This is topic Doctor-ish question in forum Open Discussions About Writing at Hatrack River Writers Workshop.


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Posted by JeanneT (Member # 5709) on :
 
Now if one were a physician and suppose life became quite dystopian (isn't it always?). You know that you won't have access to most of the niceties you were trained with. What medical books would you turn to that would be readily available to help and what equipment would you turn to assuming that you had some time and opportunity to grab some before fleeing? We're assuming a SUV so some room to carry a few books and supplies--but not much since a supply of gasoline and food will also be essential.

Help!
 


Posted by Rahl22 (Member # 1411) on :
 
Very variable depending on training and intended purposes. Headed into a battlefield? Bandages, gauze, wraps, scissors, tape, antibiotics, and morphine. No books; they'd just get in the way. If you're being whisked away to be the general care provider for a group of people, well then books become more essential along with certain diagnostic tools: stethoscope, sphygmomanometer, otoscope, etc..
 
Posted by JeanneT (Member # 5709) on :
 
No, no. There are no people left for battlefields. And fleeing not being "wisked away." Dystopian remember. VERY dystopian.

Her training is typical for a modern doctor--I haven't decided on a specialty but nothing that would prepare her for this situation. Pediatrian maybe but that seems so cliche for a female doctor. There are other human survivors who she will hope to help but not nearby so she needs to take supplies with her. At the start of the story the only survivors around are her and her daughter.

You have to think about this situation--there won't be the manufacture of drugs. So what would she do in this situation? And yes, she will want what texts she can take. But what would help in a primitive situation? And is there anything she could or would take that would help with the provision of drugs? She could take morphine and antibiotics with her--but she will want to plan for when that supply runs out.

What WOULD a modern physician do if society totally fell apart?

Edit: And with no refrigeration, what drugs could she take with her? Another complication.

My point about text books, is that most wouldn't help in a primitive situation, would they? Which would a doctor choose assuming the need to be selective? Most, I assume, presuppose modern conditions.

I may or may not go into detail about what she chooses to take, but I always feel that if I don't know the reader will know that I'm faking it.

[This message has been edited by JeanneT (edited June 10, 2008).]
 


Posted by Tiergan (Member # 7852) on :
 
Other than her doctor's bag. The first thing that came to mind were books on natural remedies. Most drugs, came from a version of nature, trees and such. Saps of trees can act like morphine and stomach soothers.

 
Posted by JeanneT (Member # 5709) on :
 
Thanks. That makes sense. Would something like that be available in a normal medical library?

Would anything be available on say surgery under primitive conditions, perhaps intended for doctors who do philanthropic work in undeveloped areas? Surely for surgery she will need items not normally in a physicians bag. (DO physicians normally HAVE a bag these days? LOL)

I had no idea what I was getting myself into with this story. <g>
 


Posted by Rahl22 (Member # 1411) on :
 
"What WOULD a modern physician do if society totally fell apart?"

Same thing anyone else would do: stack the sandbags, load the shotgun, and stock up on Spam.

In most situations, surgery would be right out. Complications, side effects, and post-operative infection would kill most people. Without modern pharmacology, chronic disease is mostly untreatable.

The idea about natural remedies seems to make the most sense, but then again, if it is the end of the world... whether you need fresh aloe or insulin, where will you find either?
 


Posted by JeanneT (Member # 5709) on :
 
Human beings being what we are, they aren't going to give up. They will get together and TRY to survive. (So maybe this isn't totally dystopian since it will have a tiny sliver of hope at the end)

But would a doctor simply refuse to try to do an appendectomy just because conditions were primitive? That doesn't seem likely. Sure it would be high risk, but a ruptured appendix would be even more so.

I don't hink a doctor would stop being a doctor just because things got rough. Or my doctor won't anyway. Sure she'll stock up the spam. But she'll still heal if she can.

No, there won't be insulin. Any diabetics are going to die--actually already have. And she will know that genetically they're probably a lost cause--too small a gene pool. But she'll still try. I know any proper dystopian would have them give up. But then I think that's what's wrong with Sci/Fi today. <g>

[This message has been edited by JeanneT (edited June 10, 2008).]
 


