American Outlaw by Dan Schultz

Like the land and legends that created it, the spirit of the American West is too expansive to capture in cohesive thought, yet we know it by its landmarks: individualism, excess, self-reliance, resourcefulness, impatience and, above all, freedom.

More than the institutionalized freedoms assured by our Constitution and body of law, it was the freedom of hidden canyons, impregnable mountains and unassailable desert. You are not free because a court says so, but you have got a fast horse and a faster gun.  It is the freedom of wide-open spaces; of unregulated rivers, unturned earth, unmolested cliffs and unencumbered spirit. It is the freedom of defiance, the right to spare the other cheek and answer any provocation with escalated force.

It is an ethic of contradictions, as a parched desert canyon channels the occasional flash flood. Where self-reliance and independence can flow over to extreme rebuke of all law and authority. Where resolve and courage to stand your ground became a sudden torrent of violence.  It is an ethic suited to making outlaws into outlaw heroes.

The tradition of the outlaw hero is universal but it flowered most profusely in the American West. There, the distinction between and outlaw hero and an outlaw hung was not always apparent, but the trail from repugnant criminal to popular desperado was well ridden. Something about life out-of bounds fascinated the public and even in the face of atrocious crimes, law-abiding citizens seemed more than willing to view bad guys with nervous admiration. In moments of musing as they bent to the task of ordinary life, it was as Eugene Manlove Rhodes, the “cowboy chronicler” who lived in and wrote about the Old West, suggested, “Outlaws are just more interesting than in-laws.”

Part of what made the celebrated outlaws of the American West interesting was their daring crimes and reckless confrontations – in-your-face close and brazenly public.  Stripped of one-hundred-plus years of fanciful pop-culture embellishment and decades of Hollywood gilding, Western gunfights were usually less knightly than legend portrays.  Any were ambushes, back shootings or long-range shootouts with adversaries crouched behind cover.  But others were eye-to-eye with mortal danger so imminent that a reasonable man would slip away and find someplace to puke. To engage in them required courage and public opinion turned on such displays of braver, regardless of what color hat the gunman was wearing.

The other standard of behavior consistently expected of our outlaw heroes was adherence to an outlaw code of honor. It was an unspoken, ill-defined standard of morality above the law that could overlook unwarranted violence, but required a measure of personal integrity: loyalty to friends and gang members, discrimination between adversaries and bystanders, and straightforward actions. If they were going to steal from you, they robbed you right up front, not by a Ponzi scheme. If they were going to kill you, they rode up and shot you. They were, in most respects, true to their word, transparent in their motives and intentions.

Although not cheered as revolutionaries or vanguards of a particular political cause, Western outlaw heroes were associated with a populist philosophy. They cultivated the same “true citizen and patriot” image claimed by today’s militia movement.

The desperate outlaw on the run not only had the freedom of the free-roaming cowboy disengaged from society; he pushed back at subjugating social forces – the relentless press of civilization and regulation. For however long he could stay at large, the systematic oppression of government, bureaucracy, corporations, technology – of ordinary do-the-right-thing life – was overthrown.  Like standing on the rim of a mesa staring westward across miles of jagged, wild country and feeling not small, but distinct and vital, the outlaw speaks to our elemental ache for individualism. The voice may not have sufficient force to drown out our social conscience or sway our better judgment that an un-captured outlaw is a menace, but it’s a whisper loud enough to intrigue, to rationalize and romanticize, and in the right circumstance transform a villain into a hero.

Hardwired by a Western narrative of guns and frontier justice, we revel in the positive attributes of strength, courage and daring action even as they open the door for acts of violence. In cheering for the outlaw hero, we are making a psychological stand for freedom, standing up to authoritarianism and dehumanizing social forces, but we are also sanctioning brutal, inhuman antisocial behavior.

The Old West is forever vanishing, but never vanished. It is a way of life successively pronounced dead, allowing each generation in its lament to appreciate it more poignantly. The West lives. Despite the Walmarts and tourist information centers, satellite dishes and Social Security, there remains a vital intrinsic West that is as it always was. It is real and it is mythical. And one sunny morning in May 1998, near the epicenter of Old West outlaw violence, it happened all over again: the guns; the killing; the posse chase and shootout; the escape into the vast wild country of sagebrush, box canyons and the occasional cowboy on horseback; Native American trackers, a grueling manhunt; and a populist outlaw disappearing into legend. Such is the Four Corners. As it was in 1898. As it remained a hundred years later.

