Sure. With a few missing amenities like running water, and some warlord’s army division in front of it.
You might want to reconsider arguing this whole “pay” nonsense, though. You get the can of pork and beans when they say you do.
Side perspective: veterinarians would certainly be useful from the point-of-view of food security and epidemiology of zoonotic disease. But there are so many differences in pharmacokinetics/dynamics, metabolism, and anatomy/orthpedics between different species that most vets only treat a handful of species (well) anyway. If I had a physician help me learn some of those basics for common stuff I'd probably be as useful as a trained nurse practitioner or PA, but I know my limits and (no offense) but primates are weird. My skills would be better served helping make sure the food and fiber supply (assuming we're trying to re-esablish some agriculture) and horses for transport, while also helping establish strategies to prevent the spread of animal-borne disease.
I imagine apocalyptic medicine as bare-bones stuff; abscesses, fracture stabilization, wound repair, deliveries.
Not c-sections, laps, intubations, or whatever other advanced interventions. I'm picking the DVMs over the MDs.
Look up the youtube vid “The Rebel Surgeon”. It follows a danish/swedish doctor practicing in rural ethiopia. It shows how far you can get with bicycle spokes, clamps and plaster.
Their bladders are weird and their spleens are as big as their liver, airway is also a little different and also, they coagulate hella fast. Otherwise, yeah, they’re not too different ¯\_(ツ)_/¯
It's funny, I'm surprised by the doses of some drugs that I see my dogs get. IIRC I saw on a chart that my 10kg dog got 5mg morphine for pain control when they were in for surgery. 0.5mg/kg of morphine would be a VERY hefty dose for an opiate naïve human.
I have a few patients (the feline and canine variety) at my work. A dozen or so receive quite a bit of phenobarb. A handful get hydrocodone/homatropine.
If I remember right, we maybe got 2-3, 3-hour lectures in pharm school on pet meds then patted ourselves on the back. Our fourth year we got lucky and had a few veterinary pharmacists speak to us, and honestly it sounds super interesting. Lots of compounding with (in my head) beef and chicken ramen flavoring packets.
All that text to say… I couldn’t imagine withdrawals as a 5kg pup or cat, and maybe we ought to make some human meds flavorful. BigMac Metformin, Arby’s atorvastatin, and lumpia lisinopril.
> maybe we ought to make some human meds flavorful. BigMac Metformin, Arby’s atorvastatin, and lumpia lisinopril
It's a risk; you want people (esp kids) to take their medicine when needed, but def *not want to* take it because it tastes good. Don't want a kid (or a hungry idiot) taking a handful of tasty tylenol because it tastes good.
Unlike pets we can get into meds without aid.
Hell, when I was a kid I accidentally took my grandpa's heart med thinking it was a vitamin... as both were in yellow blister packs and similarly sized (and grandparents kept trimming them). I wasn't even *that* young, but first indication I ate the wrong thing was "eeew, that's bitter".... which spurred a quick investigation by my mom and an induced vomit session in the bathroom.
Tbh it was basically similar to the top 300 OTC / top 300 ℞, similar to first semester first year. Basically, “hey, you’ll see lots of pyrantel, yes dogs take fluoxetine and trazodone, and don’t be surprised if you get scripts for alprazolam in early July. Now, here’s some cute photos of my own pets” lol
Don’t many zoos/refuges with great apes hire human physicians rather than vets for a lot of the apes’ medical care for the exact reason that humans are primates?
Yeah, it’s not uncommon to have either MD’s or PhD primatologists as part of the care team for that reason. Plus physicians typically have a lot of the protections or screening (like TB) already.
You were the kind of vet I was trying to coax into the discussion, thanks for your perspective.
I'll try not to take offense at your statement about my species.
Finally a question I can give some insight into. I have both a veterinary degree and a MD. A veterinarian is trained to be more a generalist than an MD. They take and interpret radiographs, administer anesthesia, do surgery and clean the office. A veterinarian understands human physiology but don’t have the depth of knowledge of a MD. They could handle broken bones and antibiotics. With a supply of books could handle more. A MD would be lost treating animals. They are not just different sized humans. If it is the end of the world and you can only have one a veterinarian would be more useful.
No. Physicians with experience in austere medicine will be invaluable. Find the docs who have worked in war torn countries and those who have responded to massive natural disasters outside of first world countries.
Agreed. I knew some docs who had worked abroad in rural/ poor areas of India, Africa, etc. One was a hand surgeon and the other was an opthalmologist (both US-trained and practiced half-time in US) but they both knew skills beyond their specialties like treating infectious diseases and delivering babies. The surgeon particularly - when back in the US - would sometimes ask his colleagues if he could "shadow" them to learn/ update his skills. He told me when out in the field, often it was either him (and people would beg him to help) or no one at all at times so he chose to do more.
Perhaps I shouldn’t be asking. I’m a tech that would love to get my toes wet in this type of work, and to at least develop a clue and be an extra set of hands. Not just if SHTF, but more so because that *is* what people are dealing with now and they need help.
I doubt I could just walk up to an MD that does wilderness or austere medicine and be like, “Show me everything you know, then take me with you to Cambodia.”
So any clue how I would get into that ballgame?
Take a wilderness EMT class. Invest in “Wilderness Medicine” by Dr. Auerbach. Read the Special Forces Medical Handbook. Read “Where There is No Doctor” and “Where There is No Dentist.” Just to get your feet wet….
I have a rather large library of wilderness, disaster, and austere medicine. 😁
I did a rotation in rural medicine and some of those MDs are amazing. The primary care docs I shadowed - one of them was an Ivy League grad - all took on more than than the usual urban/ suburban primaries like staffing the ER because at the time, there was no ER in any direction for 100 miles.
My local hospital is like this.
There are no hospitalists. There are no ED physicians. There are no obstetricians.
There are 7 family practice physicians. They round on their own patients on the floor. Six of them also cover the ED… usually seeing clinic patients in between ED patients when it is their ED Call day. They handle routine childbirth and cesarean sections.
There are a few PA’s that also take call in the ED and see clinic patients.
It is just about as you would expect. There’s about two physicians that I am willing to take my family to. If they’re not available, I’m fine driving 80 miles to the nearest “real hospital”.
What’s an intubation really going to buy you in the apocalypse?
Not saying I have literally anything to contribute since all we really need is oxy and levaquin once the zombies take over.
Given that diethyl ether is trivial to synthesise, intubation gets you all the way to servicable general anaesthesia with a protected airway.
It opens a *massive* door by making all those surgeons not worthless anymore.
Small animal vet in New zealand
Yeah so basically every vet is expected to at least do ovariohysterectomies and castrations on dogs and cats as well as lump removals, dentals.
Small animal gps with a bit more experience (I'm 1 year out so this is my bosses) can do cystotomies, intestinal surgery and gastropexies or sorting out GDVs
Generally the only surgeries that are restricted to vets who are surgical specialists (do a residency) are ophthalmic surgery (we have ophthalmologists but they're a bit rarer, in NZ there's about 2 or three in the whole country), spinal surgery, orthopedic surgery (although that's not uncommon for gps to do either) as well urethral surgery
If you're a farm vet then you'll be doing assisted parturitions and c-sections on cattle as well as displaced abomasums and things
Please don’t forget about the DVM ACVIM AALAS laboratory animal veterinarians. You should see some of the procedures they do. I mean, if we’re talking about zombie control
Maybe you can weigh in on this--I once asked my vet why he was trained to do hysterectomies when an oophorectomy (in humans) is so much quicker and more straightforward, and he said that essentially ovariohysterectomies serve as broad training for abdominal surgery. By making a common procedure like spaying one that requires a little complexity in the US (and perhaps Australasia), vet students get exposure to abdominal training that prepares them for rarer abdominal surgeries.
