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Navigating life’s shifts proves challenging, often stirring deep emotions and uncertainties. This initial passage delves into the complexities inherent in life transitions, unraveling the psychological and emotional layers that make these periods particularly daunting. From the fear of the unknown to the upheaval of comfort zones, we explore the multifaceted reasons behind the inherent difficulty of life’s inevitable changes.

Stick around, and together we’ll uncover the intricate tapestry of factors that make life transitions such formidable experiences, and perhaps, in understanding them, you’ll find the strength to let go of the familiar and boldly step into the new.

Understanding Life Transitions

Image of a thoughtful young male in a contemplative pose, reflecting on his life during a transition phase, surrounded by symbolic representations of setting life goals, such as a vision board or a notepad with plans, highlighting determination and personal growth.While life transitions are an inevitable part of our journey, understanding them can significantly ease the stress they bring. Major life transitions, whether it’s embarking on a new career, moving to a different city, or enduring a personal loss, are profound moments that can shape your path. They demand that you adjust to a new normal, which can be both daunting and invigorating.

You’re not alone in feeling the weight of these changes. It’s natural to experience a mix of emotions—uncertainty, excitement, fear, and hope. Coping with this whirlwind requires you to acknowledge and normalize these feelings. Practice mindfulness to stay grounded and reframe challenges positively, seeing them as opportunities for personal growth.

If you find the burden too heavy and it disrupts your daily life, don’t hesitate to seek help. There’s strength in recognizing when you need support, and a therapist can offer guidance tailored to your unique situation.

Navigating the tides of change, the fear of uncertainty often looms large, challenging you to find your footing amidst unknown outcomes. Life transitions require you to cope with life’s new rhythms and potentially develop new routines.

It’s essential to recognize the impermanence of these shifts, understanding that the discomfort is a temporary phase. Practice radical acceptance; it empowers you to acknowledge unchangeable circumstances, helping to reframe negative thoughts into positive ones.

Your language molds your mindset, so choose words that support growth and resilience. Remember, transitions aren’t linear; they demand flexibility and patience.

If you’re struggling, it’s not only okay but wise to seek professional help. Cultivating coping skills isn’t just about surviving; it’s about thriving in service to others and yourself.

Uncertainty’s Psychological Impact

Amidst life transitions, the fear of uncertainty often grips your mind, potentially leading to significant stress and anxiety. This fear triggers a survival instinct, a resistance to change, and a yearning for stability. As you navigate these shifts, remember that uncertainty’s psychological impact is a natural response. It’s crucial to develop coping mechanisms—creating awareness, normalizing your emotions, and accepting uncertainty as part of the journey.

Transitions take time, and as you serve others, encourage them to embrace this non-linear path. Assist them in recognizing that feeling stuck is a common experience during change. By unlearning unhelpful thought patterns and reactions, you empower yourself and others to better manage mental health and adapt to new circumstances with resilience and hope.

Disruption of Routine

Adjusting to a new routine requires considerable energy and effort. The stability and support that once came from a consistent schedule may seem lost. Yet, it’s during these times that creating a new routine becomes essential. By establishing new patterns, you can regain a semblance of control and help mitigate the turmoil of change.

As someone dedicated to serving others, remember that these transitions aren’t insurmountable. You can leverage your resilience and adaptability to navigate through these periods. It’s about taking it one step at a time, recognizing the growth that comes from challenge, and supporting those around you who might also be struggling with similar disruptions. Together, you can rebuild routines that provide peace and a renewed sense of purpose.

Emotional Responses

Image depicting a young girl in a moment of reflection, symbolizing her journey through a transition phase, with a contemplative expression that captures both the challenges and personal growth associated with significant life changes.

As you face life transitions, you’re likely to encounter a whirlwind of emotions, including the uncertainty that accompanies new beginnings.

You may grapple with grief and a sense of loss as you let go of the old and embrace the new.

Acknowledging these feelings as natural parts of the process can help you navigate through this turbulent period with greater resilience.

Facing life transitions, you’ll likely encounter a whirlwind of emotions, from anxiety to excitement, signaling the importance of recognizing and managing these responses. As you navigate uncertainty, acknowledge the natural fear and stress that arise. These feelings are normal, and allowing yourself to experience them can actually help us process change more effectively.

To steady yourself amid the flux, practice mindfulness and positivity, which can reframe your perspective and enhance emotional awareness.

Lean on those who’ve successfully managed similar life transitions for support and insight. Your existing coping strategies and daily routines also offer a sense of stability and control.

If you find the emotional toll impeding your daily life, don’t hesitate to seek professional help, as it can be pivotal in guiding you through this uncertain journey.

Grief and Loss

Grief and loss, with their profound emotional impacts, often accompany life’s major transitions, leaving you to navigate a complex array of feelings such as sadness, anger, and confusion.

When you face the loss of a loved one or a significant change, it’s not just about adapting to a new reality; it’s also about coping with a profound emotional upheaval.

As someone who seeks to serve others, you understand the importance of expressing these emotions and seeking support. Whether you’re comforting a family member or guiding someone through their grief, your role is to help make the journey through loss a transformative one.

Encouraging them to find new meaning and strength in the midst of sorrow is a delicate but essential part of service and healing.

Identity and Self-Perception

As you face life transitions, your self-awareness may undergo a transformation. You’ll find that your roles and responsibilities might shift, challenging how you’ve traditionally seen yourself.

Understanding these changes is key to adapting and maintaining a positive self-perception.

Redefining Self-Image

Often during life transitions, you’ll find yourself reevaluating and reshaping your self-image as you adapt to new roles and environments. Whether it’s a career change, moving to a new city, or even the loss of a loved one, these common transitions can prompt you to question who you’re and what you stand for.

Redefining self-image isn’t just about adjusting to the external shifts; it’s also about embracing the internal transformations that accompany your journey.

Embrace this period of change by practicing radical acceptance. Understand your self-perception is evolving, and that’s okay. Seek support through therapy or life coaching if you need it.

Roles and Responsibilities Shift

While redefining your self-image, you’ll also encounter shifts in roles and responsibilities that challenge your identity and how others see you. Life transitions, such as becoming a caregiver after the loss of a loved one, taking on a new job, or facing job loss, require you to adapt to new expectations and redefine your sense of self.

These adjustments can be taxing, stirring up conflicting emotions as you navigate your evolving identity.

It’s crucial to seek support and perhaps professional guidance to manage these changes. Embrace this opportunity to serve others and grow, but don’t lose sight of reevaluating your personal values and priorities.

Coping Strategies

Navigating life’s changes, you can anchor yourself by seeking out friends and family for social support.

Establishing new routines will give you a sense of control and normalcy amidst the chaos.

You’ll also benefit from practicing mindfulness techniques, which can help manage stress and keep you grounded in the present moment.

Seek Social Support

During life transitions, it’s crucial to lean on your network of friends, family, and support groups for emotional backing and advice. Sharing your journey with trusted individuals helps you feel understood and less alone, especially during times of upheaval like the loss of a loved one.

It’s a natural time to seek connection, so don’t hesitate to join communities or online forums that align with your current experiences. Engage in social activities and rediscover hobbies to maintain vital social support.

Establish New Routines

As you lean on others for support, it’s also crucial to craft new routines that anchor your days and offer a fresh sense of order.

  • Establishing new routines during life transitions, whether it’s the loss of a loved one or the birth of a child, can provide the stability you need.
  • Start by structuring your day with intentional practices, like morning meditation or evening walks, to foster predictability amidst change.
  • Incorporate self-care to ease stress and encourage well-being.
  • Set small, achievable goals within your routine for a sense of progress.

And remember, flexibility is key—adjust routines as needed to adapt to your evolving circumstances, ensuring you maintain control during these transformative times. Your service to others begins with taking good care of yourself.

Practice Mindfulness Techniques

Incorporating mindfulness techniques such as deep breathing and meditation into your daily life can be a powerful tool for managing the stress of life transitions.

As you experience life transitions, taking the time to practice mindfulness techniques can be immensely beneficial. It helps you stay present, acknowledging and accepting the swirl of emotions that come with change. Engaging in activities like meditation or body scans grounds you, reducing anxiety and promoting emotional regulation.

By making mindfulness a part of your routine, you bring focused attention to your thoughts, feelings, and actions. This intentional practice fosters a sense of peace and clarity, enabling you to serve others with compassion and resilience during times of change.

Seeking Support Systems

As you navigate life’s changes, it’s crucial to build a solid social network. You’re not alone, and reaching out to friends and family can provide the emotional scaffolding you need during tough times.

If you find the going gets too tough, don’t hesitate to access professional help to guide you through your transition.

