h/t WRSA
Okay, great.
What you've done is tell me about your first aid kit for Apollo 11. (And, don't get me wrong, you've nailed that, as far as it goes.)
What you've forgotten is, you forgot to invent NASA.
Or build a rocket.
"Other than that, Mrs. Lincoln, how was the play?"
The wheels all come off right here at Point Four:
- Stay connected with guerilla hospital and any available higher medical care
Um, excuse me, what "Guerrilla Hospital"??
The one you never planned for? Nor built? Nor stocked? Nor staffed?
Look, if this is just for mental masturbation, ROWYBS.
If available higher medical care means "you're going to be turned in to the authorities, and get tortured for information just as soon as you're well enough to tolerate it, and then be executed for sedition", what you're planning for is "shoot the wounded". We've already dismissed that clever plan long since.
So instead of telling us about the glorious flag pole on the skyscraper, humor us by telling us about the foundation, and the 100 floors from that to that flag pole, first. Then you can tell us about how the stars on the flag will be embroidered.
We're kind of sticklers for building things that way, as a recipe for some chance of success.
Just saying.
Hospital?
Where are you going to get your trusted doctors and nurses? (You ain't got those? You ain't got a "hospital.")
Where will you get your supplies, particularly medicines, in quantities of which you have no wild idea? (No medicines, in quantities approaching "metric fuckton"? No medicines, no hospital, even if you had the entire medical personnel available of the United States.)
The other supplies, from food to linens to sanitation to mortuary to consumable supplies (bandages, etc.) that you'll need every single day forever? Like rust, infection never sleeps.
Go to the local big-city hospital. Now, tell me how you'll be hiding that. Show all work.
Now, tell me the supply chain to get all that stuff, and keep it coming. From Wherever to You. Again, show all work.
This is like telling me how to operate the automatic body welder to make a Ferrari, without having a car factory. Or steel. Or tires. Or gasoline. You get the idea.
Amateurs talk tactics. Hobbyists talk strategy. Professionals talk logistics.
So, did you really want to talk about the weather, or just make chit-chat?
You wanna get into the real details? Cool. We've gone into it a time or three regarding bare-bones starting points. We've barely touched the tip of the iceberg, but you'd better start off by recognizing that iceberg before you hit it, and we welcome bigger and wider discussions.
Which you'd better have, at least with yourselves, if you want to do something besides kill your own people.
(We leave the greater question of "Partisan Medics? How about you start with some Partisans first?" for another discussion, another time.)
22 comments:
As much as I enjoy your commentary on these articles given your medical expertise... You have any solutions? I'd love to see Aesop's handbook for guerilla medical care. I'm not being sarcastic either.
Only solution I can think of is making the effort toward securing adequate medical supplies and recruiting (not drafting) sympathetic Nurses/Doctors for the war effort a priority. How to accomplish that I still haven't figured out. Unless they are sympathetic to the cause and are willing to accept promissory notes.
How to create the organizations?
The Democrats created their Political Control organizations. How do you think they get 100% of the 125% registered voters all for Democrats in the Philadelphia Ghettoes?
The old Democrat militant wing was the KKK. It controlled the Sheriffs Departments, Police Departments, District and county attorneys, and all the "right thinking people." The "good people" either agreed with the Klan, or were terrorized into submission. Plain Old Terror was used on Blacks and others. Read the stories about Republican Newspapers being burnt out and presses smashed, and Republican Editors being lynched.
Now the Democrats, Democrat Socialists, and Progressive Communists will use Anti-Fa, BLM and other "allies" to provide the shock troops.
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Baden Powell invented the British Boy Scouts. The Soviets used the Young Pioneers. Adolf had his self named Youth Organization.
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Who or what can the traditionalists develop in the US? The Boy Scouts went big corporate, then sold out to Big Gay and LGBTQ rights. I would not be surprised if the scouts come out with a transgender transition merit badge in a few years. The Girl Scouts are not any better.
Does your Church have a youth organization? Can you get a half dozen like minded husband-wife teams to start or expand one? Money is necessary, but active, involved volunteers are what make the difference. What to teach? A little Bible study, traditional skills like mechanics, camping, swimming, carpentry, gardening, canning, baking, sewing, multiple levels of first aid, and shooting, driving, etc. Teach civics, responsibility, love. Teach morals and ethics by living them. Make it fun for the children and teens. Get the other parents involved. "Sure, you teach about computers, and Janet and I will help you out."
