Tag: war

Posted in Psychology & Medicine

Triage

Posted on by Jinavie

In dire times such as wars, natural disasters and pandemics, we hear news of healthcare professionals setting rules to limit medical treatment provided to certain groups of people. This can come across as shocking to people as it seems unfathomable that a hospital would not do everything within its power to save a life. However, this is a well-known and commonly practised principle in medicine known as triage.

Fundamentally, triage is a system used to prioritise who should receive what level of medical care when. The word triage comes from the French verb trier, which means “to sort“. Modern triage was first designed by a French surgeon named Dominique Jean Larrey, who served in the Napoleonic Wars. Larrey categorised wounded soldiers into one of three groups:

  1. Those who would likely die no matter what treatment they received
  2. Those who would likely live no matter what treatment they received
  3. Those whose quality of life may benefit from immediate treatment

He advised battlefield medics to quickly assess what group a wounded patient would fall under and to focus on the last group. For example, if a soldier had superficial cuts and not heavily bleeding, they would be able to transport themselves back to base. A soldier who is not breathing or lost two or more limbs would be unlikely to survive despite acute surgery (especially with where medicine was at in those times). In other words, medical care would be focussed on those who would likely survive and benefit from urgent medical care, such as the patient who is needing an amputation to stop life-threatening bleeding from an injured limb.

This may sound cruel, but it is the unfortunate reality of healthcare. Ideally, we would like to give the best care to every patient, but we live in a world of scarcity, where resources are finite and limited.

Therefore, we rely on utilitarianism, where we ask “what is the most amount of good we can do with these finite resources?”.

Modern triage is more complicated than Napoleonic times, especially in the emergency department. However, in the case of emergency situations involving mass casualty, triage returns to its simple, original form.

Let us imagine a city struck by a massive earthquake. There are tens of thousands of people with varying severity of injuries. How do we prioritise who will be taken to hospital, need on-site treatment, or left to die or find their own way to hospital?

Physicians and nurses will quickly assess a patient and their vital signs to categorise them using coloured tags, such as red for needing emergency treatment, green for does not need treatment, or black for deceased or likely to die. This is because without triage and prioritisation, the available medical resources will quickly be exhausted and no further care will be deliverable.

If multiple doctors and nurses stop triaging and focus on one patient needing complex surgery, tens or even hundreds of potentially salvageable lives could be lost. If non-urgent injuries are all taken to hospital, the hospital will be overwhelmed and will not be able to provide care to those who are critically ill. If a patient with a non-survivable injury is operated on and taken to the intensive care unit (ICU), they will have lost the opportunity to use those resources on a patient with a better chance of survival.

As harsh as it sounds, saving ten people with moderate injuries who would die without treatment is preferred over the one person who has a less than 10% chance of surviving with maximum medical care. This may be as black-and-white as choosing to not rescue a person with an obviously unsurvivable injury such as decapitation, but it may be as complicated and ethically challenging as deciding if an elderly patient with a lung infection should be intubated and ventilated (breathing machine), fully knowing that a younger, healthier patient with the same infection may need that ventilator to survive, but with a much higher chance of survival and restoring their quality of life.

Triage is a classic example of when the rational solution to a problem such as scarcity challenges ethics and emotions. It may sound as if doctors are playing god when they are declining ICU level of care for an elderly patient, but we must also consider that they have a duty to provide the most effective care for all of society, not just the one patient. These kind of ethical dilemmas are an everyday occurrence in the medical field and can cause significant guilt, anger, pressure and resentment for the healthcare provider.

To simulate the weight of triage, consider the following scenario. Following an explosion in your neighbourhood, you respond to a scene with four patients:

  1. Your 28-year old co-worker with heavy bleeding from a laceration of their leg
  2. Your 83-year old mother who is bleeding from their head and unresponsive, breathing very irregularly and poorly
  3. Your neighbour’s 8-year old child who is not breathing despite straightening their airway and applying rescue breaths
  4. Your 45-year old who is screaming in pain from a broken arm but not bleeding and able to walk
    You have the capability to treat and transport one patient. Who do you choose?

As much as we would like the save the life of our loved ones or a young child first, the principles of triage dictate that the first patient demands the most immediate response.

