[Across the U.S., significantly more people die from heat each
year than from any other weather-related event. Many of these deaths
are concentrated in and around Phoenix. ]
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LIFE AND DEATH IN AMERICA’S HOTTEST CITY  
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Carolyn Kormann
September 6, 2023
The New Yorker
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_ Across the U.S., significantly more people die from heat each year
than from any other weather-related event. Many of these deaths are
concentrated in and around Phoenix. _

Mariposa County, which includes Phoenix, saw four hundred and
twenty-five heat-associated deaths in 2022., Photo by Matt York/AP

 

The record-setting heat wave in Phoenix
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summer, thirty-one consecutive days of temperatures exceeding a
hundred and ten degrees, finally broke on Monday, July 31st. But, by
the following Friday, August 4th, the thermometer was creeping up
toward a hundred and fifteen degrees. Residents liked to joke that
anything below the “teens” was comfortable. Jessica Lindstrom, who
was thirty-four, was no longer a resident. She and her husband,
Daniel, had bought a house in Central Point, Oregon, in 2015. But she
had grown up in greater Phoenix and, that week, had brought her
expanding family to Arizona to stay with her parents. The next day,
they were going to celebrate the baptism of their second-oldest son,
in the chapel of the Church of Jesus Christ of Latter-day Saints.

Lindstrom was relieved to have her parents’ help. She might not have
wanted to admit it—she could be a perfectionist, and her family
called her a supermom—but she was exhausted. In Oregon, not only was
she raising four young sons (her oldest was just ten) but she was also
a nurse, working night shifts at a hospital, in an in-patient rehab.
In between, she ran the children’s religious-education program at
her local church. Her husband worked full time as a pharmacist. So,
that Friday morning, happy to be home, back in the desert, she decided
to take some time for herself. At 8:30 _a.m._, while her parents
watched the kids, she headed to the nearby Deem Hills Recreation
Area—a small mountain, scratched over by hiking trails.

Deem Hills covers nearly a thousand acres of the Sonoran Desert, and
is known for its unique basalt volcanic-rock formations. The rock
holds the heat, meaning that the ambient temperature, what Lindstrom
actually felt, could have been ten degrees hotter than that day’s
high of a hundred and fifteen. The longest trail—a circumference of
the entire ridge—is just under six miles. Lindstrom had hiked these
hills countless times. She loved the open sky, the desert colors, the
towering saguaros, with their arms open wide. She loved the quiet, and
the sense of peace she felt, nestled in the tiny valleys, or when she
stopped to take in the view, looking out over her home town. One of
the hike’s orienting landmarks was the steeple of a Latter-day
Saints temple. Daniel, who is from California, often hiked with her
there after they started dating, and he grew to love the hills, too.
On a hike in 2012, he got down on one knee, and, “in the corniest
possible way,” as he described it to the family later, asked
Lindstrom to marry him.

Daniel, an élite runner (he was on the cross-country team at the
University of California, Riverside, and had completed several
marathons), had gone running in Deem Hills earlier that morning.
Lindstrom met him at the park before her run, and he continued to his
in-laws’ house. She left her phone in her car. Her long brown hair
was pulled back in a ponytail, and she wore a black tank top,
neon-yellow shorts, and sneakers.

Around 10 _a.m._, the family grew concerned that Lindstrom hadn’t
yet returned. Daniel and two of Lindstrom’s brothers went to check
on her. By eleven-thirty, her father, David Adams, and her third
brother had joined the search. Her mother called 911. A member of
their church is a captain with the Phoenix Police. He quickly
organized a search party with the fire department, using helicopters,
drones, and men on the ground. The police posted a missing-person sign
online, and social media filled with calls for volunteers. Adams
called his only daughter Peanut, but Lindstrom was a strong athlete,
tough and persistent. It seemed unimaginable that she could have just
vanished.

Globally, about half a million people die from heat-related causes
every year, according to a 2021 study published in _The Lancet
Planetary Health_. Across the U.S. each year, significantly more
people die from heat than from any other weather-related event,
including hurricanes, tornadoes, floods, and even rip currents. Many
of these deaths are concentrated in and around Phoenix. In 2022, there
were four hundred and twenty-five heat-associated deaths in Maricopa
County—a twenty-five-per-cent increase from the previous year. The
impacts of this year’s heat wave are still being analyzed. But, for
everyone who lived through it, this was a relentless thirty-one-day
emergency, with no respite. “We’ve hit these highs before,” Nick
Staab, the assistant medical director for Maricopa County’s
Department of Public Health, told me. “But now, it’s just not
having a break. The human body needs an opportunity to cool down.”