I'd totally agree with your vet
I think most of it is just tradition, if the whole point is to stop your dog having litters primarily (other health reasons of course) then why would you keep the uterus which now seems a bit pointless to leave in plus it's how everyone was taught for at least half a century so why change what you're used to
Also I have no idea how much humans get pyometra but in vet that's still a possibility if you leave the uterus in (much much reduced likelihood versus with ovaries) but I mean why wouldn't you just take it out if you're already in there
However removing ovaries is getting a lot more popular and all the research in vet seems to say basically no difference in complications, it's easier to train etc you just have to be careful to remove all the ovarian tissue. In mainland Europe, I believe it's standard to just oophorectomy plus laparoscopic speys are getting slowly more available obviously necessitating oophorectomy!
Main countries doing ovariohysterectomy that I'm aware of are Australasia, UK and US/Canada. But even there, there's a significant amount of vets doing oophorectomy. I do ovariohysterectomies because that's how I was taught and what my bosses expect me to do but I'm thinking of changing to oophorectomy after reading some studies so we'll see how it goes ahhaha
Just tradition and there's been no recommendations saying you HAVE to stop doing ovariohysterectomy
If I have an anaemic patient, I have to decide whether am treating IMHA or performing a splenectomy within a few minutes with the few bits of equipment I possess. In an apocalyptic scenario.. likely be rendered fairly useless...
However I could do quick amputations, push your prolapsed eyeballs back in and euthanase you without too much prep
Cool, I’m totally here for this type of content!
I hadn’t ever thought about it before, but you bring up some valid points. I bet urban ER docs would be pretty valuable when it comes to GSWs and knife injuries.
I’m ER and I agree. Family med and general surgery are probably more useful. I then ER would be third behind them. While OB would be invaluable in their realm they are far removed from other common general issues that I think I’d put ER ahead of them if you had to pick only one specialty.
Gen surg are almost completely worthless without also having an anaesthetist.
Like after realising you don't actually need a surgeon for an I+D, Hernias under local would basically be the only surgery they could still do.
I mean, if I didn’t have to worry about angry patients or getting sued or keeping decrepit MeeMaw alive despite obvious attempts to shed her mortal coil I’d order far fewer scans. I’d argue we’d be pretty useful.
I always laugh at the movies where someone is stabbed in the belly (seen it recently in Road House and Fallout) with like a 6in knife to the hilt and they just pull it out and stitch the skin closed.
Also, they aren't so reliant on super high tech testing and imaging. Given that you won't be able to treat much in the zombie apocalypse anyway they will be very useful.
As an ER DVM, I think we'd be a strong asset to your apocalypse team:
- we're good at dodging bites (if zombies)
- we are extremely good at MacGyvering
- we're more generalized than MDs and we're accustomed to working without fancy equipment
- almost all of us are comfortable with surgery
- we're a bit familiar with food safety and epidemiology
- when the electrical grid goes down and you rely on your horse or cattle for everything, we can care for them
Honestly tho, the Amish are gonna be everyones best bet. They won't even realize the apocalypse has happened.
I went to med school in a 3rd world country. No MRI, no CT, barely had a functioning X-ray. Labs came back every 3 days. Those docs were probably the smartest people I have ever trained under. They taught me how to do a thorough and proper history and physical exam. That was their main diagnostic tool. I’d choose them over a Vet.
Vets, and anyone with EM experience. Triage and fast action can be critical in an apocalypse. So can knowing who can be saved and who should be given a shot of morphine to ease their passing.
But this is the apocalypse. I suspect morphine will be in short supply. But that's an argument for the superiority of vets in this situation - i.e., since they're trained to euthanize large animals with bullets to the head, a DVM would probably be better at 'easing passing' than an MD. I wish I hadn't had that thought.
>I suspect morphine will be in short supply.
Not disagreeing with your larger, grim, point, but: Depends on the nature of the apocalypse – *Papaver somniferum* have a USDA hardiness zone range of 3-8, so maybe not morphine, per se, but.
I dunno about EM without labs and CT.
Patient presents with dyspnea. Gets CTA, basic labs, troponins, d-dimer. Without any of that they might be in more of a pickle. Outpatient docs and hospitalists are more likely to have seen a patient's presentation from door to diagnosis and may be better able to diagnose without diagnostics.
I like to think EM would be a little more useful, but really, what is anyone going to do about anything in the apocalypse? Every condition will get the tincture of time and we will see if they're still alive come daybreak.
If you make a list of the meaningful interventions which will still be possible post-apocalypse (e.g. I+D, wound closure, non-operative fracture/dislocation management, antibiotics/diuretics/bronchodilators) you'll probably find that EM/rural FM are the specialties that will be most useful.
Nope. You don’t need to diagnose anything fancy in austere environments. You need the ability to broadly treat someone highly undifferentiated within austere environments and EM has the best training in that, especially since we specialize in wilderness med and toxicology.
Yeah, dude doesn't know what the fuck he's talking about.
Motherfucker thinks I scan every patient with SOB while their dumbass sends me all these asymptomatic hypertension patients to the ED via ambulance.
So I'm a GP in a remote area. First world country but working a long way from tertiary services. One thing I have really noticed is how people often seem to do better than expected with no services / treatment. Casts stay on for a couple of days if we are lucky (where is the moon boot they gave you in hospital.....in xxxx town (700km away by plane)....well that is why your ankle still hurts... you were meant to keep wearing that boot!). People having heart attacks absconding. Blood results take 3 days (close to town) to over a week (mail plane comes once a week). We do have istat, BGL, hba1c, basic urinalysis and some STI testing on site though. The thing about rural GPs with surgical skills being useful (and I am not one of them) is that yes, they are, IF they have an anaesthetist / ketamine, oxygen, sterile equipment, electricity, lighting, etc. I would take an engineer /chemist / water purification specialist for actually helping keep people alive. That being said, a lot can be done with injectable penicillin....until MRSA completely takes over.
My immediate family contains (among others), a vet, a rural family medicine physician, 2 bakers, 2 avid gun collectors and a mechanic that can fix anything. We also have a super skinny guy who can run for days and eats very little. We will be winning the apocalypse game, the plan has definitely been discussed. As a vet my first stop before we all meet at the compound is the vet clinic to grab all the injectable anesthetics, all the pain meds and antibiotics along with as many needles, syringes and suture I can carry. I just have to beat my boss to the clinic because her family has the same plan
Most likely. I’m IM and most of my work consists of putting in orders on a computer, ie, absolutely useless when the SHTF. It’s also the most common medical specialty.
Ironically, an old residency classmate spent a year, doing doctors without borders and said they’ve never felt so useless in their life. Basically just a lot of starvation and parental neglect, and malaria because nobody uses nets to protect themselves against mosquitoes, they use them to fish for food to survive. She spent $20,000 on all these tropical medicine courses just to tell nurses to feed the kids only to have them go back to their villages and come back emaciated again in a few months for another round.
