No Winning

Dispatch led around 1730 on a tuesday. It was dark, rainy and cold. Sometime in early spring of last year. I was sitting at our main station shooting the shit with the BLS crews. 

Cardiac emergency. No notes or further info on the tablet, which is weird. “Great. I’m so Pumped for this bullshit.” I mumble to myself. Ah Dispatchers am I right? 

I am in a chase car. I arrive to a scene packed with cops and some sort of tac team. There are detectives and PD white shirts. 

This was a raid. 

Definitely not dispatch’s fault on lack of CAD notes. 

No one is running around which means the job is done. Dozens of cops are outside shooting the shit with hands in their vests. A cop friend of mine calls this a “piggy bank”. 

As I walk towards the house a cop approaches and whispers in my ear, “Doc- He’s in the back. He has been making kiddie porn. He is complaining of chest pain”

Right on cue, like out of a movie, multiple children with obvious physical and mental disabilities are being escorted from the house.

“Jesus Christ” flashes across my brain as I wait for kids be assisted down the stairs so I can enter the house. 

I brace for impact. 

The cops stare at me and reluctantly part as I walk inside. They know I have the ability to stall all their efforts of this entire evening. This man’s medical needs, despite what he has done, come first. 

What the cops don’t know is that I don’t want this power. What they don’t know is that I am already mentally gearing up to try and treat this man like a person and not a sick piece of shit. I want off this ride entirely. Give me mee maw clenching a tissue all day over this shit.

I am no one’s friend here, not even my own. I cant stand up for the kids I saw outside. I can’t smash this guy upside the head with my lifepak 15. I have to do my job: treat the patient and do so in a respectful manner. 

The living room is covered with trash and bags of clothing. It is dark. It is normal for these houses to only have one or two lights. Or no lights. There are illuminated stairs to my right. I keep walking back towards the light in the kitchen. It is a long old townhome built in another time. These homes always seem to go on forever. The bright kitchen light in the back of the house cuts through the corridor making sharp angles on the walls.

I am almost there. Dreading this encounter with every ounce of my being. I step on different from my previous steps- something squishy. I look down.

I lift up my duty boot and see a pair of bright pink dora the explorer little girls underwear. 

Fuck. This. 

The kitchen is blindingly bright and tall compared to the hallway. A few cops are back there with a detective. They are unfazed. 

There is a man handcuffed while seated in the kitchen. He is white, in his 50s and has crucifix earrings. He is claiming innocence. He is screaming at the cops. He doesn’t even look at me until one of them states I am here for his chest pain. 

He turns to me and stops yelling but still looks agitated. He is ready to take me on too. 

I explain I am medical and not part of the investigation. 

He tells me he has chest pain and it started when “these fucking cops” showed up and they “kicked me down the stairs”. 

He tells me he needs his nitro and is having a heart attack. He states the cops are refusing to give him his medication and are tearing his house apart. He has nitro upstairs but they wont get it for him. His rage explodes and He starts yelling at the cops again. He has trouble staying focused on my questions. 

This is normal for people under arrest. Right now, I hate this fucking job. 

I get vitals. Do my assessment. Grab a 12. A BLS crew with an ambulance shows up. They watch. Offer to carry my bags. 

The pt is trying to verbally initiate a fight with the cops. The cops don’t take his bait. He is sinus tach no ST changes. I ask him he wants to go to the hospital. 

He tells me again the cops kicked him down the stairs. He yells he just wants his nitro from the dresser. 

I tell him I was not there. I ask him with as much neutrality in my voice as possible if he wants to go to the hospital. 

He peers up at me and stops yelling. 

I say I can take him to the hospital for evaluation. I seriously thought he was going to say yes. 

Nope. He suddenly turns away from me and says he doesnt want to go. He goes back to yelling at the cops. Damn does he have great EJs. 

I leave the house. 

I call medical command for a refusal. A young resident answers. 

I explain the vitals and that the pt is in custody. 

The resident tells me he really wants the pt to go. He wants me to put pressure on him.

“Doc. With all due respect, I have asked multiple times. He doesn’t want to go. This man is being charged with manufacturing and distributing child pornography.“

The resident without missing a beat: “Refusal granted”

I think he heard the irritation in my voice. I just wanted off this ride. 

I go back inside and ask the man one more time if he wants to go, to be safe. Cover my bases. He is done with me. He knows I can’t help him take on police. I am useless to him. I recite the risks to him as he continues to yell at police and claim innocence. I tell him to alert someone if he wants to call us back. I will gladly return and take him to the hospital for evaluation. Police sign for him as he rattles his chair and tries to intimidate everyone around him. 

I load up and leave.

I go back to the main station to chart. I didn’t tell anyone what the call was and no one asked. Usually if it is any good, people will share it. 

The fact is, this call wasn’t any good. It was terrible. Ive treated dozens of prisoners and people in custody. They always suck. 

I don’t want to know the criminal history of my patients. It isn’t my place and makes it hard to focus on patient care. However, this is unavoidable especially on a hot scene. 

As I was driving home I called one of the EMTs who was also working tonight. 

I told him the gist of the call. 

He said something along the lines of Jesus christ, why didn’t you say anything?!

I was irritated and snapped at him “Because I was not done my shift. Now I am done. Here I am saying something.”

I linger in thoughts about how fucked up those kids will be. How one person’s actions, which were likely a result of another person’s actions, will just keep going. There isn’t any amount of therapy or time that can undo what was done. Therapy gives you a safe space to learn to cope. Time doesn’t heal anything. It just puts more distance between you and the event. And In that space, on that timeline, we pray to god, no similar traumatic events have room to manifest and restart this whole screenplay.