Do you have a Red County Sheriff? Do they have volunteer reserve organizations? How about volunteer Search and Rescue organizations? Volunteer Fire Departments? Organize and get training. Work together. These are great places to collect multi-purpose equipment and supplies.
Don't try to make them into a Gadsen Militia, or worse a GOP RINO Cheer Squad. Find the like minded, sober, moderate like minded individuals. Screen out the hot heads, the sketchy, drunks and druggies, the provacateurs, the "I can get illegal shit" guy. Likely they are Feds.
@ Unk 5:44P
Follow the embedded links ("a time or three") at the end of the article for some basic considerations. Those are starting points. But if you ain't got no shadow complete health care system, you ain't got no "higher medical care". Which kind of makes anything beyond boo-boos and band-aids kind of pointless. If you want to plan for the level of care you had during the Civil War (back-bedroom home nursing, minimal medicines, no infrastructure, etc.), you'd better plan for the casualty rates you had during the Civil War.
@Anon 7:55P,
I'm sure that was an answer to some topic in your head, but it has absolutely nothing to do with organizing, equipping, supplying, and maintaining an alternative health care network during an insurgency, which was the topic of this post.
And none of what you mention will be worth a bucket of warm spit in terms of setting up "guerrilla hospitals", or anything like. Thanks for playing.
I get you want to be snarky and that the article may not delineate every aspect of what is hinted at, but at least they are trying to instill a mindset and train people to help. Asking where their "guerilla hospital" is at is akin to asking someone on the underground railroad where their train is.
I get that you want to sharpshoot the host, but someone whose "guerrilla hospital" is as wholly imaginary as the train on an "underground railroad" would easily be able to point to the local cemetery in reply.
QED
Bummer for your poorly chosen simile, but hilariously appropriate to prove my point.
Generally, one builds the ocean liner before they worry about the wallpaper in the staterooms or the china and silver in the dining room.
There's nothing wrong with instilling a mindset or training people. (And as I noted, what they said about medics per se they got spot-on right.) But generally, setting them up for failure ("Your tourniquet application was timely and splendiferous, but unfortunately, lacking an OR, anesthesia, trauma surgeon, antibiotics, blood transfusion, or an ICU, they died anyways. Bummer, eh?") is a poor way to say "Hello". Making reference to imaginary health care facilities and non-existent systems isn't going to save anyone. It's just boob bait for the bubbas.
They can get that from ABCNNBCBS.
In the cowboy TV shows of my youth, they just shoved a red hot poker into a gun shot wound. Up and riding a horse the next day.
Modern doctors practice modern medicine. With rare exception they CANNOT practice the same way it was practiced a half or more century ago. Thdat mean without modern imaging equipment, especially a CT scanner and lab tests they are hamstrung. Capable of only the most basic interventions. The kind of medical care that yo momma might be able to provide. So when the balloon goes up anyone who is an" enemy of the state" had better not have a heart attack, get septic appendicitis, or suffer serious trauma. Because serious medical conditions will be a death sentence for such people. That is reality. Have serious asthma? Diabetes? Unless you are on the states approved list your death is certain, a slow one but inevitable.
To be fair to the writer, he did say he would address the "guerrilla hospital" in a future post...
To be even more fair, without clear front lines and non combat areas, hospitals and other medical facilities themselves will mostly go away from lack of security, supplies, personnel, etc. They will be targets for
I think that a partisan medic would need to be more of a wilderness EMT type, expecting support to be a long way and a long time away. I think it would be useful to learn from lean medical care in the Third world and get into the habit of working without a huge logistical tail, which necessarily means finding ways to maintain sanitary conditions without the mountains of disposable supplies Western medicine has grown used to. And yes, this means more work and fewer good outcomes, but with thought and planning I think an experienced nurse or doctor could come up with ways maximize their situation. It would, of course, help to have relevant items on hand such as an autoclave and instruments that can be cleaned in it.
