Part II of An Interview with Robert A. Margulies, M.D.
Interview by Gila Hayes
In February’s online journal we interviewed a semi-retired emergency room physician who, drawing upon his 50-year career in emergency medicine, identified the injuries, disability and lethality resulting from empty-hand attacks. This month, we continue our talk with him about how to thwart or preferably, prevent, an attack. If you missed our February edition, browse to https://armedcitizensnetwork.org/seriousness-of-empty-hand-attacks then return to this edition where Dr. Robert A. Margulies explores issues related to identifying dangers and reacting justifiably but quickly enough. First, a correction to last month’s interview. We introduced Dr. Margulies as “retired” when, indeed, he is semi-retired and still very active in his many pursuits. In addition to medical work, he volunteers with Doctors for Responsible Gun Ownership, furthering their mission to spread the truth about gun ownership through scientific facts and their own members’ expertise about firearms, encouraging gun safety and injury prevention through responsible gun ownership and lawful self defense. His contributions to their website are at this link .
We return now to our interview with Dr. Margulies about avoiding, countering and surviving empty hand attack.
eJournal: Last month, you gave us the sobering message that blunt force trauma, even strikes delivered by an open hand, can kill or cripple. How do you respond to the common reaction often heard at the range or gun store after the news reports a homicide by empty-handed means: “I’ll just shoot someone who tries to grab or punch me”? I rarely say “never,” but I’d like your thoughts on drawing a gun into a close-contact, physical struggle.
Dr. Margulies: First, if someone has already grabbed you, you are too far behind the curve to be able to get a firearm – especially one from concealment. We really do have to be prepared to use defensive tactics to make time and space. The average police officer needs 1.7 seconds to get a gun out of a triple retention holster and make a retention shot.
Handgun rounds, unlike rifles, are rarely stoppers. Handguns, which is what we’re more likely to have in the situations we’re talking about, aren’t stoppers. We have lots of cases where people have been shot in the liver which is a pretty bad place, and who kept going for 15-20 minutes. We have people who were gut shot who went on for a long time. Maybe if you are lucky enough to get a hit that is high enough to take out the neck or hit the head, they’ll stop.
The concept of terminal ballistics – what happens inside the body when the round hits – has to do with the kind of round, where it hits, obviously, and the motivation or drug intoxication of the attacker. A motivated attacker will take a chest hit, a gut hit, a liver hit, a spleen hit, and in the 60-90 seconds before they bleed out, do an awful lot of damage. If you hit the right spot, you can get a fast bleed out but that is less common.
If you have made some distance, how much time do you have before the individual is back on you, unless you have delivered a disabling blow? What we are really talking about is the ability, once grabbed – if awareness, avoidance and all the preliminaries have failed – to back that individual up and get them off you. Without some training, most people cannot readily do that. We are not talking about needing to be highly trained and experienced martial artists; we are talking about five or six hours of training and of course, practice after training. You need to know how to get that grabbing hand off your coat, shirt, or throat instinctively. If you must think about what to do, it is too late because the second blow is already arriving. When somebody grabs you, they intend to hit you. How much time do you have? Not enough.
eJournal: In answer to “How much time do I have?” John Farnam famously said, “You have the rest of your life.” Dynamic movement off the line of attack can buy time, but that requires recognizing the problem and getting our feet into motion.
Dr. Margulies: Can you back up safely? How much time do we have? John is absolutely right. You are either going to make it or you are not. Making it does require training.
eJournal: In February’s journal you observed how we fail to take empty-handed attack seriously enough. Do we fool ourselves by ranking potential for physical harm by an attacker’s possession of – or lack of – a weapon?
Dr. Margulies: We must eliminate the idea that one cannot be injured by an individual without a visible weapon in their hand. The danger is not the tool – the firearm, the knife, the club – the danger is the individual. The individual is the weapon; everything else is simply a tool. If the individual wishes to do harm, a kick or an open hand blow can certainly do that. That is why, personally, I study Marc MacYoung – and it is not just Marc, although he does do it so well! I also study Rory Miller and others. The keys to survive in a fight start with not being in a fight. I study awareness, avoidance, and when awareness and avoidance fail, I need to understand pre-attack indicators. [Readers, see https://armedcitizensnetwork.org/preview-recognizing-responding-to-pre-attack-indicators for an introduction to MacYoung’s work from our member education program. –Editor]
eJournal: What do we need to recognize?
