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    The Army Sees Mortars as Safe. Troops Report Signs of Brain Injury.

    After firing about 10,000 mortar rounds during four years of training, one soldier who joined the Army with near-perfect scores on the military aptitude test was struggling to read or do basic math.Another soldier started having unexplained fits in which his internal sense of time would suddenly come unmoored, sending everything around him whirling in fast-forward.A third, Sgt. Michael Devaul, drove home from a day of mortar training in such a daze that he pulled into a driveway, only to realize that he was not at his house but at his parents’ house an hour away. He had no idea how he got there.“Guys are getting destroyed,” said Sergeant Devaul, who has fired mortars in the Missouri National Guard for more than 10 years. “Heads pounding, not being able to think straight or walk straight. You go to the medic. They say you are just dehydrated, drink water.”All three soldiers fired the 120-millimeter heavy mortar — a steel tube about the height of a man, used widely in training and combat, that unleashes enough explosive force to hurl a 31-pound bomb four miles. The heads of the soldiers who fire it are just inches from the blast.The military says that those blasts are not powerful enough to cause brain injuries. But soldiers say that the Army is not seeing the evidence sitting in its own hospital waiting rooms.In more than two dozen interviews, soldiers who served at different bases and in different eras said that over the course of firing thousands of mortar rounds in training, they developed symptoms that match those of traumatic brain injury, including headaches, insomnia, confusion, frayed memory, bad balance, racing hearts, paranoia, depression and random eruptions of rage or tears.Troops of the First Armored Division fire rounds from a carrier-mounted mortar during a training exercise in New Mexico in 2017.Killo Gibson/U.S. Army, via Department of DefenseThe military is confronting growing evidence that the blasts from firing weapons can cause brain injuries. So far, though, the Pentagon has identified a potential danger only in a few unusual circumstances, like firing powerful antitank weapons or an abnormally high number of artillery shells. The military still knows little about whether routine exposure to lower-strength blasts from more common weapons like mortars can cause similar injuries.Answering that question definitively would take a large-scale study that follows hundreds of soldiers for years, and it is impossible to draw sweeping conclusions from a handful of cases. But the soldiers interviewed by The New York Times have experienced problems similar enough to suggest a disturbing pattern.Most soldiers said they had fired at least 1,000 rounds a year in training, often in bursts of hundreds over a few days. When they were new at firing, they said, they felt no lasting effects. But with each subsequent training session, headaches, mental fogginess and nausea seemed to come on quicker and last longer. After years of firing, the soldiers experienced problems so severe that they interfered with daily life.Nearly all of the soldiers interviewed for this article never saw combat, but they were nonetheless haunted by nightmares, anxiety, panic attacks and other symptoms usually attributed to post-traumatic stress disorder. Nearly all sought medical help from the Army or the Department of Veterans Affairs and were screened for traumatic brain injury, but did not get a diagnosis. Instead, doctors treated individual symptoms, prescribing headache medicine, antidepressants and sleeping pills.That is in part because of how traumatic brain injuries, known as T.B.I.s, are diagnosed. There is no imaging scan or blood test that can detect the swarms of microscopic tears that repeated blast exposure can cause in a living brain. The damage can be seen only postmortem.So, doctors screening for T.B.I.s ask three questions: Did the patient experience an identifiable, physically traumatic event, like a roadside bomb blast or car crash? Did the patient get knocked unconscious, see stars or experience other altered state of consciousness at the time? And is the patient still experiencing symptoms?For a T.B.I. diagnosis, the answer has to be yes to all three.U.S. Army paratroopers fire a mortar barrage at a training area in Germany in 2022. Kevin Payne/Department of DefenseThe problem is that people who are repeatedly exposed to weapons blasts often cannot pinpoint a specific traumatic event or altered state of consciousness, according to Stuart W. Hoffman, who directs brain injury research for the V.A. With career mortar soldiers, he said, “if you’re not feeling the effects at the time, but you’re