, fiction is an effective tool for learning facts.7
Cli-fi may help us deal with the emotional turmoil the climate crisis triggers.8 Psychologist Thalia Goldstein points out that reading fiction offers a way to process difficult emotions such as grief: “In fiction we can experience emotions without need for self-protection, and thus we can allow ourselves to feel more than we would feel in real life …. Fiction provides readers with a controlled environment in which to explore emotions they try to avoid in real life.”9
One constructive emotional response to fiction is empathy. “Fiction,” says author Paolo Bacigalupi, “has this superpower of creating empathy in people for alien experiences. You can live inside of the skin of a person who is utterly unlike you.”10 Evidence suggests that Bacigalupi is right; when readers identify with characters and are emotionally transported by what they read, empathy grows.111213 That empathy may extend to clinical care14 and to broader civic awareness,15 suggesting a role for fiction in medical education and civics education, respectively.
In the context of climate change, empathy for future generations is in short supply and needs to be cultivated; it is the bedrock of responsible climate policy.1617 Identifying with a young person who is struggling to survive in an altered world in 2070 may create powerful intergenerational solidarity.
Fiction can also cultivate another essential emotional response: hope. Cli-fi accounts of successfully tackling the climate crisis, such as Robinson’s The Ministry for the Future (2020) or Neal Stephenson’s Termination Shock (2021), even if they don’t predict all the details accurately (how could they?), offer the reader a bracing dose of hope.
Finally, cli-fi can motivate action. Educator Annie Schultz describes works of fiction whose protagonists engage in struggles, often of a political nature, “informed by a contemplative focus on inner consciousness.” Through such journeys to political consciousness, Schultz argues, “reading and thinking can become emancipatory activities and ones that might precede meaningful civic action and participation.”15
We have only a few studies of the effects of cli-fi on readers, and the findings are equivocal.181920 We need to know more. But from all we know of literature more generally, there is every reason to think that cli-fi can deepen understanding, help process emotions, and trigger constructive action—all useful outcomes as we address the climate crisis. Ideally, we will read climate fiction, be transported, and be stirred to action, before it ceases to be fiction.
A sampler of climate fiction
The Drowned World by JG Ballard (1962). Strictly speaking not cli-fi, as the global warming and resulting sea level rise that have submerged London resulted not from carbon emissions but from a solar event. The characters are scientists studying an ecosystem that is as much Triassic as Anthropocene.
The New Atlantis by Ursula K Le Guin (1975). A short novel. The continents are sinking, Atlantis is re-emerging from the depths, the government is authoritarian, and two of the main characters are working clandestinely to develop solar energy technology.
Parable of the Sower by Octavia E Butler (1993). In a climate ravaged, Hobbesian world (set in 2024), a young woman with “hyperempathy” for other people’s pain journeys on foot through California after her community has been destroyed, spreading a hopeful gospel called Earthseed.
Oryx and Crake by Margaret Atwood (2003). Horrendous storms are routine, coastlines have been inundated, and the weather is permanently tropical. Corporate depredations have flourished. And an engineered plague—a deliberate response to overconsumption—has killed most of humanity, leaving genetically modified creatures.
The Swan Book by Alexis Wright (2013). In an Australia devastated by climate change and war, a mute indigenous girl is raised by a climate refugee from Europe, and becomes the wife of Australia’s first Aboriginal premier. Mythical elements—including swans—and realism are intertwined.
Orleans by Sherry Smith (2014). A young adult novel set along the US Gulf coast, where an isolated society has emerged after a series of catastrophic climate driven hurricanes and an epidemic of febrile illness.
The Water Knife by Paolo Bacigalupi (2015). Water is in critically short supply in the southwestern US, and criminal gangs, state governments, and robber barons compete—often violently—for available water. Angel Velasquez is a “water knife”—part detective, part assassin—who locates water for Las Vegas interests. As he chases rumours of a new water source in Phoenix, he encounters a hardened journalist, a water migrant from Texas, and forces bigger than all of them.
Gold Fame Citrus by Claire Vaye Watkins (2015). Here it’s California that’s been devastated by drought. The government has relocated most Californians to other areas, but two holdouts—Ray, a war veteran, and Luz, a former child star—are barely holding on. They hear rumours of a dowser who can still find water, and set off—with a mysterious child they’ve taken under their wing—to find him, braving violent thugs and government authorities.
Clade by James Bradley (2015). A multigenerational evocation of Adam Leith, a British climate scientist, his partner Ellie, and their descendants, over more than century of a radically changed world.
American War by Omar El Akkad (2017). When the US bans the use of fossil fuels in 2074, five southern states secede from the Union, triggering a civil war. This is an account of the war, through the eyes of Sarat Chestnut, a young girl when the war breaks out, from the start of the war through reunification and the viral pandemic that follows.
Future Home of the Living God by Louise Erdrich (2018). Melting permafrost has released a virus that has caused evolution to regress. An oppressive, theocratic government has taken control of women’s reproduction, to assure a supply of babies. Cedar Hawk Songmaker, a pregnant Ojibwe woman, tries to protect herself and her unborn child.
Everything Change: An Anthology of Climate Fiction, Vol 1 (2016), Vol 2 (2018), and Vol 3 (2021) by various authors. These anthologies, published by the Arizona State University Imagination and Climate Future Initiative, compile the best entries in the programme’s annual climate fiction contest. The stories explore how our responses to this crisis will shape the world we inhabit. Freely downloadable at https://climateimagination.asu.edu/everything-change/.
The Ministry for the Future by Kim Stanley Robinson (2020). A global ministry, established by the UN Framework Convention on Climate Change, undertakes far-reaching interventions, including economic strategies, geoengineering, and “dirty tricks,” in an effort to reverse the effects of climate change. Complex characters, an absorbing plot, solid science.
Termination Shock by Neal Stephenson (2021). In a near future world suffering from all the ravages of climate change—superstorms, floods, heat waves, and pandemics—a bold Texan unilaterally launches a geoengineering project. An absorbing cast of characters including the Dutch queen, a Canadian Sikh martial artist, and a hog exterminator.
The Deluge by Stephen Markley (2023). A massive (900 page) imagination of the near future as climate related disasters intersect with government dysfunction and human drama. Unforgettable characters including a visionary scientist, an ecoterrorist, a drug addict, a neurodivergent mathematician, and many more.
Blue Skies by TC Boyle (2023). A zany and often humorous story of a family—earnest environmentally responsible parents in California, their entomologist son, their social media influencer daughter on the Florida coast, and assorted friends—as they try to navigate a world of floods, heat waves, and species die-offs.
A Fire So Wild by Sarah Ruiz-Grossman (2024). As a wildfire bears down on Berkeley, California, the lives of diverse characters—an affordable housing advocate, a homeless construction worker, a pair of high school romantics—intersect.
Perilous Times by Thomas D Lee (2024). A recasting of the Arthurian legend. Sir Kay, Sir Lancelot, and even Merlin reappear in contemporary England, not only vanquishing dragons, but tackling the climate crisis.
Footnotes
Competing interests: Howard Frumkin reports no financial conflicts of interest in connection with this paper. He reports uncompensated service on advisory boards or similar positions with the European Centre for Environment and Human Health (University of Exeter), the Global Consortium on Climate and Health Education (Columbia University), the Harvard Center for Climate, Health, and the Global Environment, the Medical Society Consortium on Climate and Health (George Mason University), the Planetary Health Alliance (Johns Hopkins University), and the Yale Center on Climate Change and Health.
Provenance and peer review: commissioned; not externally peer reviewed.