Grunt: The Curious Science of Humans at War

Oh, for the titular economy of yesteryear. The Stump Hospital is gone and in its place we have the likes of the Veterans Affairs Center of Excellence for Limb Loss Prevention and Prosthetic Engineering. Though all is not lost. We still have a Foot & Ankle Center in London, a Breast Clinic in New Delhi, a Kidney Hospital in Tehran, the Face & Mouth Hospital in Calcutta, New York’s Eye and Ear Infirmary, and the Clínica de Vulva in Mexico. The poor penis has no hospital to call its own.

? An exception is made for Dr. H. W. Bradford, who, for cosmetic purposes, transplanted a rabbit eye into the socket of a sailor who’d suffered a childhood eye injury. “The nature of the man’s calling,” wrote Bradford in the 1885 case study, “made it undesirable to use a glass eye.” I don’t know the precise occupational risks of the seafaring eyeball, but the prevalence of eye patches among pirates suggests they do exist.

Despite some clouding, the operation was deemed a moderate success. Though rabbits have larger pupils, their eyes are otherwise unnervingly similar to our own, as a Google Image search will quickly establish. I can’t recommend this activity, however, as the search results will include a photograph of a plastic-lined box captioned “Rabbit heads: no neck, no skin, with eyes. 100 grams each. Please contact me for price quotation.”





Carnage Under Fire

How do combat medics cope?





THE CALL TO PRAYER can be heard from the Carl’s Jr. parking lot. You can hear it at the Wells Fargo drive-through and outside the offices of the San Diego County Water Authority. The attentive listener will notice that something is off. Rather than five times over the course of a day, you may hear it six or seven times in a morning. Other days it is absent. If, perplexed, you were to follow the sound, you would find yourself not at a mosque but at a spread of movie studios and sets known as Stu Segall Productions. By all means, knock on the door and have a look around.

Segall was born a Stuart, but on his movie credits and in my mind he is always and very much a Stu.* Chest hair can be seen, and some necklace in there. There are whiskers, sparse and longish, somewhere between beard and I-don’t-feel-like-shaving. He has a wife but spends more time in the company of Bob, an agreeable Rottweiler who naps on the black leather couch in his office. Segall dives in and out of careers with glee. Writing, directing, producing (most recognizably, the TV crime drama Hunter). He owns a diner next to the studio. He doesn’t cook, but occasionally he names menu items, and you can pick them out without too much trouble—for example, the Boob (chicken breast) Sandwich.

Early in 2002, with Hollywood’s appetite for action dramas dampened by the events of 9/11, Segall began repurposing his talent for gore and violence. He founded a company, Strategic Operations, to produce loud, stressful, hyper-realistic (the coinage has been trademarked) combat simulations for training military personnel: the fog of war, in a box. Many of the trainees are corpsmen (Navy medics who deploy with Marines and SEALs)—men and women whose job may require them to perform emergency procedures while guns are going off around them and people are screaming and dying and bleeding like garden hoses. The underlying concept is “stress inoculation.” If you’re thrown into a staged ambush in Stu Segall’s Afghan village mock-up, the thinking goes, you’ll be calmer and better prepared when the real shit hits overseas. For medics, being calmer matters a lot. The fight-or-flight response is helpful if you’re fighting or taking flight but, as we’ll see, fairly catastrophic if you’re trying to stanch the flow of blood from an artery or cut an emergency airway or just generally think fast and clearly.

Forty future corpsmen for the 1st Marine Division, headquartered in nearby Camp Pendleton, are here today as part of a combat trauma management course. Over the course of two and a half days, the trainees will administer pretend emergency care to role-players, most of them Marines, in six varieties of military pandemonium, beginning with an 8:00 a.m. insurgent attack in the Afghan village.

The village, the largest of Segall’s sets, consists of two dozen ersatz mud-brick buildings, a small market, a rusting swing set, and, until recently, goats. (The goats were dismissed, because someone had to come in over the weekend to feed them, and more often than not it was Segall.) To get close to the action, I requested a role. I will be playing myself: a reporter who gets in the way and distracts people from their jobs. They’ve placed me in a sparsely furnished two-room house with a seasoned medical role-player named Caezar Garcia.

Under a torn pant leg, Caezar wears a simulated skin sleeve—silicone encrusted with mock gore and plaster bone fragments. A simulated severed artery will bleed via a small pump connected to three liters of house-brand special effects blood that Caezar wears in a concealed backpack, a sort of CamelBak for vampires. The flow is controlled by a wireless remote, so it can be stopped or slowed or allowed to continue unabated, depending on how competently the corpsman has placed the tourniquet. Originally the instructors, who hover on the fringes of the action during scenarios, held the remotes. Caezar, wanting a more nuanced bleed, petitioned to control it himself.

“I said, ‘Look, once you bleed me out—’” Caezar stops to listen. The call to prayer has started. The recording, being played over a set of speakers on a tower at the center of the village, is the signal for the role-players and the pyrotechnics guy to take their places. Through a window to our left, the trainees can be seen entering the village. They walk in formation, armed and armored, looking unrelaxed. The tape-recorder muezzin finishes his call, and for a moment it’s quiet. I can hear the soft, plasticky thrum of Caezar’s blood pump.

And then I can’t. First comes the familiar high whistle of an explosive-powered projectile, a sound that, depending on your life experience, presages pretty lights in the summer sky or a rocket-propelled grenade explosion. Rifle fire follows. The ammo is blanks, but you wouldn’t necessarily know that, because the pyrotechnics guy sets off an accompanying “dust hit” on the ground or wall.

The muezzin’s voice has been replaced by a recording of whizzing, ricocheting bullet noises and panicked soldiers yelling. It sounds like it was a hell of a battle. (I asked Segall about it later. “Vietnam?” “Saving Private Ryan.”) You wonder what they make of it over at the Water Authority.

“OOOOOH, FUCK! AAAAAAOHH HELP ME!” That’s Caezar. He’s very good.

A trainee steps into the room. His gaze drops to the floor, to a foot, in a boot, nowhere near a leg. Bone and mangled flesh—the remnants of a lower leg, sculpted by “wound artists” working from photos of a real injury—protrude from the boot. The corpsman blurts out, “Are you okay?”