"It's A Mad Max Situation" - Puerto Rico Doctors Practice Medicine In 'Post-Apocalyptic' Conditions

Tyler Durden's picture

Authored by Mac Slavo via SHTFplan.com,

Nearly four weeks after Hurricane Maria devastated the island of Puerto Rico, doctors are experiencing “post-apocalyptic” conditions. The reality doctors in Puerto Rico are facing is similar to that from a dystopian novel.

Doctors are conducting surgical procedures in sweltering 95-degree heat, experience malfunctioning X-ray machines, and have seen medications literally melting. “We’re practicing disaster medicine in real life,” said Dr. William Kotler, a senior resident in emergency medicine at Florida Hospital in Orlando, who spent two weeks volunteering on the island earlier this month. “We improvise if we have to, with very little resources.”

Arriving one week after Hurricane Maria made landfall, Dr. Kotler and four other emergency physicians from Florida Hospital in Orlando, finished up a volunteer mission on the devastated island. They were the first medical relief team the hospital sent to the island.

“We went in blind,” said Dr. Julian Trivino, who was among the first team of volunteers.

A second team arrived on October 8th and will stay for two weeks to assist those who need medical attention. When the physicians arrived in the town of Aguadilla on the northwestern tip of the island, the local hospital was in bad shape. The hurricane had almost completely taken down the entire electrical grid and knocked out communications.

“I got there and immediately had a patient with serious head injuries from a car accident,” said Trivino, who is the chief resident in emergency medicine.

Access to electricity was so poor that Trivino couldn’t conduct a CT scan, but he was able to do an X-ray. To review the films, he had to go outside and hold the films up to the sunlight to see anything. Afterward, he used one of the team’s two satellite phones to arrange for the patient to go to a trauma center.

Dr. Trivino must use sunlight to examine x-rays since electricity is sporadic in Puerto Rico.

The physicians are also becoming increasingly concerned that Puerto Rico could be headed toward a full-blown health crisis.

“Trauma centers are overwhelmed. Basic surgeries are being postponed. I’ve seen people lose digits because they couldn’t be treated in time,” said Kotler.

And the heat is making conditions even more extreme. At a hospital in Carolina on the northeastern coast, Kotler and Trivino had to perform an emergency surgery; attaching a temporary pacemaker to a patient whose heart rate was abnormally slow.

“It was 95 degrees in this ER room. She was sweating profusely and vomiting,” said Kotler.


“I held her hand and stroked her head. It’s what I could do to comfort her.”

But there were also several patients who suffered the ultimate fate. In Aguadilla, it was a 42-year-old man in cardiac arrest.

“He had a fever of 107 degrees. It was burning hot in the hospital. We scrambled to find ice packs to cool him down,” said Kotler. Nonetheless, he died the next day.


“If you have a major heart attack in Puerto Rico, right now, the odds are stacked against you,” said Trivino.

It isn’t just the sweltering heat that’s causing a post-apocalyptic medical crisis either. A lack of clean drinking water is compounding the problems. In one town, the medical team encountered an orphanage where children were on the verge of dehydration. The physicians flew in pallets of fresh drinking water to save the kids’ lives. Because of the lack of water,  Dr. Raul Hernandez, an internist based in San Juan, is bracing for an outbreak and possibly several deaths from waterborne diseases. He said Leptospirosis, a bacterial disease spread through the urine of infected animals such as rodents, is becoming a growing concern. Due to a lack of safe drinking water, people are drinking from whatever water sources they can find just to survive, he said. If that water contains urine from an infected rat, the disease will spread, he said. So far, at least two deaths have been attributed to Leptospirosis in Puerto Rico.

Dr. Miguel Acevedo led the second team of emergency physicians from Florida Hospital. “They say it could take six to nine months for power to be restored fully in Puerto Rico. No hospital can plan to survive on generators for that long,” he said.

What doctors are dealing with in Puerto Rico is a “Mad Max kind of situation, said Acevedo.


The reality here is post-apocalyptic,” he said. “You can’t understand the seriousness of it unless you see it.”

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OneStinkyDinky's picture

No no ask Donald, he’s doing great

9mos in he’s already got a Katrina and a Benghazi

Juggernaut x2's picture

Fake News- the only doctors in PR are witch doctors

D Nyle's picture

What do they expect when your 72 billion in debt, its like a Bum asking for Free Plastic Surgery

auricle's picture

Perhaps they should have had a rainy day fund? Pun intended.

svayambhu108's picture

The whole World is watching, and what we see a morally and economically bankrupt nation!

There's picture

Actually it is like the folks in the Hamptons who are levitating the $18 Trillion Debt.

inhibi's picture

yeah people get confused with the little guy and the rich guy. the little guy gets a heart attack and dies, the rich guy gets a heart attack and is flown to the poshest medical facility.

and the little guy isnt the one responsible for the 72 billion in debt. thats the crazy bankers and politicians that squeeze all the money from the little guy

Buck Johnson's picture

Yep, they are in debt with everybody including themselves.  They have no money, they have no resources except tourism and the land mass 100 miles by 30 can't truly sustain close to 4 million people.  Trust me on this one, we are about to see major disease outbreak.


