It’s The End of The World As We Know It. Could You Still Make Medicine?

In 1940, Eva Saxl and her husband Viktor fled Europe to Shanghai. They thought they were escaping genocide and the collapse of civilization.

They were wrong.

A year later, the war found them. Japan not only bombed Pearl Harbor but also intensified their occupation of China. It wasn’t long before Japanese forces shut down all the pharmacies, while committing countless more war crimes and atrocities. So many died that the city began sending around vehicles to collect the dead every morning, like garbage. A diabetic, Eva couldn’t find insulin anywhere except the black market. One of her friends tried.

Tainted insulin killed them.

Eva’s husband begged Japanese authorities to do something about the supply shortages. They told him his wife was expendable.

So, Eva and Viktor decided to do something unthinkable. They found a textbook, Beckman’s Internal Medicine. It described how Frederick Banting and Charles Best made insulin from animal pancreas in the 1920s. Armed with his engineering skills, Viktor used it to start manufacturing their own formula in a basement lab run by a Chinese chemist. Eva was fluent in multiple languages. She used her social networking skills to build a coalition and secure funding to buy all the supplies, including pancreases from local butchers. They tested their insulin on rabbits for a year, watching Eva’s own supply dwindle.

Finally, she tried a batch on herself.

It worked.

Eva Saxl didn’t keep the knowledge for herself. She started giving her home lab insulin to families and their children who were also facing death at the hands of an occupying military. She saved hundreds of lives.

If she can do it…

Why can’t we?

Let’s imagine an alternative future

It’s 2035.

Supply chains haven’t completely collapsed, but they’re not what they used to be. Not at all. It’s hard to get stuff. What you can find is expensive. Store shelves don’t sit empty, but you no longer make a grocery list like you did in the old days. You just go there and fill up your cart with things you’ll conceivably eat, what you can afford. You supplement heavily by trading with your neighbors, because ya’ll were smart and started growing taters and beans years ago.

It’s really not that far off from how millions live now, especially outside the U.S. Westerners were just so insulated for so long, and now it’s finally hitting them. But that’s not really where the collapse hurts the most.

As for pharmacies, we’ve already seen supply shocks to medicines. Supply chains are concentrated at a handful of hubs around the world. When a disaster hits one of these hubs, it puts tens of millions at risk. So by the 2030s, medical supply shortages are the norm. Some crucial drug is always out.

You have family members with medical conditions. Or maybe you have a medical condition. While you’re all certainly growing medicinal herbs by the 2030s, you’re so relieved that some of the science teachers and community organizers in your town got together and found ways to synthesize basic drugs like insulin and other medications for blood pressure and heart disease. Some research has found that plants like bitter melon, burdock, dandelion, purslane, and even cinnamon can help manage blood sugar. But we’ve yet to find a true insulin replacement.

It’s 2035. Your community has a simple medicine production lab, powered with solar. You didn’t sit around doomscrolling. You didn’t just stockpile JaseCase like that video ad talked about. You followed Eva and Viktor.

You organized.

Welcome to forward thinking in the collapse

Welcome to the big mental shift that’s underway. The general public seems to be going through their doomer phase, much like we did years ago. They’re freaking out over viral predictions of disaster every few weeks. They’re fantasizing about food stockpiles. Yes, it’s definitely a phase.

Yes, you’ll create a bulk food system if you have the resources—if you haven’t already. But the work we need to be doing goes far beyond bags of rice and beans. Individual prepping gets you through one or two disasters at a time. We’re facing something much larger and more permanent than a disaster, so we have to scale.

Civilization isn’t going to vanish overnight. Electricity isn’t going away. You’re just going to have to become more resourceful.

Something I’m often asked is how those of us with medical conditions will survive as our global civilization sinks deeper into chaos and instability. Sure, it’s nice to talk about growing medicinal herbs. I’ve got pages and pages on that. But let’s face it, you’re not going to tell someone with diabetes or high blood pressure to chew a root. That’s not really going to help everyone.

What I’m offering is less a “how to,” because I’m not a scientist or a medical doctor. I’m definitely not advocating that anyone try to manufacture insulin in their garage. That’s reckless. What I am saying: The knowledge and tools exist for communities with scientists to build the infrastructure to manufacture some of these medicines. You don’t need Nobel Prize-winning chemists. There are already groups around the world who know how to manufacture these drugs.

All you need is a college chemistry lab.

Even a high school lab would do…

What you need are science teachers from local high schools and colleges. What you need is some lab equipment. More than anything, what you need is a will to figure out the basics. Yes, it gets complicated when you start talking about FDA approval, clinical trials, and regulations. It gets expensive. Then again, we’re talking about a future where your community either has the capability to manufacture these drugs, or you don’t, and you have to watch them suffer.

Our future looks a lot like the life of Eva and Viktor Saxl. It looks like begging an occupying force for mercy, and getting told no.

It’s getting told you’re expendable.

It’s already happening.

