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No Better Friend

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The overhand right found its mark on the left zygomatic arch and it was lights out for the man who was now sitting in the administrator’s office watching the replay unfold on a giant security screen. As the former team physician for the U.S. Naval Academy boxing team, I’d seen this more than a few times and I had to suppress a triumphant “yes!” as the man hit the deck. Even the two cops in the room gave approving nods at the security guard’s punch. “Ouch,” I groaned, sucking in a breath through clenched teeth. The administrator was not pleased.

“Nobody should go to the hospital for help and get punched out by a security guard,” proclaimed the man seated on the couch beside the administrator’s desk. There wasn’t really much to be said. The VP just shook his head and looked at me with a look of frustration that said, What’s going on down there in the ER? My defiant silence said, If you would ever come down to the ER you might find out what’s going on down there.

“Can we back up the tape just a little bit?” I finally asked. I knew this punch hadn’t come out of nowhere. Jamal, the security guard on the tape, was our gentle giant. He had served 15 years in the Marine Corps. In fact, he had boxed with the Marine Corps team, hence the excellent form, before he was discharged with a bad knee. He’d always been a mountain of a man, weighing in at 250 while in corps and gaining another 100 pounds after discharge. These days he resembled Jabba the Hutt more than anything. His affable personality and love for a good joke had made him the epitome of the first part of the Marine Corps characterization, “No better friend…” But as he demonstrated on the tape, he also embodied the last half of that saying: “no worse enemy.”

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“What are you looking for?” the VP asked as we scanned the tape. It was clear he just wanted to get this over with, make an apology, write a check, make a deal, put it behind him. “I’m just looking for the rest of the story,” I said.

“I didn’t do nuthin’ to that guy that he shoulda hit me like that,” the patient shouted. I want him arrested. I’m gonna own him and you and you,” he said looking around the room at the VP and me.

“We’ll see about that,” I returned defiantly. The VP glared at me with a look as if to say Don’t antagonize the guy. Maybe we can just apologize.

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The security camera showed Jamal walking the man through the crowded waiting room holding both of his wrists in front of him as the weaker man just wiggled. Since the camera didn’t have sound we couldn’t hear what the patient was saying to Jamal, but it was clear that he was giving him an earful. When they got to the door Jamal released his wrists and pointed out the door. That’s when the patient swung back around to Jamal, finger in his face, hurling one last parting epithet. Then the blow.

“We don’t need to see that again,” the VP fumed.

“No, wait,” the officer said. On first seeing the tape it looked like they were obligated to arrest Jamal on a charge of unprovoked assault and battery. But now the two cops were seeing it a little differently. It was obvious that they were sympathetic to the guard. Without doubt they had been in similar circumstances before. “What did you say to the guard before he hit you?”

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“I didn’t say nuthin to him. He just hit me,” said the patient as tiny drops of blood flew out of his mouth. Well that was obviously a lie but we didn’t have proof.

“Take the tape further back, please,” I asked again. “Can we look at other cameras?” Now the VP was really glaring at me for delaying the resolution of this situation. But his assistant had already queued up other camera angles in the ER. Of course we could not see what was happening in any individual patient room, but we could see a nurse standing in the hallway speaking into the room where the patient had just been. Suddenly the patient was out of the room and in the hallway, appearing to shout at the nurse and shake his finger in her face like he had with Jamal. She backed up until she was against the wall with the patient shouting in her face.

We could see other nurses scurrying around. That’s when Jamal appeared on the screen and began his wrist-holding escort of the patient towards the door.

“You didn’t say anything to her either?” I said to the patient. OK, I was taunting him. But I knew there was more to this than Jamal just losing his cool. “Can you go get that nurse and see what she says happened in the hallway?” I asked the VP’s assistant.

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“Maybe we can take care of this man’s injuries,” the VP said to me, attempting to regain control of the situation.

“I want something for pain,” the patient demanded.

“I’ll need to do a full exam and then CT his head before we consider giving him any pain meds.

“Well I ain’t doin’ nuthin’ until I get some pain med.”

“I guess we are at a standoff then because I’m not giving a head injury narcotics without an evaluation.” The cops and the VP tried unsuccessfully for several minutes to convince the man to be evaluated, but he persisted in his demand for drugs. Finally the assistant returned to the room announcing that the nurse was afraid to confront the patient after he called her a sexual term and threatened to kill her.

“For what it’s worth,” she went on, “he said the same to Jamal, only he called him the N word.”

“Well that’s a little different story,” the officer said, shaking his head in relief. “You can still press charges, but I’m not making any arrests today.” It was clear he was glad to be relieved of the paperwork and arrest. “Here’s the number of the precinct station where you can go to fill out the forms to make a charge,” he said, scribbling a number unintelligibly on a card and handing it to the patient. He was already halfway to the door.

“Do you want an evaluation or not,” I asked the patient. “If you don’t I’ll leave you to finish your business with the hospital administrator.” Now I was the one halfway to the door.

“I don’t want nuthin’ from you,” he growled at me before turning to the white-faced VP.

I found out two weeks later that they had fired Jamal. I raised my objections at the highest levels of administration. Nothing had come of the incident – no charges, no press, no nuthin’. Why did he have to lose his job? He was really important to the security of the ER. “One of these days, one of us is going to get hurt down here if we don’t have someone like Jamal to protect us,” I had protested to the hospital president. But they would have nothing of it. They were safe upstairs.

ABOUT THE AUTHOR

FOUNDER/EXECUTIVE EDITOR Dr. Plaster has been an emergency physician for more than 30 years, working exclusively night shifts for the past 20 years in emergency departments across the country. During that period, he joined the U.S. Navy and served two tours in Iraq. Dr. Plaster is the founder and executive editor of Emergency Physicians Monthly and the founder of Plaster Publishing.

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