Dr. Margulies: OK, let’s say you and I are in a verbal altercation. If I do this [takes off his eyeglasses], what has that told you?
eJournal: You’re getting ready to go physical, and you want your specs unbroken afterwards.
Dr. Margulies: Sometimes people just take their eyeglasses off and they put them in a pocket. That is not as concerning, but when somebody takes their glasses off, looks around and then puts them on the hood of a nearby car, that is not the same as taking their glasses off and putting them in a pocket; that is a pre-attack indicator.
eJournal: There is an intentionality, there is a meaningfulness to setting the glasses aside in a safe place; the action is out of the ordinary.
Dr. Margulies: Let’s imagine the same situation and this is what I do [rolls neck and shrugs shoulders]. Did that make you feel comfortable? What about that shoulder shrug? That loosening up movement? Watch the individual who does this and then puts one foot forward. Look out for clenching fists at one’s side.
That is why you must have a broad gaze. You cannot just look at their face. Somebody who is clenching their fists; somebody who hides one hand behind them; somebody who stares at a certain part of your body – stares at your jaw, stares at your neck – that’s a target glance. They are ranging. They are computing, internally, how close must I be to hit that target. They are not consciously thinking that but that is what their brain is doing.
eJournal: To maintain the broader view, are you suggesting staying further away from unknown people to see what their hands are doing, how they have put their feet and other preparatory steps people take before they launch?
Dr. Margulies: The problem has happened because awareness has failed, avoidance has failed, and we are now inside interpersonal space: you are now within 3 feet. Can you safely increase the distance? What is behind you? Can you check without taking your eyes off the potential attacker?
If avoidance has worked, you are not going to get into my space. My space is 6 to 8 feet because you cannot reach me without moving; you cannot throw a quick punch at 8 feet. We teach police officers that their interview distance is 6, 7, 8 feet. Close enough to be personal; not close enough to be hit. Classic instruction for police interview position is that distance, bladed so your gun is further out of their reach and easier to protect. That 6 to 8 feet gives you distance and time to react.
You must be looking for those pre-attack indicators. The pre-attack indicators are the target glance, the neck roll, the shoulder shrug, the clenching fist, the hidden hand, blading, weight shifting. If our members understand that these are not trivial, nervous movements, then expert witnesses can testify what these actions mean. These are pre-attack indicators.
The key when you are on the witness stand or are giving a deposition or talking with your attorney is knowing these indicators and being able to articulate them. You must be able to tell why you did what you did. “I know from my training that when somebody takes that half step forward and shrugs their shoulders, they are about to launch. I cannot get hit first because if I get hit first, I am behind the curve.”
eJournal: At least explaining our actions, suggests we survived the attack. That is not always true, so returning to our February interview theme, causing blunt force trauma with empty hands doesn’t require extensive martial arts training; the same damage can be inflicted by a simple thug just throwing blows without training and skills.
Dr. Margulies: Especially if you miss the pre-attack indicators and he gets the first shot in. Think about just a punch to the nose. If you’re not a skilled martial artist, you are probably not going to block that very effectively. Your reflexes won’t be to move off the mark and block fast enough because that takes practice. Focusing some of your training on something other than the gun is important. Recently, I read an article by Greg Ellifritz that it is not too tough to get 80% proficient with a handgun. 80-90% is a lot harder and your likelihood of getting past 90% proficient is low. Instead of devoting all of your time to the gun, hit the 80% proficiency mark, then spend time getting to the 80% proficiency mark in moving off the mark and blocking.
eJournal: Moving – and the bit of time it adds – is so important. In their famous book Left of Bang, Riley and Van Horn taught paying attention to anomalies to stay out of range of threats. That’s so important for armed citizens because our decisions to use force balance precariously between reacting too slowly or with too little force to stop the threat weighed against peremptorily using force before it is justifiable and even when it is justifiable, the force used must be proportional to the threat. If we go to guns too early in an evolving situation, we risk being charged with a crime.
