> Much of Katie’s care is being paid for by the Department of Defense, because her youth and ballistic trauma make her a stand-in for wounded warriors. For the rest of her life, she’ll take powerful antirejection drugs with risks of their own, becoming a lifelong subject in the study of this still experimental surgery.
Kudos to the DoD for doing this. The military historically has been the driver for advances in surgery. This will not only benefit Katie, but the knowledge gained from this will also benefit many wounded soldiers in the future.
I think I remember reading that the DoD deserves credit for the entire field of plastic surgery, it was originally pioneered to help soldiers who had suffered disfigurement in combat. Only later did it become something for civilian augmentation.
Close - an Ally. It was Gilles at the Royal Army Medical Corps in WW1 who pioneered skin grafts and plastic surgery. He'd done thousands of facial reconstructions by war's end.
He set up a plastic surgery clinic between the wars.
A relative of his, McIndoe, became famous (the better known of the two today) for his work in WW2 for pioneering and inventing many treatments for burn victims. Burns had become a common injury for pilots and aircrew. He formed the Guinea Pig Club for patients and effectively pioneered rehabilitation. He convinced the locals to visit the hospital in Sussex regularly and befriend patients. They organised trips out to the town so they could feel "normal" again (that became so common locals no longer stared), allowing a bar in the hospital, regular clothes or uniforms not PJs and countless other touches. The hospital still specialises in burns and reconstruction.
McIndoe ended up with honours from most of the Allied nations if I remember right.
I recently managed to set fire to my legs, and can confirm that the unit founded by McIndoe is still going in Queen Victoria Hospital in East Grinstead [1] Luckily, my wounds weren't severe and I only needed to be treated there as an outpatient.
Do you have any citations or history books you'd recommend? That flies in the face of everything I've ever seen or read, and is not mentioned, even briefly, on Wikipedia as far as I can see.
McIndoe gets extensive entries both for himself and under plastic surgery.
I don't know about the history of plastic surgery in the US, but in Germany apparently a lot of the plastic surgery for veterans was based on experience treating coal miners. Due to the frequent and horrific injuries, some coal mines had extremely good surgical teams and a lot of experience in reconstructive surgery.
Well, I’ll forgo the proper words to describe how the US treats it’s coal miners, but one suffering from black lung disease would often have to go through the court system just to get an appointment with a doctor.
I think it’s safe to say your experience in Germany does not apply here.
To clarify, the injuries were not always related to the coal itself. There were a lot of heavy machinery and unstable tunnels, i.e. amputations, crushing and disfigurement.
The area has a history of coal mining that goes back for almost a thousand years. However I'm pretty sure the goal for reconstructive surgery wasn't entirely altruistic: e.g. a disabled worker is a non-worker but with some prosthetics he might still be able to do light work.
That said, I'd strongly believe the culture created by a centuries long tradition of coal mining in a single region is very different from that of 20th/21st century mining in the US.
When I was at German military we saw similar videos for our first aid training. The video opened my eyes. In my view this should be required viewing for everyone to make sure they understand what war really is. With all the cool smart bombs, jet fighters and night vision goggles it's being portrayed as way too clean and fun.
And with war-by-remotecontrol it gets ever closer to looking and feeling like a video game where you go home to your family after killing a bunch of people on the other side of the world.
Or, you know, we could just stop sending our young people out to get blown up... Kudos to the DoD for funding these experiments but they're solving a problem of their own creation...
This list counts major wars until 2016. Some of the wars led in this time were of defensive nature. This list does not account for covert operations and other, similar acts that might be considered war.
Since 1955: The Korean war was never ended, and there was an active and continued military engagement with daily exchanges in Iraq from 1991 through 2003.
The mainland United States has not been attacked as a part of a military operation in the modern era, so the defensive claim is questionable.
Just on the topic of why people sign up: I think many people join because they really think they're doing something good - defending those that need protection or help from the 'real' bad guys. Obviously that's not 100% what's really going on all the time but it has enough truth in it to be attractive. And I think it's true that some real good is done by (most?) military organisations - ie disaster relief, some major engineering projects, policing in areas without effective security, etc, so some people do get to live those ideals out, and pass along that part of the military culture. It's not _entirely_ propaganda, nor it is all shooting guns at people.
Yeah, I recently met a guy in the engineering corps who was super proud of the humanitarian work he's done and the opportunities he's had to travel, learn languages, etc. Could be that he got lucky with his placements, though.
If this is really your mental model of people who join, I suggest you do some deeper research; or, you know, talk to them.
As a general rule of thumb, if your view of a group of millions of people with all education levels is that they can't think for themselves, it's wrong. It's a silly simplification that gains you nothing but bitterness and makes you look ignorant to people actually in the service.
I'm going to go out on a limb and guess that you may not be aware of what "!=" means. They are saying that "people who can't think for themselves" -- the original argument -- are not the same as "people who don't think just like you" -- which is their rebuttal.
I'm aware of what "!=" means, thanks. The rebuttal was saying that just because people think differently from OP, doesn't mean they can't think for themselves. OP never said that people who think differently from them can't think for themselves, they specified a type of people who can't think for themselves, a group much smaller than "everyone who thinks differently".
It is disgusting to watch military recruitment videos in the US. They are clearly designed to prey upon the immature, ego-filled fantasies of 17yr old boys.
It's supported by the media as well. The DoD is involved in Hollywood movies, and while they will supply military vehicles and such for movie use, that does mean they have to approve the script.
Likewise, movies aimed at the Chinese market often need to involve Chinese people or Chinese locations - something you can see in a number of big budget action movies recently.
Not everyone in the military is fighting wars all the time. Many people are getting educations and building careers in normal professions that just happen to be part of the military organization.
The front-line soldiers are a small percentage, and they deserve respect for their sacrifices regardless of why they chose to join. It's easy to take freedom and peace for granted without knowing just how much conflict and blood it requires.
Most people, in my experience, sign up to pay for college or because their parents kicked them out at 18 and they couldn't find a job. That's about all it takes; ideology doesn't really enter into it.
> I hate the glamorization of the military. I don't understand how anyone would actually join.
In many countries you do not have a choice; it is mandatory. And in those countries, at least in peacetime, it is usually seen as neither glamorous nor desirable. Somewhere between a painless but a wasted year and a miserable time you must mobilize to endure to avoid corrupting your brain.
Go visit Taliban controlled Afghanistan when girls couldn’t go to school. Visit areas of Afghanistan after the US cleared Taliban areas and built schools. The girls that can now go to school aren’t rich and powerful, but it’s a fact that fighting that war helped make that possible.
The CIA were happy to supply hundreds of millions of dollars in arms to the mujahideen during the 1980s. The US chose to support Islamist insurgents in a proxy war against the Soviet Union and the Afghan people have paid the price for that decision ever since. Many of the American soldiers who died in the war in Afghanistan were killed with weapons that were bought and paid for by their own government. If you believe that the American invasion of Afghanistan was a humanitarian gesture, you have been given an extremely narrow understanding of history.
...except that now (at least AFAIU) we're backing out of those areas and the Taliban are right back in control. Maybe that military-intervention-as-societal-revenge-plot wasn't so helpful?
Precisely because the war wasn't finished... political pressure led to the military being recalled and this is the outcome. Rebuilding a nation does not just happen in a few months, it takes decades of peace. The biggest problem is the lack of commitment, due in part to a public that has lost touch with what conflict is and the will it takes to fight.
Wouldn't it be great if it was just so simple? A single organization can just stop it all? Who would oppose that?
Humans create war. It is in our nature. Every tiny effort to improve lives and perform these miracles should be cherished and encouraged, regardless of military background. It is perhaps one of the few ways we have to overcome conflict and look towards a better future.
I can't be bothered to source this information and admit it may be wrong, but common sense tells me that the vast majority of loss of life in the past 20 years that is related to armed combat happened in places where there are US troops or governments whose defense spending is subsidized by the US government. Considering the ridiculous amount the US spends on defense I can't see how this wouldn't be the case.
And most good people concentrated in one set of countries and most bad people concentrated in another. It’s not grids of interests and interesting consequences, it’s just a distribution, man! All bad guys just happen to be over there hating you. Just because you’re better and know better. /s
Surprisingly, most of the times you don’t get bites by simply not sticking your nose into every wasp nest. Still, doing that creates enough chaos and green light to “protect by any means necessary”.
It’s not too hard to look up what kinda of childhood experiences create “bad people”. If your economy is 100x your target, you just pay to make those things happen more often. Wait 20 years and you have a bunch of bad people who hate us. Instant war. Billions to be made.
It doesn’t. Military and politicians can now control how much hate there is via slight moves here and there. The end seems when otherwise smart people would stop claiming things like “war is human nature”, “don’t look at the military background of good deeds” and would finally open their eyes to see what psychopaths they are electing on and on. Until then it is a positive feedback loop.
In particular the DoD. It's not like the Iraq war helped anybody except turning Al-Qaeda from 500 people on the verge of getting kicked out of Afghanistan into an army large enough to have it's own internal civil war in Syria. And there are a lot cheaper ways to accomplish that.
A country without a military (or a dependable ally with one) is very quickly not a country. The US could stop funding the military, but the world would be a worse place for it.
