He was dressed in tactical pants, an old button-down dress shirt, blue rain jacket that was ripped out on both sides, a tan rain hat, with grey hair sticking out all around, and had blue eyes that at one time must have been vibrant but were now pale and rummy. A thin grey mustache covered his upper lip.
My partner Kelly and I had responded to a call for a man down, unknown if he's breathing or has a pulse. We were responding to a call in "homeless woods," an area where the homeless congregate to drink then sleep it off, and we never know if we're walking into something serious like cardiac arrest, assault, stabbing or gunshot. If you stay and work in one place long enough, you eventually get to see it all.
Our ambulance rolled to a stop, lights still flashing, and we climbed out of the cab. On the ground where he had been lying was a vodka bottle, just shy of empty. He greeted us with eyes now dull and glazed over from too much alcohol and body odor from too many days of not bathing.
"What's up?" he asked.
"We were called for a man lying on the ground; just checking that you're okay."
"Who called you?" His tone was belligerent.
"The call came in from 9-1-1. My name is Mike. What's yours?"
"Bradley. Who called 9-1-1?" the tone still belligerent.
"I don't know who called them. Are you okay? Do you have any pain or trouble breathing?"
"I'm okay. Just wanted to lie down and take a nap."
From far away we heard the siren heading our way. Whenever our EMS service gets called to man down with unknown cause the police are dispatched as well.
"Ah shit, who called them? Jesus Christ!"
"They get dispatched to all calls like this. It's automatic," I said.
I tried to get more information from Bradley, but he wanted to know about the police. As the officer arrived, Bradley's demeanor changed and his eyes hardened. By the time the officer got out of his car and approached our little group, Bradley had his identification out of his wallet and handed it to him. The officer went back to his cruiser to run a check on his ID.
"I want detox," Bradley said as the officer walked back to us.
"You want detox, you'll have to come to the hospital," I told him.
"That's what I want." Bradley's eyes were taking on a menacing look. I don't get nervous very often, but this looked like someone who is about to explode.
"Okay," I said, "we'll take you up to the ED, but once there you'll get lab work, IV fluids, and no alcohol or cigarettes."
"I don't care. That's what I want."
I looked at the officer and we both knew what was going on. Bradley was using his get-out-of-jail card. "You okay with that?" I asked the officer.
"If you are, I am," he said. His calls were backing up and he wanted to move on.
With that, Bradley and I got into the back of the ambulance and my partner drove us to the hospital. En route, Bradley let me check his heart rate and blood pressure. All the while I was doing this he was getting more agitated, like a caged animal peering out the window to see where we were. Was he looking for a way out? Was he thinking of jumping out the door?
I kept talking to him in a calm reassuring voice. I've found over the years that I can talk most people down if they are agitated or depressed, but it wasn't working with Bradley. The look in his eyes was becoming threatening, and I was starting to have second thoughts about not having the police officer follow us.
We were finally at the hospital, and I escorted Bradley into the ED, my hand resting in the middle of his back to give direction. Bradley was looking around, leaving me thinking he wanted to bolt. He turned to me with a look that could chill and said, "Get your hand off my back."
We were at the ED door. "Let's go in Bradley," I said in what I hoped was an understanding yet firm voice.
Once inside, we proceeded to the room that would be Bradley's and gave our report to the nursing staff.
The fun was just beginning. He refused to cooperate with the ED staff. Security was called and the police were called. Bradley paced back and forth in his room, out into the hallway, testing his bounds like a child. He was now acting like a caged animal, ready to pounce, head swinging side to side, hands fluttering all around. Once the police arrived, he calmed down and sat on the bed, gentle as a lamb.
They left, and he started again, demanding to be let go. He didn't want to be told that he was under the influence of alcohol and needed to stay until his blood alcohol level came down. He was still belligerent, loud and threatening, swearing, making the whole staff nervous and uncomfortable as they scurried past his doorway, afraid of the verbal assault that he would hurl at them. Patients within earshot of his room were getting scared, closing their doors and asking how long they had to wait before being discharged.
The police were called back and, again, Bradley calmed down and promised to behave. The police left and he started again, even worse. He was playing a game he had played many times before, and he is good. Get the staff upset enough so they will let him go just to be rid of him.
The police were summoned once again. This time, four cruisers and six officers showed up and gathered outside Bradley's door. He had run out of chances. He was told in no uncertain terms to behave or he was going to jail. He promised again. This time, one of the officers stayed behind and Bradley behaved. He had dinner, got his IV fluids and slept through the night. He was finally calm, so the officer left. In the morning, he was doing better. The belligerent manner was gone, or now that he was sober, he covered up the anger easier. He was discharged to go his own way.
I have not seen Bradley since; but as the economy changes, we are seeing more and more homeless as our job takes another twist in dealing with the public.
Mike Kennard has been in EMS for 33 years. He currently works as a paramedic at Frisbie Memorial Hospital in Rochester, NH, and is a program coordinator for the State of NH Bureau of EMS. Married with two daughters and five grandchildren, Mike is a retired assistant chief from the Nottingham (NH) Fire and Rescue Department. Contact Mike at "ahref="mailto:firstname.lastname@example.org">email@example.com.