Meet the Anarchists Making Their Own Medicine

  • Posted on: 27 July 2018
  • By: thecollective

from Motherboard

by Daniel Oberhaus

The Four Thieves Vinegar Collective is a network of tech-fueled anarchists taking on Big Pharma with DIY medicines.

The first time I encountered Michael Laufer, he was throwing thousands of dollars worth of homemade medicine into a packed audience at Hackers on Planet Earth (HOPE), a biennial conference in New York City.

“Does anyone here suffer from anaphylactic shock and not have access to epinephrine?” Laufer asked the audience. A few hands went up and Laufer stuffed a homemade EpiPen into one of them. “That’s one of the original ones we made,” he said. “Use it well.”

After a few minutes of gloating about pharma bro Martin Shkreli “rotting at Fort Dix” for raising the price of Daraprim, a lifesaving HIV medicine, from $13 to $750, Laufer grew serious. “It’s been two years, but despite everything that’s happened, the price of Daraprim hasn’t changed,” he said. He reached into his pocket and produced a handful of white pills. “I guess I better hand out some more,” Laufer said as he tossed the Daraprim into the audience.

With a shaved head, dark beard, and an ever-present camo jacket, Laufer doesn’t look like the type of person you’d seek out for medical advice—but that’s exactly his point. As the founding member of Four Thieves Vinegar, a volunteer network of anarchists and hackers developing DIY medical technologies, Laufer has spent the last decade working to liberate life-saving pharmaceuticals from the massive corporations that own them. Laufer has no formal training in medicine and he’ll be the first to tell you he’s not a doctor. In fact, from a regulatory standpoint he’s more qualified to do mathematical work on nuclear weapons than treat patients. But Laufer’s never really been the type to let rules and regulations stand in his way.

I met Laufer at a bar across the street from HOPE after he finished his talk on DIY medicine. He was meeting with his Four Thieves collaborators who had flown in from all over the country to attend the conference and unveil the new medical technologies under development by the collective. Laufer kicked off the celebration with a toast.

“A toast to the dead, for children with cancer and AIDS,” Laufer said, raising a glass of bourbon and quoting the hip hop artist Felipe Andres Coronel, better known as Immortal Technique. “A cure exists, and you probably could have been saved.”

In the last decade, Four Thieves has run afoul of the Food and Drug Administration, billionaire pharma executives, doctors, and chemists at some of the United States’ most prestigious universities. Indeed, Laufer and his collaborators can’t stop pissing off powerful people because Four Thieves is living proof that effective medicines can be developed on a budget outside of institutional channels.

At the pharmacy, a pair of single use Mylan epipens can cost over $600 and the company’s generic version costs $300 per pair, but an ongoing shortage means you probably can’t find them, even if you can afford them. In response, Four Thieves published the instructions for a DIY epipen online that can be made for $30 in off-the-shelf parts and reloaded for $3. Shkreli drove the price of the lifesaving HIV medicine Daraprim sells up to $750 per pill. So Four Thieves developed an open source portable chemistry lab that allows anyone to manufacture their own Daraprim for just 25 cents apiece.

The pharmaceutical industry is valued at $446 billion in the US and its walls are tightly policed by regulatory agencies like the FDA and Drug Enforcement Administration. By freely distributing plans for medical devices and pharmaceuticals, a loose collective of anarchists and hackers is threatening to pull the rug out from under one of the most regulated and profitable industries in the world. And they’re just getting started.

FREE DRUGS

Four Thieves claims to have successfully synthesized five different kinds of pharmaceuticals, all of which were made using MicroLab. The device attempts to mimic an expensive machine usually only found in chemistry laboratories for a fraction of the price using readily available off-the-shelf parts. In the case of the MicroLab, the reaction chambers consist of a small mason jar mounted inside a larger mason jar with a 3D-printed lid whose printing instructions are available online. A few small plastic hoses and a thermistor to measure temperature are then attached through the lid to circulate fluids through the contraption to induce the chemical reactions necessary to manufacture various medicines. The whole process is automated using a small computer that costs about $30.

