I am 27 and I have a Do Not Resuscitate (DNR) built into my will. I'm considering getting it tattooed on my left wrist.

People are generally very uncomfortable when I mention this little factoid. I'm too young for it, they think--or the conversation itself bothers them. Most of us are pretty estranged from death. I had my will set up that way even before my latest brush with death; though, now that I've come close to meeting the Grim himself, I'm even more confident that I want to keep that DNR.

The modern medical system, particularly in the U.S., is set up to be energy intensive and expensive. We pay more than any other country on the planet in both private and public money for our medical system, and we get less than many in terms of infant mortality, cost of care, and so on.

There's a bevy of mostly political and historical reasons for that (Ahhh! Socialism!), but at the end of the day the reasons don't really matter. What matters is that over the next century, public health in the U.S. is going to continue to deteriorate. Wealthy people will continue to be able to afford the best care, and more and more Americans will stop being able to afford care (regardless of what kind of politicized health care plan is offered to them), or care won't be available (as is already the case in many rural areas).

Oh and don't think you're immune, military or retired military people. The new contractor for Tricare is asking many providers to take a 20% cut (on top of the 10% cut many were already taking) below the reimbursement cost of Medicare. While I'm grateful to currently have some kind of medical care through Tricare and the VA, I expect that in my lifetime, the level of care provided will sink to the point where it's no longer useful to anyone. I expect that the propaganda available to the American people and Vets will continue to say that the available care is top-notch. Them's the way of things.

More people will die of supposedly treatable things. More people will die at a younger age. More people will die at home. More people will become intimately familiar with death. 

There is nothing you can do to stop that trend. You can maybe halt it for yourself personally, for awhile, by moving to a country with more sensible medical care practices, but even those countries base the foundation of their medical system on the availability of cheap energy and pharmaceuticals. If they had to spend more money on their military in order to maintain their borders from an onslaught of refugees from the starving and war-torn third world (as is happening right now), they probably wouldn't be able to afford all those cushy pensions and universal medical care to the same degree they do right now. Expect the future to look considerably different from the past in that regard.

If there's nothing you can do to halt this long-term trend (not that I necessarily expect you to believe me), what would I advise?

1. Get familiar with death. Go visit a Joel Salatin type farm and at least watch the slaughtering of chickens. If you've seen it, it might not scare you so much. Attending your great-grandmother's funeral doesn't count.

2. Go volunteer in a nursing home. At the very least, you might come to appreciate that sometimes death is better than the alternative, which is waiting for death. 

3. Accept your own death. Regardless of your age, do some planning. Do you want to be cremated or buried? Where? Do you have life insurance? Should you? Are you an organ donor? Do you want your life artificially prolonged and to what extent? Do you want to become a tree? If you have boomer parents, they may be singularly unwilling to talk about this topic with you. If so...them's the breaks.

4. The vast majority of ways that people used to die before the modern medical system came along involved something like getting a minor cut and then withering away due to infection. Go get real medical training--not just First Aid/CPR but a Wilderness First Aid or Wilderness First Responder (WFR) course. Put together a complete first aid kit and know how to use what's in it. Just because death is inevitable doesn't mean you need to invite the Grim home for supper.

5. If you're super crunchy granola, go learn some basic herbalism. Wound care like you might get in a WFR course is fantastic, but so is the ability to make some kind of poultice that draws out infection. Neosporin is great, but depends on an industrialized medical system dependent on cheap manufacturing and even cheaper transportation.

6. If you're on a bunch of medication, like yours truly, take steps to get off of it if at all possible. If you're a Type 1 diabetic, you're probably SOL. Three hundred years ago, many more children died before the age of five than do right now. 

Most folks I know are not appreciative of my doom and gloom prophecies. They want me to be hopeful, they want me to keep fighting the good fight.

You won't get that here. If you want hope regarding the likely earlier-than-currently-predicted -via-statistical-averages-deaths of everyone you know, including yourself, consider the following:

The last 100 years of increasing lifespan in western countries is an anomaly in world history. More frequent deaths will return the planet to something approaching it's carrying capacity for human life, which will place humanity back into a more realistic relationship with the rest of the natural world. It's okay to be sad about a relative or a child or a parent dying. It's not okay to be so divorced from that heretofore typical human experience that we take insane and expensive measures to prevent it, often to the detriment of the person who is dying.

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