Friday, August 22, 2014

Hollywood Is Working Hard to Make You Cry

Hollywood Is Working Hard to Make You Cry

Several Movies With Scenes Primed to Unleash the Waterworks Will Hit Cinemas Soon. But Getting Audiences to Cry is Getting Harder.

By Don Steinberg in the Wall Street Journal

These are happy days for people who like to cry at movies.

Opening this weekend is "If I Stay," about a cello-playing teenager who falls into a coma after a car accident. In the hospital, Mia (Chloë Grace Moretz) has flashbacks about winning the heart of Adam (Jamie Blackley), a super-cool boy given to impossibly romantic lines.

At one point, timid Mia goes to a party dressed like punk-rocker Deborah Harry in hopes that Adam, who plays in a band, will like her more. It's hard not to choke up when he tells her that the clothes don't matter: "Don't you get it? The you you are now is the same you I was in love with yesterday, the same you I'll be in love with tomorrow."

Coming this fall: more opportunities to get out the handkerchiefs. "The Skeleton Twins," "This is Where I Leave You" and "Men, Women & Children" delve into the emotional minefields of parents and children, fraying marriages and estranged siblings trying to reconnect.

Over the summer, viewers teared up at "The Fault in Our Stars," the story of terminally ill teenagers Hazel and Gus (Shailene Woodley and Ansel Elgort). "Fault," which opened in June, has brought in $124 million in the U.S., making it the highest-earning teen-romance flick not powered by vampires.

"I have people coming up to me on the street and crying," Mr. Elgort says. The 20-year-old actor is following up his role of star-crossed lover in "Fault" by playing an anxious teenager in "Men, Women & Children."

Audiences love tearjerkers, but why? How do they work? Horror movies have their clichéd "jump scares" that can get us every time—the demonic face in the bathroom mirror, the knife-wielding maniac suddenly in the doorway. Tearjerkers have triggers, too, but they are more complex, wrapped up in how characters make us feel, with their awkward attempts to connect with each other, their bravery and fears, regrets and unspoken burdens. Other hot-button themes are faith redeemed, struggles rewarded and love requited.

Filmmakers say there is no surefire trick to make viewers cry but certain techniques help. And since audiences have seen it all before, it's not getting any easier.

Some tearjerkers made years or decades ago are still vivid. Think of "Terms of Endearment," in which Shirley MacLaine's overbearing character clashes and ultimately reconciles with her dying daughter, Debra Winger. Or "Jerry Maguire," where Renée Zellweger interrupts Tom Cruise's attempt at reconciliation by saying, "Shut up, just shut up. You had me at hello."

Crafting a scene that touches emotions is "not about putting the sugar in the sauce. It's about every ingredient and decision that you make," says R.J. Cutler, who directed "If I Stay." The movie, like "The Fault in Our Stars," was adapted from a young-adult novel. Before shooting "If I Stay," Mr. Cutler says, "I read the book again to identify the moments that moved me, and I made a list of those moments."

One such moment unfolds when Mia's normally stoic and critical grandfather breaks down at the comatose girl's bedside, saying how proud he is of her. It works, Mr. Cutler says, thanks to a mix of story context, dialogue and the casting of Stacy Keach in the role of Gramps. All those factors help the viewer relate and feel moved.

"The power of the emotion comes from the fact that Gramps is fighting the emotion as much as possible," the director says. "We know Gramps, in the parenting of his own child, was unable to connect emotionally. Not a man of many words. You want to cast a man for whom that seems to be true."

Then technique comes in. "Part of the strength of the scene is that there's no music in it," Mr. Cutler says. "What the moment needed was no embellishment. And there's a camera movement that is done there and nowhere else in the film, which is this extremely slow push in that gets tighter than we are pretty much in any other moment—a sustained, single shot that pushes in on Gramps to a very tight close-up."

That shot with no cuts builds the tension and the reality—the audience doesn't get a break.

Shawn Levy did something similar when directing "This Is Where I Leave You." In that film, which opens in September, adult siblings including Jason Bateman and Tina Fey return to the home where they grew up to comfort their mother (Jane Fonda) after their father dies. In one scene, Mr. Bateman's character, who has lost his job, tells his mother he thinks his father would consider him a failure.

She says: "Your dad didn't love your job. You were his boy… As far as your father was concerned, the sun rose and set on you and your siblings."

"And we hold on a close-up of Jason," Mr. Levy says. "You see his eyes just thicken and fill, and the rims of his eyes go red and the tears come. A lot of times an actor will work himself up to tears... and you call 'Action' and they're crying. But it's a rare thing to see it happen in real time from zero to 60 within the take. There's no respite. You are with that character in real time."

Mr. Levy accompanied that scene with moving music by Michael Giacchino, who has scored films including Pixar's animated "Up."

"Music is a key tool. But it has to be used judiciously," Mr. Levy says. "The score needs to accent the emotion, but if it underlines it too boldly the audience feels overtly manipulated. Music actually needs to be subliminally manipulative."

Craig Johnson, who directed "The Skeleton Twins," about siblings (Kristen Wiig and Bill Hader) who have grown apart, agrees. "You have a music cue that comes in a little bit overwrought, suddenly you're in melodrama territory," he says.