being repeatedly exposed to it, it would be difficult to diagnose that condition with today’s current standards.”That means injuries that seem obvious to soldiers go unrecorded in official records and become invisible to commanders and policymakers at the top. As a result, weapons design, training protocols and other key aspects of military readiness may fail to account for the physical limits of human brain tissue.An Army spokesman, Lt. Col. Rob Lodewick, said in a statement that for decades the Army has been studying how to make weapons safer to fire and is “committed to understanding how brain health is affected, and to implementing evidence-based risk mitigation and treatment.”Asked if the Army plans to phase out the use of the 120-millimeter mortar, a mobile weapon that nearly all infantry units use to rain down bombs on enemy positions, Colonel Lodewick said no.Still, there are signs that the Army sees problems with the mortar. It is developing a cone for the muzzle to deflect blast pressure away from soldiers’ heads. And in January, the Army issued an internal safety warning, drastically limiting the number of rounds that soldiers fire in training to no more than 33 rounds a day using the weakest charge, and no more than three rounds a day using the strongest.That warning, though, makes no mention of brain injury; the stated purpose is to protect troops’ hearing.The military measures the force of blast waves in pounds of pressure per square inch, and the current safety guidelines say that anything below 4 PSI is safe for the brain. The blast from firing a 120-millimeter mortar officially measures at 2.5 PSI. But the guidelines do not take account of whether a soldier is exposed to a single blast or to a thousand.There are roughly 9,000 mortar soldiers in the Army — and, in all service branches, there are thousands more troops who regularly use weapons that deliver a similar punch: artillery, rockets, tanks, heavy machine guns, even large-caliber sniper rifles.Justin Andes, 34, launched about 10,000 mortar rounds in Army training at Fort Johnson, La., between 2018 and 2021.He began to experience migraines, dizziness and confusion, to such a degree that his job of keeping accurate counts of weapons in his unit’s armory became a struggle. Eventually he had an emotional breakdown with thoughts of suicide, and he left the Army in dismay when his enlistment ended.Justin Andes launched about 10,000 mortar rounds in Army training at Fort Johnson, La., between 2018 and 2021.Chase Castor for The New York Times“We had to keep a count of every round we fired, and get the mortar tubes inspected each year, because all those blasts can take a toll on the weapons system,” he said in an interview. “But no one was doing that for us.”Mr. Andes joined the Army with a college degree and top scores on the military aptitude test. He had planned to get a graduate degree in political science, but after firing so many mortar rounds, he had trouble reading. Today, Mr. Andes, who now lives in Jefferson City, Mo., speaks with a slight slur, sometimes puts the milk in the kitchen cupboard instead of the refrigerator, and spends much of his time in his basement.“His voice is different, he acts different, he is a different person from the man I married,” his wife, Kristyn Andes, said. “I didn’t start to connect the dots that this might be mortars until some of the other wives said they were having the same issues.”The first sergeant in charge of Mr. Andes’ platoon, she said, was having trouble, too. He was forgetting words, struggling to remember his responsibilities and had a stammer in his speech and a tremor in his hand.Another soldier in his platoon, James Davis, 33, started having near-daily panic attacks in uniform, as well as balance problems, migraines and sensitivity to light. He went to a specialty clinic for traumatic brain injury at Fort Johnson in 2022. “I was told that with time, the symptoms would disappear,” said Mr. Davis, who now lives in Colorado Springs, in an interview. “I am still waiting for that to happen.”The 120-millimeter mortar is a widely used weapon among American combat troops. Marines fired mortar rounds in Afghanistan in 2017.Lucas Hopkins/U.S. Marines, via Department of DefenseMr. Andes, Mr. Davis and their first sergeant all left the Army without any official record that their brains may have been injured by mortar blasts. All three went to the V.A. for help. All three were found to be substantially disabled by issues that can be caused by traumatic brain injury, like vertigo, headaches, anxiety and sleep apnea. But not one was diagnosed with a brain injury.Former soldiers who fired mortars in the 1980s and 1990s say their experiences show that the problems are not new and may not improve with time.