Hospital Safety and Teamwork Survey by Marty Makary, MD.

Based on my experience seeing doctors handle dozens of medical conditions, I became convinced that teamwork is a marker of good medical care.  Later, as a health policy researcher, I was eager to measure the phenomena. I called Dr. Bryan Sexton, a teamwork guru and author of a widely used survey showing a strong correlation between airplane-crew teamwork and pilot errors. A Ph.D. in social psychology, Dr. Sexton joined Johns Hopkins shortly after applying his survey to improve safety at Continental Airlines.

Our group brainstormed how to use Dr. Sexton’s methods to measure medical quality and detect bad outliers, i.e. hospitals littered with “danger zones.” We noted a striking similarities between airline cockpits and medical-procedure rooms: both high-stakes environments with a formal hierarchy. Confidentiality was key to eliciting honest responses about workplace culture and safety for both airplane-pilot crews and health care workers.

Dr. Sexton tailored the health care survey questions to specific departments (or clinical areas) within the hospital:

Is the teamwork good?

Would you feel comfortable having your own care performed in the unit in which you work?

Do people work as a coordinated team?

Do doctors and nurses do what’s in the best interest of the patient?

Is communication strong?

Do you feel comfortable speaking up when you have a safety concern?

We set rules for the survey: At least 70 percent of hospital employees must complete it for the results to be statistically accurate, and obviously it must be anonymous so as to elicit honest answers. Based on employee responses, each hospital gets a teamwork score both for the hospital as a whole and for its individual departments and units. The above and other critical questions are used to calculate (on a scale of 0 -100) a Teamwork Culture Score, an Overall Safety Culture Score for a hospital and a score for specific units within the hospital.

We began working on a study now known as the Hopkins Safety Culture Study.  Sixty reputable U.S. hospitals administered the survey to all their employees. We found that safety culture among those sixty hospitals varied enormously. Subsequent studies revealed that teamwork culture could also vary dramatically within a hospital (i.e., one hospital; could have a perfect teamwork culture in surgery and an awful teamwork culture in ob-gyn.

The survey allowed us to measure then insider’s perspective.  It used the “word on the ground” principle for failing businesses: ask executives about the quality of service, and you’ll get one answer; ask the workers on the ground, and you’ll get the real answer.

Thanks to Dr. Sexton, we now had a clear-cut, scientifically valid way to measure hospital quality and safety from frontline providers themselves – the insider’s perspective,. Our research team asked the sixty participating hospitals if they would let s publish the results in the interests of research.  They agreed, on condition that the individual hospital names would be kept anonymous.

We found hospital’s where fewer than 20 percent of their employees reported good teamwork. At one third of the hospitals a majority of employees believed the teamwork was bad. Some hospitals had and impressive 99 percent of their staff reporting that their hospital had good teamwork.

 Not surprisingly survey results correlated to infection rates and patient outcomes. The rate of preventable medical mistakes by doctors  grows as employee teamwork and safety scores decline.

When hospitals make decisions not to staff their intensive care units with an ICU doctor on nights and weekends, that is a “danger zone” that the safety survey readily detects. Similarly, when doctors refuse to use a checklist before doing procedures, the survey yields a low safety-culture score among staff.

While hundreds of U.S. Hospitals now use the survey, all do so under the conditions that results remain top secret, used only for internal reviewing by the government and hospital administrators. Transparency would bring on a shakeout, hospitals that ranked low on safety teamwork and safety culture would quickly address their problems.

The teamwork-safety survey is a powerful tool, but it’s not the only one. To assess the quality of medical care, you should be able to look up the hospital’s infection rate, the number of cases treated there and its patient outcomes, not to mention the comparative costs of similar procedures at different hospitals.  More data transparency, the accountability it delivers, has the capacity to revolutionize the quality of medical care in every city in America, dramatically reshaping our healthcare landscape.