Mr. Levy says it is crucial not to overdo the sentimentality. "I remember as a theater student at Yale, the teacher once said if you cry for yourself too much the audience won't cry for you," he says. "The character can't be too self-pitying because then we don't pity that character. That character is doing our job for us."

This explains why watching characters contain their emotions while braving adversity—like Tom Hanks enduring a pirate hijacking in "Captain Phillips" and Sandra Bullock surviving a space-shuttle disaster in "Gravity"—can be powerful, especially when these characters finally let themselves give in. As viewers, we hung tough with them and we release with them.

Researchers are applying science to answer questions about movie-induced weeping. Princeton University psychologist Uri Hasson, who coined the term "neurocinematics," led a 2008 study that used a type of magnetic resonance imaging to study brain activity while watching a film. The researchers used "The Good, the Bad, and the Ugly"—hardly a tearjerker—in their project. Mr. Hasson and his colleagues identified similar brain activity among people watching the same film, and suggested such research might be useful for the movie industry.

In emotion-research labs, one clip that has become standard is the death scene in the 1979 boxing film "The Champ," a remake of the 1931 movie. A young Ricky Schroder weeps inconsolably over the body of his father Jon Voight, wailing "Wake up, Champ!" Viewers cry, too. The film has been cited in hundreds of scientific papers.

Scholars also have studied why some scenes strike a chord with women and others affect men more. In "Sleepless in Seattle," Rita Wilson gets misty describing "An Affair to Remember," while Tom Hanks counters that he cried at the end of "The Dirty Dozen." Mary Beth Oliver, a Penn State professor who has studied tearjerkers, asked students to propose movie ideas designed to make men cry. "There were a lot of father-son kind of things," she says. "There were a lot of athletes. There were a lot of war films."

When asked which films choke them up, many men cite depictions of against-the-odds valor or understated affection, like "Rudy," "Brian's Song" and "Saving Private Ryan." Women name relationship dramas like "Steel Magnolias" or "Beaches" or "When a Man Loves a Woman," in which Andy Garcia tries to preserve his marriage to an alcoholic Meg Ryan.

Men and women may sob at different parts of the same film. In "Gravity," some women react when Ms. Bullock, while stranded in space, talks about her daughter who died in childhood ("Can you please tell her that Mama found her red shoe?"). Men may be more stirred by the dénouement, when the astronaut, having survived her journey, walks triumphantly ashore.

A 2008 Stanford University study found that complex emotions can arise when we are reminded of the passing of time. One illustration is in "The Notebook," where Gena Rowlands, stricken with dementia, hears the tale of two passionate young lovers from an aged James Garner. Just for a moment, Ms. Rowlands' character remembers their past together.

Some tearjerkers pack a powerful punch by compressing characters' lives. Think of the heartbreaking opening sequence in "Up," which takes Carl and Ellie from childhood to old age in about 10 minutes. Or this summer's "Boyhood," which was filmed over 12 years and literally shows children growing into young adults. What parent doesn't feel a pang watching childhood flash by in less than two hours?

"When I'm in a movie, what usually gets me to cry is identifying with a completely vulnerable human moment," says Jason Reitman, director of "Men, Women & Children." "As a filmmaker, if I want a moment to land emotionally, the key is for it to be completely truthful."

The Stanford study emphasized "meaningful endings"—the sense that a phase of life is coming to a close. Such moments can be anything from the relatively familiar sight of a father dancing with his daughter at her wedding to the scene near the end of "Good Will Hunting" when Ben Affleck goes to pick up his best friend Will (Matt Damon) and he isn't there. Realizing Will has moved on from their shabby neighborhood to pursue bigger and better things, Mr. Affleck just smiles wistfully.

Tom Lutz, author of "Crying: The Natural and Cultural History of Tears," says we sometimes cry watching movie characters behaving in storybook ways that we may feel we can't match in our real lives.

"I watched hundreds of these films trying to figure out where the flashpoints were, what it was that got us crying," he says. "It started to seem to me that it was the moments of perfect role fulfillment.... Nobody is a perfect son or daughter, husband or wife. These [movie] moments are a combination of perfect aspiration, sense of failure, sense of impossibility, guilt. This incredible mix of emotions gets stirred up, and that's what ends up making us weep."

Watch Out for the Celestial Triangle

Watch Out for the Celestial Triangle

For the past week, early risers have enjoyed a spectacular conjunction of Venus and Jupiter in the sunrise sky. The two brightest planets in the solar system have been as close as 0.2o, beaming with ease through city lights and the rosy glow of dawn itself. Now the twosome are becoming a threesome. As this photo from Abhinav Singhai of New Delhi shows, the crescent Moon is joining the show:

"We had a beautiful view of the three bright bodies rising over the India Gate," says Singhai.

Right now the Moon is moving closer to the planets. On the morning of August 23rd, the three will form an almost-equilateral triangle in the pre-dawn sky.