Funn3r's picture

That's what happens in civilised countries. If you're sick you get medical treatment, even if you're a bum. No idea why yanks hate that idea so much. 

UmbilicalMosqueSweeper's picture

Socialist tax thieves mebby?

tmosley's picture

Puerto Rico needs Federal administration NOW. Declare martial law. Conscript the fucking locals to clear roads, etc.

They won't do it on their own, and the US is apparently unwilling to force them to become independent. Federal administration is the only alternative.

Sacker of Cities's picture

Yes, the whole place needs to be taken over by the federal govt and removed from local control, but PR needs to pay for its rebuilding one way or another.

Déjà view's picture

Floridians...brush up on Español and stock black beans...

Si Señor!

Antifaschistische's picture

I have extensive experience in China...and I can tell you, the Chinese would have had those roads completely cleared in 48 hours.   Yes, Chinese people usually treat eachother like crap...but in a way, it's because they treat eachother like family....but when they need to come together to get something done, they're like army ants.

The Rican's have no excuse because unlike Houston, they can just light matches and burn a lot of that crap.  But you gotta get off your rear.  You don't need heavy equipment.  A chainsaw is helpful...and a single damn match.

Cloud9.5's picture

The roads in Highlands County are lined with debris from Hurricane Irma.  If someone drops a match into that, whole subdivisions would burn down.  Some of these piles are made up of hundred year old oaks and it is all drying out.



UmbilicalMosqueSweeper's picture

Look at Christchurch in New Zealand. After the massive earthquake there, they had the place cleaned up within weeks!

Sacker of Cities's picture

Puerto Rico was heading there without the hurricane. The hurricane just sped up the process.

Thank the crooked politicians of Puerto Rico for this situation. They squandered billions raised to improve their infrastructure and lined their own pockets. 

In the end maybe people will see where the current situation in the US will lead if we do not change.

The future is going to be full of lots of pain. Get ready for it.

Juggernaut x2's picture

It's doing a disservice to Mad Max to call this a "Mad Max Situation" as Max was a badass that could take care of himself in whatever shitty predicament he found himself in- the PRs, not so much.

Antifaschistische's picture

nailed it...once the credit card gets pulled on PR, they're going apocalyptic anyway.  

5000yl's picture

These people who are being kept alive by their medications and cant go 30 days without an operation are about to find out that medical services are a luxury, not a right. Cull the heard. Your health is your problem. Mine is mine.

buzzardsluck's picture

Life sucks and then you die.


Fuck any and everyone who can't cope (bring this shit stateside ASAP please).

Juggernaut x2's picture

A fellow fan of Darwinism, I see.

MaxThrust's picture

"These people who are being kept alive by their medications and cant go 30 days without an operation are about to find out that medical services are a luxury"

It certainly is and if the power grid goes down in any country for two months or more expect a large percentage of the population to die. Think of a number 2% 5% 10%. Thats a lot of people who are not going to make it.

Sanity Bear's picture

Yeah it's amazing how people can't hold out for 30 days without needing some technological marvel to save them.

You wonder how humanity survived before these technologies were developed.

kbohip's picture

A lot of humanity didn't.

UmbilicalMosqueSweeper's picture

Most of the Native American population in New England was wiped out pre-colonization by leptospirosis, a disease spread by rodents and other wild animals..

house biscuit's picture

Your comments aren’t pragmatic or stern; they’re the ramblings of a spoiled child

It is- exactly- the same kind of short-sighted sociopathy that characterizes the ‘elite’ which folks here complain about

The kicker is that folks like yourself would be the first to whine like a bitch if things went south for you

338's picture


I generally think right along side you, but I like to say..


I'll pick my own cotton and you can pick yours,


I don't own you and you do NOT own me.


Except those thoughts are both so pre Constitutional, where people vote every so often to elect someone to force me to pick your fucking cotton.


Pay for your fucking health care you think is a right.


Educate your fucking children, even though I have none of my own and your children will benefit me.... Never


Pay and pay and pay for failing city, county, state and federal rip-offs and scams until I'm so ready to Galt it hurts.


And listen to cucks on both sides tell me their side is the good one, when we know it doesn't fucking matter left or right, it matters right or wrong. 


Please show your Communist manifesto colors and down vote the crap outta me.  I know personal resposibility are fun words to throw around, but I'm probably in the thin one percent who can actually make it off my own investments in myself if it goes to shit, and I write DNR on my wrist every few days in Sharpee black, because I know I'm mortal and I know death is just the beginning, not the end.




Prepare to Resist







UmbilicalMosqueSweeper's picture

Pandemic transmissable diseases are everyones problem. No man is an island unto himself in this world. Bio-weapons and radiation complicate the picture even more.

freedom1798's picture

"I Want to Live in America".  1957 song about Puerto Rico that still applies.

NoDebt's picture

PR is a lesson for us all.  An over-populated third world shithole even before the hurricane, MASSIVELY in debt.  Already in a weakened condition in multiple ways, this was the straw that broke the camel's back.  All resources were not just depleted but borrowed against before tragedy struck, assuring NOBODY was going to help them except via outright charity.  They have nothing to help themselves.  They can't even borrow to get back on their feet because they had already borrowed to the hilt just to stay on their feet before all this happened.