People have inhabited and thrived in the Sonoran Desert for centuries.
In 1050, the Sinagua, a name that came from the Spanish, meaning
“without water,” made cliff dwellings in the Verde Valley, just
ninety minutes north of central Phoenix. Their homes and structures
were constructed with wood, stone, and mud and built into the walls of
a limestone ravine, extending through a system of caves, which tend to
be cooler than the outside air in the summer. The ravine walls faced
south, meaning the dwellings would have stayed warm in the winter. In
the nineteen-seventies, an Italian architect named Paolo Soleri built
his own south-facing labyrinthian cliff dwelling into the side of a
mesa outside Phoenix, hoping to construct a new kind of ecologically
and desert-mindful city. Arcosanti, as he named it, still exists, with
some fifty residents, and tourists year-round. But Soleri’s vision
seems as lost as that of the Sinagua.

In the early twentieth century, the invention of air-conditioning
allowed a city to grow rapidly, in ways that no longer heeded the
desert heat. In recent decades, farm fields and open desert have been
replaced by roads, parking lots, cars, strip malls, and endless
subdivisions, leading to an urban heat island, which compounds the
effects of the climate crisis. Maricopa County, which contains Phoenix
and more than two dozen other cities, towns, and tribal communities,
is now the fourth most populous county in the United States. Phoenix
is the fifth-largest city in the U.S., and the hottest large city,
with an average summer temperature of 93.7 degrees—an average that
has increased by 3.8 degrees since 1970. Nighttime summer
temperatures, largely owing to urbanization, now average a low of
eighty-three degrees, an increase of 5.4 degrees since 1970. Even the
saguaro cacti, which are endemic to the Sonoran Desert, can’t cool
off enough at night. They have been dropping their arms and falling
down.

And, yet, people continue to flock to Maricopa County, the
fastest-growing county nationwide last year. People might dislike the
summertime heat, but it’s a small price to pay for the other eight
gorgeous months of the year. “The key, for the summer, is not to be
here,” a Phoenix firefighter and lifelong resident told me.

People who can’t afford to leave must adjust. Runners and cyclists
invest in headlamps and glow-in-the-dark gear. Construction workers
start their days at 4 _a.m._, bringing in giant floodlights to work
sites. Since pools get too hot for swimming, homeowners buy giant ice
blocks for pool parties. Pedestrians carry parasols. Parking
attendants sit outside next to swamp coolers. Restaurants and bars
deploy fans and misters, shrouding their patios in a cool fog. (In
deep summer, even the misted patios are empty.) One outdoor bartender
told me that fans under the bar “keep us alive, mildly. And tequila
shots.”

The streets seem abandoned, save for the unhoused. People go from
air-conditioned houses, to air-conditioned cars, to air-conditioned
offices, stores, schools, or camps. They get used to seeing their car
dashboard thermometer read a hundred and twenty if it’s parked in
the sun in the afternoon. They take care not to sear themselves when
touching car-door handles. (I burned my leg on the side of a car
door.) Shade becomes sacred. “It’s kind of the opposite of how
other areas hibernate,” Sonia Singh, a spokeswoman for the
Department of Public Health, told me. “We go outside in the winter
and come inside during the summer.”

Still, this summer, which included the hottest July ever recorded on
the planet, has been different. Not only were the days scorching but
there was a stretch of sixteen days when the nighttime low was ninety
degrees or above, including one night when the low was ninety-seven
degrees. Summer is supposed to be monsoon season in Arizona, but by
mid-August the Phoenix Sky Harbor International Airport hadn’t
recorded measurable rainfall in a hundred and forty-seven days
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Arizona’s only burn center, situated in Phoenix, was full of
patients who had fallen on the ground and burned their skin. The
Maricopa County Department of Emergency Management took to holding
“FRYdays” on Twitter, cooking various foods—cookies, pizzas,
roasted red peppers—on dashboards, to show how hot a car’s
interior can get, in a lighthearted effort to remind people to avoid
the heaviest kind of risk, a calamity that continues to happen: pets
and children being left in hot cars.

The city of Phoenix established an Office of Heat Response and
Mitigation, the country’s first publicly funded city-government
office working on heat, in 2021, and appointed an energetic young
scientist named David Hondula to run it. (Miami and Los Angeles also
have chief heat officers.) “We’re writing a playbook for jobs that
haven’t existed before, and we’re trying to do so as quickly as we
can,” Hondula told me. “Obviously what we’ve experienced this
summer is not anything the region has experienced before.”