International Society for Krishna Consciousness

International Society for Krishna Consciousness

Broderick Crawford

Broderick Crawford

Antivirus Works Too Well, Gripe Cybercops

Antivirus Works Too Well, Gripe Cybercops


By Danny Yadron in the Wall Street Journal

For years, police have been in a cat-and-mouse game with an unexpected foe that can frustrate investigations—antivirus software.

Law enforcement's battle against Symantec Corp.'s SYMC in Your Value Your Change Short position Norton, Intel Corp., INTC in Your Value Your Change Short position McAfee brands and others gained new attention this month after anonymous activists published documents from FinFisher GmbH, a secretive German firm that sells computer code to help governments snoop on targets. Amid customer names and secret price lists, the cache exposed complaints from authorities that antivirus programs had thwarted their planned surveillance.

The unusual arms race offers new detail on the extent to which governments rely on computer-security holes to snoop.

"A lot of people rely on antivirus for protection against cybercriminals," said Morgan Marquis-Boire a senior researcher at the University of Toronto's Citizen Lab who has done extensive research on cyberspying. "You have the people we pay to protect us from very real crime trying to prevent this from working properly. That is somewhat concerning."

Government agencies across the world operate like hackers to install surveillance software like FinFisher's on targets' computers to monitor their communications. The Wall Street Journal reported last year that the Federal Bureau of Investigation had expanded its use of such tactics.

But the targets' computers may employ the same electronic defenses as other citizens. These defenses work against cybercops as well as cybercriminals.

"We certainly do our best to make sure the antivirus programs that are out there are not going to be able to detect the presence of the software," said Eric Rabe, a U.S. spokesman for the Italian company Hacking Team, also known as HT S.r.l, another maker of surveillance programs for police forces. "If you're trying to do covert surveillance, which of course is what we are trying to do, obviously it is something a company like ours has to worry about."

There is no documentation of U.S. state or local police using Hacking Team or FinFisher to monitor suspects. The two companies appear often at U.S. law-enforcement conferences and Hacking Team counts an office in Annapolis, Md., and is used in about 30 countries.

At a coming conference in Washington, D.C., a Hacking Team executive is scheduled to give a talk titled, "Intruding communication devices: live demonstration of latest attack techniques."

The FBI declined to comment. The agency uses hacking software with court approval on a case-by-case basis, former U.S. officials have said.

Ironically, the revelations come amid questions about the effectiveness of antivirus programs against a growing array of cyberthreats. Symantec, which pioneered antivirus software, is now focusing on products to help businesses minimize damage from hackers after they get into a network.

In 2012, a FinFisher customer who at one point called himself "Khalid from Pakistan," complained that antivirus software from Symantec and Bitdefender could block his agency's spying, according to the leaked FinFisher documents. FinFisher's tech support said he needed to upgrade to version 4.2.

A year earlier, a Qatar agency bemoaned that it couldn't "install the infection file" if the target used an antivirus program from Avast Software s.r.o. That is what Avast's software is supposed to do, said Vincent Steckler, chief executive of the Czech company.

One FinFisher product allows anyone with access to a target computer to insert a USB drive and download usernames, passwords and documents, according to previously leaked documents. But in 2011, the company told an Estonian agency it might need another way in. "Unfortunately I have to inform you that we aren't able to bypass the [McAfee antivirus] product with current FinUSB loader," the FinFisher representative wrote back.

Representatives for Estonia, Pakistan and Qatar didn't respond to requests for comment.

FinFisher was launched in 2007 by Gamma Group, a British surveillance firm, and is now an independent company, according to its website. Neither Gamma nor FinFisher commented on the authenticity of the leaked documents, first publicized in early August, and neither responded to multiple requests for comment.

FinFisher may be gaining an edge against antivirus software. The leaked documents show it has a working relationship with Vupen, a French surveillance company that boasts in ads that its tools "bypass all modern security protections and exploit mitigation technologies," including antivirus.

In a Twitter post earlier this month, Vupen CEO Chaouki Bekrar said his company only sells to governments, not other surveillance firms. In a June email exchange with a reporter, Mr. Bekrar said Vupen only sells to federal agencies in the U.S.

As of April, FinFisher claimed it could sneak past most antivirus vendors, though it sometimes had trouble with software from Slovakia-based ESET, Russia's Kaspersky Lab ZAO and Panda Security SL of Spain, according to one of the leaked documents.

Told his company appeared to have some luck blocking government-used malware, ESET researcher Cameron Camp said, "Thanks, I think."





Posters comments:

1)      Even poisonous snake bites will only and usually just make one sick for a few days. The bites usually will not kill a person, though one never knows for sure; often like it depends on the situation. If one survives a bite from a snake, even the non-poisonous kind (which are most), it may induce immunity from future snake bites and even future insect bites. Our human bodies do a good job in this kind of matter.

2)      Most snake bit people will get hurt (more often) by the response of their helpers, like racing a car to some kind of emergency health care.

Do we recognize when we are under attack?

Do we recognize when we are under attack?

Are we even willing to even fight for our own children’s right to a hopeful future in our own Country?

Are there even still people in the World who want to do us harm, again in our own Country, and for their own reasons?

I always wondered what it was like during the time of the American Revolution against England.  What did our ancestors hear, read, and think about in their time on this earth? Why did they act as they did?

