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Authors: Mary Roach

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Dianna suggests heading to a nearby Walter Reed cafeteria to continue the conversation. Josh seconds. “
Sustenance.
Let’s get it.”

T
HE PIZZA
at Warrior Café does not look healthy. By that I don’t mean that it’s unhealthy to eat it—though it possibly is—but rather that the item itself looks in poor health. The edemic crust. The sweating cheese. The scabs of pepperoni. I follow Josh and Dan to the salad bar. Like many in the US military, they are disciples of CrossFit, a workout that emphasizes real-world, or “functional,” strength over isolated muscle development. And lots of garden greens.

“Everybody wants to get big and look strong,” Josh says between mouthfuls, after we’re seated. He eats with purposeful intensity, the way he speaks or strides on a treadmill. By “everyone” he means today’s infantry. “There are different ways to do that. You can work hard, or you can do the bodybuilding thing, because you don’t care about anything other than looking good. Nobody wants to work. They experiment with steroids. They want to be bigger, faster.” The eyes fixed on the salad. “But that’s not functional strength. And they have to lug it around, that muscle, and they have to cool it . . .”

“And the supplements themselves increase the risk of heat illness,” I hear myself saying.

That’s not Josh’s concern. His concern is this: Unfit soldiers put the rest of the unit at risk. He places it in context for me: a hypothetical mission to clear and secure an insurgents’ compound. “How about this. In the middle of a firefight, where you’re already physically sucking, one of your buddies gets shot. You’ve got a casualty collection point in the first room that you cleared, but to get there, you have to drag him in his body armor. You’re already smoked, and now you’re dragging dead body weight, so now you’re really smoked.” He jabs at salad. Lunch is a syncopation of hunger and spite. Stab, shovel, chew, speak, stab. “Are you ready to deliver some first aid to this guy who’s depending on you to save his life after you just got your ass handed to you, because you wanted to go do some curls at the gym?”

There is quiet at the table. I’m thinking this story maybe isn’t hypothetical. I’m adjusting to the concept of a “casualty collection point,” to the horrible fact that there can be enough casualties for a “collection.”

“So,” Dianna says after a moment. “Back to heat.”

“I’m sorry.” Stab,
stab,
shovel, chew. “I have very little to say about heat. People used to ask me, ‘What it’s like in Iraq?’” A garbanzo bean dies on a tine. “Open your oven and crawl in.”

Dianna persists. “So Josh, I hear stories of guys superhydrating ahead of time so they don’t have to carry water. So they can carry extra ammo.”

Dr. Adolph looked into this. “By predrinking,” he wrote, “man converts his interior into an accessory storage tank. A man on foot can thus carry as much as a quart or more of additional water.” Adolph had a group of men fill their tanks by drinking two pints of water, and then sent them out into the heat on a “dehydration hike.” By checking the dilution of their urine, he was able to conclude that only 15 to 25 percent of the “predrunk” water had been peed out. The rest was available to become cooling sweat.

However, desert survival scenarios aside, the US Army does not advocate predrinking. Exerting oneself on a sloshing stomach is uncomfortable and compromises performance. And soldiers who get carried away in their effort to fill the “storage tank” risk water poisoning: overdiluting the body’s salt levels and throwing the system fatally out of whack.

Also, it may not be manly. “If you take extra ammo,” says Josh in response to his mother’s query, “you don’t take it at the expense of water. You just take it. You man up, and you take it.” Somewhere Josh found blueberries for his salad. He goes at them with brisk, well-centered stabs. He’s going to ace the Bayonet Assault Course.

Speaking of hot-weather military dilemmas: Let’s talk about body armor. The current ensemble weighs 33 pounds. You are weightlifting just going up a flight of stairs. Josh had a buddy who was killed on a rooftop without his body armor on. “His command was ridiculed for it. But in all reality, I wouldn’t have had my body armor on, either.”

“Do you take it off because it’s too hot?” I’m like a fly buzzing around his head. A little yapping dog at his ankles.

“I take it off because it makes sense.”

Dan steps in to lighten the tone. “Mary, we’re walking up and down mountains with a hundred pounds on our backs, fighting guys in sandals and man-dresses. The Army’s answer to a lot of things is to give you more equipment, more stuff, most of which takes batteries, and there’s only so much you can carry.”

The Army’s other answer, one they have flirted with for over a decade now, is a wearable hydraulic exoskeleton to help with heavy loads. Lockheed Martin posted a video of its entry, the HULC (Human Universal Load Carrier), on YouTube. Soldiers are shown bounding across gullies and taking cover behind boulders while wearing articulated metal braces on the outsides of their legs, as though the Army had taken to conscripting 1950s polio victims. The HULC was tested at Natick in 2010, on a “prolonged march” with an 87-pound load. One of the comments posted for the YouTube video comes from a participant in that test: “Everyone was pretty much done at forty-five minutes due to shin splints. ” Others questioned whether fighters could move quickly under fire or even pick themselves up if they fell. Patrick Tucker, the technology editor for the website Defense One, tripped over the battery life: five hours, provided you’re moving slowly (2.5 mph) and on level terrain. He doubted HULC’s usefulness in places without a steady power supply—“like, basically any place where soldiers might, you know, have to fight.”

“Do you want to know why my friend got killed?” says Josh. “Somebody probably heard him going into the building, because he couldn’t be quiet enough, because he’s carrying too much shit in the first place. There’s all kinds of restrictions that risk-averse people are making. They have good intentions but they have bad effects.”