Posted by Tiergan (Member # 7852) on :
 
My knowledge of doctors comes from tv, "house" so I know little. But,

If she is fleeing to the wilderness, and the world has gone primal. You might check on old west doctors for inspiration. Dr Quinn. Off hand A saw, a drill comes to mind. Drill through the skull to relieve pressure on a swelling brain, type situation.

If the city, or cities is only partially destroyed, she could get books from Barnes&Nobles and such, and raid drug stores, not all drugs have to be kept cold, and find basic rudementary stuff in the hardware stores.

I hope this helps.

Edited: reading more of your posts, I feel you should research the old west, civil war doctors and such, they did surgery with nothing, basic tools. Not always succesful but they tried. Amputations were common, but you're right they tried to survive.

[This message has been edited by Tiergan (edited June 10, 2008).]
 


Posted by JeanneT (Member # 5709) on :
 
Thanks. That kind of got my mind working in the right direction.

A good supply of things like alcohol (which you can produce pretty easily with a still later), surgical instruments like scissors, forceps, scalpels, clamps, even retractors... You'd probably want some sort of sharpener. Even today you could probably find a hand bone saw. That would give enough to do a basic emergency surgery--and I do think you're not going to do much except emergency.

Sure aloe is good but there are drugs that can be made from certain pine pitches as well.

Edit: What I was thinking was that someone who is educated will have an instinct to grab books to take and she would, I suspect. What I don't know is if there is anything that would cover the situation. So maybe she just shakes her head and grabs her Gray's Anatomy.

[This message has been edited by JeanneT (edited June 10, 2008).]
 


Posted by InarticulateBabbler (Member # 4849) on :
 
Ask Sara...she is a doctor.

And what I would take...an ambulance. To hell with an SUV!

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Posted by JeanneT (Member # 5709) on :
 
Ooo. I like that idea. *promptly steals it*

I was sure one of the Hatrackers was a Dr. but couldn't remember who. I did find a fieldguide to wilderness medicine that might be helpful to someone in that situation.

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Posted by Unwritten (Member # 7960) on :
 
But would your particular doctor have a book like that sitting around right when she needed it?
 
Posted by JeanneT (Member # 5709) on :
 
No, but she has no qualms about looting the local hospital and medical offices. The same with the medical supplies. She'll take them. But if she takes something, I want it to be something that she logically would take and that exists.

Although there is a lot of destruction there are still some buildings with supplies she can loot. It's a good point though that there should be something she wants and can't find because of the destruction. I'll think about what.

[This message has been edited by JeanneT (edited June 10, 2008).]
 


Posted by extrinsic (Member # 8019) on :
 
Modern medical textbooks, like modern doctors are highly specialized. Perhaps medical military field manuals from the WWI-WWII eras would be useful.

Organic chemistry textbooks from before WWII might contain methods for preparing and purifying basic medical preparations like penicillin. My 1860 Porter details several alkaloid extraction processes, not to mention some pyrotechnic stuff. All kinds of "primitive" chemistry methods in that book.

Willow tree bark is the natural source for aspirin. Digitalis, a medicine for heart conditions, comes from foxwood. They're easily extracted, purified, and concentrated using solvents.

A still would be absolutely essential not just for making alcohol, but for making other solvents necessary for extracting alkaloids, and for purifying other liquids. An alembic can be made from clay, but it's not as efficient as a good ole copper still. Any doctor who doesn't have access to modern anaesthesia drugs will need ether. Ether is relatively easy to make. The Civil War era method for making it is in my Porter.
 


Posted by JeanneT (Member # 5709) on :
 
The Field Guide to Wilderness Medicine is quite specialized. It discusses medical care in the wilderness when it's not possible to get to a medical facility. That's close enough to their current situation to be useful.

Chemistry texts of some kind are a good idea. She would have the skills from classes but probably not the "off-the-top of the head" knowledge for doing that. I rather doubt that pre-Civil War texts would be readily available but even a basic textbook might be useful.

[This message has been edited by JeanneT (edited June 10, 2008).]
 


Posted by extrinsic (Member # 8019) on :
 
I've skimmed field manuals for corpsmen from WWI. Those books were in the general circulation stacks of a military library.

I've seen Porter and other collectible chemistry books spanning a wide selection and range of years listed on eBay. Branch repositories of the Library of Congress have quite a collection of rare books. Porter is not rare. Many university libraries are branch repositories.

