Judged By A Higher Standard

A couple of years back, my partner and I were assaulted by a combative, intoxicated patient. Not that unusual an occurrence, really. Spend enough time in EMS, and you learn that not everyone is happy to see you arrive on a scene, and not everyone sees you as the good guys. Plenty of them will express their displeasure with fists, feet, or teeth.

And when you work in EMS, one of the things you learn to do is distinguish between a patient and an assailant. We have no duty to sustain an ass-whipping and have the right to defend ourselves, sure, but a goodly number of the people who lash out at us have no command of their faculties. They may be mentally ill, under the influence of drugs, hypoglycemic, postictal from a seizure, or any number of things.

Those people, you try to restrain humanely, and professionally. If you can’t do that, you back away until you have enough personnel and tools to restrain the patient safely and render appropriate care.

If you’re being assaulted by someone in full command of their faculties, he’s not a patient. He’s an assailant. For those people, we retreat and let the police handle them, taking whatever defensive measures are necessary to protect ourselves and escape the situation.

But we do not – EVER – retaliate.

In the assault of which I speak, the assailant was a resident of a local halfway house who had left for the day and come home intoxicated. The staff at the halfway house recognized that he was intoxicated, and confronted him about it. His response was to fake a heart attack and unconsciousness, which is how we became involved.

When we arrived, it was patently obvious that the patient was faking, and the odor of alcohol metabolytes on his breath was obvious even to my burned-out nose. Still, he got the full ACS treatment; what assessment and history we could obtain from someone pretending to be unconscious, a 12-lead ECG, and supplemental oxygen.

We packaged him for transport, and he lay on the stretcher like a limp noodle, still feigning unconsciousness, his arms hanging loosely off the stretcher. As we wheeled him outside, I sarcastically told him, “Sir, I realize you’re unconscious right now and teetering on the edge of death, but I’d be ever so grateful if you’d reel your arms in so we don’t catch them on the door frame as we leave.”

That’s when things went rodeo.

Our patient let loose a stream of expletives and started flailing around on the stretcher, threatening to overturn it. In the melee, he managed to get his hands around my partner’s throat. My partner, untrained in self-defense tactics (not that I’m any expert, mind you), reacted the way you’d expect someone to act. He panicked, and tried to pry the guy’s hands off his throat, which rarely works. As I watched my partner’s face turn purple, I reached over and grabbed the guy’s left hand, with my thumb pressed squarely in the back of his hand. One firm twist, and his left hand came loose. A little more pressure, and he squealed in pain, his left hand and wrist torqued in way they weren’t designed to go.

“Let my partner go,” I told him in my Command Voice.

“Fuck you! I oughta – aaaaagh! Lemme go!”

Okay, so Command Voice plus pain compliance techniques work better than Command Voice alone. He let my partner go.

My partner coughed a couple of times, muttered an oath, and cocked his fist to throw a punch. I managed to stop him in time.

“The time to throw the punch was when he had his hands around your throat,” I told him. “That would have been self-defense. This is retaliation.”

And we do not – EVER -retaliate.

Society places a great deal of trust in those of us who work in EMS and public safety – far more so than the average citizen. The price of that trust is that we are judged by a higher standard than the average citizen. To quote that great philosopher Ben Parker, “With great power comes great responsibility.”

A number of readers have asked me in the past couple of weeks to weigh in on the behavior of Glendale, AZ firefighters in restraining a postictal seizure patient who allegedly punched several of the firefighters and his own father. Have a look at the video:

I’d like to point out a couple of things. First, according to reports, the patient had suffered a seizure after an overdose of prescription medication. Postictal seizure patients are often combative, but they do not know what they are doing. They are patients, not assailants.

Second, even if you are a caregiver that has been assaulted, whether the patient had command of his mental faculties or not, you defend yourself appropriately and retreat from the situation.

You. Do. Not. Retaliate.

You certainly don’t respond with a beat-down and verbal threats. I can understand anger at being assaulted. Taking a punch would make anyone angry.

But you’re a public safety professional, dammit. You swallow your anger and behave in a manner consistent with the public trust.

You don’t threaten someone that they are “dead meat,” or that you will “have everything you own,” or drop F bombs every other word, or threaten bystanders and the citizen legally filming your asshattery with being arrested.

You shut your mouth, and behave like a professional. If you want to be seen as the good guys, ACT LIKE IT. Even if your actions were 100% appropriate, your language and demeanor in that video negate any appropriate self-defense measures you may have taken. If you act like an angry thug on camera, why should the public believe you behaved any different in the parts of the incident that didn’t make it onto YouTube?

The firefighters claim that their actions were appropriate, and they were merely trying to restrain the patient. I call bullshit.


Appropriate restraint methods didn’t cause that shiner. Neither did overturning a stretcher. If he had sustained those injuries from a fall from an overturned stretcher, you’d see bruising and abrasions on bony prominences that struck the ground, like nose, cheekbones, supraorbital ridge, etc.

And James Murillo might indeed have such injuries that aren’t apparent from this camera angle.

But that black eye came from a punch. I’d bet good money on it.

The punch might have even been appropriate, if it was truly thrown in self-defense. But the firefighters’ actions and language captured on the video scream otherwise.

So, my take on it? Some guy is combative after a seizure, and lashes out at his father and several firefighters, and the firefighters lost their tempers, and hit back.

That is understandable, but it damned sure isn’t excusable. Not for people in our line of work. These guys should be harshly disciplined.

While the chief is at it, he might be wise to remind them that ordering a citizen to stop filming their bad behavior is always a losing proposition. Also, schedule an Escaping Violent Encounters course for his firefighters, so that the next time this happens, their actions will be measured and appropriate, not retaliatory and indefensible.