The Honorable Associate Justice Antonin Gregory Scalia - RIP

Word comes today that Associate Justice Antonin Scalia, the lion of conservatism and strict constitutionalism on the Supreme Court, died today on a hunting trip in Texas.
When you see the flags half-masted this time, know that it's for a man among men, and a brilliant legal mind and staunch defender of the Republic as intended by the Founding Fathers.
We have lost a giant today.



With respect to the question of replacing him on the court, if Bitch McConnell and the cacophonous collection of cronies dubiously identified as the Republican caucus in the U.S. Senate can't manage to stonewall any attempt by lame duck HopeyDopey to replace him before the change of office next January, the entire collection of them isn't worth a bucket of pig droppings.

Should they perform their usual senatorial maneuver these last few years, and present the President with their offered hindquarters, pants helpfully already around their ankles, their reward in a just world would be to subsequently find their heads on the end of pike poles, and separated from their bodies by some yards of distance.

This is also the reason the utter idiots agitating for Trump have to be finally and decisively shown the door. This and the prospect of 1-3 additional SCOTUS appointments over the next 4-8 years is why electing a president is too important a task, among many such, to be left to a bunch of chattering @$$clowns.

Military Organization For Dummies - Pt. 4

This will cover the function of the S-4 section.
It is the logistics section.
And yes, amateurs talk about tactics, and professionals talk about logistics.

It's a simple job: Get everything you need. Then get everyone, and everything they need, from point A, where it is now, to Point B, where you need it to be.
Every day.
Forever.

As Bill Roberts noted in a post on WRSA, the military breaks that "everything" down into ten classes of supply:

Class I – Food, rations, and water
Class II – Clothing
Class III – Petroleum, oils, and lubricants
Class IV – Fortification and barrier materials
Class V – Ammunition
Class VI – Personal Items
Class VII – Major End Items (computers, cars, etc.)
Class VIII – Medical supplies
Class IX – Repair Parts
Class X – Miscellaneous supplies

Everything falls into one of the above categories.
All the S-4 section has to do, is make sure they have all of everything required.
And sufficient means of moving it, and the unit, from where it is, to where the leadership wants/needs it.

Whether that means a train of semi-trailers, a camel caravan, or by pushing heavily-laden bicycles down a narrow trail, that's what they have to acquire, and organize.

Your S-4 is WalMart, Target, Home  Depot, Costco, FedEx and UPS, all rolled into one.
Everybody may contribute to what they do, but at least one person has to be in charge of accumulating the stuff, accounting for it, and moving it.

What made Lexington and Concord a victory wasn't the operation of harassing the British troops all the way back to Boston, fun and cheerful though that aspect was; it was the twin coups of superior intelligence from their version of an S-2, and the superior logistical expertise of their version of the S-4 in moving all their muskets, cannon, shot, and powder out and away from where the British could get their hands on it, with bare notice of their imminent arrival. That success enabled them to later challenge the British for over a year, until the other 12 colonies decided to get aboard the revolution bus.

D-Day wasn't nearly so much about getting 100,000 men ashore at Normandy (brutally and primally brave though that was on Omaha Beach), it was about being able to get enough bullets, bandaids, beans, and all the other seven classes of supply ashore, day in and day out, to enable them to amass the wherewithal to break out and sweep across France a month later.

Napoleon sagely observed that "An army marches on its stomach."
Or as it was put on more than a few military S-4 shops and motor pool signs, "You may be the pride of the division, but without us, the pride don't ride." Or eat, or shoot, or anything.
What's in a person's pack will get them through a day, maybe three. But not 2 weeks.
You have to have a handle on what you're going to need, first for bare subsistence, and second, to be able to conduct any sort of training or operations. Or else, like Japanese soldiery on a bypassed island, you're just going to wither and die out in nowhere, for nothing.

The logistics section is what keeps that from happening.
Or, not.
Your choice.

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Military Organization For Dummies - Pt. 3

Today's lesson covers the function of the S-3 section.

The S-3 has a dual role: Training, and Operations. Why is elegant in its simplicity:
So that you have trained people to conduct operations, and so that the training is adequate to enable same.

If your training and operations were separated, your training might be worthless, on the day. But because the people ostensibly planning the operations also devise the training, the people they get can hopefully find their back end without both hands, a mirror, and an anatomical chart.

And if you ain't done no training, you ain't doing no operations. Period.
Think you don't need no stinkin' training? Suture self.

So your S-3 person(s) should be in an endless loop. They should figure out, with the input of the leadership, what operations every swinging Richard should be capable of undertaking. Then they plan backwards, and figure out all the essential individual and group tasks that will or might be needed. Then they make sure that everyone knows how to do all the things on those lists, first individually, then as part of larger and larger groups, until you've got a functional group. Crawl, walk, run, over and over until you get it right.
Then because of human memory, personnel turnover, etc., do it all again.

Remember, Rangers, SF, SEALs, etc. aren't better at stuff because they have secret knowledge; by and large, they're better because they've completely mastered the fundamentals to the point of near-flawless execution.
You can too, if you choose to do so.

Under the heading of not re-inventing the wheel, this is the sort of thing John Mosby covered back in 2013 on his mountainguerrilla website:

Planning Group Training: Mission Essential Task List

That would be an excellent place to start, for a group.
He also took a more comprehensive whack at it even earlier, down to the individual task list:

Individual And Collective Task Training

(So, as a side note, JM had this stuff pounded into him in SF, then spent some period of time helping to teach it long before he blogged it. I'm pointing you to it 3 1/2 years after reading it there, and after going over this stuff both on paper and in person going back considerably longer than that. Let's not be baby ducks: this stuff isn't new, and if, through no fault of your own, it's new to you, dig into it, and master it, for your own good. M'kay? Then get your group(s) up to speed on it as well.)

I would further suggest breaking it down to individual tasks. Then work out a schedule: weekly, monthly, and annual. Whether it's just you, or your handful of guys, or a whole group, figure out how often you're willing to work on stuff. Then do it! Then next time, do the next task. Once or twice a year, see who knows what, and test them on it. Until everybody can do everything, to the standard of mastery.