“It’s hard for me to piece together, because my memory has gotten so bad, but things are definitely getting worse,” said Jordan Merkel, 55, who joined the Army in 1987 and fired an estimated 10,000 mortar rounds over four years.In uniform, Mr. Merkel started experiencing strange fugue states, where he would be awake but barely responsive and would retain little memory afterward of what had happened.After the Army, he tried college but spent most of the time struggling through remedial classes. He married and divorced three times and said that he remembers very little about those relationships.For years he worked testing security software — a job with a predictable routine that allowed him to get by. But in 2016, he forgot how to do his work: Procedures he’d been following for years drew a blank.He was soon laid off, got a similar job and was laid off again. He has recently noticed trouble reading an analog clock.“I’m really concerned,” said Mr. Merkel, who now lives in Harrisburg, Pa. “This is not normal aging, this is something else.”He went to the V.A. this spring seeking help. The medical staff asked whether he had ever hit his head or been knocked unconscious, but they seemed dismissive when he brought up mortars, he said.“They weren’t the least bit interested in discussing anything related to blast concussion,” he said.Todd Strader had a similar experience. He fired mortars in the 1980s and 1990s at a U.S. base in Germany, and he developed headaches so severe that he would collapse on the ground and vomit. He was hospitalized in the Army for unexplained intestinal problems — a common issue among people with traumatic brain injuries. As a civilian, he struggled with fractured concentration, fatigue and anxiety.Todd Strader fired mortars in the 1980s and 1990s at a U.S. base in Germany. He developed headaches so severe that he would collapse on the ground and vomit.Matthew Callahan for The New York Times“I had plans for myself after the Army,” said Mr. Strader, 54, who now lives in Hampton, Va. “I wanted to travel the world but just ended up working a string of dead-end jobs.”He went to the V.A. in 2019 and was told that there was nothing in his record to suggest a military service-associated brain injury. Instead he was diagnosed with PTSD, even though he had never been in combat.Frustrated that the V.A. would not recognize what seemed obvious to him, he started a Facebook group, hoping to find other mortar soldiers with the same symptoms. The group now has nearly 2,500 members.The Pentagon has repeatedly assured Congress that the military is giving new attention to blast exposure, but ordinary soldiers say they have seen little change.Sergeant Devaul, who drove home to the wrong house, is now trying to get the Army to recognize that years of firing mortars injured his brain. He hasn’t had much luck.At his kitchen table in Kansas City, Mo., on a recent morning, he described how for 18 years he fired mortars, and how his life slowly fell apart.He started in the active-duty Army in 2006 and transferred to the National Guard in 2010. He deployed twice but never saw combat.After years of firing, he started to have trouble thinking. He had a civilian job doing carpentry but struggled with the math and organizational skills and left in frustration. He worked as a security guard for several years, but he developed headaches and concentration problems, and had outbursts of rage.Then he got a break from firing. For much of 2017 and 2018 he was in Qatar on a mission with no mortars and then in training away from the mortar range. He began feeling clearer and calmer. He studied to become an emergency medical technician and, in 2019, got a job with his local fire department.A slow-motion video provided by Sgt. Michael Devaul shows the training in 2021 that left him so dazed that he drove home to the wrong house.But that summer he resumed firing mortars. He started struggling to remember where supplies were kept in his ambulance. Other firefighters told him that he seemed to spend much of his time staring at nothing. The department asked him to learn to drive a fire truck, but he doubted that he could pass the test.In the fall of 2021 he was firing mortars in a training exercise and suddenly felt as though a seam had split in his head. He was dizzy and sick. For weeks afterward, he said, his skull was throbbing, and he was confused and angry.“I felt worthless and stupid,” he said. “I was so exhausted I could barely get off the couch. I didn’t see it getting better.”His wife filed for divorce. He became suicidal and spent five days in a program for PTSD.At his next National Guard training, it took only a few blasts to put him on the ground with the world spinning.The Guard now lists him as temporarily disabled by what it calls “post-concussion syndrome.” He is not allowed to fire mortars or even rifles.Since Sergeant Devaul can’t do his military job, the Guard has begun the process of discharging him. If it decides his injuries are service-related, he’ll be medically retired with lifetime benefits. If not, he’ll be forced out with next to nothing.Sergeant Devaul met recently with his brigade’s surgeon to be evaluated for traumatic brain injury. He said the doctor seemed skeptical that firing mortars could cause his symptoms.“I kept asking, ‘What else could have caused it?’ He didn’t have an answer,” he said. “I’ve got every single symptom of a traumatic brain injury. I just don’t have a diagnosis.” More

