Since 2007, I have been writing about parallels between medicine and agriculture, looking at them as two forms of care for complex systems. The emerging understanding of the importance of microbial communities as the basis of human health and soil health has been fundamental to my understanding of both systems.

In 2011, a storm swept through the rural area where I live. It swelled the rivers and streams and tore up 500 miles of roads and 250 bridges. Entire farm fields ended up downriver and sewage overflowed into gardens and ponds. Everywhere I drove, I stopped to look at the way a few inches of heavy rain had cut through hillsides, moved rocks, trees, even houses. Many people lost jobs after businesses flooded. Over the next few months, I watched as workers rebuilt roads, and piled up rocks along river banks, and I wondered: Are they treating the root cause or just the symptoms?

I had learned over 22 years as a healthcare provider that treating symptoms without addressing the root causes of an illness often led to worse problems later. On the other hand, if a patient could use basic principles of health to address the roots of their illness, they could bring about a new state of health, making it possible for their whole system to function at a higher level.

As I explored the damaged landscape around me, I started to wonder what a fully functioning and healthy landscape would look like, and what principles might be involved in restoring the function of a landscape and its watershed.

I was fueled in particular by my fascination with water. Where did all that water come from during that storm? Why didn’t the soil soak it up? Why were some areas so much more affected than others? What were the effects of runoff on my own health when I jumped in the river after a rainstorm, or swam in a lake with an algal bloom?

These questions led to more questions, which the scientists, agronomists, and farmers around me were also trying to figure out: How do plants and microbes create soil structure that holds water? What are reliable ways to test changes in soil’s health, structure, and function?

I became part of a monitoring project that was measuring changes in soil health and watershed function at innovative farms all around North America and teaching community members simple and effective ways to do the same.

In my travels, I got to see land in various stages of recovery. It was wonderful to see healthy farmland and rangeland, just as it was when I saw my patients return to health. Yet I also saw millions upon millions of acres of land that was “naked, hungry, thirsty, and running a fever” (in the words of Ray Archuleta). As I looked at the contrast between that degraded land and the lush, productive land that had been brought back to health, I saw an opportunity. I decided to create resources that would allow current and future farmers, ranchers, and policy makers to see possibilities for change and the principles that are being used to successfully restore health and productivity in many parts of the world.

I’ve always enjoyed teaching as a way of organizing and synthesizing what I’m learning. I tried out various activities in classrooms, with groups of farmers at agricultural conferences, and with friends at dinner parties. I organized materials for teachers, and started doing residencies at schools. Eventually I was invited to create a workbook on soil health and water for agricultural teachers in Oklahoma. With the help of many people, those first few activities grew into the Understanding Soil Health and Watershed Function Teacher's Manual.

In July of 2017, just as I was finishing the manual, another intense rainstorm swept through my town. This time I knew more clearly what I was seeing. The places where plant roots and other soil biology were alive and well served as large sponges that soaked up water while maintaining the integrity of their structure. The places where soil biology was not very active were washed away entirely. Just a few hundred feet from my house, in a dirt road, a gully opened up that was 8 feet deep, 20 feet wide and over a quarter of a mile long. There was no biology in the dirt road that could help hold the soil in place, and the soil was too compacted for water to soak in. On either side of the huge gully, grass, ferns, and trees were still growing happily, in intact soils. The healthy soil structure—which their roots and symbiotic microbes had created—had performed its natural function quite beautifully.

This scenario is playing out in various forms across the country and around the world. Much of our farmland is becoming as lifeless and compacted as that dirt road near my house. We lose topsoil at an alarming rate every season. Yet some places are gaining. We have much to learn from those regenerative farmers and ranchers.

May this course help you appreciate their work, as well as the work that is ongoing beneath their feet.

— Didi Pershouse