Triage does not account for emotional connections, personal biases or even justice necessarily. It is a cold, hard rule system that we use so that we can separate our emotions and instincts out amongst a horrific situation.

The algorithm for the START triage system – a widespread system used in many modern mass casualty scenarios
Posted in History & Literature

Christmas Spirit

Posted on by Jinavie

World War One, also called The Great War, is notorious for the horrors endured by soldiers and civilians during the four-year period. One of the horrors was trench warfare – a new type of battle where two armies would dig into trenches stand-off across a No Man’s Land. It was a particularly terrible experience due to constant PTSD-inducing artillery barrages, extremely unsanitary living conditions and the looming shadow of death that clouded the skies.

But even within these terrible times, the light of humanity shone through. In December 1914, the German army was facing off the French and British army along the Western Front. In the week leading up to Christmas, there were increasing reports of strange behaviour among troops from both sides: fraternisation.

It began with music and light. Many British soldiers reported seeing bright coloured lights from the German lines on Christmas Eve. They heard choruses of Germans singing carols, with not a gunshot to hear. The British and French forces joined in quickly and suddenly, the soldiers were all enjoying Christmas Eve. They were in an informal ceasefire.

Little by little, the two sides made contact on Christmas Day. Not with shots, but with greetings. They would compliment each other’s singing and make jokes across the ditch. Then, some fearless soldiers would cross No Man’s Land to meet their new friends face-to-face. It took a bit of time, but trust developed and soldiers would pop out of their holes without fear of being killed. The language barrier could not stop the fraternisation. Soldiers would make gestures at each other, exchange gifts such as smokes and chocolates and even challenged each other to a football match.
On Christmas Day, 1914, man’s love for each other won over the horrors of war, bringing the first period of peace since the Great War began. It was a Christmas miracle.

Of course, fraternisation with the enemy is far from desirable to a military commander. What man would want to shoot someone they just had a great game of soccer with? Killing only becomes possible when the victim has been dehumanised. This was the last Christmas Truce of the war, as commanders of both sides outlawed any fraternisation with the enemy.

Despite this, there are countless stories from the war where soldiers would show mercy to their enemies, reminding us how even during the darkest times of history, kindness and love exist.

Posted in Science & Nature

Four Fs

Posted on by Jinavie

Biologists state that the driving force behind evolution can simply be summarised as four forces: fight, flight, feed and mate (“fuck”). These are known as the Four Fs. Evolution is described as the process by which species adapt to an environment through modifications in the genomes of successive generations. The Four Fs describe the adaptations most commonly seen in evolution; that is, the four things that species evolve in order to better adapt and survive their environment. For example, carnivores developed sharp teeth and claws to hunt better and herbivores developed faster legs to flee from their predators better. Nature is a vicious battleground where different species compete with each other for survival, and the Four Fs are the most powerful weapons of survival.

As much as we’d like to think that we are higher-order, civilised beings, human beings are still driven by the basic four forces that drive every other species in the world. Obviously, our bodies are well-adapted to these forces, such as our fight-or-flight drive activating in the face of danger to let us fight harder or run faster through adrenaline. Anyone can see that nature has done her job well by bestowing us the gift of satiety and orgasm to promote our feeding and mating. But what is interesting that the Four Fs go beyond our “natural evolution” to affect the evolution of our civilisation.

Consider this: what is the purpose of war? Since the dawn of time, mankind has spent a considerable amount of resources figuring how to most efficiently kill another group of people, or live in fear that other people will kill us. If we study the behaviour of chimpanzees (one of the few species other than us that wage warfare), we can see that their motivation is for food and sex (i.e. mating partners). This also applies to mankind and it is not a story of ancient times. It is well-known that raping and pillaging runs rampant during wars. Less than 800 years ago, a man named Genghis Khan was so successful in waging war that DNA evidence suggests that 0.5% of the world population are descended from him. Even in the present, countries wage war to secure natural resources to ensure that their people can eat, as the health of the economy directly correlates with the ability of people to put food on their plates. Almost every war essentially boils down to a fight for food.

