“Really, Baker?” Palm sweat is a feature of fight-or-flight thought to have evolved to improve one’s grip, but too much of it obviously has the opposite effect. “Put your fuckin’ little girl gloves on if you have to.”
The instructors are mean for a reason. They aim to subject the trainees to as much fear and stress as they can without actually shooting at them. The entire experience—the mock injuries, the gunfire and explosion sounds, the anguish of being called a little girl in front of everyone—is meant to function as a sort of emotional vaccine. Combat training for all troops, not just medics, has traditionally included exposure to some kind of simulated gore and mayhem. For years, writes Colonel Ricardo Love in his 2011 paper “Psychological Resilience: Preparing Our Soldiers for War,” commanders have shown their charges photos and videos of gruesome injuries, or brought in veterans to talk about “the horrors they experienced.” To help prepare future corpsmen, the Naval Health Research Center hands out copies of The Docs, a 200-page comic book with lurid drawings of blast and gunshot injuries—a graphic graphic novel.
The pyrotechnics and battle soundtrack not only add realism but also kick-start the fight-or-flight reaction. Sudden loud noise triggers a cluster of split-second protective reflexes known as the startle pattern. You blink to protect your eyes, while your upper body swivels toward the sound to assess the threat. The arms bend and retract to the chest, the shoulders hunch, and the knees bend, all of which combine to make you a smaller, less noticeable target. Snapping the limbs in tight to the torso may also serve to protect your vital innards.? You are your own human shield. Siddle says hunching may have evolved to protect the neck: a holdover from caveman days. “A big cat stalking prey will jump the last twenty feet and come down on the back and shoulders and bite through the neck.”
This may lead you to wonder, do impalas and zebras exhibit the startle pattern? And you would not be first in wondering. In 1938, psychologist Carney Landis spent some time at the Bronx Zoological Park, testing the evolutionary reach of the startle pattern, and the patience of zoo staff. In exhibit after exhibit, Landis could be seen setting up his movie camera and firing a .32-caliber revolver into the air. Less unsettling for zoo visitors—and more entertaining—would have been the experimental technique of fellow startle response researcher Joshua Rosett, who snuck up behind his (human) subjects and flicked the outer edge of their ear with his index finger. I imagine it was a trying time for the Rosett family.
The Bronx Zoo had no impalas, but they did have a goatlike Himalayan tahr, and it was duly startled. As was the two-toed sloth, the honey badger, the kinkajou, the dingo, the Tibetan bear, the jackal, and every other mammal that endured the scientific obnoxiousness of Carney Landis.
You will not be startled to learn that Landis’s book-length treatment of the topic, The Startle Pattern, fell somewhat shy of runaway success.
TODAY’S SECOND scenario is a simulation of the aftermath of an explosion on a Navy destroyer. I have a symptom this time: smoke inhalation burns, which entitles me to some lines and a perioral dusting of soot. The set comprises a room of sailors’ bunks, or “racks,” and a sick bay down the hall. Catwalks overhead allow instructors to observe the trainees and hurl down invective.
The sight of smoke from a smoke machine is our cue to action. Five of us lie on racks in the dark, emoting amateurishly. I tell the trainee who comes to my aid that it hurts to breathe. He helps me out of my rack and steers me out to the hall. “Right this way, ma’am,” he keeps saying, as though my table awaits. He shouts ahead that I’m going to be the priority. “Ma’am, we’re going to have to crike you. Do you know that that means? We’re going to make a small incision right here.” He touches the front of my neck. Crike is short for cricothyrotomy. They’re going to pretend to cut an emergency airway for me to breathe through.
“You are?” My symptoms only call for oxygen.
“Yes, we are. Because you can’t breathe.” I’m lifted onto the sick bay exam table.
“Well, it’s more that it hurts to breathe.” I’m trying to give a hint. “It burns.”
The trainee picks up a scalpel. A voice sounds from above, like God calling to Abraham. “Stop!” It’s one of the instructors. “She’s talking to you, right? Then she’s breathing. She doesn’t need that.”
Someone else yells, “Blood sweeps!” A corpsman trainee reaches under my back and slides both hands from shoulders to hips. He looks at his hands, checking for blood, for a wound that might have been overlooked. If you don’t happen to be wounded, blood sweeps feel lovely.
My massage is short-lived. I’m carried back out to the hallway and set down beside another amputee actor, Megan Lockett. I saw Megan in the makeup room earlier. The special effects gore was still wet on her stump. She sat with her legs crossed, idly scrolling on her phone. It was like lions had come and gnawed off her foot while she checked Facebook.
The floor is slick with blood. Megan is having a bleeder malfunction. A pair of trainees skid and slip, trying not to drop the latest priority victim, a man wearing a tourniquet on his lower leg where a sock garter, in more civilized circumstances, might go. They plop him down on the exam table.
“And why is this guy so important?” yells God from on high.
“Open fracture!” someone tries.
“Is he dying? No, he’s not!” More loudly now: “Who’s dying, people? Who is the most likely to die?” No answer. God’s hand points at Megan. Megan raises her stump. Hello, boys! “What does this patient look like she has?”
Two trainees rush over to get Megan, while Open Fracture joins me in the hallway of survivable maladies. I try to make some room, but my pants are sticking to the floor. I learn later that Karo syrup is the main ingredient in special effects blood. This makes life safer and more pleasant for actors whose role calls for them to cough up blood, but if it dries while you sit or stand in it, you will fuse to the floor like a candy apple on a baking tray.
When it’s all over, the trainees are called to a debriefing on the pavement outside the set. An instructor named Cheech starts it off.
“That was godawful. You lost your minds. A woman who’s missing a leg should have been the number one priority.”
Excuses are offered. It was dark. Smoky. She was down on the floor.
“There was one patient standing in the middle of the room,” Cheech says. “Standing in the middle of the room. And no one paid any attention to him. You need to make your bubble bigger. Don’t get fuckin’ tunnel vision.”
The technical term for fuckin’ tunnel vision is attentional narrowing. It’s another prehistorically helpful but now potentially disastrous feature of the survival stress response. One focuses on the threat to the exclusion of almost everything else. Bruce Siddle tells a story about a doctor who had some fun with an anxious intern. He sent him across the emergency room to sew up a car crash victim’s lacerations. The intern was so intent on his stitching that he failed to notice his patient was dead.