Dr. Margulies: [chuckling] The Marine Corps actually trains infantrymen to look past the end of their rifle. I put it that way because how many drivers are barely looking past the front of the hood? Unfortunately, many if not most drivers’ point of evaluation is 50-75 feet in front of them. They do not match their speed to their attempt to evaluate. If you are on the highway, you really must be looking as far ahead as the next curve. Where is that next curve? Is it 2,000 yards away? Be out there because you are going to cover that distance quickly.
Bring that back to somebody on foot, and we find there are two aspects. One is the psychological aspect; the second is the physiological aspect. If you are walking down the street and glancing around, not searching, but glancing, internally you are looking for an anomaly. Anything out of place is the key. Psychologically, you must prepare. For example, in a doorway you must look both ways and up. Doing that has to become instinctive. You are doing that internally, but externally, you are telling an observer, “Oh, this is not an easy one.” Predators – animal predators or human predators – look for easy targets. They do not want to get hurt themselves. That would impact their ability to survive. The cougar takes out the fawn because it is easier. It is safer. That is the impression we do not want to give. We do not want to be the fawn. We are the bull elk.
eJournal: …with antlers.
Dr. Margulies: …and hooves. That is the psychological part. A lot can be avoided if people don’t want to interact with you. It requires some forced impoliteness.
Somebody asks, “Do you have a light?”
You say, “Sorry, I cannot help you.” That is going to slow them down. If someone comes past that, they are telling you, “I have chosen you. Today is your day.” You do not pick the day. The day picks you.
eJournal: At that exact moment, we only have a request for a light. We dare not under react for fear of attack, yet to preemptively bring out a gun too early in an evolving situation risks charges of assault with a deadly weapon. What is a poor, intended victim to do?
Dr. Margulies: That is where the second step comes in. [Demonstrates extending hand, palm out] “Stop, I can’t help you. STOP!” Everybody sees, because they have heard this and now they are going to look. Hopefully, there are people around, although if you are walking down a dark street at “zero two” and there’s nobody around, there are still surveillance cameras. You want to make it real clear and loud – loud enough to wake people up. Move into a balanced, forward stance. If that doesn’t stop it, you are facing an attempted battery. You’ll need to articulate, “This individual was told to stop. I said, ‘I don’t want to interact with you,’ but they continue to come at me in a menacing manner.”
“What is a menacing manner?”
“They kept coming after being told to stop.” That is not a normal, polite response. That is evidence that they intended to get into my interpersonal space against my wishes, wishes that were not implied, but loudly expressed. I presume people who want to get into your interpersonal space against your wishes, to have an evil intent.
You must be able to articulate that, but not to the officer who responds. There, you say, “Officer, I was attacked. I was forced to defend myself. I will be happy to assist in any way possible with my attorney present. No, sir, I do not want to answer any other questions. No, sir, I do not have any other information. No, sir. No, sir, No, sir.”
“Turn around and put your hands behind your back.”
It is going to go that way. OK, now, you tell your attorney what you went through, and your attorney can go to the prosecutor and say, “Look, you have surveillance video. Was my client attacking this person? No! He was attacked.”
eJournal: I would like to go back to the word picture you painted earlier using the tape loops of, “I’m sorry, sir, I cannot help you. Stop! Stop!” Recognizing the danger is critical so we can make some distance between ourselves and unusual behavior that may boil over into violence. What should we look for?
Dr. Margulies: “Hey, buddy, do you have a light?” [Demonstrates a bladed stance with his right hand in his front trousers pocket. Then, adding “even worse,” reveals a knife concealed in his hand behind his right hip.] Right now, I am 3 ½ feet from the camera [lunges forward, knife thrust forward].
Look for the hidden hand, the hand in the pocket, the set up, “Hey, buddy, do you have a light?” voiced while moving toward you. From where you stand, you cannot see the haymaker winding up, but with the next step, comes the blow.
Your articulation would be, “His hand looked as if he was holding a weapon or some other object that he did not want me to see.” Not, “that I could not see,” the phrase is “that he did not want me to see.” It is very specific phrasing. It paints a very different picture.
That is the picture that we are trying to give the prosecutor, not the responding officer on the street. Officer Jones on the street is not interested. As an officer, if I have someone who has apparently committed a violent act, my first concern is to prevent them from committing a violent act upon me and so I am going to stabilize the situation. If you are not answering my questions, I’m going to say, “Turn around and put your hands behind your back.” It is an easy thing and there is no downside for an officer who puts you in the car, takes you to the station, and let someone else deal with you. The less interaction, the shorter the report.
eJournal: Frankly, once you have given the bare details on the scene to support investigation and identification of the evidence, the less interaction, the better for you, too, so you don’t stumble into saying something against your best interest.