If it were up to me, my basic field kit of medicines would include;

Alcohol for sterilization and "medicinal" consumption.

Ether for general anaesthesia. Pharmaceutical grade or reagent grade until it ran out, then automotive grade if the huffers didn't get to it first, then homemade.

Lidocaine/prilocaine injections for local anaesthesia, until it ran out, then all ether as needed. Nitrous oxide is in Porter and easier to make than ether.

Penicillin for infections, made from carefully molded bread when the pharmaceutical grade ran out. I made some in my first year chemistry class in high school.

Iodine and sulfa for wound treatment. I'd grab a jar of reagent grade iodine crystals and mix it with alcohol to make tincture of iodine. Porter details how to make iodine from seaweed. Sulfa compounds date from the 1930s and aren't in my Porter, but they're readily made under primitive conditions from sulfurous acid and ammonia.

Asprin until it ran out then extract the natural compound from willows, weeping willows, or the Hercules club tree for topical and ingested analgaesics. The raw sap of the Hercules Club is a topical analgaesic.

I'd also want sodium hydroxide/lye and ammonia for cleaning and making compounds for other basic needs. Lye is easy to make, ammonia too. Lye means soap. Under primitive conditions, boiling cloth in lye is ideal for sterilizing it.

On the type I diabetes issue, the first successful insulin treatment used crudely purified insulin extracted from oxen pancreases with no noticeable side effects on the patients.
Recovery of patients in diabetic comas were swift. Pig and human cadaver pancreases have also been harvested to extract usable insulin.

The Foxfire series has a host of plant and natural remedies from American sources, plus wild food gathering, and all the basics of backwoods living. Euel Gibbons' books are another source for wild harversting. The doctor must eat.

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Posted by skadder (Member # 6757) on :
 
What would I do, Jeanne, if I were writing your story?

I would ensure that my doctor was one whose hobby/research was on bush medicine/tribal medicine, had collated lots of info on how medical emergencies were dealt with in extreme circumstances. That way she could just go, "Emergency trachiostomy--yup. I need a bic biro, a pair of scissors, and you--get some sheets."

As to what to take--ANTIBIOTICS, Antiseptics--small infections would kill loads of people--Suturing (needles and thread, forceps) equipment. She won't be able to do a coronary bypasses and her ability to heal will be restricted to what she can do. ADVANCED FIRST AID BOOK.

Also PARACETEMOL and/or IBUPROFEN and/or ASPIRIN--for fevers, from infections--also they are painkillers.

Also thermometer, stethoscope, torch. Scalpel and saw.

I am no doctor--so Sara can correct me--but I would take loads of the above, maybe some sterile dressings, bandages. You will save more peoples lives over the years with the above, than if try to cater for every eventuality.

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Posted by JeanneT (Member # 5709) on :
 
Maybe I'm making it too complicated, skadder, but wouldn't you be thinking, "What do I do when this stuff runs out?" Maybe not. Maybe you'd think about the immediate and not worry too much about the future.

There is no way she can take enough supplies to last very long though. So I'm not really sure what she would grab. Obviously she can't order something off ebay.

Oh, the "she's already an expert in survival medicine" makes it too easy. Never make life easy for your characters.
 


Posted by extrinsic (Member # 8019) on :
 
I bought my copy of Porter before the Internet came online. It cost me a nickel in a clearance yard sale that followed an estate sale. A book vendor I showed it to appraised it back then at $200. Today one in the same condition and the same edition sells on eBay for about $30. I wasn't suggesting that eBay would still be in operation after the collapse. But I would imagine similar books would either be in limited circulation or left behind in the cities.

Actually, so far, I'm reminded of Heinlein's Farnham's Freehold and the medical aspects of Richard Matheson's I Am Legend of which there were two film adaptations before the 2007 one starring Will Smith. I've not seen the first one, but I have seen Charleston Heston in Omega Man.
 


Posted by JeanneT (Member # 5709) on :
 
I Am Legend was the post-apocalypse novel that popularized the sub-genre. It wasn't the first though. To the best of my knowledge Mary Shelley wrote the first one, The Last Man. There have been hundreds of post-apocalypse stories since. Irrelevant to my question though.

