Please quit being stupid.



One of the things that appear up on my Facebook page quite frequently is a popular blog by/for healthcare providers. Overwhelmingly, the posts on this blog are about how providers hate drug abusers, people “misusing” the emergency department, and how much the author(s) dislike poor people who probably won’t pay their hospital bills.

Yesterday, on a popular EMS website, there was a post stating a documented fact about access to healthcare in a certain ethnic community. (Rather the lack of access) Many providers decided to chime in with insights such as “well if they are illegal they are criminals” and then go on to talk about how they do not deserve healthcare. One offered that they should receive care just until they are deported.

So let me share with you a story? One of the first days I found myself working as a medic in the deep South, I responded to a call for a cardiac arrest at a family reunion. I was told by my preceptor (I was riding 3rd during FTO) that it was important that we got back to the truck as soon as possible. I was not told why. We arrived on scene to find the matriarch of the family dead in a chair. From the rather contorted position of her head, using the old mark-1 eyeball, it seemed to me she was dead. A quick pulse check confirmed this. So we put her on the ground (we were outside) and went to work. I most impressively (purposefully overly self-promoting) got the tube on her Mallampati 1 airway. CPR was initiated. (this was before that whole “concentrate on quality BLS” movement.) I went to hook her up to the monitor/defibrillator, and noticed that she had moved…Several feet…Towards the truck…Not on a stretcher… About the same time I noticed the crowd forming an ever shrinking circle around us. Being “a Yankee” myself, and having worked in ‘hoods prior, the fact this patient was of black skin had absolutely no consequence to me. Black, white, green, yellow, purple, gay, straight, rich, poor, none of that stuff ever mattered before. Honestly, it never occurred to me this would be anything other than another arrest to work. But steadily while pausing now and again to do CPR, check the tube, start an IV, we continued to drag the patient across the ground into the back of the truck (ambulance). These particular trucks had no way to get from the back to the front, except by exiting the truck, which I quickly discovered to be impossible because of the people outside the truck beating on it and yelling. The look on my face must have been incredulous, because I am not sure who or when the doors were locked so we would remain in our little “safe room” I was then let in on the secret. “Black people here do not think white people try very hard to help them.” So the default reaction is anger and aggression. After a few months, it did not escape my notice they probably had some legitimacy to that assumption, though it was more of an exception than a rule.

About now I get all kinds of hate mail from Southerners about how racism doesn’t exist in their part of the US. It does. I have seen it. The only people treated worse are gay people. It is systemic, from management to the rank and file, in the agency and out. The first step to fixing a problem is identifying you have one. Spare me the “not us” comments. Many of those people who were victims should have filed discrimination lawsuits.

Now that you have some background, let me get right to the point. In the old days, when you acted like an asshole, the solution was usually somebody kicked your ass. It wasn’t personal, and generally you didn’t repeat the behavior.

But those days are gone. Now we are civilized and nonviolent. Supposedly…

Some weeks ago in Arizona, a video of firemen beating up on a postictal seizure patient went viral. I don’t know where it stands today, but I would venture that a settlement is going to be paid. Somebody might even get in trouble.

One of the projects that I am honored to be a part of is DT4EMS. It is a course designed by, in my opinion at least. The world’s leading expert on EMS safety and use of force. My role is actually really small. I edit the manual. But after reading it 4 times while doing the edits, I have learned a thing or two about the topic. This has had the side effect of me becoming more aware and even critical of violence against providers and the response of the providers, management, law enforcement, courts, etc. In this course (which I have absolutely no financial interest in, I just think it is brilliant and quality and I am honored to volunteer to help in my small way)it talks about the legal aspects, public relations aspects, documentation, and even has some easy to remember self-defense techniques which are designed not only to permit defense and escape, but are formulated so they do not look aggressive and are not offensive. (one of the best pieces of advice I was ever given in my career was: If you ever want to know if you are doing the right thing, just ask “how is this going to look on the 6PM news?”) DT4EMS meets the 6PM news test. But like all self-defense courses, one of the things it stresses is not to put yourself in a bad situation to begin with.

So…Writing hateful things on the internet for the whole world to see, makes people want to kick your ass.

Violence against healthcare providers is on the increase world-wide. It is a major problem. It has been noticed that providers are losing the respect and neutrality of the populations they serve. I could probably write a paper or even a small book as to why.

For now, let’s stick to one part? Instead of being benevolent and neutral, healthcare providers have rebranded themselves as the defenders of the true faith and morality. Then, after they talk smack on the internet, use sarcasm, and show utter disdain for various patients and populations, everyone sits around and bemoans what a tragedy this violence on providers has become.

Let me help you out. If you want to stop violence against providers, before we get into martial arts, laws, dumbasses suggesting carrying firearms, take a look in the mirror. Do you treat patients and the public in a way that would make somebody want to kick your ass? If the role were reversed, would you want to kick the person’s ass that was treating you that way? Do you perform different treatments on those you don’t like vs. those you find “acceptable”? When you start spouting hatred against races, legal status, people with different morals, low education, poor, and all the things you don’t like or agree with, YOU are making violence against providers more likely. When YOU post that on the internet it disparages the long traditions and sacrifices of the people who came before us. Yes, you have a right to free speech, but you also have responsibility. That includes not making your whole profession or vocation look like a bunch of arrogant assholes that don’t care about people or treat them poorly.

I would also make special mention that in many countries, your internet postings can and will be used against you in court. So when you start carrying on about how you don’t like criminals, blacks, Hispanic, gays, whoever; when you start posting about administering normal saline and telling patients it is a pain medication; when you start boasting on how you under-treat patients because they are drug seekers who never pay their bill and it comes out of your tax money, those posts might make their way into a lawsuit or criminal case against you. It is also not good if your photos have your agency logos all over them. It makes the whole agency look bad.

Simple ending: Stop doing that! Because whether you are a doctor, a nurse, a paramedic, a firefighter, police officer, or whatever; you are making things bad for everyone else. If you don’t like the people you have to deal with at work, find another job. Find another career. Not only will it make you happier, reduce stress, and increase life expectancy and quality; the rest of us don’t need you. Our respective professions/vocations have gotten along without you before; they will get along fine, perhaps better, after you are gone. If you need to vent as we all do from time to time, do it privately! Not on a public website where the whole world can see and record it.


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