Dr. Margulies: Use the tape loop. “I was attacked.” If there is no one else around and you must make the 911 call, you say, “Operator, I am at the corner of Street A and Street B, and I need an ambulance and the police.”
“What is the nature of your emergency?”
“I need an ambulance and the police.” At this point, the call has already been pushed forward and operator two is already dispatching. Give the location again. Location is critical. If anything else happens, if the perpetrator starts to get up and I must go back to my gun and I drop the phone, they have got to know where I am.
The first thing is location, and you ask for the ambulance before the police. That recording will get played if it gets to court. Your lawyer can say, “Members of the jury, my client was attacked, he called 911 and his first response was to call for an ambulance.” The reason is that you, the victim of the attack, want to look less violent, less felonious, more human. You can honestly say, “I told him to stop. He kept coming and it looked as if he was trying to hide something from me in his hand. He kept coming and I told him again to stop. I defended myself.” Not, “I shot him,” but “I defended myself.”
That brings us back to the question, “How much time do you have?” You do not determine how long. The perpetrator and their level of aggressiveness determines how much time we have. The guy who starts at 7 feet and then bum rushes you, gives you 4/10 of a second to do something to stop that before you are on your back on the ground.
eJournal: Physiologically, how quickly can we get into response mode?
Dr. Margulies: For most people it takes 3/10 of a second to appreciate what is happening. In the remaining 1/10 of a second, what you do has got to be effective. That comes from training and practice.
eJournal: Is that 1/10 of a second enough time for the message to get from the brain to the feet? My feet need to react to the order, “Get moving! Get off the line of attack!”
Dr. Margulies: Yes, because with training, you can cut the 3/10 of a second into 27/100ths of a second and while that doesn’t sound like a lot, it is a 3/100ths split. That is the difference with training. The difference is understanding that when someone is standing there and then they crouch, they are not crouching to say, “I hope you have a nice day.”
If I recognize that crouch, I am already 1/10 of a second ahead, because now when he starts to move, I do not have to think, “What is he doing?” I know what he is doing! The thing to understand about Boyd’s OODA loop is that it takes you to the decision point faster. If you have trained, the orientation is already done, and the observation takes you to the decision. That is why training is crucial. Boyd trained pilots to recognize faster. Getting inside someone’s decision process means our decision must be faster.
eJournal: If you can interrupt what the aggressor intended to do, he must make a new decision, putting you farther outside that 3/10 of a second range. Now you’ve regained some of the initiative.
Dr. Margulies: My sensei says, “Someone who attacks you has a priority. Change their priority.” The aggressor’s priority is to punch me. If I am prepared and block that punch and next thing, he is taking a ridge hand to the side of the neck. I have changed his priority. This does not take decades of training.
I don’t want people to get the mis-impression that they have to become a seventh level black belt in four different disciplines to do this. They must only become 80% proficient. Being able to get out of the holster and get shots on target in 1.5 seconds is the 80% mark; practicing until you can do that in 1 second, is going to take a lot of time, money, effort, and ammunition. If you can get shots on target in 1.5 seconds – the 80%, now it’s going to do more good to get to where you can block a punch and strike.
eJournal: Those time periods still do not line up in your favor! Compare the one-and-a-half second draw to the four tenths of a second in which time an aggressor can rush, bowl you over, onto your back on the ground. There’s got to be a better plan against a surprise ambush that does not entail immediately drawing right into an aggressor who is on top of you.
Dr. Margulies: Oh, no, you are not going to draw into that. Deflection is the response to a bum rush. If I can make him go past me, he is now facing away from me and he is moving away from me. I can move into the direction from which he came, giving me more time and space.
Now I have time to set up and say, “Stop!” loud enough so that I wake people up. This is the time for the drill sergeant’s voice. You want to rattle windows, because now if he keeps coming, he has demonstrated motivation. This is not a bad time to draw to low ready; you have already been attacked. “Stop!” becomes a very emphatic command.
eJournal: Meanwhile, your feet are still moving, and you are creating more distance to avoid being disarmed.