Building Social Networks

Building robust social networks is crucial when navigating life’s transitions. It provides you with a safety net of support and understanding, making these transitions more bearable. Whether you’re grappling with the loss of a loved one or embarking on a new career, the people around you can make a significant difference.

To build these networks, it’s important to take the next step and actively engage with friends, family, colleagues, or join community groups that resonate with your situation. Reach out for a chat, meet up for coffee, or participate in activities that align with your interests. By doing so, you’re not just expanding your circle; you’re also crafting a community that can uplift you, share wisdom, and offer a compassionate ear when you need it most.

Accessing Professional Help

While establishing a strong social network is a solid step, there may come a point where you need to seek out professional help to navigate the complexities of significant life changes. Life coaches with special knowledge provides excellent help. Whether it’s the loss of a loved one, a career shift, or another of the myriad life transitions people experience, accessing professional help can provide a structured way to make sense of your emotions and develop strategies to manage stress and anxiety.

Professional guidance often offers a fresh perspective, enabling you to find balance and regain control during upheaval. Don’t hesitate to make that decision for yourself; it’s a sign of strength to acknowledge when you need support and take action to access it.

Embracing Change

Embracing change offers a unique opportunity for personal growth, urging you to adapt and learn in the face of new circumstances. Life is a series of transitions, each presenting its own challenges and opportunities to serve others and better oneself. When you’re navigating the loss of a loved one or any significant life shift, embracing change becomes essential to moving forward.

In the midst of these transitions, it’s crucial to find activities that ground you and help reduce stress. This could mean dedicating time to physical exercise or seeking solace in the company of friends. Remember, the wave of emotions you’re experiencing is temporary, and new, more hopeful feelings will emerge as you continue on your journey.

Adapting your mindset is key to embracing change. Practice radical acceptance and work on reframing any negative thoughts. Whether a transition is anticipated or sudden, chosen or thrust upon you, it involves an intricate dance of internal and external shifts. By embracing change, you’re not just surviving; you’re actively learning how to thrive within a new reality, all while contributing to the lives of others through your resilience and compassion.


You’ve peered into why transitions challenge you so much. It’s the uncertainty, the break in routine, and the emotional whirlwind that make you hesitate. Remember though, with these shifts come growth and newfound strength.

Lean on your support system, employ your coping strategies, and gradually, you’ll find yourself not just enduring change, but embracing it. After all, it’s through these very transitions that you truly discover your resilience and capacity for renewal.

What role does attention play in the difficulty of life transitions?

Attention plays a crucial role because during life transitions, we must navigate new information and unfamiliar situations, which requires significant cognitive effort. Our focus can become scattered or overwhelmed by change, making it harder to adapt and maintain productivity and emotional well-being.

How does the concept of an anchor relate to the challenge of life transitions?

An anchor represents stability or familiarity in our lives. During transitions, these anchors—whether they are routines, relationships, or environments—are often disrupted or lost entirely. This loss can leave individuals feeling untethered and insecure, which contributes to the difficulty in adjusting to new circumstances.

In what way does the metaphor of a tide illustrate the struggle with life transitions?

Just like tides that ebb and flow unpredictably, life transitions can be full of uncertainties and fluctuating emotions. The unpredictable nature of change can be overwhelming, making it tough for people to feel in control and move forward confidently with their lives.

Why is it important to manage attention effectively during life transitions?

Effective management of attention helps mitigate feelings of chaos and overwhelm. By focusing on one aspect of the transition at a time or using strategies such as mindfulness or prioritization, individuals can reduce anxiety and increase their capacity to cope with change constructively.

What strategies can help individuals create new anchors during times of transition?

Individuals might establish new anchors by developing consistent routines, forming supportive relationships in their new environment, identifying personal values that remain constant regardless of circumstance, or maintaining certain habits from their previous situation to foster continuity amidst change.

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By: Willis
Title: Why Are Life Transitions so Hard – Deciphering the Struggle of Life Transitions
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Published Date: Mon, 15 Jan 2024 20:23:30 +0000

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The Future of Men’s Mental Health

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Part 5 —Male Menopause: Speaking Out About the Unspeakable Passage

This is the 5th in a series of articles on the Future of Men’s Mental Health. In Part 1, I addressed the questions, “Men and Mental Health, What Are We Missing?” Part 2 focused on the way that “Mental Health Crises Are Putting Everyone at Risk.” In Part 3, I explored Gender-Specific Healing and Man Therapy. In Part 4, I shared Recent Research From Leading Neuroscientists.

            The title of the first chapter of my book, Male Menopause, was titled, “Putting the Men Back in Menopause.” I detailed my initial explorations this way:

“When I began researching this book, I was skeptical about the concept of ‘male menopause.’ I had been a therapist for over thirty years and had worked with thousands of midlife men and women. Is there really a change of life that men go through?”

            I went on to describe my encounter with one of the earliest proponents of male menopause, the writer Gail Sheehy.

“While browsing through my local bookstore, I was drawn to a copy of Vanity Fair magazine. Well, to be absolutely honest, I was drawn to the cover photo of  Sharon Stone, nude to the waist, with her hands cupping, but only partially covering, her breasts. Sharon was staring seductively into the eyes of the reader, with two-inch letters emblazoned across her bare midriff proclaiming, ‘WILD THING!’ I was sure there was something important Sharon had to tell me.”

            I went on to say,

“However, I never read the article to find out, because just to the left of Sharon’s blond hair, right below the April 1993 dateline, were the words that grabbed me by the throat (actually a bit farther south than my throat)—‘Male Menopause: The Unspeakable Passage by Gail Sheehy.’ Those words spoke in a quiet but insistent voice.”

            Male Menopause was published in 1997 and soon became an international best-seller. It has since been translated into more than fifteen foreign languages. My follow up book, Surviving Male Menopause: A Guide for Women and Men, was published in 2000. There continues to be a great deal of confusion and controversy surrounding the whole concept of what goes on at mid-life for men. As Sheehy recognized in the 1993 article,

“If menopause is the silent passage, ‘male menopause’ is the unspeakable passage. It is fraught with secrecy, shame, and denial. It is much more fundamental than the ending of the fertile period of a woman’s life, because it strikes at the core of what it is to be a man.”

I was one of the early researchers who was speaking out about Male Menopause (also called Andropause or Manopause). Here are a few of the important things I’ve learned over the years and have shared in my books and articles.

What is Male Menopause?

Male Menopause begins with hormonal, physiological, and chemical changes that occur in all men generally between the ages of forty and fifty-five, though it can occur as early as thirty-five or as late as sixty-five. These changes affect all aspects of a man’s life. Male Menopause is, thus, a physical condition with psychological, interpersonal, social, and spiritual dimensions.

What is The Purpose of Male Menopause?

“The purpose of Male Menopause is to signal the end of the first part of a man’s life and prepare him for the second half. Male Menopause is not the beginning of the end, as many fear, but the end of the beginning. It is the passage to the most passionate, powerful, productive, and purposeful time of a man’s life.”

What Are The Most Common Symptoms of Male Menopause?

  • Loss of libido and sexual desire, particularly with the partner you are with.
  • Increased fantasy about having sex with others.
  • Difficulty developing and maintaining erections.
  • Increased irritability and anger.
  • Taking longer to recover from injuries and illness.
  • Having less endurance for physical activity.
  • Increased anxiety and worry.
  • Loss of self-confidence and joy.

What Are Common Life Changes Associated with Male Menopause?

  • Hormone levels are dropping, particularly testosterone.
  • Sexual vigor is diminishing.
  • Children are leaving.
  • Parents are dying.
  • Job horizons are narrowing.
  • Friends are dying or getting serious illnesses.
  • Martha Weinman Lear, writing in the New York Times Magazine summed it up this way.

“The past floods by in a fog of hopes unrealized, opportunities not grasped, women not bedded, potentials not fulfilled, and the future is a confrontation with one’s own mortality.”

Over the years, I have found two common extreme views: (1) Male Menopause doesn’t exist. Only women go through a hormonally driven change of life. (2) If men do go through a change, it is only a hormonal change, and can be “cured” by giving men supplemental testosterone.

            I’ve learned that neither of these views are true. Men do experience a change of life, whether we call it Male Menopause, Andropause, or Manopause. I called it Male Menopause because I believe there are more similarities than differences between what women and men experience. I also believe, as does, Gail Sheehy, that it is much more complex than simply a loss of hormones and

“It is much more fundamental than the ending of the fertile period of a woman’s life, because it strikes at the core of what it is to be a man.”

Surviving Male Menopause Together. How Can Couples Navigate the Change of Life?

