The lunar community was fortunate in one way, Barbie Thuc reflected as she made her daily rounds. They started with a much higher baseline health than most communities dirtside.
That meant there was a whole range of ailments she simply didn’t have to deal with. Take for instance the diseases of obesity. People with weight problems to the point it affected their health couldn’t get the necessary medical clearance for spaceflight. And once people got here, mandatory exercise requirements made sure they didn’t slip-slide into it.
Even over at Grissom City, which had catered to the tourist trade before the present crisis, no amount of money could buy one’s way past that requirement. More than a few spoiled-rotten scions of wealth and privilege had learned that the hard way, and had to either learn the necessary self-discipline to meet the physical requirements, or give up their dreams of a vacation on the Moon.
The population here also was much younger. That would change now that the Expulsions meant people would be retiring up here rather than being shipped back to Earth when they reached the age at which the cumulative wear and tear on the body started showing up in the form of degenerative diseases. But at least for the next decade or so she shouldn’t have to worry that much about that.
On the other hand, they did have a lot more injuries to deal with. Maybe not all that much different in terms of the population as a whole, but it was certainly a lot more of her caseload. Which meant a lot of Medstaff’s time and resources went to fixing people up after they’d busted themselves up in various ways.
And that was one of the things she was becoming concerned about. What would happen when vital resources began to run low, if shipments of supplies from Earth were not restored, or could not be relied upon?
Some, even most, could be produced locally, although they might still have problems with the amount they could produce. Most drugs were a matter of chemical synthesis. But there were some things, particularly some of the more sophisticated medical devices, that were still simply beyond the ability to reproduce locally. Which meant that once they ran out, they would have to face the problem of people dying or being left permanently debilitated by conditions that they should’ve been able to recover from.
Which meant raising the question of rationing. How should the few remaining supplies be allocated, if it looked like they could not be replaced for a month? a year? a decade?
She didn’t think “ever” was really an issue. On a world where human life was completely dependent upon sophisticated technology, there was a floor beneath which they could not fall and survive. Therefore, even if Earth had to be written off, it would be only a matter of time before lunar industry would regroup and begin to expand and innovate to replace the manufacturing capacity that they’d lost access to. Most likely it would not take more than a decade or two — but in the meantime things could get painful.
Definitely this was not a decision she should be making on her own, or even with only the other members of Medstaff here. She needed to start raising the question with her colleagues at the other settlements, and with the command structure. Do it carefully, so as to avoid tilting the conversation in any particular direction, but make the decision-makers aware that criteria and procedures needed to be developed and in place before they had to make the determination that a patient would not be treated so that other patients who would be more likely to benefit could have it, before they had to deal with angry family members, before the angry murmurs and pointing fingers could begin.
Yes, there was a certain element of military discipline in the space community — every spacecraft and space settlement was under the command of a senior pilot-astronaut who was also a military officer. But NASA had been a civilian organization from its beginnings, and no settlement, not even the earliest moonbases, had ever tried to impose full military discipline upon its civilian technical staff. And the Expulsions had given Shepardsport a large population who were still in the process of acculturating into the space community.
Which could make things more difficult as the crisis progresses beyond the terror of the initial virgin-field pandemic to the privations of long-term survival and rebuilding.