Even better would be not losing her face to begin with.
This was preventable.
Am I the only one to notice the events that led up to this?
1. Young girl moves multiple times due to her parent’s jobs, causing for stress and anxiety.
2. Girl finds stability and passion when she is granted an encouraging educational experience/environment at a private school where her parents both found contract jobs.
3. Parents both lost their contract jobs on the same day.
4. As a result of her parents losing their jobs, she could no longer go the school, because her parents could not afford it.
5. Her boyfriend who went to that school cheated on her.
6. She shot herself in the face.
Getting cheated on in high school happens. It’s a painful experience but it’s generally a pretty good time for it to happen, because (ideally) you’re in a secure place where you can experience pain without existential loss.
Moving is rough, but not nearly as rough as having your family morph between social classes. This sort of thing is just evil for a child. Either up or down is just awful. Neither you or your peers have any context for what is happening. You’re entirely misunderstood and feel out of place. I will not have kids unless I can be reasonably certain they won’t have to experience this. In her case, her family was never even in the social class she acclimated to. This is one seriously dirty trick, especially for a child. Obviously her family was doing everything they could for her. This was just out of their control.
To face those complex realities that define your entire world and have it thrown in your face by your boyfriend cheating on you with someone else, both of whom presumably had the security of surplus income supporting their education and social life, is really bad. But we forget how much worse this is for a child.
Children in high school are smart. They understand a lot of stuff, even the difference between rich and poor. But they should only be expected to be able to make sense of so much at a time. The whole idea of this stage is to develop a stable self-identity in an environment encouraging of education and confidence. She lost both in the blink of an eye.
And she had to face the reality that going to another school like the one where she had found passion and nourishment was all just short of not happening.
This is just one of the reasons these games we play with education funding and classism are sick. This girl did not have to be in her situation.
We love to talk about how competition motivates innovation, but it also motivates economic rollercoasters. Maybe adults can handle that, but children simply can’t. This is one disgusting way to live and kids all over America are riding this rollercoaster while their parents do everything in their mighty will to give them a stable healthy existence.
But we’ve created an America where an honest living means a shitty school and an existence no more stable than a contract job. Nobody thinks about what this does to the kids. All they see is innovation.
There isn't a drop of evidence that staying in the same school would have prevented this. Claiming "this was preventable" and then tying it to your pet political cause is gross.
I know someone personally that attempted suicide in high-school while staying in the same social class and not having anyone cheat on him. I know several army brats that had no depression problems at all despite their social life resetting several times throughout childhood.
The way to prevent suicide is to look for the signs of depression. It's not identifying one upsetting event in a victim's life and then trying to reshape society to avoid that class of upsetting event.
The problem with this argument is the simple fact that thousands of people attempt suicide every year even when they have all the stability in the world.
To assume that this was preventable is to assume that attempted suicides are always caused by your social situation, and not something inherently primal inside you.
> We love to talk about how competition motivates innovation, but it also motivates economic rollercoasters.
> But we’ve created an America where an honest living means a shitty school and an existence no more stable than a contract job. Nobody thinks about what this does to the kids. All they see is innovation.
Instability is natural. Disease is natural. Starvation is natural. Death is natural. Chaos is natural.
Innovation is what gives us the degree of stability we do have. Innovation in health care, in manufacturing, in communication, in a thousand tiny things that you or I have never even contemplated.
If the complaint is that we are moving too fast to more efficient, more advanced, more productive existence, then it is a valid but welcome problem to have.
Regardless of whether this analysis is correct or incorrect, I applaud you for thinking about the bigger picture and I rebuke anyone who criticizes you for going "off-topic" or argues this kind of thoughtful analysis of proximate causes is insensitive.
I do think that our current social system rewards the wrong things and drives human evolution in the wrong direction.
Traits like lying, cheating and hypocrisy are rewarded evolutionarily because they help people to accumulate more resources and produce more offspring; this works at both the genetic and environmental level.
The good news is that predators cannot exist without the prey to sustain them so there should always be more prey than predators.
The solution to the problem is decentralization of wealth; otherwise power becomes too concentrated in the hands of predators and it decreases their reliance on prey.
It takes a brave soul to wake up every day and face the world after sustaining facial damage like that. I start feeling insecure after getting some acne on my face. May she be blessed for remaining strong.
Yeah especially because it was a result of a suicide attempt in the first place. If you try to kill yourself after your boyfriend cheats on you, how do you not after this?
Also, yet another reason why America's gun laws are stupid. She wouldn't have shot herself in England.
This is a point that a lot of people don't think about. America's gun laws make it a lot easier to attempt suicide, while putting less thought in about the act.
I am British, and have contemplated it numerous times, but the effort involved in driving to a cliff, or creating a noose, or just the worry about doing it wrong, has stopped me.
If it were as simple as (getting drunk and) pulling a trigger, I would no longer be here.
Guns are usually instantly fatal and available in the home.
Overdosing is dangerous, but it's less lethal than gunshot.
Falls from high places are dangerous, but it requires the person makes a plan to travel to that location which doesn't fit for the rapid onset nature of many suicide attempts. Death by falls and fracture (these include jumping in front of trains) account for a small number of deaths by suicide. So, people can do it. But they tend not to do it. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsde...
Why is it people need to attack the US at every turn? Also, if she was in england, she wouldn't have had this opportunity because we lead the world in medical care.
That was a difficult article (pictures actually) to read. It shows (to me at least) how intimately our humanity is linked to a face that passes our own internal pattern matching heuristics.
I'm not proud to admit my initial thought was not how difficult life must be for her but rather how deformed her face was.
But then I was proud that my (our) inherent human intelligence and morality was able to put that thought aside and wonder what I could do to help her.
For many who have facial deformities, depending on how severe, every day can be a challenge as they are continually reminded by the condition they live with - and potentially the inherent limitations (actual or self-imposed) of that condition. This can be a very negative space to be in - day in and day out.
I urge all of you with children, to please foster empathy in your little people for other people less fortunate. Children can at times say the most brutal and hurtful things - and these hurtful words or even laughter - especially for children with deformities - can be very painful.
While shocking to see the pictures in this article, I hope many (most? all?) of us feel great empathy for her or others with facial or other deformities.
Thank you for being so open about your reactions to the article.
"less fortunate" is a strange way to describe the victim of a condition that isn't bad luck, it's a moral crime perpetrated against her by all the pet around her.
Geez you don't seem to be able to scrape up any sympathy for someone that felt suicide was their only way out.
I believe the converse - if there was a way for people to end their lives painlessly and surely (with the proper safeguards, blah blah blah) it might have served her better.
But in our reality I'm pleased society has stepped up for her.
> It shows (to me at least) how intimately our humanity is linked to a face that passes our own internal pattern matching heuristics.
Well said. Even as our culture purportedly idealizes the value of a person's inner being rather than appearances, one of the uncomfortable things this story drove home to me is -- I can't say it better than you have: "how intimately our humanity is linked to a face".
The image used in the meta-tag for preview/social-media is especially striking to me: several surgeons crowd around the face to be transplanted as it lies, disconnected, as if it were just a Halloween mask: https://www.nationalgeographic.com/content/dam/magazine/righ...
It brought to mind a memorable passage in David Simon's book, "Homicide", in which he describes the most disturbing stage of an autopsy:
> In the final phase of the internal exam, the pathologist uses the electric saw to cut the circumference of the skull, the top of which is then popped upward with a lever-like tool. Pulling from behind the ears, the skin of the victim’s scalp is then folded forward across the face so that any head wound can be tracked and the brain itself can be removed, weighed and examined for disease. For observers, the detectives included, this last stage of the autopsy is perhaps the hardest. The sound of the saw, the cranial pop from the lever, the image of the facial skin being covered by scalp—nothing makes the dead seem quite so anonymous as when the visage of every individual is folded in upon itself in a rubbery contortion, as if we’ve all been wandering this earth wearing dimestore Halloween masks, so easily and indifferently removed.
> Well said. Even as our culture purportedly idealizes the value of a person's inner being rather than appearances, one of the uncomfortable things this story drove home to me is -- I can't say it better than you have: "how intimately our humanity is linked to a face".
Thanks. I was thinking if this is one reason why facial recognition is so anathema to most people (as is to me). Not just because it's a violation of our privacy but it uses the very feature (our face) which as I said in so deeply part of being a human as a weapon against us.
My sense is that leap from emotional response to logical response is the lynchpin to so much potential we can unlock in millions, if not billions more of us.
As a father to two so-far-healthy young boys, one soon to be a teenager I feel devastated at the thought of either of them having to endure the level of emotional chaos that Katie went through the moments leading up to her suicide attempt. My stomach goes into a knot at the thought. I mean gosh, it was a cheating boyfriend. I don't know what to do to protect them from such a path.
What happened to Katie is super sad, but hundreds of thousands of people get dumped and cheated on every year without shooting themselves. I totally understand your feelings, because I also worry for my children.
But I also try to do a few things:
1. Try to help my kids keep things in perspective. Don't hide the risk of pain and failure from them. Instead, warn them that such things will happen, and try to teach resilience.
2. Watch out for signs of depression in my kids. If I ever see them, I'll treat it seriously and get them help as soon as possible.