Want to cross-pollinate a bit? Find out if anyone in your group is better qualified to present and teach one skill, then have them do exactly that. Take turns teaching each other. Do that in a small group, and you now have your instructors for the new people who come along. Got a gaping hole in the skill set with no expert(s)? Now you know what to recruit for, or where to spend more time learning until you have one. Lather, rinse, repeat.

Nota bene that four guys teach twelve guys, twelve guys teach forty guys, forty guys teach a hundred guys, a hundred guys teach as many as you need.. Which is a fire team - squad - platoon - company progression. And also exactly the way - and exact ratio - Jesus mentored his followers. And I bet you didn't even know he was a tactical guerrilla genius, did you?

And for those for whom inability, disability, or the march of time precludes training in some of the warrior skills, cheer up: somebody has to do those staff functions we've already laid out, including this one, and the ones yet to come. Another real world hint: In Israel, the IDF doesn't allow women in combat roles, but women do serve. And for many of them, they make them the instructors. Because using biology means, lo and behold, a bunch of guys pay more attention when the instructor is a woman. And the male trainees try to outdo each other to show off. So biology is leveraged into better-trained people, and they don't waste staff and training cadre jobs by putting able-bodied (male) warriors into them. You could do worse than to emulate that model.

Whatever your group needs to do, it needs to train to do. Practice doesn't make perfect. Only perfect practice makes perfect. And you have to put together an S-3 functional entity to do that training, whether it's one guy or several. Then what?

Their other job is to take that trained up entity, and figure out where it needs to be employed, and how best to go about it. In an actual battalion, the S-3 officer is almost without exception the third most senior person in line to command it, after the CO and XO. Because that person knows the group and its abilities the best, they are the best ones to pick up the job if actual operations create a vacancy at the head.

In the meantime, the job of the S-3 is to direct training and operations to fulfill leadership goals, and also to have any contingencies available or in mind for most possible new goals. Their job is to think things through several steps ahead, and be ready to shift to the next mission seamlessly regardless of outcome of the current one, while making sure everybody is properly ready to perform as needed beforehand, which requires that they know what is desired by leadership, and so can anticipate future eventualities

Their job isn't to plan the first move, and then the next one; it's to plan the last move, and then work backwards for every move from there to the start. This is chess, not checkers or tic tac toe.Then make sure everything required has already been done to make the plan successful.

Which beats the hell out of showing up and just hoping everything works.

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Military Organization For Dummies - Pt. 2

In today's briefing, we'll cover the S-2 section.

Oxymoronic jokes aside, the -2 shop's job is everything related to Intelligence.
Not measuring it, in an IQ sense. Rather, collecting it in a military sense.

Who are the potential enemies?
How big are they?
Where are they located?
What are their training, tactics, and procedures?
That, and anything else is the job of your S-2.
Same for friendly groups.
And for neutral groups.

Need a map or ten of a given area?
What's the weather like there next month?
When's sunrise? Moonrise? High tide? What's average temperature and rainfall?
How about three months from now?

Where are the major roads? What about the smallest trails?
Can the bridges handle heavy trucks? What's the height of the lowest overpass?
Is there water access?
Nearest airports?
How many planes there?
Any military there?
Railroads.
Highways.
Canals.
Rivers.
Overpasses.
Harbors.
Pretty much everything DHS doesn't want you taking pictures of.

Locations of everything:
Government buildings.
Which agencies are there. How many people.
What stuff do they have.
State, county, and city facilities.
Police, fire, ambulance services, hospitals, clinics.
Bad neighborhoods.
Refineries.
Power plants.
Rail depots.
Distribution warehouses.
Schools from K-PhD.
Any place big enough to land a helicopter.
Any place where you can only get there on foot.

Military facilities, from ARNG to active, all the services, army, navy, marines, air force, coast guard.

Utilities: power, water, gas, phone, cell towers, relay sites, TV and radio stations, newspapers.
Any important resources, whether for weapons, ammunition, gasoline, medical supplies, clothing, food, water, etc.

The economy.
Major employers.
Political/religious/other important groups and factions.
Criminal activity.
And on and on, to the level of minutiae.

Including language(s) spoken, in other places, and jargon, even here at home.

If there's anything you might want to know, ever, your S-2 should already know it. Or be working on getting it. Ideally, from people or sources inside. Firsthand news is usually the most reliable.

For a hint on a national scale assessment, take a look at the CIA World Factbook.
If you have access to a decent library, find any old unclassified US Mil Country Study, on anywhere. Or go read them online: US Country Studies.

Forget about the info, look at the categories of info.
Then apply the same level of rigor to your own state, then to your own county and nearest city or town.

Everything you see, hear, know, or find out can go into your own version. Get as many sources as you can, because "none of us are smarter than all of us". And all of that is just raw intelligence.

And if you thought gathering the raw intel was a monstrous job, now your S-2 has to analyze it, and turn it into usable products for your group and its leadership.
What does X plus Y times Z mean?

And what else should the S-2 be doing? Counter Intelligence: Keeping the people on your potential enemy list from finding out anything about you besides Jack, and Sh*t.
Vetting the people the S-1 recruits. Again and again, and over time. Enemies never do as much damage to you as "friends" do from the inside. The Walker ring, Bradley Manning, etc. should ring some bells out there.
The S-2 keeps the stuff you gather safe, encrypted, and as near to uncrackable and unnoticeable as possible. Their job is to find out what the Other Side is doing, and make sure no one knows what You are.

Codes and ciphers.
HUMINT: people who tell you stuff
SIGINT: what you can get from the airwaves
OSINT: what you can find out from open sources
And about a dozen other acronyms.

Maps, photos, satellite pics, books, magazines, video, etc.
And yes, GoogleEarth is your friend now, but you'd better have hard copy and new means in case the net goes away.
Got still cameras?
Video cams?
Audio recorders for radio traffic?
Thumb drives and hard drives to store it all?
Hard paper copies of everything?
You might start to get that this is going to get big, in a hurry. You'll want a few trusted friends helping to do this, not just one guy, if you can help it.

