For the Health of it™
Vol 3. No. 8
On the Need for “Rational” Self-reliance and Reliable Partners to Get Best Health & Health Care
Michael F. Mascia, MD, MPH
Thanks to *Lanie Adamson for editorial assistance
Ten years ago, Katrina got my full attention.
Katrina? Battery Explosion? Huh? OK, I hear you screaming, “What does that have to do with the need for reliability, self-reliance and reliable partners in Health and Health Care? What does a battery explosion have to do with Health and Health Care?” Let me explain how the battery explosion in the bank of deep cycle batteries of my solar power system triggered this blog. And, let me explain why “rational” self-reliance and reliable partners are needed for you to Take The Best Care™ of yourself and those in your charge.
Autonomy vs “Rational” Self-reliance plus Reliable Partners?
Are we autonomous? Is it possible? Not really. Autonomy is “the state of existing or acting separately from others.” So, by definition, the autonomous state is not really possible. Humankind is destined for something other than autonomy, because each and every human, from conception to death, relies on and interacts with people, other animals and all things in his or her environment. That environment, of course, includes other human beings, and those human beings rely on and interact with more human beings, and so on around the globe. The simple act of living and breathing means interacting with other humans, other animals and all other things living and non living on the planet and larger universe. Autonomy is an illusion, or, as other gifted authors have noted, “No Man is an Island”[2,3]. I prefer to think in terms of optimal, sensible or “rational self-reliance”. What is that?
What is “Rational Self-reliance?” Action That Counts
Self-reliance is “reliance on one’s own efforts and abilities.” And “rational self-reliance” implies reasonable limits and the inevitable need for and rational use of help from others. The term “rational self-reliance” is useful to describe the ability to survive without the help of others when safe, possible, sensible, and serves the best interest of the individual and those in his or her charge. Each responsible adult must determine safe limits and safe practices, and must know how and when to turn to others for help, when the needs arise. That’s right, for able bodied adults, “rational self-reliance” includes and requires the ability to survive, at least for a limited time, without the help of others, and to come to the aid of others with jeopardy to none.
In a nutshell, the idea is this: responsible, able bodied adults can and should learn to take the best care of themselves and those in their charge. This idea implies and assumes that each and every capable adult should be learning, training and teaching how to deliver best self-care and learning how to get best care and treatment. That requires cooperation, learning, training with others and the ability to get proper help, if and when you need it, and to get the best products and services if and when necessary.
Therefore, we see the need for reliable partners, if we expect our
- actions to have the
- best results =
- the best care and treatment with the
- best possible outcome.
Limits of Self-reliance: One Extreme Example
Of course, there are limits to self-reliance. Leningrad surgeon Leonid Ivanovitch Rogozov was pushing it when he surgically removed his appendix while on an Artic expedition in 1961.  Maybe he did not need an appendectomy after all? But, what should the professional and the nonprofessional be able to do on their own? That is the substance of health and health care literacy and the subject of many other discussions. For now, we limit our talk to “rational self-reliance” that works for most of us most of the time.
With that in mind, I like the idea of being able to help myself and others in a pinch, when the chips are down and in the midst of a disaster. Let’s face it, healthy adults should
- be able to take care of themselves and
- survive on their own,
- at least for the short haul. And,
- responsible healthy adults should be able to
- take care of routine health and health care issues on a day to day basis. They should
- know the difference between signs and symptoms of and be able to distinguish between
- ordinary self-limited illnesses and injuries and those that are
- potentially fatal and likely to cause permanent damage. They should
- know who to call and
- how and where to get the best help, if and when needed.
That is “rational” self-reliance plus reliable partners.
Disasters and Disaster Preparedness Trigger this Blog
The North American Ice Storm of 1998  and Hurricane Katrina in 2005 [7,8,9] reinforced my opinion and resolve on the matter.
Over the years, I had installed a generator, batteries and solar system, but in mid-June 2015, the system went down.
I called the guy who helped me to install the system, but he said, “Call a professional.” Bastard! Fortunately, because it was summer and I have grid service, this was just an inconvenience. In our New England winters, this sort of thing would be life-threatening. So, being June I took my time to find someone to help me fix it. This is how it played out.
But as you read this story, imagine the occurrence of a critical health event in your family or community. Imagine the event under your watch. Imagine the event and the need for immediate and best care and treatment.
The Moral of the Story Before I tell the Story?
- When “the thing” you need happens to be
- Best Care and Treatment related to a
- health or health care emergency,
- a critical illness, or injury, or
- a serious medical problem or disease,
- your life, limbs and organs depend upon the
- availability of
- reliable partners
- to help you out
- in SECONDS or MINUTES
- all day and every day.
Remember, in Critical Illness and Injury, the
>> BEST OUTCOME RESULTS FROM EARLY DEFINITIVE DIAGNOSIS AND TREATMENT. <<
- If you can’t help yourself,
- you can’t help anyone else.
The Blown Battery Story and How That Relates To Best Health and Health Care
OFF THE GRID AGAIN: Now working again and fully functional as of August 11, 2015.
Here is the story as it played out between the mid June failure and restoration of my solar system on August 11.
June 15, 2015: On Electricity Grid & System Charging?
The other day I noticed the smell of rotten eggs when I entered my barn basement. That is strange, because I have no chickens, eggs or other animals in my barn. On further exploration, while following my nose, I wandered into the “disaster room”, so named, because it has controls for my solar system and the required deep cycle lead acid batteries.