After Male Menopause was published and become an international best-seller with 15 foreign editions, I received letters from women all over the world asking questions about the relational aspects of what men go through. I wrote the book Surviving Male Menopause: A Guide for Women and Men to answer questions including the following:

  • How does male menopause differ from the midlife crisis?
  • Why do men have affairs at this time of life?
  • What are the best methods for treating erectile dysfunction?
  • Why do menopausal men act so much like adolescent boys?
  • What can a woman do to help a man get through male menopause?

Is There Anything Good About Male Menopause?

Like so many complex aspects of life, when we try to oversimplify things, we lose the very essence of what we are trying to study. When we deny the reality of a “male change of life” and reduce it to a “midlife crisis” or simply see the change in medical terms, we give men few options.

For most of human existence our lifespan was quite limited to around forty years. Men and women rarely lived long enough to experience a “change of life.” Life was a climb up a mountain and we reached the peak when we were in our 20s and had produced children to keep our species going. Then, it was a quick decline down the mountain once the children were old enough to survive.

            But now humans can live into our 80s, 90s, and beyond. Now there is another mountain to climb and what we call Male Menopause is simply the transition to the second mountain. If top of the first mountain is called “Adulthood,” the peak of the second mountain, is “Super-Adulthood” or “Elderhood.” That is why I say that

“Male Menopause is not the beginning of the end, as many fear, but the end of the beginning.”

Too Many Men Are Dying Before Their Time

These are confusing and challenging times for most people, but particularly for men. It has been said that “Old age is not for sissies.” While many men are embracing the later years, too many are losing hope and giving up. The suicide rate for men is much higher than the rate for women and gets even worse the older we get.

Take a look at this chart from the Centers for Disease Control (CDC):

Suicide rate among adults age 55 and older, by age group and sex: United States, 2021

graph deaths men women

We see the men’s death rates on the left and women’s on the right for four different age groups. It is clear that death by suicide is a huge problem for men as we age. The male/female ratio for ages between 55 and 85+ are almost 5 times higher for males. This is a tragedy and a crisis. Clearly older men are feeling pressures that women do not experience and are losing hope for a better future. This needs to change.

Welcome to the Second Mountain and an Expanded Understanding of Midlife and Aging

            My friend and colleague, Chip Conley, is transforming our understanding of midlife and what we can look forward to as we prepare for and climb the second mountain of life. Says Conley, “The midlife crisis is the butt of many jokes, but this long-derided life stage has an upside.” In his new book, Learning to Love Midlife: 12 Reasons Why Life Gets Better with Age, he expands our vision.

“What if we could reframe our thinking about the natural transition of midlife not as a crisis, but as a chrysalis: a time when something profound awakens in us, as we shed our skin, spread our wings, and pollinate the world with our wisdom?

            We know midlife and aging is not all sweetness and light. It isn’t easy letting go of old ways that no longer work for us. We all know what happens to the caterpillar. As Conley reminds us,

“When it is fully grown, it uses a button of silk to fasten its body to a twig and then forms a chrysalis. Within this protective chrysalis, the transformational magic of metamorphosis occurs. While it’s a bit dark, gooey, and solitary, it’s a transition, not a crisis. And, of course, on the other side is a beautiful, winged butterfly.”

You can learn more about Chip’s work and his book on his website,

Learning About Men’s Health, Male Menopause, and How to Live Well in the Second Half of Life

There is a lot we need to learn about life in the second half. Chip Conley suggest that there are three stages of midlife:

  • Early midlife (Age 35-50)

During early midlife we tend to experience some of the challenging physical and emotional transitions—a bit like an adult puberty. We realize we are no longer young, but not yet old.

  • The second stage of midlife (50-59)

This is the core of midlife in our fifties when we’ve settled into this new era and are seeing some of the upside. We begin to see opportunities for growth and finding passions we never knew we had.

  • Later midlife (60-75)

            We are still young enough to see and plan for what’s next, our senior years. Says Chip,

“At 63, I am just getting acquainted with this third stage, but I do know it’s also when our body reminds us it doesn’t want to be forgotten.”

I turned 80 last December and am well into the stage of Eldership. It’s a time where we are called to share what we know and have learned over our lifespan. Three years ago I started the MenAlive Academy for Gender-Specific Healthcare. The Academy offer programs for both men and women who want to learn about the unique mental, emotional, and relational issues that men face. It also offers programs for healthcare providers who are working with men and their families.

            As my colleague Marianne J. Legato, M.D., Founder of the Foundation for Gender-Specific Medicine says,

“Everywhere we look, the two sexes are startingly and unexpectedly different not only in their normal function but in the ways they experience illness.”

If you would like more information about the MenAlive Academy for Gender-Specific Healthcare, drop me a note to and put “MenAlive Academy” in the subject line. If you’d like to read more articles like these, I invite you to subscribe to our free weekly newsletter.

The post The Future of Men’s Mental Health appeared first on MenAlive.

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By: Jed Diamond
Title: The Future of Men’s Mental Health
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Published Date: Sat, 06 Jul 2024 23:01:53 +0000

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Podcast #983: Grid-Down Medicine — A Guide for When Help Is NOT on the Way

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If you read most first aid guides, the last step in treating someone who’s gotten injured or sick is always: get the victim to professional medical help.

But what if you found yourself in a situation where hospitals were overcrowded, inaccessible, or non-functional? What if you found yourself in a grid-down, long-term disaster, and you were the highest medical resource available?

Dr. Joe Alton is an expert in what would come after the step where most first aid guides leave off. He’s a retired surgeon and the co-author of The Survival Medicine Handbook: The Essential Guide for When Help is NOT on the Way. Today on the show, Joe argues that every family should have a medical asset and how to prepare to be a civilian medic. We discuss the different levels of first aid kits to consider creating, from an individual kit all the way up to a community field hospital. And we talk about the health-related skills you might need in a long-term grid-down disaster, from burying a dead body, to closing a wound with super glue, to making an improvised dental filling, to even protecting yourself from the radiation of nuclear fallout.

Resources Related to the Podcast

  • AoM Article: How to Use a Tourniquet to Control Major Bleeding
  • AoM Article: The Complete Guide to Making a DIY First Aid Kit
  • AoM Article: How to Suture a Wound
  • AoM Article: What Every Man Should Keep in His Car
  • AoM Article: Improvised Ways to Close a Wound
  • AoM Podcast #869: The Survival Myths That Can Get You Killed With Alone Winner Jim Baird

Connect With Joe Alton

  • Doom and Bloom website
  • Doom and Bloom on YouTube
  • Doom and Bloom on FB

Cover of "the survival medicine handbook," featuring a red first aid kit on a road under a stormy sky, by Joseph Alton MD and Amy Alton APRN.

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Read the Transcript

Brett McKay: Brett McKay here and welcome to another edition of the Art of Manliness podcast. If you read most first aid guides, the last step in treating someone who’s gotten injured or sick is always get the victim to professional medical help. But what if you found yourself in a situation where hospitals were overcrowded, inaccessible, or non-functional? What if you found yourself in a grid-down, long-term disaster and you were the highest medical resource available? Dr. Joe Alton is an expert in what would come after the step where most first aid guides leave off. He’s a retired surgeon and the co-author of The Survival Medicine Handbook: The Essential Guide for When Help is NOT on the Way. Today on the show, Joe argues that every family should have a medical asset and how to prepare to be a civilian medic. We discuss the different levels of first aid kits to consider creating from an individual kit all the way up to a community field hospital. And we talk about the health-related skills you might need in a long-term grid-down disaster from burying a dead body, to closing a wound with superglue, to making an improvised dental filling, to even protecting yourself from the radiation of nuclear fallout. After the show is over, check out our show notes at

All right, Joe Alton, welcome to the show.

Joe Alton: Hey, thanks for having me. I really appreciate it, Brett.

Brett McKay: So you are a retired obstetrician and pelvic surgeon, and you’ve stayed busy in your retirement by helping families prepare medically for long-term disasters. How’d you end up doing that?

Joe Alton: Well, Brett, I was exposed to disaster medicine very early in my career as a volunteer DMAT member, Disaster Medical Assistance Team member for the aftermath of Hurricane Andrew down here in South Florida in 1992. And that led me, like many Floridians honestly are now, to become what you would call a hurricane prepper. And that means instead of the three days worth of food and supplies the average American has on hand, we’d have a couple of weeks worth. But I really have to say, it was Hurricane Katrina in 2005 that opened my eyes to medical preparedness, serious medical preparedness. I mean, it was then that I saw what happens when the ambulance isn’t just around the corner. And that’s not because we didn’t have hundreds of medical personnel converging on the Gulf Coast. I knew it was going to be a big disaster. So that was going on even before the storm was completely through. But the providers and the technology were just not able to get to victims due to all the flooding. I figured that any number of disasters could actually do that. An earthquake, for example, could make roads impassable and people couldn’t get to you, for example.

