PDA

View Full Version : Portraying Wounded



No_Know_Nothings
11-11-2006, 11:03 AM
Anyone out there specialize in portraying wounded in a battlefield aid-station/field hospital setting?

What's considered appropriate within the obvious limits of good taste and common sense when depicting wounds?

What's considered appropriate in regards to "pain theatrics?"

NoahBriggs
11-11-2006, 06:17 PM
for a hands-on experience feel free to join the Columbia Rifles at the Slaughter pen in November of 2007. I will be the chief sawbones in charge. We can always use more patients. contact me by PM for more information. I will also be at the Columbia Rifles Wilderness event May 5-7, 2007, again as the chief sawbones.

85% of all wounds inflicted on the troops during the War was to the left side of the body.

Finding and Coaching "Injured/Sick Victim" Volunteers

How to make friends and influence patients?

It's difficult to phrase, but in order for the medical to do their "jobs" of working with the other groups we sometimes need patients upon whom to work. When we ask for voulnteers, we often get the kids (who like being made up so they can gross out their friends) or we get last-minute additions who sometimes detract from the display (at least this is stereotypically so in some of the mainstream events I have been to; please remember no two events are alike and the mileage will vary).

Two of the more common reasons that soldiers expressed a reluctance in volunteering were:

--not wanting the risk of fake blood stains on their uniforms

--not wanting to be coerced into being given alcohol, either for religious reasons, reaction with medication, or whatever

We solved the first by providing bandages stained with dry paint, which worked in a dim candle-light setting, and the second by not having any alcohol in fake medicines.

Recruiting all the casualties for the weekend from one single unit would help out everyone concerned. By utilizing all your casualties from a single source, it lets you and they develop all the scenarios ahead of time so that all concerned will know what's going on. It also allows you to anticipate who is going to be involved, and to shoe off those who are "not on the list".... as it were.

Transportation issues, equipment issues, etc, are all lessened as well, since those folks know that only their own equipment will be taken in by the clerk, and they won't have to worry about stuff getting mixed up or lost.

One other advantage is that certain uniform aspects can be developed way ahead of time... torn or rent garments with appropriate stains, etc, can be used to enhance the appearance of the tableau.

At a more mainstream event, it would also allow the "casualties" to be in character during the day, and then to be able to socialise after hours... at a campaign style of event, you'll be able to drawn on the more thespian casualty types and allow then to develop a character and work within the event itself to add further realism. However, if there was a small unit of 10-12 fellows that would like to be "casualties" for a weekend, to try out something different and challenging, then this might be just the ticket for them.

My experience to scrounge volunteers starts with trolling the camps early on in the day. I approach whoever is in charge, introduce myself and explain that my hospital will need a few patients upon which to perform after whatever XYZ battle. I am careful to explain what type of person I need, what sort of illness/injury we are representing and ask the head honcho who he thinks would be willing AND fit my criteria.

I then meet with the prospectives. I explain what I am doing and ask if they are game. I usually drop a speech along the lines of "we aim to show accurate wounds/illness and we are not looking for drama monarchs." Usually I get a few volunteers. I take names and ask they report to the hospital area at least two hours before the powderfest, which allows me to make them up properly. I find it’s easy to coach the patient by explaining what I am doing as I apply the makeup, and let the patient follow along with a mirror. I explain the symptoms I am applying and why those symptoms occur when they do. I use plain English with little tech talk (easy to do since that’s how I learned about these conditions).

I then explain what we will do to triage them. I then show them the repro medications I am going to use. I reiterate the ingredients and ask the volunteer patient if they have any allergies to any of the ingredients. If so, then I try to work around the allergies or we agree that person should not participate.

I suggest to any buddies, hangers-on and rubberneckers unfortunate enough to be nearby how to act regarding near misses, spent rounds, shock, trowser-pissing fear and so on. Why not spread the wealth of information?

