Grunt (14 page)

With its bleeding, wheezing, cursing role-players, Strategic Operations tries to be one-stop shopping: something pumping, human,
and
screaming. “It creates a willful suspension of disbelief,” says Stu, disarticulating a fried fish. I don’t quite understand that phrase, but I do understand what he says next. “We’ve had students wet themselves, soil themselves, vomit, faint.”

Lavell shares that Dennis Kucinich lost his congressional lunch at a Cut Suit demo. The representative from Ohio was sitting in the front row with his wife, Elizabeth, the prominent DC vegan and animal rights advocate. “When the actor started screaming and the blood started spurting, Kucinich went white. You could see the reverse peristalsis beginning.” I glance at neighboring tables, half expecting to see some here. “His wife got up and helped him to the door.”

T
HE MAIN
stressor of combat medicine is absent from every training simulation. No one is shooting real bullets at or anywhere near you. “Training is limited by liability,” said Siddle. He sounded a little mournful.

“The high number of returnees diagnosed with PTSD suggests we are not doing enough,” scolds Colonel Ricardo Love in his paper. Love hailed the ancient Spartans’ approach to “building psychological resilience in their forces.”
Pelopidamus, looketh upon these novel strategies for building resilience.
“On several occasions [the] war games were deadly and some boys were killed.” According to Sparta scholar Paul Cartledge, other military resilience-builders included the stalking and killing of random slaves and “the braving of whip-lashing seniors
#
in order to steal the largest possible number of cheeses from the altar of (Artemis) Ortheia, a goddess of vegetation and fertility.”

Many years ago, reporting a story on killer bees, I experienced a kind of stress inoculation. I accompanied a team called out to remove a hive on a farmer’s land in south Texas. The venom of “killer” honeybees is the same as that of ordinary honeybees, but the bees are far more aggressive in their defense of the hive and their pursuit of interlopers. The larger the hive, the more defensive the bees. This hive filled a fifty-five-gallon oil drum. I wore a bee suit, but I hadn’t attached the veil properly and bees began getting underneath it and stinging me. Later that day I and my throbbing welts visited a keeper of ordinary honeybees. While we talked, bees would light on my arm. My normal reaction would have entailed flailing and girly alarm noises. Instead I calmly watched them crawl around. Fear of bees: gone.

But would it have worked in reverse? Would exposure to regular honeybees have inoculated me against the fear I felt inside the killer bee swarm? Caezar’s theatrics and Tom Hanks yelling and the hectoring instructors—these are regular honeybees. Still, as Siddle allows, “Anything that narrows the gap is good.”

The other way to train medics is to have them practice a skill so many times that it becomes automatic. So when the prefrontal cortex goes AWOL, when reasoning drops away, muscle memory, one hopes, will persist. Do it enough times, and you can administer first aid in the ultimate survival stress scenario: when the gore is your own. Recall the combat engineer from chapter 4 who’d stepped on an IED. “Without thinking”—as he aptly put it—he pulled out a tourniquet and placed it perfectly on what remained of one leg.

C
AN THE
carnage of an explosion ever really
not
be stressful? Does a disarticulated head ever come to seem normal? Apparently. “After a while,” Ali told me during a break from the tutorial, “it’s just a head. You get on with your job.” Michelle told a story from her deployment in Iraq. She was carrying part of a Marine’s leg that had been blown off by an IED. The foot was still in the man’s boot, and presently his buddy went to pull it out. When the boot relinquished its hold, the foot smacked Michelle in the face. She made a face that led me to assume the foot had started to decompose. “It wasn’t decomposed,” she said. “It was a brand-new, blown-off foot.” She leaned closer. “He wasn’t wearing socks.” What repelled Michelle was not blood or gore, not the foot’s detachment from the rest of the body or the awful deadness of it, but the smell and feel of the sweat on her cheek.

And that will serve as my lurching segue to the miraculous, reviled excretions of the human eccrine gland. In a place like Afghanistan, sweat keeps more people alive than corpsmen do.

___________

*
Except when he’s a Godfrey, as he is in many of his 1970s movie credits. Godfrey Daniels produced ten titles in the long-forgotten genre “soft core,” paying loving if needless attention to his plots, one of which could be a chapter in a Mary Roach book: “A research facility uses state-of-the-art equipment to test sex dolls.”

†
And the founder of Missing Something, my second-favorite amputee organization name, after Stumps R Us. I attended a Stumps bowling party in the 1990s, which served as my official introduction to the awesomeness of Hosmer Upper Extremity Prosthetics sporting attachments. In addition to the Bowling Attachment, Hosmer makes a Baseball Glove Attachment, and the pole-gripping Ski Hand/Fishing Hand. The Hosmer-equipped bowlers kicked my ass.

‡
But not your iPhone. Smart smartphone thieves use the startle reaction to their advantage. They come up behind unsuspecting texters and whap them on the back of the head. The startled victim’s arms bend, launching the phone, which is effectively tossed to the thief.

§
More formally known as the “optional integrated phallus,” available in Caucasian and African American (different colors, same size).

¶
Expendable items like Visceral Linings, Replacement Veins, Foreskins (for the Nasco Circumcision Trainer) and Laerdal’s Concentrated Simulated Vomit are known in the industry as “consumables.” In the case of the Simulated Boluses of chewed food that get stuck in the esophagus of the Laerdal Choking Charlie manikin, the term is doubly apt.