Really, any disaster with enough casualties can overwhelm the existing infrastructure. If there’s a three car wreck in a two ambulance town, I mean, you could have a bad outcome. So I figured if I can teach the average person how to deal with injuries and illness and put some supplies in their hands, well, then maybe some tragic outcomes might be avoided. So my mission became to place a medically prepared person in every family before a disaster occurs.

Brett McKay: All right. So you co-authored a book called The Survival Medicine Handbook. And this is a tome of a book. It is, I think it was 700 pages. You co-authored this book with your wife, who’s also a nurse practitioner and a midwife. And your goal is, again, it’s a comprehensive guide to medicine in a situation where it’s a grid down situation. You might not have immediate medical access. And so how to manage things you might encounter in that period. I’m sure a lot of people have read first aid books on, say wilderness first aid or maybe prepper first aid, but you argue that those books will only get you so far in a long-term disaster scenario. How so?

Joe Alton: Well, there are a lot of books on first aid, even for wilderness settings. And many of them are really quite good, but they fail to take into account that in a true survival, long-term survival scenario, there’s no access to medical medicine, modern medicine, rather, for the foreseeable future. And that becomes a problem when every chapter of your first aid book or your medical book ends with, and get to the hospital or, and seek a qualified medical professional. Because in real terms, no such thing exists when the medical infrastructure is collapsed. And so our entire book is pretty unique in that it assumes that some disaster has happened and you no longer have the option of accessing modern medical care, maybe for the long run. And the book addresses the average citizen in plain English, as if they were the last line of defense when it comes to your family’s wellbeing in a disaster. That’s because it’s a real possibility.

Brett McKay: So a lot of the first aid books out there are geared towards taking care of the situation so you can get to medical help. But in a long-term disaster, professional medical help may not be available. So what considerations do you have to think about to deal with that situation?

Joe Alton: Well, let’s take an injury for an example. I mean, what is the difference between today and in a grid down situation when it comes to encountering somebody who’s sick and injured? Let’s say even in the normal times, let’s say they broke their leg in a car accident. What do you want to do? You want to stabilize that person, do what you can for them and get them to the nearest medical asset. That makes sense. So you’re not a doctor after all. And once you ship the patient off, your responsibility has been discharged and you’re on your merry way. But what if that’s not an option? I mean, grid down, your responsibility extends from the point of injury to full recovery. Will you be able to provide daily wound care for this person? Would you be able to identify if a wound infection is occurring? Would you have a plan of action to rehab that person and get them on their feet again, make them productive as a group member as they most certainly would have to be in an off-grid disasters type setting. I mean, you have to do this and that’s the difference. You have to be ready to be the highest medical asset left and be effective in that role.

Brett McKay: And another thing we’re going to talk about in detail later on in a bit, another thing you have to think about as the medical asset in your family is you have to think about preventative medicine. It’s just basic things you don’t have to think about because we live in the 21st century, sanitation, hygiene, things like that to prevent sicknesses.

Joe Alton: You’re absolutely right. The important thing to know is that you can prevent headaches and heartaches as the family medic if you have a plan to enforce sanitation and water disinfection and food preparation, things like that. And these are sort of part of your job description.

Brett McKay: As part of the medical asset. So one of the things you talk about in the intro of the book in the first few chapters is before you start thinking about buying medical gear, I know guys love that. It’s the one thing I think a lot of guys love about survival or prepping is buying gear. It’s fun. But you say before you even do that, there’s two things you probably need to think about in order to become a medical asset. One is establish a community, put yourself in a strong community and then two, get your personal health in order. So first, how can being part of a robust community help with medical care or healthcare in a long-term survival situation?

Joe Alton: Well, I mean, as a community, let’s take some examples from TV. Have you seen the show, Alone?

Brett McKay: Yes.

Joe Alton: Well, there you go. In Alone, they drop you off alone with some supplies, probably as much as a person might be able to reasonably carry a fair distance. And they plop you off into the off-gridest of off-grid locations. And that person has to find water. They have to make it drinkable. They have to find food. They have to cook it properly. They have to make a shelter. They have to worry about personal protection. They have to deal with injuries and other medical issues that occur along the way. I mean, how much easier would it be to have a group of like-minded individuals with that common goal of surviving? I mean, these guys survive and they survive for an extraordinary amount of time in my opinion, but it’s not for a normal lifetime. I mean, they’re there for 90 days. And when at the end of the 90 days, they look pretty ragged. I mean, a person can survive alone for a time, but you can see on Alone, on the show Alone, that it’s a pretty miserable existence. So that’s something that I think is so important to have people that can thrive.

And how about skills? I mean, I have medical skills, but I have very few tactical skills. For example, I probably couldn’t take a part in AR-15. I probably wouldn’t be very good in a firefight, but there probably are people that would be. And having people with skills that can complement each other would make for the possibility of the existence that could make a village.

Brett McKay: Yeah. Now we had an Alone contestant, a winner on the podcast a while back ago, Jim Baird.

Joe Alton: Oh, yeah.

Brett McKay: Him and his brother won. And one of the big takeaways from that conversation I had with him and also watching the season that he was on, on Alone, it was amazing to see how little tiny injuries could just devastate you. That actually ended people’s time on the show. You just, you sprang an ankle and then you’re done. Even having another person there, it wasn’t enough. You needed to have maybe two or three more people because that one person couldn’t do, you’re basically working for two people now and they just didn’t have the energy for it.

Joe Alton: Yep. [chuckle]

Brett McKay: Yeah. Okay. So have a community. What about personal health? What parts of your personal health should you have in order in order to be ready medically for a long-term grid down scenario?

Joe Alton: Well, what I hope people are doing now, I mean, eating a healthy diet, exercising, staying away as much as possible from addictive substances that wouldn’t be around in a grid down situation, like maybe alcohol or tobacco on top of that. And this is something that people are surprised to hear me say is that you should be using the high-tech available today to fix issues that would be a problem off the grid. I mean, if you have a bum knee, that’s not going to be very helpful off the grid and would certainly not increase your chances of survival. So see an orthopedic surgeon now, get it fixed. You have terrible vision, consider a LASIK procedure. For example, I had classic near sightedness blind as a bat. I got it done probably 30 years ago, probably one of the first people to get it. And now I have the eyes of an eagle, a very old eagle now, I’ll admit, but still.

Brett McKay: Okay. So yeah, get your health in order. So you’re ready for that scenario. So you talk about becoming a medical asset in your family. And when you’re a medical asset, it means you take on different responsibilities. You’re not just providing first aid, but there’s other roles you take on. We mentioned one of them. You’re sort of the chief sanitation officer of your family. Any other responsibilities that a medical asset needs to take on in order to take care of the healthcare of their family?

Joe Alton: Well, Brett, I mean, of course you’re the chief medical officer, but you’re gonna have to deal with a lot of other things too. You’re gonna have to deal with dental issues as well. Now, I’m not talking about a week without power due to a storm. I’m talking about a long-term scenario, a few months off the grid. And you’re going to wind up facing as many patients on a daily basis with dental problems as medical problems. And you’ll even have to extract a tooth now and then. 90% of dental emergencies in the past were treated that way. I’m not talking about Roman times. I’m talking about the early to mid 20th century. And you’re going to be responsible also for making sure we talked a little bit about water disinfecting. You got to make sure water is disinfected properly. Foods prepared and cooked thoroughly. Human waste is disposed of safely. These are things that are part of your job description. You’re also the chaplain. You may not have to deal with bullet wounds on a daily basis. I hope, at least I hope not, but you’re going to see anxiety and depression on a daily basis of some major disaster hits.

You need not only to be sympathetic and understanding, but you’re going to also have to be confidential as well. Nothing loses the trust of a group than a non-confidential medic, somebody that doesn’t keep people’s private things to themselves. Well, one other thing, you also actually going to be the quartermaster who decides when your limited supplies of medical items are dispensed. It’s not a committee decision. It should be the medic.

Brett McKay: You also have in here medical archivists. So you got to keep track of people’s issues.

Joe Alton: Yes, that’s right. That’s another thing. And that’s something you should probably do now. If you knew who was going to be in your extended family or in a mutual assistance group, you should probably interview them beforehand and keep everything of course, confidential, as I mentioned, and you should definitely learn what their medical issues are, what their family history is, what vices they might have. I mean, are they heavy smokers or do they drink a lot? And you should try to sort of steer them in the direction of getting healthier. And the fact that you would know what medicines, let’s say a person is on, would help you sort of encourage them to get more of these medicines, stockpile some of them so that you don’t have somebody with very high blood pressure showing up at your retreat with their last three days of blood pressure medicine and that’s it.

