The Medevac Threshold

There’s a trope in stories called the Godzilla Threshold. This usually comes up in large-scale stories, the kind where you can expect a scene of leaders pouring over maps or pacing a high-tech command room, and is more common in action, in particular disaster, movies, but it comes up other places as well. The Godzilla Threshold is the point at which all bets are off, and any measure, even releasing Godzilla, in the hopes that he will fight the new monster attacking the city, is justified.

This concept, and variations of it, come up all the time. In military strategy we have tactical nuclear weapons, which are employed when the cost of an enemy victory would be worse than nuclear escalation. In statistics, we routinely put dollar values on human lives and wellbeing to measure against other lives, or more frequently, to determine the point at which the cost of additional safety measures are more trouble to implement than whatever harm they’d prevent.
Are there other ways to stop the raging monster besides releasing Godzilla? Probably. Almost certainly. But all of those plans suffer from some variation of being more expensive, more trouble to implement, or they would’ve had to include long term planning and investment that started long before the monster arrived.
So here’s the thing about traveling with chronic health issues: there’s a very good chance that things will go catastrophically wrong. I never know if or when things will go wrong, only that they might. I have some idea of how they might go wrong, and knowing this, I have some limited idea of what would need to be done in those emergencies. I can’t know if or when, or which way things will go wrong, but I can make some contingency plans for the likeliest scenarios. This is why I always carry a full backpack within arm’s reach, equipped with sufficient variety of contingency supplies that it has been playfully dubbed by friends as “the Mary Poppins Bag”.
But my preparative efforts have to stop somewhere. At some point, trying to pack and plan on the assumption that anything that could go wrong will crosses the thin line from preparedness to paranoia, and more pertinently, becomes logistically impractical. At some point, I run out of space in my suitcase for backup prescriptions and redundant syringes. And long before that point, the extra burden, both literal and idiomatic, of trying to outwit the fates becomes simply too cumbersome to achieve anything of meaning.
After all, if I have more migraines than I packed medication for, then it’s pretty obvious that my day is already ruined, regardless of whether or not I have the medication. Similarly, if my life support device, my backup device, and the failsafe delivery mechanism, all get broken, it’s unlikely having syringes to fall back on are going to let me just go about my business. Far more likely would be a scenario where all of the above are destroyed by the same disaster, and then all I’ve accomplished is wasting the cost of syringes in addition.
There is no fix for fate deciding that today is not my day, and at a certain point, the amount of effort to salvage my plans by myself start to exceed the amount of grief that I would find from simply giving up and seeking outside help. I call this threshold the medevac threshold, because often I have to consider this in the context of packing for a cruise, where the only option for outside help may well be having a helicopter fly out and pick me up off my vacation, at great effort and exorbitant expense. But really this can apply to walking into the ER, or even to a pharmacy to get a refill.
Obviously, where this threshold is depends on the specifics. The namesake example of having a rescue helicopter fly out to intercept my cruise ship, like a scene out of The Hunt for Red October, presumably weaving through gale force winds and dodging lighting strikes, because of course that’s how it happens, is somewhat on the extreme end of possibilities. Even so, though it would certainly be a contender for most action-thriller-esque moment in my life, it wouldn’t be an automatic winner, which is, I think, a good reminder that even the worst case scenario isn’t that bad.
Keeping this in mind is one of the things that keeps me from second guessing my packing ad infinitum. Bearing the medevac threshold in mind is a good way to keep perspective. I am packing this week, and balancing between the need to be prepared and the need to avoid overstuffing the car is as challenging as ever, and so I remind myself that, in fact, failure, though it may not be pleasant or desirable, is an option.

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Renaissance Guy (Mobile)

This account is the one I use to post from mobile. Same guy though.