I was accused of being racist. This was about fifteen years ago. At the time my main assignment was working as a contract paramedic for a volunteer service in Bloomfield, a volunteer town to the north of Hartford that like Hartford had a predominantly black population. I was working that day with a black partner/friend who I had worked with periodically for well over 10 years. At the time his best friend was a white woman and I was married to my first wife –a black woman. It was a Sunday and we were called to one of the town’s many churches for a woman having a seizure.
It was early in the afternoon and the last church service for the day had ended. The patient was still up in the balcony. A woman in her early thirties in a white church dress with white high heels, she in the front row with her eyes closed rocking back and forth and moaning. I was accompanied by a church staff member and the church nurse who was an older woman in a nurse’s uniform that included an old fashioned nurse’s hat.
“The spirit is still in her,” the man said. “The service ended twenty minutes ago and she hasn’t come out of it yet.”
I approached the woman and as I moved my hand close to her eyes, I could see her eyelids start to twitch. “Ma’me, I said.
All of sudden she jerked her legs forward and knocked me off balance. The backs of my knees hit the low balcony railing and I had to swing my arms quickly to offset the loss of balance. “Watch it!” I said crossly. I stared at her but she wouldn’t look at me, increasing her rocking.
My partner and I exchanged glances and I said, ”I guess we’re going to need the stair chair.”
The woman started flopping around even more as I tried to take her blood pressure. Her asymmetrical movements confirmed to me that these movements were not being caused by abnormal electrical activity in her brain, but by her emotional attachment to showing her religious devotion and making herself a center of attention. I stood there, staring at her. I was tempted to say what I often said to people who I believed were faking seizures. “Stop it! Just stop it!” But I held my tongue, though the desired words could likely be seen in my stance.
The nurse looked at me and then at the church staff member with an unpleasant frown.
“Aren’t you going to do anything?” The man said.to me.
“This isn’t a true seizure,” I said.
The man looked at the nurse and she looked back at him like he better do something about this.
“She’s having a fit!”
I shook my head. “There’s nothing wrong with her.”
The nurse stared at him harder.
“Please do something,” he said.
“I’m waiting for my partner who’s bringing the stair chair, so we can carry her down the stairs and out to the ambulance where we will bring her to the hospital.”
In retrospect I should have given her some Ativan, not under the seizure guideline because she wasn’t having a true seizure, but under our behavioral guideline because she was having an emotional issue. Someone might suggest I just give her a shot of saline — a placebo, but I had just recently read an article that said giving someone a placebo — a trick of a scurrilous few medics not wanting to give pain medicine– was unethical. If I had given her the Ativan, it would have stopped her exhibition, satisfied her audience and spared myself continuing grief.
The stair chair carry was difficult as I had the feet and the woman kept trying to kick me as she continued her periodic fits that only urged the church member to complain more that I wasn’t doing anything. Then when we were outside, the church member was besieging my partner to make me hurry and he was demanding to know why we were not already en route to the hospital. He followed us all the way there honking his horn to try to get us to put on the lights and sirens.
At the hospital, I gave the nurse my report, along with vitals, blood sugar and 12-lead ECG all of which were normal. I was able to do the IV and 12-lead quite easily in the ambulance because as soon as she was out of sight of the church people she stopped her performance, although she kept her eyes closed.
Afterwards my partner told me the church member said I must not like black people, and my partner told him that wasn’t the case.
Nevertheless, the volunteer town service boss still got a phone call complaining about me the next day, and calling me a racist. I didn’t get in trouble. I didn’t even get investigated. My boss took my side even without talking to me or my partner.
A few weeks later my partner and I were working together again, although this time we were working for the city commercial service. I worked my scheduled shifts in the contract town and then worked overtime in the city three additional days a week. We got called to the same church. The volunteer ambulance was on another call at the time. As we walked into the church, the very same woman was walking out. “Oh, it’s you two again,” she said, not unpleasantly.
“How are doing?” my partner asked her.
“Oh, I’m quite fine,” she said. “Nice to see you.”
“Curious that she recognized us,” I said.
My partner just laughed.
And then we went in and took care of a woman who had fallen and cut her leg. My partner bandaged her and we got a refusal. The church member who had complained about me was there and would speak only to my partner.
I reflect on this years after not to tell how I was categorized as a racist, but to look with fresh perspective.
I wonder if I was black and I was in a white church, and the parishioners felt that I was racist toward them, if I might not have come under more scrutiny when a complaint was filed. If I was black and I was in a white church would I have been so confident to do nothing. Maybe I would have fussed more and put on a concerned caregiver show instead of letting my anger at the woman almost pushing me off the balcony in her careless display of how much she was into the lord get to me.
I also wonder if today, as often happens, I might have been being filmed by five church members holding up their i-phones, and if that would have made me act differently.
Treating people who are faking seizures in front of crowds is challenging, particularly when the chances of being filmed are so high today. Medical professionals will recognize pseudoseizures as they are politically correctly called today, meaning seizures that are caused for emotional reasons as opposed to physiologic, but the public does not understand. That’s another reason, I have gone to a small amount of Versed (which we didn’t carry at that time) in an intramuscular injection. It stops the performance and brings cheers from the crowd. If I can rapidly extricate the person without giving them the drug, as soon as I close the ambulance doors, I find, “Knock it off!” also works well, but for understandable reasons doesn’t play well or work well in front of the patient’s audience.
The call at the church that day was all a long time ago. Much has changed since then.
My partner ended up marrying his white girlfriend and I ended up divorcing my black wife.
The volunteer service chief, who defended me, but who I always had a bit of a tenuous relationship with, ended up kicking me out of the contract town several years later over a blog post I wrote that he didn’t like. I never even got a face to face explanation. He had the sole right to have whatever medics in the town he wanted per their contract with our company. I have never missed him or the Fox News that was often on the TV there, but I missed the people of the town I used to care for.
I still do calls in that town when the volunteer ambulance is out and I still work Sundays and respond often to churches. I have even been back to that same church a time or two. I never again saw that church member, the woman in the white dress or the old nurse with the white hat. I do remember the way the church member and the nurse looked at me, and I have wondered what injustices in their past brought them to view me as they did.
Over the years I have slowly learned not to judge. I do my best to treat everyone right and yes, I fuss over people a little more than I used to. If a patient angers me, I try to not let it get to me. Anger serves little purpose, I try to let it float away like a rare grey cloud on a sunny day. I hope that when I come through someone’s doors now, they see the goodness in my heart, as I hope that I see the goodness in theirs, as well as to try to understand the roads they have traveled. I haven’t had any more complaints.