In December, CAPE President Dr. Samantha Green told the Toronto City Council Executive Committee a story about supporting her 84-year-old patient with asthma, kidney disease, and diabetes. His portable air conditioner had broken during an unprecedented 29-day heat wave. But helping him replace it through the city’s hardship fund proved impossible.

First, he needed a prescription from Dr. Green. Then he waited on hold for hours to request a paper application, which required extensive financial details. In the end he was denied funding, because he had $700 in his bank account.

She went on to describe the communal cooling room available to him in his building.

“In that space, there are three plastic chairs in a small room. There is nothing for him to do there, and no reason for him to spend time there,” Dr. Green said. “Common cooling rooms will not prevent him from experiencing heat illness or death.”

“Just like a minimum temperature bylaw in winter, we need universal protections to ensure that these most vulnerable Torontonians have a cool place to live and to sleep,” she continued.

Mayor Olivia Chow responded immediately, asking city staff to fix the broken hardship program and to develop programming for cooling centers.

This was one victory in an energizing winning streak in Ontario late last year. Working in coalitions with legal experts, environmental organizations, and tenant advocacy groups, CAPE ON physicians helped secure multiple policy changes that will protect thousands of people from deadly heat and harmful emissions.

These wins demonstrate what’s possible when physicians step up as trusted messengers and strategic coalition partners. They also offer a roadmap for other CAPE physicians concerned about deadly heat in their communities, after Environment and Climate Change Canada’s recent long-term forecast that 2026 to 2030 will likely be the hottest five-year period on record.

“This is not just a summer issue,” said Dr. Sehjal Bhargava, CAPE President-Elect and ON co-chair. “This is a winter-planning issue for a summer crisis. Crisis mode is not the time to be planning and coming up with solutions. It’s now.”

For each of these initiatives, CAPE ON physicians partnered with other organizations that brought complementary strengths — technical policy knowledge, legal expertise, and tenant advocacy. Medical student Anne Fu made a particularly strong impression when she called in to speak to council in the midst of her classes. “Everyone commented – even Mayor Chow – how great it was to see a student making the effort to give a deputation,” said Anne Keary, CAPE ON regional coordinator. “That really showed a commendable interest in civic engagement.”

“We can amplify and validate the stories of tenants and people with lived experience,” Keary explained. “Doctors have these trusted voices in society, especially when speaking with decision makers.”

Dr. Mili Roy, CAPE ON co-chair, agreed the coalition wins showcased the power of collective action. She had never seen city council chambers so full of people waiting to depute. “There were so many people in the room that day, ready to defend these policies,” Dr. Roy said. “The politicians really heard and could see how important this was.”

But evidence alone wasn’t enough. “You need to be evidence-based. That’s necessary, but it’s insufficient,” Dr. Green said. “We need to illustrate the evidence with patient stories. That’s the only way to connect with decision makers. Our brains work on narrative. They don’t work on numbers.”

Through these narratives, physicians not only moved city councillors to pass better policies. Their messages rippled outward—through coalitions and across decision-making tables—to shift a larger narrative: they reframed extreme heat, building emissions, and gas plants as health issues.

“We are only as healthy as our environment,” Dr. Bhargava said. “When extreme heat is effectively trapping people in dangerously hot homes and condos, that’s a public health emergency, and it demands action.”

Most city officials—like health professionals—rightly want to make decisions based on the best available evidence. But that can slow down or stall political decision-making. When physicians bring their health perspective to the table, the stakes become harder to ignore, Dr. Bhargava observed.

“Are we really going to wait for ‘perfect evidence’ to act on this, when we know there’s a real potential for 600-plus people to die in a city in the next heat wave?” she said. “There is evidence in witnessing the health impacts that we’re seeing as physicians and through data like coroners’ reports. That’s where a frontline voice really becomes key.”

Critically, in Toronto, Keary noted that the coalition of frontline voices was heard by the right people at the right time.

“Narrative change doesn’t just sort of waft around,” Keary said. “There are key moments in which the message needs to be connected to people pushing the levers of power.”

That will hopefully be easier for CAPE ON in the future, thanks to the connections forged through these recent wins.

“The more we can get our names out there and be at that table, the more they know they can come to us with their questions,” Dr. Bhargava said. “We show we’re an accessible resource. We don’t have to always be calling from the outside. It opens doors to be in those inside conversations when you engage politically.”

There have been other signs that CAPE ON’s work has left a lasting impression in Toronto. Coalition members and councillors have echoed physicians’ messages in subsequent city discussions. City councillor Alejandra Bravo recognized how powerful it was to hear from such a broad coalition of health, environmental, and community voices.

“We have three reports that address an emerging threat to life and health—not just in Toronto but across the globe,” Bravo said. “We’re all sharing the same city, the same climate, the same conditions. We build this out through massive amounts of solidarity and conversations. It’s an example of how we should be doing everything.”

While CAPE has much to celebrate in Ontario, the work continues. Keary said more medical students will be keeping up the pressure on Toronto city councillors to ensure the heat bylaw stays on track and passes its final vote. And now CAPE ON is working with Healthcare Providers Against Poverty to push for a similar maximum-temperature bylaw in Hamilton.

“I think given everything else going on in Canada and the world, these are the victories that are so important to be focused on, because it’s very easy to feel hopeless and paralyzed. But these are very life-changing wins,” Keary said. “At the municipal level, at least, we have been fortunate enough to be able to make a difference. There’s a space there for democracy. There’s a space for solidarity.”