There, you’re smarter than a scientist.
Diabetes
An old disorder of the blood. Without insulin, the only way to manage it is with a starvation diet. I doubt anyone has diabetes today.
Dysentery (Bacterial)
Don’t get poo in your mouth.
Dysentery (Amoebic)
Don’t drink nasty water.
Normally I don’t have patience for people who lack the common sense to stick to clean water or beer, but I have to admit that accidents happen. For example, a man traveling up the coast might stop and make camp at Clearlake, not knowing that the two settlements that used to be there recently wiped each other out in a war over the last fertile fields. And they sank corpses in the lake to poison the water, and the streams in the area may look clean, but they’re crawling with bacteria. It’s maybe not a man’s fault, under those circumstances, if he drinks the water.
For both forms of dysentery, the treatment is the same as for cholera. It’s not as bad as cholera, but if you’re already sick or weakened it can kill you. I’ve nursed a lot of people through it. I know what to do. When the patrol guards hauled Dr. Spendlove onto the porch of the trading post, I knew.
Dysentery is not a romantic disease.
Exposure
All my life, I’ve avoided places where the temperature drops below freezing. As far as I’m concerned, that’s the best way to prevent death by exposure, just like not getting pregnant is the best way to prevent death by childbirth. Don’t go north. It’s so simple. Especially don’t try a mountain crossing late in the year, when the air in Gualala is already crisp and cold at the height of the afternoon, and there are no stars in the night sky.
But, as with pregnancy, sometimes things happen. Sometimes you find yourself in the mountains of Oregon in December, in a shattered wagon with the snow starting to fall all around and your fibromyalgia acting up. It’s not smart. Maybe it turns out you’re pretty stupid after all. But it happens.
If you’re caught outside in the cold, the first thing to do is build a shelter. Put pine needles or other cushioning between yourself and the ground, because the frozen earth sucks out heat. Get out of the wind and into some kind of insulation. Straw is good. I could use a pile of straw.
Share body heat.
Feral Dog Packs
Anyone who’s ever gone into a city with a foraging party knows to pick up rocks to scare the dogs away. Because most dogs will slink away at the first hint of a threat, people often underestimate the danger of dog packs. People are stupid. They worry about bears and snakes and so on, but when you get down to it, truly wild animals are glad to ignore you. They don’t care about humans. Dogs care. And they know us.
Not all dog packs are scared little clusters of skinny sucker dogs. Some are big and organized and know how to hunt. And I’ve seen normally harmless packs turn dangerous when fighting each other over territory. So play it safe. If you hear barking, turn and walk the other way.
People ask which are worse, dogs or wolves. Don’t ask questions like that. If you’re smart, you’ll never know.
When Dr. Spendlove was a boy, he had a dog as a pet. Its name was Jacob. He talked about it while we sat around the fire at night, watching the trees for movement. Nights like this we could use a warm dog at our feet, he said. I’ve read books with that kind of thing, but it’s hard to picture.
Foraging
Lauren and I were good at foraging. Summer and autumn up in the Berkeley Hills, foraging all day and cooking in the granite-countertop kitchen of some abandoned house at night, those were the best times. With all I’d memorized from my mother’s little electronic library, I knew what to gather and what to avoid.
Without a library, it’s harder. You have to be careful, because lots of things that look good can kill you. It’s as true with food as it is with the rest of life.
What I ought to do here is put in some drawings of poisonous things, mushrooms and hemlock and all kinds of nightshades mostly. But I’m not much of an artist, and I’ve got a deadline coming up fast. Lauren could have done it. That’s why you pull rotten teeth.
Frostbite
In the cold there are so many things that can kill you. Wolves, for example. And things can go wrong in too many ways. Take frostbite. As if it wasn’t bad enough on its own, it can lead to gangrene, which can lead to blood poisoning, which can kill you.
There are treatments, I know. Easy ones. If the frostbite is moderate, you can chafe with snow to remove the damaged skin. If it’s more severe, you have to amputate the dead parts of your body. But still, it bothers me. The skin gets so black, and it feels like fire and ice at once. It’s not a good way to die.
Toes and fingers go first. If I have to amputate my fingers, I’ll never finish this book.
Heatstroke
If you exert yourself out in the heat and you don’t drink enough good, clean liquids, your body may become unable to handle the heat normally and go into heatstroke. A common sign is losing the ability to sweat. A person suffering from heatstroke should be moved to as cool a place as possible and kept hydrated. Cover them with damp sheets, splash them with water, make them drink.
Heatstroke can kill you, but it can also cause long-term health problems. Dr. Spendlove has a weak heart from bouts of heatstroke as a child. His family was one of the ones that stayed in Salt Lake City after the evacuation, back when the trouble started. It was a hard life of hot, dry death. But at least he escaped the worst of what was happening in the outside world, just like I did on the island off Mexico.
Still, his heart is weak. That’s why I agreed to go north with him. He might have had another spell, and where would he have been without me?
Hypothermia
When you get cold enough, your body starts to freeze. If this goes on long enough, it will kill you. But don’t panic. Stand too quickly, and the cold blood could rush up from your legs and give you a heart attack. Especially if you have a weak heart.
Move slowly. Try to shiver under the blankets. Blow on the little yellow fire. Keep writing.
Malnutrition
I’m sure I don’t need to tell you the symptoms of malnutrition. Anyone who’s ever lived around the dead places has seen it, and most places are dead places these days. Now that the white plague has spread everywhere and the cities are mostly picked clean, feeding people has gotten harder and harder. Outside of a few good places, everyone’s starving to some degree or another.
The human body is funny. You can live a long, reasonably comfortable life without ever getting enough to eat, your body always eating itself a little but never too much. Or you can drop dead from the lack of a single vitamin. For most people, though, malnutrition kills sooner rather than later. There is no cure but to eat, and to eat as varied a diet as possible.
I’m sorry. That’s all I have. Until there’s more food, that’s it.
Mites
Use only oat or wheat straw in chicken coops, and never line coops with wet straw. Keep the coops away from your house and away from your source of fresh water. This is another thing people never take seriously until they start getting sick.
Reading my mother’s library when I was younger, I always thought this was the kind of thing that would kill me. Pet a chicken and pick up mites, sip a cup of cloudy water and get a tapeworm, prick your finger on a needle and the lockjaw sets in. Some tiny thing that slips into you and grinds the gears of your biology to a halt. I am a small, quiet person. I am made for a small and silly death.