Wednesday, April 16, 2008

Contest Winner!

Jesse "Doc" Wendell! He wrote this comment when he thought I was being dismissive about his skill set.

You're confusing road bikes with off-road. Off-road rides ANYWHERE. Including up and down the sides of mountains.

The Wright Brothers built bicycles. If you think roads are going away, even after an oil blowoff, you're mistaken. Horses... they'll be around. Trails. All these call for bicycles, the single most efficient means of transportation ever invented. Even people who can't afford a horse, can afford a trail bike.

The WHEEL has been around forever, and there are plenty of wheels which don't require -- at all -- a rubber inner tube. There is enough other rubber in the world that in my lifetime, I'm not at all worried about running out of tires for bicycles, even if it is re-purposed use.

Again, what is going to matter isn't road bicycles, the kind the Tour de France rides on, but off-road bikes. With shock absorbers, that can go anywhere. Or the bicycles which are just for putting around, go down to the market and back, haul a load behind you back to the house. EVERYONE will have a bicycle. We are rapidly getting all of the tools to repair them right here in my home. Chelsea (daughter #2) works (when she's not in college) at the leading bicycle shop in our town) and is getting better and better at bike repair all the time. Not to mention all the various bikes I personally own.

As for being a medic, when was the last time you had someone put in a chest tube on the fly when your lung was collapsing? Made out of improvised parts? I can chest tube you or someone you love, using ordinary household goods including a glass bottle (just like those found in caning though bigger is better) successfully put in a chest tube when your lung decides to collapse due to your pulmonary edema from having smoked your whole life. I can also successfully do most minor surgery, for example, open your airway with a knife and a ballpoint pen casing. I lost count years ago of how many (100s of) c-sections I've watched, scrubbed in or passed instruments for. I'm not going to open the cranial cavity (short of drilling bore holes with a neurosurgeon talking me through it) or chest cavity, although I won't hesitate to stick a needle in your heart or do a pericardial centesis (sticking a big-ass needle in) to relieve a tamponade (a heart which is leaking into the sac around the heart.)

You should think of me as the hands and eyes of a full-blown emergency physician, who just is not likely to settle down in your town. That isn't how things are going to shake out in terms of their practice after this oil outage. But I will end up in your town. It's towns like yours which will need medics. And I can do much of the day-to-day'ness of what she (the emergency doc) can do, right now, and will learn the rest, fast. Because medics are going to be your doctors.

In the absence of oil, expect the standards of practice for medics and nurses practicing alone to change massively; we'll be allowed to radically increase our scope of practice. With a video camera and high-speed internet over my shoulder, I can hold the scalpel for a surgeon at the ivory tower medical center, whose job it now is to supervise 30 medics in the field who are performing surgeries and day-to-day primary clinical care. This is the kind of restructuring of standards-of-practice one would expect to see VERY fast in the absence of oil. It isn't that in this new community you're building I might fill in for a doc; it's that I would BE your doc, working remotely under telephone/video conferencing/supervision.

*smiles* Chemists are important. We all need medicines. But you have to be alive to use them. Worst case, you can trade for drugs with a neighboring town. When you need someone to put in a chest tube, you need them to come right fracking now. I am that NOW. And I have my own bicycle and up-to-date medical and surgical kit. *laughs*

Finally, people talk to me. With my walking stick, I am the picture of the old family doc. If we really do go back to this small-town no-oil world, what makes the difference is the internet and being connected to the outside. It won't be the dark ages. We'll have enlightened practice standards. But it will be folks like myself, and clinical nurses doing the actual surgeries and day-to-day work, under the guidance of docs in the main med centers in the metropolitan areas. Those docs -- just like Judges used to do -- will "ride circuit", once every three months, and see the worse cases, the ones which are too tricky for us to touch. But day-to-day, we're going to do all of the medical care, appendectomies, ob/gyn, routine bowel work, asthma/copd, hearts not requiring open heart work, heads not requiring surgery (bore holes okay in a pinch), and so on. We'll have say, two ICU beds locally, maybe three, one surgery and a recovery room. The autoclave for our surgical instruments if nothing else, can be fired with wood/steam.

This will work just fine. The small town will get better medical care than many people in the U.S. get now, because they'll have someone ready-to-hand who follows them from birth, who knows them all, and for whom preventative care is a must.

This is what I'm bringing to the table.

I graduated second in my class from the #1 ranked paramedic program in the United States. You can always trade for drugs. You want your doc living and working right there in town, available 24/7. Plus, um, with my own bicycle, in repair, ready to go. Heh.


There may be lots of rubber, but what about glues? Internet? Surely you jest. It's not because I think he's right about what skills he would be bringing. We still disagree on that. What tipped it in Jesse's favor was that he stood up for himself. That he has a sense of what he is worth, and the worth and abilities of his family. That's the spirit that will bring us through.

Here are some thoughts on courage:

The bravest are surely those who have the clearest vision of what is before them, glory and danger alike, and yet notwithstanding, go out to meet it.

Courage is doing what you are afraid to do. There can be no courage unless you're scared.

Eddie Rickenbacker

This is no time for ease and comfort. It is the time to dare and endure.

Winston Churchhill

The cowards never started. The weak died on the way. The strong made it through. They are the pioneers.

Willa Cather

Private Joker is silly and ignorant, but he's got guts. And guts is enough.

Gunnery Sergeant Hartman, "Full Metal Jacket"

That's why you have a chance Jesse. Guts is enough. I expect that when you were faced with a three or four mile ride to the site of the emergency, after somebody made the three or four mile ride to tell you that there was an emergency, you'd try. I imagine that when the bicycle proved to be less than useful, your daughter would figure out a way to turn into a cane crush or a pump for water. You'd stand up for yourself.

That's what we'll need. I'd probably find my way back to the White Mountains. That's where the Raven Soldiers gather in times of trouble.

Nohwi'odla nayid ntaahgoh, nhildizitigo adanizih, yexaaiidelah go deyah tc'indii

(our character has been tested, we proved strong, having been prepared we walk, all our people say this)

From The Song of the Ravens by Soulflyer, born to the Bear Clan, born for the Flute Clan

Email me your shipping information Jesse and I'll send your book.

Big Brass Blog


Blogger Sherry said...

i think you are right.

but, as far as being the type to survive or help others survive some of us are way tougher than we look, or look like we've lived thru.

1:00 PM  
Blogger seventh sister said...

Good choice. great essay.

1:37 PM  
Blogger angry ballerina said...

I printed that up and put it in my office.


1:39 PM  
Blogger Lisa said...

I love your rationale. Spunk and commitment count for a lot.

3:10 PM  
Blogger seventh sister said...

mb, you have to read this post on the chocolate zodiac

check it out and have fun

6:49 PM  
Blogger konagod said...

I guess I got tied up in my gardening and yard maintenance skills! Haven't been over here in awhile and missed it all! :lol:

8:51 AM  

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