The Real American War in Vietnam by Nick Turse

On January 21, 1971, a Vietnam veteran named Charles McDuff wrote a letter to President Richard Nixon  to voice his disgust with the American war in Southeast Asia. McDuff had witnessed multiple cases of Vietnamese civilians being abused and killed by American soldiers and their allies, and he had found the U.S. military justice system to be woefully ineffective in punishing wrongdoers. “Maybe your advisers have not clued you in,” he told the president, “but the atrocities that were committed in Mylai are eclipsed by similar American actions throughout the country.” His three-page handwritten missive concluded with an impassioned plea to Nixon to end American participation in the war.

The White House forwarded the note to the Department of Defense for a reply, and within a few weeks Major General Franklin Davis Jr., the army’s director of military personnel policies, wrote back to McDuff.  It was “indeed unfortunate,” said Davis, “that some incidents occur within combat zones.” He then shifted the burden of responsibility for what happened firmly back onto the veteran. “I presume,” he wrote,” that you promptly reported such actions to the proper authorities.” Other than a paragraph of information on how to contact the U.S. Army criminal investigators, the reply was only four sentences long and included a matter-of-fact reassurance: “The United States Army has never condoned wanton killing or disregard for human life.”

This was, and remains, the American military’s official position. In many ways, it remains the popular understanding in the United States as a whole.  Today, histories of the Vietnam War regularly discuss war crimes or civilian suffering only in the context of a single incident: the My Lai massacre cited by McDuff.  Even as that one event has become the subject of numerous books and articles, all the other atrocities perpetrated by U.S. soldiers have essentially vanished from popular memory

The visceral horror of what happened at My Lai is undeniable. On the evening of March 15, 1968, members of the American Division’s Charlie Company, q1st Battalion, 20^th Infrantry, were briefed by their commanding officer, Captain Ernest Medina, on a planned operation the next daty in an area they knew as “Pinkville.” As unit member Harry Stanley recalled, Medina “ordered us to ‘kill everything in the villager.’” Infantryman Salvatore LaMartina remembered Medina’s words only slightly differently: they were to “kill everything that breathed.” What stuck in artillery forward observer James Flynn’s mind was a question one of the soldiers asked: “Are we supposed to kill; women and children?” and Medina’s reply: “Kill everything that moves.”

 They killed  everything. They killed everything that moved. Over the course of four hours, facing no opposition, the methodically killed more than five hundred unarmed victims.  Along they way they also raped women and young girls, mutilated the dead, systematically burned homes and fouled the area’s drinking water.

An army inquiry into the killings eventually determined that thirty individuals were involved in criminal misconduct during the massacre or its cover-up. Twenty-eight of them were officers, including two generals, and the inquiry concluded they had committed a total of 224 serious offenses. But only Calley was ever convicted of any wrongdoing. He was sentenced to life in prison for the premeditated murder of twenty-two civilians, but President Nixon freed him from prison and allowed him to remain under house arrest. He was eventually paroled after serving forty months, most of it in the comfort of his own quarters.

The public response generally followed the official one. At the end of it, if you ask people what happened at My Lai, the would say: “Oh yeah, isn’t that where Lieutenant Calley went crazy and killed all those people?” No, that was not what happened.  Lieutenant Calley was one of the people who went crazy and killed a lot of people at My Lai, but it was an operation, not an aberration.

Looking back, it’s clear that the real aberration was the unprecedented and unparalleled investigation and exposure of My Lai.  No other American atrocity committed during the war – and there were so many – was ever afforded anything approaching the same attention. Most, of course, weren’t photographed, and many were not documented in any way. The great majority were never known outside the offending unit, and most investigations were closed ,quashed, or abandoned. Even on the rare occasions when allegations were seriously investigated within the military, the reports were soon buried in classified files without ever seeing the light of day.  Whistle-blowers within the ranks or recently out of the army were threatened, intimidated, smeared, or –if they were lucky –simply marginalized and ignored.

The stunning scale of civilian suffering in Vietnam is far beyond anything that can be explained as merely the work of some “bad apples,” however numerous. Murder, torture, rape, abuse, forced displacement, home burnings, specious arrests, imprisonment without due process –such occurrences were virtually a daily fact of life throughout the years of the American presence in Vietnam. They were no aberration. They were the outcome of deliberate policies dictated at the highest levels of the military.