Aesop, what are you thought on how to minimize bad outcomes in a situation like this?
First, im no genius. I do have 30 years of healthcare experience starting in the ER, then ICU, and i have been providing anesthesia for the last 15 years. That knowledge and EXPERIENCE makes me useful.
If you doubt Aesop on this, then prove him wrong. Do the math. I came to the same conclusion.
The best i can come up with is supplies to keep me out of the ER on a Sunday evening.
I can close a wound and give some fluids. Splint a fracture, remove ocular fb and patch a corneal abrasion. Oh and by the way, the shit outdates. And how sure are you outdated meds are fine? Do you want that yellow liter bag of Ringers? Hard pass for me.
Concentrate on the basics. Clean, safe water. Hygiene. Food safety. Physical security. Adequate tools and supples. How are you gonna keep things clean? How are you gonna repair what gets broken?
Everything in any society runs on systems that create logistics, manpower and use of resources. Why is this so hard to understand? That truth doesn't change just because we hope it will....keep up with the common sense Aesop.
What a snarky hit piece on a well thought-out post.
"There's nothing wrong with instilling a mindset or training people. (And as I noted, what they said about medics per se they got spot-on right.) But generally, setting them up for failure ("Your tourniquet application was timely and splendiferous, but unfortunately, lacking an OR, anesthesia, trauma surgeon, antibiotics, blood transfusion, or an ICU, they died anyways. Bummer, eh?") is a poor way to say "Hello". Making reference to imaginary health care facilities and non-existent systems isn't going to save anyone. It's just boob bait for the bubbas."
So it goes back to "The dead cost nothing." Put a few more magazine pouches on the carrier instead of an IFAK. No point in providing first aid because there's no hospital. Is that pretty much what you're trying to say?
My question to all the "revolutionaries"....where is your infrastucture/support system for bringing down The System?
I spent six years as a paid on call EMT with my city fire department. I did it to innoculate myself from the stress of trauma. Seeing a severed arm and smashed knees in auto accidents was eye opening and reviving drug overdosed people helped me to act decisively. I have since compiled medical supplies I know how to use for the common ailments we saw. Narcan, epinephrin, glucose, etc plus lots of antibiotics and over the counter meds. I know the five doctors in my neighborhood well and would tell them of my supply larder if appropriate. I also acquired two nebulizers along with Albuterol to treat asthma issues. I’m not s doctor but I have resources I believe can help me get through tough times short if a wound requiring surgery.
You're entirely right. "Guerilla Hospital" is like a bunch of drunk friends suddenly deciding at 11pm on a Saturday night to "form a band."
This is actually the common thinking in many large prep groups, especially the loathesome Oath Keepers - of I which I was part of in Yavapai County until I got wise. They "stockpiled" med gear which was really just gauze and DME stuff left over after grandpa kicked off. Thrift store crap.
I remember coming back from an ACEP conference in Denver and having lunch with the leader and "doc" who always wore a stethoscope around his neck. "Well guys, I spent many thousands of dollars to enter the emergency medicine field and here is my report..." I was cut off with "What we really need is a vascular surgeon."
The shit has hit the fan, these clowns think they are going to treat people on plywood and 2x4 makeshift tables in the gym of a church and... "Oh we need to suture up an aorta."
I've been immediate responder in many car wrecks, the most recent two weeks ago. Observation: nobody knows (or wants) to do jack shit.
These people are just playing and the comments here are a tantrum when you point that out.
Forget stroking the newest HK handgun at the gun store and get 'yo ass trained up on trauma care. Buy the gear, the good stuff. Learn how to use it.
How do the Cartels in Mexico do it?
I'm sure life flight helicopters are used for other things.
@Anon 8:40A,
What a stupid comment on an article with a gaping hole where its brains should be.
You want to start the topic, you better bring a modicum of common sense.
Depending on fairytales ≠ common sense.
If you're going to talk about something you're going to rely on, tell us how that happens, before you start planning the menu for the dinner at the mansion you haven't built, with the millions of dollars you don't have, from the treasure you haven't yet stolen from the giant's castle you haven't gotten to, because the magic beans haven't sprouted yet.
@Anon 11:19,
No, and obviously, following links was too hard for you.
