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How will medical issues be dealt with in a real-life Gulch?

Posted by  $  winterwind 4 years, 4 months ago to Culture
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subtitle: an offshoot of "What will you sacrifice....
This thread assumes that we are talking about one of the various types of real-life Gulches, not a virtual one. I'm not looking for conversation about "what kind of Gulch will we have?" - that is dealt with elsewhere.
I am re-posting my comments on the subject, with additions, originally from "...sacrifice..."


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  • Posted by Technocracy 4 years, 4 months ago
    Individuals can stock up on medical supplies to "self prescribe". Assuming proper storage, most medicines are fully effective well beyond their expiration dates.

    As to the hands on medical care. Individuals can find reference materials to help for low level diagnosis and treatment. But there is no substitute for a trained doctor for serious problems.

    Outside of modern civilization, even if its nothing more than a hiking trip in the wild, things that are normally minor can become life or death issues.
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  • Posted by NealS 4 years, 4 months ago
    My dad got his new teeth by painting the dentist's home and office. And when my dad caught me, rolled me on the ground, to put out the fire, he paid our family doctor with food and drink (alcohol) from our little country store. I'm not sure how he paid Dr. Sakaguchi (sp) for my skin grafts. I don't think doctors then even had a degree. Maybe they were self proclaimed doctors? I grew up to be a total do-it-yourselfer, I can fix just about anything, and I usually do. About the only thing I don't do is doctoring beyond first aid, although I remember playing doctor with friends a few times and learning the differences between girls and boys in my early years. That's how I view the Gulch, everyone has some specialty they are willing to share or trade.

    I feel like I used to actually live in the Gulch, then something recently went wrong. Does every generation have these feelings? Does every generation not realize just how good the previous generations had it? Do we really need all the technology and interaction with everyone that we get today? I still don't have a cell phone, I'm just not important enough (actually I do have one, but it's in my desk drawer with a dead battery). Is there anyplace that still maintains a small community environment?

    PS.. Cell pone is only taken when necessary, might have to pick up special needs daughter, or when traveling, or might lose daughter at Disney World (actually happened) in the rain. It's on a $100/year plan with 1000 minutes that roll over if you renew before last day of current contract. I've had for fours year and have about 3982 minutes left my plan for this year.
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    • Posted by  $  JCLanier 4 years, 4 months ago
      NealS: you are a dream! I really admire your resistance to the cell phone. I am intrigued by your statement that you felt as though you were living in the Gulch and "... something went wrong." - umh, that's almost like leaving the Garden of Eden... Hopefully you learned something?
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  • Posted by wiggys 4 years, 4 months ago
    I do not wish to rain on the parade, but a real life Gulch is not real life. Thinking that it will ever come to be is not reality. The logistics of having an isolated community that is so self sufficient as you would like is not possible. You would be returning to a primitive way of life.
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    • Posted by JoleneMartens1982 4 years, 4 months ago
      Wiggys, I would willingly gulch at any moment go gulch, and having been raised in a limited technology home, could pretty easily survive it. I have also been studying survival and prepper skills for a year now. I am also now researching herbal healing and homesteading. I rarely go, or take my kids to the doctor, unless I have to. My doctor and I discuss home healing, and he gives me ideas I haven't found yet and supports our way of life. I bet he would go Gulch.
      I also have a goal to make my own home as self sufficient as possible, with or without the "fall of Rome".
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  • Posted by  $  4 years, 4 months ago
    Despite comments about camping which resulted in the title "Mrs. Gatsby" [which I often wear proudly, BTW], there is one area on which no one has touched - medical care. Not "wellness checks" or a prescription for an antibiotic for an infection, but care for catastrophic incidents or chronic conditions.

    That is not what I WON'T give up, it is what I CAN'T give up. I am what is termed a "chronic pain patient" - what that means is that I got one of those spines on which the warranty runs out early, and I take narcotics every single day.

    As I think about shrugging [in the go somewhere else sense] I have researched opium poppies, and the process of obtaining the narcotic from the plant is not difficult, just need a good chemist or even someone who can follow directions exactly.

