Health care in a post-collapse world

by John House, who blogs at Health by Dr. House

I can’t begin to count the times that I’ve thought about the collapse of the industrial economy. Even before I knew that such a thing was not only possible, but probable, I was hoping for collapse, or at least some sort of radical change, every time I saw a poor defenseless little animal dead on the highway or I encountered an otherwise beautiful stream with piles of trash strewn all along its banks.

Now that I realize that collapse is happening, I find that sometimes I actually long for its rapid completion; particularly when I see yet one more example of my species’ wanton destruction of other life forms. Sometimes my longing is more selfish, like when I’ve just wasted several hours of my life dealing with the myriad obfuscations of government medical bureaucracy.

For all my bravado about longing for collapse, I’m well aware that life will be incredibly hard after, if not impossible, and that I’m going to miss all sorts of things, some inconsequential, some life-saving. Like hot showers every morning. My favorite movies on DVD whenever I want them. Chatting online to friends around the world. Ready access to food at the grocery store. Antibiotics. Clean water. The list goes on and on. So, when I wish that the proverbial other shoe would drop, I have to ask the question, “am I really, truly ready for the collapse of all that I’ve known?”

To answer that question accurately is impossible. I won’t know if I’m ready for collapse until after the fact. I’ve never lived without the industrial economy — not even a little bit. So, I can only imagine what it will be like. The ways upon which I’m dependent on this complex, stressful, confusing world we’ve created are almost innumerable.

As I’m a physician and someone who has hypertension (high blood pressure), I also wonder how ready I am to survive collapse when it comes to medical care.

Health care as we know it will not exist in a few years. Once collapse is in full swing health care will disappear almost overnight. Of all the industries in our complex world, medicine has become one of the most energy-intensive, technology-dependent, and thus fragile endeavors that exists.

I am asked from time to time how a person with disease X or malady Z can prepare to survive the loss of essential medicines or therapies provided to us by the industrial economy. In fact, when Guy asked me to write this essay, he suggested that readers might find that particular topic useful. While we may hope that those of us in the medical field will have some really cool herbals and old-time remedies hidden up our sleeves to cure all our infirmities, the reality is not very encouraging, I’m afraid.

To make my point, I analyzed the 25 most common reasons people come to my clinic. Of those, only a few had any kind of treatment that didn’t require some sort of petroleum-derived therapy. It’s important to remember, contrary to what those involved with “alternative medicine” may say, prior to the 20th century, other than opium, there were virtually no medical treatments which were effective with any regularity.

Of those top 25 reasons for seeking medical care, the number one reason — pain — is the one which we will still have the ability to treat post-collapse. Opium, and thus morphine, heroin, and so on, is derived from the poppy. Wikipedia has a wonderful article on this topic and should be required reading for anyone preparing for collapse.

There are many other plant-derived drugs; however, extracting them often requires a good knowledge of organic chemistry as well as a supply of petroleum-derived chemicals. Compounding this difficulty is that many such plants are only grown in certain regions of the world.

If there is any good news in all of this, perhaps it would be that many of those top 25 reasons people come to see me will disappear or at least lessen in severity post-collapse. For example, diseases related to obesity such as diabetes, hypertension, high cholesterol, heart disease, and low back pain should improve significantly. When people are scrounging to grow their own food, obesity-related illnesses will be non-existent.

Gone too will be people needing medicine for their depression, anxiety, and insomnia. I have no doubt that those maladies will still plague us, but I suspect that we will have much more important things to worry about. In fact, in a world where we are trying to protect our family and property from thieves in the night, a little insomnia might serve a useful purpose.

On the flip side is the hard reality that immediately post-collapse there will be outbreaks of all sorts of plagues and diseases which we in the developed world thought were conquered, such as cholera, malaria, measles, starvation, smallpox, polio, tuberculosis … the list goes on and on.

When it comes to preparing for collapse of the health care system, If you are dialysis dependent, or you have hepatitis C or HIV, or survive only with chemotherapy or radiation, the outlook is indeed bleak. For everyone else, there are some things you can do to prepare. I’ve started a short list. I’m sure there are many other things which readers can come up with, but this should get us going:

1) If you take regular medication which isn’t a controlled substance (like opiods or benzodiazepines) and doesn’t require refrigeration, talk to your doctor about getting a few extra prescriptions “just for emergencies”. He or she may be willing to accommodate your request.

2) Grow your own poppies. Nobody wants to suffer from severe, long term pain.

3) Have at least one book which deals with medical emergencies in a wilderness setting.

4) Take a basic course in first aid.

5) Avoid the cities at all costs — those outbreaks of once cured diseases will center on large collections of people.

6) Always wear good foot protection and other protective clothing and eye wear when needed. Remember, antibiotics will be a thing of the past (this is already starting, but that’s a different topic) and even a little cut can lead to death if it gets infected.

7) Make sure your water supply is not contaminated by feces from humans or any other animals. Many diseases are spread this way.

8) Wash your hands any time after you come into contact with blood, bodily fluids, or excrement.

9) Avoid those who are sick. This seems harsh by today’s standards, but this was common practice in times past.

10) Do your best to eat a wide variety of foods, focusing more on fruits and vegetables with a minimum of red meats.

I wish I had a more encouraging assessment, but as with so many other areas of our complex world, health care is about to go back to the stone age. Best wishes for us all.

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This essay is permalinked at Island Breath.