Brett McKay: Okay. So let’s get into skills and gear here. Do you recommend people like just a lay as an average citizen, take any sort of formal intensive training to get ready for a grid down disaster scenario when it comes to healthcare?

Joe Alton: I think a good start is just go through your municipality and see what courses that they have available. Many times they have free courses available for first responders or CERT members, Community Emergency Response Team members, other people that will be willing to volunteer in disaster settings. Sometimes they’ll have stop the bleed courses. Seek these out. And like I said, they might even be free. And there are, of course, a lot of wilderness first aid courses out there, a lot of companies that put forth these kinds of courses. You can find them online. I’m sure your experience may vary with them, I have to say. But all of these courses do prepare you to do what you need to do, stabilize and transport victims in normal times, but not so much for long-term care. So therefore, what I recommend to people is that when you take each class, think about what you would do if transport to a modern medical facility was not an option. What would you do with that particular individual, that particular sickness or that particular injury? And that’s the key is to have the right mindset and a plan of action in situations where you’re not going to be able to take that person to a higher medical asset.

Brett McKay: One of the most useful things that I’ve done, I really enjoyed it, too. I need to go back and do it again. I took like a first aid CPR certification class. It was done at one of the community colleges here in town. It was a couple hours, I believe. But not only did you do the CPR, but they just went over like basic first aid, what to do about burns, head injuries, big wounds. And I remember I learned a lot. But what I realized is that knowledge and like we actually practice some skills, like how to how to bandage things and things like that. But I realized that stuff, that knowledge and those skills, they degrade if you don’t use them. Like you have to constantly refresh yourself on it.

Joe Alton: You’re absolutely right. We teach wound care class and wound closure class. And I teach people how to suture close simple wounds and things like that. And more importantly, when to close a simple wound and when to leave it open and provide open wound care. And I always make sure I give people extra sutures to take home and they keep their instruments so that they can practice. Now, whether they all do or not, that depends. But you have to develop muscle memory for just about any of these things. And the more you do it, the more effective you’ll be at.

Brett McKay: Okay. So take some sort of class that’s out there. You can find different things out there, but as you do kind of keep in mind, well, how can I take this further and how would I apply this in a long-term grid down situation?

Joe Alton: It’s a mindset.

Brett McKay: Yeah. Let’s talk about medical supplies now. And you’ve got, I love this section because I love checklists. You have these checklists for different medical kits. You think people should start building up so they’re ready for that long-term situation. The first kit is an individual first aid kit. What are some of the things that you would recommend people keep in this individual first aid kit? So every person in your house or your group is going to have one of these, correct?

Joe Alton: Right. Ideally, you would want everybody in the group to have it. In the military now, everybody carries, every infantryman, for example, carries an IFAK kit and the medic carries a more advanced kit that allows him to put an IV in and things like that. But these guys will carry things like a tourniquet to stop bleeding, maybe a burn gel and dressings, elastic wraps to wrap orthopedic injuries, things like that. And I think that that would be a good start for a first aid kit. We have a number of kits on our store that we designed that are very compact, but they manage to deal with a number of different issues that are most commonly seen. So an individual first aid kit, I think for every member of the family would be good, especially in situations where you have to be on the road. So it just depends on the situation. Does your 10-year-old have to carry a first aid kit to school? No, probably not. But in a true long-term disaster situation, which is what I write about, this is something that everybody should have.

Brett McKay: Yeah. This is good just to have if you go on a hike or backpacking trip. I always carry one and it’s got things, band-aids, got Benadryl in there. We got pain relievers, so Tylenol, Advil.

Joe Alton: Right. Moleskine, things like that.

Brett McKay: Moleskine, things like that. And you also have, I thought it was in raw honey packets. What’s the raw honey packets for?

Joe Alton: Raw honey has actually very strong and actually accepted medically antibacterial properties. And so you can use raw honey for a number of things. And of course you can use it to treat hypoglycemia, low blood sugar cases, but you can also put it on burns and other injuries and it actually would have an antibacterial effect.

Brett McKay: That’s interesting. Alright, so that’s the first kit. Start building up a basic individual first aid kit. The next one is the vehicle kit. What’s the vehicle kit for and what kind of stuff are you keeping in that?

Joe Alton: Well, the vehicle kit is more extensive and it really allows you to carry things that you might not be able to carry. Like in other words, a sturdy pair of boots if you found yourself stranded in a blizzard or something like that. And you have to actually go somewhere, although of course it might be better to stay in the car. It has changes of clothes, it would have foldable, multi-tool, shovels, tow ropes, flares, rock saw, things that would help you in situations where you’re in your vehicle. And also it has more of every item.

And the reason why is because you’re not physically carrying this. And so you have the ability to deal with not only things, but do you deal possibly with multiples of things, more than one injury?

Brett McKay: Yeah, we got an article on the site about what to keep in your car. And people are like, that’s kind of a lot of stuff. Like, when would you ever use that? It can come in handy. So my dad, I remember it was this probably 30 years ago. He was driving from Oklahoma City to Albuquerque on I-40 and in the middle of the Texas panhandle. He got stuck in a blizzard, and he was in his car, I think, for a while. I mean, I think it was like a day, but it was well stocked. He had blankets and he had some stuff. And so he was able to ride it out until he’s able to get towed out.

Joe Alton: It’s something that can be a serious thing if you have to make the right decisions. There’s one guy who got stranded. He decided he was going to go for help, and they found him the next morning and he did not make it.

Brett McKay: All right, so the third kit is the family kit. You’re going to keep this at your home, or if you got a retreat somewhere, you’re going to keep it there. And this thing is massive. This was a lot of fun to look through because it’s so big. You break it up into different modules. So what sorts of modules do we have in this family kit?

Joe Alton: Well, of course, we talked about dental situations, so a dental module would be there. You would have, depending on the makeup of your group, you would have maybe a module for a delivery of a baby. You might have your surgical modules with the ability to do more extensive things like sewing some tendons together, things like that. A lot of daily wound care items, because this is something that you can easily do if you are able to stay in place.

Eye care modules, things like that, in case there’s foreign objects. And a lot of people, when they do activities of daily survival that they’re not really accustomed to, they can injure themselves. And so you could be chopping wood and you wind up getting a splinter in your eye. So we have the ability to deal with foreign objects that could get caught in your eye. Just a lot of different things. We’re beginning to get to kits that have hundreds of items. And indeed some of our biggest kits in our entire line will have hundreds of items in them.

Brett McKay: Yeah. One potential module you might have, if you’ve got small kids, a pediatric module. So you have… Make sure you have medications for them.

Joe Alton: Yes, exactly. So you have all sorts of stuff in these situations. You want to have maybe growth diaries, and then you can identify basically how well your young people are doing by, if they’re growing in a normal fashion. And so that’s something that they might have. You have a lot of different sized things, like a CPR mask for an infant would be different than a CPR mask for an adult, and blood pressure cuffs, things like that. So there are a lot of items that are sort of size differential.

Brett McKay: So the fourth kit is… This is if you’re going all in, you want to actually have a field hospital. What sorts of items are in this kit?

Joe Alton: Oh, boy, that’s… I got about 10 pages of…

Brett McKay: I’m looking at it right now.

Joe Alton: And each page has 50 items each. So, I mean, you would have everything from, gosh, biohazard suits to operating tables to… I mean, we’re talking about a real mash unit kind of deal.

Brett McKay: When would you want to do that? I mean, you have a question in the book that you try to answer, which is, how much is enough? When do you know? Well, yeah, maybe I’m good at the family kit and I don’t need to go field hospital.

Joe Alton: Well, I think that it’s probably very few people that will reach the point where field hospital is what they’re going to wind up being responsible for. So I think that people really just need to get the items that are going to be able to deal with the most common issues that they’ll expect to be confronted with. And what we have here, I mean we’re talking about medical…

I’m looking through my list right here because I don’t remember all 500 things that are on here, but we’re talking about automatic portable defibrillators, and we’re talking about oxygen concentrators and things like that. Things that you would need if you had… You would have to have some solar power, for example, to get enough power to, let’s say, do some oxygen concentration. These are some of these items that you’re going to need a little power. And if you’re ready to put together a field hospital, you will have taken power into account. So at least if it’s solar power.

Brett McKay: Another point you make, kind of a broader mindset point you have to take when it comes to medical care in a long term disaster scenario, is that you have to adjust your expectations of what’s possible in this situation. I think today we take it for granted. It’s like, well, if something happens to me, I just go to the doctor and I’ve got medicine. Or if even like a serious thing happens. It’s not so serious. There’s things we can do. I mean, I guess what I’ve read is that people are surviving gunshot wounds more often because our skill and technology has gotten better.