    So my case is covered, at least to my satisfaction, but I know there are other people with other problems who should consider how to deal with them.

    addition: This is also why I long ago decided if the SSI came for me I'd make them kill me before they took me - cold turkey withdrawal overseen by very unsympathetic men IS a death sentence and I am not sure I wouldn't surrender. I can at least follow the example of the William Wallace in Braveheart.
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  • Posted by TeresaW 4 years, 4 months ago
    This is a favorite subject of mine. However, I am just off a 14 hr shift and have surgery scheduled tomorrow, so am not able to address it right now. Hope it is still a hot topic next week.
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  • Posted by scojohnson 4 years, 4 months ago
    Realistically, the Gulch may have to take a Canadian-approach to immigration... prove you are not chronically ill, or accept your own responsibility for it.

    There are a few options though - people don't go into the Gulch without ever having worked a day in their lives, the taxation is what drives us there.. many will have Medicare, or some kind of retirement health plan anyway. Those that don't can pay into a community fund, kind of how Mexico does it, with minimal money going in, minimal / zero waste, and it's a pool to pay for emergency care and medications if needed.

    I'm sure several doctors will be in the Gulch, they get pummeled by the tax code as much as anyone, and would be happy to trade services for other services or products I'm sure.

    Existing without any community cash is unrealistic, pumps will be needed, pavement, building supplies, things that can be bought quietly on the market but you can't necessarily build a village or community very well without. Some will bring these resources and expertise to the Gulch, some might have to be purchased.

    Medical care really isn't a challenge, I have both a PPO and a flexible spending card for example from my employer. I always ask what the cash price of something is, I'm on some maintenance meds... the cash price of the generics is like $1.56 for a 30 day supply on one of them, under $4.00 on the second, and something like $3.00 on the other. If I use my insurance, it's a $15.00 copay on each of them. That's one of the secrets of health insurance... that 'overage' at the pharmacy goes back to your insurer. It's a credit, goes to someone, doesn't go to you... Many meds you buy is just pure profit for the insurer because they don't touch the thing and the price is less than your copay.

    There is a thriving medical business along the Mexican border... quite frankly, I know a few people that have used it and its incredibly scary with the results I've heard about (first-hand), but the same type of economy could develop in the Gulch. A dentist that will do the normal stuff for a $40 or $60 office visit (and still more than they make billing insurance companies, paying employees to code the billing, etc.) and the same for doctors. If its just them and no overhead, the price goes down a lot...

    Meds can be delivered by UPS or something to a mailbox at a nearby community or a rental mailbox/shipping type thing for the community.

    It's really not a big concern I don't think. People that are in the last phase of life, or have serious health problems are probably not great candidates though (unless they really just want to live out their days). Life on the frontier is hard, firewood to cut and stack, gardening/harvest/canning, livestock, minimal appliances because of the power constraints, I imagine a lot of biodiesel and electrics... but that means people maintain wind turbines, solar panels, and biodiesel refinement cells in their garage... This wouldn't be eating bonbons in front of the TV all day. Without the services and availability of products we take for granted, and the need for seclusion, there would be a lot of "do for yourself". Probably something closer to "Life Below Zero" in Alaska than "Real Housewives of Orange County".

    I would imagine very little or zero waste, as every resource would have to be fully used to minimize contact with the outside world.
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  • Posted by  $  Temlakos 4 years, 4 months ago
    Recall that the founder of Mulligan's Valley was a still-robust man. The first residents were in fact pioneers. Pioneers self-diagnose, self-treat, and self-manage. They have to.

    Rand did not say specifically when John Galt managed to recruit THomas Hendrix, M.D. Who then had to go from being a neurosurgeon to a general practitioner in a trice.

    I hold the degree of Doctor of Medicine. I haven't used it in many years, and I trained in pathology and laboratory medicine. Nevertheless, in me you have one familiar enough with human anatomy to know how to train others in emergency first response, and to manage "hurry cases" and other kinds of pioneering accidents.

