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Protecting your own — and your patients

There’s no room for street justice in EMS, no matter how surly a drunk gets

drunk-bellows-litho.jpg

“Drunk Father,” Lithograph by George Bellows

Library of Congress, Call number FP - XX - B435

The patient was drunk, and obnoxious, and combative, and threatened us when we moved him. He threw a few punches, spit, swore and struggled to get away.

“Rescue 5 to Fire Alarm, I need a company for assistance.”

“Roger Rescue 5, nature?”

“Combative male.”

I wasn’t worried about the guy hurting me; I was more concerned that I would hurt him. It takes more than two people to restrain a combative person with some modicum of safety: the more people on scene and involved, the less chance of having to haul off and start swinging. I’m not a swinger, and have no intention of becoming one.

I held one arm, my partner the other, and we walked him toward the waiting ambulance. He had given up the fight and decided to go along, for now. Just as we were walking him in, the fire company arrived on scene.

“You guys are all set,” I said as the big rig rolled to a stop, but before the words had left my mouth one of the rear doors opened and a 6’ 4”, 250-pound firefighter stormed over.

“That’s Ryan,” he said, “He took a swing at me last week.” The firefighter moved to enter the back of the ambulance. I blocked his path.

“Not today,” I said.

“You guys are all set,” I said to the officer in charge of the fire company.

“What do you mean we’re all set?” said the firefighter, trying to get in. He had been on the job for a few years longer than me, and was liked by most of the people on the department. His aggressive attitude was great at a fire, not so much on an EMS call.

“We’ll handle it, he’s tired, you can go back in service.”

The fire officer nodded his head from the officer’s seat and beckoned his man back to the truck. They were gone as quickly as they had arrived.

Not that kind of help

Ryan grew impatient and began mouthing off. We put him onto the stretcher, strapped him in, took some vital signs and a blood glucose test while he struggled.

“We could have used some help,” said my partner, a new guy who had yet to see the kind of street justice that had arrived.

“I can do without that kind of help.”

The last time I had worked with “Brutus,” he threw a couple of cheap shots at a 16-year-old kid who had been mouthing off at a group home and got a little squirrelly with us during transport. He did it when my back was turned -- I never saw a thing, but heard the commotion, and listened to the patient claim he was going to “own us.”

“What happened, Brutus?”

“Little punk took a swing at me, I had to defend myself.”

Another time I had an intoxicated person on the stretcher and Brutus showed up, and before I could stop him, he was in the truck slapping the patient around.

“That was for last week,” he said when I threw him out of the truck.

It’s not OK

As sick as it sounds, it happens. It happens all the time, and not just in Providence. It’s one of those ugly things that go on when nobody is looking and human nature takes over, and people forget why they are here and what is acceptable.

We are here to offer emergency medical help to people who need it. That some of those people need it every day, and fight us when we arrive, is no reason to dispense street justice. The intoxicated, homeless population is here to stay, and they can be nasty, and belligerent, and dangerous. I do not like putting myself in harm’s way. I do not appreciate being punched, kicked and spat on. But like it or not, it comes with the territory. Calling the police is not the answer.

I know my patients. If a person is somebody new or somebody acting psychotic, I call the police; otherwise, I handle things on my own. It doesn’t make me a tough guy, and it is not at all what I signed up for, but I’ve learned that somebody has to do the dirty work, and that somebody is Providence Fire/EMS, and I’ll be damned if I will allow a “brother” to abuse one of my abusive patients.

Code of honor

Call it stupidity, call it laziness, call it what you will, but I see it as a code of honor, and take pride in my ability to get these sick, suffering, combative, awful people the help they need without smacking them around in the process.

My brother works as a correctional officer. I once asked him how he dealt with the child molesters, rapists and murderers that he keeps watch over.

“Police arrest them, lawyers defend them, judges sentence them and I guard them. It’s not my job to punish them.”

I keep that in mind when I’m wrestling with the people who called me, or had somebody call me for them. They are intoxicated or otherwise impaired, and impaired consciousness is a medical condition, and if I call the cops they are going to have to do my job for me.

As for street justice? I keep that in the station.

“Head to the station,” I said to my new partner, after we transported Ryan without incident. “I need to have a talk with Brutus.”

It’s a long career, and reporting a “brother” to the authorities is a last resort. Like I said, ugly things happen in the city, and all I can do is do my best, and every now and then remind somebody to do theirs.

Captain Michael Morse (ret.), mmorsepfd@aol.com, is the bestselling author of Rescuing Providence, Rescue 1 Responding, City Life and Mr. Wilson Makes it Home. Michael has been active in EMS since 1991 and offers his views on a variety of EMS and firefighting topics, focusing mainly on the interaction between patient and provider as a well-respected columnist and speaker. Captain Morse is a Johnson/Macoll fellow in literature from the Rhode Island Foundation.