Archive for the ‘Psych’ Category

Mar
2

Gangsta Rap 3/3

The police officer sees us on the security camera and pushes the button that activates the large sliding metal gate. We drive in to see the parking lot full of police cars and head towards the sally port – a secure transfer spot for taking prisoners in and out of the city jail.

Five officers are waiting for us as Kevin and I step out of the rig to see why they called us to the back of the jail today.

The officer with the stripes on his sleeve approaches me and gives me the story. “Hey guys, so we picked this guy up on being drunk in public. While we’re getting him booked he starts talking about being suicidal and wanting to kill himself. So instead of booking him we put him on a green sheet to get checked out at EPS.”

“Did he actually do anything to hurt himself or is it just talk?” I’m just trying to see if I’ll have any injuries to deal with or is it just verbalizing suicidal ideation.

“No, he didn’t do anything – he actually wants to go to EPS. Go figure.”

“Has he been violent with you guys?” Trying to gauge the need for restraints or not.

“No, he’s been good, but he’s a big guy so we kept him cuffed.”

“Sounds easy enough. Do you want us to come in and get him or do you want to bring him out?”

“You can hang tight here, we’ll bring him out.”

We’re in the mid-county, more affluent cities, so there are more available police officers than in our Big City. In these cities it’s common to have four or five police cars respond to a single incident where as in the Big City they are stretched so thin it’s hard to get just two cops even when we need them.

The officers return from the sally port escorting a man in handcuffs. With one officer on each arm, and three more keeping watch, the man is doing a slow shuffle towards me as I wait next to the rig. He’s got his eyes closed down to slits which gives him a menacing look yet also allows him to surreptitiously observe his environment without others seeing the direction of gaze – prison yard stealth. With his shifting gaze he never looked past my blue uniform, which matches the police officers, to see who I am.

“Yo, Lil’G, what the hell you doin’ down here?!” The officers stop mid-stride as they didn’t expect to hear “street speak” coming out of the clean cut paramedic standing in front of them.

Lil’G’s eyes pop up to full round and he drops the prison yard stealth mode as recognition sets in. He gets a big smile on his face, “Yo, T2, it’s my boy. Ya’ll did me right, you called my boy to come get me.”

“Lil’G, you all right man. You gonna be cool if I get you outta those cuffs?”

“Yeah man, I cool, you my boy.” I can smell the alcohol coming off of his breath and hear the slight slur to his speech.

I turn to the officers holding on to his arms. “I’m good guys, you can un-cuff him. We’re old friends.” They catch the irony in my voice.

Lil’G happily climbs up into the ambulance as I chat with the sergeant for a few minutes.  “I usually see him up in the Big City around the seventies. I’ve never run into him down here.”

“Yeah we haven’t seen him before. I’m happy to send him up to EPS and out of our city.” It’s the classic small town sheriff giving the trouble maker a bus ticket out of the city.

“I hear ya’. We’ll take care of him. See you next time.”

I climb in to sit on the bench next to Lil’G and pull out the fat person blood pressure cuff to fit around his enormous guns.

“Lil’G, you losing some weight? You’re looking skinnier than the last time I saw you.”

“Yeah man, I going through some shit, you know. Not eatin’ much. I lost my daughter two week ago, she dead.” He’s introspective and just a little bit sad. I’d say that’s justified.

“Oh man, I’m sorry to hear that.” I’m curious about the circumstances but I honestly don’t want to talk about it too much with him. Remembering his bipolar diagnosis I know he could cycle on me and you just never know where that’s going to go.

In an attempt to steer the conversation somewhere else. “You got any new raps for me?”

“Yeah man, I got a rap for ya T2, it’s my story.”

I’m a play’a… that’s my number one life style.

I’ve been a play’a… since I was a li’l child.

I grew up… havin’ hard times every day.

I had to choose a road… but didn’t know which way.

 

Started kickin’ it with the fellas… on seven ohh.