And I always wondered what is like during the rise of the Nazi’s in Germany and what our ancestors did then, like less than a century ago?

It is still going on, whatever still going on means?  At least that is my opinion as to the question.

And I still wonder if our elected leaders and their appointed minions want to live in a world as they hoped it might be, vice what it is at present?

It is only our blood, and our children’s blood, like dying or being maimed or seriously wounded, that these leaders seem to deal with these days in pursuing their own ideas.  Are our elected leaders willing to sacrifice their own blood, and their own children’s blood in pursuit of their own agendas?

Are these people so important to our future that they are even above the law that applies to most other people?  It is like do as I say, not as I do?

Do they want to try rule the world, vice just an influential Country like the United States of America?

Just how much is one life valued? Just how much are millions and billions of lives valued?

And do they think they can get rid of war just by saying to do it?; and then replacing war with something like an all legal justice system.

In hindsight

In hindsight

Is there a better way?

The subject is the best way to rule ourselves, including in our new world USA.

How to pay taxes is always part of that discussion, too. Said another way, I suspect most people of the world believe in some kind of government where they live, and are willing to pay taxes to help their own causes along.

All the previous forms of governments one can pursue and read about on their own, like make up their own mind.

And of course often we just have to live with what we were born into, like that is all we are willing to work on in our own lifetimes, and to put up with. Often that seems like tribal to me, sometimes called Balkanization in other terms.  Even in the USA we seem to be celebrating “diversity” these days, vice another government (and older) policy called “humanizing”, which is what really is happening anyway. What a country and isn’t it amazing how our own children marry and breed their own future children.

So back to the subject of how best to be ruled.

So far I think our own American Constitution is a good way to balance the rule of law with our own human behaviors, like it or not. Even throw in some capitalism. Now even I am willing to hear about better alternatives, too, including how to get there, like from A to B.  And then, if there is a better way, let’s do it. 

And if there is not a better way, then let us just reinforce what we already have, and even make it better than it is today.



Introduction to Tactical Combat Casualty Care, by W.H.

Introduction to Tactical Combat Casualty Care, by W.H.

This is an introduction to Tactical Combat Casualty Care (TCCC), which is the medical training that U.S. troops are currently taught to save lives on the battlefield. TCCC is the result of collaboration between U.S. Special Operations Command, trauma doctors, and emergency medical personnel to address the shortcoming in combat medicine at the start, and actually well into the current Wars On Terror. It is the combination of good medicine with good tactics. It incorporates some procedures that are proven to save lives but in the past 75 years were shunned in the medical community. TCCC has proven to reduce the number of preventable deaths on the battlefield. The 75th Ranger Regiment had all of its troops and doctors train in TCCC. Their percentage of preventable deaths on the battlefield dropped to 3%, compared to the average of U.S. combat troops, which is 24%. Also note, the mindset for these procedures are not to necessarily save someone’s life but to prevent them from dying long enough to receive hospital level care. This is a very basic introduction. I am not certified in any medical care beyond TCCC, but I have seen and done these procedures on live patients, and they do work, when properly applied. The references listed on the bottom of the article have much more detail and information, as well as great videos and pictures, that help illustrate the topics covered in this post.

I will briefly describe the five main wound areas that need to be addressed and then the equipment needed to treat each wound. Nearly all of the equipment described can be bought easily online. The acronym MARCH can be used to remember the order of treatment, descending in order of importance.

Massive Hemorrhage





Massive hemorrhage (or bleeding)
This is the number one preventable killer on the battlefield. It is caused by a penetration to a major blood vessel or a complete or partial amputation. Any bleeding that is bright red, squirting, or heavy is considered massive hemorrhage and needs to be treated immediately. A major bleeder can kill the casualty within minutes; therefore, prompt treatment is essential. There are two treatments for a massive hemorrhage– tourniquets and wound packing.

The tourniquet is an essential tool for battlefield medicine, which has made a huge comeback in the recent wars. A tourniquet is used to treat a massive hemorrhage on a limb. They are fast, cheap, and extremely effective at stopping bleeding, if applied properly. There are many different types of tourniquets easily available for purchase on the Internet, but they all work roughly the same way. The tourniquet is placed high up on the affected limb, and the windlass is tightened until the bleeding stops. "High and Tight" is the easy way to remember. If placed too low on the limb, the pressure generated on the blood vessel won’t be high enough to stop bleeding; likewise, if it is too loosely applied, it won’t be effective. A number of deaths from the War on Terror were attributed to tourniquets being applied too loosely, where if applied properly, the bleeding could have been controlled and the casualty saved. It is worthy to note that having a tourniquet properly applied is VERY uncomfortable. Patients will plead and beg, or even try to loosen the tourniquet themselves, but under no circumstance should a tourniquet be removed by anyone other than a trained medical professional.