Then what about sex? Like it or not, sex has been a tremendously influential force in history. From Cleopatra’s seduction of Caesar preventing Rome’s invasion of Egypt, to Henry VIII turning against the Catholic Church to marry Anne Boleyn, sex has been a timeless motivator for humanity. Although the consequences would not be as dramatic as those described, a significant proportion of our actions are also based on our primal desire to reproduce.

Of course, this is not always the truth and human beings are capable of acting on less wild motivators such as happiness and altruism. However, the next time you make a decision or see a conflict on the news, question this: how much of an impact did food and sex have to motivate that?

Posted in History & Literature

Hitler

Posted on by Jinavie

There are millions of units for various things. Some are simple and standard like the metre and gram, while others are quirky and humorous like the Helen unit and the Banana Equivalent Dose. As long as you can justify it with logic and objective quantification, you can virtually create any unit. Using this logic, some historical knowledge and a cruel sense of humour, one can come up with an extremely disturbing unit called the Hitler unit.

As most people know, Adolf Hitler is one of the most notorious criminals against humanity in the history of mankind. He was responsible for the death of at least 17 million people, including the 6 million Jews and 5 million other ethnicities killed during the Holocaust, and victims of World War II. For simplicity’s sake, let us only consider the victims of the Holocaust as direct victims of Hitler’s ambitions.

Using this statistic, we can now create a new unit called the hitler – equivalent to 11 million human deaths. Ergo, killing a single human amounts to a crime of 91 nanohitlers. The “hitler level” of some of history’s worst notorious dictators are as follows:

  • Kim Il Sung: 1.6 million deaths = 145 millihitler
  • Pol Pot: 1.7 million deaths = 154 millihitler
  • Hideki Tojo: 5 million deaths = 455 millihitler
  • Adolf Hitler: 11 million deaths = 1 hitler
  • Jozef Stalin: 23 million deaths = 2.09 hitler
  • Mao Zedong: 78 million deaths = 7.09 hitler

The hitler unit gives us a clear picture of “how much worse” someone’s crimes are compared to those committed by Adolf Hitler. For example, Jozef Stalin could be considered twice more evil than Hitler.

The true utility of the hitler unit is that like other units, it allows for useful conversions to other units. For example, the EPA currently values a human life at $6.9 million (USD). A simple unit conversion thus tells us that 1 hitler is equivalent to the loss of $75,900,000,000,000 (-$75.9 teradollars). In 2008 when the US Congress failed to pass a stimulus bill following the subprime mortgage crisis, the market lost $1.2 trillion over one day – the equivalence to 15.8 millihitlers. Conversely, if a mugger took $200 from you, they have technically committed a crime of 2.64 picohitlers.

Although the crimes of Adolf Hitler were beyond tragic, this imaginary unit teaches us that almost anything can be quantified in the field of science and mathematics.

Posted in History & Literature

To End All Wars

Posted on by Jinavie

In his play Lysistrata, Greek playwright Aristophanes gives a comic account of one woman’s extraordinary mission to end the Peloponnesian War – a 30 year old war between Athens and Sparta. How did one woman bring an end to such a deadly war?

In the play, Lysistrata (the female protagonist) becomes sick and tired of men treating women like simplistic hedonists incapable of functioning on their own. She believes that the war is a result of irrational men making stupid decisions and the long war is a waste as young, nubile women are aging away. She holds a convening of the women of various city states and proposes that the women must rise up to stop the war. Lysistrata’s plan is simple: withhold sex from the men until they cave (i.e. a sex strike). The women are reluctant at first, but agree to join her. They then take over the acropolis of the city, setting up a safe haven for women, barring any man from entering.

The men initially scoff at this revolution and try repeatedly to lay siege on the acropolis. However, they fail and the women continue to not provide any sexual pleasures to any male. The men constantly make snide comments about how women are hysterical and only seek pleasure, but sooner or later, they become desperate for sex. One by one, desperate men (sporting “burdens”, i.e. erections) come to the acropolis, pleading for relief (funnily, some women desert the acropolis in desperation for sex as well). The women take the men in, but only to tease them and leave them disappointed.

Eventually, the men (of both Athens and Sparta) cave and surrender, agreeing to end the war. There is a hilarious scene during the peace talks where Lysistrata brings out a stunning young girl named Reconciliation in front of the men, quashing any complaints or objections. Even the men who protest against the women’s demands are overcome by their lust and want(/need) for sex. Once peace is declared, the men and women all come together in the acropolis for singing and dancing, celebrating the women’s success in ending the war.