There will always be some drama monarchs and kids who hope to join in after the battle. These are the screamers and the guys with the old, pink bandages, and the mythological "drunken Irish malingerers". I believe I mentioned in an earlier post that I would "triage" them to one side and leave them out of the picture. In "my" hospital, nobody gets "treated" without having their "condition" cleared through me or my staff first, because we want accurate medical problems accurately portrayed, not pink bandages and sausages piled on stomachs.

For "inexperienced victims," with "traumatic injuries” ( e.g., fractures, internal injuries, lacerations) coach them to exhibit "pain" by moaning quietly or occasionally gasping. Be sure they don't hyperventilate by doing this too often or they will actually pass out. Wounded should respond to the staff attempting to help them by moaning if the staff touches or moves an injured extremity.

Shock
Remember that very severely injured victims in shock are often very "quiet" so that is a good indicator of the severity of the injuries (possible internal and/or head). For head wound simulations, altered mentation (delirium) is often a good way to convey that the victim has a life threatening condition (victim acts intoxicated or irrational, or becomes lethargic and incoherent).

Also, they should exhibit extreme thirst, ie, asking for water all the time. (This comes from extensive fluid loss due to massive bleeding.) If openly “wounded” (ie, “bleeding”), the patient should also exhibit feeling very cold, even in the heat of summertime.

Internal Bleeding
To simulate blunt trauma to the chest or abdomen, create "bruising" by using a Ben Nye bruise wheel to create a "site" injury (e.g . a spent round, or for abdominal trauma from an impact with a blunt object), create a small bruised area on the abdomen. Have the victim simulate rigidity and severe pain of the abdomen to indicate internal bleeding. A classic sign of a ruptured spleen with abdominal bleeding and shock, is "referred pain" in the area of the collar bone, when there is no apparent injury to the collar bone (clavicle) which is sometimes missed by rescuers, but is a potentially life threatening condition.

Gangrene and advanced limb wounds
Hits to the limb which are not treated right away are candidates for gangrene. For advanced gangrene (“green rot” in common parlance) take the darkest color from the Ben Nye Bruise wheel and paint the fingertips with it. Paint the nails slightly green. Dab the limb below the wound with irregular splotches of the darker red, green and yellow. Take an eyeliner pencil and trace some of the major veins up past the wound towards the trunk. This is called “black vein”. It means the body is generating blood clots to stop the bleeding, but they have been knocked loose and they have relodged somewhere up further in the vein/artery. This disrupts the flow of blood to the injured area and increases the chance for gangrene to set in. The dark splotches are the beginnings of oxygen-starved, potential necrotic tissue.

Concussion
Concussion is caused by close proximity to explosions, loud noises or some other violent shock to the head. Examples include (but not limited to):
· cannons discharging,
· shells exploding,
· muskets discharging in a closed interior like a house,
· grenades,
· infernal machines,
· getting clubbed in the head, be it with a musket or some other blunt object
· working in a loud factory like an ironworks or Bessemer steel works

In minor cases, it brings about a cherubic face and sometimes a bloody nose. Advanced cases may show the following symptoms (not all will be present)
· Blotched red face
· Black eyes
· Bleeding from the ears, nose, mouth or eyes leaking “bloody tears”
· Lethargy, delirium, confusion, fatigue, incoherency
· If you can get away with it an eye drop which dialates one pupil (administered to the opposite side of the injury).

Opiates - when administered, they will create about a couple of minutes of excitement. Then the patient will slowly nod off or develop a faraway look in his eyes. The opiates will distance you from your pain.

When they administer the anesthetic, they should coat your face with simple cerate and drape a wet cloth over your eyes - ether and choloroform tend to create chemical burns. When they tell you to "breathe in", struggle for a brief moment (you're taking in something which is not air and smells funny, so your body's initial reaction is not to inhale). Then stop struggling and relax.

don't disrupt the surgery. On occasion you can test how well the anethesiologist is paying attention by moaning or twitching the feet, which should tell him he is not "administering enough".

Once you come out of the anesthetic in whatever passes for the post-op area remain quiet and distant. Remember you are still under the influence of opium and/or laudanum, and you are still in a semi-stupor.