Tourniquets are now required to be carried by every soldier in his kit and be easily accessible, as it is a piece of life-saving equipment. During WWII and the Vietnam War, tourniquets were believed to be very dangerous to apply, and it was believed that it condemned the patient to loose that limb. Nowadays, they are saving countless of lives, as the dangers once associated with them have been tested as false. Sadly, movies and TV shows shape much of the public’s perception of trauma medicine. After the Boston bombings, many good Samaritans jumped in and used makeshift tourniquets to try and stop the bleeding from amputations caused by the explosions; however, none of these makeshift tourniquets were successful in stopping hemorrhage. Please don’t think that when the time comes, you can ripe your shirt off, put a stick through it, twist it a couple of times, and save someone’s life. It is my humble opinion that every household should have at least one tourniquet (preferably more) and know how to use them. I was issued 4 SOF-T tourniquets, so I have one in my at-home trauma bag, one in the bag I take to work, one on my kit, and one in reserve.

The second way to treat a major hemorrhage is wound packing. This is done on any major bleeder, not on a limb. While more time intensive than applying a tourniquet, wound packing can be just as effective at stopping bleeding. The idea behind wound packing is to first apply direct pressure proximally (closer to the heart) to the blood vessel against a bone. This will ensure that the immediate blood flow stops. If the wound is deep or on the trunk of the casualty, place gauze or a dressing as deep into the wound as possible. This will maximize the clotting effect. Also, once a dressing is soaked through with blood, it is imperative to leave it in place in the wound. If removed, it will remove the clot you are trying to form. Pack the entire wound with gauze, ideally placing it towards the head as you pack. Once the entire cavity has been packed, it is wrapped with another bandage to secure it in place. If done right, the pressure from the packing will slow down the bleeding enough for the platelets to start to clot, which will in essence seal off the blood vessel from further blood lose.

A note on Quikclot. It has undergone a couple of different variations, but the current product on the market is called Combat Gauze, which is a bandage impregnated with a compound that speeds up the clotting process. It is not a miracle cure-all product, but it does lead to a much more robust clot, which is more durable if the patient has to be moved. Additionally, Quikclot makes a Silver addition, which has a silver compound in the bandage that helps prevent infection. This could be very helpful in a survival situation in which doctor level care may be much longer away. The Israeli bandage is also another useful bandage to secure the dressings, once they have been placed in the wound. Like tourniquets, Quikclot and other bandages can be easily and cheaply purchased online, but be aware that the Quikclot has a shelf life, where gauze and other bulky dressings do not.

The second killer on the battlefield, which like bleeding can be controlled, is a blocked or restricted airway. There are some procedural differences between civilian and combat medicine. (Remember the ABCs, in which airway is treated first in civilian emergency medicine?) This is because by the time emergency responders arrive on scene, a massive hemorrhage has more than likely already killed the patient (in as little as 1-3 minutes). In tactical medicine, the number one killer is massive hemorrhage, followed by a blocked airway, and that is why it is treated in that order. Simply put, if the patient cannot breathe, he will expire in roughly four minutes. If a patient can talk, cry, laugh, or scream, they have a clear airway. If a patient is unconscious, it is easy for a patient to choke on his or her own tongue. When consciousness is lost, the tongue relaxes and, being a large muscle, can fall back and block the esophagus. The way to treat a blocked airway is an easy procedure called a nasopharyngeal (NPA), or in layman’s terms it’s often called "a nose hose". It is simply a flexible rubber hose that is inserted into a patient’s nose to open the airway from the nostril to the back of the throat. When inserting a nose hose, push the hose straight back towards the spine, not up towards the bridge of the nose, as the nasal cavity goes straight back. It is standard TCCC procedure for any unconscious patient to automatically receive a nose hose. A nose hose can be purchased online for roughly $7. [HJL Adds: Rather than a $7 single NPA, you should have a kit of different sizes] After inserting a nose hose, make sure to look inside the patient’s mouth for any obvious obstructions. When checking the airway for obstruction, take care not to place your fingers inside the patient’s mouth, as the patient can seize and bite down without warning. Lastly, if the situation applies, consider rolling the patient onto his or her side, as this will help keep the airway clear of any fluids, such as vomit or blood, as well as the patient’s own tongue.

After massive hemorrhage and airway have been addressed, the patient’s respiration needs to be checked. This is done by removing any body armor, kit, and outer clothes, and then looking for an equal rise and fall of the chest, listening for breathing, and feeling the chest rise. The risk to respiration is a pneumothorax. Simply put, this is caused by a penetration to the chest cavity that lets air into the pleural space– the area surrounded by the rib cage that protects the lungs and heart. This air bubble puts pressure on the lungs and heart– a condition that can be fatal, if left untreated. It will start out with shortness of breath, labored breathing, and can lead to the patient feeling an impeding sense of doom, unconsciousness, and death. The fancy medical term for this is "progressive respiratory distress". The treatment for pneumothorax is needle decompression. This involves sticking a large gauge needle (14 gauge and 3.25 inches long) into the patient’s chest to relieve the pressure. While this sounds dangerous, if done right, it can and will save lives. The injection site for the needle is two to three finger widths below the center of the clavicle bone on the affected side of the patient. As the needle to do this is not easily available, I will not go into great detail. If there is any wound to the torso (above the belly button up to the neck and 360 degrees around the body), immediately seal the torso wound by placing your hand over it, and then sealing the hole, preferably with a medical chest seal, but in a pinch, duct tape and any airtight wrapper will do. If a gunshot wound is suspected, check very carefully for an exit wound, and again seal the wound to prevent air from entering the chest cavity.