    The next question is what reward I might expect. During the Depression and earlier, country doctors received their fees in kind. Roof shingles, laying hens, fresh farm produce, that sort of thing.

    And with my earlier training in chemistry, I am sure I could learn the procedure for extracting opium from the poppy. To take only the one example mentioned.

    But I won't boast of being able to handle everything forever. If John Galt needs to send a substitute to recruit the next Doctor Hendrix, I'm there.
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  • Posted by  $  AJAshinoff 4 years, 4 months ago
    I would expect people to take care of themselves using whatever meds they determined they needed. After that, if the situation warranted, or they felt the situation was beyond their ability to handle, they'd seek more professional assistance and would pay for it themselves. Value for Value.
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    • Posted by  $  4 years, 4 months ago
      Yes, of course. The question was partly personal, but more Gulch-wide. I was hoping to get what ideas other people had about how it might work, or what they themselves might do.

      I'd like to have a nurse [who might teach first aid in her spare time!] around the place. I'd probably contribute to her salary. An herbalist? acupuncturist? dentist?
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      • Posted by wiggys 4 years, 4 months ago
        The answer of course is to get a sail boat.
        living off of the ocean will keep you health, I know as it did it for 13 months as well as having the boat 6 years. also you do not need money the wind is still free. with all of the electronics available today that use minor power the solar power collectors and small wind generators made for use on boats will supply you with all the power a boat needs. and you will be able to hear on your radio all of the horrors taking place on land. so you will not call it gulch but trough.
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  • Posted by  $  jlc 4 years, 4 months ago
    Some points to consider:
    *The FDA is considering allowing rapamycin to be sold as the first approved anti-aging drug.
    *The use of CAT scans, MRI and PET scans has increased by 30% to 300%. CAT scanners cost from $35K to $600K.
    *Medical Laboratory instruments cost between $5K to $250K (unless you get into real high-end or genetic testing)
    *a friend of a friend of mine is a Optic Neurologist

    So, while we are OK with respect to saving 'something' in case of total social collapse and providing basic medical care (antibiotics, setting bones) ourselves in the Gulch, if there is no need to abandon interaction with the rest of the technological world, we should not do so. The population require to support a Neurologist who specializes in the optic nerve is...well...I understand that there are 20-30 of them in the world. I do not want to abandon the incredible technology that is in existence or being developed.

    If the world collapses and this tech is not available, then the question is moot, but if we are living in a valley in Peru there is no reason not to fly to Israel for robotic surgery; it will be a long time before we have the Gulch infrastructure to have robotic surgery there.

    Unless we are dealing will social collapse, or the chance to go to a new planet, then what I think the best tech model for the Gulch will be is to have a refuge where we can live our daily lives and create new innovation without Big Brother pulling the strings. We can earn money that is legitimate in both worlds (gold works just fine). Our freedom allows us to create new wonders; we can avail ourselves of the existing tech of the larger world. This seems fair to me.

    That being said, I am a Medical Technologist, and I can run the lab instruments and do a decent job of understanding the results (legacy of having worked graveyard shift for 17 years). Yes, I can become part of the medical infrastructure...but that makes me aware of how I cannot perform a C-section or a simple appendectomy, let alone rebuild someone's arm after it has been crushed by a falling tree or implant a pacemaker in their stomach to remedy gastroparesis.

    Jan
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    • Posted by wiggys 4 years, 4 months ago
      anti-aging drugs do not exist. those who say they have something that will keep a person from aging are faking reality. the best method to keep from aging is to die young.
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      • Posted by  $  jlc 4 years, 4 months ago
        Perhaps true 20 years ago. Not true today.

        There is no 'magic pill' but we are starting to understand the mechanism of aging and there are substances that alter gene expression (epigenetics) to change the rate of aging.

        Give us time; we will solve this too.