They should also be running anyone tasked with gathering intelligence, whether it's folks taking pictures and counting cars, or guys sitting on a site in the weeds, or someone inside who works there.

Yeah, exactly what people in the trade call "spook stuff".

So somebody better know about espionage and tradecraft, and know how to disseminate it to everyone who needs it.
This is all the job of the S-2.
Some fun recent resources:

100 Deadly Skills
Spy Secrets That Can Save Your Life

For those who find two whole books TL;DR, let me boil it down for you from both books:
Stay situationally aware, always, everywhere.
That's everyone's job, unless they're lunchmeat.

But the people doing the S-2 function, for you, should be the unquestioned subject-matter-experts, able to make sure that your group doesn't get caught with its pants down.
Because doing that metaphorically, leads to that situation in reality.

Just ask the Bundys.

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Safety

Avoiding the Angel Of Death

Many of you, at some point, have had some decent first aid or first responder training. Your instructor probably went to some pains to impress on you that, like the alphabet, medical response begins with the ABCs.

I'm sorry, but you were lied to.

In a distant blog post, I shared a story about one of my first instructors. Let me illustrate what I just said about being lied to by telling you about one of that instructor's minions: Sam. Sam was very quiet man, who spent most of our lectures sitting quietly in the back. Like a vulture, as it turned out. Our lead instructor introduced him early on as "The Angel Of Death," but he told us not to ask why, since we'd find out soon enough. And how.

During a break between segments one night early on, the 30 or so of us students were having coffee and junk food. Sam approached one of the students, led him aside, spoke to him briefly, and took him down the hall. Sam came back shortly afterwards, and picked out two more students. They left too. Our supposed 10 minute break stretched out, and our numbers dwindled. No one was really noticing this at first; I was perhaps the 12th one picked.

"COME WITH ME.*" I followed Sam down the hall, around a corridor, and we stopped about 10 feet from the building’s supply/copy room. We hadn't been taught much, so I had no idea what he expected me to do. We hadn't even gotten to first aid kits.

"THIS IS A PRACTICAL QUIZ – YOU’RE ON," said Sam. I walked up to the door, and laid out on the floor before me were the first 11 people Sam had led off. They were laying on the floor, close together. I looked around. Do I see anything unusual" I asked. "WHAT YOU SEE IS WHAT YOU’VE GOT." said Sam. I knew there was a trick, but I couldn't see the trap. I looked up, down, left, right. It was just a normal copy room. Finally, conscious of time ticking away, I reached down to check a pulse on the nearest "victim."

As my fingertips made contact with his wrist, Sam said, "YOU’RE DEAD. LAY DOWN ON THE FLOOR NEXT TO THE PERSON YOU’RE TOUCHING." 10 other casualties and the original victim softly convulsed in shared snickers. I obligingly lay down and played dead.

Well, our 10-minute break stretched into 30 minutes or more. By which time, the daisy chain of "dead" students extended across the copy room, out the door, and halfway down the hall. And my experience repeated itself over and over.

As Sam "killed" the last student, he had us all get up. By this point, the other half-dozen instructors and assistants were standing at the end of the hall. "How'd it go?" they asked. "GOT ‘EM ALL." said Sam. A class of 30 bright, serious people wiped out in almost as many minutes.

Sam then explained to us that the first "victim" had theoretically touched the copier, which had an electrical short, and been electrocuted. And was still in contact with it. As each and every one of us walked up, and completed the circuit, we added to the body count. We, of course, felt stupid. We also learned a valuable lesson without actually "dying." One which we'd actually been taught in the second lecture on the very first night, which hadn't (obviously!) penetrated very well.

The first step in rendering medical assistance isn't A for airway, or B for breathing, or C for circulation. It's S.

For safety. Yours most especially.

Go to the Darwin Awards website, and you can read story after tragic story of someone who died from stupidity, because he didn't proceed safely. 5 people who climbed down a well to rescue a chicken -- 5 drowned, chicken recovering nicely. Man who couldn't swim, jumped into river to save person floating by, both drowned. And so on. Just like us in that copier room, except we could still laugh about it.

A nurse I know got in a fender-bender, and her car stopped against the center divider. Ricky Rescue, First Class EMT driving the other way, saw the accident, parked his car on the other side of the freeway, and ran across six lanes of racing freeway traffic. "Hi! I'm an EMT, can I help?"

The nurse, in pain from injuries, saw his approach, and said through clenched teeth "NO! Anybody so stupid they'd run through traffic is TOO DUMB to lay a hand on me! Stay away!" and she rolled up her window to wait for paramedics. I find it impossible to argue with that logic.

The most important thing to do in an emergency is make sure of safety: yours, the victim's, that of others. You don't want to simply add to the number of victims by becoming one stupidly. And if you did, who's going to then take care of you?

If somebody fell off a cliff, make sure the edge isn't taking you next. When a guy is stabbed or shot, how about making sure the person who did it isn't still hanging about? Don't touch the car crashed into the utility pole with those sparking wires nearby until you're sure it's safe. Don't flip the lights on to check for somebody in that room that smells like...natural gas. And so on.

If you're in a more sporty environment, the maxims of TCCC apply: if bullets are flying, the first step is to take cover and return fire.

But even if you're in a medical facility, whether an actual one, or an ad hoc casualty collection point, for whatever reason, the Safety "S" is still first. I've related other times how under first-world medical conditions, with the best care available, I've had patients arrive covered in feces up to their sternums, crawling with maggots, or contaminated with unknown chemical agents. So your first step, always, is safety. Put on your gloves. Maybe goggles or a face shield. Maybe even a barrier gown. And perhaps, sometimes, even a Level A fully- encapsulating chem/bio/radiological protective suit. It's funny until it isn't.

Fools rush in where angels (well, except for that one) fear to tread. Don't be a fool.

Sam isn't out there waiting for you. But the real Angel Of Death always has room on the bus for one more rider.

 

 

*(In hindsight, I realized Sam should speak, just like Death in Terry Pratchett’s hilarious novels, always in capital letters. So his dialog has been changed to thusly comply.)