3. That said, I also try to keep things in perspective myself. There are so many big risks. The best I can do is care for my little ones as best I can.
It's hard to prepare someone for emotional devastation from a life event. I had loving and supporting parents, and when I found out my exwife was cheating I went through some kind of scary. My kids no doubt will experience emotional torture at some point, I just hope it comes at a time that a) I'm there to realize it and be preemptive, or 2) they are adults that have some level of emotional balance (that I hopefully had a part in building :) to sustain and live through it.
My greatest fear is that I will emotionally injure my kids despite my unconditional love for them. I make mistakes afterall, sometimes not even realizing it.
Regarding 1, it's one of the things I focus on a lot. I try not to "teach" resilience I think. I let them fail, and I'm emotional support when they fail. I let them see me fail, and I hope the combination will slowly instill resilience in them.
Perhaps if there are no instruments at hand that allow the young to act on such a disastrous suicidal impulse, at least some of these incidents could be prevented.
If you want to go that route, then you'll need to also remove the following instruments:
* Ropes or any kind of cords that can be used for hanging
* Blades of any kind (kitchen knives, scissors, box cutters, utility knives, etc.)
* Anything that can be sharpened into a point that can puncture flesh
* Any kind of chemical substance that can be deadly in sufficient quantities.
* Any bodies of water where one can drown
* Any accessible point that is high enough for one to jump off of.
The list goes on. Eventually, the environment that is left would basically be a padded room in a psychiatric hospital in a straightjacket.
To most people a gun is pretty much a button you can press and instantly end your life, and in the hands of a knowledgeable user that's about right. I think that kind of ease makes a gun very different from other methods you list, most of which require some combination of willpower, preparation, and endurance of pain and discomfort.
Your belief is common but misguided and incorrect. Many suicides are impulsive and if an easy method isn’t available the moment passes and no attempt is made.
From the story, clearly it isn't. I've a friend who killed himself with a pistol. From the blood spatter around his house it was determined that he shot himself, survived and woke up, put a towel on his head, then shot himself again.
That's a fallacy. If you have both of you sneakers untied, I bet you don't refuse to tie the first one (whatever it is) because the second would still be untied.
There are so many ways to commit suicide it's hardly worth listing them here. If her family kept any pills in the bathroom it's likely she could have killed herself without leaving the room.
It isn't about guns per se, it's about all lethal items. The how of suicide is just as important as the why. Having anything in your home that is a highly efficient means of killing yourself greatly increases the risk that you will in fact kill yourself. Most suicidal intent is temporary and most suicidal behaviour is impulsive, so restricting access to highly effective means of suicide is a vital tool in preventing suicide.
In 1998, the UK restricted sales of paracetamol (acetaminophen) to packs of no more than 32 tablets. The result was a lasting reduction in suicides by paracetamol poisoning, with no commensurate increase in suicide attempts by other means. Several studies have found that interventions like installing suicide prevention barriers on bridges can reduce the suicide rate rather than merely changing the choice of means.
If you take an overdose of tablets or slit your wrists, you'll probably survive with suitable medical care. You probably have the opportunity to change your mind, call an ambulance and save your own life. Very few people survive a gunshot wound to the head; all of them sustain life-altering injuries.
You have the right to own a gun, but that comes with responsibilities. You need to recognise that your gun poses a serious risk to you and your family, especially if it isn't consistently stored in a suitable gun safe or someone in the house is at risk of suicide.
If you're worried about the mental health of a family member, controlling their access to convenient and highly lethal means of suicide could well prevent an impulsive decision from becoming a tragedy. Clear out your liquor cabinet, throw out any surplus medication and get your gun out of the house.
Rather than offer your thoughts on what may have happened, you might be interested in reading about actual research into suicide. The gist is that many suicides are impulsive when an easy method is available– most often a gun.
Maybe. A close friend of mine used pills instead of a pistol. Thankfully they didn’t succeed in their endeavour but the fact is people who are intent on doing the deed will find a method.
The rate of success with pills is lower, and it allows time for regret and the patient to seek help, whereas with a gun after the trigger is pulled it's over. The reasons that American men commit suicide twice as often as women do even though only half as many men attempt suicide is because they are more likely to use a gun.
If you're arguing for proper storage of guns, I completely agree with you. If you're arguing that we should reduce gun ownership to save lives, you're ignoring how many lives are saved by private ownership of guns. Unfortunately, no one keeps track of this statistic, but the CDC estimates between 500,000 and 3,000,000 lives are saved in any given year [0]. This study only provides an estimate, but still, compare that to 13,000 firearm related murders [1] and 22,000 suicides [2, Table 6 on page 33]. I think we need more data but from what I've seen so far it seems to me private gun ownership is a net benefit.
> the CDC estimates between 500,000 and 3,000,000 lives are saved in any given year [0]
From that link:
> Almost all national survey estimates indicate that defensive gun uses by victims are at least as common as offensive uses by criminals, with estimates of annual uses ranging from about 500,000 to more than 3 million (Kleck, 2001a), in the context of about 300,000 violent crimes involving firearms in 2008 (BJS, 2010).
Firearms being used in self defense =/= lives saved by firearms.
Indeed, it turns out it's complicated. That's why I said we need more data. I'm not ready to throw the baby out with the bathwater just yet.
Edit: posted in a different comment but including here as well.
> A different issue is whether defensive uses of guns, however numerous or rare they may be, are effective in preventing injury to the gun-wielding crime victim. Studies that directly assessed the effect of actual defensive uses of guns (i.e., incidents in which a gun was “used” by the crime victim in the sense of attacking or threatening an offender) have found consistently lower injury rates among gun-using crime victims compared with victims who used other self-protective strategies.
Moreover, "firearms used in self defense" practically mean more dead people even if the defense was "successful". The mindset of dehumanizing perpetrators is disgusting, they are still people and we should strive to minimize their injuries, too, if possible (there are plenty of nonlethal means like tazers and pepperspray).
> Moreover, "firearms used in self defense" practically mean more dead people even if the defense was "successful".
You appear to be assuming that using a firearm in self-defense means killing in self-defense. If that is your position (I apologize if I'm misinterpreting you), I am not convinced you are correct. Many uses of firearms in self-defense are brandishing only; and even if a firearm is discharged in self-defense, it is not a given that it kills the original aggressor.
Not sure I agree with this either. I expect the most likely circumstance would be that the defender shows the weapon and the aggressor runs away. It's possible that it results in more gun deaths or injuries when you count both attackers and defenders, but not certain. IMO ctric isn't wrong that, as with anything, you need to study both harms and benefits and make educated decisions; I just had to point out that his initial interpretation of the study results was misleading.
I personally don't own a gun (I'm also in Canada where things are a bit different) but I have to admit that if someone broke into my house I would prefer to have one than not. That doesn't mean that unrestricted gun ownership is a net good though, of course.
Fortunately it appears we can all agree that it is critical gun owners store and secure their guns properly. In my opinion that would be a good place for new laws to focus: for example you could be required to demonstrate that you have a secure storage location and proper training before you could be licensed to own a firearm.
> but I have to admit that if someone broke into my house I would prefer to have one than not.
Someone actually has broken into my home, when I was there, and I am profoundly grateful that I, and probably the burglar, didn't have a gun available.
It didn't even cross my mind to arm myself with a weapon. I offered him a cup of tea. I told him I had nothing of value in the flat, and that it'd be safer for him to come down from the loft and leave by the front door than to climb down the scaffolding of the building next door (which is how he got in). He declined the tea, and decided to leave via the scaffolding. I called the police, and they found him in the garden of the house next door. He pulled a beer bottle on them, they subdued and arrested him.
Guns and weapons would have made this mildly stressful situation hugely worse.
I'm glad that situation worked out well. Could you not have done exactly the same even if you'd had a gun though? And that way had he not responded to your excellent de-escalation technique, and had instead attacked you with a bottle, the deterrent of the weapon might have saved you from injury.
I feel the need to again emphasize that in general I am in support of gun control and that I don't personally own guns; I can see how a person might want to though.
No he couldn't. First, the temptation to escalate is there and real. Second, if there is a chance that the homeowner will be armed, the burglar might just as well arm themselves, too. It's a cycle of fear and violence which becomes so ingrained in population's psyche that they don't even consider the world with lesser stakes.
I don't get it? Just because you own a firearm or have one on your person does not mean you must use it. Also, just because you do not feel comfortable deciding when it's appropriate to use a firearm does not mean other people feel the same way.
It still means more guns in the society and, correspondingly, more death. The externalities of arming yourself with a gun are just too high to justify it.
I like to think of my role as "dad" is to prepare my kids as opposed to protecting them. Life is going to happen, we can't protect them from everything. What we can do is help our kids create themselves in such a way that "emotional chaos" is not part of their experience.
I hear you (I also have kids) but I always feel like the level of hype here is 75% about that pretty, white "before" photo. Yes it is tragic but what about the 1000s of disadvantaged kids that yearly fall into crime and drugs, ruining their lives, being incarcerated or killed, because of institutionalized indifference to the poor non-white members of our society and the corresponding negative feedback loops that trap them generation after generation. No personalized stories about them. No years of Jean Benet follow up, nothing except vilification and blame from the right.
