Preparing for the Worst:
A Reminder

I'm sitting in a tire store on a Saturday afternoon, waiting for one of my car tires to be changed. It's amazing how a small thing like a flat tire can mess up your week. I had a bunch of plans for today, but that all had to change when I noticed a tire going flat yesterday. It also makes one realize how dependent we are on our technology and what can occur if we're not prepared for disaster.

Have you ever thought about how reliant you are on your technology? Think about all of the tech we rely on day in and day out. What would happen in a disaster when all of that stopped working?

The list goes on and on.

Would you be able to survive if the power went out?

During my first year of residency in 2003, shortly after arriving, there was a major power outage in the Northeast United States which extended from the Eastern seaboard all the way to the western suburbs outside of Detroit. Luckily, it only lasted four days because if it had gone on longer, it would have been a complete disaster.

I recall sitting at a pay telephone booth (yes they still had them in 2003) calling my family to let them know my wife and I were safe. Our cell phones didn't work, nor did our landlines. Oddly, the payphone worked.

Of course, our toilet didn't work, and we had no water, and within a couple of hours, all of the grocery stores had been picked clean of any supples that mattered. Similarly, the gas stations didn't work, and we had to drive 30 miles to find a gas station that had power. The closest one was just over the county line, which still had power because it was fed from a different electrical grid. Can you imagine what the line at the gas station looked like?

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As it turned out, there had been a disruption to the grid fed by a station on the U.S.-Canadian border, which caused the entire Northeast to go black. The one impression that stuck with me from all those years ago was just how unprepared we were for this. I often reminisce about that time and think about my current level of disaster preparedness…and cringe.

There's something about preparing for disasters that forces you to acknowledge that they can actually happen. For example, I live in an earthquake zone (imagine that being in California!), and recently, we've had a series of thankfully small quakes. We've even evacuated the patient center at the University. I recall one of the times the dentistry clinic in the building evacuated, and there were a bunch of people with dental appliances literally hanging out of their mouths. And, by the way, they couldn't even close their mouths! So much for dignity during emergencies!

Thinking about all the possibilities that could go wrong can be disturbing. We don't want to think about all the bad things that could happen, and it's human nature to want to avoid these scary scenarios.

But, I'm here to tell you not to do that.

Always have a backup plan. It's better to sit down at your leisure and think about all this nastiness before it happens, rather than in the middle of a disaster, when you don't have time for a clear-minded approach.

Think about your surgical training. We spend a lot of our time thinking about and preparing for all of the bad things that can happen during a case. The first major question I received as a resident doing surgery was, "What would you do if..." If I wasn't able to come up with an alternative method, I wasn't allowed to do any more of the procedure. This has been ingrained in me since those early years, and I ask the same questions of both myself and my residents when preparing for a case today.

The same is true for any profession. Consider pilots. You think they worry about what would happen if the landing gear didn't come down or an engine fails in the middle of the flight during the flight? Of course not. The airline industry is very well known for spending a lot of time on preflight checklists, maintenance, training with flight simulation, and keeping safety at the forefront. If they didn't, then why would we have to make sure our seat backs are in the upright and locked positions for landing, when we only had two inches of extra space to begin with?

We spend so much time in medicine focusing on the common diseases and less time on the rare ones. I'm sure most of you have heard the phrase, "When you hear hooves in Texas, you think of horses and not zebras." We aren't necessarily prepared to deal with disasters that by their very nature are zebras.

So, for those of you in disaster prone areas – just about anywhere it seems – be sure to think about those zebras and prepare for the unexpected while you have a chance.

Best wishes,

Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor
[email protected]