The hundreds of previous buried and now de-classified reports that I gathered and the hundreds of witnessed that I interviewed in the United States and Southeast Asia made it clear that killings of civilians –whether cold-blooded slaughter like the massacre at My Lai or the routinely indifferent, wanton bloodshed like the lime-gatherers’ ambush in Binh Long – were widespread, routine, and directly attributable to U.S. command policies.

And such massacres by soldiers and marines, my research showed, were themselves just a tiny part of the story.  For every mass killing by ground troops that left piles of civilian corpses in a forest clearing or a drainage ditch, there were exponentially more victims killed by the everyday exercise of the American way of war from the air. Throughout South Vietnam, women and children were asphyxiated or crushed to death when their bunkers collapsed on them, burying them alive after direct hits from jets’ 500-pound bombs or 1,900 pound shells launched from offshore ships.  Countless others, , crazed with fear, bolted for safety, when helicopters swooped towards their villages, only to have a door gunner cut them in half with bursts from an M-60 machine gun – and may others, who froze in place, suffered the same fate.

There is only so much killing a squad, a platoon, or a company can do. Face-to face atrocities were responsible for just a fraction of the millions of civilian casualties in South Vietnam.  Matter-of-fact mass killing that dwarfed the slaughter at My Lai normally involved heavier firepower and command policies allowed it to be unleashed with impunity.

This was the real war – the one in which My Lai was and operation, not an aberration. This was the war in which the American military and successive administrations in Washington produced not a few random massacred or even discrete strings of atrocities, but something on the order of thousands of days of relentless misery – a veritable system of suffering. That system, that machinery of suffering and what in meant for the Vietnamese people, is what this book is meant to explain.

Taipei by Tao Lin

Around midnight, after everyone in the café had gone to a concert, Paul was alone in the Drawn & Quarterly bookstore’s manager’s apartment. He looked at Twitter for what felt like twenty minutes, alternating hands to hold his iPhone ten to fifteen inches above his face. He emailed Charles –

I’m lying in bed on a sofa

Fell strongly like I simply want to relate my feelings of

Bleakness in this email

My legs feel cold

- with “Feeling bleak” as the subject. He was looking at Twitter again, a few minutes later, when for the the fifth or sixth time since getting it in August he dropped his iPhone on his face, which did not register in its expression that anything had happened until after impact. He considered emailing Charles that his iPhone fell on his face. Then he tried to do what he couldn’t specifically remember having done since college – he chose one of his favorite songs and, with a meekly earnest sympathy towards himself, listen to it on repeat at high volume and tried to focus only on the drums, or bass guitar, until he was drowsy and decontextualized and memoryless, when he would half-unconsciously remove his earphones and turn off the music, careful not to be noticed and assimilated by the world, and disappear into the reachable mirage of sleep.

But he couldn’t focus on the music.  He couldn’t ignore a feeling that he wasn’t alone – that, in the brain of the universe, where everything that happened was concurrently recorded as public and indestructible data, he was already partially with everyone else that had died.  The information of his existence, the etching of which into space-time was the experience of his life, was being studied by millions of entities, billions of years from now, who knew him better than he would ever know himself. They knew everything about him, even his current thoughts, in their exact vagueness, as he moved distractedly towards sleep, studying him in their equivalent of middle school “maybe,” thought some fleeting aspect of Paul’s consciousness, unaware what it was referencing.

.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .

To Paul, who’d stayed mostly in his uncle’s sixteenth-floor apartment on previous visits, the vaguely tropical, consummating murmur of Taipei, from his parent’s fourteenth-floor apartment, had sounded immediately and distinctively familiar.  The muffled roar of traffic, hazily embellished with beeps and honks and motorcycles engines and the occasional, looping, Doppler-effected jingle from a commercial or political vehicle – had been mnemonic enough (reminding Paul of the 10 to 15 percent of his life on the opposite side of the Earth, with a recurring cast of characters and no school and a different language, almost fantastically unlike the other 85 to 90 percent, in suburban Florida) for him to believe, on some level, that if a place existed where he could go to scramble some initial momentum, to disable a setting implemented before birth, or disrupt the out of control formation of some incomprehensible worldview, and allow a kind of settling, over time, to occur – like a spaceship that has exhausted its fuel and begun falling towards the nearest star, approaching what it wants at a rate it’s wanted, then easing into the prolonged, perfectly requited appreciation of an orbit – it would be here.