Although the play is only a comic exploration of the battle of the sexes, it clearly shows the power women have over men, and how they can use that power to easily control men.

Posted in Philosophy

Fundamental Malevolence

Posted on by Jinavie

Human beings are fundamentally evil. This was a theory concerning human nature put forward by Xunzi – a leading Chinese Confucian philosopher, along with Confucius and Mencius. Xunzi stated that human beings naturally seek out only their own interests and greed, envying and hating each other so much that they are bound to fight if left alone. He suggested that people needed to learn etiquette and culture themselves to correct this.

Xunzi’s philosophies are on a background of the chaotic setting of the Warring States Period. The Warring States Period was a period when China was split into many different countries, all warring with each other to gain dominance over each other’s lands. During these wars, Xunzi saw countless cases of people looting and killing each other, which led him to the conclusion that people are naturally selfish beings. He believed that human beings focus on their greed and self-preservation from the moment of birth. He also believed that leaving people without order would indubitably lead to social chaos. Thus, to effectively rule over the people, a leader must place limits such as laws, ethics, etiquette and culture.

From an evolutionary point of view, the theory of fundamental malevolence (성악설, sung ak sul) makes sense. Would a starving lion mourn the death of a baby zebra? Protecting one’s own interests is a great way to increase your chance of survival and propagating your genes.

The more you carefully observe people’s behaviour, the more credibility the theory seems to gain. Human beings are selfish beings who become jealous of others for having more than themselves, kill someone because they tried to take away their love and engage in fratricidal war because others do not share their beliefs. You as the reader may state that you cannot imagine hurting anyone, let alone taking a life. In that case, let us examine the following thought experiment.

One day, you are kidnapped. When you come about, you find that you are trapped in a pitch-black room, tied to a pole. The room appears to be completely empty and you cannot see or hear anything. Suddenly, you hear a voice coming from the other side of the room. The voice talks about how it will murder you in a violent, excruciating way, over and over. The voice continues to threaten you in a macabre way for three days. Just when you are near your breaking point from the overwhelming fear of imminent death, another voice appears. The voice says: “If you nominate someone you are close to that I can kill in your stead, I will let you go and not harm you in any way”. Would you have the courage to not give a name?

Posted in Science & Nature

Slavemaker Ant

Posted on by Jinavie

Slavery is considered one of the most inhumane acts in humanity’s history, where a group of people enslave another group of people to do their bidding in harsh conditions. Slavery is an interesting concept as at the cost of other members of your species, you can greatly increase the productivity of your own society. Some may argue that only humans are evil enough to enslave their own kind, but there is one other species that enslaves other animals: ants.

Certain species of ants, known as slavemaker ants, are known to enslave entire ant colonies to do the bidding of their own colony. The way slavemaker ants enslave colonies is as follows. First, a pregnant queen ant lies in front of an enemy nest after mating and feigns death. Scouts from the nest carry the “body” back to their queen so that she may devour the fallen enemy. When the two queens are left in the same room, the queen slavemaker ant springs back to life and proceeds to eviscerate the other queen ant. She then rolls around in her remains to coat herself in pheromones – the substance through which ants identify each other. The ants of the colony now believe the queen to be their own queen and serve her and her eggs. When the brood fully matures (only soldier ants), they swiftly overrun the nest and completely enslave the colony, forcing them to fill the role of the worker ants, which the slavemaker ants lack.

Eventually, the original slaves die out and the colony becomes short on worker ants (as the queen only produces soldier ants). To overcome this issue, the colony sends out massive raiding parties to attack other colonies, after which the ants steal the eggs and larvae of the captured colony to breed them into new slaves. Interestingly, it has been observed that slavemaker ants tend to attack the most defended nests, knowing that they contain the most eggs and larvae. There are variations on how the army attacks and raids a colony depending on the species. Some choose to launch a full-on assault, decimating the colony and leaving only the eggs and larvae. Some secrete chemical gases that force the colony to evacuate, leaving their young behind in the rush. In some cases, a fertilised queen ant will sneak into a raid and kill the queen ant in the midst of the battle, commandeering whatever is left of the colony following the raid.