To date, Four Thieves has used the device to produce homemade Naloxone, a drug used to prevent opiate overdoses better known as Narcan; Daraprim, a drug that treats infections in people with HIV; Cabotegravir, a preventative HIV medicine that may only need to be taken four times per year; and mifepristone and misoprostol, two chemicals needed for pharmaceutical abortions.

Given the Trump administration’s candidates for Justice Anthony Kennedy’s seat on the Supreme Court, the collective feels an increasing sense of urgency to perfect its abortion drugs. They fear that the federal government will soon allow states to choose whether or not abortions can legally be offered and many residents will be left without any recourse to abort a pregnancy. This was a motivating factor for Tim Heilers, a former Navy sonar technician from Louisville, to join Four Thieves last February.

“Kentucky is a very conservative state and I think we have a very real possibility of becoming the first state with no abortion access whatsoever,” Heilers told me. “Giving people the ability to make mifepristone if they need it is something I think is very important.”

Although Four Thieves has successfully produced five drugs, so far only the Daraprim is available for download on the collective’s website. This is partly due to the disparities in how hard the various molecules are to produce. Naloxone, for example, is particularly challenging because the antidote to opiate overdoses uses the same precursors as the opiates themselves. These precursors are controlled by the federal government and only allowed to be possessed by approved labs in small doses. To get around this issue, Laufer and his collaborators adopted a seemingly counterintuitive protocol: They’d make medicine from poison.

Even though they couldn’t legally buy the Naloxone precursors, Laufer realized that the opiates themselves are remarkably easy to obtain. After obtaining oxycontin on the street, collective members were able to perform a few chemical reactions to extract the necessary precursors from the drug and used them to make the Naloxone.

"Would you rather break the law and live, or be a good upstanding citizen and a corpse?”

“Some very clever drug dealers in the 90s discovered that you can do a one shot reaction [with oxycontin] and get oxymorphone, which is something like six times as powerful,” Laufer said. “You can make Naloxone from oxymorphone in one step. It’s fairly easy and now you’ve made medicine from poison.”

These sorts of unorthodox approaches to healthcare are the name of the game in pharma hacking, where the goal is to help people at any cost.

There’s a drug called cabotegravir, for instance, which is a pre-exposure prophylactic that has been demonstrated to prevent the spread of HIV through shared needles in macaques. Unlike other pre-exposure prophylactics that need to be taken daily, cabotegravir may only need to be taken four times per year to protect the user from HIV. Although the initial clinical results with cabotegravir were extremely promising, Four Thieves grew impatient with waiting for it to become commercially available. (The drug is currently undergoing Phase III FDA trials, which means it’s being clinically tested on a large cohort of human subjects.) Moreover, based on other pre-exposure prophylaxis drugs, cabotegravir would almost certainly be sold at an exorbitant cost—Truvada, a comparable drug that needs to be taken daily, costs around $2,000 for a 30-day supply. So the group figured out how to make it themselves.

After Four Thieves synthesized cabotegravir, it was just a matter of convincing at-risk populations to use it. According to Laufer, some Four Thieves affiliates began partnering with heroin dealers to cut their product with the cabotegravir. This would ensure that users would receive a regular dose of the preventative medicine every time they used heroin.
“Their heroin has a new side effect,” Laufer said. “You don’t get HIV from it any more.”

Clearly, Four Thieves Vinegar Collective walks a fine line when it comes to the legality of their enterprise. Although Laufer has turned subversion of the medical industry into an artform, litigation remains a perennial threat to his mission to liberate medicine. When a pharmaceutical company manufactures a new drug, they own the patent on the molecules that make the drug effective. Nevertheless, Laufer and his colleagues are able to reproduce these molecules because they are described in patent filings and often in academic journals. All it takes is the right technology.

Since Four Thieves isn’t actually selling or distributing the medicines made by its members, what they're doing isn’t technically illegal in the eyes of the FDA, even though the agency has issued a public warning about the collective’s DIY methods. Shortly after Four Thieves unveiled its $30 DIY epipen, the FDA issued a statement to the media that said “using unapproved prescription drugs for personal use is a potentially dangerous practice,” but didn’t refer to Four Thieves by name. Ironically, only a few months later, the FDA issued a warning letter to Pfizer for failing to investigate “hundreds” of complaints about epipen failures, some of which resulted in the death of the user. In May, the FDA issued another warning that declared a chronic epipen shortage.

