You might think that escaping from the winter from hell would give me a chance to reflect on the good life. Yet, as I sit here in 78 degree comfort with a view to the ocean framed by palm leaves, I am thinking about how amazing it is that humans have gone from a life expectancy in 1900 of 48 for males and 51 for females to 74 for males and 80 for females in 2000.

These are numbers that reflect the progress of medicine and they can be directly related to things such as the discovery of antibiotics and the manufacture of insulin, along with the thousands of treatments for diseases that would have easily killed people 100 years ago.

Every so often I play a little game with myself and try to figure out what would have happened to me had I lived in the days of the wild west in the mid to late 1800s. One thing that often comes to mind is the role that whiskey played in the West.

There are few cowboy movies or stories that do not have a few scenes in saloons or that do not describe the fact that whiskey was as ever present as a six shooter or a Winchester rifle. Whiskey was a welcome relief from the struggle for survival, but it also had a lot of medicinal properties and I suspect it probably saved a few lives.

When people had wounds they sometimes were smart enough to pour a little whiskey on them. They instinctively knew that the alcohol could kill a lot of bad things. No doubt a few sprinkles of whiskey on a wound might have prevented a life-ending infection.

Back then the only dental care available was either do-it-yourself teeth pulling or paying for the services of itinerant "doctors" who mostly just pulled teeth. I'm sure there was at least one bottle of whiskey in their tool kit.

There is no way to know for sure, but it is possible that those who kept a regular amount of whiskey in their mouths every day may have prevented a certain amount of dental disease. Some of the more effective mouth washes on the market today contain a fair amount of alcohol.

The real wonder drug of the day, however, was opium. According to Jeremy Agnew in his book, "Alcohol and Opium in the Old West," "Through the 1800s opium was an important medicine with three principal uses. One was for the relief of acute or chronic pain, another was as a cough suppressant for lung diseases such as tuberculosis and the third was as a medicine to treat dysentery and diarrhea. Nineteenth century physicians held opium in such high regard that it was regarded as a miracle."

So back to my little game. In my 30s I would have had to live with a right elbow that was fixed at a 90-degree angle. A locked elbow on the plains might have forced me to ask someone to force it back into position. Who knows what that might have done.

In 2001 I developed a cyst on a spinal nerve that caused enough pain to render the 1-to-10 pain scale useless. I had surgery and there was some relief, but without that surgery I suspect I would have become dependent on opium back in the cowboy days. There is also a good chance I might have gone out behind the barn and blown out my brains.

Ten years ago I had pneumonia and it was the first time that an illness made me feel like my life was in the hands of something very powerful. Dying seemed possible, but antibiotics provided the cure. A few weeks ago I had another bout of pneumonia and, although it did not seem as severe, there is a good chance that the outcome would have been pretty bad without antibiotics.

As I reflect on the progress of civilization, it is clear that I probably would have died in my early 50s, or sooner, had I been a cowboy on the plains. Of course, a simple cut could have lead to an overwhelming infection or tetanus at any time.

Somehow, I find this silly little game of "what if I had been a cowboy" to be therapeutic. I look back at the mishaps of my life and when I am finished with this morbid reflection I am thankful that I am still breathing and walking.

As I often say to people, expecting more than that is not realistic as the aging process takes its toll.

Richard Davis is a registered nurse and long-time health care advocate. He writes from Guilford and welcomes comments at rbdav@comcast.net.