Stop seeing everything through a racial lens. It is the first time an incredibly complex surgery has been performed, the race of the person is irrelevant. If this surgery was in China and performed on a Chinese person it would be just as groundbreaking.
Sorry, I definitely disagree with you and I'm not going to stop. I don't see everything through a racial lens but I do think there is a lot of racial injustice and it should be called out and discussed where it makes sense, like here (IMO).
There are definitely stories that are sadly under-reported, but I do think that this story is an interesting feature that would’ve been done even if the patient were not a young white woman.
While I agree with you that stories about the plight of the underprivileged are certainly underreported, I strongly disagree with you that most of the hype around this story is due to race. Face transplant is a very new, highly risky, and highly experimental medical procedure that only recently became viable. There is an extremely non-trivial amount of scientific research, R&D, and funding that has gone into developing this procedure, and this story is nothing short of groundbreaking, regardless of the race of the patient.
For this particular instance, I think your claim is essentially the inverse of #whataboutism.
This seems to be a popular thought on hacker news for some reason, but seriously, there's countless ways to commit suicide. If your solution is to take away just one of the tools, you aren't going to get very far.
Chances are there were pills in the medicine cabinet that could have been used as well. Or countless other ways that also take only a split second decision (and that's assuming she picked up the gun off the table and didn't have to go find it).
The method of choice, however, does have a significant effect on survivability or reversibility of a suicide attempt (pills in the medicine cabinet are a prime example, many people have been saved after taking a lethal dose of medicine) and the ease of availability also has a meaningful effect on the likelihood of suicide attempts; if people are forced to think about it some more, some of them reconsider (e.g. this very case which was a non-repeating impulse, not something premeditated). A solid example for this is the pesticide-based farmer suicides in SE Asia, where countries that limited availability of human-deadly pesticides significantly reduced the number of farmer suicides.
While there are countless other ways to commit suicide, experience shows taking away just one of the tools can save many, many lives.
>While there are countless other ways to commit suicide, experience shows taking away just one of the tools can save many, many lives.
I have found two studies with that claim. One is going state by state (like there may be no other factors?) [1]. The second is comparing urban Maryland vs rural (if you've ever been to rural Maryland, you'd know comparing it to Baltimore is ridiculous) [2].
If you're arguing for proper storage of guns, I completely agree with you. If you're arguing that we should reduce gun ownership to save lives, you're ignoring how many lives are saved by private ownership of guns. Unfortunately, no one keeps track of this statistic, but the CDC estimates between 500,000 and 3,000,000 lives are saved in any given year [0]. This study only provides an estimate, but still, compare that to 13,000 firearm related murders [1] and 22,000 suicides [2, Table 6 on page 33]. I think we need more data but from what I've seen so far it seems to me private gun ownership is a net benefit.
You wildly misquote your source, which makes it hard to take your comment as good faith.
The source actually says:
> Almost all national survey estimates indicate that defensive gun uses by victims are at least as common as offensive uses by criminals, with estimates of annual uses ranging from about 500,000 to more than 3 million, in the context of about 300,000 violent crimes involving firearms in 2008.
> On the other hand, some scholars point to a radically lower estimate of only 108,000 annual defensive uses based on the National Crime Victimization Survey.
It is a huge leap to say that approximately every defensive use of a firearm prevented a death. It does not come anywhere close to passing the sniff test, as we don't see unarmed people dying of crime in the massive numbers implied by your misquote.
> A different issue is whether defensive uses of guns, however numerous or rare they may be, are effective in preventing injury to the gun-wielding crime victim. Studies that directly assessed the effect of actual defensive uses of guns (i.e., incidents in which a gun was “used” by the crime victim in the sense of attacking or threatening an offender) have found consistently lower injury rates among gun-using crime victims compared with victims who used other self-protective strategies.
I agree that it's not a definitive link, which is part of why I said we need more data, but the it's not non-existent either. I wish police departments would track and report this statistic like they do murders and suicides.
I am amazed, that 0.2-1% of population would be murdered every year.
Have similar statistics been acquired in other western countries, but with much more strict gun ownership laws, i.e. people can't protect themselves from violence?
It sound to me that it's a vicious circle, isn't it? Guns are easy to get -> bad people get guns -> good people need to get guns to protect themselves -> everybody is "fealing threatened for their lives".
Show your boys this article. Own up to your mistakes, and teach your boys not to repeat them.
Watch how they handle disappointment in smaller things, helping them to cope. Maybe this article will open their eyes to how decisions made in a moment of passion can affect their lives and the lives of many others.
You will not be able to protect them from everything. Start with that understanding and prepare.
Keep them mentally healthy in general, and keep an eye out for latent problems. People deal with cheating boyfriends all the time, but when that's added to other mental health issues things can go very wrong very quickly. In this case, the sudden life changes seem to have left Katie off balance and vulnerable, and when the article refers to "perfectionism" I suspect that's a reference to some underlying mental health problem.
Note that there's a fine line between pathologizing normal personality variations, and missing real issues.
A good first step would be to create a good life for them that they could always go back to in the event if such a crisis. If you are happy or at least content being by yourself, even if you get cheated on, you can get back to normal. If you are empty without a partner and then get cheated on, you lose a lot more.
Thanks for finding this. I would've posted that if I had known about, since I think most HN readers (like me) dislike interaction-heavy stories that can go screwy on various computer/browser setups. I know the NatGeo front page has links to both versions (technically, they are entirely separate stories, with different content/angles), but maybe I'm missing it, but I don't see a link to the text version in the multimedia piece, and vice-versa. Or if the crosslinks do exist, they aren't prominent at all. That's a huge oversight, I hope it's not because of some internal office politics -- e.g. the multimedia team not wanting readers to bounce to the text version, and the print team not wanting to lose readers to the multimedia version.
It's still a crappy version - since when do browsers need javascript in order to display images?
I know that it is off-topic, and the topic of the article is much more serious than web technology, but I feel it is always worth pointing out that if a high-profile website like www.nationalgeographic.com can't provide elementary functionality without javascript, what hope is there for the smaller websites?
In this case, though, I am glad the images are not shown, the text description was gruesome enough.
I'm generally averse to JS-heavy presentations but I wouldn't consider this "crappy" -- in fact, I think this might be the best usecase/justification of such a format that I've yet seen, and this includes the NYT's Pulitzer-winning Snow Fall [0].
The JS in the NatGeo story is used for certain important and dramatic effects, such as the transition from a full page photo of the patient's original face, to the x-ray after her suicide attempt, to what her face looked like after the 22 reconstruction surgeries. The JS allows for as graceful a transition as possible while forcing the user to see the entirety of each of the faces. Scrolling through the photos with a standard vertical scroll would not have the same effect. Nor would a static layout of the 3 photos side by side (since they'd have to be drastically scaled down in size).
As you said, the subject matter is gruesome. The photos are best seen each all at once, as they would on a magazine print page. The JS for the feature works as a pretty good digital replacement for a physical page turn, IMO.
This is an incredible work of journalism, the gravity of which is felt within the opening paragraphs and photos. Really puts things in perspective, doesn't it?
The advancement on face transplant has been amazing to watch. Especially since the largely publicized face transplant for the Mississippi Firefighter two years ago (Patrick Hardison). Does anyone here know how long it takes for the face to "settle in" where the donor face and patient face start fusing? Also I noticed that the eye movements on all these transplants have a distinctive unusual movement to it. Is this a physical limitation where doctors/surgeons cannot operate too closely in the eye area due to the risk of damaaging the eye? Or is does it take a couple years for the muscles near the eye to adapt to the new face?
To echo what another poster already said, it's all about the nerves.
Several years ago I tried to kill myself by cutting my neck. I sliced below the jaw-line from my ear to my chin. I still have "numb areas" after 3+ years, and there aren't really any muscles there that need to be controlled. It's very easy to imagine not ever getting full facial muscle control back in her situation.
I still have areas of both numbness and hypersensitivity on my face from nerve damage that occurred when my wisdom teeth were removed decades ago. Both the damage and the current effects were and remain minor, but there's a noticeable improvement now vs. 10 years ago vs. 20 years ago.
The UK is soon to be moving to an opt out for organ donation (with the usual caveat that family members can still refuse to allow it), I was saddened to see some people spinning it as "the government wants control over my body" when all it takes is a simple checkbox to say you don't want to be a part of it.
Make it opt-in. Then you give control away to the government deliberately.
All it takes is a simple checkbox to say you want to be a part of it.
It should be easier to receive mailing list spam, than it is to sign over your body, but opt-out makes it the other way around.
Forgetting (or being unwilling to be forced) to sign a checkbox does not make one a willing participant, but an unwitting one. I understand this saves lives, but then again, lots of unconstitional actions may save lives. No excuse. No convience.
You, and only you, as an adult, has sovereignity over your body. Opt-out is a grave breach of this sovereignity. That is the spin "the government wants control over my body": A violation of your human rights and a government-run organ market.
Bodies are a kind of use it or lose it deal. If you are buried, everything except your bones and teeth will be eaten. Organ donation is the least of your sovereignty problems.
Make it opt-in and secure, and I have no problem with it.
For instance, send a letter every 6 months where you tell of the social benefits of donating your organs and thank-you notes from receivers. Sponsor national organ donation days. Even properly aligned incentives: Make certain government-sponsored health care cheaper and more available for donors than non-donors.
