Survive and Thrive: Nurturing Nature

Nature always has an interesting way of impacting our lives as humans. Humans also have an interesting way of impacting nature. When in harmony, both survive and thrive incredibly well. When out of harmony, the results are less favorable. Those of us in healthcare routinely see the results of discord between humans and nature. Can physician leaders help create a positive impact to ensure harmony?


Isn’t it intriguing, the behaviors we manifest when our regular routines are disturbed? I have always enjoyed a wide variety of outdoor activities that allow me to be close to nature. Planned overnights usually include sleeping on the ground in a tent after a long day of hiking, climbing, or mountain biking.

For the past several months, however, I have been building out a Jeep Gladiator truck to make it more rugged and ready for travel into off-road, off-grid areas — making it ready for “overlanding.” I’ve tinkered mildly with Jeeps in the past, but this time, it’s different. Building out a full-blown overlanding rig was new and took me totally by surprise.

What was I thinking? Perhaps an unrecognized effect from my COVID-19 vaccination? Maybe just a simple desire to have a closer relationship to nature given months of pandemic time?

In an interesting piece for the Center for Humans & Nature, research scholars Geoffrey Garver and Peter Brown write, “Over just the last two decades, science has radically altered its view of the arrangement both of life and non-living components of the earth. New understandings are emerging that place relationship at the center. Biology and physics are moving away from a ‘reductionist’ view of function, in which the activity of a living cell or an ecosystem, for example, is explained by being reduced to its parts, rather than including the relationship between those parts as essential to our understanding.”

They further explain in the article, “Humans & Nature: The Right Relationship,” that “bearing witness is a Quaker term for living life in a way that reflects fundamental truths…and is also about getting relationships right….it is something done by inspired people of all faiths and cultures when they live life according to cherished values built on caring for other people and being stewards of nature’s gifts.”

Undoubtedly, local epidemics and regional pandemics are constants worldwide, but true global pandemics are relatively rare. Internationally, everyone has continued to adjust to the current pandemic, seeking ways to survive better and to thrive again with their own relationship to earth. Inarguably, this current discordance in the relationship between nature and humans has taken an excessive toll in many ways, and our understanding is far from complete.

In the 1940s, conservation biologist Aldo Leopold, reflecting on what he had come to see as the next stage in human moral development, created a useful definition of the “right relationship.” When working out what he called the land ethic, he explained, “A thing is right when it tends to preserve the integrity, stability, and beauty of the biotic community. It is wrong when it tends otherwise.” This definition is heavily used and referenced in eco-conservation circles.

When it comes to the nature–human relationship, it turns out this area of natural philosophy is ripe with interested writers and philosophers. For example, searching terms related to this relationship results in the following:

  1. Benefits of nature on humans, 554 million items.

  2. Positive effects of nature on humans, 435 million items.

  3. Influence of nature on humans, 596 million items.

  4. Benefits of humans on nature, 556 million items.

  5. Negative effects of humans on nature, 495 million items.

  6. Influence of humans on nature, 510 million items.


The roughly half-billion items in each category indicates interest and concern regarding the place of humans in nature and their relationship to it. Further questions ask how we achieve or maintain harmony, and when discordance is recognized, how or if we should adjust. At a most basic level, we can ask:

  1. What is nature’s influence on humans? Are we simply surviving, or actually thriving?

  2. What is the human influence on nature? Do we help it survive, or can we help it thrive?


The ecology of human–nature interactions has been further reviewed by professors Masashi Soga and Kevin Gaston, advocates of bio-diversity, who share views from a human perspective: “…positive interactions occur when a person obtains beneficial outcomes (e.g., health and well-being benefits), such as when viewing roadside flowers through a window or visiting a green space. We do not generally consider eating plants and animals as positive human–nature interactions because for most people the associated beneficial outcomes are normally derived from dead organisms which lie beyond our definition of nature. Negative interactions occur when these result in physical or mental injury, such as being attacked by wildlife or when encountering a type of organism about which one has a psychological phobia (e.g., apiphobia, arachnophobia, ophidiophobia).”

And from the perspective of nature, Soga and Gaston say in their article for The Royal Society, “…positive interactions occur when it derives beneficial effects from interacting with humans (these positive outcomes may or may not be desirable from a management or conservation perspective). This could, for example, be in the form of resources (e.g., feeding wild birds in a domestic garden; or protection from potential predators (e.g., reduced risk of nest predation due to human recreational use of urban parks; the so-called ‘human shield effect.’ Negative interactions might occur when wildlife suffers greater disturbance or greater mortality risk, such as when vehicles collide with deer or when hikers trample rare flowering plants.”

In a critical review regarding this relationship and its impact on health, British researcher Valentine Seymour reflects that “the human–nature relationship goes beyond the extent to which an individual believes or feels they are part of nature. It can also be understood as, and inclusive of, our adaptive synergy with nature as well as our longstanding actions and experiences that connect us to nature.”

Seymour discusses the disconnectedness across the four main research fields of evolutionary psychology, environmentalism, evolutionary biology, and social economics. She states, “there has been comparatively little discussion of convergence between them on defining the human–nature relationship… highlighting, that the reorientation of health toward a well-being perspective brings its own challenges to the already complex research base in relation to its concept, measurement, and strategic framework. For a deeper sense of understanding and causal directions to be identified requires further attention to the complexities of these aspects’ interlinkages, processes, and relations.”

The human-nature connection (HNC), per researcher Matteo Giusti, is another concept that emerges from a multidisciplinary review of the body of knowledge on human–nature relationships. This concept joins three complementary dimensions of human–nature relationships that are often studied in isolation from each other.

