Some times in the wonderful world of paramedicine and serving the community you come up against some pretty unsavoury characters. It becomes the norm to be called names and told to F@*k off, and it almost becomes expected that at some point one of our patients will take a swing at us. This I am sure, is a universal fact!
As a health care professional, and I don’t use the word professional lightly, I have to be courteous, polite and tolerant of some of the abuse that comes my way. Maybe the patient isnt deliberatly trying to offend me or my parentage, maybe they have a head injury, or are confused through a medical condition which has altered their perception of what is socially acceptable?……Or maybe they are just horrible people?
*A little warning first. I don’t normally use bad language or profanity in my writing, but to do this story justice I want to describe to you exactly what was said. If you are offended by strong swearing, dont read on.*
I was working with my mate Michael, on the ambulance, when we were called to a 28 yr old male, collapsed in a shopping centre in the centre of town. Upon arrival, we were met with the usual waving security guard (still waving as we turned the engine off!!), who informed us that the patient seemed to be fitting.
We arrive at the patients side and notice that he is not fitting, but instead is thrashing around on the ground with a co-ordination that shows he is aware of what he is doing (and he also has his eyes tightly shut, which is a bit of a give away). I let him continue for a few minutes and tell everyone around him to be really quiet and not move.
This did the trick and within a couple of minutes of intensely watching his face and eyes, I spot him having a quick look to see if we are all there, before he satisfies himself and starts thrashing around again.
M999: “Come on sir, that’s enough, I know you are not fitting, why don’t you stop what you are doing and tell me what I can do to help you?”
The patient then slows down his thrashing and flutters his eyes open before looking around the room in a ‘dazed’ fashion and asking
Pt: “errr….whats going on?…..where am I?”
At this point I really wish I wasn’t governed by my ‘professionalism’ so that I could stand and give him a round of applause, but I am, so instead I ask him what his problem is.
Pt: “I was just coming in here for some food and then everything just went funny and I fell to the ground”
M999: “OK, have you hurt yourself in any way when you fell to the ground?”
Pt: “No, I don’t think so”
One of the people standing around stepped forward and told me that he didn’t fall, he actually lay down on the ground.
Pt: “Who the Fuck do you think you are!!, Fuck off you stupid bitch!”
M999: “Woooa there mate, that’s enough of that, just settle down. This lady is only trying to help.
The lady looks at him, then at me. She tuts loudly and walks off, muttering to herself.
M999: “Whats your name?”
M999: “Ok Steve, this is how it is going to go, you are going to calm down and stop being abusive. We are here to help you, but I will not tolerate the type of language and threatening behaviour that you have just used. If you continue, I will happily just walk away. Do you understand?”
As I finish the sentence, he starts thrashing around on the floor, but this time is lashing out with his arms in all directions. It is so obviously not a fit, it would almost be comical if it wasn’t quickly becoming so annoying!
M999: “Steve!…That enough mate, you need to stop now!”
I look at Michael, and silently motion for him to contact control and request the police to attend to assist us. Michael walks outside and places the call.
By the time Michael came back in, Steve had decided to stop again and was doing a repeat of his oscar performance.
I inform him that as he seems to be unable to stop himself from ‘fitting’, then he will have to come to hospital, which he appears quite happy with. (Maybe he lives next to the hospital and wants to get a lift home, call me cynical but….)
He gets up and walks unaided to the ambulance, no evidence of confusion, unsteadiness or any signs of being post ictal. As he is walking I ask him if he is going to be any trouble in the back of the ambulance, and he assures me that he isn’t.
Now is the time for the dynamic risk assessment. I look at what has happened. He has been verbally abusive to a member of the public, he has been non-compliant with my requests, he is acting in an erratic manner…but, he hasnt displayed any aggression either verbally or physically to me or Michael. We are informed that the police are ‘busy’ and will get someone out to us as soon as possible.
I look at Michael,
M999: “I think I will be fine, I’m happy to go without the police, what about you?”
Michael: “If you are happy, I am”
Ok, I make the decision and I place Steve on the stretcher. I attach the 5 point harness and pull the straps tight. (I figure that may help if things did change and he started to ‘kick off’)
A couple of minutes later, once we were moving, Steve started…
Steve “Look at you, you think you are so fucking great don’t you? Sitting there all high and mighty. You’re just a piece of shit”
M999: “Thats nice, Steve, thanks for that! but no, I dont think I am great, I am just here to try and help you”
Steve: “Yeah, whatever. You are just a fucking bitch aren’t you?”
M999: “Erm, no not really”
Couple of deep breaths and a loud sigh signify that I am starting to get a little tired of Steve now.
M999: “Steve, you can keep this up all you want, but the only thing that will happen is that I will stop this ambulance and ‘help’ you to exit it OK? You can either lie on the bed and be quiet, or we can do it my way ok?”
Steve: “eh?….what?…..what happened?”
M999: Steve, you are not fooling anyone with that now!
With that he looked at me and gave a little smile.
I’m really starting to doubt my decision of not waiting for the police now. Although I don’t feel threatened by him, as I am quite a bit bigger than him and know I could restrain him easily enough if anything happened, I am still starting to feel a little apprehensive about how this is going to end. I look out of the window and see that I am only a few minutes out of the hospital. I decide to not react to his taunts any more and just concentrate on keeping calm until we get to the hospital.
The next five minutes are filled with
“You pussy….you fucking cunt…..I could shit on your face……you fucking piece of shit etc etc etc.
I sit there quietly, writing my patient report form and silently wishing that I wasn’t in uniform. Why do some people thing that this is acceptable behaviour?. How much do they think a paramedic will take before they get something back?
We pull up at the hospital.
“Here we are Steve, we are at the hospital now”
With that he reaches over and takes a wide swing with his right arm, aiming for my head. I manage to dodge out of the way of it and then catch his arm and place it in a lock (all of the years of Aikido finally paid off!). I finally decide enough is enough
M999: THAT’S ENOUGH!! Who the hell do you think you are!!
I move closer to the stretcher so that I can keep his arm under control, then I grab his other arm so he cannot swing with that one either.
M999: “MICHAEL…..GET SECURITY!!”
I hear Michael mutter his own quick profanity, then he quickly opens the side door to see if I am ok before running into the hospital to get help.
I quickly look back to Steve as he is telling me to “GET THE FUCK OFF ME!!”, just in time to see him open his mouth and go to bite my arm
M999: “DON’T YOU FUCKING DARE!!!”
At the same time that I shout that out loud, the back door opens and I see the look of shock on Michael’s face.
You see, I am just about as placid as anyone can get. I cant remember the last time I really lost my temper, and the last time I had a ‘proper’ fight was about 20 years ago at school. I avoid confrontation unless absolutely necessary and sometimes to a fault (which can sometimes make me a bit of a walk over!)
But I really had enough at that point, and no-one is going to get away with trying to bite me. Steve apparently heard the threat in my voice and suddenly relaxed back down onto the stretcher.
Steve ” Oh……where I am, what happened?”
He was taken into the A&E department surrounded by 2 security guards and 2 porters. I handed him over to the nurse and told her to keep her distance as he is a ‘nasty piece of work’ (although you know I used stronger words than that!!) I went and booked him in at the reception then went outside to tidy up the back of the ambulance. I was shaking with the anger and adrenaline coursing through me!
The radios went off…….”Yeah, Swalwell 205, we were just wondering if you were clear for a further emergency?”
(However, with due credit to control, they knew nothing of what had happened. Once I had informed them, they returned us to station and apparently left us alone for a while to calm down a little)