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    Bacteria That Cause Meningitis Are Spreading Again, C.D.C. Warns

    The NewsFederal officials are warning health care providers to be on the lookout for invasive meningococcal disease, a rare but potentially deadly illness that has increased in prevalence in recent years and requires prompt treatment with antibiotics to prevent long-term disability or death.Colonies of Neisseria meningitidis bacteria, which cause meningococcal disease.Brodsky/CDC, via Associated PressBy the Numbers: A rising fatality rate.The illness is caused by infection with a bacterium called Neisseria meningitidis. Last year, 422 cases of invasive meningococcal disease were reported in the United States, the highest number since 2014, according to the Centers for Disease Control and Prevention.But as of Monday, 143 cases have been reported to the C.D.C. so far this year, 62 more than the number of cases reported last year during the same period.The illness is extremely dangerous. Even with appropriate treatment, 10 to 15 percent of patients who develop meningococcal disease will die. Many recent cases were caused by an unusual strain of N. meningitidis called ST-1466. This strain caused 17 deaths among 94 patients whose outcomes are known, a fatality rate of 18 percent.Survivors of meningococcal disease may be left with long-term disability, deafness, amputations or brain damage.The Mystery: What’s causing the outbreaks?A majority of people affected in the recent outbreaks were Black people and adults ages 30 to 60.Others who are susceptible to the infection include people living with H.I.V., who account for 15 percent of patients; individuals who have had their spleens removed; people with sickle cell disease; and patients with certain rare immune conditions.A meningitis vaccine that protects against four of six N. meningitidis types — including group Y, which includes ST-1466 — is recommended for adolescents as well as those with medical conditions like H.I.V. Most older adults have not received the vaccine.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    New Havana Syndrome Studies Find No Evidence of Brain Injuries

    The findings from the National Institutes of Health are at odds with previous research that looked into the mysterious health incidents experienced by U.S. diplomats and spies.New studies by the National Institutes of Health failed to find evidence of brain injury in scans or blood markers of the diplomats and spies who suffered symptoms of Havana syndrome, bolstering the conclusions of U.S. intelligence agencies about the strange health incidents.Spy agencies have concluded that the debilitating symptoms associated with Havana syndrome, including dizziness and migraines, are not the work of a hostile foreign power. They have not identified a weapon or device that caused the injuries, and intelligence analysts now believe the symptoms are most likely explained by environmental factors, existing medical conditions or stress.The lead scientist on one of the two new studies said that while the study was not designed to find a cause, the findings were consistent with those determinations.The authors said the studies are at odds with findings from researchers at the University of Pennsylvania, who found differences in brain scans of people with Havana syndrome symptoms and a control groupDr. David Relman, a prominent scientist who has had access to the classified files involving the cases and representatives of people suffering from Havana syndrome, said the new studies were flawed. Many brain injuries are difficult to detect with scans or blood markers, he said. He added that the findings do not dispute that an external force, like a directed energy device, could have injured the current and former government workers.The studies were published in The Journal of the American Medical Association on Monday alongside an editorial by Dr. Relman that was critical of the findings.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    Multitasking Is a Bad Habit. Here’s How to Stop (Kind of).