One of the points you make is that in a long term situation, long term disaster situation, the best you can do is maybe just make people feel comfortable and you might not be able to cure them. You have to be okay with that.

Joe Alton: We have to be very, very realistic about what can be done and what can’t be done. In an off grid situation, you can expect a gunshot wound to the abdomen or a gunshot wound to the chest to probably have a 70% death rate. And it’s a terrible thing to say and certainly not the case today with modern medical facilities, but it’s what’s going to happen. And if it’s not the actual trauma from the injury itself, it’s the chances for infection.

Again, remember, your skin is your armor, and so once you have breached that armor, you have that chance of infection.

Brett McKay: That brings up a point I want to talk about. In the book, you talk about how you can plant a garden with herbs and plants that have medicinal purposes. But what do you do about prescription medicines like antibiotics for infection? Is it possible to stockpile antibiotics?

Joe Alton: There are some companies that are beginning to offer, “emergency antibiotic packs” with a televisit, as long as you fill out an application and do a televisit. So these are becoming more popular. They’re just popping up now. And I believe that there’ll be a thriving industry in this probably in the next few years, or at least until the state medical boards get a hold of them.

Brett McKay: What about special medications like insulin? Say someone’s diabetic, is that tough to stop…

Joe Alton: Brett, insulin like that are basic insulins like regular and NPH are actually over the counter in most states these days. You can get them as you need them.

Brett McKay: We’re going to take a quick break for your word from our sponsors.

And now back to the show. We’ve talked about supplies, we’ve talked about getting some training, hoping we can talk about some specific skills here in a bit. But I want to turn to this idea of hygiene and sanitation, because if anyone’s read any history book about war, war up until the 20th century, really, most of the casualties came from poor sanitation. Men were dying of dysentery, cholera, things like that. In a grid down scenario, there might be a situation where you no longer have flushing toilets. So you have to think about human waste. So what do you do about human waste in a grid down scenario?

Joe Alton: Well, human waste should always be buried if you don’t have a toilet. Now, if you have a toilet, you have two gallons of water. Even if it’s wastewater, you can actually flush that toilet, if it’s the typical configuration of the toilet in your home today, by flushing two gallons of water into the toilet, and it will actually flush. But if you’re out, let’s say you’re on the road, you’ve been driven from your home, you’re on the road, human waste, you’re in a retreat in the forest somewhere. Human waste should be buried no closer than 200ft away from the main water source to prevent contamination.

And the medic, if you’re in a community, let’s say you’re the medic for an actual community, that you should have an idea of how to put together a community latrine. And so the dimensions would depend on the length of time, of course, that’s needed, and the number of people in your group. If you had a small group, an 18 inch wide by about 24 inch deep, several feet long, that probably would work pretty well. A longer trench in some kind of partition sheet. If your group is big enough to have more than one person using it at a time, and you keep the dirt from the trench that you dug in a nearby pile with a shovel, and that covers up the waste after each use. So that’s something that would be good for dealing with human waste.

But you’re absolutely right about the importance of sanitation. In the past, entire populations succumbed to diseases that cause diarrhea, leading to severe dehydration. You mentioned cholera and dysentery. Those can be very, very lethal. I mean, more soldiers in the civil war died of these issues than from bullets or shrapnel. So, again, this is probably the third or fourth time we’ve mentioned already, but the medicine has to strictly enforce water disinfection, proper food preparation, waste removal, and more, or infection’s gonna run rampant among other people.

Brett McKay: So here’s something I’m sure people may have thought about if they’ve kind of do these hypotheticals in the head of, like, a long term disaster scenario where you’re not gonna have access to the comforts of modern life for a long, long time. What if someone dies? What are you supposed to do with the body? ‘Cause, like 200 years ago, when someone died in your family, you knew what to do today, you call the funeral home and they take care of everything, so what are you supposed to do?

Joe Alton: This is something that most people have absolutely no idea what to do, and you have to figure out what to do with the body. The body should be placed in a body bag. These are currently commercially available, by the way, and some of them actually have handles to facilitate transport. But if you don’t have these, you can found items like plastic sheeting, bedsheets from abandoned homes. These are things that you can use. Choosing a place to bury them is important. I mean, it should be at least 200 to 250 meters. That’s about 800ft from any water that might possibly be used by the living. That’s very important.

But the funny thing is that if you can properly dispose of the dead body and in that type of location, it doesn’t have the ability… It doesn’t really cause major contamination of the environment. So that’s something that’s important to know.

Current grave guidelines suggest a depth of about five or 6ft. That’s 1.5 meters, and preferably that amount of space above the water table. In some places, that’s really difficult to achieve. Down here, our water table is like 6 inches below the ground. That’s why you see in this area, the older crypts are either concrete and they bury them in the ground, but they’re buried in concrete. Or if you go to places like New Orleans, you see that everybody’s buried above the ground.

Now, you also use something called quicklime, and that’s calcium oxide. It’s been used in burials for centuries, but people think that it’s being used to speed the decomposition of the body, but it actually preserves tissue, which is funny. So why is it useful? Because it actually eliminates odors that attracts flies and animals. And there’s actually a formula for that. 1 kg or 2.2 pounds of lime per 10 kilograms of body weight.

Brett McKay: So you mentioned dental issues. You might not think that you have to take care of a dental problem in a long term situation, but you would. I mean, what are some of the dental issues you think are treatable in a long term disaster scenario?

Joe Alton: Well, the grand majority of dental issues can be dealt with by extraction, as I mentioned earlier, including dental decay. You also need to learn how to fasten loose crowns, replace loose fillings, lost fillings, broken teeth, knocked out teeth, tooth abscesses, gum inflammation. These are all things that you can easily deal with, with the right materials, but you can definitely take care of dental decay. Lost fillings you could put together with clove oil, two drops of clove oil and zinc oxide powder will put together a hardening filling material, material type of cement that will last for a pretty good long time. And you can use it to fasten a loose crown. And of course, you need to have extractors. There are extractors for different types of teeth. And there are probably as many different types of extractors as there are different types of teeth.

Brett McKay: And of course, with dental care, an ounce of prevention is worth a pound of cures. You gotta take care of your teeth. Even in a grid down scenario, brush your teeth, floss, and avoid all the sugary foods. Don’t eat too much of that raw honey. Save that for the…

Joe Alton: Right. Save that for the hypoglycemic patients.

Brett McKay: So in this book, you cover lots of different medical care skills that you think someone might need to know in a long term situation. What do you think are, let’s say, five skills you recommend people prioritize learning, either because, they’ll be especially common or because they’re not the kind of things you’ll have time to consult a textbook or your book to figure out how to do it in an emergency.

Joe Alton: Oh, boy. Well, I have like 40 that I’d like you to know. But if I had to pick five, of course there’s a sexy, sensational stuff like how to stop bleeding. That is, of course, always very important. And there’s a whole stop the bleed apparatus nationally that will help you learn that. But we, of course, we talk about it in detail, and we also describe all the different tourniquets and things like that in our book. And they’re good. There are pros and cons.

You can also expect to deal with a lot of orthopedic issues, ankle sprains and things like that. Of course, there’s going to be respiratory infections. That’s going to be very, very common. Open wounds. You need to deal also how to deal with significant problems. I think the ability to use a flexible splint to treat a bunch of different issues, I think that’s a big skill. The use of cravat or bandana or triangular bandage. We have videos to show you how to use that in seven different ways for different things. I think those are good skills to have because they handle different issues. So I think that’s important.

And of course, as we mentioned before, maybe the most important skill to obtain is how to enforce preventative strategies against injuries and illnesses. And to do that, you have to actually get the knack of observing simple things, such as whether your people are dressed for the weather and enforcing the use of hand and eye protection during work sessions. I mentioned you can really save yourself a lot of headaches as a medic and maybe heartaches if you can keep these people protecting themselves and adequately dressed for the weather. I think that’s important.

Of course you want to be able to treat burns and you want to treat open wounds, and you want to be able to close a wound if you absolutely have to. But more importantly, you need to know when to close a wound and when to not close a wound because you can lock in some bacteria and could cause some major issues.

Brett McKay: Okay, so we got know how to stop a bleed, know how to use different splints for orthopedic bone breaks, sprains and things like that, knowing how to do preventative medicine, and then how to deal with wounds. On the wound issue, like how do you know if you should leave a wound open or close?

Joe Alton: Well, if a wound is obviously dirty, in which a lot of wounds will be, if you happen to be on the road and in a situation where you know you’re not in a controlled environment, your wound is going to be dirty. And so if it’s an animal bite, for example, it’s going to be dirty. And these days, in the emergency room, they’ll actually close some of these wounds, but off the grid, you should definitely not close them. You should treat them as an open wound and just make sure that you keep them clean.