I am glad more people are asking to portray wounded correctly. God knows we got enough of it in real life. Ask any paramedic the next time you buy him/her a beer when s/he comes off duty.

NoahBriggs
11-11-2006, 06:21 PM
Ways to spice up your first-person, even if you are not severely wounded. Recycled from the earlier part of this Conference, if you tried the Search function.

Sore joints (rheumatism)

hard hearing, bad vision, green feces, insensate fingertips, hair falling out, teeth falling out, mental apoplexies (ie, starting to go crazy), painful sores on the mouth, and same sores aggravated by hot coffee and food (side effects of blue mass pills for diarrhea and dysentery; not all of these symptoms will be present all at once)

night blindness, teeth falling out, pale complexion, possible open sores (scurvy)

Loose, bloody stools (dysentery, sometimes called the "screamers” from the pain you got trying to hold it in until you reached a latrine)

Diarrhea (loose stools, aka the s***s, the Tennessee Trots, the Virginia Quickstep)

Open sores or constant itching on the skin (bugs, popped zits, boils, blisters from constant rubbing of accoutrement straps or your braces; from lack of washing)

Constant, hacking cough (smoking, chronic chest infection, leftover cold or flu, tuberculosis, beginnings of pneumonia)

Bad hearing, ringing or buzzing in the ears, comrades' voices and other sounds muffled or otherwise distorted (hearing loss and tinnitus; excessive quinine usage)

Nervous twitches, hyper sensitivity to ordinary stimuli, (ie, flipping out over a twig snapping) minor hallucinations in the form of "ghosts" and such, sudden violent outbursts (stress-induced, possible beginnings of PTSD)

Jaw ache (rotting teeth, teeth improperly extracted, beginnings of tetanus)

Bad teeth (you can buy bottles of "nicotine colorations" at Halloween supply stores. The bottles are about $1.50 each and come in light brown, medium brown and black. To use, dry your tooth/teeth with a tissue, and paint on your tooth with the brush which is supplied. Allow to dry and set. The directions say you wipe it off with rubbing alcohol but I have discovered a good brushing of the teeth will clear it off. The stuff tastes minty. Do not bother with the fake "hillbilly teeth". They do not look right. I recommend painting your teeth brown and then letting the black color creep into the gaps between your teeth.)

You'll notice some of these symptoms and complaints overlap. That way nobody can figure out exactly what you have.
__________________

NoahBriggs
11-11-2006, 06:43 PM
One more thing. In the January-February issue of The Civil War Historian is an article by Kevin O'Beirne. It's called "Taking Hits - The Behavior of Soldiers Wounded In Battle". It tells you, with sources, how to behave under fire and how to take a hit realistically.

FranklinGuardsNYSM
11-11-2006, 10:02 PM
Jaw ache (rotting teeth, teeth improperly extracted, beginnings of tetanus)


Read an account today of a member of the 153rd PA in the field hospital during Gettysburg who apparently had lockjaw resulting from getting hit in the leg.

Is this a fairly common account?

NoahBriggs
11-11-2006, 10:32 PM
Good question. I will now reveal I do not have a Ph.D because the words "don't know the answer offhand" just came off the keyboard.

TimKindred
11-11-2006, 11:09 PM
Noah,

If not a common occurence, it's certainly possible with every wound, since it's Tetanus. A full description may be located here:

http://www.health.state.ny.us/diseases/communicable/tetanus/fact_sheet.htm

It's especially dangerous in our period, with the prevalence of animals and maure, coupled with the difficulty in treating the disease as well as generally less-than-sanitary conditions found with an army in the field.