“Aha! Deep cycle, liquid filled, lead-acid batteries = Sulfuric acid and a possible source of hydrogen sulfide” I thought. But why? The voltage controller flashed fault and showed no charge on the batteries. Thinking, “Very strange,” and after opening the battery box, I first saw nothing. Upon closer inspection, I noticed black stains on the plywood lining the bottom of the box. Then I spotted the out of place cell cover “That’s odd. What’s that doing there? I don’t recall buying any spares. Did I?” It was in the wrong place, because it had blown off the top of one cell of one of the 8 batteries, that is 1of 24 cells, and the system was down. Mystery solved  and … system down. Now what to do?
System down means no part of the system works: no solar, no batteries and, no generator for back up, because the generator starter battery had died just a few days before the explosion.
I called my electrician and he recommended Mo’s electric in Lovell, Maine … a couple towns over. I go about finding MO. Mr. Google points me to a few phone numbers. This one works.
There is no hurry, because I am on the grid and this is summer. After several days and phone calls, I connect with Mr. Mo. He is busy, but goes out of his way to make a service call on the night before I have to leave town.
June 18, 2015 at around 7 PM
We check the problem together, so I can point Mo in the right direction and I can learn. We make a diagnosis together. The cause of the problem is a blown cell of one battery due to cap vent failure. Easy to fix. Order a battery. Replace battery. Start again. And, he shows me how to replace the starter battery in my generator. Easily done by me when I have the time.
Mo offers to get the battery ($400 out of his pocket). But, I front him the money and set him up to fix it while I am gone.
July 12, 2015
Upon returning from my trip I found that the thing was not fixed. Call Mr. Mo again. Batteries are on back order. He returns with a new battery the day after they arrive in stock.
July 15, 2015
We hook up the new battery and test it to the max. All systems go … fully operational.
WHAT’S THE POINT? Rational self-reliance can give you the tools and action plans you need to help you best meet current and future medical needs.
No, this is not an advertisement for Mo’s Electric and Solar. The point is this: for most things in life, unreliable partners result in an inconvenience, unnecessary delays and money wasted. In Health and Health Care, your life, limbs and organs depend upon reliable partners to help you get the best care and treatment when you need it. In other words, your efforts at health, wellness, self-reliance, self-confidence and self-care will get you through most things medical. But, when faced with a critical illness or injury, you need reliable partners to help you get the best care and treatment as fast as possible. Get your reliable partners lined up in advance of any critical health events. These are the people (relationships) that determine the best outcome and that may mean the difference between life and death.
Said another way, your noble and valiant efforts at rational self-reliance are not wasted. It will get you and your family through most things including health, wellness, self-care and most things medical. But, you need to
- know your limits, you need to
- know when to call for help
- know who to call for help in the event of critical illness or injury.
- You need reliable partners to
- help you get the
- best care and treatment
- as fast as possible for
- critical illness and injury.
- Get your reliable partners lined up now, before critical health events.
These are the people (relationships) that may make the difference between life and death.
And, just in case you are incapacitated without warning
- make your health and health care wishes known in writing,
- designate your health care proxies, medical power of attorney, and
- prepare and sign your written advanced directives.
That way people will know your care and treatment wishes, in the event that you are not able to make them known to your physicians and other providers in the event of a sudden, life threatening accident or illness. Consider this idea:
- Create a video recording of your wishes that you can
- share with your primary medical care team, medical power of attorney, immediate family, friends and other reliable partners.
Follow our blog and join us at www.veritasHC.org where you will see
- What I Would Do “If I Were In Your Shoes?” a new blog series from VHC
- Find Reliable Health and Health Care Partners with us,
- as they emerge in our daily coaching, teaching, training, team building, care and treatment of real people, in real time, with real health and health care problems.
- put our reliable partners on display when they deliver exemplary care and treatment (B2 Score 100. B2 = B Squared = Best Care™© )
- show you how to use the B2 System to build your best practices, care and treatment options.
- health and health care literacy,
- “rational” self-reliance,
- how to Take The Best Care™ of yourself and those in your charge,
- how to find and use reliable partners to help you get the best health and health care
We will show, teach, train and coach you to help you
- build your best health and health care team
- build your best practices and outcomes
- build your personalized quality and performance improvement and building best practices tools
- define your “rational self-reliance” limits
- increase your health and health care Knowledge and skill
- take the right Actions to
- find and use reliable partners
- to get the care and treatment you need,
- when you need it.
Thanks and have a sweet day.
 “Autonomy.” Merriam-Webster.com. Merriam-Webster, n.d. Web. 3 Sept. 2015. <http://www.merriam-webster.com/dictionary/autonomy>.
 Donne, John (1574-1631) http://www.poemhunter.com/poem/no-man-is-an-island/
 Merton, Thomas (1915 – 1968), No Man is an Island
 “Self-reliance.” Merriam-Webster.com. Merriam-Webster, n.d. Web. 3 Sept. 2015. <http://www.merriam-webster.com/dictionary/self-reliance>.
 Auto-appendectomy in the Antarctic. BMJ 2009;339:b4965
 Inside Katrina > http://veritashc.org/wp-content/uploads/DPCombinedforCD-PDF.pdf
 Inside Katrina > https://www.youtube.com/watch?v=Yn3slYkfyac
 The Limits of Self Reliance: Emerson, Slavery, and Abolition by James H. Read
For Editorial Assistance, I am grateful to Lanie M. Adamson, MS,
Fellow, American Medical Writers Association