Book review: “The Prepper’s Medical Handbook” by William W. Forgey, MD

Right or wrong, the term “Prepper” has certain connotations. However, Dr. William Forgey’s “Prepper’s Medical Handbook” isn’t necessarily aimed at doomsday believers. (Given the current social and political state of the world, the idea of prepping for doomsday might not seem as crazy as it one did…but I’ll leave that idea for another blog post.)

As Forgey says in the introduction, the goal of the book is to teach the reader how to “prepare and then act to manage medical problems in the ultimate austere environment, the one in which you must be fully self-dependent for even emergent medical care without any help from ‘the grid.'” Of his background and philosophy, Forgey writes, “I am a traditional MD….I prefer proven, rigorously studied, outcome-based protocols to…traditional healing folklore remedies, but there is a place for both when off the grid. [E]ven the greatest achievements of big pharma will do us no good when their products are not available.”

The book covers a wealth of topics directly relevant to hikers and backpackers including altitude sickness, snake and tick bites, water purification, fluid replenishment and wound treatment. To be sure, some of the subjects explored in the book might not be directly relevant to hikers, but if you ever do experience puffer fish poisoning, radiation exposure or venereal disease while through-hiking the Pacific Crest Trail, you’ll know what to do thanks to this book. (In case of puffer fish poisoning, use CPR; the book includes a basic overview of that procedure). As for jellyfish, Forgey doesn’t mention anything about treating with urine, although apparently vinegar works to help stop the  spread of venom.

His advice on diagnosing and treating heat stroke is typical of his approach to presenting this material: “[Heat stroke] is a true emergency…the patient will be confused, very belligerent, and uncooperative, and will rapidly become unconscious. Immediately move into shade or erect a hasty barrier for shade. Spray with water or other suitable fluid and fan vigorously to lower the core temperature through evaporative cooling.”

Dr. Forgey also offers practical information (and warnings) that might not have occurred to lay people. On hypothermia, he writes: “You do not have to be in a bitterly cold setting to die of hypothermia. In fact, most chronic hypothermia deaths occur in the 30-50 degrees F (0-10 degrees C) range. This temperature range places almost all of North America in a high-risk status year-round.”

The book also contains Forgey’s off-grid medical kit, including five modules: topical bandaging, non-prescription oral, prescription oral/topical, prescription injection and prescription cardiac. He breaks down each item in each of these modules, listing the necessary amounts to carry in an emergency and stock up on for longer stays.

Throughout the book, Forgey sprinkles just enough humor to appropriately lighten the mood: “Unless group discipline has really degenerated, human bites are due to accidents such as falling and puncturing flesh with teeth.” On treating a snakebite: “The first step is to calm the patient and treat for shock. How do you calm a person who has just been bitten by a snake? Not surprisingly, just telling him to remain calm won’t work.”

While the book published before the Coronavirus outbreak, some of the passages read somewhat eerily today. On Coccidioidmycosis (“San Joaquin” or “Valley” fever): “Symptoms can be delayed in travelers, appearing after leaving the endemic area. The primary symptoms are those of an upper respiratory infection, bronchitis or pneumonia. Incubation time varies and may occur weeks, months or years after the original infection…” Forgey gives overviews of diseases such as encephalitis, Zika virus and West Nile virus which, while now overshadowed by COVID-19, have recently been in the national consciousness.

The format of the book takes some getting used to; with frequent cross-referencing, a lot of jumping back and forth is necessary. A good way to use this book would be, in anticipation of an overnight (or day) trip into the wilderness, to review specific areas that are likely to be of relevance (for example, if you are headed to the Salton Sea, you probably don’t need to worry about acute mountain sickness) and to have them bookmarked for quick reference. In an emergency, some might find it intimidating to locate the right topic in the book.

Hopefully, none of us will ever be in a situation where we will need to apply the information in this book, but if the last few months have taught us anything, it’s that you never know. If we are ever off the grid by our own choosing or by unforeseen circumstances and have an unexpected medical problem, Dr. Google won’t be able to help us, but Dr. Forgey will.

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