Just In Time: or, Why Barnes & Noble Wants You Dead

This is an aside. I'll have something more on topic up later on.
But in visiting the 5 nearest huge book warehouse stores hereabouts, I was hoping to find some common reference work on first aid or medical topics.

The reality was not just no, but Hell to the F*cking No!
They don't carry that.

You can find out how to ace every exam for every healthcare occupation, from slinging bedpans to doing surgery. Even for non-English speakers.
But if you came into the store hoping to find a book covering basic first aid, you'd bleed to death, or die of old age before you found one.

Personally, I'm not worried; I have 80 feet of bookshelves at last glance, and the damned things keep mating and multiplying when my back's turned, occupying every flat surface like Tribbles from an episode of Star Trek.
But if you, being reasonably intelligent, and wanting to prepare, trotted on down to the single largest retailer of printed materials hereabouts, you'd be S.O.L.

I'm sure some drone will pipe up about how they have everything online. That's nice, really it is. But so does Amazon. And I wanted the book now, not a week from Thursday, if the UPS guy doesn't leave it on the porch and it gets stolen before I get home. And all that "just-in-time" bullsh*t won't do any good if there's any one of a dozen natural catastrophes. As opposed to walking up to the store, handing them cash, and walking away with a book, which would.

Considering that locally, an average year within swing-a-dead-cat range could include brushfires, mudslides, earthquakes, floods, riots, shootings, stabbings, multi-car pile-ups, train derailments, and so on, ad infinitum, not having so much as one raggedy-ass copy of any first aid handbook ever penned strikes me as a pretty short-sighted and incredibly jackassical thing for Barnes & Noble.

No one, anywhere, has ever rushed into a store and said "Quick! It's an emergency! I need a copy of Noam Chomsky's latest screed!" Or "Get me an adult coloring book, right away!" And yet they have a shelf full of each of those.
But not one single solitary copy of anything that would help you in a medical emergency, unless you bought a newspaper or magazine, and rolled it into a splint. Of course, you'd need some handbook to tell you about that unless you're already trained, wouldn't you?

So much for finding anything useful there: get your references, medical and any other kind, in dead tree form, and do it right away. No one will have it when you need it if you don't.

In-effing-credible.

Military Organization For Dummies - Pt. 1

(Somebody was asking about this info recently...-A.) 

 

Pay attention please, you'll see this material again.

For any group larger than one person, the above breakdown is how any notional battalion (about 500 guys, since you asked) gets what it needs done. For reference, a Special Forces Operational Detachment A-team was originally conceived to be essentially the staff for any given guerrilla band of merry men (and women) when operating in an unconventional warfare role.
The same thing is done on a smaller scale at company (about 100 or so guys) level, and even the platoon (20-40 guys) level. And an ODA divvys up the functions amongst 12 guys. (And among 6, in a pinch.) Because it works, and everything that needs doing gets done, because somebody is answerable for getting it done, and knowing how that's coming along.

So, who cares?

Anybody that's thinking of setting up, running, organizing, or participating in anything larger than a nuclear-family survival group should, at a minimum.

So let's get started with it.

The S-1 Section:

When you hear somebody speaking militarese jargon S-1 (G-1 for divisions  - 10-15K guys - and bigger units) is personnel: they are the people responsible for everything to do with your people. Who they are, how many of them, their training, records, status, etc.

The takeaway for any group, small or large, is that this person/group would be responsible for recruiting people, knowing what jobs/functions each person could do, their medical status and conditions, and anything like that.

This is also the shop that takes care of all individual and unit records, mail and pay distribution, awards and decorations, legal problems, official correspondence, and a whole host of crap, most of which you won't deal with. But some of which you might. It's probably handier all around if any of those things, if they crop up, be handled by this person/group. If you have/need a lawyer, this section should be dealing with that.

The point is simply so that the people in charge and other staff members
a) know who to ask about the specifics of how many people they have, what jobs/functions they are filling, how well they can do them, how many they are short, etc.
b) don't have to deal with a metric f**kton of paperwork that always pops up in any group, sooner or later.

Whether you call them Human Resources, as in business, or the S-1, this section is going to recruit people, put them in jobs, keep track of them, and deal with anything that might come up related to people, paperwork, finances, etc.: leases, vouchers, purchase orders, funds, expenditures, property and tax information, legal correspondence, etc. ad infinitum.

In an actual larger group, they're the ones that make sure everyone in Group A gets the same word as Group B and Group C.
They also manage publications, which for an informal group would make them responsible for the group reference library, and information on everything you do.

The section leader is traditionally the Adjutant, by whose direction all the commander/leadership's policies and procedures are disseminated, and people assigned to the next lower level of group/unit.

If you were, for example, going to participate in something not as fusterclucked as the Malheur shenanigans, the S-1 should be the person who knows who you're bringing, how many there are, maintains a roster of them all, including pertinent personal information on them, and how many of them are present for whatever on any given day, including which shifts they're on, who's responsible for them, and any duty rosters of essential tasks.

Professionalism is an attitude, not a paycheck, and people who don't want to half-ass what they're doing, whether it's a small group's retreat, an actual peaceful protest (say, bussing to the state capitol to raise some hell with your public servants), or a group going, e.g. to patrol a ranch along an international border, would have someone designated to keep tabs on every swinging Richard at all times, and know where they were and who they were.

As membership names and information are sensitive, they'd have it secured, both in physical terms, and in cyber terms, and it'd be bomb-proof, both metaphorically, and literally. And yet they'd be able to pull it out at a moment's notice, for planning and administrative purposes. Or make it disappear forever, should that prove necessary.

Hopefully you can begin to understand why this is a lot more important than just shuffling papers.

After we hit the highlights of the various sections, we can also talk about how different sections co-ordinate among themselves to get things done.
As you may have deduced from the clever title and the opening graphic (which embiggens), we'll be hitting this topic quite a number of times.

Feel free to refer to any number of references on this stuff , from Army Field Manuals down to even Wikipedia. The more times you see the material, the easier it'll be to keep it in mind, especially if you didn't have to deal with it for 2-30 years as a cammie-clad guest of your Uncle Sugar.

