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ER doctors say we need to pay more attention to heat

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ER doctors say we need to pay more attention to heat

Across Southern California, emergency room workers are primed for the wave of patients that pour in as heat waves like the current one drag into their second, third and fourth days. Heat takes an accumulating toll on the body, especially when people cannot cool down at night with air conditioning.

Dr. Jennifer Roh, medical director of the adult emergency medicine department at Harbor-UCLA Medical Center, said preparation means hydration supplies, ice packs and other cooling devices at the ready.

ER doctors, nurses and technicians see the obvious cases of heat illness and heat exhaustion, of course, with fainting and cramps among the symptoms. Heat stroke is the most severe version of heat-related illness and can be life threatening.

But some doctors say their profession is less adept at recognizing that heat may be the reason some patients come in presenting with other illnesses.

Football players take a break from practice to hydrate and cool off amid high temperatures and a heat wave on Wednesday at Santa Margarita High School in Rancho Santa Margarita.

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(Allen J. Schaben / Los Angeles Times)

Heat waves are like an “invisible tsunami,” said Dr. Marc Futernick, an emergency physician in Los Angeles. They can exacerbate heart disease, kidney problems and respiratory illnesses.

A patient with diabetes who can’t keep insulin refrigerated during a power outage, for example, could land in the ER in critical condition without anyone making the connection.

When they arrive, they may also be confused because of the compounding effects of heat exposure, leaving physicians to try to piece together what happened. That, says Roh, makes it hard to be certain what role heat has played in an ER patient’s symptoms.

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The most vulnerable patients during heat waves are older adults, people with chronic conditions and those taking medications that impair how their bodies self-regulate when it’s hot.

“There’s so much illness beyond heat illness that even doctors who are taking care of those patients aren’t recognizing it,” Futernick said.

A runner passes by the downtown skyline at Echo Park Lake amid a heat wave on Thursday in Los Angeles.

A runner passes by the downtown skyline at Echo Park Lake amid a heat wave on Thursday in Los Angeles.

(Carlin Stiehl / Los Angeles Times)

Dr. Sam Torbati, head of the emergency department at Cedars-Sinai Medical Center, said most conditions he sees in the ER during heat waves are largely preventable.

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The health issues fall disproportionately on communities with fewer resources.

“Heat in L.A. affects everybody, but it does not affect everybody equally, and some of the people who are the most affected are the most vulnerable people in our community,” said Dr. Alex Gregor, who works at the ERs at Los Angeles General Medical Center and the University of Southern California.

“Skid Row is a heat island, a lot of our patients come from Skid Row or from [other] communities around town where they don’t have access to shade, to cooling, to nature — so there’s an unfair distribution of the burden of illness caused by heat and climate change around our city.”

“It’s a huge health equity and racial justice issue,” he said.

Most doctors don’t typically take climate change into account. Those that do say this needs to change.

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Dr. Stefan Wheat, an emergency physician and assistant professor at University of Washington School of Medicine, is one advocate for broader climate-related training that would teach clinicians how heat acts as a “threat multiplier.”

Gregor similarly suggests that emergency medical service providers should be trained to recognize subtle signs of heat illness, and that social workers could be brought in to connect patients to resources such as cooling centers, or to help patients establish a buddy system, as some cities have, so someone notices if they’re in trouble.

A construction worker takes a water break while working on new homes amid a heat wave on Wednesday in Irvine.

A construction worker takes a water break while working on new homes amid a heat wave on Wednesday in Irvine.

(Allen J. Schaben / Los Angeles Times)

The climate-health connection is not new. There are more than a dozen books on the subject, and some medical schools already include climate-health training.

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Some hospitals in L.A. and elsewhere now distribute heat-preparedness materials, and outreach efforts to both uninformed doctors and patients have expanded.

But awareness still lags and heat-related mortality is rising, some say. “We’re doing a good job of not making it as bad as it could be,” said Futernick. “But it’s getting worse.”

ER nurses, techs and doctors could take on a more prominent role.

“We can use our voices as healthcare professionals to push for policies that better help protect patients on a larger scale in the community,” said Wheat.

That could mean supporting building codes that ensure adequate cooling, or worker protections for those laboring outdoors in extreme temperatures.

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“Heat exhaustion or heat stroke … that’s not capturing the full picture,” Wheat said. “It’s an increasingly pressing challenge.”

In Southern California, it’s expected to remain intensely hot well into September.

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FBI probes cases of missing or dead scientists, including four from the L.A. area

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FBI probes cases of missing or dead scientists, including four from the L.A. area

Amid growing national security concerns, the FBI said Tuesday that it has launched a broad investigation in the deaths or disappearances of at least 10 scientists and staff connected to highly sensitive research, including four from the Los Angeles area.