Go back and try it again, and then take another shot by using your eyes to read instead of your keyboard to type, to imagine what I'm trying to say, when I already said it 5, 8, or 9 years ago.
You have a range of possibilities.
They depend on how well you plan ahead.
Just like dinner, you're only going to have then, what you prepare now.
For you, "bring a large supply of body bags" should probably cover all your first aid needs going forward, unless you smarten up.
That stinging sensation is your head meeting a brick wall.
@Bill,
They point a gun at the doctors' head, and tell them what to do.
This leads doctors to either go along, or GTFO. Or both: once for the former, and then the latter as quickly as possible.
Which tends to kill health care for everyone.
This is why Mexico is no one's destination for top-notch medical care.
"@Anon 11:19,
No, and obviously, following links was too hard for you.
Go back and try it again, and then take another shot by using your eyes to read instead of your keyboard to type, to imagine what I'm trying to say, when I already said it 5, 8, or 9 years ago.
You have a range of possibilities.
They depend on how well you plan ahead.
Just like dinner, you're only going to have then, what you prepare now.
For you, "bring a large supply of body bags" should probably cover all your first aid needs going forward, unless you smarten up.
That stinging sensation is your head meeting a brick wall."
Please spare me the snark. I am still in agreement with you. The level of planning you're suggesting I can't accommodate at the moment. Nobody I know personally can accomplish it either. Even if I were to attempt to do so it would only be enough for a patient or two at most. Not sure what chest seals or chest needles are going to accomplish without the preparations you're listing. Even then if any of us were to pool our resources to reach that goal we're still short of medical personnel. So the designated space and supplies would serve no purpose. Outside of a lot drop. Didn't say or suggest giving up. Just saying that if tomorrow everything went to hell why should I strap on an IFAK when I don't have access to adequate medical care or the preparations in place to provide that care? Going to focus on solving the problem of not having experienced medical staff. Guess I should start hanging out with people who work at the local ER and hope I find some like minded people.
Fair enough. My apologies, by with Anonymous users, I can't tell which one of the 17 Anonymous commenters anyone is, so when someone asks questions I've answered...
At any rate, an honest question deserves the snark-free version.
1) I posted a pretty thorough article on why nobody's shooting the wounded, and linked to it.
2) Doing nothing is similarly not an option, and for pretty much the same reasons. If getting shot is a death sentence, ain't nobody who's gonna do gangster things.
3) Lacking higher care, you should still do first aid and even CLS/TCCC things, because you don't know how things will turn out, or what may happen along. Worse than doing something "futile" would be not doing something easy, and then you somehow get the opportunity to get your patient to definitive care, but you threw up your hands and did nothing, so now they're dead, or expectant and non-salvageable, because you didn't do what you could.
4) Chest seals and chest needles keep someone from dying right now. If you didn't use them because you didn't have them shame on you. If you didn't use them because you used all you had up, and can't get more, sh*t happens.
5) Your situation is going to be like the medic in Blackhawk Down taking care of Cpl. Jamie Smith: even if you and the casualty(ies) are screwed, you still have to do everything you can with what you've got.
https://www.youtube.com/watch?v=jqyFi_l1lZs
That's as real as it gets.
There's one other moment in film that conveys it pretty well, from The Grey:
https://www.youtube.com/watch?v=QNMiH_LaJu8
Gonna be a lot of that.
I point to movies here because I can't show you what it's like in Main Trauma, and it's a lot more hectic, and less frequent (thank a merciful heaven).
Without people or supplies, it's going to be come tediously regular.
Get as many supplies as you can manage, now, while it's easy, and get as much training as you can manage, and try to find higher-level people.
You can only do what you can do.
But abandon any illusions that this is going to be a campfire weenie roast.
It's doubtful anybody will ever make a movie about field surgery at Antietam or Gettysburg, anywhere close to the reality; people would be puking in the aisles.
And that's the closest thing I can think of to what any of us might face, or what people are dealing with daily in Ukraine, or anywhere else with combat so brutal and wanton.
You'll probably never feel abysmally bad about trying your best, and failing.
But you'll regret not trying at all, or knowing you could have prepared better, but didn't, for the rest of your life.
Crappy, but there it is.
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