Dr. Margulies: Do not take a gun out when someone is already in your interpersonal space. No! Hard no. We really want to emphasize staying left of bang. We are back to looking for anomalies. Three guys are walking down the street. I cross the street. It is a good time to remember “plus one” and just check across the street before you start. If they cross the street, too, now we have an anomaly. Because I am not going to outrun three teenagers, in my opinion now is the time to say something like, “OK gentlemen, this is not going to work well. I am going to go that way, and I am strongly suggesting that you do not follow me.” I have not drawn, I have not done anything except show open hands and as I move off-line, I am watching them and making it clear that I am not looking for engagement. “I am leaving. Don’t follow me.”
eJournal: The game is up; you will not be surprised. You have also notified anyone who might be watching that you disengaged.
Dr. Margulies: That is the point of the open hands, held up. People will see hands up. If the first thing they notice is a shot and they turn around and they see somebody with a gun, the brain will fill in the gap and the witness will say they saw me shoot. It won’t make any difference if the aggressors were the three young men. That is where the expert witness comes in, especially if the gun is unfired.
Learn what the common anomalies are and then extend your knowledge to recognize the more subtle anomalies, like the guy who’s leaning against the wall when it is the two guys coming down the street that you notice. Coincidence? Maybe, but maybe he is the plus one.
eJournal: The difficulty is that we cannot know in advance what the situation in which you, me, or our reader may get caught up. Maybe preemptive action means just keeping distance and a close eye on a person exhibiting worrisome behavior or demeanor. It certainly means knowing how to get to cover and how to leapfrog from there to an exit. In crowded conditions, that is no small accomplishment, and that’s something that is very real for members who live in densely populated metropolises. They must use subways and wait on train platforms, queue up for buses and get jammed into elevators. What are they supposed to do?
Dr. Margulies: There is no good answer. In the subway station, the mall, the line in the supermarket there is no good way to turn around and tell the person behind you, “Back up 6 feet.” I don’t like crowds; I try to avoid them. But people have the problem of where they live and what they do. Your question about subway stations is probably the most pertinent because in our major cities people need to go to work, they need to shop, they need to live, and so they use that transportation. The same thing is true in a bus line, the same thing is true in an airport terminal. It is a difficult environment, and most people ignore it, sometimes because they do not know what to do or because, “it can’t happen to me.” That is wrong, but that is their personal choice. Once you are aware and you have made a choice that you are going to be an EDC (everyday carry) then you have not made the choice to ignore it; you have made the choice to operate on what you know.
eJournal: It is tempting, despite recognizing abnormal behavior, to risk of getting swept into a violent situation because we really need to be on a flight or bus to fulfill a commitment. If I am queued up to get a cup of coffee or standing in the security check line at the airport, how should I react to anomalous behavior by others in the same line?
Dr. Margulies: A cup of coffee? No fuss! I am gone. At the airport? I am not alone. I have the TSA; I have police. [Demonstrates looking around, lifting his hand and calling out] “Officer?” That is going to get a lot of attention. There is going to be a crowd now. At least one TSA supervisor is going to be on the other side of the track. Officers are going to be coming directly toward you. Perfect! They will ask you what that was about. Now you must be able to articulate it. “Officer, I was just trying to get my stuff checked and through the x-ray machine, and this guy kept pushing me. I couldn’t tell if he was pushing me so I would go faster, or whether he was trying to take something from my pocket. I don’t know. All I know is that his behavior made me very concerned.” Let him talk to the cop. If he has an innocent explanation you can say, “Officer, I apologize. I misunderstood. [Demonstrates turning to address another person showing open hands] saying, “Sir, I misunderstood. I apologize! I hope there are no hard feelings. I certainly didn’t mean to cause any disruption.”
“Officer, thank you for your help.”
eJournal: People are so hesitant to speak out for fear of being wrong. We forget that we can always apologize.
Dr. Margulies: It should not be forgotten. An apology should be part of our tape loops. If we have done something that created an anomaly, we should know how we are going to resolve that situation without the officer saying to us, “Turn around and put your hands behind your back.”
eJournal: Fear of a mistake makes us unsure how far ahead of a developing situation we should preemptively try to stop what we are afraid is about to happen. Expanding our scenario beyond an interpersonal scuffle, what is the rational and proportional response to seeing another person in the security line who exhibits furtive, nervous behavior or out-of-place clothing like a heavy parka in the summer?
