History and Disaster Preparedness

An 1849 depiction of Bridget O'Donnell and her...

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The following post on history and disaster preparedness is contributed by Pete Farmer,  who holds advanced degrees in research biology and history, and is also an RN and EMT. 

Thank you, Pete, for this lesson from history.

* * *

October 24, 2010 

What can history teach us about being prepared for natural or man-made disasters? 

Simple question, complex answer – but perhaps we can make it less complicated. 

Looking backward over human history from the perspective of the post-industrial age and all of its comforts and amenities, it is easy to forget that the story of humanity has often been one of hardship and privation. To live was to struggle against other humans, with whom one was competing for scarce resources, and against nature – disease, famine, pestilence and simple bad fortune. Life was rather Darwinian. Those fit and resourceful enough to survive did, and those who were not, did not. Prosperity was much more precarious, to the extent that it existed at all.

Before the mid-19th century and the revolution in science and medicine, death in childbirth, infancy or childhood was unremarkable and common. Families were large, party because parents wanted at least some of their progeny to make it to adulthood. Communicable diseases were endemic, and took a toll upon all ages. Life expectancies were much shorter than today; old age and its infirmities arrived in what would now be considered midlife. Public health measures were non-existent or poor, and sanitation deficient – especially in urban areas. Work was dangerous and physically-demanding. A dependable supply of food depended on favorable weather and avoiding crop failures. An occurrence of widespread famine – such as the famed Irish Potato Famine – could have geopolitical consequences.  People of all ages and social classes were much more subject to the vicissitudes of life than their modern-day counterparts. 

Which brings us to lesson one… the kind of prosperity which we enjoy today is historically an anomaly, not the norm. Modern societies of the developed world are remarkable for being the first in human history to defeat scarcity on a widespread, sustained basis. The poorest among us enjoy conveniences and comforts unimaginable to the wealthy aristocracy of the 18th or 19th centuries.

What are the implications of this truth? Several come to mind. First, if you are fortunate enough to live and prosper in the modern world  – be grateful. You’ve won the historical lottery. Second, because most of us have never experienced real hardship on the order of the Great Depression or the Dust Bowl – we tend to take our prosperity for granted. Of course, preppers tend to be the exception, but others of us cannot or will not see the troubling cracks appearing in the edifice of western civilization.

This isn’t simply myopia, for most humans suffer from a peculiar affliction – something cognitive psychologists call “change blindness,” the inability or delay in perceiving gradual change happening around us – especially variation that does not fit our personal models of reality. Nor do human struggle only with perceptible change, we also can get blindsided by unforeseen, high-impact events.  Nassim Taleb, in his book, “The Black Swan,” examined this phenomenon in detail. A “black swan” is an unforeseen event which profoundly alters our reality, in ways that fall outside of the predictive powers of the sciences, history, and economics. Black Swans can be good or bad events; the rise of the personal computer and the internet, World War One, the influenza pandemic of 1918 and the 9-11 attacks are examples. Taleb convincingly argues that not only do we fail to see black swan events coming, we often misunderstand them in retrospect by drawing the wrong lessons from them. 

Lesson two: no matter how hard or thoroughly one prepares for the future, reality probably isn’t going to unfold in the way one has planned. Expect the unexpected, because it is probably going to happen. Do your best to see reality as it is, not as you wish it to be, and stay flexible and adaptive. Work hard – but don’t be afraid to cross- your fingers for luck. Everybody needs it. Be sure to temper your can-do attitude with a bit of realism – even fatalism. Sometimes smart, resourceful people get caught up in events beyond their control, and despite their best efforts, they don’t get out alive. Two soldiers are side-by-side in the same foxhole; one lives and the other is killed by an errant bullet. Chance plays a far-bigger role in our lives than we like to acknowledge. Combat soldiers have always known this. And of course, all of us will eventually get carried out “feet first.” None of us gets to cheat death forever. At first glance, this attitude seems pessimistic, but at least for this writer, it has proven enormously liberating. Fear of the unknown is often worse than whatever finally happens.   

Lesson three: sometimes the worst-case scenario is accurate; black swans can be every bit as bad as our nightmares. This is the flip-side of lesson two. For medical preppers, this is an important lesson, which speaks to motivation to prepare for crises-yet-to-occur.

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In the period 1880-1910, American medical education and research underwent a remarkable transformation at the hands of such visionaries as Henry Welch and his colleagues, such as Simon Flexner, Anna Williams and Oswald Avery. These pioneers brought American medicine into scientific age, thereby making such institutions as Johns Hopkins University Medical School into world-class instutitons of medical knowledge, research, and practice. Unknown to them, Welch and his colleagues were soon to face the severest tests imaginable – first in World War One, the most-costly war in human history, and then in the most deadly plague in history, the influenza pandemic of 1918. As horrific as these events were, the death toil would have been appreciably worse if Welch and his colleagues had not been working so furiously to transform how medicine was practiced in the preceding decades. None-the-less, the influenza pandemic nearly brought down western civilization. It strained the bonds holding society together as perhaps nothing before or since has done. The nearest parallel is perhaps the scourge of HIV/AIDS in modern Africa. 

Interested readers are urged to read John M. Barry’s remarkable book, “The Great Influenza: The Epic Story of the Deadliest Plague in Human History” (Penguin, 2004).

Barry’s outstanding scholarship and penetrating writing make this a classic every historian, medical scientist and prepper should read.

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About Cynthia J. Koelker, MD

CYNTHIA J KOELKER , MD is a board-certified family physician with over twenty years of clinical experience. A member of American Mensa, Dr. Koelker holds degrees in biology, humanities, medicine, and music from M.I.T., Case Western Reserve University School of Medicine, and the University of Akron. She served in the National Health Service Corps to finance her medical education.
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