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Posted by wrenbird (Member # 3245) on :
 
Hey JeanneT,
My husband is an optometrist, and there are several emergency care/basic care manuel's for the eye that most optometrists own. I am assuming that there are several like that for basic medicine.

However, he carries his around in a pdf file (or whatever it's called) in his Blackberry. Just a thought. That might make it a little more futuristic. Of course, batteries die, books don't.
 


Posted by JeanneT (Member # 5709) on :
 
Good idea. A lot is in electronic form now and it could be very frustrating when she tries to find something that isn't. Thanks.
 
Posted by KayTi (Member # 5137) on :
 
There's a great book we use in breastfeeding circles called the Nursing Mother's Herbal. A little too specialized for your case, but you might look in that general direction, or look for what kinds of texts are studied at Colleges of Osteopathic Medicine. Our doctor is a DO (Doctor of Osteopathy) and is much more familiar with things like essential oils, herbal and alternative remedies, etc.

Tea tree oil, for instance, has antiseptic qualities. Lavendar and Camomila/camomille are calming. Dandelions are useful for all kinds of things, but in the midwest where I life, they're most abundant only for about a month from late April til late May. Like most perennials (plants that come back year after year) they have a 3-4 week blooming period and then are pretty much done for the season.

The leaves of a certain plant are good to pack wounds to prevent infection...I just read this in my local paper's home and garden section. I think it's Yarrow leaves...someone more up on herbals can confirm or you can look that up - but that would be something someone could do out in the wilderness. Yarrows are in bloom right now in the midwest, most are clumps of tiny yellow flowers on 12" stems with clusters of almost silvery foliage. Tons of wildflower/herbal sites out there - do you need some recommendations? Oh, and a fun one to stick in if she's really out in the prairie is compass plant. The plant orients itself straight north/south, so that it gets the morning sun on its east face, the afternoon sun on its west face, and at the heat of the day the sun is not beating down directly on the face of the plant. It is a reasonable way to navigate to find a compass plant (common in prairie restorations around where I live) and that will help establish north/south (you still ahve to figure out which one is north, which one is south - but that's not too hard unless it's high noon on June 21.)

One thought for consideration (I've recently written a post-apocalyptic story...) is that if the majority of the population is gone, there might be somewhat large storehouses of things like medications and bandages that are going unused because there's so few people left. She just needs to find them.

Good luck - sounds like fun!
 


Posted by JeanneT (Member # 5709) on :
 
Yes, although many of the buildings were destroyed in massive fires, there are supply stores. She keeps thinking that eventually what she takes with her will run out though. So I think she might try to snag something that she would need in the future. How to make soap--distilling alcohol. That kind of thing.

Most of the medical stuff in this story is on a pretty primitive level--dealing with wounds that involve stitching someone up. But I don't want some dr. reading it and saying well any idiot should know that a doctor would pick up something or other I didn't think about. LOL
 


Posted by Corky (Member # 2714) on :
 
quote:
I haven't decided on a specialty but nothing that would prepare her for this situation.

May I suggest that you "up the ante" by having this be a psychiatrist who hasn't done general medicine in ages, and who chose psychiatry because the sight of blood makes her queasy?
 


Posted by TaleSpinner (Member # 5638) on :
 
"So I think she might try to snag something that she would need in the future. How to make soap--distilling alcohol. That kind of thing."

That's the kind of thing I'd like to see her take, because she's thinking about sustaining herself and others beyond what will fit in the SUV.

Cram it with books. How to make whisky--not alcohol dammit, whisky--dual purpose!

How to purify water. How to make fire to boil water to purify it. (Pack a kettle.) How to find water (maps showing rivers, streams.) How to stop water-borne disease. How to get rid of human waste hygenically when the sewers don't work.

How to sharpen steel. Something to heat and causterise wounds with? Some weapons. (Your female characters don't need books on self defense, right?)

How to make bandages and string from stuff you find in the forest. Herbal remedies. And for those who will die anyhow, how to make death more comfortable.

If she's a modern specialist, no matter what her specialty is, it will be almost useless if the world is falling apart. She'll have to change her game to one of life and death. So, general medical books covering the specialties she knows little of. How to run a triage system. How to recognise who will live with the treatment available, who must die. How to train nursing help quickly--the ten things you need to know to help someone live.