The TCCC procedure to address circulation in the MARCH sequence is to check the patient for shock. While there are many different types of shock, an easy definition for non-medical professionals is the inability of the body to transfer blood to its tissue (also known as profusion). In the case of traumatic injury, this is usually due to blood lose and the change in hormones following a traumatic event. As the body comes down from its amped up state, immediately following an injury, it realizes that it cannot keep up its current state and begins to shut off blood flow to the outer, less essential areas. However, a patient can suffer shock without sustaining a traumatic injury, usually after a person witnesses a horrific event. One of the easiest and most timely ways to check for shock is to check the patient’s radial (wrist) pulse. If there is a radial pulse, the body is still pushing blood to the hands. If no radial pulse is present, it is an indicator the body is no longer pushing blood to the hands in order to keep it for vital bodily functions and is going into shock. To prevent shock, timely treatment of massive hemorrhage is critical, as it reduces the amount of blood lose. Another way to help a patient suffering from shock it to elevate their feet, unless there is any indication that the patient has received any wound that could cause a spinal injury, in which case you DO NOT want to elevate their feet as this could paralyze them. My wife who is a trained EMT says that if there is any blood on the patient, EMTs would not risk paralyzing them by raising their feet. Likewise, it is not incorporated into TCCC, yet it remains a viable option in some instances. Lastly, getting fluids back into the patient as quickly as possible is a way to prevent shock.

Head injuries are a common occurrence on the battlefield, especially with the proliferation of Improvised Explosive Devices. While there is not much that you can do for yourself or your buddy on the battlefield, it is an important to pass on any information regarding signs of head injury, or Traumatic Brain Injury (TBI) to advanced medical care personnel. The signs and symptoms for a TBI include altered mental state, "raccoon eye" shaped bruises around the eyes, clearish yellow fluid leaking from the ears, mismatched pupil size, and any bumps or deformation in the skull. To check for TBI, check the patient for any of these signs.

Hypothermia can be a problem for wounded patients, as any blood loss or injury can diminish the body’s ability to retain heat. Even in a very warm climate, a patient can succumb to hypothermia. Anyone who has ever field dressed an animal knows how hot the internal organs are. To prevent this, after the patient is screened using the MARCH protocol, ensure that any body armor or clothes are put back on, and the patient is covered with a warming garment, whether it be a space blanket, wool blanket, sleeping bag, or in extreme cases, a buddy can use his body heat to re-warm the injured.

Everything Else
After the MARCH sequence has been completed, move on to everything else. The main preventable death injuries are covered in MARCH, but there are still other injuries, while not life threatening in minutes, that are still very important.

Superficial or non major hemorrhages: Any wound that does not strike a major blood vessel or organ is not immediately life threatening but can still look pretty scary. Injuries like this include cuts or wounds on the outside of the body, such as the forearms, outer legs, buttocks, and shoulders. Since the major blood vessels are located on the inside of the body and protected by bone and muscle, wounds to the outer parts of the body can be dealt with last, usually with a simply pressure dressing.

Eviscerations: While definitely very frightening and disgusting to witness, evisceration (abdominal wounds with the intestine hanging out) are not immediately life threatening. The old protocol was to keep any exposed intestines outside the body in a wet bag. However, the updated TCCC protocol is to gently place the intestines back into the wound and seal the wound up any way possible. While putting exposed internal organs back into the body does raise the risk of infection, it has been show that it is safer for the patient’s long-term health than leaving them outside the body.

Eye Injuries: While in any high-threat situation, eye protection should always be worn; still, the chance of eye injury exists. The best thing to do is to protect the eye but do not put the bandage directly on the eye; rather, allow the eye room to still move. While there are fancy eye patches out there, anything that will protect any further injury to the eye while still letting it move will do. To note, U.S. troops are issued battlefield antibiotics when deployed, in a survival situation these may not be immediately available, but with any injury, infection needs to be addressed, especially with eye trauma.

Some General Principles of TCCC:
Use a combination of good tactics and good medicine
Suppress effective enemy fire or immediate threats before attending to wounded personnel
Any completely or partially amputated limb receives a tourniquet
Treat major bleeders first (Care under Fire), then move injured person to cover, and begin Tactical Field Care (the rest of MARCH)
Before completing the next step in MARCH, check previous steps. For example, after placing a tourniquet on a major bleeder and moving the patient to cover, check the tourniquet before restoring airway, and then before checking the chest for wounds (Respiration) check that the tourniquet is still stopping the massive hemorrhage and the airway is still clear.

Building a Trauma Bag
I strongly recommend everyone have some sort of emergency medical bag. While first aid kits are great, they often times are severely lacking in medical supplies needed to stop life threatening injuries.

I attach my trauma bag, which is relatively small (3"x5"x8") onto my larger medical bag. In a hostile environment survival situation, I can quickly remove my trauma bag from my med bag and attach it to my battle rattle.

