Life Support: Medics With Guns

Last year I was ready to write about whether paramedics should be armed. Here’s what I was going to say:

I realize reports of violence against members of our profession seem to be escalating, but equipping public servants with enough firepower to kill patients, partners, bystanders and themselves hardly seems like a solution. I can’t imagine any realistic amount of verbal instruction or scenario-based practice being sufficient to teach medics with zero law-enforcement and military experience how to perform invasive procedures with a Glock.

Then I bought a Glock.

The world seems different to me now than it did six months ago, maybe because there were over 300 shootings involving four or more victims in the U.S. during 2015. So I decided to arm myself and up the ante for anyone who might see me as prey. I’m pretty sure that’s what I am to your average maniac: prey. I say that because I’m 63 and not as spry as I used to be—not that spryness or youth are much consolation in this era of random violence.

Consider the mindset of two-legged predators: Unlike the four-legged variety, they hunt to terrorize and kill, not to eat. Unless you’re in the business of profiling sociopaths, though, there’s no use trying to understand them—at least not with the kind of logic favored by civilized people. How these deranged creatures got that way doesn’t matter when they’re hunting you. Once you become a target, the consensus from the FBI and the Department of Homeland Security is to suspend disbelief, then run, hide and fight.

How helpful is that advice for EMS providers? Not very, if you and a predator masquerading as a patient are sharing an ambulance. As noted terrorism experts Martha and the Vandellas said, “Nowhere to run, nowhere to hide.”

That leaves fighting. There would be no choice, I suppose, but fighting with customers is a concept I still struggle with. Something about first doing no harm made me reluctant to hit back the two times patients attacked me. I was lucky, though—a lot luckier than some of the 1,210 EMS workers out of 1,780 surveyed in 2014 who were attacked in the field.¹

What that survey couldn’t show is how many victims of workplace violence might have been better off armed. I think that would have depended on their defensive skills and mindset—ideally, a willingness to use deadly force while understanding when not to. You’re not going to learn that in a four-hour class like the one I had to pass to earn a carry permit. Unless you’re in law enforcement or the military, it’s pretty hard to get the kind of tactical training that sticks with you. It’s sort of like working or volunteering in a low-volume, low-acuity EMS system, then one day having to sort out an MCI with multiple critical patients for the first time.

Can carrying handguns be good gambles for prehospital personnel? Perhaps, but not without some serious soul searching. Consider what might happen:

• You could shoot someone who would have needed much less persuading to behave.
• You could fire at a threat and hit a bystander.
• Someone could grab your weapon within the cramped confines of an ambulance and shoot you.

I could go on, but you get the idea: lots can go wrong. On the other hand, if you carry that sidearm off duty as well, you might have an opportunity to save more lives in places like Aurora, CO, or Bridgewater Plaza, VA, than in your entire EMS career.

I’d feel safer on an ambulance these days than in a shopping mall or a movie theater, and I say that after two on-duty wrecks. My wife agrees. She no longer patronizes target-rich retail environments unless I’m with her, playing bodyguard. It’s a bizarre, frustrating development in our otherwise conventional lives, but all we can do is adapt to a world that’s very different from the one we grew up in. Part of adapting, I believe, is taking more responsibility for our own safety, and perhaps even the safety of others.

Drawing a deadly weapon around lots of innocent people is different than defending yourself one-on-one against a combative patient; however, you might be the only one at a public place with a chance to prevent carnage. If you can embrace an armed-and-vigilant off-duty role backed by whatever training you can get, accompanied by a conviction to be the most tolerant, reasonable person in any group of two or more, then maybe a sidearm makes you a little more valuable to society than just a medic card does.

At least that’s what I keep telling myself.

Reference

1. Crowe RP, Eggerichs JJ, et al. A Description of Violence towards Emergency Medical Services Professionals. Poster presentation at the annual meeting of the National Association of Emergency Medical Services Physicians, 2014.

Mike Rubin is a paramedic in Nashville, Tennessee and a member of EMS World’s editorial advisory board. Contact him at mgr22@prodigy.net.