Restraint

Lately it seems like these weird things only happen to me.

Paramedics brought in this pleasant young woman named Deborah Peel who had been using crack cocaine at home just prior to her arrival. She then got into an argument with her husband, called 911, and hung up. Since 911 hangups automatically result in a visit by the local police, Ms. Peel was both surprised and upset when the local sheriff knocked at her door. She then ran into the kitchen, took a handful of Effexor, chewed up the pills, swallowed most of them, and spit the rest at the officer who was chasing after her.

So not only did Ms. Peel arrive by ambulance, she also sported a nice set of matching metal bracelets and a was accompanied by a police escort. All the way to the hospital she kept telling the paramedics that if she couldn’t go home, she would kill herself.

She was screaming obscenities when she arrived. She got into the room and didn’t want to be there. Eventually the nurses were able to calm her down to the point where she would allow blood draws and an IV insertion. She was relatively calm when I went into the room, but she was still upset about being in the hospital.

She wouldn’t cooperate that much with the history. She did state that she was still “suicidal.” I told her that we would get her help, but that we had to make sure that she was medically stable before seeing the psychiatrist. Because the pills she took have a potentially fatal side effect, I told her that we would have to pump her stomach to get the pills out and to administer charcoal.

Deborah Peel went nuts.

She pulled on the tubing to the blood pressure cuff and tried to knock over the monitor. The security guard ran into the room. She ripped off all of her EKG leads. She began screaming and swearing at me. Then she went to pull out her IV. I grabbed her hand before she was able to do so. Then something happened to me that has never happened to me in my career … I got punched.

Using her free hand, Deborah Peel punched me in the chest. I saw it coming at the last second, so I leaned back and she didn’t get me that hard, but she still got me. Then she took another swing at my face. I leaned my head back and she missed.

I have trained a lot in different martial arts. I still had a grip on the arm that she was going to use to pull out her IV, so I twisted her wrist into a joint lock and told her to stop. She yelled “you want to fight ME?” and then took another swing at my face, this time catching the corner of my eye with her finger.

At that time, my mind went into a time warp.
If I let her go, then either she goes after the security guard or she falls off the bed. In either case, someone could get hurt. Don’t let her go.
First, my mind flashed to my martial arts training. Her open targets were both eyes which I could gouge very easily, her nose which I could hit very forcefully with my forearm/elbow, and her throat which I could hit with the heel of my hand or my forearm.
Then my mind flashed to what consequences would occur if I chose to strike the patient. Would it be considered self defense? Could she press charges against me? What if I seriously injured her? Why should a physician even be in a situation where striking a patient would be a consideration?
By then, the instinct to strike back had passed. I was able to keep control of one hand while the security guard got control of her other hand. The patient traded in her metal bracelets for some leather ones - along with matching ankle bracelets.

Then the patient’s husband came into the room. His questions bothered me as much as the patient’s actions:
“What did you expect her to do if you were trying to jam a tube down her nose?”
“Well, sir, she attacked me before we even tried to do that.”
“You know she has issues…”
“Sorry, no, I did not know that, and even if I did know that, people with ‘issues’ don’t have the right to do whatever they want to other people.”
“Well at the other hospitals she has been at, if someone is suicidal, they restrain them immediately. If you had of just restrained her when she came in, this wouldn’t have happened.”
“We can’t just restrain someone that is not an imminent threat to themselves or others.”
“She didn’t even hurt you … did she?”
“Are you suggesting that it is OK to punch people as long as you don’t ‘hurt’ them?”
“Well, no. She’s a psych patient anyway. She didn’t know what she was doing.”

That urge to hit someone was coming back. I’m forced to provide medical care to someone by virtue of a federal law, the patient hits me, and now her enabling husband is treating me like I’m the one at fault.

Can someone remind me why I enjoy my job so much?

The rest of the story is that I pressed assault and battery charges with the police.
When the call went out on the radio, a couple of ED employees who listen to police scanners called into the ED to find out what happened. In no time, it was all over the hospital that WhiteCoat got hit by some crazy lady named Deborah Peel.
According to the police, Ms. Peel has a history of previous arrests. Assaulting a health care worker is a felony in our state, so she’s reportedly going to be spending a couple of years in the GrayBar Hotel.
Last, but not least, I have caught more crap from people in the past 12 hours than I have caught in a long time.
“Hey - I heard some old lady kicked your ass!”
“Oooh, let me know which martial arts gym you go to. You all get some gooood training there.”
“I heard they’re hiring your son as security guard so that we have some real protection around here.”

Now I remember why I enjoy my job so much.

I fit right in.

Everyone’s a smart-ass.