A book on midwifery and child rearing--assuming she makes the world a better place, they'll want kids. And some books for the kids, so they can learn how to avoid dystopia the next time around.

Sounds like an interesting story.
Pat

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Posted by skadder (Member # 6757) on :
 
Also, unless she was trained, she would have concerns about getting the right plant. You often read of people picking the wrong mushroom and dying. I would presume, as plants with powerful chemicals in them are members of a group of plants--sometimes only differentiated by size or some tiny detail--and sometimes the 'sister' plant will have something toxic in it, rather than healing.

Birch bark contains a basic form of aspirin and can be used as a painkiller and to reduce fevers. Cannabis has medical uses--perhaps she could find some seeds in a dead person's stash bag. Then she could grow it. They used to give it to pregnant women when they gave birth--yeah, baby.
 


Posted by RobertB (Member # 6722) on :
 
Honey as a wound dressing; it keeps the wound moist, is a natural antiseptic, and is coming into use in hospitals. Propolis (plant resins collected by bees) as a natural antibiotic, widely used in eastern Europe. I've cured abscesses with it.
 
Posted by RobertB (Member # 6722) on :
 
Honey as a wound dressing; it keeps the wound moist, is a natural antiseptic, and is coming into use in hospitals. Propolis (plant resins collected by bees) as a natural antibiotic, widely used in eastern Europe. I've cured abscesses with it.

[This message has been edited by Kathleen Dalton Woodbury (edited June 12, 2008).]
 


Posted by skadder (Member # 6757) on :
 
We heard you first time.
 
Posted by Robert Nowall (Member # 2764) on :
 
I'd date the present ancestry and popularity of the post-apocalyptic novel to George R. Stewart's Earth Abides rather than Richard Matheson's I Am Legend.

If one were carrying around a book, how about the Physician's Desk Reference? I think that's what it's called---I don't have a copy myself. I don't know how useful that would be in anybody's hands but a trained doctor...
 


Posted by TaleSpinner (Member # 5638) on :
 
And some 80lb bond paper upon which to write notes so she can turn the whole experience into a book?

;-)
Pat
 


Posted by JeanneT (Member # 5709) on :
 
quote:
I don't know how useful that would be in anybody's hands but a trained doctor...

Perhaps you missed the part where I discussed that she is a physician.

My doubt is that it would be useful in a situation where you don't have access to medical supplies. But it might be something she would want.

Pat, I'm sure she will never want to be an author. She isn't that insane.

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Posted by AstroStewart (Member # 2597) on :
 
My fiance is in pharmacy school about to get her PharmD, and I asked her this question to get her response. Her reply went something like this.

Firstly, many modern drugs are derived from natural sources, plants etc. She would go to a library / medical library / something and get books both on: the local plantlife of her region/her destination ; books on what plants have what medicinal uses -- herbal medicine books etc ; books on HOW to extract the useful medicinal parts of these various plants, do you chew a leaf? boil it? extract sap? etc.

Now, there is bound to be many things that can be reproduced naturally. She wouldn't bother to stockpile things like tylenol / asprin / advil / etc, because headaches, sores, rashes, common things like that won't be life threatening, usually, and will probably have some kind of medicinal treatment that could be found in the wild.

So far as drugs that she WOULD stockpile and take with her, she would take as much as possible of every different class of wide-spetrum antibiotic. Because once you have an open wound, say, and it has become infected, you have prescious little time to get yourself and antibiotic, and many modern antibiotics work against a WIDE range of bacterial infections.

Now, this is heavily from the pharmacalogical side. Obviously a surgeon would want to bring a scalpel, etc. But so far as drugs go, this is the natural instinct / response of a soon to be doctor of pharmacy.

Hope this helps. =)
 


Posted by RobertB (Member # 6722) on :
 
Sorry, my computer was misbehaving yesterday, and the site won't let me delete the superfluous copies of my post.
 
Posted by Robert Nowall (Member # 2764) on :
 
I caught the part. You know the medical profession is over-specialized these days...a podiatrist might be at a loss for treating a skin disease, a dermatologist might have trouble with a broken foot, etc... General practitioners seem to have gone by the wayside---there are "internists," whatever they are, which kind-of-but-not-exactly fill the niche. Could a specialist use the PDR properly.