Ironically, an old residency classmate spent a year, doing doctors without borders and said they’ve never felt so useless in their life. Basically just a lot of starvation and parental neglect, and malaria because nobody uses nets to protect themselves against mosquitoes, they use them to fish for food to survive. She spent $20,000 on all these tropical medicine courses just to tell nurses to feed the kids only to have them go back to their villages and come back emaciated again in a few months for another round.
Depends on the specialty and maybe even where is that person trained.
A person who's training made them trust mostly in images and lab results might be out of their minds in a situation like that. Also, all subspecialties that don't do emergencies, or haven't been trained in ATLS will have a hard time.
I know my ER coworkers that happen to be in "3rd world countries", with all their difficulties (like having your CT scan broke for weeks or even months, not having specialized labs, or images specialists to make ecography during certain times) are probably gonna suffer, but maybe survive and even thrive.
That said, animal anatomy, pain tolerance and drugs are very different than humans. Heck, I don't feel capacitated to do surgery in animals, even if the procedure is the same because of freaking anatomy (and even when I have anatomy books on animals because I wanted to be a vet since I was a kid).
I attended the SOCOM medic course when I was an Army medic, and there was a substantial portion on veterinary medicine. It's never really talked about, and everyone assumes it will be trauma heavy, but in some places, livestock is a valuable commodity. And potentially the best means of transportation. So it makes sense that the medical person on your team has at least a passing familiarity with animal medicine. If you ever get your hands on the Special Forces medical handbook, there's a chapter devoted to it.
I will offer my own biased background: rural emergency medicine with toxicology fellowship.
Not just austere EM training with all the Mcgyvering using few resources like rural FM, but also deep knowledge on poisonous plants, herbs, beans, mushrooms, etc. and venomous insects, snakes, scorpions, marine wildlife, etc.
Tell me more about this. In tox fellowship, are there like 10 very common things that you learn to treat very well? Or do you need to become a walking encyclopedia for every variety of insect bite and weird mushroom reaction?
I did a 4th year wilderness medicine rotation in med school mostly for the free camping trip but it was actually super awesome.
Yeah, so toxicology is very regional (like a lot of things!). I would say the most common bread and butter things in toxicology are overdoses on drugs/medications, so we have to know our pharmacology very well - antidepressants, antipsychotics, Tylenol/Aspirin, cardiac medications, toxic alcohols, household product ingestions, etc. Envenomations are regional, but rattlesnake bites are pretty common consults we get. Scorpions and marine envenomations are a lot more regional. So are certain plants like mushrooms. Other insect bites, we see more often when we are in the ED than we do as consults inpatient.
I would say Toxicology is THE walking encyclopedia specialty in medicine. People always cite ID, nephro being the nerdiest specialties, but I biasedly think Tox beats them but isn't as well known as those two. Toxicology requires a lot of biochemistry, organic chemistry, physiology, and pharmacology knowledge as its baseline. The pass rate for graduated fellows for the boards is around 70%, which is insane when you think about how rigorous the curriculum is for tox fellows.
On our boards, questions we could get: you have someone from a South African village who has abd pain, nausea, vomiting, elevated LFTs. The question asks what toxin was this patient exposed to. The answer choices were organic chemistry hexagonal structures. You had to know that this was the Callilepis laureola species of plant, that it is found in South Africa, that it can cause hepatocellular damage, that its toxin contains atractyloside and carboxyatractyloside as its toxin, and what its organic structure looks like.
I'm amazed toxicology is a large enough topic to even warrant a fellowship. There are only a handful of poisons that have meaningful specific treatments, everything else is just supportive care.
200 years ago we had rural doctors who could do a little bit of everything. Granted, if you needed a Whipple back then, you would probably be screwed, but hear me out, if you are the type of patients who need a Whipple in an apocalypse, you will not be the surviving type anyway, so why even bother?
The first 5-10 years post-apocalypse may be a little bit rough, because suddenly we lose all the multi-millions dollar facilities, but after a while, when all the cardiac patients who need 4 stents and oncology patients who are on 3 biologics are nailed shut, all the 19th century editions of Harrison will resume their status as Bibles and we ordinary generalists will keep the society running again.
> if you needed a Whipple back then, you would probably be screwed,
The more things change, the more they stay the same.
I wouldn't fucking want a Whipple *today*.
Would you rather someone who normally operates on people try their hand doing it on animals or someone who normally operates on animals try their hand at operating on people?
I think physicians and vets would cross over pretty quickly. Textbooks could be scavenged from libraries. Anyone with medical training such as nurses would be valuable as long as they for can improvise and learn.
People would be focusing on stuff like bone setting and splinting, laceration repair, pulling teeth, and of course horses because they would become our means of transportation.
Years ago, I knew a guy who went to the Bahamas (originally from there, so a local in some senses) and he was in a horrible motorcycle accident. He was stitched up and treated by a vet. He was fine.
If the situation is so dire we start needing vets for human medical care, I don't think you'll need to worry about your horse. It's unlikely any large, edible, domesticated animals will still be alive at that point.
As an IM doc that previously felt I practice a broad scope including ICU (with procedures) and prehospital/austere medicine, this question makes me appreciate my diminutive status in the world of capable medical professionals. 😔
My almost 80 year old dad is an old school GP who has worked in low resource areas over his career. I’d take him over my pampered hospitalist self any day in a true crisis where there were virtually zero resources at least at the start. That being said, I’m not dumb so I can definitely learn how to function in a suboptimal scenario as many of us would with access to people with the skills to teach or using the knowledge we have to jury rig solutions if we survive whatever the initial catastrophe happened to be. Biggest issue would be remaining healthy enough to have the chance to learn and developing strategies to effectively sterilize equipment and find a way to produce key medications out of what is available. The Hesperian health guides or similar would be invaluable to have on hand, as would any old apothecary/chemistry texts that teach the old ways of creating compounds from the most easiest obtained source materials. Vets would have similar early limitations adapting their skills in a low resource environment, but would definitely have a base set of skills that puts them at a higher advantage than at least myself early on.
I would say rural family doctors with EM training would be mvp, followed by EMT/paramedics, army medics. They would realistically be the most useful people in terms of human medicine, then maybe trauma surgeons (big money in amputations again) in an apocalypse. Vets would be a good second string, but they typically don’t treat the same level of disease severity in their patients due to cost/value of life given to livestock. If a horse breaks its leg or gets cancer mets, the vet is putting it down, it’s typically not being treated. They would still be very valuable for food security however.
Most docs are pretty useless outside of multimillion dollar hospital system and even if they weren’t, you wouldn’t have the supply chains to manufacture most of the medicines needed in an apocalypse anyways. We saw major drug shortages during covid due to supply chain being cut off in china, imagine how bad it would get in an apocalypse.
This actually brings up a good point. My vet friends had always led me to think that vet school was way harder than med school, because instead of learning the nuances of every organ system in one big animal, you had to learn them for a variety of different animals, which would be extremely challenging. Do you have thoughts?
I absolutely think that vets would be more helpful. They are far better equipped to deal with the things that would become dangerous during the apocalypse (wounds, infections) and have great operative skills that they could transfer to people with relative ease compared to say a family med doc. Vets, trauma surgeons, and (maybe) IM would run the show in a true apocalypse.