But make any opt-in cryptographically verifiable, and signed with an e-ID. I really don't want my opt-out hacked during DEFCON 2023. And implement it correctly: often government attempts to curb self-ownership are well-intented (physical and mental healthcare), but ill-executed (block internet porn, close fast food restaurants, ban psychedelic drugs) and they compound.
I full well realize that anything that happens after my death is out of my hands. Even if I don't donate now and opt-out, maybe in a 1000 years they can clone some of my DNA to grow new organs. It is purely about opt-in vs. opt-out for me (and about democratically consulting the majority opinion on an opt-out).
Opt-out (happens during life and on life-support) of self-ownership [1] is, to me, a violation of human rights. One of the most fundamental and innate rights, which should be a given (but could be opted out of by opting-in for donorship). To partly take away a right, unless you say "no!" sets a dangerous precedent.
> Everyone's right to life shall be protected by law. No-one shall be deprived of his life intentionally save in the execution of a sentence of a court following his conviction of a crime for which this penalty is provided by law. - Human Rights Act 1998
> The legitimate powers of government extend to such acts only as are injurious to others. [not: are beneficial to others, unless you want to posit that opting out of donorship injures others in need] - Jefferson
> My impression is this is only true for some transplant types.
Other way around. Organ donation after cardiac death is only possible for certain types, and only in very limited circumstances.
Hopefully things will improve because it would vastly increase the number of possible donations. The vast majority of people can not donate organs even if they want to - it requires a very specific type of death (brain death where the body is just fine).
Many people also have religious and ethical problems with it because you are killing someone. Obviously that depends on how they define death, which has no commonly accepted definition, the current definition "brain death" was set that way to make organ donation possible, and that makes many people uneasy.
> It's opt-in now, and easy to opt in, yet despite many people saying they support it, few opt in.
Let's take this as a fact. You don't solve the problem by flipping this around, because then you only solve for social gain. You just make it worse for the individual:
> It's opt-out now, and easy to opt out, yet despite many people saying they don't support it, few opt out.
Now you have people not supporting (or wanting to remain blissfully unaware of) donorship, registered as donors. You bank on apathy and ignorance, because a simple and deliberate opt-in was not convincing enough, and turned supporters for or against, but still, for whatever reason, on the fence, into fair gain.
Having your cake and eating it: If it is very easy to go through opt-in process, yet there are problems with registering a deliberate choice, then it will also be very easy to go through opt-out process, but there will be the same problems with registering a deliberate choice. The ease cancels out, and the problems remain. But taking away a human right, until registered protest, is far worse than a deliberate opting out of it.
I am an organ donor myself, but having it be opt-out does not sit right with me.
For me, an opt-in model where it is hard to avoid not making an active choice sounds like the best solution.
Like if you have to renew drivers-license, ID-card, passport etc, you have to fill out an organ donor form. This encourages people to make a choice, which I have no problem with.
The main problem today (at least in Denmark, which is the system I know best), is that people want to be organ donors, but just never get around to opting in. 90% answer that they are in favour of organ donation, but only 22% have actually registered their choice in the central organ donation registry.
She's pretty brave to go through all of that, so much pain in so many ways.
I think had this been my own situation I'd rather have some kind of plastic prosthetic than someone else's face and a lifetime of rejection treatment. I just don't think my psychology could handle the physical and emotional pain of accepting another face. That said, I know little about living with the alternative that she was dealing with.
I think monkeynotes was more talking about a high quality mask. After this article, I'm thinking I would feel the same way. I'm not sure I could handle going through this process, especially all the unending maintenance required afterward.
I hope Katie and her family are continually keeping in mind how they are helping push medical science forward and benefiting future patients. That's a big part of the value of these efforts, in my mind.
It's not about cosmetics that can be tackled with a high quality mask - it's also about all the practical functions that the face needs to tackle; e.g. the lip musculature necessary for speech and eating, eyelid/tearduct function, and nose breathing. If you're missing lots of tissue from your face, you will need a transplant (inevitably high maintenance) of some kind, so it might as well be a full-face one.
Besides the functional issues she has pre-transplant, there is the devastating daily effects of being seen as and treated like a monster by society at large. It would be bad enough to handle your own reflection in the mirror each day, but to know that everywhere you go you'd be treated as less-than, would be treated cruelly with some regularity, would be basically treated as sub-human by most people -- that kind of toll on ones psyche is immense, and there is little chance she'd ever have much quality of life.
If the choice is between being a monster guaranteed to be mistreated and abhorred by most people vs potentially being a somewhat decently normal-looking person, then I think there is no way that someone would choose the way of the monster.
I was thinking the same thing. I'd rather wear a "mask" that kinda looks like me, or that looks like a mask, than literally someone else's face. Even the thought of another person's organs bothers me. Not just because the organ isn't mine, but because it was once another person's.
Holy shit. It’s incredible that someone could survive such extensive damage, never mind recover in any way. I’m impressed by her fortitude and the skills of her many doctors. At the same time, I would rather die than go through all of that myself. I guess she’s just a stronger person, much much stronger.
While the two were outside talking about how upset Katie was, she went into the bathroom, put the barrel of Robert’s .308-caliber hunting rifle below her chin, and pulled the trigger. When Robert kicked in the locked door, he found his little sister covered in blood. “And her face is gone,” he recalled
Who puts a loaded hunting rifle in so accessible way in their homes?
Maybe I’m missing part of the article but who says it was just laying around loaded? It obviously wasn’t locked up as well as it could have been. But I’m sure she knew how to load the rifle and pull the trigger. It’s not a complicated process at all.
The article alleged they weren't going to work with her if they deemed her at risk of trying to take her life again. I think it's anyone's guess what is going on in her mind, given that expressing any doubt her is worth living would result in future refusals to help (such as in the event her body rejects this face).
As someone who sincerely has every intention of "being strong", my current behavior is indistinguishable from the times I was pretending to be strong due to the huge cost of behaving otherwise.
I am what I can do: programming, music and road-racing. If I had lost even just my sight in the same manner as this young woman, let alone at the same age ... my only remaining desire would be to try again and aim better.
As impressed as I am by the facial transplant I think I'm even more in awe of the fact that they were able to save her life after sustaining such a grievous maxillofacial and cranial injury. I can't even fathom the amount of intensity it probably took to keep her among us.
Indeed. If you're hunting large animals, you want to cause plenty of destruction to a vital location in a single shot, so that the animal dies quickly and humanely. (And you certainly don't shoot at their face, parallel to their face.)
If you own dangerous tools that don't happen to be useful outside hunting (bolt-action, small magazine, high-penetration cartridges), you also want to store the dangerous tool in a secure manner. That clearly was not the case in this story.
why anyone need to hunt animals again? killing animals for fun seem like odd hobby in country so focused on no harm done during shooting movie or other times to any animals, seem animals there get better treatment than many citizens with exception of hunting
One example: deer are vermin that frequently overbreed and destroy the landscape since we've wiped out many of the natural predators and provide reliable food sources to them, but on the other hand they make great stew.
Especially in the US, deer are extremely destructive to any environment they appear in, with herds numbering hundreds of thousands and eating every crop they happen upon. They were allowed to grow that much, partially because we have killed their natural predators, but also because hunting them has been aggressively frowned upon for decades now. So any suggestion of culling the herds is immediately and fiercely met with groups protesting any sort of hunting, without offering any sort of alternative solution.
My understanding is that yes, rangers can cull down the population, but it's actually not a bad solution to issue say $500 permit to hunt deer(that allows you to shoot say 2-3 animals), and that way you cull the numbers without engaging already thin group or rangers.
But the issue exists no matter who does the shooting - there are groups who protest any kind of animal shooting, even if their population is wildly out of control.
It's better to take payment for a license granting the privilege of doing a job, than to go through the rigamarole of hiring someone to do it, paying them, and keeping them paid even if there's no work for them at the moment. The reduction in payroll expenses, plus the license revenue, can then be invested into conservation-related projects. Plus, as fun as hunting may be to those who find it fun, many such people have other skills too, and wouldn't want to stop honing them just to be paid to hunt.
I was also confused at one point why someone would go hunting until i had it explained to me: it's a challege at its core. People go hunting because even with rifles it is still hard to identify a target and without alerting it, fire. And not miss. You can be out for hours and spend counrless hours at the range and lose all that time in 5 seconds if you mess up. Its a rush and as for everything its not for everyone but that is a bit of the mind of a hunter.
I’ve gone out hunting and yes, it is absolutely work even with a gun. It’s a lot of waiting and preparation to be in range for a shot. As paradoxical as it may seem, I’ve found hunters to be generally more appreciative of nature than the average person. Also, hunting license fees fund a huge part of conservation. The decline of active and paying hunters is a significant threat to the preservation of nature reserves: https://www.npr.org/2018/03/20/593001800/decline-in-hunters-...
In my country deer are an introduced species that decimate the local flora. Alongside pigs, cats and other animals that are simply in the wrong place thanks to humans.
She lost her eyesight and several years of her youth; it's a safe assumption that many HN readers, my future self included, owe significant chunks of their careers and lives (pardon the redundancy) to those two things.
