Monday, September 14, 2009

You Just Can’t Make This Stuff Up…

Recently, myself and some of the people that I work with were talking about strange calls that we’d responded to. At one time or another, we have all shown up at a scene that was either strange, or bizarre, or just plain funny. Some of them have a mix of all of those things. And to be an EMS provider, unofficially it is written somewhere that you have to have a sick, twisted sense of humor.

It’s true. I mean seriously – how else could anyone do the job that we do without it?

I don’t think I’ve ever been on a call that was truly funny, but I would like to share an experience I had that was mostly just strange, but part of it, at least to me, was kind of funny. I wrote about this briefly not long after it happened, but it was such an off-the-wall situation that I think it is worth talking about a little bit further, mainly because I’ve never forgotten it…

One time – it was about 18 months ago - I and the partner I was working with at the time (my friend Squid) were dispatched to the east side of Manchester for a psychiatric emergency. We were told to stage and await police, which we did.

We arrived at the location where we were going to stage, and we had the residence we were going to be ultimately walking into in sight, probably 100 yards away. Not five minutes into our time there a person emerged from the house and started waving at us to come. As it was, there was no way either of us were going to do that; first, the police hadn’t arrived yet. Second, I’d had a negative experience with that early in my career. I was stupid, and it taught me a valuable lesson – one that I nearly paid a heavy price for. So we weren’t going anywhere.

Since we didn’t move, she started walking towards us. Without giving up the truck’s position, I got out and started walking toward her. As we approached each other, we had a conversation, although if someone were to look at us back then it probably would have looked like we were in the OK Corral and heading into a gunfight. And the conversation went something like this:

Woman Approaching: Why are you parked so far away? She’s fine now and you can come in to get her.

Me: Sorry, ma’am, but I’m not going anywhere until the police arrive.

WA: Really? Why? Are they coming?

Me: Yes, they are. In fact, they’ll probably show up like the cavalry because there was a report of an assault in the house, which is why we’re sitting over here. We were told to wait until they came to make sure it was safe for us to go inside.

WA: There’s no need for that! My sister is fine now. She’s just having trouble with some medication she was prescribed. And she didn’t hit anyone! I promise you that.

Me: Okay, but we really still need to wait. Who else is in the house with you, and are they okay?

WA: Well, there’s me, my mother, and my sister. My mother was trying to calm her down, but my sister is having so much trouble with this medicine, and she wants to hurt people, but she really won’t do it – she’s really a nice person – honest!

As she’s telling me all of this, three Manchester police cruisers rolled in, literally from three different directions, all lit up like it was Christmas or some other high holiday. Then two more showed up right behind them. They all stopped and parked tactically around the house. Then the trunks of the vehicles all popped open almost at the same time, the officers were out of the vehicles, and they were putting on body armor and helmets and pulling assault weapons out of the vehicles.

These guys were all member of the SRT, or Special Response Team. And all I could think of was the REM song, “it’s the end of the world as we know it…”

It was pretty quick; the cops went to the house and did the tactical entry that they practice so often. The woman talking to us started to freak out herself, and there wasn’t a damn thing we could do right then and there. But within about three minutes Fire Alarm gave us the green light to go to the house. So we did.

When we got there, we walked in through the front door to find 5 cops all standing around, most of them looking a bit uncomfortable. The officer in charge, a Sergeant that I’d dealt with a lot in the past, started filling me in on what was happening. Apparently the reports of an assault were grossly inaccurate; the mother of the woman who ultimately became my patient, while I was being briefed, was lecturing the other officers about how they needed to be more careful about bursting into the homes of private citizens who had done nothing wrong and how ill her poor daughter was… I don’t remember exactly what she said to these cops, but I do remember that she was yelling up to all of these guys.

It’s a visual thing. You’d have to have seen it to appreciate it.

When the Sergeant was done with me, I walked over to the mother and remaining daughter and introduced myself and I asked what was wrong and why we were there. I should have known it was going to be an interesting situation when they both warmed up to me, which was totally opposite of how she was dealing with the cops.

Anyway, the woman who was to be my patient was a 47 year-old female. She’d been prescribed Chantix, a medication used as a tool to stop smoking, and from what she told me, it had worked effectively. However, it is reported to have a rather nasty side effect profile, which includes mood alteration.

