|  It is a clear shot, though not a perfect one – I have to stand at full height to make it. But I know I can make it and I say, “Thank you. I am sorry.” Still I hesitate, for though I can lose myself in the hunting, I have never been able to stop thinking about its results – that I forget it’s this elk rather than that elk who is about to die; that it’s this creature whom I’m about to take from the world rather than some number in an equation proving the merits of wild food harvesting over being a supermarket vegetarian; that this being before me – who sees, who smells, who knows – will no longer be among us, so that I may go on living. And I don’t know how to escape this incongruous pain out of which we grow, this unresolvable unfairness, other than saying that I would rather be caught in this lovely tragedy with those whom I love, whom the ground beneath my feet has created alongside me, than with those far away, whose deaths I cannot own. Not that I think all this. I know it in my hesitation.
— Ted Kerasote If you have somehow wound up being the sole long-term caregiver for some community which is remote from definitive medical care, or you are planning on becoming one, you may find yourself in the position of having to educate yourself from medical textbooks. This is not, of course, the recommended procedure. I am not saying it can’t be done, because people have done it; but I truly believe that a healthy humility is the best source of good wilderness medical care. In any event, what you would need is one or more good general medical texts geared toward family practitioners or physician assistants, a book on simple office surgical procedures, and a good medical dictionary to help you figure out what they are talking about. You will need the best anatomy text you can find. Under some scenarios, you might have access to drugs – anywhere from a looted pharmacy, to veterinary drugs, to a brightly lit drugstore in, say, Iquitos – and you will need a book to teach you what disease goes with which drug, how much to use, and, most important, what can substitute for something else. In many cases, books such as anatomy texts or medical dictionaries are a matter of simple personal preference; any large bookstore will stock several of each, and you can decide what you are most comfortable with. New editions come out frequently, so you should check to see what is most current, but you can also save a lot of money by finding a used copy of a slightly out-of-date edition.
 Anne M.R. Agur, Grant’s Atlas of Human Anatomy (Baltimore MD: Lipincott Williams & Wilkins, 1999), ISBN 0-68330-264-7. What I like about this classic text – it has been in use for more than fifty years – is that the illustrations are representations of actual dissections rather than idealized views of human anatomy. It has color schematic illustrations to supplement the dissection figures and clarify anatomical concepts, show the relationships of structures, and give an overview of the body region being studied. This edition contains many new illustrations and simple orientation drawings, expanded coverage of neuroanatomy, diagnostic imaging sections at the end of each chapter, and muscle tables. This atlas differs from most other atlases available, such as Netter's Atlas of Human Anatomy, because it contains not only illustrations, but also a significant amount of factual and clinical information in the accompanying text. It is actually as much a text as an atlas.
 Kenneth N. Anderson, et al., The Mosby Medical Encyclopedia (New York NY: Plume/Penguin, 1992), ISBN 0-452-26672-6. This is an authoritative medical reference for the general reader, with 20,000 definitions. Its entries on drugs include use, cautions, and adverse effects; entries on procedures often include method and outcome; and those on diseases often include diagnosis, treatment, and patient care. There are drawings and charts in the text and a section of anatomical drawings in color. Appendices include a drug interaction guide and a cross reference to generic names; tables for height and weight, nutritional requirements, and pregnancy delivery dates; immunization schedules; and charts of leading health problems and communicable diseases. This is a detailed and practical encyclopedia for answers to basic questions about diseases, symptoms, treatments, and medical procedures.
 Ragnar Benson, Survivalist’s Medicine Chest (Boulder CO: Paladin Press, 1982), ISBN 0-87364-256-2. As its title indicates, this is a book for survivalists on how to acquire drugs for long-term survival situations. This is the book in which Benson first wrote about acquiring veterinary drugs and devices for human use without the need for obtaining a prescription from a doctor. This book is now badly out of date, as Benson himself admits, both in terms of the drugs he recommends and the stringency with which veterinary supply houses examine the credentials of their customers. But the book continues to be offered for sale, so I mention it here to advise you to avoid it.
