Bill Frist, the former Republican Senate majority leader, racked up a slew of notable medical successes during his years as one of the country’s top heart and lung surgeons.
He founded one of the country’s busiest transplant centers. One of his patients held the Guinness World Record for being the longest surviving single lung transplant recipient. And, in 1991, Mr. Frist performed lifesaving thoracic surgery on Gen. David Petraeus, then a lieutenant-colonel, when, during a training exercise, the military leader was accidentally shot in the chest.
But now, Mr. Frist, 74, advocates for the health of the biggest, most famous patient of all: the Earth.
In earnest writings, folksy videos recorded on his front porch in Tennessee, podcasts, speeches and congressional testimony, Mr. Frist has been highlighting the inseparability of planetary and human health.
“A healthier planet means healthier people,” Mr. Frist said. “The science shows it. Our experience shows it. Nobody can really argue against that.”
This environmental advocacy puts Mr. Frist at odds with much of his own party and even his younger self. At his retirement from the Senate in 2007, the League of Conservation Voters gave Mr. Frist a lifetime rating of 7 percent for his legislative environmental record, which included voting for oil drilling in the Arctic National Wildlife Refuge. “Things like the Arctic, I definitely would not have voted that way today,” Mr. Frist said.
It seems Mr. Frist is making up for lost time. In June, he published a minute-long video detailing how ecosystem collapse and wildlife habitat loss imperils children’s brain development and immune response, by reducing their exposure to beneficial microbes. On Substack, where he has around 31,000 followers, he’s written about the ways air pollution speeds up cognitive decline. In 2023, he presented data to the Senate Budget Committee showing how rising temperatures lead to escalating health care costs. He is also writing a book about how climate and nature shapes human health.
He said he’s aiming to “depolarize” the climate conversation.
On a recent day, Mr. Frist spoke by Zoom from his office in Nashville, surrounded by photos and mementos. A map of Tennessee, rendered in green thread on reclaimed barn wood, to symbolize conservation, hung behind him. On his right wrist, he wore a wooden beaded bracelet from the Loisaba Wildlife Conservancy, north of Nairobi. Mr. Frist has visited Africa about 20 times, mostly for medical trips: In the Senate, he was crucial to the passage of the President’s Emergency Plan for AIDS Relief, PEPFAR, which funneled billions of dollars into the prevention and treatment of H.I.V. and AIDS abroad.
But one photo was especially important, he said. It was a portrait of his wife, Tracy Roberts Frist, and their Border collie, Bonnie, sitting on a woodsy ridge. The couple married in 2015 — it was his second marriage — and live on a working farm outside of Nashville, along with eight sheep, nine horses, three herding dogs, geese, goats, chickens and two donkeys.
They also have a 995-area farm in Virginia that includes an arboretum and federally protected wetlands, where they raise grass-fed cows, and regularly host environmentalists, scientists and 4-H students. In 2024, they donated $1 million to fund an initiative for planetary and human health at The Nature Conservancy, the nonprofit where Mr. Frist chairs the global board of directors.
Mr. Frist said his wife helped him connect with the wild, natural world. She did her graduate studies in animal and human behavior, and oversees riparian and wetland restoration along with regenerative agriculture at their farms. “She is born of nature, is part of it, it is written into her soul,” Mr. Frist said.
Mr. Frist grew up on five acres in Tennessee, which he said laid the groundwork for his environmental awareness, as did his career as a cardiothoracic surgeon. Cyclosporine, a drug that revolutionized organ transplants, is derived from soil fungus and acts as a immunosuppressant, stopping the body from rejecting organs; the FDA approved it just as Mr. Frist was finishing his surgical residency. “It hit me, the power of nature and biodiversity,” he said.
Mr. Frist’s pivot to environmental advocacy unfolded after he left the Senate, as the issue was becoming increasingly polarized. He had been put off by the strand of environmentalism that he said used shame as a lever.
But after paying deep attention to the science of climate change, he saw connections between human well-being and planetary health.
“Our national leadership too often, and I was probably a part of that at the time, has failed to connect those dots with what the urgency of today requires,” he said.
This makes Mr. Frist among a vanishingly few number of Republicans championing the environment and encouraging ways to slow global warming. President Trump has called climate change “a hoax,” and has been promoting fossil fuels, the burning of which is dangerously heating the planet. A recent poll found that just 6 percent of Republicans are worried about it, a record low.
“There’s a very small group of us known right-of-center climate advocates, the so-called eco right, who see this really dire forecast,” said Alex Flint, the executive director of Alliance for Market Solutions, a conservative group that support carbon taxes. “It’s lonely.”
Yet Mr. Flint and Mr. Frist share the view that their party will come around, eventually.
“In the long run, there is going to be a political response forced by the reality of the changing climate,” Mr. Flint said. “It is inevitable.”
In his writings, appearances and videos, Mr. Frist talks about the toll that pollution and extreme weather take on people’s health. About operating on lungs darkened by tobacco smoke and airborne particulates, and how pollution contributes to every coronary artery surgery he’s done. He comes across as straightforward and plain-spoken, like an old-fashioned kindly doctor.
According to his office, he has more than 130,000 followers across his social media platforms, and got more than 2.5 million impressions on LinkedIn last year.
His target audience, he said, is the center right. “People who are reasonable, rational, appreciate science, educated not necessarily in college degrees, but educated in the sense of listening to other people, treating them with dignity, always assuming the other person might be right,” he said.
He also said he’s received minimal pushback. This past May, he was interviewed onstage by former Vice President Al Gore, a fellow Tennessean whose office in Nashville happens to be down the hall from Mr. Frist’s, as part of Mr. Gore’s climate initiative. “It’s wonderful to have Bill Frist out there saying these things,” Mr. Gore said.
Mr. Frist said the key to his messaging, and bringing people together, is highlighting what they value most.
“It’s the health, hope and the healing of themselves, their loved ones and their kids,” he said, “Not 10 years from now, or 20 years, not 30 years from now, but today.”
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