By John C. Malcolm, NRP, CCEMTP, FP-C

It was Memorial Day at about 7 p.m. when the tones dropped for a male who had overdosed. My partner Bridgette, an EMT, and I jumped in our truck and off we went. A police officer arrived on scene first.

Around this time, a familiar voice came across the radio. Mike Monck, a paramedic, friend, and mentor of mine had signed on to give additional help. He arrived before us.

John Malcolm

Monck – my EMS father – was my first boss. He is an intimidating figure at 6’ 6" of muscle and he has a booming voice with a New Jersey accent that is unforgettable. To meet Monck in a dark alley at night would be terrifying if you did not know him. However, physique aside, he is also the most caring and kind-hearted human being I have ever had the privilege to know.

Monck gave a quick rundown of what was going on with the man. The patient had ingested a large amount of alcohol, narcotics, marijuana, diphenhydramine, and phenylephrine nasal spray.

Before the 911 call the patient allegedly drove to his ex-wife's house, where we were headed, and crashed into her front lawn. She called the police.

Police on scene; is it safe?

How do we maintain safety in an inherently unsafe environment? All EMS students are taught the mantra of “Scene Safe, BSI,” but do they really understand what that means?

When you think about it, how many calls do we respond to that have the potential for violence? I used to think I understood what scene safety meant. I was sadly and unfortunately mistaken; I did not know what it meant or truly grasp its importance.

We found the patient sitting on the floor, attempting to use the nasal spray bottle like it was a phone. He was a large, broadly built man. He probably weighed 275 to 300 pounds. The patient seemed calm, and we had a police officer and three EMS providers – Monck, Bridgette, and me.

I felt pretty safe.

Assessment and history; a futile endeavor

Our patient was visibly upset and told me, "I want to die."

We asked how much of the medications he had taken, which was a futile endeavor. He could not remember. Nonetheless, he gave the police officer permission to search his car for any other clues.

While the officer was searching the car, Mike and I helped the patient to his feet and started walking him to the ambulance. The man was cooperative and thanked us for our help

I’m not sure what happened to make made him upset. With his next step he moved me in front of him, grabbed me around the waist with one arm and the neck with the other.

A sudden blur of violence

Most EMS professionals that I know work more than one job. I used to work three jobs; two of which were in large cities that exposed me to varying degrees of danger and uncertainty. The third job was in a small town on the coast of Maine. I always assumed that if I was going to get injured, it would happen in the big city. I was wrong.

After the patient grabbed me I remember being in the air and deciding to go limp to try to avoid injury. The next thing I know I was on a couch with my back against a wooden arm rest. The patient either body slammed me or fell on me. I’m honestly not sure what happened.

Monck was upset. He grabbed the patient and attempted to lift him off of me. He moved him enough so that I could crawl out from under him.

Bridgette called dispatch for additional help. I told her that I felt fine, but as soon as I spoke the pain kicked in.

All of a sudden I struggled to breathe. With every breath, it felt like my rib cage was being ripped away. I doubled over in pain and limped outside.

Monck convinced me to go to the hospital. I refused ambulance transport, opting instead to drive myself.

Assessing my own injuries

During the 25 minute drive to the hospital I did a self-assessment. I decided that I had at least one broken rib, if not two. My right upper quadrant was increasingly sore.

My self-assessment was accurate and confirmed by the ED physician. I had two broken ribs and a bruised liver.

With narcotics for the pain management I could not drive, so my parents came to get me.

The man who assaulted me had been brought to the same hospital and just as my parents arrived, he walked in surrounded by police officers.

I seriously thought my mom was going to go punch him. Thankfully, she did not. No matter how old, we are still children that our mothers want to protect. She was definitely an angry mama bear.

No work, but lots of work to do

My next seven weeks were filled with doctors’ appointments, workers compensation claim meetings, a family wedding, no work, and a lot of sitting around.

At first, the whole event was didn’t bother me. I thought of it as a minor inconvenience. I was happy to give a statement to the police.

I remember thinking that I did not want any legal action taken against the man. After all, he was very intoxicated at the time and I was sure he did not mean to hurt me.

The outpouring of support after the assault was amazing. People from all parts of my life were there to help, there to listen.

In those early weeks I had no needs and I didn’t have much to say. I took on the macho attitude of “I’m fine,” or “it’s just a part of the job.”

It wasn't until much later that I began to ask, "When did getting physically wounded become part of my job? And what had led me to think that was an OK way to handle this?"

I don’t think I’ll ever know.

Change of heart about pressing charges

A friend pointed out that EMS providers were being assaulted more and more often by the people who had asked for or needed our help. I realized he was right.

I realized that my acceptance of what had happened to me was also giving other people license to attack my colleagues, people I consider to be family.

For the first time since the assault I was angry.

The enormity of it all finally sinks in

When I finally realized, on an emotional level, what had happened to me I was already back at work and running a similar call.

This patient, like the man before, was very intoxicated; on drugs and alcohol. I was in the back or the ambulance treating the patient when I saw his hands clench into fists.

I froze.

I was gripped by fear, paralyzed, and thinking only of the initial assault.

My ribs, broken five months ago, started to ache.

This patient, to my relief, was making fists as a seizure began. That’s probably the only time I ever have or ever will watch a patient start to seize and relax.

I was ready to talk; bewildering my co-workers

When I was finally ready and needed to talk about the assault, my coworkers did not understand. Some listened and offered words of encouragement, but most were bewildered that after five months of silence I suddenly needed to talk about the assault.

I’m still dealing with the repercussions of what happened. I’m not paralyzed or trembling with fear on calls, but my level of awareness is much higher than it ever used to be. It's mentally exhausting to work busy shifts now, because every scene I enter I become acutely aware of actual and potential dangers.

I always thought I assessed the scene before. I guess not.

Man sentenced for felony assault; serves just 90 days

The man who assaulted me was found guilty of felony assault and sentenced to 24 months of jail time, but he only had to serve 90 days in jail and the remaining 21 months on probation.

My sentence is much longer. I am going to be dealing with this violent encounter, in some way, for the rest of my EMS career.

I am marked. I am that guy. I’m used as an example in classes as a “it can happen to you.”

Brand new EMTs ask me what it was like. I’m happy to talk about it. Talking is the only way to start a dialogue that might prevent this from happening to someone else.

A 30-second encounter is defining the rest of my career. A drunken and drug intoxicated man only spends 90 days in jail. How is that fair?

A felony assault charge and conviction is punishable up to five years of imprisonment. Do I want him to serve five years?

No.

Do I want him to serve more than a laughable 90 days?

I think so. I have to live with this forever.

Growing frustration over many incidents of mistreatment

Writing this is making me more upset. I have dedicated my life to helping people by becoming the very best paramedic I can be.

I have been spit on, slapped, shoved, yelled at, pissed on, sworn at, severely injured by an assailant and more; all while I was trying to help.

Join me in talking about violence against paramedics. Together we need to raise the public's awareness of the hazards we face and the assaults on our brothers and sisters.

About the author

John has been a paramedic for 3 years and involved in EMS for 5. He works full time as a paramedic, as well as an EMS educator teaching licensure classes and AHA ACLS/PALS classes.