Wednesday, August 20, 2008


I rolled him over from his prone position rather unceremoniously, first pulling on the topmost arm and then pushing at his hip in order to force the move. Like a barrel suspended on top of water, the man reached his tipping point and flopped over, rolling downward onto his back.

We were called for a cardiac arrest, but this man was breathing. He groaned after we moved him, and sluggishly flopped there on the bed without the energy (or will) to right himself completely. He looked exhausted. His breath was laden and heavy, his bare chest and protruding belly heaving in slow motion with clear exasperation. He smelled like liquor.

I didn't give him much time to consider his options. "Up you go," I demanded, yanking on his arm and pulling the man upright. He groaned some more as I continued to pull but it was he who relented first, and up he sat as I pulled, tipsy and top heavy coming to rest at the edge of the bed.

My flashlight in his eyes. "How much was it that you drank?" Stern and truly without compassion I wanted answers from the man. Unknowingly or not, he had instigated a dangerous lights and sirens response from across the city, inspired undue concern, and let us all down with his sluggish demeanor and potent breath. His pupils were dilated and equally reactive to light. The man tried to focus on me with the bulb in his eyes, curiously confounded. "Just five," he slurred.

I don't feel sorry for him. I don't feel compassion or energy or willingness to help. I feel exasperated, and I wear it on my sleeve. We roll him out of the apartment quickly, taking little time for comfort or care. He is a waste of our time. He is a chronic abuser, a hopeless cause, a train wreck derived from proportions of choice and circumstance. Forget the ratio whatever it may be, we don't care. Here and now he sits, drunk, and I am without inclination to delve into much more.

It is only until after the call and upon reflection that I am able to truly understand how callously we treated that man. Each step replayed in my mind, I can think of hundreds of other occasions where I would have done something different - either more slowly, cautiously, or with more care - had the patient been someone or somewhere else. ...And yet at the time, in the moment on the call, it all seemed normal. Somehow our behavior was in sync with the environment, and though out of place within our daily routine, temporarily acceptable.

...But that wasn't what bothered me most. It was the patient. Though all of this he sat still, groaning in his toxicity but nevertheless fully aware of his circumstance and the "providers" sent to rescue him from it. The expression on his face was stoic and accepting, conscious of the abuse and yet submissive.

This man was used to being treated this way.