Besides, there's the issue of training---when and where, and what kind. I'm reminded of Granny on "The Beverly Hillbillies." She said she was an "M. D.---Mountain Doctor."
 


Posted by MrsBrown (Member # 5195) on :
 
Lucifer's Hammer by ? and Pournelle has a wonderful description of an old man stashing away a private library before an apocolypse. He wanted to preserve basic knowledge and technological applications, so future generations would be able to recover from the loss of knowledge. Later the old man used it's location to trade for membership in a surviving social group. It was well thought out.

Given time and opportunity, perhaps your character would have similar thoughts about medicine in some of her book selections. Not to take with her, but to store, protected from theft (especially as fuel for fires) and moisture.

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Posted by Robert Nowall (Member # 2764) on :
 
Larry Niven and Jerry Pournelle.
 
Posted by JeanneT (Member # 5709) on :
 
I think a pediatrician would be considered something of a generalist as opposed to say a surgeon, although they all have to some degree generalist backgrounds. They all go through the same med school training and start out as interns so they should be able to figure out a reference book.

Astro, thanks. That makes sense although I'm not sure I follow the thinking on aspirin which can act as a fever reducer (and there was a time when people died of high fevers) as well as a pain reducer. It's not like it would take much room for a couple of thousand-table bottles and it would take some time before she could make some replacement.

The same with alcohol. She can distill it but that won't happen right away so I think she would take some as it's an easy way to sterilize and it can even be used directly on wounds.

Wide spectrum antibiotics are a good idea as long as they don't need refrigeration but many don't.

The books on making herbal medicines are a very good idea.
 


Posted by skadder (Member # 6757) on :
 
quote:
Wide spectrum antibiotics are a good idea as long as they don't need refrigeration but many don't.

Most come as tablets, IV (which would need refrigeration), or oral suspensions (which would need refrigeration). Some supensions come as a powder in the bottom of a bottle and you mix it with water when you start the course. If your doctor could get a couple of bags of amoxycillin powder (very common broad spectrum antibiotic and she could mix her own supplies), and clarithromyicin tablets(again quite common) or flucloxicillin she would be primitively covered for a wide range of infections--but obviously not all. Newer antibiotics cost a fair bit more and so fewer would be kept in hospitals pharmacies etc, as the low-cost options are usually tried first.

Again I am only a psychiatric nurse and my knowledge is very limited, I am sure a doctor will show up here and say how wrong I am!

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Posted by JeanneT (Member # 5709) on :
 
Yes, the good ol' pink stuff if available in powder form would be good. She has to think that anything that is "fancy medicine" she couldn't handle anyway. It's not like she can do heart surgery. Thanks for the suggestions Skadder.

I've actually discussed this with a couple of doctors who have a really hard time wrapping their minds around the idea that someone won't start manufacturing medicines. Post-apocalyptic novels apparently aren't on their reading list.

[This message has been edited by JeanneT (edited June 12, 2008).]
 


Posted by sholar (Member # 3280) on :
 
Not sure about this, but the effectiveness of different antibiotics might be changing over time. So, you have a population that is now using exclusively one type of antibiotic, most bacteria are going to gain resistance to that antibiotic. But, you also have a less sterile environment then you used to, so people are not going to be using antibiotic soap all the time (since it will be limited). So, the bacteria outside the body might be getting weaker. There are more resevoirs for bacteria that don't need to be resistant so you might have a higher chance of getting a disease that isn't resistant. Not sure what the end result would actually be.

I would probably also look into how to isolate phage. While that won't be good for internal stuff, I have heard of some success at preventing and treating external wounds. Anything to try and save the good stuff.

I also have read that appendicitis is more of a first world disease, so I would not worry too much about that one (and probably wouldn't include it in a story about a post-apocalyptic world).
 


Posted by JeanneT (Member # 5709) on :
 
Yeah, but this is first world even if post-apocalypic.

I'm not sure why people in 3rd world countries wouldn't suffer from it though. My point, however, was that this is the kind of emergency surgery a doctor would have to do whatever the conditions as it is life-threatening in its advanced stages. I would assume that she would put off surgery as long as possible if it came up. Whether something like that will come up or not is--open to question. I'm still in the "what if" stages of plotting. The story will more be people coping with a horrible situation than concentrating on the medical aspect.