“The FBI is spearheading the effort to look for connections into the missing and deceased scientists. We are working with the Department of Energy, Department of War, and with our state and state and local law enforcement partners to find answers,” the agency said in a statement.

The FBI’s announcement comes after the House Oversight Committee announced that it would investigate reports of the disappearance and deaths of the scientists, sending letters seeking information from the agencies involved in the federal inquiry as well as NASA, which owns the Jet Propulsion Laboratory in La Cañada Flintridge, where three of the missing or dead scientists worked.

“If the reports are accurate, these deaths and disappearances may represent a grave threat to U.S. national security and to U.S. personnel with access to scientific secrets,” Reps. James Comer (R-Ky.), chairman of the committee, and Eric Burlison (R-Mo.) wrote in the letters.

President Trump told reporters last week that he had been briefed on the missing and dead scientists, which he described as “pretty serious stuff.” He said at the time that he expected answers on whether the deaths were connected “in the next week and a half.”

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Michael David Hicks, who studied comets and asteroids at JPL, was the first of the scientists who disappeared or died. He died on July 30, 2023, at the age of 59. No cause of death was disclosed.

A year later, JPL physicist Frank Maiwald died at 61, with no cause of death disclosed.

Two other Los Angeles scientists are part of the string of deaths and disappearances.

On June 22, 2025, Monica Jacinto Reza, a materials scientist at JPL, disappeared while on a hike near Mt. Waterman in the San Gabriel Mountains.

On Feb. 16, Caltech astrophysicist Carl Grillmair was fatally shot on the porch of his Llano home. The Los Angeles County Sheriff’s department arrested Freddy Snyder, 29, in connection with the shooting. Snyder had been arrested in December on suspicion of trespassing on Grillmair’s property.

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Snyder has been charged with murder.

There is no evidence at this point that the deaths and disappearances, which occurred over a span of four years, are connected.

A spokesperson for NASA, which owns JPL, said in a statement on X that the agency is “coordinating and cooperating with the relevant agencies in relation to the missing scientists.

“At this time, nothing related to NASA indicates a national security threat,” agency spokesperson Bethany Stevens wrote. “The agency is committed to transparency and will provide more information as able.”

Representatives from Caltech, which manages JPL, did not immediately respond to a request for comment.

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What’s in a Name? For These Snails, Legal Protection

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What’s in a Name? For These Snails, Legal Protection

The sun had barely risen over the Pacific Ocean when a small motorboat carrying a team of Indigenous artisans and Mexican biologists dropped anchor in a rocky cove near Bahías de Huatulco.

Mauro Habacuc Avendaño Luis, one of the craftsmen, was the first to wade to shore. With an agility belying his age, he struck out over the boulders exposed by low tide. Crouching on a slippery ledge pounded by surf, he reached inside a crevice between two rocks. There, lodged among the urchins, was a snail with a knobby gray shell the size of a walnut. The sight might not dazzle tourists who travel here to see humpback whales, but for Mr. Avendaño, 85, these drab little mollusks represent a way of life.

Marine snails in the genus Plicopurpura are sacred to the Mixtec people of Pinotepa de Don Luis, a small town in southwestern Oaxaca. Men like Mr. Avendaño have been sustainably “milking” them for radiant purple dye for at least 1,500 years. The color suffuses Mixtec textiles and spiritual beliefs. Called tixinda, it symbolizes fertility and death, as well as mythic ties between lunar cycles, women and the sea.

The future of these traditions — and the fate of the snails — are uncertain. The mollusks are subject to intense poaching pressure despite federal protections intended to protect them. Fishermen break them (and the other mollusks they eat) open and sell the meat to local restaurants. Tourists who comb the beaches pluck snails off the rocks and toss them aside.

A severe earthquake in 2020 thrust formerly submerged parts of their habitat above sea level, fatally tossing other mollusks in the snail’s food web to the air, and making once inaccessible places more available to poachers.

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Decades ago, dense clusters of snails the size of doorknobs were easy to find, according to Mr. Avendaño. “Full of snails,” he said, sweeping a calloused, violet-stained hand across the coves. Now, most of the snails he finds are small, just over an inch, and yield only a few milliliters of dye.

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Video: This Parrot Has No Beak, But Is at the Top of the Pecking Order

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Video: This Parrot Has No Beak, But Is at the Top of the Pecking Order

new video loaded: This Parrot Has No Beak, But Is at the Top of the Pecking Order

Bruce, a disabled kea parrot, is missing his top beak. The bird uses tools to keep himself healthy and developed a jousting technique that has made him the alpha male of his group.

By Meg Felling and Carl Zimmer

April 20, 2026

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