Makin’ money… cuz that was the way to go.

Smokin’ dank, full tank… get an even high.

Even had three ho’s… on my side.

 

Two was cool but one… thought she was a gangsta.

But I didn’t know… I was fuckin’ with danger.

She kept on tellin’ me how down she was… you know.

She said she didn’t give a fuck… about five-ohh.

 

Till the day on the ave… we was kickin’ it.

Wasn’t nothin’ else to do… but get lit.

Straight hands to a gangsta… whole nine yards.

Till the sucka tried to pull… my damn playa’s card.

 

I threw a left… and connected to the fool’s jaw.

The punk fell an’ tried to walk… but he had to crawl.

I split the scene… and went to the fuckin’ sto’.

On the way back… I ran into the Po Po.

 

Shit was cool… so I didn’t want to bail.

Fuck the po-lice… I ain’t going to jail.

I cocked my nine… then I fired at the dirty mack.

I started trippin’ and my mind… started to un-fold.

I’m in the middle of a shoot out… damn I’m told.

 

As curiosity was fuckin’… with my damn head.

Bullets kept flyin’, people dyin’… and bodies bled.

I dropped my nine, then I reached… for my four-four.

Empty one clip, then I headed… for my car door.

 

I couldn’t believe my eyes…

It’s my mind’s surprise…

I’m the only black nigga gonna stay alive.

 

Jesus Christ… this mutha fuckin’ gang.

Po Po try an’ jack me… and playin’ wit my fuckin’ brain.

But I ain’t going down… I’m not a sucka.

You want me… you gotta kill me mutha fucka.

 

Bill Gates… and the rest a the klan.

Ya’ll can suck my dick… cuz I’m a crazy ass black man.

But in the mean while… I’m just as versatile.

That’s my life… gangsta life… that’s my life…style.

My name is Lil’G… and I’m out.

Lil’G is a very real man and the above rhymes are his words. I apologize for the graphic nature and language yet I think it’s important to keep it authentic as an accurate  representation of how his mind works. It would be easy to dismiss this as typical gangsta rap but I think it goes deeper than that. This is a man who has been in and out of institutions – criminal and psychiatric – since he was young. He may have actually picked up some coping mechanisms to deal with the turmoil that haunts his waking moments and it manifests with introspective communication in the only way he knows how. Just as his bipolar mind cycles from emotion to emotion his physical body will cycle from street to institution until both are exhausted. There is no escape for his mind or body from the streets that created his life…style. 

Mar
0

Gangsta Rap 2/3

Kevin and I are dumb-founded. It was actually a good rap, despite the disturbing subject matter, and Lil’G seems to have some talent. I’d much rather listen to him rhyme than watch him tear the place apart.

“Lil’G man, you got some talent, you write that when you’re in prison?” I’m honestly curious.

“Nah man, I gots too much to do when I’m in the joint.” He’s dismissive with a wave of his hand.

“Too much to do? What, you working out all the time? Gotta build up those guns?” Referring to his biceps. Yet a tickling on the back of my neck reminds me that we didn’t exactly search him before he got in the ambulance with chest pain a few minutes ago. I hope Kevin did the “EMS pat down” as he put the monitor leads on him.

“Nah, I don’t work out in the joint. I’m too busy keepin’ an eye on all those niggas. Don’t never know when some fool’s gonna come up and try to stick me. Gotta be ready for a smack down, you know?”

After what seemed like an eternity PD shows up. Fortunately they pulled up to the front of the rig and I’m able to brief them before Lil’G notices they are here. The officers walk around the back of the rig so Lil’G can see them and it’s obvious by his expression that he’s not surprised. He knew this was happening all along. He’s been in this situation before and knows the drill just about as well as we do.

After a quick conversation and some paperwork the green sheet is finished and we can start to transport to the Emergency Psychological Services (EPS). Lil’G will get a psych evaluation and maybe stay a day or two for observation. It all depends on how he answers the questions.