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Merkeled

 

 (Daily Mail UK) VIENNA - A 10-year-old boy was so brutally raped by an Iraqi migrant in a swimming pool cubicle that he had to be hospitalised for his injuries.

A lifeguard immediately called an ambulance after the boy went to him in floods of tears, while the Iraqi was entertaining himself by repeatedly jumping off the three-metre diving board.

Police arrested him on the spot at the pool in Vienna, and during an interrogation, he told them that it was a 'sexual emergency' as he had not had sex in four months.

Point of Grammatical Order: the boy was not merely raped.

He was merkeled.  

That's what it's properly called when what happened to him, happens to you, or even entire countries.

Because Vidkun Quisling shouldn't be the only Youreapeon politician grammatically accorded Rockstar of Infamy status for eternity.

Dirty = Infected = Dead

Reading, in my spare time, Florence Nightengale's Notes On Hospitals, what becomes rapidly apparent, in a tome from when Pasteur's germ theory was still largely theory, was that even then, anyone (like Florence) who spent 5 seconds looking at the problem noticed that building medical facilities that were third-world dirty and rampant with lice, flies, rats, shit, etc. was a passport to 50% mortality levels. Which she published, to rave reviews, after having reformed British Army hospitals and cutting casualties  to less than 10%, which is pretty amazing given the primitive level of even the most advanced mid-19th century medical treatment, let alone for field hospitals in a wartime army.
 
Clara Barton did the same thing over here a few years later during the Civil War, with similar results. (It's also significant that neither the British nor American military supervision had either the wit nor wisdom to figure this out their ownselves, despite having actual degreed and medical-school trained professional doctors to figure it out. Nightengale was a nurse when the only requirement to become one was to put on an apron and do it - no schools, no diplomas, no nothing. Medical education from 20-30 years prior was obviously nothing to write home about, and the bureaucratic mentality - or rather, its lack of any - has been unchanged for six millennia, since before Pharoah's time and back to Hammurabi, probably.)

So, besides the historical note, so what?

In anything from a nasty regional disaster, to major societal upheaval, you're going to be in similar circumstances in a hurry. And the lesson at the individual level is exactly the same:
You can't provide care for anyone that's worthy of the name, if you're working up to your elbows in filth.

So, some notes for you, at any level.
1. Wash your hands. Always. Frequently. Compulsively.
2. Expose and clean the patient.
3. Clean everything, on, over, under, and around the patient, with religious fervor.
4. Before and after EVERY patient.
5. Then do it all again.
6. Literally, lather, rinse, repeat.

Now, some details.

Soap and water are your friend. And warm to hot water are way more fun to wash in than cold water. You lather and wash for the same length of time the "Happy Birthday Song" takes, then rinse, getting all the nooks and crannies around fingernails, and you're as clean as you need to be for 95% of medical work. (Surgery standard requires repeating with povidone iodine scrub and finger brushes, then rinsing that too, before gloving in sterile gloves, gown, cap, and mask. Just saying. Surgical Scrub 101 for med students YouTube video)

Alcohol is for sterilizing instruments, not wounds. Write that on your hands in indelible ink, and don't wash it off. Alcohol, given 15 minutes to work, will kill the cooties on most everything. Provided you've first scrubbed the thicker accumulations of yuck off of them.
It's also inflammable, kills healthy tissue, and burns like hellfire in open wounds. If you use it on your patient, EVER, you deserve to have them cock-punch you. And if you set them on fire, even accidentally, nobody will cut you any slack. Save the isopropyl alcohol for instrument baths, in a covered basin. Period. And remember the "inflammable" part.
Bearing this in mind, where wash water is scarce or unavailable, alcohol hand sanitizer gel is better than not washing up at all.

Hydrogen peroxide is for getting blood out of clothing, carpets, etc. Not for sterilizing anything. It works poorly for that. Need to get bloodstains out of your scrubs? Great stuff. Need to get bloodstains out of the carpeting before the cops arrive, after you hide the body? It'll do that. Sterilize a wound? No way in hell. It also burns like hell, it foams up and makes you think it's doing something, but it's really only cleaning superficially, so it hurts plus it misses things. Two bad things for one low price. Save it for getting bottle-blonde, or cleaning blood spots out of linen or clothes. Not for patient care. If you want to use it for very minor wound cleaning, to assist in getting organic (bodily fluids, etc.) stuff up and out, and decrease germs (NOT eliminate them), it's not terrible for cleaning up an infected toenail, or making sure you cleaned everything off a pair of tweezers. But it's never the last, let alone only, agent to use. With other things, okay. Alone, never.

Betadine (c) (trade name) or povidone iodine (generic name) is the standard - if the patient is not allergic to iodine. Iodine allergy, or shellfish or seafood allergy? No iodine, period.
Use solution (the weaker formulation) not scrub (the stronger one). You can and should even cut it 1:1 with either clean tap water, or any form of sterile water or sterile saline, and it makes an excellent wound soak. You can pour it or blast it (with an irrigation syringe) straight into open wounds, to kill the germs you're dealing with in a dirty/infected cut. Just suction it mostly all back out after a bit, once it's done its job.

After that, there are a host of engineered antiseptic chemicals. the most commonly available commercial one is benzylkonium chloride (abbr.: BZK). It's in all sorts of handiwipes and such. It is the lion's share of what makes Bactine (c) work. It hurts far less than alcohol or hydrogen peroxide, and cleans one hell of a lot better, along with having no allergy issues for people with iodine problems. Therefore anything with this should be your first-line choice. Povidone iodine should be used afterwards, if there are no allergy issues. And lastly, clean water and soap. Phisohex etc. is okay, but so is Ivory.

Next is simple household bleach. You can look up all sorts of dilutions for it's use, bearing in mind it is for things, not people, and it, you know, bleaches things. Like your clothes, when you splash it. At four to eight drops per quart, and given 30 minutes or so, it'll turn a canteen or jug of water into clean water. At higher concentrations, you can make a slurry that'll kill anything, including biological and chemical agents. Which is handy when you're having to decontaminate an impermeable surface on a treatment bed or what have you that got someone's blood or diarrhea, etc., on it. You should have handbooks or cheat sheet cards made and laminated that tell how to do all of the above. And get an eyedropper too.