My trauma bag consists of the following:

1 tourniquet (SOF-T brand) (spare in my med bag)
Quikclot Combat Gauze
H and H compressed gauze
Space blanket
Quickclot Silver x 2
H bandage
Chest seal x2
Benadryl (for allergies)
Two simply 3"x 4" nonstick bandages
Duct tape

With a few differences (lack of decompression needle, the addition of the Quikclot Silver and Benadryl) this is what current U.S. soldiers carry in their Individual First Aid Kit, also know as a blow out kit. All of the items in my trauma kit can be purchased online for under $150. I strongly recommend, at the very least, a tourniquet, some bandages, and a chest seal.

Final Thoughts
In closing, while TCCC is primarily for a tactical battlefield environment, the principles of it can be applied to most traumatic injuries and can be very useful in a variety of survival situations. Whether it is surviving a mass shooting or bombing attack and giving the wounded precious minutes until professional medical responders can arrive, to rioting where medical services may be degraded, to a near total societal collapse, preventing death will always be useful. Like any survival skill, the knowledge, while important, is useless without practice. Every piece of medical gear listed in this article (with the exception of a decompression needle) is easily available for purchase online, and a very well-stocked trauma bag can be put together for around $150, but it is essential to practice the actual MARCH sequence and how to treat each wound. Thanks for reading. While I hope that no one ever has to use the skills mentioned in this article, I hope that when the need arises, the training, mindset, and equipment will be there to meet the challenge!

National EMT TCCC homepage

A great resource for more info, videos of procedures, et cetera.


From the Survival Blog

Thursday, August 21, 2014

Why We Stare at Brides

Why We Stare at Brides

It didn't start out as a social experiment, but it became one.

A young woman from the neighborhood was getting married. The family invited me, and asked that I take some pictures. They had an official wedding photographer, but I'm a photojournalist and would get some backup shots. This was fine with me -- I actually prefer that role, as I think that people look much more natural and beautiful when they are not posing.

So I was a participant in the ceremony, but also something of an outsider. I could be close to the wedding party, yet also watch those watching the ceremony, which was at Georgetown University in Washington. It was a position that left me with a question.

Why are we so mesmerized by wedding brides? 

I realize all the usual, and correct, answers. She's beautiful. It's an important day. People like to see happy things.

But all of this could apply to seeing a group of women out on the town celebrating a birthday. People are not mesmerized by a girl's night out. They are mesmerized -- some seem frozen in place -- when they see a bride. It was a rich and funny experience to be a fly on the wall and watch people abandon their shopping bags, friends, and even smartphones (other than to take pictures) and simply stand and stare. And stare. And stare. And stare.

They stare, some of them with deep longing, because that in a world that insists on being more and more secular and selfish, a woman on her wedding day is a shocking countercultural totem of resistance. She is a defiant sign that immortality can be touched when you make yourself a gift to another human being. The groom does this also, of course, but men tend to be more violent, promiscuous, and in in the evolutionary order of things, more expendable. People might notice the groom, say he looks handsome, but they positively forget themselves when they see a bride.

Women are more moral (look at the prison population), are the primary transmitters of life and culture, and just smell better. There is just something divine about them. As pornography, dressing down, and feminism keep trying to drag them down to the guys' level, the wedding gown reveals their true selves. And in the metaphysical scene of things it is much more crucial to human flourishing than "equal pay for equal work."

Real men know that the woman's true self is worth loving, protecting, and dying for. The best women call us out of ourselves. They teach us discipline, self-sacrifice, and giving ourselves up for future generations and for love. And not romantic love, but the love, as Pope Benedict XVI once put it, that goes all the way to the end; the love that endures through sickness, depression, disease, even indifference. That is why we stare at brides in their white. We stare in awe and in gratitude.

The night after the wedding, I went to see a great band from Austin, My Jerusalem, play at the historic State Theater in Virginia. I was mulling what I was going to put in the wedding video I was putting together for my friends. Then the band provided the answer, in their song "Mono." Here are the opening lyrics:

You're gonna die in this room
In your twin size coffin tomb.
When all your friends have bailed out,
Who will rescue you now?

The sheets, they make you itch
And bedsores make you twitch.
And you just can't figure out
How you've gotten here somehow.

I wanna be the one who rolls you over.
I wanna be the one who rolls you over.


Not your typical wedding vows, but it hits the mark.




Customers Snap Up Stretchy Tees and Leggings, Boosting Growth for 'Athleisure' Apparel

Yoga Poseurs: Athletic Gear Soars, Outpacing Sport Itself


Customers Snap Up Stretchy Tees and Leggings, Boosting Growth for 'Athleisure' Apparel

By Sara Germano in the Wall Street Journal

Why work out when you can just buy the clothes and look like you did?

The rate of growth in the U.S. retail athletic apparel market is surging, even as Americans' rate of participating in most sports is in decline.

The result is a phenomenon the apparel industry calls "athleisure"—a bright spot in a sluggish business thanks to Americans who are increasingly donning sneakers in the boardroom and yoga pants at brunch.

Analysts at Barclays estimate the U.S. athletic apparel market will increase by nearly 50% to more than $100 billion at retail by 2020, driven in large part by consumers snapping up stretchy tees and leggings that will never see the fluorescent lights of a gym.