And we talk about, in detail, the ability to perform that daily wound care. And that’s why I think that’s a very important thing to be able to know. And you have to be able to identify when a wound is not getting better and when you may need to break out that last course of antibiotics that you’ve been saving, because in the end, that could save a life.

Brett McKay: Can you superglue a wound shut? I’ve seen that. If you decide you can shut this wound, can you superglue it?

Joe Alton: Yes. I’ll tell you exactly how. Take superglue, and I want you to use the gel version of it. It’s much easier to handle than the liquid version. So take superglue gel and hold the skin together, the cut edges of the skin together, and apply a line of superglue gel on top of that, holding it together, wait for it to dry, and then take a second layer, put a line over the first layer, and then go around and around in an ever widening oval for a couple of layers, then hold that together and let that dry, and then do it one more time on top, and even a little wide, a more widened oval. And if you do that and allow that to dry properly between, then you should do okay… It should be okay.

And the good news is that we’ll have an even less chance of infection than if you close it almost any other way because of the sealing of the superglue. Now, if you don’t hold the skin together properly, you’re going to put superglue in between the two cut edges, and they’re not going to close. It’s something that you just have to do. You might practice on, make a cut in a pool noodle and try to practice with that until you get that right.

Brett McKay: In regards to tourniquet, I know tourniquet use can be controversial. People have really strong opinions about it. Anything people should take into account when they think, well, maybe I need to use a tourniquet here?

Joe Alton: Well, I’ll tell you that the committee on Tactical Combat Casualty Care has stated recently that if you know that you’re dealing with heavy bleeding, that the use of a tourniquet should be your first course of action. Normally they recommend direct pressure with your hands and with either gloved hands or a hand with a barrier between the wound and the hand, but some sort of cloth or something like that. But they’re saying if you know you’re dealing with arterial bleeding or the bleeding is just of a volume that is serious, then use that tourniquet as the first course of action.

And that is a departure from previous eras. And in World War I, they actually called it The Devil’s Instrument because a lot of people just left it on too long and wound up causing nerve damage or even amputation. But you can definitely keep a tourniquet on for a period of time, at least two hours without permanent damage.

Brett McKay: I mean, okay, so the idea of a tourniquet, you’re supposed to put that on there so you can get to professional medical help. What do you do if you have severe bleeding in a long term situation?

Joe Alton: What I would say is you would transport that person to where the bulk of your medical supplies are. And there is a way to transition from a tourniquet to a, let’s say a compression bandage that you can actually do. Now, in normal times, you want to just get that person to the hospital. But if you don’t have the ability to get somebody to a hospital, then you might just have to transition that tourniquet to a pressure dressing by itself. And if you do, then you want to use on the actual wound itself something called a hemostatic dressing. And a hemostatic dressing is impregnated with material like kaolin or chitosan. And this is a blood clotting material. And so what you do is you apply it directly on the bleeding vessel, and you hold it in place for three full minutes, and it actually will stop the bleeding, even arterial bleeding, if you apply pressure and do it for the right amount of time.

I actually was talking to somebody who was a follower of our website, and he was a purchaser for the Navy in Hampton Yards, and he talked about a study that they did in which they basically hung up a pig and they shot it with a 9 millimeter and severed its artery, its femoral artery. And so they used the quick clot material, which is a brand of hemostatic dressing, held the pressure on it, and it stopped the bleeding. And then what they did is they shot the other leg, and they took the dressing out, the hemostatic dressing out, and then put the hemostatic dressing in the second wound and actually stopped it the second time around.

So it is something that, if you know how to use these things, when you have the right materials, the right hemostatic dressings, you can actually stop the bleeding in, at least from the standpoint of the emergent bleeding.

Brett McKay: Related to this idea of bleeding like gunshot wounds, are there any special things you got to think about there?

Joe Alton: Gunshot wounds, of course, are going to be difficult to treat off the grid. You have to remember that there’s things that happen when there is a projectile that enters the body and it forms a permanent channel, which is where the bullet actually went, physically went through. That’s called permanent cavitation, but it also forms something called temporary cavitation. And temporary cavitation is a shockwave that occurs as a result of the bullet passing through with speed through the body. And so if you shot me just under my liver, for example, I would have a channel that went through the area just under my liver, but there would be liver damage, and I could bleed to death as a result of the temporary shockwave that went through and disrupted liver tissue.

Brett McKay: Okay, I’m sure everyone’s thought about this at one point. What do you do in the case of a nuclear disaster? Because I think people have heard about radiation sickness. Are there things you can do to mitigate that?

Joe Alton: Well, nuclear disasters, believe it or not, if you’re not standing at ground zero, you actually have a pretty good shot at surviving. In Hiroshima, they lost more than 100,000 people total to the bomb. But it was a city that included the military that was there at the time, had swelled to 450,000 people at the time of detonation. So you have a shot to survive this. In the early going, your goal is to prevent exposure, and you want to prevent exposure over 100 rads, let’s say. Rad is the amount of radiation that’s absorbed by a living thing. So you might want to have a radiation dosimeter, and that gauge is radiation absorbed. And it’s widely available online. You can find it anywhere. This item predicts the likelihood that you’re going to develop it. But there are three basic, different ways to decreasing the total dose of radiation.

One, limit time spent in the open. Radiation damage is dependent on the length of exposure. So leave areas where high levels are detected and no adequate shelter is available. That’s important. The activity of radioactive particles decreases over time, which is great. After 24 hours, the levels have dropped a 10th of their previous value or less. Then you want to increase the distance from the radiation source. A lot of this is common sense. Radiation disperses over distance. And the effects will be decreased in proportion.

Nuclear reactor meltdowns common evacuation patterns include a complete 10-mile circle. Or if you looked at the pattern, it looks like a keyhole or an old timey keyhole comprising of, let’s say, a two mile circle and an additional three miles radiation radiating from the direction of the prevailing winds. So that’s something that’s important to know.

And then shielding, shielding, shielding, shielding. Shield your people to decrease radiation where they are. In many cases, they’re going to have to shelter in place, and the shielding is going to decrease exposure exponentially. So it’s important to know how to construct a barrier between your people and the radioactive source. And denser materials will give greater protection. Now, let me talk about halving thickness for a second. When I say halving thickness, I’m saying H-A-L-V-I-N-G. Shielding effectiveness is measured in terms of this. This is the thickness of a particular material that will reduce gamma radiation, the most dangerous kind, by one half. And when you multiply halving thicknesses, you multiply your protection. So let’s say the halving thickness of concrete is 2.4 inches or 6 cm. So a barrier of 2.4 inches of concrete is going to drop between you and the radiation.

It’s going to drop the exposure by half. If you double that and make it 4.8 inches, it drops it to 1/4th, one half times one half. Tripling it drops it to 1/8th. And 10 halving thicknesses drops the total radiation exposure to one in 1024th. So if you’re in a concrete bunker that’s 24 inches thick, you are 10 halving thicknesses thick. And so you’re exposed to only 1/1024th of the outside environment. So that’s something that’s important. Now, treating radiation thickness. You treat them as you would burn patients. But once you’ve received four to 500 rads, however, there’s not too much that can be done. You either survive or you won’t.

Brett McKay: And there’s like a medication you take for your thyroid?

Joe Alton: Yes. Well, that’s a also protective thing. For one thing only. And that is thyroid cancer. And you would take… An adult would take 130 milligrams of potassium iodide once a day or 65 milligrams a day if you’re a child. And it’s very useful to prevent thyroid cancer down the road, then the people that are getting thyroid cancer from Chernobyl, those people were children when they were exposed. So if you have a limited amount of this, the brand is called Thyrosafe. We have it on our store. And this is something that you would only give… If you had limited amount, only give it to the kids.

Brett McKay: Gotcha. Well, Joe, this has been a great conversation. Where can people go to learn more about the book and your work?

Joe Alton: Well, we’ve written several books. The main one now is called The Survival Medicine Handbook: The Essential Guide for When Help is NOT on the Way. And it’s now in its fourth edition. You can find it in black and white on Amazon, in color and spiral bound versions at our site, at, along with an entire line of medical and dental kits for the serious medic in times of trouble. Now, our website at now has over 1500, 1500 articles, videos, podcasts and more on medical preparedness. We also have a YouTube channel called Dr. Bones, Nurse Amy. That’s a nickname of mine, Dr. Bones, that has about 300 videos. You also find my articles on the newsstand in Backwoods Survival Guide, Off Grid Recall, Backwoods Home, Prepper’s Survival Guide and other magazines in the homesteading and survival genres.

Oh, and on Facebook we have survival medicine, Dr. Bones, Nurse Amy groups. We have a group that’s 8000 strong there. You’ll get all my articles and videos on that too. Also have presence on PrepperNet and [0:47:03.0] ____.

