GWOT IV - Surgeon General
Dec. 15th, 2019 01:55 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
drewkittyAt some point when I was lucid, in the site infirmary while we were waiting for the IV antibiotics to root out the deep seated infections in my hand, I asked an orderly about what the medical care was costing, now that this was a Resistance hospital.
She looked horrified. She did not answer.
I asked the surgeon in command, the same surgeon who had been employed by the Client to run the infirmary, and now apparently was a commissioned officer in the California Republic.
She took a long breath and sat down next my bed. I wasn't going anywhere even if I could reach the bed rails and take out the IV tubes. Physical therapy had made that clear.
"You're not ready for a lot of things yet. You had a really, really bad time. But this I think you're ready for.
"When Janine came to us and informed us - informed us! - that the Client was now working for the California Republic, that this entire building was needed for immediate use as a military hospital, and that we would be conducting a raid on the Federal Building in six hours and I was to prepare to receive mass casualties, I was more than a little shocked.
"But we were ready. A lot of the reason we were ready was you -- your insistence that we be ready for anything, even if anything ended up being receiving two truckloads of medical supplies and equipment four hours before having to put all of it into use immediately.
"I was given a choice. I could be just another doctor, and Janine would have to find someone to run the place, or I could be put in charge of the hospital and I would have to accept a commission in the California Republic.
"It was yes or no, and right then. So I accepted. That's when I got these on my collar, and the new fashion look. Then I started getting E-mails.
"Here's one of them."
She passed over her phone, on the Client network.
###
From: Surgeon General, California Republic
To: All California Republic Medical Providers
Re: Medical State Of Emergency
As the duly appointed Surgeon General of the California Republic, I declare as follows:
-- A state of war and of insurrection exists in the state of California.
-- A continuous Mass Casualty Incident exists in the state of California.
-- A general Public Health Emergency exists in the state of California.
Therefore, I order:
-- All laws with respect to scope of medical practice are hereby declared to be 'preferred' but not 'obligatory' until ordered otherwise by this office. As applicable, pre-War standards of "austere care" and "disaster care" shall be continued in full force and effect. No prosecution for unlicensed care shall be sustained without actual harm done to one or more person(s) in violation of medical practice; the mere fact or absence of licensure is insufficient.
-- Any designated hospital, clinic or infirmary shall be under the control of a licensed medical professional, preferably a doctor, and shall be so registered with the County Health Officer. Designated facilities shall 'indent' or make requisitions for medical supplies and equipment reasonably needed to provide medical care. As feasible, the County Health Officer and County Hospital shall fill these requests, in medical priority of care consistent with the principles of triage.
-- All medical professionals who take oath to the State of California are hereby ordered and directed to care for the ill and injured to the best of their capability. This is a lawful order under the authority of the Republic of California and also under the Uniform Code of Military Justice. While it is understood that the primary focus of military medical establishments must be the military mission, this is an obligation to provide medical care generally or to properly and swiftly transfer non military patients to the civilian medical system.
-- All noncombatant medical professionals are strongly encouraged to care for the ill and injured to the best of their capability. California Republic forces are ordered and directed to assist them insofar as their primary missions permit, provide them supplies whenever possible, and in all cases leave them free to do their work, except if actually engaged in espionage or violent crime.
-- All enemy medical professionals under California control, for example as prisoners of war, are hereby ordered and directed to care for the ill and injured to the best of their capability, as is their duty under the Geneva Conventions and at their personal peril under the Uniform Code of Military Justice.
-- No person shall be denied medical care under any conditions whatsoever. If it appears for any reason that necessary medical care cannot be provided, it is the obligation of the medical professional making this observation to immediately and swiftly report this fact to the Public Health Officer of their county, who will either take swift and immediate action to provide that care, or individually and personally inform my office in each and every case.
-- This order shall be treated as a general 'writ of habeus corpus' for the purpose of taking a person in need of life or limb saving medical care to a County Hospital without delay. Exceptions for persons in California Republic custody must be processed through my office.
-- Discrimination in the provision of health care on any basis, including military, prisoner or detainee status, is a violation of this Order. It is of particular importance to the Republic that all current and former soldiers, sailors, prisoners and detainees receive health care, including enemy prisoners of war, unlawful combatants, criminals under California control, and persons rescued from Homeland or other unlawful confinement, as well as the California Republic's own forces.
-- In every county under California control, a Public Health Officer and County Hospital have been designated. The County Hospital shall, except in unusual circumstances, be the tertiary or final provider of care for all persons needing medical care within that county.