Hint: Put the eyedropper inside a 4"-6" section of end-threaded PVC sprinkler/plumbing pipe, and screw on pipe caps at both ends. Drill a small hole thorough one cap, knot a piece of cord inside, and tie or loop the other end through your laminated instruction card, and over the neck or handle of your bleach bottle, and you'll have a crushproof container for the dropper to make your bleach solution when you need it. If you need a small plastic measuring cup for stronger mixes, add that as well.

Lastly, if you want to go with potassium permanganate, it can, just like household bleach, be used to purify water, make a cleansing wound wash, etc. (If you look up the details, it can even make an improvised incendiary device. NTTAWWT.) So be careful lest you set your own stuff on fire accidentally, if you choose to stock it.

There are literally catalogs full of other items and solutions you can use and should acquire, some for cleaning surfaces that aren't people, and others for use directly on people. Anything else you get should be studied exhaustively. You're responsible for everything you put on, in, or next to people you treat. Get the MSDS sheets for all of the above, because the stuff you use to clean will splash someone in the eyes or mouth, and you'll want to know what to do if that happens too. And for pete's sake, store your stockpile intelligently, so it doesn't corrode your cabinet, mix with other chemicals and make a toxic brew, or burn your stuff down. All chemicals should be treated with the same diligent care you'd use for unstable nitroglycerin or a running chain saw, and you'll never need to treat yourself for screwing things up. Murphy is a bitch.

And stockpile as much of any of the above as you can justify. Pool shock can make gallons of liquid bleach. Bar soap lasts for decades without going bad; so does liquid soap in jugs.
Alcohol is a flammable, as noted. Hydrogen peroxide will, over time, turn to tap water (H2O2 becomes H2O), even in brown light-resistant jugs (yet another reason why it's a poor choice for long-term stocking and usage). And so on.

Bear in mind you'll need sponges, mops, wipes, and other cleaning supplies, and the more people you contemplate treating, the more cleaning stuff you'll need, in small mountains. The only way to make something clean, is to make something else dirty (i.e. clean floor requires a dirty mop and bucket), and that goes double for trying to create any sort of clean or sterile area for minor, let alone major, surgical undertakings.

On an individual level, hand sanitizer gel, betadine, and BZK wipes and solution should be in every kit you stock, without fail, down to the smallest one. Leakproof travel bottles for TSA use are perfect for keeping a small quantity of each in a personal/car/field kit.

You would also be well advised, living in nice, clean, lemon-scented first world conditions, to make sure you can deal with rats, mice, body lice, bedbugs, fungal infections, and a host of other nasties that will crop up when everyone reverts back to a weekly bath/shower, when they're lucky. The plague spread very nicely in medieval through industrial times, when everyone had their own supply of body and hair lice 24/7/forever.

So do you want to guarantee 50% casualties, or less than 10%?

This concludes your hospital cleanliness briefing. Screw it up, and kill your patients, and/or infect or infest yourselves.
Don't be that guy.

Pop Quiz

Look at the bones in this picture.
Name them.
No references allowed, no time limit.

Not in comments. I mean click on the image, take a pointer (pen, toothpick, whatever) and start at the top and work your way to the bottom, and name every bone in the picture.

Can't fool yourself on this one, and if you can't do it, you're not serious about this stuff.
Passing grade is 100%.
Study and re-test yourself until you get it.

VodkaPundit Wins The Social Mediasphere For the Month!

Hopey Dopey:
"For more than a thousand years, people have been drawn to Islam's message of peace."

StephenGreen@Vodkapundit:
"For more than a thousand years, people have been drawn to Islam's message of peace or else."

On the Snappy Comeback scale, that was a 1000.
And the reason he's not been writing the GOP response to every (D) State of the Union is...?
Beuller?
Beuller...?

Same now as it was back in the day:

 

Come and get, it mofos. I'll see your jihad, and raise you a magazine-load of virgins for the zealous.

Maybe then you'll learn why some people got the nickname "Leathernecks".

(Come to think of it, they started out kicking your asses.

Plus ca change, and all that.)

 

Oh, and fuck your baby-raping goat-screwing cult of idiots, and the malignant miscreant lump of pigshit who founded it.

 

Just saying.

Adult Supervision & The Media Plan

 

 

H/T to WRSA: Topic: Adult Supervision

(and for adding this salient point to the following topic:

"EVERYTHING YOU AND YOUR PEOPLE DO WRONG WILL EXIST FOREVER AND BE ACCESSIBLE FOREVER AND BE GUFFAWED AT FOREVER UNTIL SMOD BRINGS THIS UNFORTUNATE INCIDENT CALLED HOMO SAPIENS TO A BLISTERING YOTTAJOULE END." -C.A., WRSA)

Amen! Hallelujah!
This, this, a thousand times THIS!^^^

Spew about me or anyone else who twists your underpants, but get the points:

1) EVERY incident is a tactical incident. You don't get a pass by waving your arms afterwards and claiming "peaceful protest". I don't mean tactical as in combat, or "tacticool" mall ninja, I mean as in a tactic to advance (or butt-rape) the message and agenda you're trying to advance. Anybody who doesn't get this (Anyone named Bundy, come on down!) is playing tee-ball at the World Series. The participation trophy is an orange jumpsuit.

2) If somebody isn't your media liaison person, then nobody is.
There will be daily quizzes, and a final exam.

3) If you don't have a better grasp of managing the message than the man on the street, our guys will always look like the doofii on man-on-the-street idiot tests, coming up short on basic questions.

4) And you'd better have someone outside whose entire job is to look at what's coming out, both officially, and from the media, and from your own folks on social media, and getting that word, daily at a minimum, back to your own inside media/message liaison person. Then you can
a) spot the clowns, on all sides
b) tune the message
c) spot the rockstars (yours, the media, the authorities)
d) weed out the handicapped.
In the case of "d", perhaps right back out the front gate, before they become more disasterpiece theatre for you.
(Bonus: This will also get rid of a good number of planted provocateurs.)