Brett McKay: Fantastic. Well, Joe Alton, thanks for your time. It’s been a pleasure.

Joe Alton: Same here, Brett. Thank you so much for having me.

Brett McKay: My guest today was doctor Joe Alton. He’s the co author of the book The Survival Medicine Handbook. It’s available on You can find more information about his work at his website, Also check out our show notes at, where you can find links to resources where you can delve deeper into this topic.

Well, that wraps up another edition of the AOM podcast. Make sure to check out our website at where you find our podcast archives as well as thousands of articles that we’ve written over the years about pretty much anything you think of. And if you haven’t done so already, I’d appreciate it if you take one minute to give us a review on Apple podcast or Spotify. It helps out a lot. And if you’ve done that already, thank you. Please consider sharing the show with a friend or family member who you think would get something out of it. As always, thank you for the continued support. And until next time it’s Brett McKay reminding you to not only listen to AOM podcast, but put what you’ve heard into action.

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By: Brett & Kate McKay
Title: Podcast #983: Grid-Down Medicine — A Guide for When Help Is NOT on the Way
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Published Date: Wed, 17 Apr 2024 12:37:37 +0000

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Mens Health

Homecoming: An Evolutionary Approach for Healing Depression and Preventing Suicide

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Captura de pantalla 2024 07 13 a las 17.40.10 1
Photo by: Andreea Popa /

Part 1

Depression and suicide have been my companions as far back as I can remember. I was five years old when my mid-life father took an overdose of sleeping pills. Though he didn’t die our lives were never the same. I grew up wondering what happened to my father, when it would happen to me, and what I could do to prevent it from happening to other families.

In an article, “Being Bipolar: Living and Loving in a World of Fire and Ice,” I described my own mental health challenges and healing journey. In my book, The Irritable Male Syndrome: Understanding and Managing the 4 Key Causes of Depression and Aggression, I shared my research and clinical experience that convinced me that men and women are different in ways they deal with depression and aggression in their lives and in other ways as well.

Depression and suicide are not just problems for men, but there is something about being male that increases our risk of dying by suicide. According to recent statistics from the National Institute of Mental Health, the suicide rate among males is, on average, 4 times higher (22.8 per 100,000) than among females (5.7 per 100,000) and at every age the rate is higher among males than females:

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Even during our youth where suicide rates are relatively low, males are still more likely to die by suicide than are females. It is also clear to me as my wife and I move into our 80s, we face many challenges as we age, but it is older males who more often end their lives by suicide with rates 8 to 17 times higher than for females.

In my book, My Distant Dad: Healing the Family Father Wound, I describe my father’s slide into depression and the despair that increased when he couldn’t find work. As a writer, he wrote regular entries in his journals. I still feel the pain as I re-read them and feel his increasing shame when he couldn’t support his family:

            July 3rd:

“Oh, Christ, if I can only give my son a decent education—a college decree with a love for books, a love for people, good, solid knowledge. No guidance was given to me. I slogged and slobbered and blundered through two-thirds of my life.”

            July 24th:

“Edie dear, Johnny dear, I love you so much, but how do I get the bread to support you? The seed of despair is part of my heritage. It lies sterile for months and then it gnaws until its bitter fruit chokes my throat and swells in me like a large goiter blacking out room for hopes, dreams, joy, and life itself.”

            August 8th:

“Sunday morning, my humanness has fled, my sense of comedy has gone down the drain. I’m tired, hopelessly tired, surrounded by an immense brick wall, a blood-spattered brick world, splattered with my blood, with the blood of my head where I senselessly banged to find an opening, to find one loose brick, so I could feel the cool breeze and could stick out my hand and pluck a handful of wheat, but this brick wall is impregnable, not an ounce of mortar loosens, not a brick gives.”

            September 8th:

“Your flesh crawls, your scalp wrinkles when you look around and see good writers, established writers, writers with credits a block long, unable to sell, unable to find work, Yes, it’s enough to make anyone, blanch, turn pale and sicken.”

            October 24th:

“Faster, faster, faster, I walk. I plug away looking for work, anything to support my family. I try, try, try, try, try. I always try and never stop.”

            November 12th:

“A hundred failures, an endless number of failures, until now, my confidence, my hope, my belief in myself, has run completely out. Middle aged, I stand and gaze ahead, numb, confused, and desperately worried. All around me I see the young in spirit, the young in heart, with ten times my confidence, twice my youth, ten times my fervor, twice my education. I see them all, a whole army of them, battering at the same doors I’m battering, trying in the same field I’m trying. Yes, on a Sunday morning in November, my hope and my life stream are both running desperately low, so low, so stagnant, that I hold my breath in fear, believing that the dark, blank curtain is about to descend.”

Four days later, he took an overdose of sleeping pills and spent seven years in a mental hospital receiving “treatment” until the day he escaped. The book has a happy ending, but it took a long time to get there.

            I share what I have learned over the years in an on-line course, “Healing the Family Father Wound.”  I recently read a chapter in the book, The Palgrave Handbook of Male Psychology and Mental Health edited by J.A. Barry, et al., by Martin Seager, titled “From Stereotypes to Archetypes: An Evolutionary Perspective on Male Help-Seeking and Suicide,” that adds some important pieces to the puzzle and added to my understanding of male depression and suicide and how we can more effectively help men and their families.

An Evolutionary Understanding of Male Psychology

            “In our current age it is unfashionable to think of human gender as connected with our biology and evolution,”

says Dr. Seager.

“Gender is currently thought of primarily as a social construct, a theory that carries assumptions that gender can be fluid, molded by education or even chosen as a part of a lifestyle. Gender is increasingly seen as a collection of disposable social stereotypes, separate from and unrelated to biological sex.”

            Dr. Seager goes on to say,

“This hypothesis is bad science and even worse philosophy…When held up against the anthropological and cross-cultural evidence, a social constructionist theory of gender cannot explain clearly observable and universal patterns of male and female behavior.”

            I agree with Dr. Seager and have long held that we cannot understand or help men, or women, without recognizing our biological roots in the animal kingdom. In my book, 12 Rules For Good Men, Rule #4 is “Embrace Your Billion Year History of Maleness.” I introduce the chapter with a quote from cultural historian Thomas Berry.

“The natural world is the largest sacred community to which we belong. To be alienated from this community is to become destitute in all that makes us human.”

            I also say in the book that all humans are also mammals and we cannot understand men without recognizing that fact. Dr. Seager agrees.

“Human beings are evolved mammals and they have never stopped being so,”

says Seager.

“Whatever social, cultural and political structures are placed upon us as humans, these cannot erase our mammalian heritage and indeed are constructed upon and shaped by that heritage, though not determined or defined by it.”

            Dr. Seager goes on to say,

“Globally, across all human tribes or societies and throughout all known history and pre-history, allowing for inevitable variation across a spectrum, there are universal patterns of male and female behavior in the human species.”

Based on the most massive study of human mating ever undertaken, encompassing more than 10,000 people of all ages from thirty-seven cultures worldwide, evolutionary psychologist Dr. David Buss found that there are two human natures, one male and one female. In his book, The Evolution of Desire: Strategies of Human Mating, Dr. David Buss explains the evolutionary roots of what men and women want and explains why their desires differ so radically.

            “Within human beings perhaps the most obvious universal patterns of sexual differences are: Female: (1) Beauty, attraction and glamour (Including body adornment) and (2) Bearing and nurturance of new-born infants and young children. Male: (1) Physical protection (strength) and (2) Risk-taking,”

says Dr. Seager.

            Dr. Seager goes on to say,

“In all human cultures throughout history and prehistory there is consistent and incontestable evidence of males taking high levels of risk to protect and provide for their family, tribe, and community or nation either collectively as bands of hunters and warriors or as individuals.”

Some view male risk-taking as foolhardy, immature, self-destructive, and harmful to women and children as well as men themselves. But both Dr. Seager and I recognize that protecting women and children and risk-taking behavior are archetypal, instinctual, positive, and evolutionarily important for survival strategies.

In the second part of this series, we will continue our exploration of ways we can improve our understanding of male depression and suicide and how we can be more effective in helping men and their families.

You can learn more about the work of Martin Seager at the Centre For Male Psychology.

We need more programs for men that are evolutionary-archetypally informed. You can learn more at and If you like articles like these, I invite you to become a subscriber.

The post Homecoming: An Evolutionary Approach for Healing Depression and Preventing Suicide appeared first on MenAlive.

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By: Jed Diamond
Title: Homecoming: An Evolutionary Approach for Healing Depression and Preventing Suicide
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Published Date: Sat, 13 Jul 2024 23:40:56 +0000

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