Let me define “mood alteration” a little more clearly. In this woman, it was violent mood swings that were happening about every 3-4 minutes, and they were impressive as I got to witness three of them in the span of the 10-15 minutes that we were in the house with them. They went from her being able to behave calmly and rationally to her breaking down in tears and weeping uncontrollably to her becoming extremely agitated to the point of threatening violent behavior. It went something like this:

Me: So can you tell me what’s going on when these changes happen to you?

Patient: Well, right now I feel okay, like I did before I started the medication, and then a couple of days ago I started having these incredible changes in how I feel (here she bursts into tears), and I’m sorry, so sorry that you had to come here to see me like this, and I’m such a horrible person (voice changes to something like the character Regan in “The Exorcist” while she’s possessed by the devil) but I want to beat you like a dog and make you bleed and see you suffer! (Bursts into tears again) I’m so sorry, but this keeps happening and I can’t control it…

Anyway, I think you get the picture now. Female patient, having intense side effects to prescribed medication that make her feel like a terrible human being one minute and make her want to commit grievous bodily harm the next. And the cycle goes on and on.

So, I asked her if she thought she felt safe going with us to the hospital for her to be evaluated to see if there was anything that could be done for her. She told me that she felt like she would be okay, but she was afraid she might try to hurt me, all the while telling me that she wanted to rip my lungs out of my chest and use them as a punching bag.

It was really wild; here I had family members who were worried about one of their own having a really hard time with something that was supposed to be helping her in fact not doing that plus they were pissed off at the cops for storming their house like they had a clandestine drug lab set up inside. I also had to deal with cops who not only felt like idiots for responding in the manner they did but also thought that this woman’s outbursts were funny.

In a sick way, though, they kind of were. I realize that she was in difficulty, but to see her swing back and forth like that was just, well, almost comic to watch. I didn’t laugh at her, though. At least not then.

So we got her into the ambulance. She was able to walk with no trouble with us, and she was actually being really cooperative. She was oriented appropriately, and she knew that she was having a serious problem that she didn’t have any control over at that time. The irony of all of this was that she was a very attractive, well put-together woman who had a successful career and, by all appearances, a good life. But at that moment she was acting like the Tasmanian Devil on a bender.

I tried to assess her further and determine if there were any other problems, but the roller coaster continued with her saying at one point to me, “I’m so sorry I’m acting like this but I really want to kill you!!!”, and other such things. One time she tried to start punching me, but I grabbed her wrists and forced them into her lap. And she started crying uncontrollably again.

By the time we’d arrived at the hospital, I had seen this happen about 10 times. We walked through the doors and the nurse waiting for us said to me, “is this your intermittently violent patient? She doesn’t look like she could hurt anyone.”

All I said was words to the effect of, “fine – don’t believe me. But I guarantee you she’s either going to hurt you or herself if she’s not taken care of somehow.”

I found out a couple of hours later that she’d been rather heavily sedated and restrained because of the mood swings. She was sleeping rather peacefully, in fact, when I checked in on her later in the shift…


Elizabeth @ The Garden Window said...

Poor woman, I hope she soon got over the medication induced side-effects.
Not much fun for her, her family, or all of you in the emergency services to have to deal with.......

TOTWTYTR said...

"They went from her being able to behave calmly and rationally to her breaking down in tears and weeping uncontrollably to her becoming extremely agitated to the point of threatening violent behavior."

Interestingly, people I've known who have tried to give up smoking without Chantix have acted pretty much the same way.

Walt Trachim said...

True. But probably not with the cyclic type of swings that I saw with this. And they were really fast changes; that was the wildest part of this situation. I'd never seen anything quite like it.

Crusty said...

Sounds like I need to throw a Chantix party. Imagine how much fun 30-50 people, in one room, having those mood swings, would be. You know, a good EMS provider would have just exorcised the demon.

That's funny stuff. Thanks, Crusty.

Anonymous said...

Ck's cousin:

So thaaaat's what the small print and quick, low voice-over on the Chantix television commercial means.

Good to know, I'll just keep smoking.

Interesting blog.