The question is what you’re going to do to prepare for the day you’re finally told you or someone you care about is expendable, that you’re all too difficult to keep alive in a civilization upended by climate chaos and all the violence that comes with it. The question is what kind of community and what kind of resources you can bring together when your leaders decide they care more about data centers and crypto than the lives of their citizens. At the center of that lies the biggest question, what kind of person are you going to be? Are you going to be the kind who stockpiles food and hides from your neighbors? Or will you be the kind of person who helps build a lab that makes insulin and saves hundreds of lives?

I’m calling these kinds of posts “speculative nonfiction.” Because I’m not telling anyone exactly how to do something. I’m trying to sketch an outline of how you’d do it. I’m trying to break down attitudes and mindsets that it would be impossible. I’m trying to illustrate that it’s doable.

I’m discovering the way.

The equipment you’d need

So you want to make insulin in a bio-chemistry lab.

Here’s what you’d need:

First, you need regional networks to facilitate supplies. Your network’s primary objective is maintaining a master cell bank of E. Coli or yeast (a specific strain) that produces the insulin used in pharmaceuticals. Forget cow pancreas. That won’t work in a longterm collapse scenario where you’re trying to supply thousands of people over the course of many, many years.

You need a bioreactor. It’s a container made from glass or stainless steel that holds 5-20 liters (or a lot more). It has controls for temperature, dissolved oxygen, and other environmental factors. It stirs or mixes raw materials.

What else?

A centrifuge: It’s a device that “spins down” the liquid and separates the cells from the mixture when they’re ready.

A chromatography system: This device separates and purifies the insulin from the waste products.

A lyophilizer or freeze-dryer: This device can freeze-dry the finished insulin so you can store it in a powder, reducing the need for refrigeration.

Autoclave: A sterilizer that uses steam to clean all the equipment. It’s essential to keep it all sterile to keep invasive bacteria from ruining the bioreaction process.

A liquid chromatagrophy machine (HPLC) to analyze the insulin for quality. You could also use a gel electrophoresis (SDS-PAGE) machine.

Finally, you need a buttload of acids, buffers, purified water, and other materials. As long as some kind of supply chain exists, you’ll be able to get them. This isn’t one person’s job. It’s a team. You have to divide the labor. One group concentrates on the lab work. Another concentrates on securing the gear and supplies, as well as maintaining it. Yet another concentrates on finding or generating the electricity and the fuel to run the lab and the supply network.

If you want to know how a community truly forms, this is it.

This is the grit of community.

A collapse community isn’t about sitting around a water cooler trading small talk. It’s not about those warm, fuzzy moments. A collapse community has to coordinate. They have to divide labor and share resources. They don’t have to like each other. They just have to share a purpose, a vision, and a plan.

Over the last several years, biohackers have been fighting back against big pharma. They offer the way forward on this.

They’ve been reclaiming drug production and setting up labs to experiment with cost-based production along with regional supply chains. For example, the Open Insulin Project has already developed a protocol for synthesizing insulin in more robust, decentralized labs at a fraction of the cost it’s sold by big pharma. They need more time and money for clinical trials and navigating the labyrinthine approval process. It’s exactly the kind of thing we should be talking about more. This is where rogue biohacking preppers come in. Collapse survival isn’t just about growing beans in your backyard. It has to include this, too.

At the current rate of collapse, wars and disasters are going to decimate our medical supply chains while these protocols inch their way through a corrupted system that’s been taken over by profiteers and bureaucrats.

So if you really want to challenge the system, if you really want to save lives, I would suggest less performative politics online, less empty rhetoric about “revolution,” and more capacity building. One day, you just might find yourself in need of some homegrown insulin because the idiots in charge did something even more stupid than what they’re already doing. It’s highly likely.

And by the way…

As Eva Saxl’s story reminds us, the vulnerable are much more than liabilities or trophies to put on our compassion display shelves. They are valuable. They have knowledge. They have skills. They can contribute. They just might not contribute in the ways that ableist society structures have conditioned us to think about what’s “useful.” That’s exactly the problem with ableism. It assumes that because someone can’t do one thing, they can’t do anything.

We’re not going to understand the entire process of manufacturing a medicine like insulin in one post online. That’s not the point.

The point is to stop assuming that we’re at the mercy of collapse. The point is to stop thinking about survival and prepping on the individual scale. It’s to stop thinking you can simply fill a pantry with canned salmon and then wait for the famine to kill your neighbors. It’s to stop thinking that just because you live in an apartment, there’s nothing you can do except wait to starve. You can join a collaborative that hacks some aspect of survival. You can form the collaborative.

Does that sound nuts?

Well, here’s what sounds nuts to me: Going to a lousy job every day, trying not to think about the end of civilization, then going home and watching Netflix while trying not to think about the end of civilization, and then getting angry and leaving snarky comments on Reddit. That sounds nuts. So does sitting around sharing more articles simply reacting and emoting over the latest assault on humanity by the fascists. Ultimately, that’s not resistance. That’s letting them win. To me, true resistance is building things that give agency back to your community. There are ways to do the things we consider impossible. We just have to find them.

Fascists took Eva Saxl’s insulin and told her she was going to die, and they didn’t care. She said fine, I’ll make my own insulin.

And she did.

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