Should ambulance crews be allowed to carry weapons?
Those who fear or do not understand weapons always make dire predictions of fanciful scenarios when firearms restrictions are eased
It was supposed to be a routine seizure call.
We were barely inside the door when a hand grabbed me from behind and spun me around, and a face that towered over me by at least six inches growled, "You got 10 seconds to help my mama, white boy, and then I'm gonna kick your [expletive deleted] ass."
Behind me, on the floor next to the couch, lay his middle-aged mother, in the throes of an epic faked seizure. I'd dealt with her before and always treated her professionally, despite what I knew was attention-seeking behavior.
Without taking my eyes from his, I set down my cardiac monitor and oxygen cylinder, keyed up my radio and asked for police assistance at the scene ASAP. I tried to look as friendly as I could and said gently, "We're here to help, man. If you want us to help your mother, first we have to assess her. Threatening me only slows things down."
His response was to cock his fist and crowd me further.
I backed away, told my partner to run to the truck, lock herself inside and scream for help on the radio.
Luckily, cooler heads prevailed, and his friends manhandled him out of the house long enough for me to do a hurried assessment of his mother and bodily carry her and my gear outside to the cot. As I pushed the stretcher to the rig, I could see him in my peripheral vision, being restrained by his friends in the neighbor's yard.
Before I could load the cot into the rig, he broke away from his friends and charged across the yard, fists cocked and ready to rumble. I calmly pushed my partner back into the rig and sidestepped to put the cot between me and him. As he rushed me, I set my feet and prepared to brain him with my portable oxygen cylinder.
And I remember thinking quite clearly, "I'm the one they called to help, yet I'm going to have to kill this guy or let him kill me."
Luckily, nobody's skull got caved in that night. The police arrived just in time, with our area supervisor hot on their heels. But it was a harsh reminder that no scene is every truly safe, and my partner learned an ugly lesson in her second night on the job that not everyone sees us as the good guys.
Unfortunately, such incidents are not uncommon in modern EMS. Most EMTs who have been practicing for some time can share a similar story, and there are plenty who work in grittier settings than I who have to contend with the threat of violence on an almost daily basis.
In September 2012, a gunman fired on a Fort Wayne, Ind., ambulance carrying a stabbing victim to the ED, injuring a medic and wounding three others. The rig was hit 17 times.
In June, 2012 an ALS ambulance in Houston was shot at four times, and in September 2012 two New Zealand teens hijacked an ambulance manned by a solo paramedic, threatening to kill her unless she drove their overdosed friend to the hospital.
Violence is a reality in our profession
The question is how do we deal with it?
At least one fire chief is considering arming his EMTs. Chief Tim Holman of the German Township Fire Dept in Clark County, Ohio, is considering the merits of allowing concealed carry for ambulance crews. Chief Holman addressed the issue at last year's EMS World Expo in a presentation entitled, "Is It Time We Arm Our EMTs?"
Holman's crews have been assaulted on numerous occasions, and he himself has twice stared down the barrel of a gun on an ambulance scene. Chief Holman has stated that he is simply studying the issue, and current township policies forbid EMT's carrying firearms.
It's a question that bears careful consideration.
In Va., Gov. Bob McDonnell is looking to continue a trend of easing firearms restrictions by allowing EMS crews to carry concealed weapons on the job. If passed, the measure would remove a state prohibition forbidding it. Public comments are currently overwhelmingly — if not unanimously — in favor of repealing the prohibition.
At least one paramedic and educator thinks a more measured approach is called for. Kip Teitsort, a Mo. paramedic and veteran police officer, believes there is no question that EMTs need more training in avoiding and escaping violent encounters but that they lack the proper training to utilize firearms for personal protection on the job.
In an interview in the Dayton Daily News, Teitsort said, "I am fully for people carrying guns, but I am just not for EMS providers carrying guns on scene."
Kip teaches a nationally-recognized defensive tactics class for EMS and firefighters, and I believe similar training should be mandatory for all EMS crews. EMS training in situational awareness, non-violent conflict resolution, avoidance and non-lethal defensive tactics is rudimentary, at best. We need more, and the streets are a harsh teacher.
As a lifelong Second Amendment advocate, I have a biased perspective. I believe that self-defense is first and foremost a personal responsibility. Every moment I am off-duty, I carry a firearm. I hold a concealed handgun license, and I train regularly. I fire more rounds and practice with my weapon more diligently than the vast majority of police officers I know.
But most importantly, I long ago made the mental decision over which circumstances I felt justified in taking someone's life. Carrying a weapon is a huge responsibility, and not everyone is ready for it. I know that when I am carrying a weapon, I am more acutely aware of my surroundings, gentler with my speech, and less likely to engage in confrontation because I know the consequences. In short, I'm a big, fat chicken… with a pistol strapped to my hip. I will run away from a fight every time; just don't be unlucky enough to catch me.
Weapon is the mindset
As most defensive trainers will tell you, the gun is just a tool. The weapon is the mindset. With a combat mindset and good training, even the most innocuous objects can be lethal weapons. It doesn't take a gun, but even a trained guy with a pair of trauma shears is still at a major tactical disadvantage when facing an untrained guy with a firearm.
The combat mindset is fundamentally at odds with our focus as healthcare providers. Are you ready to develop that mindset? Are you honestly willing to look at your patients as potential threats and not as people in need of your help? That's the mindset necessary to defend yourself effectively with a firearm, and even with a lifetime of gun handling and shooting behind me, I worry about what effect it will have on my interactions with my patients.
The most valuable part of my concealed handgun permit class was not the shooting. That qualification was ridiculously easy. Even the firearms qualification course for La. law enforcement officers is not that difficult.
What was valuable was the two days of classroom instruction on self-defense laws and non-violent conflict resolution. If my instructor said it once, he said it a hundred times: "The only sure way to win a gunfight is not to engage in one."
Expand that classroom instruction to a week or more, perhaps incorporate a class somewhat like Kip's, and then you might have something approaching adequacy in teaching a medic the responsibilities of going armed on the job.
Ultimately, I can make a prediction on what will happen if Virginia allows EMS crews to carry concealed weapons: nothing.
Nothing, except that ambulances in Virginia will no longer be de facto victim disarmament zones.
Those who fear or do not understand weapons always make dire predictions of fanciful scenarios when firearms restrictions are eased, and those predictions keep not happening. What will happen, if the government and the employers allow concealed weapons, is that the medics who already possess concealed handgun permits will simply start to carry them at work as well — and not all of them will even do that. They will self-select to concealed handgun permit holders, already a demographic that is among the safest and most law-abiding in our society.
Would I have shot the guy who attacked me? I honestly don't know, and I'm fervently thankful I never had to find out. More likely, I'd have administered a little topical oxygen therapy until he was no longer a threat, but if he'd pulled a gun and I'd been armed... yeah, I'd have shot him.
But the hard part isn't pulling the trigger. The hard parts are the mental preparation that leads you to that point and the emotional and legal anguish you will deal with in the aftermath. I've done that mental preparation. If you think you're ready to carry a weapon, you need to have done so as well.
It's easy to distill the decision into a trite little soundbite: "I'd rather be judged by 12 than carried by 6," but real life is a lot messier.
I invite your comments.