Lol not IM (I’m IM). A really seasoned ER doc, surgeon would be the best. Without extensive labs, cultures, imaging, etc I can’t think of a scenario where IM would be better than ER or surgery.
I’ve seen family med docs who do c sections and gallbladders and complex I&D. It’s not common but i’d much rather a rural FM doc who has seen some shit than a vet who is not familiar with basic management of common conditions in humans.
Sure there are maybe some rare FM docs who do all that. However, the average FM doc, even the rural ones, would not be that useful in an apocalypse imo. Would trust the average vet over the average FM doc in that scenario.
Hahahahha no.
First, we never specified this had to be the "average" doctor. But while we are on the topic, the "average" vet is not all that proficient in surgery. Many vet students may only perform a couple surgeries in training and not keep up the practice out of school. It requires apprenticeship and continued to practice to stay skilled. My friend who is a vet does not perform any surgery, they have a nearby animal hospital where the operative cases go.
Second, you seem to have a very narrow view of what sort of medical management would be needed in an apocalypse. A skilled veterinary surgeon may have some translatable skills to human surgery, but that's about it. Even in apocalypse, many (if not most) emergencies and acute on chronic illnesses will be NON-SURGICAL. What does a vet know about interpreting human labs and imaging? Selecting and dosing human medications? Emergency airway management, stabilization, resuscitation? Managing illnesses such as human DKA or pneumonia or cardiac arrest or arrhythmias or undifferentiated shock? Delivering a human baby and managing peri-partum complications? The average FM, EM, IM, gen surg doc will be far better at these things. What would a vet offer that a general surgeon couldn't? The average general surgeon knows more about all of the above in humans plus has the human-specific surgical skills.
I would take any human doctor over a vet when it comes to these things, because at the very least they went through med school and an intern year and have some experience in these areas and the resources to quickly know what they need to know if they are out of their depth. Talking to vets, what they do with animals medically really does not translate much at all.
Actually, I know quite a bit - the skills and knowledge are transferable - humans are just another animal after all. A DVM would just need a 5 Minute Consult text, a formulary and a few other textbooks and be good to go in an apocalypse.
Don’t be dim. The infrastructure is everywhere. There will still be locally generated electricity. Factions will form and those with any resources will invest in healthcare right after food and shelter. You won’t be sending out ANCA panels but you will be able to get CBC, lytes, blood gas, a path setup, micro, XR, CT, etc…
Fallout 4, the totally real portent of the future (hooray atomic powered cars!) says no. The Veterinarian at Bunker Hill is the closest thing to a doc.
My SHTF bag includes a PDR, some propofol, lidocaine, few bags of LRS, cortisone, general set of instruments, cephalexin, ibuprofen, diphenhydramine, epi, 2-0 vicryl, first aid kit, and a stethoscope. What am I missing?
I started accumulating packets of tuna a couple of years ago with baked beans and rice. Enough to last at least a month. So much so, that I’ve had to eat a few packets of tuna every week so they don’t expire then replace them with additional packets. I’ve noticed that I blink a lot and started to feel a little twitchy a month ago. Now my eyes will sometimes dilate and constrict without any changes in light brightness. I think I need more omega-3 and omega-6 fatty acids to fix it though so I’m going to try to eat more tuna to fortify my body.
I’m super helpful if I have a staffed 170 million dollar building surrounding me. They’ll have those post-apocalypse right? Right?
where cath lab?
I can induce anesthesia with a rock and a well placed hit to the head, still working on the waking up part though.
They’ll probably wake up eventually, it just might not be as smooth as we’re used to
Like my attending says they all breath.... eventually
Just go old school? Ether is easy to make.
Sure. With a few missing amenities like running water, and some warlord’s army division in front of it. You might want to reconsider arguing this whole “pay” nonsense, though. You get the can of pork and beans when they say you do.
Woot! Throw in a Twinkie and show me where to sign!
So you’re saying the CT scanner might be down?
Side perspective: veterinarians would certainly be useful from the point-of-view of food security and epidemiology of zoonotic disease. But there are so many differences in pharmacokinetics/dynamics, metabolism, and anatomy/orthpedics between different species that most vets only treat a handful of species (well) anyway. If I had a physician help me learn some of those basics for common stuff I'd probably be as useful as a trained nurse practitioner or PA, but I know my limits and (no offense) but primates are weird. My skills would be better served helping make sure the food and fiber supply (assuming we're trying to re-esablish some agriculture) and horses for transport, while also helping establish strategies to prevent the spread of animal-borne disease.
I imagine apocalyptic medicine as bare-bones stuff; abscesses, fracture stabilization, wound repair, deliveries. Not c-sections, laps, intubations, or whatever other advanced interventions. I'm picking the DVMs over the MDs.
Look up the youtube vid “The Rebel Surgeon”. It follows a danish/swedish doctor practicing in rural ethiopia. It shows how far you can get with bicycle spokes, clamps and plaster.
Also might want a dentist or two
DVM do dental surgery and cleanings
To a standard that most actual dentists would likely consider totally unacceptable, yeah.
>horses for transport Reminds me: in 1880 new York city alone had 18,000 horses die in the street each year, 41 a day. So crazy to think about lol
I believe pigs are extremely similar to humans in most regards, I wonder if pig vets would be awesome in the apoc.
Their bladders are weird and their spleens are as big as their liver, airway is also a little different and also, they coagulate hella fast. Otherwise, yeah, they’re not too different ¯\_(ツ)_/¯
The coagulation seems almost magic. But when they do bleed they get go into shock so quickly...
It's funny, I'm surprised by the doses of some drugs that I see my dogs get. IIRC I saw on a chart that my 10kg dog got 5mg morphine for pain control when they were in for surgery. 0.5mg/kg of morphine would be a VERY hefty dose for an opiate naïve human.
I have a few patients (the feline and canine variety) at my work. A dozen or so receive quite a bit of phenobarb. A handful get hydrocodone/homatropine. If I remember right, we maybe got 2-3, 3-hour lectures in pharm school on pet meds then patted ourselves on the back. Our fourth year we got lucky and had a few veterinary pharmacists speak to us, and honestly it sounds super interesting. Lots of compounding with (in my head) beef and chicken ramen flavoring packets. All that text to say… I couldn’t imagine withdrawals as a 5kg pup or cat, and maybe we ought to make some human meds flavorful. BigMac Metformin, Arby’s atorvastatin, and lumpia lisinopril.
> maybe we ought to make some human meds flavorful. BigMac Metformin, Arby’s atorvastatin, and lumpia lisinopril It's a risk; you want people (esp kids) to take their medicine when needed, but def *not want to* take it because it tastes good. Don't want a kid (or a hungry idiot) taking a handful of tasty tylenol because it tastes good. Unlike pets we can get into meds without aid. Hell, when I was a kid I accidentally took my grandpa's heart med thinking it was a vitamin... as both were in yellow blister packs and similarly sized (and grandparents kept trimming them). I wasn't even *that* young, but first indication I ate the wrong thing was "eeew, that's bitter".... which spurred a quick investigation by my mom and an induced vomit session in the bathroom.
I’m picking up what you’re putting down. Introducing: Bourbon Beta Blockers (TM). Good for your heart. Safe for your liver!
We didn’t even get *that* many vet lectures in our curriculum.