Dr. Margulies: I am going to do the same thing. [Raises his hand] “Officer?” because that makes everything stop and if that person has some evil intent, he is either going to be prevented or he is going to have to act now, before we get past security. I am going to be prepared to hit the deck. I am going to be prepared to run as best I can, but I am not going to ignore an anomaly that puts me in danger. I must protect me. That is my first response. Is that harsh? I understand that. In the real world, if you think you are going to protect somebody else, you had better be prepared to protect yourself, so you are able to help the other person. I do not want to be standing there when a hand grenade goes off.
While talking about crowds, we need to understand that there is evil in the world. If we figuratively and literally close our eyes to it, we will miss the danger. Think about this: We intellectually understand that the executive function in the brain does not develop until 20 to 25 years of age. Sometimes young people do things from simply the lack of the ability to process the risk. Now, who is responsible for at least 90% of the knockout games? Youth marauding through a mall, shoplifting en mass. If you try to stop them, they are not going to pay attention to your authoritative voice. They are running on adrenaline, serotonin, maybe a little methamphetamine. That is evil.
eJournal: I agree, but is it our job to interdict it? For me, I have to say, “No, not my duty!”
Dr. Margulies: It is our job to understand that evil can come to us. A crowd of children can be dangerous. I pay attention when I see a group that isn’t standing around looking at their phones and talking to each other. If they do not have anything in their hands and they are looking around, I am changing locations. I am not walking through there. Their behavior is an anomaly. Think about it just in terms of what is ordinary. How often do you see boys, girls, or a mixed group under the age of 20, that do not have their phones out and their earphones in? If you see a group and none of them are doing what is normal, move “left of bang.”
eJournal: That is an excellent illustration of clusters of anomalous behaviors. We resist reacting to one minor, out-of-place action. You have identified a cluster of three or four and chosen the smartest reaction. Just leave.
Dr. Margulies: It is not worth it. I may want something from the adjacent store, but I am willing to walk around the block first or go to that store another day. I do not need to fight my way to that store. I am not in combat and that is not a mission objective.
eJournal: That’s a good example of prioritization. Trainers often urge people to be willing to act and use deadly force to save life. Nothing wrong with that, but I think the willingness to act starts long, long before the moment when bringing out a gun is appropriate. Willingness to act means choosing not to enter a risky situation at all.
Dr. Margulies: I can honestly say that I have not been involved in a physical altercation since I retired from the military in 1989 – 30-plus years – except for a couple of times in the emergency department at the hospital and when I was on police duty. I avoid altercations because I do not want to have to explain why I punched somebody. I would rather not be there.
Am I a chicken? Sure, I don’t care; that doesn’t bother me. Going to jail? That potential bothers me, so I will try to do the best I can to avoid that. Does that mean I have made up my mind that I am never going to shoot? Oh, no, but I am not going to willingly put myself into a situation that is going to force me to shoot. Sometimes the day chooses you. It is not that you did anything wrong. You just happen to be the person walking down the street or through the mall when these two kids decided you’re the one they are going to knock over and take the watch and wallet. You must be prepared, but you do not have to go looking for it.
eJournal: Luckily, your preparation makes you more alert to the subliminal messages predators broadcast. There is an intentionality in the way the hunter eyes its prey and when you see it, you leave quickly because you recognize the hunt.
Dr. Margulies: This has two sides: We do have to be prepared and then train. There is not any question that the training is critical. In medicine, cardiac arrest or major trauma doesn’t happen all the time, but when it does happen, I don’t have time to scratch my head and ask, “Where is the book? What do I do with this?” An emergency response must come before the conscious thought happens. The training in open hands, firearms, or edged weapons must be done before you need it. The training on awareness must be done before you are surrounded by a group of 12-14-year-olds who don’t care what you want. They want what they want.
That is how I try to live.
eJournal: Thank you for putting your attitudes and beliefs into words. We should all strive to follow your example.
Meet Dr. Margulies and his wife Sara Barron, RN through their private instruction opportunities at International Emergency Consultants in Richland, WA (https://i-e-c.org/instructors/) and be sure to follow Dr. Margulies work with Doctors for Responsible Gun Ownership along with the great work all the other doctors in that group are doing.