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In Memoriam: Kirk R. Smith

Balakrishnan K, Clasen T, Mehta S, Peel J, Pillarisetti A, Pokhrel A, Samet J, Thompson L, Zhang JJ. In Memoriam: Kirk R. Smith. Environ Health Perspect. 2020 Jul;128(7):71601. doi: 10.1289/EHP7808. Epub 2020 Jul 27. PubMed PMID: 32716644; PubMed Central PMCID: PMC7384884.

Sometimes, you get the unexpected.

Professor Kirk R. Smith, close friend, mentor, and pioneering environmental health scientist, passed away unexpectedly on Monday, June 15th, 2020 at home with his family. This news has been hard to process; a remembrance of Kirk follows.

I don't know where to begin, how to start. So I'll start at our beginning.

I emailed Dr. Smith, as I insisted on calling Dr. Smith then, out of the blue in July 2006. I was applying for a Fulbright in Nepal and proposed an air pollution assessment in a few rural villages. I needed help identifying a local field partner and knew Dr. Smith had worked in Nepal on similar issues. I had no sense of the scale of his work, knew only a little of his renown, and had enough youthful hubris to reach out blindly. Still, I honestly expected no response.

To adapt (or bastardize, you pick) a mantra of Dr. Smith's 1, and the motto of his research group: You don't get what you expect; sometimes, you get the unexpected. Dr. Smith wrote back a few hours after my random inquiry -- succinct and helpful, my first exposure to the notorious slash-k 2. He introduced me to Amod Pokhrel -- at the time, a student in EHS -- who helped me find a field partner and who has been a friend and colleague since. My first experience of one of Dr. Smith's many gifts: his generosity of time and thought. One short act - three lines in total, 2 of which were email addresses - opened a door for me and lay the groundwork for lifelong friendships and collaborations.

About a year later, Dr. Smith and I met in person in Nepal, over lukewarm chai, while I was on my Fulbright. As is often the case, this meeting was (1) after he had given a lecture and (2) before he had to dash off to another meeting. I remember being struck then, as ever, by his warmth, his willingness to interact despite being very busy, his quirky sense of humor, and his intellectual rigor. He encouraged me to consider a PhD at Berkeley. We had about a half hour talk and then went to find cabs: it was pouring, otherwise I am confident he would have walked or taken the bus or a tuk-tuk.

We were infrequently in touch for the next year. I applied to the EHS PhD program at Berkeley in late 2009, got in, and moved into an apartment in Oakland in July of 2010. At some point in that first few months, I called Dr. Smith's home, up Panoramic Way, and Joan answered. Joan scared me just as much as Dr. Smith in those days. I asked for Dr. Smith, and she gave him the phone, saying something along the lines of, "Will you please tell him to stop with this Dr. Smith nonsense?" It was just loud enough that I could hear it, and it worked: 'Dr. Smith' (eventually) gave way to 'Kirk'. An example, one of many, highlighting Joan's wit, grace, warmth, and intellect.

Between then and now, there are a lot of stories -- some are mine, but so many more are Kirk's. We know he was never shy with a story. I never tired of them (okay, yeah: sometimes I tired of them).

I had the privilege of working directly with Kirk - first as a doctoral student, then as a postdoc - for the last decade, on small and large projects of all types, all over the globe. He was the greatest advocate for his students I have ever seen, and our working relationship was the best I have had. I learned much watching Kirk move through the world, with his grace, wit, inquisitiveness, and, when needed, prickly sharpness. Our friendship grew into something deep and constant. I'd like to think I gave to Kirk a thousandth of what he gave to me, but that is unlikely.

My last in-person visit with Kirk was in mid-February, about six weeks after we moved from Oakland to Atlanta, and ten years since we made the opposite journey, from Atlanta to Oakland. Mid-February, just before the pandemic obliterated routine and instated an era of uncertainty. Just six weeks after I had started a new job.