5) If you're going to go with "peaceful occupation", leave the guns in the trunk. Or at home. Period.
I loves me some guns, I do. But if you're toting them, or packing them on your hip, or wearing them anywhere visible, the media will shoot an entire interview pointing the camera at the weaponry. Visuals are like that. And then you come off like a rabid Che, instead of a reasonable Jefferson.

6) ALL Carhartts, NO camo should be the rule, unless you want the 21st century equivalent of being treated on-camera and vilified like the Michigan Militia were. A couple of suits and ties wouldn't go amiss either. Even in rural areas, folks aren't shocked nor run screaming in panic that people know how to wear business attire. If you mean business, dress like it.

7) Time your briefings to make it convenient for newspeople to make deadline, but at minimum, have a morning and afternoon briefing.

8) Your media person better understand what information can be given out, and what must NOT be given out. They should also be smart, and able to think on their feet, and not rattled by a herd of cackling newsreaders. Bonus if they look like they came from Central Casting for the part of Mr. Reasonable Rational Everyman. Or Woman. Don't be afraid to make a sharp woman your spokesperson. The media looks bad for picking on her if they try. And people may ignore a guy as a nut, but someone who looks like KoolAid Mom while being as sharp as Condoleeza Rice isn't going to hurt you on camera every chance you get. Think that over carefully, but in any event, pick the best person you can find.

And you want practical tips on a media set up?
Video Camera: Canon Vixia HF R600, HD handicam, about $200 @ BestBuy.
Get a skylight filter to protect the lens for each one.
Spare batteries, extra SD cards, and chargers for every one.

And a quality fluid-head TRIPOD: No shaky-cam. Ever!

Audio: Get any of the Zoom H--whatevers: high fidelity sound recording to sync up with your visuals, or for separate audio podcasts. A couple of hundred bucks, and it's smaller than the video camera.
DO NOT use the audio from the handicams. EVER!
(Keep it for reference, but don't broadcast it unless you have no other choice, and it's flawless audio.)

People who've never done this think it's about the video.
Horse chestnuts!
A great video is 60% audio, and 40% visual.
People will watch crap video with great sound to the end; they'll watch great video with shit sound for about 5 seconds. Think about how you feel when you get a crappy phonecall on your cell. Or watch 2M shitastic YouTube videos with wind rumble, dogs barking, and a cacophony of chattering, and see what I mean.

Get a decent wireless lav mike or two for interviews (one on the questioner, one on the interviewee), and a good shotgun mike, and have a dedicated sound person point that mike, listening to the audio it's getting on headphones. You can do it as an all-in-one with some self-training, but you have to be watching AND trying to get clear sound, and most people suck at that amount of on-the-fly multi-tasking. The average TV show looks like it does with the help of 50-75 people, and even a TV news broadcast requires 3-4 on-site, and more at the station. Learn this lesson if you want to do big-league content.

Get windsocks for every live mike.
EVERY live mike.
EVERY LIVE MIKE.

And any good high MP pocket cam  - not a cellphone cam - or an actual dedicated DSLR camera.

Spare batteries and chargers and media storage for everything.

Any top-end laptop, coupled with any good non-linear-editing software will work. I prefer Pinnacle Studio Ultimate  - whatever the current version is (19 now) - (about $100), because its Daddy is the AVID system used for every movie since forever, but NLEs from Sony and the other names will do as well.

If people are going to do these things, they cannot be seat-of-the-pants affairs anymore.
The media plan has to be as well-thought out as the actual event.
(And face it, Malheur was well-thought out on no levels whatsoever.)
It's also not a bad idea to have an actual, you know, SCRIPT of what message(s) you're trying to disseminate.

What are the key points?
Reinforce them over and over AND OVER AND OVER with visuals, interviews, etc.

Nothing off message. NOTHING off message.

If the authorities lie or misrepresent something, correct it immediately. Both with MSM interviews, and in your own content.
If the media lies or misrepresents something, same-same.
Then go back to hammering the message.

If anybody inside your perimeter violates the media liaison rule, either verbally spank them one time max, or invite them to leave for good. If you can't work within the media plan, you're an ass, not an asset.
And those people will pull their pants down, on camera, and cause you endless grief.
Anybody who's a crook, crazy, or just a PITA will be attracted to your media circus like moths to a flame. Find them, and weed them out ruthlessly.

If you control the narrative, then TPTB don't.
This pisses off the MSM, and TPTB, immensely.
They will try to isolate you.
They will deny you coverage or outlets.
They will blockade you and cut off your power.
They will jam and cut off your comms.

HAVE BACKUP PLANS.
P.A.C.E. isn't just for foot patrols.

Sat phone?
Ham packets?
Flash drive handoffs to people bringing you humanitarian supplies?
If you can't get video out, what about still photos and sound?

CNN became CNN nearly overnight, because they and their three reporters hunkered down in Baghdad in 1991 when the bombing started had a dedicated hardline pipeline to get audio and video out, when the MSM networks to that point didn't.

If you can get your video, still photos, and audio out despite attempts to cut you off, you win.
If you don't, you let TPTB and the MSM tell your story, and no matter what happens after that, you've lost public attention and opinion.
Then they'll marginalize you and ridicule you until the press goes away.
After that, you're just an easy target.
If you start out marginalized targets, and never considering your media plan, you just abbreviate the entire process.
Learn from this recent endless mistake, and never let this kind of disaster happen again.

The only way they can't stop the signal, is if you make sure THEY CAN'T STOP THE  SIGNAL.