As temperatures increase worldwide, heat’s invisible danger will
threaten more and more people. By 2030, according to a new climate
analysis from the Washington _Post_ and the nonprofit CarbonPlan,
four billion people will be exposed to at least a month of extreme
heat. (In dry climates, like Phoenix, that could mean a month of days
reaching a hundred and twenty degrees Fahrenheit or higher.) By 2050,
that number will increase to five billion, or more than half the
planet’s population. So far, the Maricopa County Office of the
Medical Examiner has confirmed
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eighty heat-associated deaths this year, with three hundred and thirty
still under investigation. Both numbers are much higher than those at
the same time last year, despite a lag in the data, since it takes
about six weeks for the O.M.E. to conclude a death investigation. The
O.M.E.—already one of the busiest medical examiner’s offices in
the U.S.—has been overwhelmed.

One morning in August, I arrived at the Forensic Science Center, the
O.M.E.’s headquarters, to meet with Jeff Johnston, the chief medical
examiner, who was rail-thin, wearing black-rimmed glasses, a gray
beard, and a gray suit. He spoke about his work softly and kindly,
with a subtle drawl, having grown up in the Southeast. He did his
pathology residency at the University of Tennessee, in Knoxville, and
worked in the university’s forensic-anthropology facility (commonly
known as the Body Farm). He saw his profession—which, to his great
frustration, is struggling to recruit enough people—as a critical
form of public service. “By understanding what people died from,”
he told me, “we can have this huge impact on preventing future
deaths.”

Johnston was accompanied by one of his investigators, a wide-eyed
twenty-six-year-old named Emily Sprague, who had very long, straight
blond hair. They both carried giant water bottles. Sprague’s job is
to take a report about a decedent from the first responders, then
drive to the scene, investigate the environment and the body, and
coördinate the return of the body to the Forensic Science Center. (On
such trips, Sprague and the office’s other death investigators wear
“cool” vests, which have pockets stuffed with ice packs.)
“We’ve just gone through a historic surge,” Johnston said. “We
had to push everybody to the limit in order to respond.” This meant
they had less time to find and notify next of kin. If they couldn’t
release bodies, their refrigerators were at risk of filling up. At the
end of July, as an emergency precaution, the office trucked in
portable refrigerators, as it did during the city’s
worst _covid_ surge. (In the end, the office did not need to use
them.)

Heat illness
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in two ways. The first is classic heatstroke, a result of prolonged
heat exposure, which typically strikes infants; the elderly; those who
are overweight; and unhealthy, sedentary adults, who may be suffering
from other chronic conditions such as cardiovascular disease,
diabetes, or hypertension. It’s what kills a person stuck in a house
with malfunctioning air-conditioning on a summer day. The second type
of heat illness is exertional heatstroke, which occurs during physical
activity. “So you can get this,” Johnston said, pointing at me.
“Anybody can get this.” The risks are highly individualized.
Respiratory problems, prescription or over-the-counter drugs, alcohol,
even scars on the body, can affect how a person regulates heat. Young,
fit people, such as long-distance runners, are more capable of warding
off the warning signs of heat illness until, sometimes, it’s fatally
too late. Acclimatization matters. In the desert, for instance,
visitors are not only unaccustomed to the heat, they don’t realize
how much fluid they are losing just by breathing and talking in the
dry air, which leads to dehydration, then reduced blood volume,
exacerbating heat exhaustion.

In the hot sun, or a very hot dwelling, the body must work to maintain
its normal internal temperature, generally about ninety-eight degrees.
The heart starts pumping more blood to the skin, where it can cool
down. You will start sweating profusely, and might experience cramps
or nausea. If you cannot find a way to cool off, your core temperature
will quickly increase, forcing your heart to beat faster, which
increases your metabolism, and generates more heat. As blood is
diverted away from your internal organs, including your brain, they
become starved of oxygen. You will feel dizzy, or faint. Once your
body temperature rises above a hundred and three, heatstroke can
begin. Sweating stops, and the skin will turn red, hot, and dry. Your
head will throb. As the blood pressure falls in your brain, you will
probably pass out. Sprawled, unconscious, in the hot sun, you will
continue to overheat. Once your body reaches a hundred and five or a
hundred and six degrees, your limbs might convulse, and, at a hundred
and seven, your cell membranes melt, and proteins inside the cells
unfold. Organ function starts to shut down; muscle tissues begin to
disintegrate. It becomes increasingly difficult to cool you off fast
enough to save your life. The heart just stops.

Still, for forensic pathologists, it can be difficult to identify heat
as the primary cause of death. There is nothing specific that
signifies a person died from heatstroke, apart from the environment in
which the person was found. But Johnston’s office has always had a
rise in “admissions” (deaths to investigate) in the summer months.
From 2013 to 2021, in Maricopa County, the month of July averaged
twenty-four-per-cent higher admissions than in non-summer months. But,
in 2022, July saw a sixty-per-cent jump. This year, there were eight
hundred and forty-two admissions—a seventy-eight-per-cent jump.
“It is a substantially larger surge than we’ve ever seen,”
Johnston said.