Dianna points to my tape recorder. “You can probably turn that off.” Heat isn’t going to be a topic, just a mood.

D
RIVING BACK
from lunch, Josh and Dan sit in the back, planning their workout. I hear Dan say, “one hundred snatches,” which hits my ear like a Dr. Seuss title. Up in front, Dianna and I talk science. I tell her about my recent visit to Natick Labs.
They have a manikin that sweats!
And “water-needs prediction equations”! You plug in the weather report and the fighters’ loads and activity levels, and it tells you how much water you’re going to need to haul to the battlefield. How excellent is that, I want to say, but I know Josh is listening.

I understand his scorn. I understand there’s always a factor left out of the equation, something unknowable to someone who’s not out there, inside the madness. I know every mission has unique requirements and risks. I know why there are derogatory names for people who sit in air-conditioned offices making rules for people out humping artillery across an open courtyard at noon in Afghanistan. Though at the moment, I can’t remember what those names are.

“Chairborne Ranger?” offers Dan. “Pogue?”


Scientist
,” says Josh. Dianna taps the steering wheel with one thumb. She glances in the rearview mirror. “I love you, son.”

Josh stares out the window. “I love you too, Ma. No shame.”

A few words in defense of military scientists. I agree that squad leaders are in the best position to know what and how much their men and women need to bring on a given mission. But you want those squad leaders to be armed with knowledge, and not all knowledge comes from experience. Sometimes it comes from a pogue at USUHS who’s been investigating the specific and potentially deadly consequences of a bodybuilding supplement. Or an army physiologist who puts men adrift in life rafts off the dock at a Florida air base and discovers that wetting your uniform cools you enough to conserve 74 percent more of your body fluids per hour. Or the Navy researcher who comes up with a way to speed the recovery time from travelers’ diarrhea. These things matter when it’s 115 degrees and you’re trying to keep your troops from dehydrating to the point of collapse. There’s no glory in the work. No one wins a medal. And maybe someone should.

___________

*
Kuno and his team spent a great deal of time exploring the differences between thermal and emotional sweating, the latter wetting the palms and soles and the former, everything but. One researcher excised a patch of leg skin and grafted it to his palm. Would the patch henceforth, unlike normal leg real estate, sweat when the man was nervous ? (Yes.) Would it remain dry in emotionally trying circumstances, such as when colleagues tittered over the sudden and suggestive appearance of hair on one’s palms? (No.) The emotional sweat work conferred a corollary talent for lab-based sadism. The researchers invented and delivered terrible news to their subjects. They tasked them with oral arithmetic problems. They threatened to administer painful shocks, provoking “the uneasiness of expecting pain.” Kuno was the Stanley Milgram of perspiration.


The human head sweats like a mother. As the cradle of the brain, it’s served by a lot of blood vessels, and those vessels, unlike the vessels of the body’s other extremities, don’t constrict. Thus head wounds bleed readily and faces flush and sweat. But it’s misleading to say, as one so often hears, that people lose 90 percent of their body heat via their head. “My father-in-law, when he sees me go out in winter with no hat, always tells me that,” says military research physiologist Sam Cheuvront. “I say, ‘If that’s true then I should be able to put on a tassel cap and go outside naked and retain 90 percent of my body heat.’” When in fact, he’d be losing heat through his exposed body parts. Though gaining my affection.


Charms used to be part of ground rations, too. They were removed partly because of a persistent belief that they brought bad luck. No one at the Natick Labs Combat Feeding Directorate knows the origins of the unlucky-Charms superstition. I like this guess best, from the gun-enthusiast website AR15.com: “Because the plastic wrapper sticks . . . and results in you getting drilled in the brainpan because you were picking at a piece of candy and not paying attention.”

Leaky SEALs

Diarrhea as a threat to national security

 

S
HOULD YOU ONE DAY
travel to the overlooked desert nation of Djibouti, you will see from the window, as you land, what appears to be a large construction site adjacent to the airport. In fact, it’s a US military base, Camp Lemonnier: 3,500 people who live and work in retrofitted shipping containers, some stacked, some side by side, a Tetris of unadorned rectangular boxes. Other than the shrubs that grow in the drip from the air-conditioning units, there is no landscaping. Interior décor takes the form of emergency instruction placards (“Stop and listen to the Giant Voice . . .”) and framed chain-of-command portraits. In three days on base, I’ve seen a single item that one might class as luxury: one indulgent, cushy, costly item shipped here for no other reason than to add a little comfort to a soldier or sailor or airman’s life. Captain Mark Riddle requisitions Charmin Ultra Soft for the container that belongs to Naval Medical Research Unit 3. The sign on the door explains it: Diarrhea Clinical Trial.

The word alone makes people want to laugh:
diarrhea.
Riddle doesn’t fight this. On the contrary. He recruits study subjects through GOT DIARRHEA? signs on the backs of restroom stall doors. One of the photographs on the Stool Grading Visual Aid he created for participants in the current study comes from a Campbell’s Chunky soup ad. (“Look closely,” he’ll confide, “there’s a spoon sticking out.”) Nevertheless, for reasons you will come to understand, Riddle takes diarrhea very seriously. As he has put it, intending nothing funny, “I live and breathe this stuff.” I have heard him use the word
sacred
to describe a collection of frozen stool samples. Riddle would like military brass to take it seriously, too.

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