-- Each County Hospital shall report to me weekly on its care and logistics needs, including particularly medications. Each County Hospital shall have first right to draw on local, statewide and humanitarian relief stocks of medications.
-- Under the present emergency, and until the California legislature can be reconvened, no fee may be levied or charge may be made prior to the provision of health care, and past nonpayment may not be used as an excuse for failure to provide care, then or in the future. Reasonable charges may be incurred and tracked, and reconciliation of medical debt and payment in kind are encouraged. Strictly elective medical procedures which do not involve loss of function, such as cosmetic surgery, are exempted.
-- The California Republic stands as responsible payer of last resort for any health care provided on behalf of the Republic, for example for a State employee or soldier or sailor, or on behalf of any individual that would otherwise be considered 'bad debt' or uncollectable. This explicitly includes medical care for minors, prisoners of war, criminals and unlawful combatants. These costs should be tracked for future credit against taxes.
-- Medical professionals who become aware of famine, epidemic, sanitation, chemical or radiological contamination, or other public health emergency shall report same to the applicable County Public Health Officer(s) and also this office. The County Public Health Officer shall take the lead in responding to any such event on behalf of the State of California, and is fully empowered to take traditional actions such as impoundment, condemnation and/or distribution of food; quarantine, curfew, imposition of martial law, closure of an area or business or water source; or direct other reasonably related measures.
-- The object of this order is the direct saving of as many human lives as possible without regard to political, economic or military considerations. Any situation in which California Republic forces contemplate the conflict of military necessity with this order must be escalated at once to the Commanding General, California Republic, who asserts entire authority over this subject with respect to blockade, deliberate famine, denial of medical care or food to areas under California control, etc.
Promulgated this date under the authority of the Provisional Emergency Governor
###
I read it again. Twice. There were a lot of nuances.
"So whatever this is costing, the California Republic will pay for," I said at last, weakly, as I said everything.
"You're a cheap date. A bed, one fortieth of a nurse, some IV antibiotics, and a touch of surgery here and there. Sorry about that last, but I'm awfully glad I got practice on that other guy before I had to work on you."
That 'other guy' had lost all fingernails and all toenails, and yet had crawled several miles from where he was dumped to the outskirts of Site.
"Rest up. We need you."
Long after she left, the thought echoed in my empty head.
We need you.
Need me.
For what?
She looked horrified. She did not answer.
I asked the surgeon in command, the same surgeon who had been employed by the Client to run the infirmary, and now apparently was a commissioned officer in the California Republic.
She took a long breath and sat down next my bed. I wasn't going anywhere even if I could reach the bed rails and take out the IV tubes. Physical therapy had made that clear.
"You're not ready for a lot of things yet. You had a really, really bad time. But this I think you're ready for.
"When Janine came to us and informed us - informed us! - that the Client was now working for the California Republic, that this entire building was needed for immediate use as a military hospital, and that we would be conducting a raid on the Federal Building in six hours and I was to prepare to receive mass casualties, I was more than a little shocked.
"But we were ready. A lot of the reason we were ready was you -- your insistence that we be ready for anything, even if anything ended up being receiving two truckloads of medical supplies and equipment four hours before having to put all of it into use immediately.
"I was given a choice. I could be just another doctor, and Janine would have to find someone to run the place, or I could be put in charge of the hospital and I would have to accept a commission in the California Republic.
"It was yes or no, and right then. So I accepted. That's when I got these on my collar, and the new fashion look. Then I started getting E-mails.
"Here's one of them."
She passed over her phone, on the Client network.
###
From: Surgeon General, California Republic
To: All California Republic Medical Providers
Re: Medical State Of Emergency
As the duly appointed Surgeon General of the California Republic, I declare as follows:
-- A state of war and of insurrection exists in the state of California.
-- A continuous Mass Casualty Incident exists in the state of California.
-- A general Public Health Emergency exists in the state of California.
Therefore, I order:
-- All laws with respect to scope of medical practice are hereby declared to be 'preferred' but not 'obligatory' until ordered otherwise by this office. As applicable, pre-War standards of "austere care" and "disaster care" shall be continued in full force and effect. No prosecution for unlicensed care shall be sustained without actual harm done to one or more person(s) in violation of medical practice; the mere fact or absence of licensure is insufficient.