The scenes that Johnston’s team of investigators encountered this
summer were exceedingly challenging. They found bodies sprawled on
asphalt, curled up in tents, collapsed in back yards. At one deceased
man’s home in August, where the air-conditioning was not
functioning, the temperature was roughly a hundred and thirty degrees.
Sprague told me that she had conducted many investigations a couple of
blocks down the street, in the Zone, a large homeless encampment
surrounding a cluster of outreach organizations. Unhoused people were
the victims in more than half of confirmed heat-related deaths in
Maricopa County in 2022, and two-thirds of those deaths involved drugs
or alcohol. Sergio Armendariz, a case manager now working for a
Christian nonprofit organization called the Phoenix Rescue Mission,
told me that, during a half decade spent living on the streets, he
started using heroin, and smoking meth. “It made sense for me to
just be high all the time, because I didn’t have to eat, and I could
stay awake at nighttime,” he said. “So, eventually, I started
slamming it into my veins, too.” Meth allowed him to cope.
“You’re numb to everything.”

I met Armendariz—a strong, smiling, relaxed man in his mid-thirties,
wearing a Diamondbacks cap backward—next to a dumpster, in a large
church parking lot. He was overseeing a landscaping and street-cleanup
program that he started last year, specifically to give the unhoused a
stepping stone toward housing and employment. That morning’s group
of workers had just arrived to empty a truck bed full of litter and
brush. A few mornings each week, a Phoenix Rescue Mission van—well
supplied with water and ice—picks up a group at 5 _a.m._, in order
to beat the worst of the heat. The workers finished emptying the
truck, and walked over. “A lot of the parks have turned their water
off,” a sixty-four-year-old woman named Jennie Gaudioso, who had
long, wavy, gray-brown hair, said. Her mouth was trembling.

“I live in front of Q.T.,” a tall, skinny young man named Alan
Miskiewicz said, referring to QuikTrip, a gas-station chain. “It’s
close to water and stuff. They kick you out of the park.”

“We’re looked down on,” Gaudioso said. “But they have to
remember they could be us.”

On Friday, August 11th, as the death toll increased, Arizona’s
Governor, Katie Hobbs, declared
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extreme-heat state of emergency, allocating funds for grid-resiliency
projects and opening two new cooling centers near the state capitol.
During the hour I visited, several unhoused people came through to get
water or snacks, or to watch television.

Currently, because heat is not considered a major natural disaster,
there is no mechanism by which local offices, including Johnston’s,
can easily get federal support during a surge of heat deaths. In June,
the Arizona congressman Ruben Gallego, with two other legislators from
Texas and Nevada, introduced
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bipartisan bill to add extreme heat to _fema_’s list of
major-disaster qualifying events. This would provide the O.M.E. one
path for requesting help from the federally directed Disaster Mortuary
Operational Response Teams, or _dmort_, which is made up of forensic
dentists, pathologists, anthropologists, DNA specialists, funeral
directors, and medicolegal death investigators. Some staff members
from Johnston’s offices are on standby with _dmort_, including
their forensic dentist, who received a request to respond to last
month’s deadly fires in Maui
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Johnston told me, “He’s, like, ‘No, I can’t go, I’m
identifying bodies here in Phoenix.’ ”

Ty Wade, a self-taught artist, was at a studio, sketching a charcoal
portrait, when he got a text from a friend. “There’s a woman
missing after going for a run at Deem Hills at 8am,” she wrote,
sending screenshots of the Lindstrom family’s social-media posts
from earlier that afternoon. “Sounds like they are asking for
volunteers to search . . . the mountain area.” Wade, who is from
Arizona, had served twenty-four years in prison for a murder he got
caught up in with a friend, in New York, when he was only sixteen. (He
had pleaded guilty, but was tried as an adult and sentenced to thirty
years without parole.) He was released in April and relishing his
freedom back home with family in Arizona. He wanted to make his time
count. He texted his friend back, “Fuck it I will go.”

Lindstrom’s father and her brothers had already been searching for
hours. Firefighters and police had responded to the scene first,
around 12:30 _p.m._ Technical rescue teams circled the mountains,
and flew drones. Around the same time, friends, family, and strangers
from the community, eventually numbering in the hundreds, went to Deem
Hills, to support the family, with water, food, and logistics. A
friend took Lindstrom’s mother’s phone, to field calls and texts.
Another friend watched Lindstrom’s four sons back at her parents’
house.