She - like a mentally-vegetative senior citizen on life-support - reminds us how little the word "alive" really means, by itself.
The second level of the story is exposing the all-too-common issues of American society: Katie's rushed suicide attempt using her brother's unsecured rifle and the donor being an amphetamine overdose. It's horrifying but at least it fits together this time.
I would guess that it's swelling and scar tissue buildup (fibrosis) from the surgery and ongoing autoimmune response. As far as her immune system is concerned, the grafted face is a foreign invader. She's going to take anti-rejection drugs her whole life and she will always be at risk for total rejection in the future.
They mentioned that the donor had to be from someone of a similar age; these things deteriorate over time, like the rest of our bodies. Even for internal organs, younger is better.
> The face surgeons go first. But since organs are precious and face transplants are not lifesaving, if the donor’s condition started to decline, the team would have to abandon its work to allow other surgeons to collect the donated organs.
What exactly is meant with "if the donor's condition started to decline"? How does one monitor the condition of organs in a dead body? What technology is used to monitor the state of organs in a dead body?
I’m only an EMT, but I can try to answer this for you. The organ donor was brain dead, but the heart continued to beat and a ventilator was used. The organs would stay perfused with oxygen and nutrients and the surgery would be performed as if the donor were otherwise alive. Surgery is inherently risky - risks include spontaneous bleeding or clotting that could abruptly end the organ recovery. I believe this is the situation they are referring to.
As an EMT do you frequently witness people being pronounced/determined brain dead? If so what does it look like? I can't imagine an EEG device being attached to each presumed dead patient to double check? Or is that in fact what happens to each patient dying in the care of a hospital?
I am very fascinated about the possible technology involved for monitorinng the state of these organs while the face was being removed. Or am I overimagining and its mostly heart rate, and blood content (oxygen, glucose, what others?) ?
Us normal citizens -seldom in contact with death- we must have an oversimplified view of alive vs dead: atomic (before and after) and monolithic (the whole person is dead, or the whole person is alive), while we are in fact multicellular organisms and some cells have more demanding needs to be met depending on cell type, location in the body, and so on. I can imagine a failing human body prioritizes the functionality of some organs over others?
In the text they mention that donor side and acceptor side can initiate communication through the centralized authority, without obligation to respond, and if they both consent they are allowed to meet each othe as happened here.
Here they had to request explicit permission for the face.
What happens if there was not enough time for properly removing the face yet the donor's next of kin try to ccontact the (non-existent) acceptor? Do they get by policy a "no counterparty response" boilerplate, or are they informed that in fact there was no recipient due to complications?
As EMTs we are trained to provide the best possible care for all of our patients unless very obvious signs of death are present - brain death is not something we really consider because that's something the hospital determines. Obvious signs of death include dependent lividity (blood settling to the lowest point in the body) and decapitation, among other things. EMTs are not qualified to make such judgements in the field (outside of a mass casualty incident and triaging) and opt to be "better safe than sorry" and let someone with an MD after their name and malpractice insurance worry about making the final call. I expect the signs and symptoms of someone with brain death would be indistinguishable from any other apneic unconscious patient without a pupillary response, but some of those can be saved, so we transport them all.
At the hospital, protocols for determining brain death vary depending on the institution, but we have more advanced tools than just EEG now. I see a lot of radiological investigations that measure cerebral metabolism with scintigraphy - here's an example of what that looks like with a poor outcome (I am not a radiologist by any means, and I explored this outside of being an EMT) [1]. Notice how the brainstem is dark but the rest of the brain isn't doing much. Other investigations such as some MRI sequences may prove useful to identify ischemic insults and damage that strongly correlate with poor outcomes. Based on the phrasing of your question, I would point out that these tests would only be performed on a patient where brain death were clinically suspected based on e.g. prolonged cerebral hypoxia from a drug overdose... not every dying patient.
I don't know enough about the medicolegal or surgical side of things to go into more detail there.
Given the 3 days between death and operation and the ventilator, sounds like a case of someone in a coma and being declared dead due to brain function ceasing. In such cases basic stuff like heartbeat etc is still running on its own (otherwise the tissue wouldn't be supplied with oxygen and die), so there's still vital signs to monitor.
They mentioned cocaine, I never realized you could die by cocaine? What is LD50 of cocaine in street units, say "lines"?
Why are some people in coma declared dead and others kept alive? Have people ever "recovered" from coma? Is it a question of permission from next of kin to keep the patient alive? Or does it boil down to a financial question?
"Coma" can mean a wide variety of things, and a persistent vegetative state still isn't considered "dead", as was the case here. Judgement of death relies on specific tests that establish the absence of cerebral and brainstem functions. See, for example: http://n.neurology.org/content/neurology/45/5/1012.full.pdf When the brain stops functioning systems such as electrolyte balance and internal temperature control often go as well, and we don't know yet how to keep bodies without brain function functional for extended periods of time (as opposed to comas where the patient's brain can still control autonomic processes.)
In cases where a patient isn't dead, they or their health care proxy have the right to turn down treatments, including those necessary for life. Not everyone wants to be kept alive in a persistent vegetative state, even if they are not dead, and for plenty of reasons other than the cost.
I can't imagine myself being able to continue preparing lines of cocaine and inhaling them for ~7.5 grams on end!? thats 75 of the larger lines or ~214 of the smaller kind of lines.
I could try my best but I am pretty sure I would simply fail to sniff 75 average lines. It seems impossible to succeed.
Looks like she aimed almost completely parallel to her skull, causing the bullet to expend most of its energy on bone. It barely had any energy left by the time it reached her brain.
Her choice of aim was likely just the first thing to come to mind, given her short stature compared to the length of a Remington rifle.
Had she thought on this one iota more, tilted her neck down and placed the muzzle onto her forehead ... the result would have been very different.
I should also point out that since a bolt-action .308 is just about one of the worst possible civilian weapons to use for home-defense, and that therefore it was likely a hunting tool ... there was no excuse for this gun and its ammunition to be kept in an insecure manner.
The linked article says nothing about the rifle in question being a bolt-action, Remington or other make, and nothing about how the rifle or ammunition was stored. Do you have some other source for your information or are you speculating?
1) Would a civilian-converted Galil battle-rifle be so readily described as a "hunting rifle"?
That said, the make is irrelevant. What is relevant is that getting all the muzzle energy and accuracy out of a .308 cartridge so as to make it useful for hunting, means a rather long barrel, and specifically one about as long as the M700's barrel.
Also, I'll admit that the rate-of-fire is not actually relevant because you still don't want to use any kind of .308 cartridge for home defense, because of overpenetration.
However, Remington's M700 is the most popular civilian-available weapon in the US, by far, which meets the description of ".308 hunting rifle".
2. Someone other than the owner, obtained it without authorization. That means that it was not securely stored.
Human bodies are weirdly resilient. Sometimes you can trip while walking, hit the wrong bit of your head and die on the spot. Other times, someone shoots themselves in the fact and survives. I guess she missed all the absolutely vital parts, so she survived.
Even so, the parts that the bullet missed still underwent enormous stress - note all the mention of brain injury just from concussive force, rather than a direct hit - and still survived.
Content aside, the usability of this layout needs some work. Its very "page-focused" with each image having a small bit of overlaid text content, but the breaks between pages are impossible to tell because the actual content only scrolls a tiny vertical amount and then suddenly changes pages before fading in the next bit of text. Using page up/down jumps to random spots instead of to a natural break with the next page/text centered. It takes more then one entire scroll on my mouse to move less than one page and I found myself furiously scrolling the wheel just to move through the article at an appropriate reading pace.
NYT does these kind of scrolling picture stories but at least in those its long-form content interspersed with images and it scrolls at a "normal" pace for most of the article.
I actually expected more of those type of comments. It is a "heavy" kind of interactive experience, and I'm generally not a fan of them, especially the throttling of the mouse scroll, but this is one of the few cases (and maybe the only one I can think of not done by the NYT) in which the extra animation and load times enhanced the storytelling and visual effect.
Honest question, why do some people like sushi? I hate how sushi tastes, all sushi restaurants should therefore be closed, as they bring no value to the world.
As happy as you could possibly get in this situation. Katie would be a "professional patient" all her life, but she can at least go out in public without everyone staring at her. She wouldn't look normal - perhaps ever - but with a scarft and some glasses, she'd melt right into any crowd. Which is a mighty achievement.
This is an overwhelming story. I'm awed, amazed, and filled with a strange sense of almost religious reverence for the surgeons' work, the family's struggle, and the gumption it must take to endure the suffering. Just wow.
They didn't mention in which state was the donor before her grandmother agreed to donate her face. Was she already dead from the overdose? Did they just take the full skull to the hospital?
After this story I'd personally make it a given for me. I've been an organ donor since I could first give the okay, but take whatever the hell you need from me and as much as you can salvage if I've died.