Demand for yoga gear, for example, is outpacing growth of the sport itself. Yoga participation grew 4.5% in 2013, according to the Sports & Fitness Industry Association.

Meanwhile, sales of yoga apparel were up 45%, according to Matt Powell, an analyst for SportsOneSource, a sporting-goods industry tracker.

"Everyone is wearing yoga pants, even people who aren't doing it," said Karen Score, the owner of Yoga Mandali, an independent yoga store in Saratoga Springs, N.Y.

Ms. Score, who also runs an adjoining yoga studio, is drawing up brochures for fall classes with the tag line: "Do you wear yoga pants? Why not try yoga?"

Lauren Wheeler-Woodburn estimates that she owns at least 25 pairs of yoga pants.

As a graduate student at the University of Southern California and social-media strategist, she says she wears them mostly every day, for class or to work, or just sitting at home lounging.

"I sound like the yoga pants version of a crazy cat lady," said Ms. Wheeler-Woodburn, who prefers Lululemon but dons other brands too.

The 25-year-old isn't a diligent yogi, though she practices at home sometimes. For her, the clothing isn't an athletic utility but a wardrobe staple. Yoga pants, she said, are easy to clean, don't need to be ironed and, at $90 a pop at Lululemon, are cheaper and more versatile than even her favorite jeans, for which she pays upward of $200 a pair at Nordstrom.

The trend isn't limited to yoga. Organizers of a trade show for traditional outdoor and camping retailers earlier this month debuted a new exhibit devoted to so-called urban wear for "millennials" who wear their boots and flannels with no intention of actually hiking.

For men, retailers are rolling out new versions of jogger pants—sweatpant-like trousers with elastic cuffs at the ankles. Mr. Powell, of SportsOneSource, said they have been a main topic of discussion at apparel trade shows throughout Las Vegas this week.

Tracksmith, an online apparel boutique, made its debut in July offering preppy, $90 men's running shorts.

Not long afterward, a parody site called Running Team JVA mocked Tracksmith's marketing. "Running is free. But it shouldn't be," the site reads.

Matt Taylor, a co-founder of Tracksmith, which sold out its first shipment of inventory, said he thought the site was "pretty clever."

Betabrand, a San Francisco-based apparel startup that crowdsources ideas for items and crowdfunds the production, said the debut of its chino-styled dress-pant yoga pants earlier this year was so successful the company has put ideas for other projects on hold to focus on the athletic apparel business, particularly for women.

The Sports & Fitness Industry Association tracks participation rates across six categories. Over the past five years, participation in individual, racket and team sports fell, and was flat for outdoor, water and fitness sports.

Meanwhile, the size of the U.S. market for workout clothes grew by 5% a year on average, from roughly $54 billion to $68 billion, according to analysts at Barclays.

Athletic apparel manufacturers and retailers are reaping the benefits. Under Armour Inc., UA in Your Value Your Change Short position once known largely for its compression gear worn by football players, expects its annual revenue to surge 29% this year to $2.91 billion, fueled by its expansion into women's wear, youth apparel and footwear.

Consumers "have and will continue to want versatility, to look great everywhere, in the gym, on the street, in class," said Henry Stafford, president of Under Armour North America.

Dick's Sporting Goods Inc., DKS in Your Value Your Change Short position reeling from downturns in both the golf and hunting categories, said this week it is looking to grow its other businesses, and has already begun allocating more store space to sports apparel, particularly for women and children in time for back-to-school shopping. Bon-Ton Stores IncBONT in Your Value Your Change Short position in May said it would "outsize the active athleisure category across all zones." Kohl's Corp. KSS in Your Value Your Change Short position will begin selling flashy sweatpants by Juicy Couture in the fall as a means "to capture more of the athleisure market."

In March, Andy Mooney, chief executive of surf and snowboard apparel maker Quiksilver Inc., ZQK in Your Value Your Change Short position said the company was de-emphasizing the core adventure-sports community and "going back to what we did when we first started, which is, we were both functional and fashionable at the same time."

The changes are even being noted in high-end markets. Online luxury apparel retailer Net-a-Porter in July unveiled a channel devoted exclusively to high-fashion athletic looks, named Net-a-Sporter.

Luxury brand Christian Dior CDI.FR in Your Value Your Change Short position unveiled some sneaker-inspired pumps for its fall ready-to-wear line. A glazed rubber pointy-toed upper is paired with a rubber sole inspired by running shoes. The heels are available for preorder in Dior stores starting at $1,450.

The athletic apparel market isn't without its challenges. Lululemon Athletica Inc., LULU in Your Value Your Change Short position which has been wrestling for a year-and-a-half with supply chain and quality issues, cut its outlook for the year as it works to clear excess inventory.

Alexandra Medina, of Costa Mesa, Calif., likes to wear yoga pants around town, which is standard fare in her community. She said she likes to work out, but can't always find the time in days that are consumed with running her flooring company and chasing her 19-month-old daughter.

"When you put on your workout apparel," she said, "you think, 'Huh, maybe I should think about working out today.' "