 Ragnar Benson, Do-It-Yourself Medicine (Boulder CO: Paladin Press, 1997), ISBN 0-87364-918-4. This book is intended to supersede Survivalist’s Medicine Chest, Benson’s earlier book. He now offers advice on getting drugs and devices from mail-order and foreign pharmacies, as well as from veterinary supply houses, along with brief discussions on their use. I do not think we need to debate the wisdom of getting drugs from these sources; but I personally think it is far better, wherever possible, to develop a relationship with a sympathetic doctor who will give you prescriptions for needed wilderness or survival supplies.
 Robert Berkow, et al., The Merck Manual of Diagnosis and Therapy (Whitehouse Station NJ: Merck Research Laboratories, 1999), ISBN 0-911910-10-7. For a hundred years, The Merck Manual has been the standard reference work on diseases and their treatment, and is probably the most widely used medical textbook in the world. The book covers every aspect of modern medicine in a relatively small, well-organized reference book. Published since 1899 as a service for the medical practitioner – family physician, internist, and emergency room physician – it presents all relevant diseases in all specialties with a practical and up-to-date approach for clinical management and diagnosis. This most recent edition has been updated to include new topics, such as smoking cessation, Gulf-War Syndrome, Chronic Fatigue Syndrome, Multiple Chemical Sensitivity Syndrome, rehabilitation, and drug therapy in the elderly, as well as many of the new, innovative medical therapies that have become the practice norm since the previous edition. If you were to have just one book in this section, this would probably be your best bet.
 Robert Berkow, et al., The Merck Manual of Medical Information: Home Edition (Whitehouse Station NJ: Merck Research Laboratories, 1999), ISBN 0-911910-87-5. This is, in effect, the Merck Manual for Dummies – less dense, less rich, but a lot easier to understand. This consumer version contains just about all the information found in the manual but written for the lay reader. The layout is accessible, with the book divided into sections organized around either organ systems or medical specialties. Each section begins with an outline detailing the contents of following chapters, the text is extensively cross-referenced, and the line drawings are clear and understandable. Appendices include information on legal issues, tables of weights and measures, common medical tests, trade names of generic drugs, and a resource listing of organizations providing information and support.
 Philip M. Buttaravoli, et al., Minor Emergencies: Splinters to Fractures (St. Louis, MO: Mosby-Year Book ,1999), ISBN 0-32-3007-562. From vaginal bleeding to pinworms, from carpal tunnel syndrome to heel spur, from colored urine to a zipper caught on the penis, from a broken toe to diaper rash – for each problem, this book gives a clear and often illustrated exposition of the patient’s presentation, what to do, what not to do, and a general discussion of the condition, with references to the medical literature. Do you have to remove a bean from a child's nose, relieve persistent hiccups, remove a fishhook from a finger, or treat tear gas exposure? This handy reference is ready to provide a fast, efficient treatment procedure. This is an absolutely wonderful book. I believe this is essentially the same as the spiral-bound Philip M. Buttaravoli et al., Common Simple Emergencies: How to Treat 185 Urgent Medical Problems (Washington, DC: Longwood Information, LLC, 2d ed., n.d.).
 Judith Hopfer Deglin, Davis’s Drug Guide for Nurses (Philadelphia PA: F.A. Davis Company, 2001), ISBN 0-80360-733-4. Nurses are the people who actually keep you alive, and one way they ought to be doing that is by making sure you are getting the right drugs at the right dosages. That is why drug guides for nurses can be so handy to have available. This is one of the most comprehensive, current, and bestselling of the nursing drug guides, with 1500 drugs organized by generic name, and featuring color images of drugs, lifespan dosing, available drug forms, and expanded IV information. The entry for each drug outlines indications, action, pharmacokinetics, adverse reactions and side effects, interactions, route and dosage, nursing implications, lab test considerations, implementation, and evaluation. It has a full-color insert with photographs of nearly 200 generic products.