One difference between human and ant slavery is that slave ants are not aware they are slaves. Since they have been brought up since birth to work for the colony, they simply believe that they are worker ants birthed by the queen. Thus, they have no objections to serving the colony as to them they are merely fulfiling their objectives. 

This type of interaction between species is known as social parasitism, where one group benefits and survives at the cost of another group. Interestingly, “parasitism” also suggests that slavemaker ants cannot survive without their host. The reason being, slavemaker ants are so specialised in infiltrating and raiding other colonies that they cannot feed themselves or construct a colony by themselves. Even their mandibles are evolved into perfect killing machines, so much that they cannot use it to feed (slave ants have to feed them). In some cases, it has even been observed that slave ants had to carry their masters from one colony to another.

Slavemaker ants enslave not because they are tough or superior, but because they are desperate and have adapted to this unique form of surviving. Thus, if there was an Abraham Lincoln ant, he would certainly kill his colony within one generation.

Posted in Psychology & Medicine

Tit For Tat

Posted on by Jinavie

In human society, there are many ways for a person to interact with others when in a group setting. Some may choose to be selfish and only be out for their best interests, while others may choose altruism and cooperate with each other. The mathematical model that tries to predict human behaviour and outcome in these settings is the Prisoner’s Dilemma – the core of game theory. Tit for tat is one strategy that can be employed in such a setting.

The basis of tit for tat is equivalent exchange. A tit for tat player always chooses to cooperate unless provoked. As seen in the Prisoner’s Dilemma, if both players cooperate, both benefit (let us say 3 points each); if one player defects, that person gains more than from cooperation (5 points) while the tit for tat player gains 0 points.
If a tit for tat player is provoked, that player will retaliate. However, the player is also quick to forgive. Ergo, if the other player chose to cooperate, the tit for tat player (following the principle of equivalent exchange), will also cooperate. If the other player defected, the tit for tat player loses the first round and then chooses to defect from then on.
Note that tit for tat strategy only works when there is more than one game so that the player has a chance to retaliate.

Let us use an example to illustrate why tit for tat strategy works. In this scenario, two tit for tat players and two defectors all play six games each, using the above point system (if both defect, they each receive 1 point). The results are as follows:
  • Tit for tat vs defector: Tit for tat loses first round, both defect for next 5 rounds (5 vs 10)
  • Tit for tat vs tit for tat: Both cooperate on every round (18 vs 18)
  • Defector vs defector: Both defect on every round (6 vs 6)

When the points are added up, a tit for tat player gains 28 points (5 + 5 + 18) while a defector only gains 26 points (6 + 10 + 10). This is a surprising turn of events, as the defectors never lost a round and tit for tat players never “won” a round. This goes to show how cooperation leads to better long-term results while selfishness prevails.

There are shortcomings of this strategy. If there is a failure in communication and one tit for tat player mistakes the other’s actions as an “attack”, they will retaliate. The other player then retaliates to this and a vicious cycle is formed. This is the basis of many conflicts ranging from schoolyard fights to wars (although interestingly, tit for tat strategy is also found during wars in the form of “live and let live”). One way to prevent this is tit for tat with forgiveness, where one player randomly cooperates to try break the cycle (a defector would respond negatively while a tit for tat player will accept the cooperation), or the tit for two tats, where the tit for tat player waits a turn before retaliating, giving the opponent a chance to “make up for their mistake”.

Computer simulations have all proven that tit for tat strategy (especially the other two types mentioned just before) are extremely effective in games. In fact, it is considered one of the most optimal strategies in overcoming the Prisoner’s Dilemma.

In human societies, there is usually a mix of “nice people” and “selfish people”. By cooperating and trusting each other, we can produce a much greater gain over time compared to being selfish. And since society still unfortunately has “defectors”, you can retaliate to those who refuse to cooperate by defecting on them also. Ergo, a good approach to life is to initially reach out your hand to whoever you meet and treat them from there on according to how they respond. If they take your hand and want to cooperate, treat them with altruism and help them out. If they swat your hand away and try to use you for their selfish gain, it is fine to shun them and not help them out.

