Thursday, May 27, 2021

The Collapse LXV: Health

 26 January 20XX + 1

My Dear Lucilius:

One thing I think of as I sit here, day after day, trying to stay busy and engaged and waiting patiently for a Spring that constantly seems forever out of reach, is the reasonable health I have enjoyed this past year.

I have always enjoyed moderately good health, with the caveat of course that age is the great leveler of us all: with the exception of the usual aches and pains of sore knees and a lower back that needs monitoring, I have little to complain of. Working to stay active, especially when I moved here permanently, during the Winter months was a challenge, but a resolvable one with the proper equipment.

That said, I realized this morning that I have not had a cold in well over two years.

The answer, of course, is pretty easy: no people. Or not many, anyway. Young Xerxes, when he comes by. An acknowledgment when I am watching the road coming in, from time to time. But really, that is it.

It does make you wonder about the urban areas though – perhaps like the ones you find yourself closer to (though not fully by choice). People, all the makings of epidemics – and the health services which are undoubtedly very much less than they once were, if they are at all anymore.

Not that we are in any wise better, of course. The regional hospital is about 25 miles away – an easy 30 minutes back in the days of fuel, now a solid day walking to get there and another to get back, assuming that they are still open (they are not, so we hear). If you have an “emergency” anymore (and I suspect our definition of such things has changed dramatically), do not count on making it there in time for a resolution. We are thrown back on our own resources, in this as in so many other things.

And although we may (at least temporarily, if not more permanently) now lack the benefits of so defined “modern medicine”, we at least have practices that our ancestors – even our very recent ones – did not. Wash your hands regularly and practice general good hygiene (thankfully, we know how to make soap now, although like so many other humble items I am sure it will become a trading good rather quickly). Eat sensibly, and in general monitor your intake of things like sugar and salt (sugar is a passing problem I suspect; give this interruption enough time and sweets and the resultant tooth decay will be a very small problem). Brush your teeth. Care for wounds quickly. Keep the weight down and the activity up. Protect your hearing, your knees, and your back (you will need them all).

But at best these are all maintenance activities. Unless things turn around fairly quickly, the great advances of modern medicine will have gone beyond our reach to recover them. Instead, we will be rewarded with conditions and diseases that we in the modern world thought we had conquered long ago, without the benefit of the modern world to fight them.

One wonders, Lucilius, if those who blithely continued down this path of interrupting our ability to create and build and replaced it with a philosophy of the generous spending of others’ money, of replacing the independence of the individual and the sharing between individuals to the enforced cooperation of the caring collective, foresaw such impacts in their grand social plans? No matter; they forgot the most fundamental point of macroeconomics that I learned long before the then-current system had existed: the modern economic system was a highly complex systems depending on multiple inputs and stasis to bring us wonders beyond compare. Break that system in one place just enough, and the whole thing – not just the thing one was trying to “fix” – comes crashing down.

We used to have highly effective compounds and materials to fight contamination. Within my lifetime, we may very well be back to boiled water as the primary instrument of sterilization. If this represents progress, my hands are too small to grasp it.

Your Obedient Servant, Seneca


  1. We are all mortal. But the goal of healthy living is "compression of morbidity". Instead of declining over years in a wheelchair, we hope to fade away in a week or so when the need is inevitable.
    That said, I've had a wake up call like no other this week. Monday I had a general, diffuse but painful bellyache all day. It seemed to wax and wane in severity, but Tuesday morning it had migrated to the right lower quadrant, at which point I said "Uh-oh" and headed for the local walk-in in clinic. Yep, appendicitis.
    Now bear in mind that our small town has a Safeway and a good hardware store. Any other shopping is ninety miles away. But our little old country hospital was amazing. The NP who saw me clued right in to the problem, ordered labs and a CT--yes, we have CT, MRI, and Ultrasound. The films are read in the big city 170 miles away, but with everything online, we had interpretations in thirty minutes. We had a surgeon on hand, and as soon as OR could prep the room, they had me in. And it was a modern laparoscopic procedure, no four inch incisions and weeks of recovery, just three small holes punched in my abdomen. I am so blessed. We got it out before rupture (which always was a sure death sentence before powerful antibiotics), so I should be on the mend in a couple days.
    My point being that in a true collapse environment, I would be near death now if not already gone. So, as my philosophy professors taught, in thinking the thought through to its ultimate conclusions, no one who does so would want to see us delivered back to 19th century health care. I am always seeking to increase my medical knowledge and supplies, but first aid is always predicated on getting to "second aid" for serious treatment. As Seneca notes, if the facility is a days walk away and closed when you get there, what is to be done?
    In a collapse, one of the near term causes of mortality will be people who get hungry and thirsty enough to eat and drink things they shouldn't. Intractable vomiting and dysentery can kill in short order, not to mention a society that has no concept of hygiene when the water stops running. I have enough calcium hypochlorite stored away dry and sealed and the equipment to treat thousands of gallons of water. I have just recently been learning of Dakin's solution for wound debridement. In our ancestors times, the most trivial wound could get infected and kill in short order. Once you can get past the politics in healthcare, we truly do live in an age of miracles.

  2. Greg - First of all, I am extremely grateful for your happy ending (and relating the story); my nephew also had this happen to him within the last month (same three holes). And you are correct: prior to the 20th Century, this would have been a death sentence indeed. Now, we take it all for granted.

    Medical Knowledge is important - something I am actually not as facile with as I should be. Some of it, I wonder if a lack of confidence brought on by our specialized society in which "other" people handle it. But, as a great deal of the country saw in February, it does not take a collapse to have a specialist not available, merely an interruption.

    I need to start doing as you have done. As you have said, in a significant failure there will be a lot of misery from spoiled food, bad water, and poor hygiene (do people even remember boiling water was, once upon a time, the sterilizing agent available?).

  3. I am curious as to why Seneca doesn't consider the ancestral skill of herbal medicine. Seems a logical course of action, for whatever it's worth.

    Regarding the complexity of our economic system, I perceive that, although I do not understand it. Actually, I'm amazed it hasn't come crashing down around our heads already.

    1. Leigh, Seneca is no better than many others in this instance - quick in some cases, slow in others. I suspect in this case - between his relatively good health and not having to really fact the issue -he has not considered - yet - herbal medicine. Even with all of his efforts, in some ways he is still rooted in "The Modern World". (Although that will have to change here soon enough).

      My ability to understand the system was eclipsed long ago. At this point I only understand it is terribly complex and fragile. And terribly complex and fragile things do not have a solid history of surviving.


Your comment will be posted after review. If you could take the time to be kind and not practice profanity, it would be appreciated. Thanks for posting!