In late 2015, two seemingly very different statements were published: a landmark Lancet report on planetary health and an obscure legal grievance filed on behalf of sugarcane plantation workers in Nicaragua suffering from chronic kidney disease. The prologue examines the ways in which each of these documents frame questions of human-environment relations, economic growth, and grassroots action. It sets a point of departure for the book in the concept of “life support,” drawn from the Lancet report, and briefly summarizes the historical context for the ethnography to come.