    We can’t really do more than one thing at a time, experts say. But these tactics can help.Multitasking is just the way many of us live. How often do you text while stuck in traffic, lose track of a podcast while doing chores, or flutter between the news and your inbox?“We get stuck in this multitasking trap even without realizing that we’re doing it,” said Nicole Byers, a neuropsychologist in Calgary, Alberta, who specializes in treating people with burnout.There are a few reasons for our collective habit, she added. Most of us avoid boredom if we can, Dr. Byers explained, and multitasking is a reliable way to ward it off.There’s also a lot of pressure to do it. “How many times have we seen a job posting that says, ‘Must be an excellent multitasker’?” she asked. “Our modern world — where so many of us spend most of the day on screens — really forces our brain to multitask.”The fact remains that we’re not great at doing it, and it’s not great for us. But there are ways we can be smarter in our approach.Your brain on multitaskingFirst, “multitask” itself is typically a misnomer. According to experts, it’s not possible to do two things at once — unless we can do one without much thinking (like taking a walk while catching up with a friend).We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    Traumatic Brain Injury Found in Maine Gunman Could Have Wide Ramifications

    Exposure to blasts, even at low levels, may play a much greater role in veterans’ mental health struggles than has been known, with implications for treatment strategies and for criminal justice.Shredded connections deep in the brain. Battered and scarred blood vessels that are no longer able to support neurons. Clumps of dead cell debris marking a long pattern of injury.The results of the autopsy of Robert R. Card II, the Army Reservist who killed 18 people, then himself, in the deadliest shooting in Maine’s history, left little question that his brain was profoundly damaged. But the finding raises other questions that have broad implications for the military and for the nation’s millions of veterans.Mr. Card was a grenade range instructor who never deployed to combat. He is not known to have ever hit his head in a serious car crash, he never played football, and he does not appear to have had any other accidents that might account for the damage to his brain.His only exposure came from routine training blasts on the training range — at a level that is supposed to be safe.If those blasts were still strong enough to profoundly damage his brain, as it appears happened, then how many other troops are being exposed to the same risk? How many veterans may be struggling with similar injuries that have gone unseen or been misunderstood? How should those veterans be treated if they seek mental health care, or are accused of crimes?“The implications are just so large,” said Frank Larkin, a former Navy SEAL and sergeant-at-arms of the U.S. Senate, whose son, Ryan, also a Navy SEAL, died by suicide and was found to have extensive brain damage from blasts.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    Lewiston Shooting Panel Presses Army Reservists on Maine Gunman

    A commission in Maine asked former colleagues of the shooter about key moments of inaction before the rampage. A commission investigating the October mass shooting in Lewiston, Maine, interrogated Army Reserve colleagues of the gunman, Robert R. Card Jr., at a hearing Thursday, pressing for answers about their failed efforts to prevent him from inflicting harm and eliciting some of the most detailed accounts yet of the months leading up to the rampage. Members of the commission drilled down on key moments of inaction by military supervisors who knew of the shooter’s threats, erratic behavior and access to weapons, seeking accountability among the multiple law enforcement agencies and military personnel who traded concerns about Mr. Card, as his mental state deteriorated last year.“Since families can’t police their own, was it a very good plan that relied on the family to remove his weapons?” George Dilworth, a former assistant U.S. attorney for the District of Maine and a commission member, asked Army Reserve Capt. Jeremy Reamer, who was involved in the response to Mr. Card’s worrisome behavior.After a failed attempt by the local sheriff’s office to check on Mr. Card’s welfare in September, authorities conferred with his family on a plan for them to secure his firearms. “I didn’t know the family dynamic, so I can’t comment on that, but it was a plan, and in my experience, a viable plan,” said Capt. Reamer, his voice quiet and his demeanor solemn as he sat alone at the witness table.On the night of Oct. 25, Mr. Card, a 40-year-old Army Reserve grenade instructor, shot and killed 18 people at two popular recreation venues in Lewiston, a bowling alley and a bar where cornhole enthusiasts gathered to unwind. After a two-day manhunt for the missing gunman, he was found dead of a self-inflicted gunshot wound.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    Death of David Gail, ‘Port Charles’ Star, Was Drug Related, Publicist Says