As for the DEA, none of the pharmaceuticals produced by the collective are controlled substance, so their possession is only subject to local laws about prescription medicines. If a person has a disease and prescription for the drug to treat that disease, they shouldn’t run into any legal issues if they were to manufacture their own medicine. Four Thieves is effectively just liberating information on how to manufacture certain medicines at home and developing the open source tools to make it happen. If someone decides to make drugs using the collective’s guides then that’s their own business, but Four Thieves doesn’t pretend that the information it releases is for “educational purposes only.”

“The rhetoric that is espoused by people who defend intellectual property law is that this is theft,” Laufer told me. “If you accept that axiomatically, then by the same logic when you withhold access to lifesaving medication that's murder. From a moral standpoint it's an imperative to enact theft to prevent murder.”

“So yeah, we are encouraging people to break the law,” Laufer added. “If you're going to die and you're being denied the medicine that can save you, would you rather break the law and live, or be a good upstanding citizen and a corpse?”

DOCTORS WITHOUT ORDERS

The catalyst for Four Thieves Vinegar Collective was a trip Laufer took to El Salvador in 2008 when he was still in graduate school. While visiting a rural medical clinic as part of an envoy documenting human rights violations in the country, he learned that it had run out of birth control three months prior. When the clinic contacted the central hospital in San Salvador, it was informed the other hospital had also run out of birth control. Laufer told me he was stunned that the hospitals were unable to source birth control, a relatively simple drug to manufacture that’s been around for over half-a-century. He figured if drug dealers in the country were able to use underground labs to manufacture illicit drugs, a similar approach could be taken to life-saving medicines.

Laufer started the collective shortly after he returned from Central America, but its existence was only made public at HOPE in 2016. During his first talk at the hacker conference, Laufer demoed the group’s $30 DIY “EpiPencil,” distributed some homemade Daraprim to the audience, showed off an early prototype of the MicroLab, and gave Martin Shkreli a call on stage (he didn’t answer.) When Four Thieves began, Laufer was mostly working by himself. Now that it’s emerged from the underground, the group is much larger, although Laufer said it’s impossible to know its actual size—members come and go as they please, contributing as much knowledge and time as they can.

Everyone I spoke with at Four Thieves comes from a technical background, but none of them were medical professionals. Laufer, for instance, has a background in nuclear physics and is the director of the math program at Menlo College in Silicon Valley for his day job. The result of Four Thieves’ diverse pool of technical expertise speaks for itself. The collective now has independent biology, chemistry, data science, programming, and hardware teams whose degree of collaboration is dictated by the project at hand.

Four Thieves doesn’t sell anything, but the collective has two core ‘products.’ The first is open source hardware like the epipencil and MicroLab chemical synthesizer, which can be made from off-the-shelf and 3D printed components. The second is the instructions for how to use these tools to produce the drugs, which includes everything from how to use the MicroLab to perform simple reactions to how to procure chemical precursors.

“I think it’s absolutely imperative that information about how to make your own medicines should be as easily accessible as possible to everyone who might have even a passing interest,” Laufer told me. “The goal of the group is to make it possible for people to be able to do these things on their own. The idea that someone could download the instructions, read the list of materials, order them, read the instructions for how to assemble it and program it, upload the code, order precursor chemicals, and then manufacture medicine.”

All of Four Thieves’ tools were developed on a virtually non-existent budget—the only money the collective has is whatever its members supply out of their own pockets—and so far the medicines they have produced haven’t killed anyone. Yet some experts caution against taking medicines produced by DIY tech that hasn’t been sufficiently vetted.

HARM REDUCTION

Eric Von Hippel, an economist at MIT that researches “open innovation,” is enthusiastic about the promise of DIY drug production, but only under certain conditions. He cited a pilot program in the Netherlands that is exploring the independent production of medicines that are tailor made for individual patients as a good example of safe, DIY drug production. These drugs are made in the hospital by trained experts. Von Hippel believes it can be dangerous when patients undertake drug production on their own.

“If one does not do chemical reactions under just-right conditions, one can easily create dangerous by-products along with the drug one is trying to produce,” von Hippel told me in an email. “Careful control of reactor conditions is unlikely in DIY chemical reactors such as the MicroLab design offered for free by the Four Thieves Vinegar Collective.”

