I left Canada for the Isle of Man over a year ago, but my Canadian medical licence has not yet expired, and as a result I am still on the mailing list of the College of Physicians and Surgeons of Ontario (CPSO). I was therefore interested to receive from that venerable body a notice of a consultation on a new draft College policy on “Physician Services During Disasters and Public Health Emergencies”.
Having written an entire book, Post Peak Medicine, on how physicians might provide services during the greatest disaster of all, the “Long Emergency” following peak oil, I was somewhat interested to see what this policy might contain, and read it carefully. It is thankfully quite brief – only four pages – and the main thing which struck me about it was its lack of imagination. Specifically, the only disasters and public health emergencies which it could foresee were brief ones, following which life would return to normal (or what we believe to be normal, which in historical terms is actually highly abnormal). There was no discussion of what might happen in the event of a disaster of such magnitude and duration that the normal institutions of society, such as the CPSO or the economy, cease to function, and/or a permanent lifestyle change is forced upon us. Specifically, the expectation of the policy, and the College, is that “physicians must provide physician services during disasters and public health emergencies” (page 3).
Yeah, right. That is fine for relatively minor disasters such as a localised severe weather event lasting no more than 24 hours, but the author of this policy obviously doesn’t read the same books or visit the same websites that I do. Take a look at this:
“…fire trucks were driven by stoned teenagers in weird uniforms…” (during the civil war in the former Yugoslavia). Had the firefighters reported for duty to provide firefighting services? No, they were protecting their families. Or there’s this:
An article in The Lancet describes the physician shortage in Iraq due to doctors leaving the country because of fears of violence. Or this:
When Hurricane Katrina struck in 2005 (see picture above), 37% of a sample of Disaster Support Professionals (DSPs) interviewed said they evacuated the area either alone or with family members.
The reality is that in a severe and prolonged disaster, doctors and other emergency service personnel are likely to look after themselves and their families first, regardless of whatever policies and guidelines are in place, and I can’t blame them for doing so. Family must come first.
This failure of imagination is endemic today in public discourse in the media, politics and economics. When oil becomes too expensive or unavailable to burn in car engines, people can’t imagine that we may have to stop driving cars: surely we will just switch to electric cars? When aquifers and glaciers stop supplying water to farmland, people can’t imagine that millions of people may starve to death: surely we will just get food and water from somewhere else? When central banks print billions of dollars per month out of thin air, people can’t imagine that it could lead to paper and digital money becoming worthless: stock markets always go up over the long term, right? People like me who think otherwise aren’t welcomed into the public discourse, which is one reason why Post Peak Medicine keeps a low profile (for the time being). And it’s the reason why I don’t think I’ll be contributing to the CPSO consultation.
Slaynt vie, bea veayn, beeal fliugh as baase ayns Mannin