    The 58-year-old actor, who was also on “Beverly Hills, 90210,” died last month in a Tampa, Fla., hospital days after going into cardiac arrest.David Gail, the “Port Charles” and “Beverly Hills, 90210” actor who died in a Tampa, Fla. hospital on Jan. 16, had been intoxicated from a mix of drugs and alcohol that caused him to go into cardiac arrest, his publicist said on Tuesday.A number of drugs were found in Mr. Gail’s system, including amphetamines, cocaine, alcohol and fentanyl, according to a statement from the publicist, Linda Brown. The cardiac arrest led to a brain injury, which ultimately caused his death days later, she said.The Hillsborough County Medical Examiner did not immediately respond to a request for Mr. Gail’s autopsy report on Tuesday evening.The family previously said that Mr. Gail, 58, had died from complications from a sudden cardiac arrest.Paramedics who found Mr. Gail after he went into cardiac arrest performed CPR and used a defibrillator to try to revive him, but he ultimately wound up on life support at the hospital, according to Ms. Brown.Mr. Gail’s mother, Mary Painter, said in the statement that her son had for years been reliant on medication to manage pain from hand and wrist surgeries that kept him out of work for nearly a decade.“It breaks my heart to learn my son died this way,” Ms. Painter said, adding, “I can only assume that his former dependence played a part in self-medicating from uncontrolled sources.”Her son’s death, she said, highlighted victims of pharmaceutical addiction and the fentanyl epidemic.Mr. Gail had a bountiful television acting career in the mid- to late 1990s, including his most prominent role, as Dr. Joe Scanlon on the “General Hospital” spinoff show “Port Charles.” Mr. Gail played Dr. Scanlon in 216 episodes in one season, which ran in 1999 and 2000, according to IMDb.Years before that, Mr. Gail appeared on eight episodes of “Beverly Hills, 90210,” playing a minor part in an episode in the first season and returning to the show for the fourth season in a more established role.“When I came back it was such a shock, I was asking, ‘How could I possibly come back?’” Mr. Gail said about his return on the “Beverly Hills Show Podcast” in 2021.“But it worked,” he added.He also made dozens of appearances in a variety of television shows throughout the 1990s and several films in the 2000s. More

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    A ‘Corpsicle’ Came Back to Life on ‘True Detective.’ Is That Possible?

    An incident involving a group of frozen bodies on the fourth season of the HBO series has raised some scientific questions.The men lay frozen naked in a ghoulish pile, with mouths agape and eyes glazed over, their hair encrusted with ice and snow. They were all dead — or so the investigators on the HBO series “True Detective: Night Country” thought.Frozen bodies are a familiar problem in this fictional Alaska town near the Arctic Circle, but this giant “corpsicle” is unusual. And so is what happens at the end of the episode, which aired last Sunday: one of the men wakes up when his arm is accidentally snapped off by an officer.The resurrection has sparked grisly speculation among some fans: How can a person be living, a viewer on Reddit asked, if that person’s limbs are so frozen? “They could have been flash frozen in a moment of terror” at the moment of their deaths, another speculated. Many were skeptical that the human body could survive such an ordeal and wondered if the show was straying into the supernatural.Doctors say that it is impossible for a completely frozen person to make a recovery. But it is possible for someone who appears frozen — limbs stiff, skin cold and hard, and without a pulse or breath — to be resuscitated, depending on how long the person has been out in the cold.“If all the tissue in your body is ice, or has ice in it, then you’re not coming back,” said Ken Zafren, a physician and a professor of emergency medicine at Stanford University, who also works in Alaska. But, he added, “I’ve seen plenty of cases in which the person really looked dead, and could come back.”During hypothermia, an adult’s body temperature can cool well below the normal average of 98.6 degrees, Dr. Zafren said. A person’s pulse and breathing slow significantly, reducing the body’s need for oxygen. Eventually, the person may go into cardiac arrest, stopping the pulse and breathing altogether. But because the brain is cold, the lack of oxygen takes longer to cause damage, he said.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber?  More