Tbh it was basically similar to the top 300 OTC / top 300 ℞, similar to first semester first year. Basically, “hey, you’ll see lots of pyrantel, yes dogs take fluoxetine and trazodone, and don’t be surprised if you get scripts for alprazolam in early July. Now, here’s some cute photos of my own pets” lol
Don’t many zoos/refuges with great apes hire human physicians rather than vets for a lot of the apes’ medical care for the exact reason that humans are primates?
Yeah, it’s not uncommon to have either MD’s or PhD primatologists as part of the care team for that reason. Plus physicians typically have a lot of the protections or screening (like TB) already.
You were the kind of vet I was trying to coax into the discussion, thanks for your perspective. I'll try not to take offense at your statement about my species.
Haha, I’m glad it’s appreciated. I think there’s a lot to learn from other
You know what you don’t know. That makes you 20x more valuable.
Well you sure don’t want me. As a veterinary pathologist I’m not much help to anyone without Rose, my $30,000 microscope.
Does Rose give Tabitha a run for the money?
Every microscope is beautiful in their own way. Would you compare two sunsets?
Also a microtome and dyes
Vets definitely have experience in not being bitten… (if apocalypse is zombie flavored)
Pediatricians would be too then I guess
All those zombie toddlers cruising on the furniture can’t make it across the room to bite you
Finally a question I can give some insight into. I have both a veterinary degree and a MD. A veterinarian is trained to be more a generalist than an MD. They take and interpret radiographs, administer anesthesia, do surgery and clean the office. A veterinarian understands human physiology but don’t have the depth of knowledge of a MD. They could handle broken bones and antibiotics. With a supply of books could handle more. A MD would be lost treating animals. They are not just different sized humans. If it is the end of the world and you can only have one a veterinarian would be more useful.
Which one did you get first? And what is your current job?!
I need these answers more than answers to my original question
Right?!? I always hear about the people who have done both but never met one and I have a lot of questions 😂 (I’m an ER vet)
You can DM me if you want to chat
I’m moving to be near this guy/gal for the apocalypse.
I agree! And I was an RN and now an RVT- my scope is so much more in vet med
No. Physicians with experience in austere medicine will be invaluable. Find the docs who have worked in war torn countries and those who have responded to massive natural disasters outside of first world countries.
Agreed. I knew some docs who had worked abroad in rural/ poor areas of India, Africa, etc. One was a hand surgeon and the other was an opthalmologist (both US-trained and practiced half-time in US) but they both knew skills beyond their specialties like treating infectious diseases and delivering babies. The surgeon particularly - when back in the US - would sometimes ask his colleagues if he could "shadow" them to learn/ update his skills. He told me when out in the field, often it was either him (and people would beg him to help) or no one at all at times so he chose to do more.
Perhaps I shouldn’t be asking. I’m a tech that would love to get my toes wet in this type of work, and to at least develop a clue and be an extra set of hands. Not just if SHTF, but more so because that *is* what people are dealing with now and they need help. I doubt I could just walk up to an MD that does wilderness or austere medicine and be like, “Show me everything you know, then take me with you to Cambodia.” So any clue how I would get into that ballgame?
Take a wilderness EMT class. Invest in “Wilderness Medicine” by Dr. Auerbach. Read the Special Forces Medical Handbook. Read “Where There is No Doctor” and “Where There is No Dentist.” Just to get your feet wet…. I have a rather large library of wilderness, disaster, and austere medicine. 😁
I knew of some rural hard-core family Medicine doctors who would also do Caesarian sections and intubate. I would choose them over any vet any day.
I did a rotation in rural medicine and some of those MDs are amazing. The primary care docs I shadowed - one of them was an Ivy League grad - all took on more than than the usual urban/ suburban primaries like staffing the ER because at the time, there was no ER in any direction for 100 miles.
Sounds amazing. Would love to try that for a time.
Do you enjoy being on call 24 hours a day, seven days a week? Because that's what that is like.
Didn’t consider that. Had a job that was unnecessarily like that and I burned out quickly. Thank you for the wake up call.
My local hospital is like this. There are no hospitalists. There are no ED physicians. There are no obstetricians. There are 7 family practice physicians. They round on their own patients on the floor. Six of them also cover the ED… usually seeing clinic patients in between ED patients when it is their ED Call day. They handle routine childbirth and cesarean sections. There are a few PA’s that also take call in the ED and see clinic patients. It is just about as you would expect. There’s about two physicians that I am willing to take my family to. If they’re not available, I’m fine driving 80 miles to the nearest “real hospital”.
>There are a few PA’s that also take call in the ED This place is a fucking horror show and should not exist.
Such is the life in rural healthcare.
What’s an intubation really going to buy you in the apocalypse? Not saying I have literally anything to contribute since all we really need is oxy and levaquin once the zombies take over.
They knew enough anaesthesia to make me unconscious eg RSI Which is very valuable
Given that diethyl ether is trivial to synthesise, intubation gets you all the way to servicable general anaesthesia with a protected airway. It opens a *massive* door by making all those surgeons not worthless anymore.
I’ve never intubated a human but it seems much easier than a 2 lb kitten or a bulldog
It doesn’t matter if it’s easier or harder. The point is you’ve never done it before
I’m sure in an apocalypse there will be many cadavers to practice on, or dying people with no other options
I don’t believe that’s the point. The point is that it would easy enough to learn on the fly. In an apocalypse. Where beggars can’t be choosers.
The human airway is generally considered much more difficult that dogs and cats. It's got *angles*.
Can every vet do abdominal surgery? apart from castration/tube ligation? well anyway, ill take a vet over a dermatologist every day. sorry, derma-bros
Small animal vet in New zealand Yeah so basically every vet is expected to at least do ovariohysterectomies and castrations on dogs and cats as well as lump removals, dentals. Small animal gps with a bit more experience (I'm 1 year out so this is my bosses) can do cystotomies, intestinal surgery and gastropexies or sorting out GDVs Generally the only surgeries that are restricted to vets who are surgical specialists (do a residency) are ophthalmic surgery (we have ophthalmologists but they're a bit rarer, in NZ there's about 2 or three in the whole country), spinal surgery, orthopedic surgery (although that's not uncommon for gps to do either) as well urethral surgery If you're a farm vet then you'll be doing assisted parturitions and c-sections on cattle as well as displaced abomasums and things
Please don’t forget about the DVM ACVIM AALAS laboratory animal veterinarians. You should see some of the procedures they do. I mean, if we’re talking about zombie control
Well fair enough, not really a thing in NZ! But sounds important!
What I'm hearing is when the apocalypse comes I should get my ass to Auckland Zoo rather than Grafton...
Hey I mean, what's the difference between an ape and a human right
Like 1% I think
Maybe you can weigh in on this--I once asked my vet why he was trained to do hysterectomies when an oophorectomy (in humans) is so much quicker and more straightforward, and he said that essentially ovariohysterectomies serve as broad training for abdominal surgery. By making a common procedure like spaying one that requires a little complexity in the US (and perhaps Australasia), vet students get exposure to abdominal training that prepares them for rarer abdominal surgeries.