I wish that in all of these stories that the donor would be celebrated as much as possible. It's extraordinary how such a trivial gesture (like you: strip mine me when I'm gone, I've got no more use for it...) can have have - without exaggeration - life-and-death existential impacts on so many people. Easiest way to be a hero.
ps: if you're reading this and are not signed up as an organ donor, please consider taking a minute to do so right now: https://www.dmv.org/organ-donor.php
Yes, whenever feasible, the donor is still on life support and the organs are removed before the body dies, ideally in close proximity to the recipient. I used to work with the eye harvesting team all the time when I was a surgical tech. A quick Googling turned up this: https://www.portlandmercury.com/news/i-harvest-human-eyeball...
isn't she too young for transplant, are the bones and other parts completely settled at such age? in the end of article they mention eyes transplants, is she blind currently? what is success rate of these have transplants and what is plan B in case of rejection, can they keep the face and just suppress reaction or it gets that bad that face must be removed? and during the suicide attempt she blew only face without parts of brain? it's not clear from 3D image
I hate to contribute to it going off topic, but it really is a sad postscript that what could have been an impulsive action as a teenager had such tragic aftermath. Totally separately from reading this I was recently reminded that more than 20,000 people kill themselves with guns in the US per year. And looking this statistic up to confirm it, I learned that people in households with guns were more likely to die by suicide than those without by a factor of 3-4 (https://www.nejm.org/doi/full/10.1056/NEJM199208133270705 via https://en.wikipedia.org/wiki/Gun_violence_in_the_United_Sta...)
This is like the archetypical off-topic ideological tangent. On a thread about a stunning and complicated medical achievement, more than 30% of the comments are a firearms debate issuing from this comment. Please don't write stuff like this. I know it seems natural to use this story as a launching point for talking about the broader ideological issue, and unnatural not to do that when it's the obvious thought the story generates in your head, but with volatile topics we have to resist the urge lest flamewars burn down the threads.
(I fucking hate firearms, for whatever that's worth).
I might have otherwise been inclined to agree, but the framing of the original story I think wisely spends at least a little bit of time -- maybe not 30% -- discussing the para-political and social issues surrounding this, not just the scientific and technological issues of the transplant and the human story of Katie's recovery.
I think it's wise for the original article to discuss at least in passing the access to guns that allowed the suicide attempt to happen, the drug crisis that leads to there being any young donors at all, the donor waitlist situation and the choice to become a donor, and the DoD's involvement, and I'm glad the comments do as well.
I do agree that the comment you're responding to directly probably isn't the best kick at the can, though, and so to the extent that you mention the parent comment needing to resist the urge, I think the urge that should be resisted is the urge to have a driveby comment on a volatile subject, not to bring in related social/political issues.
If I understand correctly, plenty of research shows that it's an impulsive decision, and access to a tool that makes it easy greatly increases the likelihood of acting on it. The research shows that the presence of guns, in particular, in increases suicide. Killing yourself is hard; a gun makes it a push-button operation.
However, it would be much better if someone could share the actual research with us.
If someone thinks about suicide for years and then "impulsively" picks up that gun, I'm guessing the researchers count that as an "impulsive decision". On the other hand, it does seem Katie's attempt was genuinely a spur-of-the-moment thing, and a proper gun cabinet might have been sufficient to stop her.
As a PSA, don't ever try to kill yourself with a gun. The success rate is only 70 percent. The 30 percent who survive are much worse off than the rare jumper who survives the golden gate bridge
> If someone thinks about suicide for years and then "impulsively" picks up that gun, I'm guessing the researchers count that as an "impulsive decision".
Is there something you can point to that supports that theory? I appreciate that you say you are "guessing".
Also, I don't know what "thinks about suicide for years" signifies. Probably everyone thinks about it at some point, and probably at multiple points; thus we all 'think about it for years'. I thought about being a fireman for years when I was a child. There's a big difference between thinking and acting, or there would be a lot more startups in the world.
We have plenty of research to show that method substitution is unusual.
This research comes from a few places: looking at people who've died by suicide and the methods they used, and any previous attempts. Looking at survivors of suicide attempts, and at what methods they've used in the past. And some natural experiments, such as the introduction of catalytic convertors to cars, or switching the UK gas supply from coal gas to natural gas.
She totally could have. But other means of suicide give family and bystanders a chance to intervene. Pills and alcohol can be pumped out of the stomach. You can be pulled down from the edge of a bridge. You can rescue yourself from a hanging if you find you have last minute regrets.
A gun is brutally efficient at killing you; Load and pull the trigger. If the gun is lying around loaded, all you have to do is pick it up and pull. A gentle flick of the finger and it's over.
Even if we were to agree with such a right, you would have a duty about how you do it to reduce trauma to others and society has a duty to make sure it is a rational choice. Also, even in a world where adults would have that right, but I doubt those under 18 would without special circumstances such as terminal illness.
I see this as on par with banning alcohol to drastically reduce drunk driving. People tend to not support that one because they see, though they would likely never formulate the thought in such a fashion, that having the freedom to buy and consume alcohol is worth the trade off of people drunk driving and the lives ruined by it. Of course, other actions are done to reduce the harm of drunk driving, but people are not willing to give up alcohol for it. Many people, especially in the USA, view guns in the same manner.
I do find it odd that some people who hold the first view concerning alcohol find the second view as being immoral.
i don't find these comparable, at least not in Europe, drink driving cause very few deaths in car accidents statistics which are already drastically better than they have been and pretty much everyone adult drinks at least occasionally, I seriously doubt pretty much every adult in US shoot gun occasionally let alone own it
but I don't see problem with ban on alcohol even if it would save only few people killed by drunk drivers, because it would decrease cases of domestic violence and violence in general and most importantly for me we would get completely rid off those hordes of drunk Britons roaming our cities, also no drunks (homeless) in streets and cleaner public transport and streets would be nice, so it sounds like great trade off, not because of drunk drivers deaths which are really rare to ban alcohol from majority of adult population, but because of other factors,
so great idea and I say this as someone who was basically alcoholic for a year in my first job in China where we drink spirit (baiju) during lunch break and then after work, then after switching jobs basically stopped drinking completely and now back in Europe me and wife consume maybe 1-2 bottles of wine per month so it's not like we are abstainers that it would not affect me, although i think charging like 500-1000% tax on alcohol and raising agree limit to 30-40 years and strictly enforcing it would seem more realistic regarding voters than complete ban, after all those people with alcohol issues started usually very young
It's difficult to compare rates of suicide across countries because there are different ways of counting deaths, and there are different ways of ruling that something is a suicide.
You also have a substantially reduced ability to defend your families against violent criminals that live in your country, so there's kind of a trade off there.
And no, violent criminals don't need guns to hurt you. People have been hurting each other a lot longer than gunpowder has been around.
> You also have a substantially reduced ability to defend your families against violent criminals that live in your country
Does that really happen enough to worry about? Should I spend my money on a newer, safer car or a gun? Or maybe on more comprehensive healthcare for my family instead? Perhaps on living closer to schools and other amenities so we don't have to drive as much?
I can't imagine that there are that many scenarios where a gun saves the day from violence... but maybe that's because I don't live in america
This is where the argument always fails for me. "But having a gun means I can defend my family!" Against what? I just don't buy the premise that you're significantly at risk of a violent attack out of nowhere, for no reason, at any given time. I've never felt even remotely unsafe living in London, let alone felt the need to keep a weapon on me.
In the US, that would be against the individuals who collectively commit millions of violent crimes per year (surveys indicate this number easily exceeds 5 million per year).
What are the odds of that happening to you though? I don't know what the actual statistics are but it seems highly improbable. And it doesn't seem logical to me that a criminal who wants to (i.e. rob you) is really going to actually shoot and kill you to do it.
About 150 per 100k people are the victim of a violent crime every year in my hometown. And the rates are much higher than that in some neighborhoods.
You mentioned London. St. Louis has about twice as many homicides per year as London. There are 300 thousand people in St. Louis. London has, what, 8 million? And half as many murders.
I’m sure you do feel safe there. I’m less confident when I’m back home.
You’ll forgive me, I hope, for accidentally posting the crime rates for the greater St. Louis area, immediately followed by the homicide totals for only the City of St. Louis.
The actual rates within the city are almost unbelievable: 1,913.2 violent crimes per 100k people.
Of course, this highlights the truth of a chorus oft-repeated there, which is that the region as a whole isn’t nearly as unsafe as the City numbers imply, a problem exacerbated (and concealed) by the City’s relatively small footprint within the area.
But that’s small consolation to those of us who make our homes and spend our time in that undeniably violent core.
That's hugely dependent on who you are and where you live and so on, but there are estimated to be around 6 million violent crimes per year, or about 55 people per violent crime. Of course many people are victimized more than once, so you can't easily extrapolate to how likely a random person is to be victimized. Either way, over a lifespan, that is a significant risk.
>And it doesn't seem logical to me that a criminal who wants to (i.e. rob you) is really going to actually shoot and kill you to do it.
What you're missing is that I don't want someone to rob me. I don't want my family to ever be at the mercy of a violent thug. They ultimately depend upon me for their safety, and I am going to do what I can to guarantee it.
Okay we are not on the same page at all because again I don't understand what "deadly threat" you could be encountering. You're talking like you live in the Purge or something.
I'm talking about the ~6 million estimated violent crimes that occur each year. Many, many of those are deadly threats. Any that involve a weapon are automatically deadly threats. Any involving multiple attackers are deadly threats. Any that involve a significant advantage in physical force of the attacker over the target are deadly threats. In general, any that involve the attacker being in a position to cause death or grave bodily harm are considered deadly threats, and can be legally met with lethal force if that is necessary to stop the threat.
