ERA - The Mass Extended
In August 2017, the USS Bataan received a mass casualty incident (MCI) of 6 foreign special forces operators after a helicopter crash. All 6 patients were medically evacuated successfully to the USS Bataan, and all patients survived and were successfully returned to their allied country. Four of the patients received whole blood with 2 receiving over 10 units of blood or massive transfusions. One patient required 44 units of blood, and at 1 point in his resuscitation, he received 12 units of whole blood every 30 minutes. Due to administrative factors outside of the ship's control, these 6 patients had prolonged stabilization during the MCI. This factor differentiates this MCI on the USS Bataan from previous cases. Internal medicine trained physicians with their expertise in inpatient care, postsurgical management, and critical care were instrumental in sustaining these casualties in this prolonged stabilization environment. In the era of distributed maritime operations, where casualty-receiving ships will experience more geographic and resource isolation, there is a potential for the need for prolonged stabilization above the 6 to 12-hour window typical of role II platforms. The known increase in cardiac and pulmonary morbidity and mortality with medical evacuation delay highlights the importance of internal medicine physicians in the role II setting. It is critical that we emphasize the inpatient and critical care principles of these patients in the prolonged field care environment.
The consequences of mass incarceration then may extend far beyond the costs to the individual bodies behind bars, and to the families that are disrupted or the communities whose residents cycle in and out. The criminal justice system may itself legitimate and reinforce deeply embedded racial stereotypes, contributing to the persistent chasm in this society between black and white.
In an attempt to resolve the substantive and methodological questions surrounding the consequences of incarceration, this book provides both an experimental and an observational approach to studying the barriers to employment for individuals with criminal records. The first stage observes the experiences of black and white job seekers with criminal records in comparison to equally qualified nonoffenders. In the second stage, I turn to the perspectives of employers in order to better understand the concerns that underlie their hiring decisions. Overall, this study represents an accounting of trends that have gone largely unnoticed or underappreciated by academics, policy makers, and the general public. After thirty years of prison expansion, only recently has broad attention turned to the problems of prisoner reentry in an era of mass incarceration. By studying the ways in which the mark of a criminal record shapes and constrains subsequent employment opportunities, this book sheds light on a powerful, emergent mechanism of labor market stratification. Further, this analysis recognizes that an investigation of incarceration in the contemporary United States would be inadequate without careful attention to the dynamics o