My thought on the antibiotics is that she won't have a large enough supply to make any long term effect on bacteria. Certainly what she has will only be used when it has to be. And of course she won't have access to equipment such as centrifuges.

[This message has been edited by JeanneT (edited June 12, 2008).]
 


Posted by SimonSays (Member # 3307) on :
 
Hi JeanneT,
I can't help you much with the book selection,(I think AstroStewart is on the right track though for the long term--local plant books, etc.).
I'm not a doctor, but next (or perhaps first) on my list would be preventive medicine. I.E., nutritional supplements(vitamins,minerals,corral calcium?,...) and some books on maintaining proper hygene.
After that I think fighting infection would probably be her next biggest worry. Most people (many
doctors included, i'm sorry to say) only think of drugs(pharmaceutical antibiotics) when they want to combat infection. They don't (remember/or know) that before $drugs$, doctors, and laymen alike, used silver. (Silver foil for bandages, silver eating ware, etc.) (The F.D.A. passed silver coated bandages like SILVERLON in 1999) Silver is reputed to be the most powerful antibiotic(killing 650+ pathogens,including fungi). . . It even works against viruses, where antibiotics do not.
I would also bring a portable/flexible photovoltaic pack like they show on the Dicovery Channel's "Planet Green", and a colloidal silver generator.(technically, a silver-ion generator)(for more info. google "silver + infection", and check out "The Body Electric: electromagnetism and the foundation of life," by Robert O. Becker M.D. (a great read!) )

Steve

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Posted by rstegman (Member # 3233) on :
 
The big reason that third world countries are not as effected, is that they have so little to fall to return to their roots. They are almost living there already.

We, on the other hand, are so used to our technology and our market society that when there is a collapse, it is a real collapse. A vast majority of the people cannot even start a camp fire from sticks and stones, let alone survive easily.

Where the doctor is, makes a very big difference in what is planned and expected. A doctor in the middle of the city might be able to get loads of supplies, but one would need a special reason why the doctor survived when everybody else did not.

A doctor out in the boonies, living near a town with a small hospital, might not have to escape very far. The hospital itself could be the only place for supplies since they are trucked directly in. There might not be any supply houses around.

A doctor in a small town might not even have a hospital nearby. The family doctor would, of course, be pretty good at dealing with most problems with a limited amount of equipment or supplies. One might have to drive an hour to get to a hospital so they might not have to even leave their town. Another place just might not be any better. Small towns tend to be self sufficient anyway so they would likely stay put unless it is like those floods in the mid west right now.

I will not use the phrase
"I am not a doctor, but I played one with my girl friend one time.....


I am thinking that books describing pills and their effects would be quite useful. She finds a stash of pills, she can verify which they are and how they are used. A book listing diseases and their
symptoms. basically books outside what the doctor handled all the time. It could be the books used for when they worked emergency.


 


Posted by JeanneT (Member # 5709) on :
 
I was referring to Sholar's comment that people in 3rd world countries don't suffer from appendicitis which I find strange. In this case, 3rd world countries would probably suffer even worse--that is would have even higher casualties. But I'm not doing the I Am Legend thing where everyone dies. On the other hand, I think I'm killing off more than Niven and Pournelle did in Lucifer's Hammer.

quote:
A doctor in the middle of the city might be able to get loads of supplies, but one would need a special reason why the doctor survived when everybody else did not.

I think that is true in a post-apocalyptic story no matter what the career or the location of the character.

[This message has been edited by JeanneT (edited June 12, 2008).]
 


Posted by Kathleen Dalton Woodbury (Member # 59) on :
 
RobertB said:

quote:
Sorry, my computer was misbehaving yesterday, and the site won't let me delete the superfluous copies of my post.

I fixed it. But I have to say, RobertB, that I am impressed. I've never seen a triple post before. Way to go!


 


Posted by JeanneT (Member # 5709) on :
 
quote:
One might have to drive an hour to get to a hospital so they might not have to even leave their town.

Of course, she is leaving. The size of the town has nothing to do with it. *looks confused*

I must have explained something really wrong.

Anyway, thanks for the help everyone. You've given me a lot to think about.
 