        Jan
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        • Posted by wiggys 4 years, 4 months ago
          you unfortunately are not considering the FACT that young people today are developing illnesses earlier in life for a few reasons; they do not exercise as my generation did. they eat for the most part garbage food. they are fixated on screens like tv, phones ipads etc. their intelligence level is so low that they do not know what they are doing and of course they are smoking weed and the government is striving to make it even easier for them to acquire it. so they will not be living longer than the current generation even IF an anti aging drug appeared. do these mad scientists have any idea of the long term consequences of such drugs NO! There is no magic anything now or has been or will be. that is one of the premises of objectivist philosophy.
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          • Posted by  $  jlc 4 years, 4 months ago
            Agreed. No magic. Agreed. Deeds have consequences.

            Right Now we have studies that suggest deeds that have the consequence of delaying aging. That is not in the future. It is now.

            In the future we will probably have more of these deeds/drugs/procedures (such as rapamycin). People who take care of themselves and avail themselves of these techniques will live longer.

            What stupid people of all ages do re eating poorly and not exercising has nothing to do with what I can choose to do.

            Jan
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            • Posted by wiggys 4 years, 4 months ago
              well I am set on living to 120 years. then i'll be able to report on what has happened. but in the meantime I believe in your life time you will not see a population in general increasing with respect to living longer. drugs are drugs are drugs and the drug companies will tell you the most glorious of things but they are all faking reality.
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  • Posted by starznbarz 4 years, 4 months ago
    Veterinary meds and people meds are almost always exactly the same drug - except for dosage per unit. Here in Florida, most major food stores with a pharmacy do not charge for filling antibiotic prescriptions, even if it`s a vets scrip. Great way to stock the go buckets.
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  • Posted by bz1mcr 4 years, 4 months ago
    Like all other products and services in the Gulch. You will pay for the services provided, or in the rather unexpected case where you can't come up with payment you will do with out or someone else will volunteer to to pay or provide the service for you. Advanced medical services would quickly be available at costs lower than "normal" and new services would be developed sooner than those developed by persons working for the moochers.
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  • Posted by Rocky012 4 years, 4 months ago
    We have all been brainwashed to believe health and repair come out of a pill. Fortunately many in the gulch have learned better. Has anyone heard of a zapper? I can testify from personal experience it is great at helping your body fight off all kinds of infections. Along with garlic and the right colloidal silver good health can be maintained, Of course there is no substitute for a DO (Doctor of osteopathy) for severe situations. I'm new to the gulch so I'm assuming this has been the subject of other threads I don't know about. Just felt like I should jump in here. here
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    • Posted by Kittyhawk 4 years, 4 months ago
      The rest of it I've heard of, but what is a zapper? Is it electrical?
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      • Posted by Rocky012 4 years, 4 months ago
        It is a small device that is battery powered or plug in. There are two grips to hold in your hands. It produces a positive standing wave form that disrupts bacteria and virus metabolism like silver colloid I believe. There are many listed on the internet. Most are asking to much for them and you never know how good they are. I got mine through a health food store from a guy I trust. Still working after ten years. Has help me with everything from nail fungus to the flu.
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  • Posted by term2 4 years, 4 months ago
    Medical care is the one thing that would be most difficult in a real time GULCH. There is an economy of scale that allows things like CT scans and MRI and robotic surgery to be done at a reasonable cost. Until the gulch was large enough to afford these things, members would have to rely on going outside for their serious medical care, or perhaps setting up a specialized medical center (Not in the USA however) where people would travel to have things taken care of
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  • Posted by davidmcnab 4 years, 4 months ago
    @winterind you might be worrying over nothing.

    In the Gulch, so many causes of stress will simply be absent. Expect weeks of tears and exhaustion collapse as people first settle in, as they throw off all the years of all that insidious soul-destroying abuse they've suffered at the hands of looters. But as they get all this crap out of their system, they will emerge glorious, and from then on, present only the barest fraction of medical issues they were suffering outside the Gulch.

    A close friend of mine toured the Himalayas some years ago, and encountered a couple of communities where all the doctors ever do is teach good nutrition, deliver babies and (very occasionally) treat cuts and re-set broken bones. No cancers, no heart disease, no dementia, no diabetes, no Parkinson's, none of the usual crap that haunts the western world. That's what you can manifest when you have a community living in harmony. (Not quite so good, though, when the Chinese are on their doorstep).