PR's population will permanently drop by a third within a year.  In modern times that means many will just LEAVE and never return.  If it was not "modern times" it would mean a third would no longer be there a year from now because they were dead.



HRClinton's picture

You're one of the more sensible and level headed people here, who sees the Big JPG.

From my 'perch', this does indeed reminder us once again, what the Pareto of Assets, Supplies and Skills one needs when TSHTF.

Disaster Planning as a family activity once a month, probably beats some tawdry movie on TV or cinema. 

ghengis86's picture

I was there the week before the hurricane hit. My customer didn't seem too concerned as they've weathered others, taking glancing blows and none to worse the wear for it. This one fucked them something bad. Had employees that literally lost everything; they're gone, most to family in Florida and other gulf states. My customer has a giant diesel generator to run his plant; problem is, getting diesel when power is on 15% of the time and infrastructure in shambles. A big competitor got blasted and they decided to not even bother to try and reopen and are closing; my customer is getting the business...what's left of it or whatever comes back when the lights come on.

It's a fucking wreck. Imagine taking your parents stuff in their house that hasn't moved from the seventies, run over it with a car, then through it a pool. That's what happened to PR

Cloud9.5's picture

You are preaching to the choir here in Florida.  Most of us now have electricity.  Roofs are getting repaired but some places are still under water.  A couple of times a week we still get heavy rains.  A lot of people still got blindsided by the storm.  Even if it is projected to be a category one storm, you still can have spin off tornados that turn neighborhoods into match sticks.  Water, food, propane and gasoline are a must for these situations.  Don’t forget cash.

The normalcy bias for us comes from the fact that always in the past, infrastructure begins to come back on line within a week.  The grid comes back up and fuel is once again available.  We got a brief taste of Puerto Rico’s troubles during the 04 hurricanes when we had three storms back to back.  Then backup generators began to fail for lack of fuel. The water and sewer systems failed.  The sheriff’s office ran out of fuel and there were no patrols.  Had that continued life would have gotten interesting.  I was beginning to get some sideways looks from the people up and down the street because I still had a generator running.   Decent people once they become desperate are extremely dangerous.


VoteSmarts's picture

Sad in a benevolent-minded way for PR, but hells bells, the island has been a drain on the US economy for decades. I don't necessarily have a solution, vis a vis the history of what has gone before, but it seems to make sense to cut them loose to form their own republic. 

VWAndy's picture

 YOYO  aka Your on your own. !   Ok?   GO.

wisehiney's picture

Nothing some good rum can't fix.

MuffDiver69's picture

Tell it to the people in California or anywhere else..Life sucks many times. Blame the President if it makes you feel better, I could care one iota at best..

JLee2027's picture

Worst thing you can do to a liberal is require them to live w/o Government.

Intelligence_Insulter's picture

I see a lot of Puerto rican flags in cars around here maybe they can help.  They are a bunch of affirmative hires anyway meeting that diversity quota.  Let them send some of their welfare checks.  Don't take it out of my payroll via taxes.


IntTheLight's picture

I feel like this is Groundhog Day. Children at orphanages dying? Didn't we hear similar stories about babies in Libya which required us bombing them? Or Iraq? Oh wait, that can be blamed on Albright. What's 500,000 children in Iraq?

Well this is supposed to bring us to tears. My guess is life sucked there before and will continue to sick. Unless we replace Puerto Rican's with the Swiss.

ToSoft4Truth's picture

It was the Haitian children after the volcano. 

Muppet's picture

"I've seen people lose digits cause they havent' been treated in time."

Well, U.S. citizen paychecks are losing digits too, since the U.S. has cosigned and must backstop all Puerto Rico municipal bonds.   Just after becoming Speaker, Paul Ryan led and passed the Bill for U.S. taxpayers to backtop Puerto Rico defaults.  At the time, this saved PR from being being declared in default.   Speaker Paul Ryan said the bill included naming a blue ribbon panel of experts who would steer PR away from default and therefore U.S. taxpayers had nothing to worry about.



ToSoft4Truth's picture

I learned how to operate watching MASH reruns at ClassicTVHits.com and you can too!


Heat, cold, shelling...  all conditions. 

PitBullsRule's picture

People dying in hospitals in the US, due to lack of electricity.  I don't think thats ever happened before.  Its almost like we have an asshole for a president.

Congratulations Deplorables, you took us to a new low.

Yen Cross's picture

 You're so pathetic. I think I hear the dinner bell ringing for your " Pizza Party".

kbohip's picture

PitBullsRule.  Yep, every owner is an asshole.

Pernicious Gold Phallusy's picture

New York City after Sandy. Your favorite cock was President.

Last of the Middle Class's picture

Ever heard of a little storm called Katrina? Louisiana governor Kathleen Blanco? How about horror stories from the Super Dome after that storm. How about the ACA act? Have you seen health care premiums since? I'm not even going to go into the constitution, snowflake.