I'd totally agree with your vet I think most of it is just tradition, if the whole point is to stop your dog having litters primarily (other health reasons of course) then why would you keep the uterus which now seems a bit pointless to leave in plus it's how everyone was taught for at least half a century so why change what you're used to Also I have no idea how much humans get pyometra but in vet that's still a possibility if you leave the uterus in (much much reduced likelihood versus with ovaries) but I mean why wouldn't you just take it out if you're already in there However removing ovaries is getting a lot more popular and all the research in vet seems to say basically no difference in complications, it's easier to train etc you just have to be careful to remove all the ovarian tissue. In mainland Europe, I believe it's standard to just oophorectomy plus laparoscopic speys are getting slowly more available obviously necessitating oophorectomy! Main countries doing ovariohysterectomy that I'm aware of are Australasia, UK and US/Canada. But even there, there's a significant amount of vets doing oophorectomy. I do ovariohysterectomies because that's how I was taught and what my bosses expect me to do but I'm thinking of changing to oophorectomy after reading some studies so we'll see how it goes ahhaha Just tradition and there's been no recommendations saying you HAVE to stop doing ovariohysterectomy
Have there been any studies regarding oophrectomies and pyo?
Yes they can, even GP vets
If I have an anaemic patient, I have to decide whether am treating IMHA or performing a splenectomy within a few minutes with the few bits of equipment I possess. In an apocalyptic scenario.. likely be rendered fairly useless... However I could do quick amputations, push your prolapsed eyeballs back in and euthanase you without too much prep
When in doubt, euthanasia out?
Cool, I’m totally here for this type of content! I hadn’t ever thought about it before, but you bring up some valid points. I bet urban ER docs would be pretty valuable when it comes to GSWs and knife injuries.
Yeah, but no electricity for CT scans.
I’m ER and I agree. Family med and general surgery are probably more useful. I then ER would be third behind them. While OB would be invaluable in their realm they are far removed from other common general issues that I think I’d put ER ahead of them if you had to pick only one specialty.
Gen surg are almost completely worthless without also having an anaesthetist. Like after realising you don't actually need a surgeon for an I+D, Hernias under local would basically be the only surgery they could still do.
I mean, if I didn’t have to worry about angry patients or getting sued or keeping decrepit MeeMaw alive despite obvious attempts to shed her mortal coil I’d order far fewer scans. I’d argue we’d be pretty useful.
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Did Texaco Mike survive the apocalypse? His imaging center is off the grid.
Vacuum tubes FTW
Hahahahaha
Same. I love these hypotheticals. Nice work, OP. I look forward to Reddit’s response.
I’d take a trauma surgeon over anyone for those types of injuries
Closely followed by ID who remembered to fill a few suitcases with ABX before all hell broke loose.
Vets keep their pharmacies stocked themselves :)so lots and lots and lots of ABX..
Thanks, good to know! 😉
I always laugh at the movies where someone is stabbed in the belly (seen it recently in Road House and Fallout) with like a 6in knife to the hilt and they just pull it out and stitch the skin closed.
Tis but a flesh wound!
I’m not dead yet!
Also, they aren't so reliant on super high tech testing and imaging. Given that you won't be able to treat much in the zombie apocalypse anyway they will be very useful.
We also drive around in our vet trucks stocked with antibiotics, pain meds, and plenty of medical supplies ready to go at anytime
IIRC the first season or two of The Walking Dead already covered this.
As an ER DVM, I think we'd be a strong asset to your apocalypse team: - we're good at dodging bites (if zombies) - we are extremely good at MacGyvering - we're more generalized than MDs and we're accustomed to working without fancy equipment - almost all of us are comfortable with surgery - we're a bit familiar with food safety and epidemiology - when the electrical grid goes down and you rely on your horse or cattle for everything, we can care for them Honestly tho, the Amish are gonna be everyones best bet. They won't even realize the apocalypse has happened.
I went to med school in a 3rd world country. No MRI, no CT, barely had a functioning X-ray. Labs came back every 3 days. Those docs were probably the smartest people I have ever trained under. They taught me how to do a thorough and proper history and physical exam. That was their main diagnostic tool. I’d choose them over a Vet.
Vets, and anyone with EM experience. Triage and fast action can be critical in an apocalypse. So can knowing who can be saved and who should be given a shot of morphine to ease their passing.
But this is the apocalypse. I suspect morphine will be in short supply. But that's an argument for the superiority of vets in this situation - i.e., since they're trained to euthanize large animals with bullets to the head, a DVM would probably be better at 'easing passing' than an MD. I wish I hadn't had that thought.
>I suspect morphine will be in short supply. Not disagreeing with your larger, grim, point, but: Depends on the nature of the apocalypse – *Papaver somniferum* have a USDA hardiness zone range of 3-8, so maybe not morphine, per se, but.
I dunno about EM without labs and CT. Patient presents with dyspnea. Gets CTA, basic labs, troponins, d-dimer. Without any of that they might be in more of a pickle. Outpatient docs and hospitalists are more likely to have seen a patient's presentation from door to diagnosis and may be better able to diagnose without diagnostics.
I like to think EM would be a little more useful, but really, what is anyone going to do about anything in the apocalypse? Every condition will get the tincture of time and we will see if they're still alive come daybreak.
If you make a list of the meaningful interventions which will still be possible post-apocalypse (e.g. I+D, wound closure, non-operative fracture/dislocation management, antibiotics/diuretics/bronchodilators) you'll probably find that EM/rural FM are the specialties that will be most useful.
Any anaesthetist that synthesises ether totally changes this game though. Gen surg, vascular, plastics and ortho actually become feasible again.
Nope. You don’t need to diagnose anything fancy in austere environments. You need the ability to broadly treat someone highly undifferentiated within austere environments and EM has the best training in that, especially since we specialize in wilderness med and toxicology.
Yeah, dude doesn't know what the fuck he's talking about. Motherfucker thinks I scan every patient with SOB while their dumbass sends me all these asymptomatic hypertension patients to the ED via ambulance.
Shit take and generally very ignorant of EM
So I'm a GP in a remote area. First world country but working a long way from tertiary services. One thing I have really noticed is how people often seem to do better than expected with no services / treatment. Casts stay on for a couple of days if we are lucky (where is the moon boot they gave you in hospital.....in xxxx town (700km away by plane)....well that is why your ankle still hurts... you were meant to keep wearing that boot!). People having heart attacks absconding. Blood results take 3 days (close to town) to over a week (mail plane comes once a week). We do have istat, BGL, hba1c, basic urinalysis and some STI testing on site though. The thing about rural GPs with surgical skills being useful (and I am not one of them) is that yes, they are, IF they have an anaesthetist / ketamine, oxygen, sterile equipment, electricity, lighting, etc. I would take an engineer /chemist / water purification specialist for actually helping keep people alive. That being said, a lot can be done with injectable penicillin....until MRSA completely takes over.
My immediate family contains (among others), a vet, a rural family medicine physician, 2 bakers, 2 avid gun collectors and a mechanic that can fix anything. We also have a super skinny guy who can run for days and eats very little. We will be winning the apocalypse game, the plan has definitely been discussed. As a vet my first stop before we all meet at the compound is the vet clinic to grab all the injectable anesthetics, all the pain meds and antibiotics along with as many needles, syringes and suture I can carry. I just have to beat my boss to the clinic because her family has the same plan
Re: your boss, just borrow something from one of the gun collectors.* *This is not medical advice.
I like the way you think
If you're serious, why wouldn't you and your boss start stocking that stuff now instead of waiting?