Kirk asked me to return to Berkeley to lecture in two of his classes: one an air pollution and health course that he and I launched with John Balmes, and the other his Environmental Health breadth course, which he was in the process of reimagining. Always reimagining, always improving.

We met a few times during that short visit, between other obligations. Kirk offered advice about new jobs, which he said he borrowed from Joanie, and his own supportive words; we discussed ongoing and potential work together; we ended the day with a nice Korean meal. It was a cool, drizzly Berkeley evening. I remember walking after that meal, full of bibimbap and nostalgia, heavy with memories (and with rice). The next morning's lecture, in the air pollution and health class, was small, intimate, fun; Kirk shuffled out early to go up to Bear Valley with his family. When class wrapped, I dropped some things off at Maria's desk, wandering by Kirk's office, wondering when I would see it again.

I never expected that visit to be the last time we would meet in person or see each other; nor did I expect our lives to be turned upside down by a new, emergent public health threat enabled, in some ways, by the same time- and space-folding habits that enabled Kirk and I (and so many others) to do our work. I never expected to form a deep bond with such an important, transformative thinker, and certainly never expected to count him among my closest confidants, mentors, and dearest friends. I didn't expect to hear the words "Kirk" and "stroke" and "cardiac arrest" strung together a few months later.

I expected our plans for new studies - that we discussed, just days ago - to bear fruit through our collective efforts. I expected that we would carry on for at least another decade of work, of stories, of excitement, of quibbles, of jetlag and food poisoning, of kids and grandkids, of small and large adventure, of gentle silence and enthusiastic proclamation, of our Kirk.

Sometimes, you don't get what you expect, or what you inspect. Sometimes, you get the unexpected.

  1. "You don't get what you expect, you get what you inspect."

  2. Dr. Smith's emails were short, very short, and unique. The subject line was usually the first part of a sentence: whatever he was emailing about; the next terse phrase continued that thought; they invariably ended with '/k'.

PH290: Global air quality & health: A survey of research methods and recent findings

Globally, between 5.5 and 7 million deaths per year are attributed to air pollution, making it one of the most prominent contributors to the global burden of disease. This survey course will provide an overview of global ambient and household air pollution, a brief background on atmospheric processes relevant to air pollution; the implications of air pollution on public health, with a focus on recent clinical, toxicological, and epidemiological evidence, and emergent issues in air pollution epidemiology, measurement, and policies. Health impacts and policy implications of exposures to household and ambient pollution as well as occupational exposures and exposures to environmental tobacco smoke will be examined. Syllabus

Select Lectures
Lecture 1 - Introductions + Overview | Lecture 2 - Pollutants | Lecture 4 - Air Pollution Measurement 2 | Lecture 5 - Air Pollution Measurement 1

John Balmes: Don't Let a Killer Pollutant Loose

Professor John Balmes, close colleague and friend, and physician member of the California Air Resources Board:

PM 2.5 kills people. There has been little dispute that microscopic particulate matter in air pollution penetrates into the deepest parts of the lungs and contributes to the early deaths each year of thousands of people in the United States with heart and lung disease.

One recent study called PM 2.5 “the largest environmental risk factor worldwide,” responsible for many more deaths than alcohol use, physical inactivity or high sodium intake.

The Environmental Protection Agency’s own website says: “Numerous scientific studies have linked particle pollution exposure to a variety of problems, including: premature death in people with heart or lung disease, nonfatal heart attacks, irregular heartbeat, aggravated asthma, decreased lung function, increased respiratory symptoms.”

Which makes it deeply troubling that the very people at the helm of the Trump administration’s E.P.A. responsible for protecting public health and the environment are now pursuing a course that would make the air we breathe even more hazardous.

