outsiders who then leave to sell ceremony. Orientation – The door may face a sacred fire. The cardinal directions may have symbolism in the culture that is holding the sweating ceremony. The lodge may be oriented within its environment for a specific purpose. Placement and orientation of the lodge within its environment are often considered to facilitate the ceremony's connection with the spirit world, as well as practical considerations of usage. Construction – The lodge is generally built with great care and knowledge, and with respect for the environment and for the materials being used. Clothing – In Native American lodges participants usually wear a simple garment such as shorts or a loose dress. Modesty is important, rather than display. Risks Physical effects Even people who are experienced with sweats, and attending a ceremony led by a properly trained and authorized traditional Native American ceremonial leader, could suddenly experience problems due to underlying health issues. It is recommended by Lakota spiritual leaders that people only attend lodges with authorized, traditional spiritual leaders. There have been reports of lodge-related deaths resulting from overexposure to heat, dehydration, smoke inhalation, or improper lodge construction leading to suffocation. If rocks are used, it is important not to use river rocks, or other kinds of rocks with air pockets inside them. Rocks must be completely dry before heating. Rocks with air pockets or excessive moisture could crack and possibly explode in the fire or when hit by water. Previously used rocks may absorb humidity or moisture leading to cracks or shattering. Deaths The following is a list of reported deaths related to non-traditional "New Age" sweat rituals: Gordon Reynolds, 43 (died November 21, 1996) Kirsten Babcock, 34 (died 2002) David Thomas Hawker, 36 (died 2002) Rowen Cooke, 37 (died 2004) Paige Martin, 57 (died July 17, 2009) Kirby Brown, 38, of Westtown, NY (died October 9, 2009 at retreat led by James Arthur Ray) Lizbeth Neuman, 49, of Prior Lake, MN (died October 17, 2009 due to injuries sustained at retreat led by James Arthur Ray) James Shore, 40, of Milwaukee, WI (died October 9, 2009 at event led by James Arthur Ray) Chantal Lavigne, 35, (died July 2011 in Sherbrooke, Québec, after event led by Gabrielle Fréchette) Sedona deaths and Lakota Nation lawsuit In October 2009, during a New Age retreat organized by James Arthur Ray, three people died and 21 more became ill