 Anthony S. Fauci, et al., Harrison’s Principles of Internal Medicine Companion Handbook (New York NY: McGraw-Hill, 1998), ISBN 0-07-021530-8. Here is the distilled essence of the famous Harrison’s Principles of Internal Medicine, 1237 pages thick, but still of a size you can put in your pocket, if it’s a big pocket. The editors of Harrison’s have created a condensed version of the larger classic text, with a review of each condition providing concise guidelines on pathophysiology, etiology, clinical signs, diagnosis, management, and therapy. This is a truly encyclopedic treatment of just about every known human disease, and you can hold it in one hand.
 Walter D. Glanze, Mosby’s Medical, Nursing, & Allied Health Dictionary (St. Louis MO: Mosby, 1997), ISBN 0-81514-800-3. The advantage of this 1500-page dictionary is its coverage of nursing and allied health terminology in addition to the usual core medical terms. This new edition has 2300 illustrations, all in full color, which is especially helpful in illustrations of anatomy, medical equipment, and skin and eye disorders. It includes comprehensive definitions of major diseases, disorders, and procedures; detailed drug entries; a color atlas of human anatomy; and 74 appendices providing a variety of practical reference information.
 Dana Lynge, 20 Common Problems: Surgical Problems and Procedures in Primary Care (New York NY: McGraw-Hill, 2001), ISBN 0-07136-002-6. This book brings together in a single source the procedures necessary to manage the twenty most common acute problems that require immediate surgical action, covering the acute abdomen, abscesses, breast lesions, burns, trauma, lacerations, dislocations, bladder outlet obstruction, spontaneous abortion, Caesarian section, anesthesia, and excision of cutaneous and subcutaneous lesions. This is not just a procedure manual and certainly not an all-inclusive texts of academic surgery. Its virtue is to approach surgical procedures in the context of clinical problems rather than as isolated events.
 Frank H. Netter, Atlas of Human Anatomy (East Hanover NJ: Novartis, 1998), ISBN 091416-881-9. Dr. Frank Netter is an artist of the human body. In his fifty years as a medical artist, he has produced more than 4000 illustrations for anatomical texts that are now considered classics. This volume contains his anatomical illustrations, some updated and improved, with additional pictures to fill in gaps in his prior coverage – 514 color plates, many with multiple views, all of them clear, understandable, and beautiful. There is a 36-page index.
 Nurse’s Drug Guide (Springhouse PA: Springhouse Corporation, 1998), ISBN 0-87434-892-7. This is another of the nurses’ guide to drugs – more sophisticated than guides for lay people, and providing immediately useful information on dosages, side effects, and substitutions. This book contains very helpful introductory tutorials on drug therapy, dosage calculations, the administration of medications, and drug classifications. The main portion of the book consists of drug entries, using both brand and generic names, each of which covers generic and trade names, pharmacologic and therapeutic classes, pregnancy risk category, dosage forms, pharmacokinetics, pharmacodynamics, indications and dosage, adverse reactions, interactions, contraindications and precautions, nursing considerations, planning and implementation, patient teaching, and evaluation of response.
 John L. Pfenninger et al., Procedures for Primary Care Physicians (St. Louis MO: Mosby-Year Book, 1995), ISBN 0-80166-384-9. This text is an 1170-page compendium of diagnostic and therapeutic procedures useful to practicing general physicians, residents, and medical students. The volume is organized by medical-anatomic systems – skin, reproductive organs, cardiorespiratory, obstetrical, gastrointestinal, and so on – with each section subdivided into multiple chapters, each of which is devoted to a single procedure. The range of topics is very broad – simple skin biopsy, frenotomy, arterial cannulation, Swan-Ganz insertion, removal of foreign bodies from body orifices, stress testing, vasectomy, and techniques of cautery, cryosurgery, and sclerotherapy. Each technique is presented in terms of its indications, contraindications, needed equipment, patient positioning, caveats, and pitfalls, often along with the pathophysiology of the condition. Where appropriate, the book discusses alternate techniques, and, for most techniques, the book provides patient education materials, both preprocedure and postprocedure. It often even tells you where to get the equipment.