    All these generations of living out of integrity (ie living for others, expecting them to live for oneself), then indulging in horrific dietary, drug and lifestyle choices to try and chase away the anxiety all of this causes, has created endemics of illness which we have come to describe as "normal".

    In the Gulch, get used to a whole new kind of "normal!" :)
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    • Posted by  $  4 years, 4 months ago
      thanks, David;
      I think you're right about many people and some of my issues as well. However, I have bio-mechanical issues that also lead to pain whether I'm stressed or not - and I've done a lot of work on this issue because it's the first thing doctors say when you come in with what looks like a classic tension headache: do these neck exercises, you'll be fine. Not if every disc in your neck is damaged or out of place, you won't be fine. You can hope for "better".
      You are also right about "a new normal" - in different ways, we are all reacting to/defying/ignoring/etc the stresses of what modern American life does to people who belong here. There will be a "let down" period - the kind that comes when you make a decision that is right and damn the torpedoes - and get no torpedoes!
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    • Posted by  $  JCLanier 4 years, 4 months ago
      Davidmcnab:
      Your comment was refreshing. I would sincerely hope that the shedding of layers of accumulated stress, of ridding oneself of the shackles imposed by society/government in "being your brother's keeper" ... would bring such a relief and rejuvenation of the body and soul that we would all bask in the glow of health and happiness.
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  • Posted by DaveM49 4 years, 4 months ago
    A few stray thoughts:

    Anyone considering going on strike should take the EMT course as an absolute minimum unless they aready have medical training.

    Plant your personal "gulch" with medicinal plants--and learn how to process, store, and use them. No replacement for a drug store, but there are plenty of essential supplies that can be growing in place,

    A few books for the library: "Emergency War Surgery", "Where There Is No Doctor", "Where There Is No Dentist", "Ditch Medicine", and a comprehensive guide to medicinal plants.

    Many veterinary drugs can be purchased without a prescription. Notably, antibiotics intended for fish can be bought at "big box stores". Some of these in pill form are identical to generics sold by prescription a copy of the Physicians' Desk Reference will help to identify them. Otherwise, antbiotics made to USP standards will be safe for human use. Make sure to read up on expiration dates--tetracyclines, in particular, degrade into toxic substances.

    And yes, you can grow all the "ornamental" poppies you want. The milky sap from slit pods is raw opium. Concentrating it into morphine is a more involved process but the raw sap is a powerful analgesic.

    Analgesics, from aspirin to opiod equivalents, can be extracted from a number of easily cultavated and wild plants, none of which will attract any attention as poppies might. Cattails, lettuce, and willow bark are three examples.

    An aside: have your kids get into Scouting. They have some goofy ideology which I won't get into here, but the Scout Manual has a LOT of useful material on First Aid, "bushcraft", and the like. Virtually anyone can learn to set and splint a bone, attend to someone in shock, or bandage a wound.
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  • Posted by Wim 4 years, 4 months ago
    People don't get sick in a safe environment with healthy foods and natural remedies. In countries or areas where doctors go on strike the average health of the population increases rapidly. That is enough proof for me.
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  • Posted by  $  tekcoyote 4 years, 4 months ago

    I "retired" from practice nearly 2 years ago. Ha. Friends and relatives get sick and guess who they call. Unlike being at the University or in private practice, I get to pick and chose who I take care of and what--or whether--I do. Normally I don't insist on a quid pro quo, but if nothing is forthcoming, that can't help but have an influence on my response to further requests.

    On a different plane, though, it allows me to practice like the old fashioned GP of yore: I spend as much (or as little) time as I need or want on a problem, and my solutions are largely either a medication or a referral--I don't do surgery any more, but I still have a zillion excellent contacts.

    In a pinch, surgery remains an option--I did it very well--but until and unless it's necessary, it's not necessary.
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