#
I suppose that by “seniors” Cartledge means people older than the boys; however, Spartan senior citizens weren’t the courtly walker-pushers of current stereotype. “Tribal elders” would screen babies for military worth; those deemed unfit were hurled into a chasm called “the deposits.” Nothing in antiquity makes much sense. Who gives cheese to a goddess of vegetation?

Sweating Bullets

The war on heat

F
ORT BENNING, GEORGIA, HAS
three key ingredients for heatstroke: humidity, intense sun, and Army Ranger School. Rangers, like their better-known cousins Navy SEALs, are part of the US Special Operations forces. To borrow the words of their creed, the Ranger is an “elite soldier” expected to “move further, faster and fight harder than any other soldier.” Josh Purvis would seem to be maximally elite in that he was, when I met him, an instructor at Army Ranger School and a contender for the annual Best Ranger Competition. The competition falls into the category of a multisport event, surely the only one to include a Bayonet Assault Course and a litter carry. (They don’t mean trash.) Competitors march and run twenty-plus miles with a sixty-pound pack, and every year, a few will experience a second litter carry, in the horizontal position. In 100-degree heat, “further, faster” can be a lethal undertaking.

Today Purvis, along with a fellow instructor, will march in a hot spell of mechanical making. As subjects in a heat tolerance study, they will walk fast and uphill for two hours at 104 degrees Fahrenheit on a treadmill inside the “cook box” at CHAMP: the Consortium for Health and Military Performance, part of the Uniformed Services University of the Health Sciences. Some individuals are constitutionally prone to heatstroke and other heat illness, and the Army would like to have a way to know who they are before sending them out into the scorch of a Middle East afternoon with a hundred pounds of gear and other human beings whose lives depend on them.

Purvis leans against a counter, shirtless, filling out a “mood state” questionnaire. I see him put a check in the “Moderately” column beside the descriptor “full of pep.”
Pep
isn’t really a word for Josh Purvis.
Pep
wants some spring to the step, some twinkle, a tendency to whistle. I don’t believe Josh Purvis whistles. His features, while handsome, have a hard set to them, a sort of coiled restiveness.

The researcher, a fit blonde with a luminous complexion, tells Josh to make a fist. She and her colleagues are looking for biological and genetic markers that might lead to a simple blood test to identify combatants prone to heat illness, so their superiors could keep closer tabs on them. However, her request is unrelated to the drawing blood. “Josh, let us see your muscle.” The researcher is Josh’s mother, Dianna Purvis.

Josh’s arms remain at his side. “
Mom
.”

Purvis the elder holds out an apple from the pre-test meal pack. “Josh, eat your snack before you go in.”

“Mom, s
top
.”

I can’t see which box Josh has checked beside the descriptors Uneasy, Peeved, and On Edge, but I’d mark them “a little bit.” His mother has put this down to “the probe.” He will be having his tolerance tested—heat and otherwise—by way of a rectal probe: a slim, flexible, insertable thermometer. The rectal probe is attached by a six-foot wire to a piece of portable hardware labeled Physitemp Thermes. It is the size of a hardback book, and heavy as a brick. It’s heavy enough that if you set it down on a counter, forget that you are tethered to it, and walk away, you will be very
effectively
halted before you drag it off the counter.

The rectal thermometer enables the researchers to monitor their subjects’ core temperature. Like any complex bioelectrochemical system, the human body works best when its vital components are humming along in a set temperature range. For humans, that’s roughly ninety-seven and a half to ninety-nine and a half degrees Fahrenheit. When your core temperature begins to rise, either because it’s hot where you are or you’re toiling hard, or both, the body takes measures to bring it back to the happy range. First and foremost, it sweats.

Until this trip, I thought of sweat as a sort of self-generated dip in the lake. But sweat isn’t cool. It’s warm as blood. It essentially
is
blood. Sweat comes from plasma, the watery, colorless portion of blood. (A dip in the lake cools by conduction: contact with something colder. Highly effective but not always practical.) Sweat cools by evaporation: offloading your heat into the air. Like this: When you start to overheat, vessels in your skin dilate, encouraging blood to migrate there. From the capillaries of the skin, the hot plasma is offloaded through sweat glands—2.4 million or so—onto the surface of the body to evaporate. Evaporation carries heat away from the body, in the form of water vapor.

It is an efficient system. A human in extreme heat can sweat as much as two kilograms an hour, over a span of a few hours. “Roughly speaking, 10 kilograms loss of sweat [over the course of a day] is not rare for workers in overheated factories and active soldiers stationed in the tropics,” states the late Yas Kuno, longtime professor of physiology at Nagoya University School of Medicine, in the 1956 edition of
Human Perspiration.
“One will be struck with wonder . . . when he thinks that such a large amount of sweat is produced from glands which are extremely small in size.” Though humans have, by weight, more than twice as much salivary gland tissue as sweat gland tissue, they are capable of producing six times as much sweat as spit.

Human Perspiration
is itself a prodigious output: 417 pages. There was a lot to report,
*
in part because Kuno’s sweat studies spanned thirty years, and in part because he had a lot of collaborators: “some 65 in all.” The book includes a collection of black-and-white photographs of Japanese men in thongs, sweating after a session in the Perspiration Chamber. Because the men had been dusted with a special starch that turns black on contact with sweat, their torsos, foreheads, and upper lips are speckled with what appears to be an especially virulent mildew. One set of images highlights the surprising variety of sweat distribution patterns on the human scalp.
†
Rather than take a razor to their own heads, the researchers recruited “eighteen Buddhist Japanese priests who make it a custom to shave their heads” and, going forward, to ignore all calls from Nagoya University.