Through cooperation, understanding and connection, we can build a far more productive and efficient society, just like the ants.

Posted in History & Literature

Thirty-Six Stratagems: Chapter 6 – Desperate Stratagems

Posted on by Jinavie

(For all 36 stratagems, click here: https://jineralknowledge.com/tag/thirtysix/?order=asc)

Desperate Stratagems are last resort tactics that can be used when you are placed in a disadvantageous state or risk losing the war.

Stratagem 31: No weapon could beat seduction
This is the strategy where you use a beautiful woman to tempt the enemy to extract information or undermine their will to fight. It is a deadly strategy that never fails.

Stratagem 32: Empty fort strategy
Purposefully empty your fort to show the enemy that you are defenceless, causing them to think that it is a trap and retreat. It was effectively used by Zhuge Liang in The Three Kingdoms.

Stratagem 33: Countermine the enemy’s spy
Use the enemy’s spy to spread false information or use them as a double agent that can extract the enemy’s intelligence. The “double spies” and “dead spies” from Sun Tzu’s The Art of War fit under this stratagem.

Stratagem 34: Sacrifice yourself to comfort the enemy
Inflict injury on yourself to win the enemy’s trust. For victory, you may have to sacrifice even the dearest things such as your wife or most loyal servant.

Stratagem 35: Chain stratagems
This is an elaborate strategy where you first restrict the enemy’s movement then make use of a series of tactics one by one to decimate the enemy. The most famous example is from The Three Kingdoms in the Battle of Red Cliffs. All of the ships of Wei were linked by chains and could not move freely, making them vulnerable to a fire and causing Cao Cao to lose the battle in an instant.

Stratagem 36: If all else fails, retreat
It is often misquoted as “retreat is the best option”. The Thirty-Six Stratagems explain that retreating is not the most ideal option, but if there is no chance of winning and the cost will be too much, it is wiser to retreat then fight again after reinforcing your forces. Knowing to retreat when you are disadvantaged and the cost is too high is true wisdom.

By utilising these thirty-six stratagems wisely, you will be able to win no matter what situation strikes. Remember: life is a fierce battlefield and without effective strategies and tactics you cannot seize victory.

Posted in History & Literature

Thirty-Six Stratagems: Chapter 5 – Proximate Stratagems

Posted on by Jinavie

(For all 36 stratagems, click here: https://jineralknowledge.com/tag/thirtysix/?order=asc)

Proximate Stratagems are tactics that utilise something even more fearful than the enemy outside: the enemy inside.

Stratagem 25: Replace the beams with rotten timbers
If you slowly remove the pillars of foundation beneath the enemy one by one, they will naturally fall. More specifically, if you buy off the enemy’s officials and subjects, you can make the country into a useless shell even before starting a war.

Stratagem 26: Point at the mulberry tree while cursing the locust tree
This is a method where you publicly criticise someone’s actions while intending for someone else to indirectly get the message. If you criticise an ally or a subordinate, you run the risk of being betrayed. Thus, it is far more effective to indirectly criticise someone else in a way that the other person understands what you think.

Stratagem 27: Feign madness but keep your balance
It is far better to act like a fool and refrain from misconducting than talking out loudly and committing a rash act. A true leader hides his ingenuity, meaning he may appear as a fool to others. This is the ideal look of a leader. Furthermore, if you keep up an act of foolishness while meticulously planning on the inside, the enemy will drop his guard.

Stratagem 28: Lure the enemy to the roof then remove the ladderMake your army look weak and defenceless to lure the enemy into a trap, then surround and destroy them. On the other hand, this can also mean to intentionally trap your forces to boost their ferocity.

Stratagem 29: Deck the tree with false blossoms
Bluff to suppress the enemy psychologically. For example, if you make it look like your forces are far greater in number than they actually are, the enemy will be hesitant in attacking and you will have the lead. This is very effective when you are outnumbered.

Stratagem 30: Make the guest act as if he was the host
This is the survival strategy cuckoos use where they push the original babies out of a nest and hog the food that the mother brings. It is a strategy where you patiently wait for the right moment when you can sneak in and seize the authority, taking someone else’s resources for your own. An example of this stratagem would be when the reinforcement that is supposed to protect the allied country turn into an invading an army to take over the country.