Respects,

tompritchett
11-12-2006, 01:40 AM
In a related question, what is an acceptable protocol for someone portraying a walking wounded during a battle reenactment when they happen to pass by a Bn aid station. At Cedar Creek, I was portraying a soldier wounded in the upper left arm walking back from the battle, when the artillery safety zone forced me to have to walk right up to the stationed Bn aid station which was directly in front of the spectators. There was literally no way that I could have avoided the situation because of the way the artillery was deployed and the way that our troops were falling back. Being "wounded" and in front of the spectators, I felt it would be inappropriate for me to bypass the station even though they had no idea I was coming. Obviously I felt as awkward about the situation as they did but I really felt I had no choice but stop. Fortunately the Union troops came so close to the station, I felt justified in retrieving my equipment, while still portraying the wound, and retreating even further to avoid the potential of being captured. But still the situation bothered me and I am woundering whether or not I did the right thing by stopping.

hanktrent
11-12-2006, 10:01 AM
Along with Tom Pritchett's question, I had a problem at one event, where the plan was for me to be a private about 24 hours, then take a hit and be walking wounded Saturday evening through Sunday morning, for the local civilians to care for.

Some of the other soldiers were complaining about heat and the speed and length of maneuvering, and were dropping out with real physical issues. The corporals were watching us like a hawk, and despite having no problems whatsoever, I got hassled several times about "not looking good." Maybe any 46-year-old looks bad to a 22-year-old corporal or something, but it was getting ridiculous.

By the time it came for me to take my hit, I was scared to! If I acted hurt, walking the gauntlet of officers a quarter mile to the semi-modern aid station and then another quarter mile to the farm house was going to be an endless magic moment--not!--of saying, "No, I'm really fine. I'm just acting. I'm a designated casualty. No, really, I'm fine."

Instead, I just walked up to my captain (who knew the plan) said, "I'm going back to the hospital now," and walked off normally, and didn't try to behave wounded until I got to the civilians.

So during the average battle/skirmish/march, how does one portray a minor injury without constantly explaining you're not a real casualty, or seeming like you're crying wolf to your comrades or the real first aid personnel?

I'm thinking it probably isn't acceptable to realistically "portray" joint problems or heat problems or frostbite on a march, or get grazed by a ball in a skirmish, or any minor injury or illness that could really happen in the 21st century--at least not without some extensive pre-arranging. But I dunno. When I see the military, it's more from the medical side, so I'm curious about the norms in the ranks.

By the way, ditto to what Tim said about tetanus. Only catch is its delayed onset, so it would need to be from an injury that occurred well before the days being portrayed.

Hank Trent
hanktrent@voyager.net

NoahBriggs
11-12-2006, 10:35 AM
It sounds like event size is the problem. At larger events, everyone arrives and everyone participates. They come from all over the country at the behest of XYZ Organizers to celebrate the 152nd anniversary of Roiling Thunders of Destiny. There is, for better or worse, some sort of coordination for the battle (at least to get the two mobs moving in thr same direction on the field). However, there is no central coordination of medical setups or designated wounded. Oh, we try, but when it comes to cat-herding medical seems to be the worst. Egos, canvas, mannequins, museum displays, everyone has a comfort zone they are unwilling to leave. This does not include individual reenactors who already have their own "wounded materials" and show up at whatever passes for your dressing station. They exhibit no symptoms; they exhibit the "extreme pain which looks more like ants in the pants"gyrations; they let their sausages fall out in front of the spectators; they joke.

Add to the mess the ice angels, kids as stretcher bearers, and "medical stewards" who wear Ambulance Corpsmen caps with their half-cheverons asking you if you are all right and anyone behind the immediate lines who may (or may not) be doing some sort of first-person to keep the "cowards" from deserting the field.

Thus it's hard to say you are designated wounded, or to set up a field-dressing station or whatever, because you may find yourself in the way of someone else (as in the Pritchett scenario) or not everyone understands you are a Designated Early Casualty (as in the Trent scenario). You are at the mercy of the event and the organizers.

