Natasha Dow Schull, Addiction by Design: Machine Gambling in Las Vegas (Princeton University Press, 2012).
This is a book about gambling machines.
Gambling machines are everywhere. They occupy most of the floorspace in casinos, which have found them more profitable than traditional gaming tables. Arcades are full of them. They are in supermarkets, pharmacies, restaurants, bars, even car washes.
At their conventions representatives of the gambling industry discuss how to design machines that will maximize ‘revenue per available customer.’ How to get people to gamble longer, faster, and more intensively.
Bob Stupak, CEO of Las Vegas Stratosphere, put it like this:
When we put in 50 slot machines, I always consider them 50 more mousetraps. You have to do something to catch a mouse. It’s our duty to extract as much money as we can from customers.
What happens when a mouse – oops, a customer – has a heart attack?
The author recounts how she happens to meet a team of paramedics drinking coffee as they stand around an ambulance outside a Las Vegas hospital. They are happy to chat with her about their job.
When a call comes in from a casino, they tell her, it’s usually because a gambler has had a heart attack. But it’s hard to get into — or out of — a casino.
They won’t let you pull in at the main entrance. Bad for business. The sight of an ambulance might inspire second thoughts in nervous visitors. So the paramedics have to park around the back and enter through side doors.
Once inside, they have to find their way face through a labyrinthine layout, designed to make it hard for gamblers to leave:
It all looks the same. You go up and down elevators, there are no direct It routes, the carpets lead you around and around, you lose your sense of direction.
Once they locate the patient, they have to deal with another problem – the reluctance of other gamblers to leave their machines.
I remember once the gamblers just wouldn’t move to let us out. I had to start an intravenous line in a narrow aisle between two rows of machines.
Although they reach the casino within 4—5 minutes of a call, they take an average of 11 minutes to reach the patient. Every minute lost following a cardiac arrest reduces the patient’s chance of survival by 10%. The average loss of five minutes almost halves that chance.
The author watches a video taken by a surveillance camera. It shows a gambler collapsing suddenly onto the person next to him, who doesn’t react at all. The man slips to the floor in the throes of a seizure. Two passersby stretch him out… Few gamblers in the immediate vicinity move from their seats… Play continues unabated all around him… Despite the unconscious man lying at their feet, touching the bottoms of their chairs, the other gamblers keep playing (pp. 20, 22, 29—32).
Medical specialists advise against having a heart attack while at a casino.
Capitalism is dangerous for your health.
Mice of the world, unite!