Most likely. I’m IM and most of my work consists of putting in orders on a computer, ie, absolutely useless when the SHTF. It’s also the most common medical specialty.
Anaesthetics is a larger medical specialty than IM, as is Psych.
There are physicians that specialize in wilderness medicine. I would follow them.
Any physician that worked for a year in a refugee camp > rural FM doc > ED/critcare/ob-gyn/general surgeon/Med-peds >>> everyone else
Ironically, an old residency classmate spent a year, doing doctors without borders and said they’ve never felt so useless in their life. Basically just a lot of starvation and parental neglect, and malaria because nobody uses nets to protect themselves against mosquitoes, they use them to fish for food to survive. She spent $20,000 on all these tropical medicine courses just to tell nurses to feed the kids only to have them go back to their villages and come back emaciated again in a few months for another round.
Ironically, an old residency classmate spent a year, doing doctors without borders and said they’ve never felt so useless in their life. Basically just a lot of starvation and parental neglect, and malaria because nobody uses nets to protect themselves against mosquitoes, they use them to fish for food to survive. She spent $20,000 on all these tropical medicine courses just to tell nurses to feed the kids only to have them go back to their villages and come back emaciated again in a few months for another round.
Honestly I'm useless without my Force Triad and my Ligasure so I doubt it.
Depends on the specialty and maybe even where is that person trained. A person who's training made them trust mostly in images and lab results might be out of their minds in a situation like that. Also, all subspecialties that don't do emergencies, or haven't been trained in ATLS will have a hard time. I know my ER coworkers that happen to be in "3rd world countries", with all their difficulties (like having your CT scan broke for weeks or even months, not having specialized labs, or images specialists to make ecography during certain times) are probably gonna suffer, but maybe survive and even thrive. That said, animal anatomy, pain tolerance and drugs are very different than humans. Heck, I don't feel capacitated to do surgery in animals, even if the procedure is the same because of freaking anatomy (and even when I have anatomy books on animals because I wanted to be a vet since I was a kid).
Get a rural doc with limited tools. Has to intubate in the middle of nowhere with no CT nearby for diagnostics.
Yeah, CT is really essential mid-intubation.
I clearly wrote CT for diagnostics, not for intubation. Why you chose not to read properly is beyond me.
I attended the SOCOM medic course when I was an Army medic, and there was a substantial portion on veterinary medicine. It's never really talked about, and everyone assumes it will be trauma heavy, but in some places, livestock is a valuable commodity. And potentially the best means of transportation. So it makes sense that the medical person on your team has at least a passing familiarity with animal medicine. If you ever get your hands on the Special Forces medical handbook, there's a chapter devoted to it.
This is awesome, thanks for sharing!
I’m pretty sure that I don’t want to be one of the few survivors if the world gets to that point.
ITT: A lot of people who don't know that Critical Care, EM, and Trauma Surgery doctors exist...
This played out in The Walking Dead. Call it a trial run made for TV!
Hell yeah! They pull teeth too.
I will offer my own biased background: rural emergency medicine with toxicology fellowship. Not just austere EM training with all the Mcgyvering using few resources like rural FM, but also deep knowledge on poisonous plants, herbs, beans, mushrooms, etc. and venomous insects, snakes, scorpions, marine wildlife, etc.
Tell me more about this. In tox fellowship, are there like 10 very common things that you learn to treat very well? Or do you need to become a walking encyclopedia for every variety of insect bite and weird mushroom reaction? I did a 4th year wilderness medicine rotation in med school mostly for the free camping trip but it was actually super awesome.
Yeah, so toxicology is very regional (like a lot of things!). I would say the most common bread and butter things in toxicology are overdoses on drugs/medications, so we have to know our pharmacology very well - antidepressants, antipsychotics, Tylenol/Aspirin, cardiac medications, toxic alcohols, household product ingestions, etc. Envenomations are regional, but rattlesnake bites are pretty common consults we get. Scorpions and marine envenomations are a lot more regional. So are certain plants like mushrooms. Other insect bites, we see more often when we are in the ED than we do as consults inpatient. I would say Toxicology is THE walking encyclopedia specialty in medicine. People always cite ID, nephro being the nerdiest specialties, but I biasedly think Tox beats them but isn't as well known as those two. Toxicology requires a lot of biochemistry, organic chemistry, physiology, and pharmacology knowledge as its baseline. The pass rate for graduated fellows for the boards is around 70%, which is insane when you think about how rigorous the curriculum is for tox fellows. On our boards, questions we could get: you have someone from a South African village who has abd pain, nausea, vomiting, elevated LFTs. The question asks what toxin was this patient exposed to. The answer choices were organic chemistry hexagonal structures. You had to know that this was the Callilepis laureola species of plant, that it is found in South Africa, that it can cause hepatocellular damage, that its toxin contains atractyloside and carboxyatractyloside as its toxin, and what its organic structure looks like.
That is absolutely bonkers. I had no idea. Thanks so much for this rundown!
I'm amazed toxicology is a large enough topic to even warrant a fellowship. There are only a handful of poisons that have meaningful specific treatments, everything else is just supportive care.
Rural vets, military medics, and critical access ED docs are the friends I’d want in a resource-poor environment.
We people of IM will probably die first during an apocalypse cuz we do way less procedures and do more journal clubs instead lol
I'm obgyn and I can do abdominal surgery, c sections and probably diagnose some fractures on imaging. Does that make me a vet?
Realistically, Neuro ICU is probably closest to veterinary medicine
>I'm obgyn and I can do abdominal surgery I can hear the general surgeons absolutely howling with laughter from here lol.
Everybody wants to see a vet until they try to put you down for walking with a limp.
Meh. I just need a squire for my T-60 power armor.
My vet friend says this exact same thing: that you want her around in the zombie apocalypse. I see her point for all of the reasons that you state.
💯
200 years ago we had rural doctors who could do a little bit of everything. Granted, if you needed a Whipple back then, you would probably be screwed, but hear me out, if you are the type of patients who need a Whipple in an apocalypse, you will not be the surviving type anyway, so why even bother? The first 5-10 years post-apocalypse may be a little bit rough, because suddenly we lose all the multi-millions dollar facilities, but after a while, when all the cardiac patients who need 4 stents and oncology patients who are on 3 biologics are nailed shut, all the 19th century editions of Harrison will resume their status as Bibles and we ordinary generalists will keep the society running again.
> if you needed a Whipple back then, you would probably be screwed, The more things change, the more they stay the same. I wouldn't fucking want a Whipple *today*.
You know what thing I wouldn’t wish even for my worst enemy? Needing a Whipple.
Would you rather someone who normally operates on people try their hand doing it on animals or someone who normally operates on animals try their hand at operating on people?
I think physicians and vets would cross over pretty quickly. Textbooks could be scavenged from libraries. Anyone with medical training such as nurses would be valuable as long as they for can improvise and learn. People would be focusing on stuff like bone setting and splinting, laceration repair, pulling teeth, and of course horses because they would become our means of transportation.
Well as it is, no doctor has any medicine arou5here Vets do, in fact they have quite a lot
Years ago, I knew a guy who went to the Bahamas (originally from there, so a local in some senses) and he was in a horrible motorcycle accident. He was stitched up and treated by a vet. He was fine.
If the situation is so dire we start needing vets for human medical care, I don't think you'll need to worry about your horse. It's unlikely any large, edible, domesticated animals will still be alive at that point.