Surprise, at a smaller event where the medical is working directly with the rest of the scenairo organizers and senior commanders from the get-go, then it's easy to set up and/or organize the medical. Paynes Farm is a perfect example, and the upcoming Wilderness Event in May 07, and the Fredericksburg Slaughter Pen event in October or November 07 are, I hope, textbook examples of how to do this. Patients volunteer, they report to the POC designated as the medical coordinator, they are coached on proper behavior. The result is less dramatic in the sense of the screaming and such, but more dramatic in the sense of not as much blood and the silence of a hospital (or at least not as noisy.)

Historically, the senior hospital administrator worked with the Army command before and during a campaign to locate an area designated as the hospital, an ambulance park, and to make sure who has priority on the roads when wagons go to the front and ambulances come to the rear. There is a reason the Army often used a simplified command structure - to make it as efficient as possible to conduct operations. That was the idea, anyway.

tompritchett
11-12-2006, 12:11 PM
By the time it came for me to take my hit, I was scared to! If I acted hurt, walking the gauntlet of officers a quarter mile to the semi-modern aid station and then another quarter mile to the farm house was going to be an endless magic moment--not!--of saying, "No, I'm really fine. I'm just acting. I'm a designated casualty. No, really, I'm fine."

In the past at events when real heat injuries were a problem, I would just give a quick thumbs up signal as soon as I saw someone approaching me. Very rarely, have I had someone miss the signal and still persist and ask. Yes, it breaks the immersion slightly, but less so than having to actually be constantly questioned and it is not visible to the public, if they are also present. Works whether you are portraying dead, immobilized wounded or walking wounded.

Just a suggestion.

No_Know_Nothings
11-13-2006, 08:06 AM
Wow... thanks for all the responses. In summary, are these answers to my original questions generally accurate?


Anyone out there specialize in portraying wounded in a battlefield aid-station/field hospital setting? Answer: No. The ranks/camps usually have to searched for volunteer wounded.


What's considered appropriate within the obvious limits of good taste and common sense when depicting wounds?Answer: Seems to be up to the surgeon in charge. Triage the pink bandages and sausage guts to the side and focus on the guys who want to do it right.


What's considered appropriate in regards to "pain theatrics?" Answer: Play it by ear, but less is more.

NoahBriggs
11-13-2006, 09:26 AM
If you are looking for quick answers because you are too overwhelmed to read our dissertations, then I suppose those which you writ will do.

The reason we gave lengthy answers, though, is to help you with a broad understanding of how the body reacts to physical trauma. Not much has changed when a bullet, bayonet or shrapnel hits a body - either a hundred forty-five years ago or just five minutes ago. Tissues are rent. Nerves are damaged. Bones broken (or shattered). There is still blood loss. There is still pain. There is still stiffness. There are still stitches and bandages and whittlling away long, lonely hours in a hospital. If you act now, we'll even throw in the recurring nightmare to relive the whole thing over and over again in your mind, which is something remarkably absent at reenactments. Was PTSD around back then? Probably so. Read "Shook Over ****" for more information.

Unfortunately not everything will fit into a simple answer mold in this hobby. You must adjust yourself on a case-by-case basis. If you want to portray wounded then you need to research the battle engagement you are representing and pay attention to the references to wounded. Take into account the bias of the writer (and yes, bias can be a good thing, too).

As you may have guessed, a lot of us in this conference are not of the "rubber limb and pink bandage" school of recreating field hospitals. We feel the excess "shock and awe" theatrics are counter to the goal to show the public what the Army's Hospital Department was like during the war. When someone is wounded there are consequences far beyond the initial tournequets and suturing. We are also sensitive to the fact that a lot of families who are visiting events may have friends or relatives stationed in active war zones overseas. They may not necessarily find the hospital displays all that "educational".

Something way overlooked at most events are the plethora of ordinary ills the troops had. Okay, having the trots or popping boils does not make for compelling drama in the field. Nevertheless there were all sorts of ills the troops had on a regular basis. My personal editorial is to encourage participants to use the list of symptoms I posted earlier to engage in first-person or to bring to the attention of the surgeon at sick call. At the very least you will give the surgeon something to do instead of him sitting around sharpening scalpels.