-- Any designated hospital, clinic or infirmary shall be under the control of a licensed medical professional, preferably a doctor, and shall be so registered with the County Health Officer. Designated facilities shall 'indent' or make requisitions for medical supplies and equipment reasonably needed to provide medical care. As feasible, the County Health Officer and County Hospital shall fill these requests, in medical priority of care consistent with the principles of triage.
-- All medical professionals who take oath to the State of California are hereby ordered and directed to care for the ill and injured to the best of their capability. This is a lawful order under the authority of the Republic of California and also under the Uniform Code of Military Justice. While it is understood that the primary focus of military medical establishments must be the military mission, this is an obligation to provide medical care generally or to properly and swiftly transfer non military patients to the civilian medical system.
-- All noncombatant medical professionals are strongly encouraged to care for the ill and injured to the best of their capability. California Republic forces are ordered and directed to assist them insofar as their primary missions permit, provide them supplies whenever possible, and in all cases leave them free to do their work, except if actually engaged in espionage or violent crime.
-- All enemy medical professionals under California control, for example as prisoners of war, are hereby ordered and directed to care for the ill and injured to the best of their capability, as is their duty under the Geneva Conventions and at their personal peril under the Uniform Code of Military Justice.
-- No person shall be denied medical care under any conditions whatsoever. If it appears for any reason that necessary medical care cannot be provided, it is the obligation of the medical professional making this observation to immediately and swiftly report this fact to the Public Health Officer of their county, who will either take swift and immediate action to provide that care, or individually and personally inform my office in each and every case.
-- This order shall be treated as a general 'writ of habeus corpus' for the purpose of taking a person in need of life or limb saving medical care to a County Hospital without delay. Exceptions for persons in California Republic custody must be processed through my office.
-- Discrimination in the provision of health care on any basis, including military, prisoner or detainee status, is a violation of this Order. It is of particular importance to the Republic that all current and former soldiers, sailors, prisoners and detainees receive health care, including enemy prisoners of war, unlawful combatants, criminals under California control, and persons rescued from Homeland or other unlawful confinement, as well as the California Republic's own forces.
-- In every county under California control, a Public Health Officer and County Hospital have been designated. The County Hospital shall, except in unusual circumstances, be the tertiary or final provider of care for all persons needing medical care within that county.
-- Each County Hospital shall report to me weekly on its care and logistics needs, including particularly medications. Each County Hospital shall have first right to draw on local, statewide and humanitarian relief stocks of medications.
-- Under the present emergency, and until the California legislature can be reconvened, no fee may be levied or charge may be made prior to the provision of health care, and past nonpayment may not be used as an excuse for failure to provide care, then or in the future. Reasonable charges may be incurred and tracked, and reconciliation of medical debt and payment in kind are encouraged. Strictly elective medical procedures which do not involve loss of function, such as cosmetic surgery, are exempted.
-- The California Republic stands as responsible payer of last resort for any health care provided on behalf of the Republic, for example for a State employee or soldier or sailor, or on behalf of any individual that would otherwise be considered 'bad debt' or uncollectable. This explicitly includes medical care for minors, prisoners of war, criminals and unlawful combatants. These costs should be tracked for future credit against taxes.
-- Medical professionals who become aware of famine, epidemic, sanitation, chemical or radiological contamination, or other public health emergency shall report same to the applicable County Public Health Officer(s) and also this office. The County Public Health Officer shall take the lead in responding to any such event on behalf of the State of California, and is fully empowered to take traditional actions such as impoundment, condemnation and/or distribution of food; quarantine, curfew, imposition of martial law, closure of an area or business or water source; or direct other reasonably related measures.
-- The object of this order is the direct saving of as many human lives as possible without regard to political, economic or military considerations. Any situation in which California Republic forces contemplate the conflict of military necessity with this order must be escalated at once to the Commanding General, California Republic, who asserts entire authority over this subject with respect to blockade, deliberate famine, denial of medical care or food to areas under California control, etc.
Promulgated this date under the authority of the Provisional Emergency Governor
###
I read it again. Twice. There were a lot of nuances.
"So whatever this is costing, the California Republic will pay for," I said at last, weakly, as I said everything.
"You're a cheap date. A bed, one fortieth of a nurse, some IV antibiotics, and a touch of surgery here and there. Sorry about that last, but I'm awfully glad I got practice on that other guy before I had to work on you."
That 'other guy' had lost all fingernails and all toenails, and yet had crawled several miles from where he was dumped to the outskirts of Site.
"Rest up. We need you."
Long after she left, the thought echoed in my empty head.
We need you.
Need me.
For what?
