American Partisan: Medical Care When the Lights Go Out

An American Partisan staff member who is a surgeon has written Who’s On Call: Medical Care When the Lights Go Out about the basics

…We tend to think of collapse scenarios as abrupt, but through history they have often occurred in slow motion. One could argue that our health care system is already in a state of partial, ongoing collapse, especially since 2009. Anyone currently working in that sector knows it, as from a boots-on-the-ground, practical standpoint the PPACA may have actually reduced effective access to care and utilization and has engendered a rather unique set of patient and provider survival skills for the prevailing medical landscape that share commonality with the grid down world. The most important of those are mental, emotional and psychological. Long wait times, restricted access to providers, high deductibles and out-of-pocket expenses, third-party bureaucracy, system consolidation (i.e Aetna + CVS) and increasing use of non-physician providers (not a denigration of them, so please no hate mail, I love my NP) are all potential barriers to care that have parallels in the austere environment. Developing skills for self-care and outright avoidance of the system are increasingly necessary, as things are inexorably getting worse, and it’s not just domestic. The Gray Lady just outlined slo-mo collapse of health care in China.

Primacy of basic, mundane grid-down issues such as water purification, sanitation and disinfection cannot be understated. They are the three most important areas to address; dismiss them at your peril. Grid-down medicine, like all things military and surgical, is mostly boring and even mind-numbing. It’s not all sexy trauma stuff. Most of that will leave you dead. While the products of human violence will most certainly be faced, failure to provide clean water, properly address latrinage, and keep wounds clean will kill many more than bullets and bombs. Monsoon rains after the Haiti earthquake led to a cholera outbreak (traced to Nepalese relief workers) that killed thousands. Dysentery is a big inflictor of suffering and death after disasters. Modern trauma care is very complex, needful of extensive resources and still can not prevent all death. In a grid-down world, my specialty will likely be reduced to Civil War-era skillsets: draining pus and amputation…

Click here to read the entire article at American Partisan.