Assessing Willingness to Pay for Environmental Health Interventions

Attended a great lecture today by Isha Ray and Jack Colford as part of a new BERC IdeaWorks series. It was a discussion of "Water resources for sustainability and health", focusing mainly on water quality issues in the developing world. A number of interesting studies were described (amazingly clearly, given the complexity of them on the ground) by Dr. Ray and Dr. Colford - both masterful professors. Dr. Colford's undertaking a multi-country assessment of water, sanitation, and hygiene interventions (individually and combined) to see their effects on height, weight, diarrhea. The challenge of doing this kind of randomized trial is not to be underestimated; they plan a year of pilots before the full study begins. A heady undertaking.

Dr. Ray described a couple studies that try to understand how people use these services, how they pay for them, and how they weigh options for water and sanitation. The most striking example she gave is a study kicking off shortly in Tanzania. Her research team is assessing how willing people are to use and pay for six commercially available point-of-use water treatments (like chlorine, a safe-water bucket, a UV filter, a biosand filter, etc). Her approach is novel. As with all studies of this sort, intervention devices will be given to participants. At the end of the study, she'll try one of the following two things: (1) randomly give participants an envelope with a cash amount her team will pay to buy back the point-of-use device or (2) plan the study so that at its conclusion all devices are returned to the researchers; participants are given the option to buy the device back, again at a randomized price. Its an elegant solution to figuring out how much a person would be willing to pay for a technology that is available on the local market.

Our work in the stove world needs to look towards these kinds of assessments to help us frame the issue of poor uptake and compliance of cookstove usage. Both of these types of environmental health interventions often run into the same issues - the technology is poorly designed for the target population, or the population doesn't perceive a need for it. Trying out locally available technologies and helping NGOs and governments figure out which ones people are willing to pay for -- which we hope is a proxy for willing to use -- is one step in the right direction.

This discussion ignores the impact of the devices on the market -- it assumes they work. That's a second, additional wrinkle that plays into the technology adoption.

athabascan tar sands = "energy insanity"

Classes started today. Began my return to academia in what I'm told was true doctoral student fashion -- I missed my first class because I was on a conference call about a potential project :). It was completely worth it. Its fun to glean and interact [even minimally, at this point] with brilliant, engaged folks.

I made it to the second class, in a big theater filled to the brim with an eclectic smattering of students - undergrads, masters, doctoral, the works, from every discipline across the board. The class is out of the Energy & Resources Group and is titled "Energy and Society." Its going to be awesome and cover a breadth of topics pretty quickly.

We concluded today's lecture with a brief discussion of fossil fuel stores, much of which was enlightening to me. I knew about some of the general environmental issues surrounding tar sands and the rampant destruction producing crude from tar sands entails; I had little clue about the complete energy inefficiency of the process. The prof noted that if we include shale and oil/tar sands in our peak oil calculations, the notion that we've hit 50% capacity becomes moot -- we've hit something like 2.5% capacity. That said, he mentioned that if we assume sweet crude to require environmental/energy inputs equal to 1, tar sands is 30 or 40% higher. The process for refining tar sands [which i'll revisit as I learn more] goes something like the following:

Dig a deep-ass pit. Around 100m down, you'll hit tar sands, or as the Canadians like to call it, oil sands. Mix with water and separate the oil. There's a lot of sulfur in tar sands, and we don't like sulfur. So we take CH4, strip the carbon off, and bubble this hydrogen through the tar sand slurry. This'll form H2S. Precipitate the elemental sulfur in an ice bath, release the hydrogen into the atmosphere. You waste natural gas, you throw hydrogen away, and you get all of this goodness:

Sulfur Stockpile

Apparently there's a glut of sulfur in the market, so that just sits there in all its inimitable yellowness. Piles upon piles of sulfur cakes.

This process above is over-simplified, but that doesn't change the fact that its completely f-ing insane. The size of the Athabascan tar sands hellhole is equivalent to Saudi Arabia's oil field before it was pilfered. The government of Alberta thinks it can push production beyond 3 million barrels per day. Hard to imagine a world in which we're not reliant on oil when we keep finding ways to extract it.