The patient died – A parable
At a faraway hospital at which that faraway region’s foremost medical specialists were on call, a comatose patient was brought in through its busy emergency entrance.
The patient had been found unresponsive in the midafternoon shade of a city park and brought in as a charity case. Her vital measurements were taken:
Heart rate: 120 beats per minute.
Body temperature: 107 degrees Fahrenheit.
Respiration rate: 26 breaths per minute.
Oxygen saturation: 72%.
But there was another condition that was apparent to all who examined her: eczema. Her beautifully formed face was pockmarked with sores surrounded by flaking skin. Her wrists and the backs of her hands were likewise blemished.
There was an immediate conference between the internist on duty and the dermatologist who had been reflexively called in by the intake nurse. A professional but heated discussion ensued and was referred to a medical administration that disliked arguments. A short time later, over the internist’s objections, the patient was wheeled into the care of the dermatologist, who, looking back over their shoulder, said to onlookers, “Well have her looking good in no time!”
The next day, the patient died.
This faraway hospital did not practice medical triage.
Moral:
We, too, must practice triage and establish a dynamic approach to resilience. Currently, the policy is, “Whatever we have, we must save every square foot of it,” a heroic stance of perfection that is the enemy of the good, thereby risking all we seek to save.
Given the need to literally clear the air and at the same time provide energy security to a demanding population, what can be saved, what can be moved and where is there more of it? Such an inventory with natural systems analysis would be a valuable planning tool.
We are in a conflict; whether we created it or not is beside the point. Why make it worse? There will be losses in any event, but only with triage can the losses be minimized while preserving life at large.
Think about it.
Bill Appel
San Juan Island