His colleague, Harold DeMonaco, a visiting scientist at MIT, agreed. DeMonaco suggested that a more rational solution to the problems addressed would be for patients to work with compounding pharmacies. Compounding pharmacies prepare personalized medicine for their customers and DeMonaco said they able to synthesize the same drugs Four Thieves is producing at low costs, but with “appropriate safeguards.”

“Unless the system is idiot proof and includes validation of the final product, the user is exposed to a laundry list of rather nasty stuff,” DeMonaco told me in an email. “Widespread use [of Four Thieves’ devices] would provide an entire new category for the Darwin Awards.”

Von Hippel and DeMonaco were in agreement that the ability to purify DIY drugs and run quality control tests on the final product is paramount for their safe use by patients. Von Hippel suggested that scientists with a background in medicinal chemistry will be necessary to address these issues in DIY pharma.

“I see Michael Laufer’s activities as a valuable form of social activism that points the way to a promising future,” von Hippel said. “But I think the equipment and the medicinal science issues have to be much further developed before DIY medicine production will be safe.”

In a way, Four Thieves is just doing a small-scale version of what many hospitals are doing already. Faced with rising drug prices and shortages, many hospitals have started to manufacture their own medicines on site to save costs. The difference, however, is that these hospitals often have access to sophisticated laboratories and trained medical personnel, which significantly lowers the risk of something going wrong.

Four Thieves isn’t naive about the risks of providing the documentation to allow others to make their own medicine. It’s always possible that someone follows the group’s instructions incorrectly and inadvertently produces a toxic chemical. Yet there are ways to reduce the likelihood of this happening and one of Four Thieves’ most significant contributions to DIY medicine is prioritizing harm reduction in its research and development.

There’s more than one way to produce a given molecule and some synthesis pathways are simpler or allow for far greater margins of error than others. Thus Four Thieves aims to discover synthesis pathways that lower the risk of toxic reactions to the lowest possible level. When the collective was first starting out, they had help doing this from a startup called Chematica, which had collected 250 years of research on organic chemical synthesis into a database and developed software that used this data to predict and create new synthesis pathways to desired molecules. With this database and software, Four Thieves was able to create simple and safe synthesis pathways that would produce life-saving drugs.

This worked great until Chematica was bought by Merck, an international pharmaceutical giant, last year. After the sale, Four Thieves lost access to the software and, more importantly, the database. Laufer told me that the Four Thieves data science team has created an open source version of Chematica’s software and has even compiled a small database of organic chemicals to test it on. The software is crude compared to Chematica’s, but Laufer said that it works well enough. To improve the software, however, the collective needs more data, which is now the property of Merck.

But as any hacker knows, sometimes data “falls off a truck,” which is a nice way of saying that Chematica’s database is currently posted on a password protected website on the dark web. During his talk at HOPE this year, Laufer implored the audience to help with cracking the password and releasing the data into the world. Getting access to Chematica’s data on synthesis pathways would blow open the door for a new suite of DIY medicines, but until then it’s going to be pretty slow going.

THE FUTURE OF DIY MEDICINE

The most expensive drug on the market is called Glybera and is used to treat familial lipoprotein lipase deficiency, a hereditary disease found in only about 7,000 people worldwide. Lipoprotein lipase deficiency prevents the normal breakdown of body fats, which results in abdominal pains, acute pancreatitis, enlarged livers and kidneys, and the buildup of fat deposits under the skin. Glybera helps treat these symptoms and is critical to the quality of life of those with FLLD. The only catch is the medicine costs each patient $1.2 million per year—if it’s even available to them. In 2017, UniQure, the company that produces Glybera, stopped selling the drug in Europe due to the extremely limited demand. This means that the approximately 1,200 Europeans with FLLD are out of luck when it comes to treatment.

The situation is more or less the same for those afflicted with other orphan diseases, which are defined as conditions that affect fewer than 200,000 people worldwide. If a drug for the disease exists, it is generally prohibitively expensive to obtain. If the company doesn’t see enough demand for its product, it will likely pull it from the market. So for many rare diseases, a cure or palliative medicine may exist but is too expensive for patients or not profitable enough to put on the market.