No_Know_Nothings
11-13-2006, 10:22 AM
If you are looking for quick answers because you are too overwhelmed to read our dissertations, then I suppose those which you writ will do.I read all the responses and was not "overwhelmed" by them. I'm sorry if I gave that impression. I have read Kevin B.'s fine article in CWH and have a decent collection of accounts written by and about the wounded. Among them:


A Vast Sea of Misery

Grappling With Death

My Life in the Irish Brigade

Out of the Wilderness

Soldiering

Fallen Soldier

Bleeding Blue and Gray


etc.

So, I know what many of the wounded endured... just didn't know much about how it is portrayed by reenactors. That was all. Sorry if I gave offense for wanting to get a comprehensive summation. I didn't expect to get a lecture on how to build a watch... I just wanted to know what time it was. wink, wink ;)

Wounded_Zouave
11-13-2006, 10:38 AM
You don't always need to do a full-blown field hospital impression to convey the plight of the wounded. I once did an NPS LH portrayal of a wounded soldier (hence my user name). I was just a wounded guy sitting with his back against a tree before he was picked up by the ambulances. Some wounded would have to lay on the battlefield for days before getting any attention and pretty much had to tend to the wounds themselve, espcially if they were behind enemy lines, so that was the impression I did. I had an old shirt wrapped around my leg since soldiers at that time were not issued field dressing kits. Out of consideration for the public, it was more muddy instead of bloody. I did a third person talk. No one took offense, were sympathetic, and asked good questions.

NoahBriggs
11-13-2006, 11:53 AM
So, I know what many of the wounded endured... just didn't know much about how it is portrayed by reenactors. That was all. Sorry if I gave offense for wanting to get a comprehensive summation. I didn't expect to get a lecture on how to build a watch... I just wanted to know what time it was. wink, wink ;)

None taken. :)

Wounded_Zouave and yourself are one of the few exceptions to a vast majority of reenactors doing wounded. To portray someone who is wounded requires a different mind-set - more waiting, not much to "do", and it requires a little more mental preparation than what we are used to. Lying there, in perpetual wait for an ambulance you know will never come (in real life, anyway). If you get the benefit of talking with the public, then some of your boredom is allieved.

If in first-person, then complain of low, throbbing pain, feeling cold and thirsty or be delerious. Or even quiet.

Respects,

Spare_Man
11-13-2006, 11:54 AM
The wounded imprression is way underrepresented in the hobby. I'm not talking about the medical impression, which is well covered, but, as Cyruss points out, the wounded impression itself. When its done, it tends to be overdone and becomes too theatrical and often becomes borderline offensive. Personnaly, I think the non-battle reenactment, living history mode is the best venue for quality, non-offensive wounded impressions.


To portray someone who is wounded requires a different mind-set - more waiting, not much to "do", and it requires a little more mental preparation than what we are used to. Amen.

To overcome the "more waiting, not much to "do" syndrome, I'd like to do a walking wounded type of event sometime. A slow, leasierly hike at an actual battlefield with a bunch of pards making their way from the battleline to the rear, bandaged with shirts, rags, but not excessively bloody. Dirty, muddy and powder-besmirched, looking battle-weary, but in generally good spirits. The great thing about this is would give folks a chance to a variety of impressions all in one group... infantry, artillery, zouaves, sharpshooters... and could incorporate an authentic co-mingling of rebs and yanks.

Wounded_Zouave
11-13-2006, 12:34 PM
To overcome the "more waiting, not much to "do" syndrome, I'd like to do a walking wounded type of event sometime. A slow, leasierly hike at an actual battlefield with a bunch of pards making their way from the battleline to the rear, bandaged with shirts, rags, but not excessively bloody. Dirty, muddy and powder-besmirched, looking battle-weary, but in generally good spirits. The great thing about this is would give folks a chance to a variety of impressions all in one group... infantry, artillery, zouaves, sharpshooters... and could incorporate an authentic co-mingling of rebs and yanks.Great event idea! Where do I sign up?