Posted by sholar (Member # 3280) on :
 
Where I read that appendicitis occurs at much lower levels was an article arguing what the role of the appendix is. It isn't my area at all, but the basic idea seemed to be that the appendix is a storage area for good bacteria. When you get sick and flush out all you bacteria, the appendix shoots the bacteria back into your stomach. However, in first world countries, this doesn't happen, so the appendix just sits around, accumulating bacteria. And since it doesn't have an opportunity to release them, sometimes it bursts.

I have been contemplating my earlier bacteria question and I think that with the amount of bacteria used in our food processing today, the elimination of that would allow for less resistant bacteria to thrive, so I think the antibiotics are going to be more effective. Right now, things like penicillin are pretty useless (except for syphilis but syphilis is special).
 


Posted by JeanneT (Member # 5709) on :
 
Interesting about the appendix. Thanks for the info.
 
Posted by rstegman (Member # 3233) on :
 
My book as an appendix

I always wondered what if was for...... <g>


 


Posted by Robert Nowall (Member # 2764) on :
 
Right-angle thought...in Heinlein's last novel, he had a scene where a veterinarian participated in emergency battle surgery. (Even had the guy use his own surgical instruments.) I was a little dubious at the idea...I suppose many skills would be applicable, so a vet (or veterinarian surgeon) would be able to perform some emergency surgery in a pinch...I don't know how far those skills would extend.
 
Posted by annepin (Member # 5952) on :
 
Of course, if she's banking on herbal medicine she'd better stock up on a couple field guides and possibly make a trip to a botanical garden or nursery! Depending on where she is, many medicinal plants won't be growing out in the wild.

Good luck with this. Sounds like fun!
 


Posted by AstroStewart (Member # 2597) on :
 
Just to clarify my post, I wasn't trying to say your doctor shouldn't bring ANY aspirin, etc. Of course she's going to take some. But if you're concerned about LONG-term... if you're going to ransack a hospital / pharmacy and take absolutely everything they have of X drug, that's when my fiance said antibiotics.

There are many natural remedies for things that aspirin cure. Herbal teas, etc. Things in the wild that, after a learning curve, could be used as a decent proxy. It's the drugs that cannot be easily reproduced with herbal medicine from indigenous plants that should be stockpiled to no end, cases and cases, thousands of pills not hundreds.

And more common antibiotics (penicillin is a prime example) have been used and overused the the point that its potencty in the current world has gone down by a lot. This was the comment she/I made about taking as much as possible of EVERY current "class" of wide-spectrum antibiotic. That way you can use the "penicillin derivative" drugs like amoxicillin, etc. but if the bacteria become too immune to that class you can switch over to the next class.

But certainly there will be a learning curve period where your doctor will have to read and study the herbal medicine books she's snatched, and will want a steady supply (enough for a few months? a year?) of more common drugs. A year's supply of aspirin, etc. isn't going to take that much space (a year's supply for one person anyway). The other reason to stock up on antibiotics to such an extent also goes beyond one person's need for them. (How often do you require antibiotics? Once a year at most, on average?) But if there are any other survivors that this doctor finds, or expects to find, if she ends up in a small community of survivors, you have to think about everyone. The point of raiding a pharmacy / a few pharmacies / a hospital is to serve as "post-apocolyptic" doctor for an entire community, I would think.

 


Posted by JeanneT (Member # 5709) on :
 
Yes, certainly she will take all of the antibiotics she can. In fact, they will be rather important later in the story as the community's (yes, she is assuming she will care for others) most valuable assets to be used very carefully and guarded from others who covet them.

HOwever, if you think the hospitals after Katrina except somewhat worse you will see the problems she will have. It won't be easy to find what she needs and most supplies will have been destroyed. But I do need to know what she would look for and your help is greatly appreciated.

She will have a steep learning curve. She isn't trained for this kind of medicine but she can learn. And of course she has to plan for the possibility/probability that she will have to train any future doctors for her community.

This story has grown from what I originally envisioned. It's nice when one takes on a life of its own.

Thanks again for all the help everyone.
 


Posted by jdt (Member # 3889) on :
 
Hey,

I'm late to the party, but:

Why didn't the crusty old country doctor "uncle" who inspired your protagonist to become a doctor when she was a young girl have a copy of this stuff in his library? Why didn't she read these materials when she was a kid? And why doesn't she break into his widow's abandoned house to get them? It might make some good backstory, too.

Joe
 




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