I'm not sure what world you are living in. There are millions of people who are victims of violent crime each year in the US. It happens. A lot.
The US is awash with guns. There are multiple guns for every US citizens. Despite all these guns the US, as you say, is also a very violent crime ridden country.
I can see that they're not an automatic cure-all for violence. There are parts of the US with extremely high gun ownership rates, and virtually no crime. And there are parts of the US with high gun ownership rates and high levels of crime. The fact is that there are many people in this world with violent tendencies. There always have been. Their violent tendencies are not a consequence of guns being around.
However, guns are a very effective tool for defending one's self and one's family against such people.
What the hell do you mean "surveys"? You don't need "surveys" to tell you how many violent crimes there are in a year. We have actual statistics. And the numbers are not in the millions. Stop pushing lies.
Crime victimization surveys. The 'actual statistics' you refer to are reported crimes, i.e. crimes which were reported to the police and which the police took the time to record. They vastly underrepresent the actual number of crimes. That's why people who are interested in getting a more accurate estimate of the actual number of crimes do crime victimization surveys. This is all pretty well known and obvious. That you aren't aware of it is telling.
Hahaha uhh no. Not even remotely. This is completely pulled out of your ass. First of all the CDC has been banned from studying guns since GW Bush administration. Secondly deaths by homicide in the US aren’t even close to that. California had the most murders of any state in 2016 and it wasn’t even 2000, then it drops off quickly from there. Total murders in the US is less than 20k per year. For your number to be right guns would have to be stopping 93.7% of murders.
Where did you even get that ridiculous number from? Insanity.
Yes, of course it does. There are literally millions of violent crimes in the US in any given year.
>Should I spend my money on a newer, safer car or a gun?
I leave that to you to decide. I don't know you. Bringing a gun into your home might make you less safe if you are an irresponsible person or if you have psychological issues. If you are a responsible person with no psychological issues, but you live in an area that has virtually no violent crime, then it might just be a waste of money.
>I can't imagine that there are that many scenarios where a gun saves the day from violence
There are estimated to be over 100,000 defensive uses of guns in the US each year. The widespread ownership of guns has had a clear influence on the behavior of violent criminals. Particularly, in the US, criminals avoid breaking into homes when they are occupied, because they know many occupants will be armed.
> You also have a substantially reduced ability to defend your families against violent criminals that live in your country, so there's kind of a trade off there.
You don't wish to go here as the statistics are against you.
Gun owners are far more likely to have their gun fired in an accident or in a suicide than as genuine defense against a criminal.
> And no, violent criminals don't need guns to hurt you. People have been hurting each other a lot longer than gunpowder has been around.
As the victim, you are far more likely to survive an encounter if a gun isn't involved.
>You don't wish to go here as the statistics are against you.
What a hilariously arrogant statement.
>Gun owners are far more likely to have their gun fired in an accident or in a suicide than as genuine defense against a criminal.
Whether your gun is more likely to be used against you or in an accident is almost entirely in your power to control. Whether someone else decides to attempt to make a victim out of you is much less so. Wealthier people may be able to take precautions like avoiding areas frequented by certain groups of people and strategically choosing where to live but that is out of reach for many.
>As the victim, you are far more likely to survive an encounter if a gun isn't involved.
You're also vastly less able to prevent yourself and your loved ones from becoming victims in such an encounter if you aren't armed. That's why criminals in the US have a much greater tendency to avoid occupied homes than do criminals in other parts of the world. I would much rather take my family's safety into my own hands than leave it to the benevolence of violent thugs.
i don't have gun in my place and feel perfectly safe about violent criminals, i am more afraid i will be hit by bad driver or about building fire than violent criminals, violent crimes are very rare here in Europe where i live, especially during burglary
>i don't have gun in my place and feel perfectly safe about violent criminals
Perhaps you are. I don't know where you live.
>violent crimes are very rare here in Europe where i live, especially during burglary
I hope it stays that way. That's not how it is in many parts of the USA. And no, it's not that way because we have guns. It's because we have more people who are inclined toward violence. I'll leave you to guess why that might be.
All of these nations have higher suicide rates today than the US did in the late 1990s.
So is the premise that the US would have a far lower rate of suicide than European nations if guns were more tightly controlled, or would people in the US commit suicide in other ways as they do in European nations?
Unless I'm misreading, the data you link suggests that the correct interpretation is that the US has basically middle-of-the-road suicide rates by European standards, no? Going by the age-standardized rates, it's sandwiched between Sweden and France in the list. Some European countries are significantly higher (Belgium, Poland), while others are significantly lower (Spain, UK), but the US doesn't seem to be a real outlier.
The linked page says you can't compare suicide rates across countries.
For example, the UK statistics would tend to over count deaths. Here's the definition we use:
---begin
The National Statistics definition of suicide includes all deaths from intentional self-harm for persons aged 10 and over, and deaths where the intent was undetermined for those aged 15 and over. This definition was revised in January 2016 and further information on the impact can be found in the 2014 suicide registrations bulletin.
Deaths from an event of undetermined intent in 10 to 14 year-olds are not included because although for older teenagers and adults we assume that in these deaths the harm was self-inflicted, for younger children it is not clear whether this assumption is appropriate. Deaths from an event of undetermined intent cannot be applied to children due to the possibility that these deaths were caused by unverifiable accidents, neglect or abuse.
---end
I'm unable to find the definition used by the CDC, but I think it's likely to include language like "with the intent to end life".
not sure what have suicide rates to do with guns, they are based on various socioeconomic factors so if you want honestly compare us with something you should find country with similar living standards, environment etc which doesn't have easily accessible guns
but you are right banning access to guns doesn't mean that 100% of those people won't commit suicide, but I guess it could shave at least few percentage points from suicides by gun and most importantly gun accidents would be drastically reduced, you don't see children accidentally killing/hurting someone daily in Europe
if you want serious comparison i am aware of only one country with similar cultural background - Australia, proving limiting gun access can reduce crime, accidents etc
Seems to me she wants to live. I am not sure anyone would go through with that surgery if they did not want to live.
Edit: Reading more about the story. Her suicide attempt was entirely impulsive and not premeditated at all.
> "I never thought of doing that ever before, and so on hearing about it, I just didn't know how to handle it," she told National Geographic. "I felt so guilty that I had put my family through such pain. I felt horrible."
This is not an appropriate story to be talking about assisted suicide as it does not apply what-so-ever. This is more of a teenage depression / gun control discussion if there is to be any relevant meta-discussion at all.
If you want to talk about inappropriate, talking about gun control in relation to this story is COMPLETELY inappropriate here. This 100% is a story about suicide, hence my comment about assisted suicide.
Firearms advocates don't think that it's ever the appropriate time to talk about the issues. It's always "too soon" after a tragedy because guns cause so many tragedies in America every day. This story is about someone who needs a new face because she made an impulsive decision and had access to a gun, so it removed her face. No other form of suicide would have led to this scenario. In fact, if there wasn't an easily accessible gun, it's entirely possible this might not have led to a suicide attempt at all. Gun control is ESSENTIAL to this story.
One of the key measures to reduce death by suicide is to reduce access to means and methods, especially if they are more lethal.
This means you put high fences up around the top floor of a multistorey carpark. (At least one car park in the UK has completely closed the top, open, floor.) It means you put barriers up by bridges. It means you teach gun owners to be more responsible when storing their guns and you consider whether the x0,000 suicide deaths to guns each year are a price worth paying for the benefit of ... well, whatever the fuck gun owners think the benefit is.
BS dude, and you know it. If the gun hadn't been to hand (and locking it up with ammo separate is a form of control) it is more than reasonable to suggest she would have had time to be less destructively impulsive. Even slitting wrists or downing pills is more survivable than a gun to the head.
To be clear, I own a rifle and I want to be able to continue to own that rifle. However, I keep it locked up in the basement with the ammunition far away from it. It's a lethal weapon, I treat it with respect.
I'm sure it was a highly traumatic experience for her, but she survived it and can live a mostly normal life now. I can't see how you can say that it'd be better for her to die.
The humane thing is to let her choose what to do. But I agree that assisted suicide should be an option, under the supervision of trained psychiatrists and science-based protocols.
Given that her only choices were to live horrifically disfigured or to undergo experimental treatment that involves living highly medicalized for the rest of her life, I think assisted suicide should absolutely have been an option.
Actually, I think assisted suicide should be a right for all people 25+ years old, in particular, at the very least, should be optional for those presented with harsh physical issues like those presented in the OP.
She went to her brother's place. It was his hunting rifle. Do you comment on stories about Nikki Catsouras that her family should not have owned a Porsche? Or a car at all?
If you're curious like me and wanted to know what happened to Nikki Catsouras, skip it. There are some _extremely_ gruesome images that come up when you search for the incident.
That's good advice, especially pools. Pools are sneakily dangerous and homeowners generally can't afford good security. (Not to mention the wastefulness of the expense of a private home pool.) Although some basic precautions (100% gate around pool) are underutilized but go a long way.
Kudos to the DoD for doing this. The military historically has been the driver for advances in surgery. This will not only benefit Katie, but the knowledge gained from this will also benefit many wounded soldiers in the future.