Medicine used to provide localized care. Doctors and apothecaries where located in each small town. The doctor would provide care from ‘birth to grave’ meaning that she would take care of the majority of ailments found in the community. For the rare occasions where specialized care was necessary, the physician would send the patient to the nearest hospital for extended care.
This medical model was used until around the first part of last century. Then something happened. Doctors became god. They started to expect more pay, more specialties emerged and soon consultants and specialist learned that the real money was not in rural healthcare. Physicians flocked to the big cities to get their piece of the pie. No one wanted to practise medicine in the small towns anymore. General practitioners became scarce. Now the rural townsfolk could not go to their local doctor anymore but had to travel to the nearest hospital and wait for hours to be seen.
What really made changes were the invention of high technology medicine and the immergence of the pharmaceutical industry. Both of these modalities have been integral in saving countless lives. It is important to remember that. What I am referring to is that they created a separation between the doctor and patient. The patient started to put the doctor on a pedestal. As more pharmaceutical discoveries emerged, the patient gave up their control over their health and collectively decided that it was preferable to just take a pill for a problem instead of changing their lifestyle.
High technology in medicine has provided extensive diagnostic advancements that also have saved countless lives. Doctors and other medical professionals have relied heavily on technology so long that their physical diagnostics skills have all but vanished.
My question is this: How will modern doctors be able to provide medical care without the use of both the technological toys to diagnose or the benefit of pharmaceuticals? Both of these options rely mainly on the access to unlimited supplies of energy and petrochemicals.
Enter Community Oriented Medicine
We must prepare ourselves for the time when technological based medicine and access to unlimited pharmaceuticals comes to a halt.
My thesis is that we can minimise the collapse of modern medicine by creating Community Oriented Medicine.
Community Oriented Medicine (COM) uses what works to provide ‘birth to death’ healthcare when access to Modern Medicine in unobtainable. COM will continue to use all aspects of Modern Medicine that have survived the energy collapse. That would include knowledge of anatomy, physiology, biochemistry, clinical laboratory diagnosis, and medical advances that ended so many of the historical diseases. We do not immediately get kicked back into the dark ages. We have a tremendous amount on medical knowledge that was gained over the past hundred years.
COM will introduce a collaboration of the remains of Modern Medicine with Herbalism, Osteopathy, Acupuncture, Naturopathy, Preventative Medicine and the current Wilderness/Military/Expeditionary Medicine. There are many benefits to currently seen in the use of alternative medicines. In the US this is a multi billion dollar industry as people realise that there are better options out there.
Let’s look at each of the medical specialties that will be available after the collapse.
Modern Medicine
The current model of modern medicine will provide the base for our Community Oriented Medicine. It has been the most successful medical model we have seen so it only makes sense that it will provide most of the methods for medical care.
Before 1900, modern medicine was mostly sustainable. Doctors were taught the skill of physical diagnosis in medical school. There was little need for an X-ray exam for most of the minor injuries sustained. Even in the current system most of the X-rays taken are only to confirm what the doctor already knows and also to cover themselves from lawsuits.
Many of the skills found in modern medicine will transition safely past the coming collapse. Symptoms of disease will remain the same, the ability to set broken bones, surgically remove an appendix and even the ability to stop massive bleeding will not change.
What will change will be the specialties of medicine: Oncology, Cardiovascular surgery, and other specialties that rely heavily on energy will have to discover ways to continue medical care without using petrochemicals or massive amounts of electricity.
Without these specialties there will be an increase in mortality. People will not recover from heart attacks. There will be steep learning curve between the lack of modern tools and the innovation and invention of sustainable approaches to specialized medicine.
Alternative Medicine
Over the past twenty years there has been resurgence in alternative medicine. Under this modality is Acupuncture, Naturopathy, Osteopathy, and Herbalism. There are far more alternative methods out there but I have limited it scientifically proven treatments.
Acupuncture has been used successfully for over 25 centuries. It offers treatments based on the Asian method of diagnosis and understanding of a different view of anatomy and physiology. Acupuncture and Chinese Medicine provide an ideal way to provide ‘birth to death’ healthcare.
Naturopathic and Osteopathic Medicine find their roots in the Nature Cure movement from the early 1800s. Germany and eventuality England and the United States embraced Eclectic Medicine. These practitioners were prosecuted by mainstream medicine because they refused to treat their patients with mercury and blood letting which was a common practise for physicians. The Nature Cure doctors chose to use herbs, hydrotherapy, diet and nutrition to heal their patients. This lasted for almost one hundred years before the Flexner Report of 1910 made it illegal for those medical rebels to practice their heretical craft.
Herbalism offers a highly effective means of medical treatment. Before the use of oil, pharmaceuticals were made from natural materials. The list of medications that doctors prescribed used to be mostly from plants. Modern Medicine is also prosecuting this heretical approach. In the United Kingdom, herbalists are protected from a Royal edict that allows for the use of herbs from medical treatment. Herbalism will find its feet in the coming Change. People will need access to medication and the plant families will be a willing contribution.
Each of these alternative options will be greatly needed at the 21st century unfolds. There are more alternative modalities out there and hopefully the useful one will prevail.
Military /Expeditionary/Wilderness Medicine (MEW)
I chose to leave this last category for the final entry. I feel that this medical model will have the least amount of adjustment needed in the coming Collapse. This medicine emerged from the times of disaster and extreme austerity. It has gained its feet in the past ten years during the Constant War that the Americans are fighting as well as providing excellent medical care in remote environments. The lessons learned and the technologies discovered have made MEW medicine a viable healthcare option.
The disadvantage of Remote Medicine is that it still is energy intensive. Evacuation protocols are usually in place. Remote Medics often deploy with a large amount of medical gear. But once they have used up their supplies getting replacements is often delayed or impossible. The ability for the Remote Medic to rely on her skills to offer medical care will be a huge advantage in the next decades when the entire world is in austere conditions.
Community Oriented Medicine will have to evolve to use each of these medical specialties to the best that the post collapse doctor can provide. This post collapse doctor (PCD) will need to change the way the she views medical care. She will not have the technologies currently available. She will have to adjust into a PCD that uses what she has on hand while learning, evolving and creating a new Community Oriented Medicine.
More information can be found at www.ipna.ie.
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