 The Physicians’ Desk Reference (Montvale NJ: Medical Economics Company, 2001), ISBN 1-56363-288-8. This – known familiarly as the PDR – is the granddaddy of all books on prescription medications. It contains the text of the package inserts for all drugs registered with the FDA that are currently in use – more than 4000 of them. The package insert contains information on indications, contraindications, mechanism of action, warnings, dosages, and interactions. The text includes life-size color photos of the drugs and three indexes – by manufacturer, by brand and generic name, and by prescribing category. A new volume appears every year, which is handed out free to doctors but costs regular people around sixty bucks in the bookstore. Your best bet is to have your doctor give you last year’s volume for nothing, since he or she would normally just throw it out anyway.
 The PDR Family Guide to Prescription Drugs (New York NY: Crown Publishing, 2001), ISBN 0-60980-766-8. This consumer handbook is the home version of the well-known Physicians’ Desk Reference, and it summarizes the FDA-approved package inserts in the PDR in layman's language. The drugs are listed by generic and brand names and by disease or illness.
 Professional Guide to Diseases (Springhouse PA: Springhouse Corporation, 1998), ISBN 0-87434-926-5. This is a 1346-page encyclopedia of illnesses, disorders, and injuries, along with their treatment. It is a clearly written, comprehensive text intended for medical practitioners of all sorts – MDs, interns, residents, nurse practitioners, RNs, and PAs – and covers more than 600 disorders, organized under 21 body systems. Chapter introductions discuss anatomy and physiology, and each entry defines the disease, describes signs and symptoms, causes and complications, and relevant diagnostic tests, summarizes medical treatment, and describes specific patient care in detail. Graphic logos direct the provider to patient signs and symptoms that warrant immediate medical attention, as well as emergency interventions. The book even includes tips on age-specific differences in pediatric and geriatric patients. Three appendixes provide information on cultural considerations in patient care, rare diseases, and community resources with Web site addresses.
 Professional Guide to Signs & Symptoms (Springhouse PA: Springhouse Corporation, 1997), ISBN 0-87434-856-0. Someone tells you he has trouble breathing or stomach pains; what might this mean medically? This book is an encyclopedia of more than 300 such signs and symptoms, listing what underlying disease process each may relate to, including, in this new edition, signs and symptoms of important emerging diseases, such as Ebola virus infection, Hantavirus pulmonary syndrome, and cryptosporidiosis. There is a definition and description of each sign or symptom; emergency interventions for life-threatening conditions; history questions and physical examination guidelines; medical cases and their associated findings; special considerations, such as tests, monitoring, and ongoing care); and pediatric pointers. The signs and symptoms are arranged alphabetically, and there is an appendix of 250 additional, less common signs and symptoms. This is an extraordinarily useful book.
 Clayton L. Thomas, Taber's Cyclopedic Medical Dictionary (Philadelphia PA: F.A. Davis Company, 2001), ISBN 0-80360-654-0. This is the dictionary that medical students and doctors use. It is the nineteenth edition – the book has been published since 1940 – and the most recently published medical dictionary I could find. Each definition includes symptoms, etiology, treatment modalities, patient care, and caution statements, and the terms are illustrated with detailed color photographs, anatomical drawings, radiologic images, and illustrations. Despite its breadth of coverage, the book is still relatively small and light compared to other health care dictionaries.
 Lawrence M. Tierney, Jr., Current Medical Diagnosis & Treatment (Stamford CT: Appleton & Lange, 2000), ISBN 0-07136-466-8. This is an encyclopedic reference text, written for physicians, and therefore rich in jargon; but it has an excellent index and tells you everything you would ever need to know about every disease you might ever run into. Although the book is designed for family practice and internal medicine practitioners, it intends to include residents, medical students, nurse practitioners, and physician assistants as well. It is intended as a single source reference for generalists, and packs a tremendous amount of medical knowledge into a readily accessible format, covering all the most important topics in general medicine. It includes information on over 1000 diseases and disorders – including gynecology, obstetrics, urology, dermatology, psychiatry, neurology, otolaryngology, and ophthalmology – with an emphasis on prevention and cost-effective treatments.
|