Wade drove ten minutes from his studio to join the search. He met
Lindstrom’s father in the emergency staging area. Wade had never
been hiking in the area, but he knew the desert, and, at first,
couldn’t believe that no one had found Lindstrom yet. There seemed
to be nowhere to hide. Deem Hills was surrounded by upscale
subdivisions and small shopping centers. As the bird flies, a hiker is
often barely a mile from safety.

But, high up the mountain, Wade found the terrain treacherous. He had
to circle carefully around rocks and thick vegetation to make sure
someone wasn’t lying on some unseen spot of the desert floor. He
stayed within a relatively small, steep range, and zigzagged up and
down. Eventually, he returned to camp to hydrate. He had become dizzy
from the heat before, and knew its risks.

Around six in the evening, another volunteer found Lindstrom. Wade had
been searching very close to where she was, possibly just yards away.
She was off the trail, on the north side of the mountain, lying
between a large rock and a paloverde tree, a desert species with
pastel-green, photosynthesizing bark. She had no water with her.
Others on the hill heard the searcher’s cries, and rushed toward
them. Lindstrom’s husband and youngest brother arrived before the
police. She was unresponsive. Emergency responders showed up, and
confirmed, with a heart monitor, that she was beyond resuscitative
efforts. Lindstrom was pronounced dead at 7:14 _p.m._ The O.M.E.
investigator arrived shortly thereafter to prepare a report of the
scene. Captain Scott Douglas, of the Phoenix Fire Department, told
reporters that her death was likely a consequence of heat exposure.
“Unfortunately, Mrs. Lindstrom was in town from Oregon, where it
doesn’t get this hot,” Douglas said.

Given the location and position of Lindstrom’s body, on the side of
the mountain, there was concern that she had taken a fall. The O.M.E.
report, which was finalized a little more than a week ago, confirmed
that she had abrasions on her head, neck, torso, and limbs, and had
dislocated her neck. She was dehydrated. The medical examiner
determined that accidental blunt-force trauma of the head and neck had
caused the death. Environmental heat exposure was a contributory
cause. While no one will ever know the exact order of events, it is
highly likely that Lindstrom passed out from the heat, fell, and hit
some rocks.

Two weeks later, on a cloudy Saturday morning, Lindstrom’s family
held a funeral at the Church of Jesus Christ of Latter-day Saints in
Glendale. For the first time since June 13th, the valley failed to
reach a triple-digit temperature. The meeting room where the funeral
was held was connected to a gymnasium, where the basketball hoop was
raised to the ceiling. By 10 _a.m._, the entire space was filled with
mourners. Two police officers stood in uniform at the back.
Lindstrom’s casket, covered with an enormous fan of colorful
flowers, stood before a simple wood stage. I sat near Wade, who stood
out among the gathered, during the service. His shaved head, part of
his face, and his arms were covered in tattoos—a way to practice his
art, pass the time, and learn a new trade while in prison. I noticed
him wiping away tears.

After Lindstrom’s service, the family went to the graveyard, and
church members prepared the gym for a luncheon, setting up a buffet
with roasted ham and salads, and placing a picture of Lindstrom, a
plant, and some jelly beans on each table. Wade stood outside in the
hall, and spoke to another man who had searched the hills on August
4th. “It was a brutal day,” Wade said. He had wanted to help save
Lindstrom’s life. Down the hall, in the entrance lobby, among many
photos of Lindstrom and her family, there was a large, framed,
charcoal portrait of Lindstrom, which Wade had made for the family.
“This is part of my chance to give back,” Wade told me. Prompted
by his involvement in the search, he had joined the Red Cross. He will
soon begin training sessions to become a member of their
volunteer-based Disaster Action Team, and, through a separate
organization, he is planning to partner with a search-and-rescue dog.

Lindstrom’s parents, David and Angela Adams, approached. “We meet
again,” David said to Wade, shaking his hand with both of his own.

“I’m humbled,” Wade started to say.

“Many people have made comments about it,” David Adams said,
referring to the charcoal portrait. “Appreciate you.”

A few more condolences were exchanged. “Most people don’t pass in
such a public way,” David Adams told me. “But, for some reason,
Jessica did. We were on the mountain looking. We looked at all the
trails. It wasn’t until the community pulled together, and the
volunteers came, like Ty, looking for her. One of them found her.
We’re so grateful that they did.” ♦

_Carolyn Kormann has been a contributor to the The New Yorker since
2012, and became a staff writer in 2018, covering energy, the
environment, and climate change. _

 

* Climate Change
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* heat wave deaths
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* Phoenix
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