Physiology Goals

Recommended texts:
Basic:The Physiology Coloring Book, 2d Ed. $14
Advanced:Human Physiology,Fox, 14th Ed. $244
Nice to have: Gould's Pathophysiology For The Health Professions, 5th Ed. $114
Cool sites: Ward's Science Supply , Carolina Biological Supply

Those 10 major body systems from anatomy?
Learn how each of them works. First independently, and then how one relates to the others.
Take your time, and go back over it until you have at least the grasp of a fairly skilled layman. Pay especial attention to the nervous system, the cardio-circulatory system, the respiratory system, the digestive system, and the skeletal system.
All the systems of the body are important, all the time, but those five are where the vast majority of problems will crop up, over and over and over again, in both emergent situations, and chronic conditions.
Anatomy was about structure. Physiology is about function.
You need both as a building block to understand why you're going to do (or not do) what you do.
And Pathophysiology is what health care is all about: the dysfunction of the original system.
How things got there, and how to get them back, or work around them some way or another.
If you were hoping to get this from a pill, or a blog post, nice try.
Put. In. The. Book. Work.
The coloring book is an excellent and inexpensive way to start this.
The text by Fox, while pricey for some, is a once-in-a-lifetime purchase. It is quite simply masterful, and you'll find out it's pretty accessible to anyone.
If you have any school-age children around, the Ward's site is a cornucopia of science toys, including lab-grade instruments. If you're homeschooling, or thinking about it, you should already know about the Ward's site, and Carolina Biological. (And lest you think this is just for play or school, they also sell dissection supplies. That would be surgical instruments, by any other name. And generally better quality and cheaper than those from people trying to sell you Apocalypse Field Surgical Kits. Just saying.) Their stuff is exactly what's used from grade schools all the way to med school. Hint: You might decide down the road that having a medical lab-grade microscope, and some other toys, isn't a bad idea.

If this sort of thing grosses you out, or PETA has successfully conditioned you otherwise, it's time to revert back to first aid classes, and stay out of this.
And mayhap die, or let loved ones die, on the day, because you're too squeamish. There's no shame in that if you know going in, because health care isn't for everyone. But find out now, and focus on other things, before things get sporty in a disaster or such.
Everybody needs a medic, but not everyone can be one.


(Nota bene, I'm not suggesting, with either this nor anatomy, that you can nor should attempt to grasp this in a day. But you can put in the work, and should, indeed must, at some point, if you're serious about all this. You can get an excellent idea of what's involved, and the reality of college-level education is that an entire semester's class, which health science college-level biology is, is in fact about a week's worth of 8 hour days of lecture, and about two weeks of lab time hands-on. Put another way, that's less than two solid weekends of 12-hr days for the lecture, and four solid weekends for the lab time. In other words, if you applied yourself for three workweeks, or six weekends total, you'd have the same amount of training in either subject as a nursing student, in either subject. You can make this as hard or easy as you like, but unless you're working three jobs and raising 5 young kids, this is within reach for just about anybody who wants to put in the effort, in your spare time. Like just about anything else. Bonus if you go serious: if you grasped either the Tortora or Fox texts for A and P, better yet both of them, you could likely walk into the local community college and test right out of them. Really. - A.)

Take A Day Off Or Something Like It

Take your time catching up with yesterday's lesson goals, or whatever else you ought to be doing.

Personally, I've got both Groundhog Day and a new Jesse Stone video sitting on the player, and I've got a 20-gal. tub full of odds and ends to sort out and distribute among three different medical bags, so my day is set.

And Ted Cruz kicked the crap out of Loudmouth Hairpiece in Iowa, so today's a good day to enjoy life, despite the fact that for SoCal, it's witching cold today: I might have to put on a sweater.

And remember, "Don't drive angry."

Anatomy goals

Reference texts:
Basic The Anatomy Coloring Book, 3d Ed. $2-30
Advanced Principles Of Human Anatomy, Tortora, 13th Ed. $60
Good idea: Mosby's Pocket Dictionary Of Medicine, etc. 7th Ed. $18-30
Fun site: The Anatomical Chart Company

Anatomy = Form and Structure of the body.
If you're going to work on the car, you need to understand the parts.

Objectives:
1) Learn and name the bones of the body.
Head to toe. All 206 of them.
Challenge: In the first class I took, one of the assistant instructors had a 3-year-old daughter who tagged along, and had since she was one year old. When working professionals could not name the bones of the human body, on a fill-in-the-blanks exam, or when asked in class, the instructor would point to the bone that stumped the person in question, and have Katie walk up and name it. And spell it correctly. She executed flawlessly. So if you're as smart as a three year old child, you can do this. And BTW, patients don't come with a), b), c), and d) choices helpfully tattooed on their skin. You need to know this stuff cold, looking at it. Not try a 50/50 guess after you narrow it down to the two best choices. Welcome to the medical version of Big Boy Rules.
2) Learn and name the major organs of the body.
I had a leg up here. I had a model set of the human organs, which I painted, when I was 10, and looooong before I had any inkling of my career. (Remember what I said earlier about all that knowledge inside you piling on? There you go.) So I learned all the major organs from shoulder to pelvis. And where they fit. And what they connected to. You can do this too.
(I also had a human skeleton a foot tall at the same age, but it was far less interesting because I didn't have to do anything to it except connect dem bones: it was articulated. It also glowed in the dark if you charged it up with a flashlight, which combined to give me something I could use to scare the hell out of the family cats and my little brother at night with a broomstick and some thread.)
3) Learn and name the body's 10 major systems.
You get a hint: DRESMICREN
Learn it, love it. They make submariners learn all the sub's systems in order to get their dolphins. For the same reason they make doctors and nurses learn all the body's systems before they get their diplomas.
4) Name the 12 cranial nerves, and what they control.
Hint: OOOTTAFAGVAH
5) Learn the general anatomy of the brain, including the 3 cortical divisions, and the regions of the cerebrum and the body functions associated with them.
If you know what's not working, you can deduce where the problem might be.
6) Gain a basic familiarity with the major veins and arteries, and various muscles.

You'll see all this material again (and again and again and...)
Anatomy is all about structure. It's simply the terrain map of where you'll be working.
For med students, gross anatomy is a good chunk of their first year. It's a weed-out, as well as solid prep for everything else. Just like the body itself, all your medical education hangs on your knowledge of where stuff is and what it does.
For nurses, it's a semester. For EMTs, it's a week.

You'll get out of this what you put into it. Including, hopefully, some small sense of awe at the machine you inhabit. Whether you think it's there via divine blueprint, or the knitting of time and chance over hundreds of thousands of years, it's a pretty amazing contraption.

Learn the landscape. And the lingo to describe it clinically. Spelling also counts.
A passing grade on all this is 100%.