Emergency: This Book Will Save Your Life - Neil Strauss (2009)

Part V. RESCUE

Lesson 61

In the event of amputation of the penile shaft, whether partial or complete, an EMT should “use local pressure with a sterile dressing on the stump.”

If during “particularly active sexual intercourse, the shaft of the penis is fractured or severely angled,” an EMT should immediately transport the patient to a hospital for possible surgical repair.

If the foreskin of the penile shaft is caught in one or two teeth of a zipper, the EMT may attempt to unzip the pants. But “if a longer segment is involved or the patient is agitated, use heavy scissors to cut the zipper out of the pants… Be sure to explain how you are going to use scissors before you begin cutting.”

These valuable life-saving tips come from the book Emergency Care and Transportation of the Sick and Injured—1,296 densely packed pages detailing nearly every medical and traumatic emergency that could possibly happen to a human being in a civilized country, from strokes to gunshot wounds to zipper mishaps. It was one of the best, most concise, most information-dense survival resources I’d read since FM 3-05.70, the U.S. Army’s survival field manual.

It was also my textbook at the California Institute of Emergency Medical Training, where I was studying to become an EMT.

Alwood had steered me in the right direction. The course was exactly what I needed. In fact, the very first class was about handling stress.

“Are you going to see people die?” Matt Goodman, the small, hyperactive head of the institute yelled at us.

The class listened in silence.

“Yes, it’s actually part of the job. Is this stressful?” He paused and waited for a response. A few students murmured in agreement. I was so out of my element that I had no idea whether my classmates were silent out of shock or boredom. “It’s definitely stressful. The truth is, we see people die. But you don’t have the luxury of screwing up just because you’re under stress. You cannot let it affect you at that time. Family members may lash out at you. Don’t try to win them over or change their minds. Stay calm and let it roll off your back.”

I felt like an imposter. The student on my right wanted to work with the fire department. The girl on my left was applying to medical school. The guy in front of me was part of a local search-and rescue-team. And me? I was practicing for the apocalypse.

Somehow I’d crossed a line in my pursuit of safety. I was no longer taking courses teaching me things to do Just in Case. I was actually going to be doing these things.

In subsequent classes, Goodman drilled us on how to recognize and, when possible, treat everything that can go wrong with the human body: heart attacks, car crash injuries, strokes, allergic reactions, seizures, poisonings, gunshot wounds, broken bones, burns, drowning, hypothermia, heatstroke, drug overdoses, childbirth complications, lung diseases, diabetic emergencies, snake venom absorption, lightning injuries, and scores of other diseases, accidents, and mental disorders.

And, though we were taught how to recognize and deal with symptoms related to nearly every weapon of mass destruction conceivable, we also learned that there were bigger things to be scared about than a jihad-bent teenager in a crop-duster or a gun-toting neighbor with an empty stomach.

Like McDonald’s, for example. Every minute, an American dies from heart disease, Goodman told us, his eyes burning a hole in the Chicken McNuggets I was dipping into hot mustard sauce as a midclass snack. Though I’d spent the last eight years worrying about the outer world, I’d never once thought about the inner world. I’d never considered that eating fried chicken and hamburgers and french fries was the culinary equivalent of walking through Baghdad at night.

Perhaps survivalism, then, is about more than shooting guns and drinking out of toilet tanks. It’s also about physical exercise and a healthy diet. After all, these are more likely to keep me alive than a solar still. Even the survivalist pioneer Mel Tappan, despite all his preparations and heavy artillery, died at age forty-seven of congestive heart failure.

After Goodman led a class on heart disease, I decided to look into what I was up against. I wanted to know exactly what factors posed a threat to my life, and what their chances were of occuring, so I could better prepare myself for them.

According to the most recent census figures, 2,448,017 United States citizens died in 2005. Of these deaths, 652,091 were due to heart disease, 559,312 were from cancer, 143,579 were from a stroke, and 130,933 were from chronic lower respiratory diseases.

The fifth-largest cause of death was the one Katie and I, along with every other negativity avoider on the planet, worried about most: 117,809 Americans died from what the government calls unintentional injuries and EMTs call trauma.

This means that every year, roughly one in every 2,500 Americans is at risk of losing his or her life due to some sort of accident or injury.

According to the National Center for Injury Prevention and Control, nearly 40 percent of those deaths—approximately 45,343—were due to motor vehicles. Being in or around them is probably the most risky behavior we engage in as human beings. Evolution never designed us to withstand impacts faster than the top speed at which we run.

The next-biggest cause of accidental death, surprisingly, was poisoning, which took the lives of 23,618 Americans. This was followed by falling, which claimed 19,656 lives.

Despite the arguments of those both for and against gun control laws, Americans with firearms actually posed more of a danger to themselves than to other people: 12,352 people were murdered by guns, while 17,002 took their own lives with one. Overall, there were 18,124 homicides in 2005, in comparison with 32,637 suicides.

Other causes of traumatic death included burns and fire (6,496 people), suffocation (5,900 people), and drowning (3,582 people). Even though eight hurricanes and tropical storms (including Katrina) and seven earthquakes hit the United States in 2005, the number of people who died due to environmental disasters was a comparatively low 2,462.

Coming in near the bottom, just above overexertion (responsible for eleven deaths), was terrorism. Fifty-six Americans died of terrorism in 2005 (not counting military personnel on active duty), and none of those attacks took place on American soil.

So who was the bigger idiot: me, who had spent the last seven years obsessed with terrorism, economic collapse, and natural disasters, or Katie, who was too scared to drive?

I’d teased her about her fears on an almost daily basis, but she had been right the whole time: the mundane is far more terrifying than the apocalyptic.

Fortunately, thanks to my EMT training, I was now prepared to handle both.