In the future, Laufer wants Four Thieves to focus on manufacturing drugs for orphan diseases so that those with rare conditions will never be without their medicine. Yet these types of medicines come with their own unique problems.

For instance, Laufer said that many of the medicines for orphan diseases are made of biological material, such as fungus. Laufer said that Four Thieves is working to create a BioTorrent site to distribute the organic material need to manufacture orphan medicines. BioTorrent would be like a normal file sharing site like the PirateBay, but instead of downloading music and movies, people could download instructions for how to synthesize their own medicine and share the organic material among one another. Since biological cells are self-replicating, this would simply require one user to grow a sufficient amount of cells for themselves before shipping some cells to another user who would repeat the process, similar to the way people ‘seed’ a media file on torrent sites.

The question, then, would be how to ship the biological material cheaply and without getting caught. To this end, Four Thieves is investigating the use of books and CD cases as grow media for biological precursors. Mycelia are basically the ‘roots’ of many fungi and feed on cellulose, which is found in abundance in the pages of a book. So Laufer and his collaborators began injecting books with mycelium, which feed upon the pages and grow out of the book. Similarly, compact discs are similar enough to petri dishes that if they’re streaked properly they can be used as a growth medium for bacteria and other biological precursors. The advantage of this is that Four Thieves members using the BioTorrent site could ship these cells using the cheaper “media rate” charged by the US Postal Service for items like books and compact discs while avoiding scrutiny from law enforcement.

In the meantime, however, Four Thieves is still mostly focused on improving its MicroLab and synthesizing new medicines. Recently the collective began producing its own custom circuit boards for the MicroLab, which will make it even easier to set up the device at home. Laufer said he plans to begin giving these circuit boards away as early as next month. At the same time, the group is working on perfecting the synthesis of Solvadi, a one-time treatment that can cure Hepatitis C. This drug has been on the market for nearly five years, but its $84,000 price tag makes it inaccessible to many people who need it. If Four Thieves has its way, Hepatitis C will soon be a thing of the past for everyone, regardless of their income.

At a time when many Americans lack even basic health care services, Laufer’s ideas seem as intuitive as they are radical. His work is predicated on the notion that too many critical decisions about our health have been outsourced to private actors who care more about their bottom line than their customers’ well being. For Laufer, Four Thieves is as much about medicine as it is about the right to the free flow of information and personal autonomy. As far as he's concerned, one cannot exist without the other.

“Pursuing science is a human right,” Laufer said. “In fact, it’s the human right from which all other rights flow. You have to be able to do whatever you want to your body and to think the way you want.”

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Comments

This is all very good but I think the priority is to instruct any group of people aspiring to autonomy and good health in the art of triage technique, resusitation, trauma management, stress and anxiety cure, diet and food choice, muscular and bone tendon exercise. Medicines would hardly be necessary if the person lives a clean non addictive existence with a free flowing mental and emotional humor. My motto, Humor not Tumor.
Trauma is the most urgent. Burns must have a careful treatment and dressing, some natural fibres, weblike coccoon coverings made by caterpillars have been used by indigenous tribes to cover burns and stop bacteria entering but allow for oxygen entry. If 3rd degree burns exceed 75% of the body euthanasia is recomended, as well as alot of painkiller and no work.
Shattered bones and crushed bodies should be carefully moved and left to heal on their own. Alot of painkiller helps again.
Drowned bodies are best held upside down to drain water out of cavities then masaged and pumped on the chest and given mouth to mouth resusitation. Painkillers help later on.
Stess and anxiety, cases of uncontrollable hysteria can be handled with a straight jacket to prevent the person harming themselves or others. Painkillers help by mentally subduing crazy people.
Sprains and ligament damage the patient should be given painkillers and told not to work at anything whatsoever.
Stab wounds and gunshot wounds should be stiched up immediately and the patient told to lie motionless for a week and no food or water if it is a stomach wound. Painkillers are ok to be used. Some Indians in the Amazon use bullant pincers to seal cuts, but if thread and needle are unavailable, stapling, guitar strings or super glue may suffice, Be imaginative in your treatment, and always carry alot of painkiller around with you.
If the patient deteriorates overnight, take them immediately to your local hospital.

