Holding a defensive weapon does not ensure that we will win a fight. Even highly trained, motivated men — America’s Special Operators — lose a fight now and then. Protective weapons, however, increase our odds of surviving a confrontation. There are just so many variables at play in any situation.

So what happens if you’re shot by a criminal? What happens after you are rushed, bleeding, to a hospital? Again, there are almost infinite variables but please consider that whether you live or die, your family will be saddled with enormous, crippling bills that may never go away. America’s health care and justice systems may be the best in the world, but only if you’re rich. But anyone who has fought a health insurance company (I have — for cancer treatments, not a gunshot — and I lost) will suspect that our system, not the wonderful people who are nurses and doctors and support staff, but the system itself is simply an efficient money-sucking machine.

In 2005, 21-year-old Derrick Owens of Chicago, a part-time bicycle mechanic, was robbed and shot twice. Since then, Owen has lived in a wheelchair. The cost of his emergency room visit, surgeries, medications and follow-up has been more than $10 million … so far.

Can a part-time bicycle mechanic pay? Sure, if he wins the lottery.

Jim Doherty, director of the Medical Center which treated Owens, says that except for homicides, 4 of 5 people live after being shot. Other than immediate injuries though, victims “end up with long-term consequences.” This means that aside from the physical pain, the mental anguish alone can be crushing. Doherty says it’s common for billing of more than $1 million to inundate a victim.

The immediate issue for the hospital is paying for doctors and IVs and ventilators. The victim’s immediate issue is recovery … and avoiding poverty.

If you have no insurance, the hospital and the government pay. It’s called charity and a variety of public services provide free or inexpensive assistance. Disability and Medicaid are available.

If you have insurance, your caregiver will spend endless hours fighting to get your insurance company to help with the bills which, with rehabilitation and therapy and special equipment, will continue for years or for life. You’ll probably lose your job and your credit will vanish. In the worst-case scenario with a permanent disability, your spouse’s wages could be garnished and the hospital, insurance company and government could seize everything. Every state has Violent Crime Compensation, but anticipate that it will be a nightmare getting it to help.

How do you prepare for the worst? Open a secret bank account in the Cayman Islands?

Here are 10 ideas and readers may suggest others:

  1. Document correspondence and conversations (name, date, time) and keep every piece of paper from hospitals, doctors and labs;
  2. Use telephone apps to record calls;
  3. Use the Internet, email, telephone, fax and even hand-written letters;
  4. Talk to your health insurance company now — difficult, but worth a try;
  5. When you get a “no” from one person, call again or ask for their supervisor — be persistent;
  6. Examine every charge, no matter how small;
  7. Some billing is actually negotiable — set aside middle class sensibilities and haggle;
  8. Set up a payment plan, even $10 a month, and stick to it religiously;
  9. If you are financially underwater, check out relatives, crowdsourcing, your neighborhood association, charities … everything that may help you get back on your feet and your family out from under crushing debt; and
  10.  Never lose your cool.

I’ve written this after reading the story of a 23-year-old Oklahoma man who shot and killed three men who invaded his family’s home at night. Against 4 people (a get-away driver waited outsider) the odds were heavily against him.

The answer is to train, prepare and then take aggressive action when needed. Have a Living Will in place and a Health Care Power of Attorney beside your Smith & Wesson. Now, be careful out there.