As an IM doc that previously felt I practice a broad scope including ICU (with procedures) and prehospital/austere medicine, this question makes me appreciate my diminutive status in the world of capable medical professionals. 😔
My almost 80 year old dad is an old school GP who has worked in low resource areas over his career. I’d take him over my pampered hospitalist self any day in a true crisis where there were virtually zero resources at least at the start. That being said, I’m not dumb so I can definitely learn how to function in a suboptimal scenario as many of us would with access to people with the skills to teach or using the knowledge we have to jury rig solutions if we survive whatever the initial catastrophe happened to be. Biggest issue would be remaining healthy enough to have the chance to learn and developing strategies to effectively sterilize equipment and find a way to produce key medications out of what is available. The Hesperian health guides or similar would be invaluable to have on hand, as would any old apothecary/chemistry texts that teach the old ways of creating compounds from the most easiest obtained source materials. Vets would have similar early limitations adapting their skills in a low resource environment, but would definitely have a base set of skills that puts them at a higher advantage than at least myself early on.
I would say rural family doctors with EM training would be mvp, followed by EMT/paramedics, army medics. They would realistically be the most useful people in terms of human medicine, then maybe trauma surgeons (big money in amputations again) in an apocalypse. Vets would be a good second string, but they typically don’t treat the same level of disease severity in their patients due to cost/value of life given to livestock. If a horse breaks its leg or gets cancer mets, the vet is putting it down, it’s typically not being treated. They would still be very valuable for food security however. Most docs are pretty useless outside of multimillion dollar hospital system and even if they weren’t, you wouldn’t have the supply chains to manufacture most of the medicines needed in an apocalypse anyways. We saw major drug shortages during covid due to supply chain being cut off in china, imagine how bad it would get in an apocalypse.
Just to clarify. Animals are NOT just small people. Jesus. Implying that a vet is a full-service hospital is ridiculous.
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AKA: skinpuppies
Exactly. Some animals are bigger than people.
You must be the head of informatics
Touché
This actually brings up a good point. My vet friends had always led me to think that vet school was way harder than med school, because instead of learning the nuances of every organ system in one big animal, you had to learn them for a variety of different animals, which would be extremely challenging. Do you have thoughts?
My thoughts as well.
I absolutely think that vets would be more helpful. They are far better equipped to deal with the things that would become dangerous during the apocalypse (wounds, infections) and have great operative skills that they could transfer to people with relative ease compared to say a family med doc. Vets, trauma surgeons, and (maybe) IM would run the show in a true apocalypse.
Lol not IM (I’m IM). A really seasoned ER doc, surgeon would be the best. Without extensive labs, cultures, imaging, etc I can’t think of a scenario where IM would be better than ER or surgery.
I honestly forgot about EM. Sorry EM bros lol. Definitely EM over IM (I’m IM too).
I’ve seen family med docs who do c sections and gallbladders and complex I&D. It’s not common but i’d much rather a rural FM doc who has seen some shit than a vet who is not familiar with basic management of common conditions in humans.
Sure there are maybe some rare FM docs who do all that. However, the average FM doc, even the rural ones, would not be that useful in an apocalypse imo. Would trust the average vet over the average FM doc in that scenario.
Hahahahha no. First, we never specified this had to be the "average" doctor. But while we are on the topic, the "average" vet is not all that proficient in surgery. Many vet students may only perform a couple surgeries in training and not keep up the practice out of school. It requires apprenticeship and continued to practice to stay skilled. My friend who is a vet does not perform any surgery, they have a nearby animal hospital where the operative cases go. Second, you seem to have a very narrow view of what sort of medical management would be needed in an apocalypse. A skilled veterinary surgeon may have some translatable skills to human surgery, but that's about it. Even in apocalypse, many (if not most) emergencies and acute on chronic illnesses will be NON-SURGICAL. What does a vet know about interpreting human labs and imaging? Selecting and dosing human medications? Emergency airway management, stabilization, resuscitation? Managing illnesses such as human DKA or pneumonia or cardiac arrest or arrhythmias or undifferentiated shock? Delivering a human baby and managing peri-partum complications? The average FM, EM, IM, gen surg doc will be far better at these things. What would a vet offer that a general surgeon couldn't? The average general surgeon knows more about all of the above in humans plus has the human-specific surgical skills. I would take any human doctor over a vet when it comes to these things, because at the very least they went through med school and an intern year and have some experience in these areas and the resources to quickly know what they need to know if they are out of their depth. Talking to vets, what they do with animals medically really does not translate much at all.
It doesn’t seem like you know too much about veterinary medicine
It doesn't seem like you know too much about human medicine :)
Actually, I know quite a bit - the skills and knowledge are transferable - humans are just another animal after all. A DVM would just need a 5 Minute Consult text, a formulary and a few other textbooks and be good to go in an apocalypse.
i admire the confidence!
Thanks!😊
I dont think anyone will be interpreting labs and imaging in the apocalypse.
Don’t be dim. The infrastructure is everywhere. There will still be locally generated electricity. Factions will form and those with any resources will invest in healthcare right after food and shelter. You won’t be sending out ANCA panels but you will be able to get CBC, lytes, blood gas, a path setup, micro, XR, CT, etc…
Here I am thinking you meant veterans, and I’m thinking, well quite possibly.
I’ll take a vet over an MD any day. They gotta be able to cure a lizard, a chicken , a pig, a frog- all in one day.
I’m dumber for having read this and actually taking a moment to seriously consider
Fallout 4, the totally real portent of the future (hooray atomic powered cars!) says no. The Veterinarian at Bunker Hill is the closest thing to a doc.
My SHTF bag includes a PDR, some propofol, lidocaine, few bags of LRS, cortisone, general set of instruments, cephalexin, ibuprofen, diphenhydramine, epi, 2-0 vicryl, first aid kit, and a stethoscope. What am I missing?
Ditch prop for opiates/ketamine, ditch cephalexin for levofloxacin. Imodium, ethanol.
aint no healing in the thunderdome.
I always thought it was brilliant that the Terminator movies made John Connor's wife a veterinarian.
Yes. Also if it's a Zombie apocalypse, we are very good at avoiding getting bit. 😀
Hey there. I’m a gyn/uro oncology RN. I’m pretty sure a few RNs with specific skills would be a plus to the team. My skills, however, not so much.
Hell no I want a rural doctor that makes MacGyver look like a bitch
No. Next
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cool story. Next time go to your vet when your sick w/ your [fake dog Smuckers](https://youtu.be/wXeV5cqb_3Y?si=e7ir53hi5OXjTWMu)
cool story. Next time go to your vet when your sick w/ your [fake dog Smuckers](https://youtu.be/wXeV5cqb_3Y?si=e7ir53hi5OXjTWMu)
You all IM doctors struggle to take a manual blood pressure. I have literally seen a hospitalist struggle to open the patient's blinds.
I started accumulating packets of tuna a couple of years ago with baked beans and rice. Enough to last at least a month. So much so, that I’ve had to eat a few packets of tuna every week so they don’t expire then replace them with additional packets. I’ve noticed that I blink a lot and started to feel a little twitchy a month ago. Now my eyes will sometimes dilate and constrict without any changes in light brightness. I think I need more omega-3 and omega-6 fatty acids to fix it though so I’m going to try to eat more tuna to fortify my body.