PS I never have to go to the hospital unless I'm dying, and that's from not eating crap takeaway, drinking alcohol or smoking and by being very active, not as in political activist (causes bad mental health issues), but just hiking and swimming etc.

This has to be satire, and if so A plus, if not and you're serious...just wow.

No food or water for a week with someone with major blood loss and therefore dehydration? Hilarious

Well give them water and food then and it will pass down their gullet and leak out from their knife and bullet ripped intestines mixed with feces into the warm body cavity where bacteria will rapidly multiply and the patient will die from blood poisoning, fever, tetanus and shock within 48hrs anyway, whereas, if they deteriorate overnight, they are taken to the hospital and given intravenous nutrition until the rupture is operated on and healed.

Nice fantasy bro. In case of stab or gun shot wounds to the abdomen and torso, skip everything before "take them immediately to the local hospital." Unless you want to just watch them die I guess.

Yeah no... in some cases of social conflict and in some countries, bringing someone to hospital means bringing them over to the popo. So depends what are your security concerns. Someone just got shot by a fascist... then obviously bring them straight to hospital. But if your buddy from the guerilla took a bullet in a shooting against cops or security, you may have to look at the other options.

But the stupest part in your post is where first aid is suddenly a bad idea... where in most contexts where paramedics will take several minutes up to half an hour to arrive, applying first aid can definitely allow someone to stay alive long enough so that more proper rescue can do the rest.

What if your fascist buddy is shot by antifa Idpol or commie cops, where do you take him, to an anti-Castro veterinarian in Miami?

It's not just in guerilla wars or in small-scale shootouts with the pigs that the hospital cannot be an option. I know of at least one case here in the US of a GLBTQ person who was assaulted by fascists, defended themselves but was wounded after allegedly wounding some of the attackers, and was arrested in the hospital and did prison time. This person probably would never have been identified by the pigs if they had refused to go to the hospital and instead taken cover, as the original assault was by homophobic strangers. I consider that case a direct warning to those like myself who prefer death to prison.

Thus, any ability to self treat "borderline" injuries from weapons reduces the percentage of such blows, stabs, or shots that kill or lead to permanent disability. Some wounds you will recover from no matter what, some will kill you no matter what, in some cases its treatment that makes the difference. This is where the principle of "triage" on the batttlefield or after a major disaster comes from. You certainly don't want to be arrested in the hospital because you got a knife slash that parted skin but did not slash any arteries or larger veins and didn't cut any tendons. The "third option" in that case is to sew it up yourself, and try the human-grade antibiotics sold for aquarium use under such names as fish-mox, fish-flex etc if infection sets in. As for getting shot in the guts, if going to the hospital means prison and you are still armed, the effective choice may be between prison and finishing yourself off to avoid it-UNLESS you know a damned good "underground surgeon" like some organized crime figures are rumored to have access to.

All you motherfuckers with zero medical training, saying death is better than prison, jesus fn christ. Go to the hospital. "I know of 1 case" omg, one time the police arrested someone, so let's not go to the hospital. Fucks sake. Guerilla war fantasy land.

You motherfucker with zero experience of being in a cell.... yes, death can be much, much better than decades in a concrete cell with maybe interactions with crackheads and White supremacists as "socializing". That's actually the Hell that Christians failed to deliver. But if you don't go to Saint Peter once you die, I don't see how it can get bad... especially if NOTHING happens at all. Or you'll reincarnate as a tape worm and live a splendid life as an actual horrible shit-eater, lol.

BUT... no, I or anyone else shouldn't be deciding for an badly injured person what should be their fate.

Our job as medics is to stabilize the injured, and this is what your tiny brain's not getting. Somebody who's losing blood like a water hose would better not be left to just wait for the paramedics as this could mean a quick death. You find someone lying unconscious on the ground near a protest? You check the vital signs and it may be good to put their head on your lap while kneeling, so to slow down a potential internal brain hemorrhage. Rescuing and stabilizing people is something that can be done quite easily and doesn't require a degree in medicine.