Psychological HNC emerges from research that considers human–nature relationships as an attribute of the mind. This body of literature studies the psychological connection to an abstract form of nature. Changes in people’s connection with nature are measured by quantitative methods, often to describe psychological dynamics or to predict specific pro-environmental behaviors.

Experiential HNC represents qualitative research that describes human–nature relationships as experiences of being in nature. Here, researchers observe and describe people’s interaction with local nature.

Contextual HNC emerges from research on “sense of place.” It investigates human–nature relationships as the sense of belonging that people develop with geographical areas over time. Typically, these studies use questionnaires to study people’s attachment to specific natural landscapes.

Nature connectedness is the extent to which individuals include nature as part of their identity. It involves an understanding of nature and its make-up, even the parts that are not pleasing. Characteristics of nature connectedness are similar to those of a personality trait: nature connectedness is stable over time and across various situations.

Psychology professor P.W. Schultz describes three components that make up the nature connectedness construct:

  1. The cognitive component is the core of nature connectedness and refers to how integrated one feels with nature.

  2. The affective component is an individual’s sense of care for nature.

  3. The behavioral component is an individual’s commitment to protecting the natural environment.


At a broad level and highly important, the construct of trait nature connectedness is associated with well-being. This means that individuals who are highly connected to nature also report higher psychological and social well-being. Emotional well-being is related to nature connectedness, but less consistently; however, psychological and social well-being are consistently related to nature connectedness, suggesting that feeling connected to nature is related to participants’ well-being in their personal and social lives.

Trait nature relatedness is significantly correlated with psychological well-being and its six dimensions (autonomy, environmental mastery, positive relations with others, self-acceptance, purpose in life, and personal growth), according to psychologists Elizabeth Nisbet, John Zelenski, and Steven Murphy in their 2010 Journal of Happiness Studies article.


Creating a Positive Impact as Physician Leaders

We are all aware of the stress factors, increased anxieties, the prevalence of burnout, and the incidence of suicidality in healthcare. The healthcare workforce needs to become even more proactive with its own pursuits in novel, innovative ways that better address workforce wellness. Proactively developing systems and processes that facilitate a simpler approach to an integrated and balanced work-life lifestyle will be imperative for many — especially the younger generations. Trying to find a simple balance between work and life while connecting more effectively with nature is not so simple, but nature can help us get there in its own way.

Creating change in the healthcare workforce is one thing; creating change in our patient populations is another. Patients look to physicians as leaders, and they look for directions in their lives from the physician workforce. Isn’t it a perfect time to help create positive change in the healthcare workforce and the general population by giving increased attention to the benefits of a stronger nature–human relationship? Isn’t it also time for us to continue to ramp up the efforts to create a more sustainable world by improving the human relationship with nature?

Referring again to Garver and Brown, we acknowledge, “Right relationship with life and the world is both a personal and a collective choice, but it is a choice that we must make. It can support and inspire people struggling to find a foundational base for the development of productive societies and a healthy human–nature relationship. Opting for healthy human and ecological communities is a decision we can make that will require us to find new ways to live and to run our economies.”

They continue: “In the commonwealth of all life, the actions of each individual member or species affect the entire commonwealth, however small the result might be. We human beings are now in a position to have a far greater impact on the commonwealth of life than most of the other life forms with which we share the planet. Therefore we have the responsibility and privilege to consider other beings and ecosystems when we engage in any sort of social action, including an economy.”

Keep uppermost in mind that leading and creating significant change in healthcare is our overall intent as physicians. AAPL focuses on maximizing the potential of physician-led, interprofessional leadership to create personal and organizational transformation that benefits patient outcomes, improves workforce wellness, and refines the delivery of healthcare internationally.

And as for that overlanding Jeep…quite honestly, I am still not sure whether there is harmony or discordance in place. My sense of adventure suggests harmony, but my pocketbook suggests discordance. Regardless, sometimes this outdoor lifestyle and its perpetual need for gear are more of a disease and less of a hobby. Still, by the WHO definition, it does provide physical, emotional, and social well-being…and I am trying to be ever mindful of my larger social responsibilities to the commonwealth of life and nature. I hope you are as well.

We must all continue to seek deeper levels of professional and personal development and recognize ways to generate constructive influence for one another at all levels. As physician leaders, let us become more engaged, stay engaged, and help others become engaged. Exploring and creating the opportunities for broader levels of positive transformation in healthcare is within our reach – individually and collectively.



  1. Garver G and Brown PG. Humans & Nature: The Right Relationship. Minding Nature. 2(1).

  2. Giusti M. Human-Nature Relationships in Context. Experiential, Psychological, and Contextual Dimensions That Shape Children’s Desire to Protect Nature. PLoS ONE. 14(12): e0225951.

  3. Nisbet, EK, Zelenski JM, and Murphy SA. Happiness Is in Our Nature: Exploring Nature Relatedness as a Contributor to Subjective Well-Being. Journal of Happiness Studies. 12(2): 303–322. doi:10.1007/s10902-010-9197-7.

  4. Schultz PW. Inclusion with Nature: The Psychology of Human–Nature Relations. In PW Schmuck & WP Schultz (eds.), Psychology of Sustainable Development. (pp. 62–78). Norwell, MA: Kluwer Academic; 2002.

  5. Seymour V. The Human–Nature Relationship and Its Impact on Health: A Critical Review. Frontiers in Public Health. November 18, 2016.

  6. Soga M and Gaston KJ. The Ecology of Human–Nature Interactions. Proceedings of the Royal Society B. January 15, 2020. 28(1918).





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