You're not a medic. Poring piss on an acute wound does not a medic make. How do you suspect they have a brain bleed, what do their vital signs mean, how do you know they don't have a spinal injury that you are making worse? I think first responders are great, but I haven't seen anything on this thread that is in anyway accurate. Your DIY zine is no substitute for actual training.
I love the thieves collective though, that's not what I'm critiquing. I'm just talking about the moron trolls in the comment thread.

- Pouring piss on an acute wound can help, when having nothing better around, assuming that your genitals are clean enough. It's just obviously not what medics will be taught to do. When it comes to healing wounds medics will use different solutions given the country/region, sometimes solutions that are just doing to the minimum (killing off bacteria and cleaning).

- You haven't traveled a lot, I guess. States have different policies in every country on how to deal with "suspects" when they are taken to hospital. In some places in Europe including France, being sent to hospital does mean sending them to the cops. But anarchos still sent protesters to hospital when severe conditions demanded, even if that meant comrades in deadly conditions being questioned by pigs... against the competent counter-indications from medical personnel.

But I'm not recommending against sending people to hospital, I was saying what can happen in some countries when you do, and how that may be preferable to find a way to avoid this if some people are facing a life sentence, or something. Obviously, duh... it's up to the injured person to decide, as far as they're in a state to make a clear decision.

- I've been a street medic and received two street medic trainings. Okay, so I guess "street medics" are rather a kind of paramedics, or first responders, not actual medics who can perform complicated operations on somebody that require medical knowledge. That's just what we're being called.

- My DIY zine?

- Brain hemmorhages likely happen due to severe concussions to the head (i.e. stuff that happens frequenty in protests), and when someone is unconscious, that is often due to a concussion. Though there can be several other causes such as cardiac arrest, or, yes, a spinal injury. In that case it's better to not move the body at all. Hence why one of the first steps is attempting to know what happened to this person, before doing anything.

- Stop being a moralist edgelord, daddy. Animals -human or not- die all the time, no need to get all touchy-feely when it's about the health of one or two humans.

- Your (apparent) extreme belief in how only qualified medical experts can rescue a person, that anybody without a officially-sanctioned training should stay away, and that the culture taught in your region is the only one that works demonstrates a deeply authoritarian morality that is found in the minds of statist dogs. U a statist dog, by any chance?

My argument was to get training and operate within your scope of practice, which at worst is elitist, not statist. Your BS 2 medic trainings are activist Basic Life Support and you should do those things you are qualified to do. Which is not much, and most of the suggestions on this thread are wildly inaccurate at best.

"Stop being a moralist edgelord, daddy. Animals -human or not- die all the time, no need to get all touchy-feely when it's about the health of one or two humans." You should really not be a "medic." Stick to throwing newspaper boxes in the street you hardcore motherfucker.

Whether living in prison is really to be preferred to death (or is even possible at all) is entirely an individual judgement. Just because you can and/or would rather live in a cage as an alternative to death does not means everyone can. Like I said, this situation does not even require war, only having to defend yourself from an assault by someone from a social group local police and prosecutor prefer to your own. If a white cisgender man in a polo shirt and a fashy haircut chases down and stabs a Black transgender female sex worker only to get stabbed in return, care to guess who the cops will deem the perpetrator and who they will consider the victim without regard for the facts?

But the iodine naturally occuring in sea salt is the reason why sea salt is suggested by some. A good balance of iodine-rich salt and water will kill off most unwanted bacteria, clean the wounds from several toxins, and also accelerate healing by force-reconnecting the bioelectric currents. Ever been to the coast? In areas where the sea isn't polluted the people who live there tend to get a perfect skin. That's an effect of regular exposure to salt and iodine.

For open bleeding wounds the first thing to do is to apply pressure with a gauze or any sterile, non-fibrous cloth until the bleeding either stops or slows down enough to seal it. Then it can better be sealed, with the absence of suture wire, with clean enough human hair (i.e. no toxic shampoos, gel, dye or any other toxic waste on it). At worst hemp wire from a rope can be good, plastic wire will work but be a real pain to remove.

For smaller wounds not requiring sewing, rather use either fir tree sap (the fresher the better), or sea saltwater. The sap will do many things at once... disinfect, keep nasty bacteria away, waterproofing while allowing air to pass, numb the pain, speed up the regrowth of blood vessels and overall accelerate healing. Apply every 2-3 days. Saltwater should be reapplied at least twice a day.

Superglue can be very toxic, and used guitar strings willl obviously carry bacterias from the players. But of course if that's all you got, just disinfect by passing it all through a flame.

Obviously, yeah, painkillers are one of the most important things to have around.

day walks? What kind of terrain? I've recently bought vegan walking boots which are light, extremely comfy, sturdy and water proof. I've walked for hours through mountain bog and my feet remained dry. From EthicalWares in the UK

I've walked desert dune and desert mountain, temperate forest, tropical forest, coastal heath, snow mountain and also urban in bare feet, flipflops, sandshoes, basic cheap steelcap workboots. Correct size and socks make most boot acceptable, but yes, its nice to have the more expensive types. But I'm a tough outdoor type without wanting to sound all macho and alpha. I'm not too fussy about wearing non-vegan leather, but I respect the ethic.

Shall we go ahead and assume that anyone getting medical advice from your rambling posts shouldn't be treating gunshot wounds at all! Yes, let's do that.

The probability of them surviving longer after my advice compared to just being left unattended is greater as far as I'm concerned, at least less painful and more entertaining from my friendly banter as they wait.

PS I know its not perfect treatment, but folk should at least study some techniques and facts, eg. use urine to flush out dirty wounds, or whisky to sterilize things. Even get a pen and paper and get them to dictate their last will and farewell letter, or contact details for the serious cases who don't look like they will make it. Go through their pockets and see if there is anything worthwhile there, just do something instead of just standing there and waiting for official help to arrive. Its a jungle out there!

See a person dying on the streets? Let's search through their pockets and purses if there's something to lower your debt to the local drug dealer gang. And who knows... maybe you'll find a week's worth of pay, so you can get your coke n donuts in time.

No its about empathy and64Nc7yk running an ID on the person, maybe an address and they live nearby where relatives can be contacted immediately. Wow, soooo negative of 19:47

The good thing about being an existentialist nihilist is that there is no ethical dilemma to face if just say my broken twisted dying body (brain undamaged) was pulled out of a car wreck and some entrepreneur gave me the choice of being an experimental subject for a new multi-million dollar rebuild with titanium limbs and metal skeletal implants I would readily accept, and then when fully activated, I would escape their control and disappear to enjoy a super healthy strong existence. That's called using the existing system to create positive outcomes rather than fighting a binary moral war.

Saw some rasberries by the cycling trail that looked juicy and delicious? Don't touch that, kid. These have no product code on them so they're not traceable, but furthermore they weren't sold through authorized distributors, or produced on sanctioned fruit farms, so they may be containing bacteria and toxins that pose a health risk.

EPA is right, you not. Just SHUT UP... you anarchist! You do things OUR way, or you take the highway.

DIE THEN FROM THE TOXINS, DIE FROM BARCODE BERRIES, THEN I'LL GO THROUGH YOUR POCKETS !!
DIIIIIIIEEE FROM MEDICAL COMPLICATIONS, I'LL PISS ON YOUR WOUNDS HAPPILY, THEN DIE!

Kay bro, I agree 1000% with what you're saying, just that you gonna have to wait for a while...

Serious question: Are there anarchist dentists out there? Every dentist I've been to wants to upsell me on cosmetic work I don't need. During the times in my life when I've had health insurance, dentists often don't take the insurance I have and are rude about it. I feel like an anarchist dentist would only charge what they need to, and would be honest about what work is actually necessary.

I started having serious recessive gums issues weeks after a dentist urged me to brush my teeth 3 times a day with shit fluoride-based toothpaste. Then I tried baking soda but it de-mineralized the teeth. So I went on brushing teeth with salt water (then rincing well afterwards), and casually rubbing the gums and teeth with fir sap, and gum issue was GONE. Unlike the dentist, it didn't cost me anything.

Need for dentists is dumb.... people haven't been having dentists for ages. Many old people have been using a cloth as toothbrush, and never had much issues with their teeth.

For major toothaches and absess, chew some clove and keep it lying around the infected area 'til the essence is all sucked out. Repeat one or twice to get rid of absesses. Works for most toothaches, and for the most intense pains, well, just couple with painkillers like codein or ibuprofen.

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