It’s Kevin’s tech so I’m up front driving to EPS while Kevin finishes off the paper work. It turns out that no restraints or sedatives were necessary as Lil’G seems to want to go to the EPS. I can only imagine the life he’s led up to this point and how it may actually be comforting for him to rest in a relatively safe institution for a few days.

Growing up in the hood he presumably had few positive role models. He must have been in harm’s way often and exposed to some traumatic events. Just as a soldier comes back from a war with PTSD, I can imagine that life in the hood can create the same effect. Then at a formative age he’s placed in prison with its strict routine and lack of freedom accompanied by the ever-present danger of prison violence. Past traumatic experiences have created at least as many mental/emotional scars as physical ones.

Yet even with these obstacles this man has made it to his forth decade of life, which is rare for people in his situation. He seems to focus his energy on his rhymes, which he presents in all modalities of communication, with a harmony of visual/kinesthetic/auditory artistry. A man with limited education and vocabulary is able to access his inner emotions and express his feelings, dark and violent as they may be, to others and himself.

Pulling into EPS I hear the disturbing rhymes from the back of the rig.

I chop your head off… let it roll in a buck-et.

I punch your eyes out… so I can skull fuck-it.

 

But I aint trippin’ nigga… I won’t beg.

I drink the blood… from a bull dog’s left leg.

 

I told you once nigga… I ain’t even trippin’.

You get found nigga… by three old men fishin’.

 

We can do some shit… I might bust your brain.

But on the tip of my shoes… I’m leavin’ doo-stains.


Mar
0

Gangsta Rap 1/3

gang·sta

1  :  black slang; a gang member

2  :  a type of rap music featuring aggressive misogynistic lyrics, often with reference to gang violence and urban street life

rap

1  :  to hit sharply and swiftly; strike

2  :  a criminal charge; a prison sentence

3  :  music; to talk using rhythm and rhyme, usually over a strong musical beat

4  :  to have a long informal conversation with friends

Violence is a part of America. I don’t want to single out rap music. Let’s be honest. America’s the most violent country in the history of the world, that’s just the way it is. We’re all affected by it. That’s one of the frailties of the human condition; people fear that which is not familiar.

Spike Lee

“Ya’ see, I didn’t really call you here because I was havin’ chest pain. It nothin’ like that at all. Ya see, I thinkin’ about killin’ myself.” As the fire engine accelerates away from us Kevin and I have a very different call on our hands than the one we thought it was going to be just a few seconds ago.

Getting called to the middle of the hood for chest pain is a common enough thing and we answer these calls on a daily basis. Today we happened to be just a few blocks away when the call information arrived on the Mobile Data Terminal (MDT). I turned the ambulance around and we were on scene in less than two minutes.

Sitting on a chair in front of an urban church outreach center was a man in his early forties. The pastor and church volunteers are comforting him as we walk up to see what’s going on. Holding his chest he tells us of the pain he’s feeling and how he wants to get checked out at the hospital. It’s an easy call and the assessment and treatment are so rote that we fall into auto pilot as we go through the motions.

Seeing the fire engine approaching from down the street I write the man’s name and birthday on my glove and hold my hand up high so the fire lieutenant can copy it down for his records without having to exit the engine. In seconds they are off to the next call and we are alone with the patient. Of course, that was before I knew the true nature of the call.

After our patient drops the bombshell on us, Kevin and I take a collective deep breath and one look between us confirms the sudden detour this call has taken. In our business suicidal ideation is taken very seriously. A person who is truly suicidal, who has ceased to care about their own life, may not care about other people’s lives. Therefore, we can be in danger when dealing with these people.

Our new patient, Lil’G, is quite a formidable man. He has scars on his face, one of which is consistent with a knife wound. He’s 240 pounds of compact, short, boxer’s build with huge upper body development. He’s seriously built like a smaller Mike Tyson. He jokes with Kevin because he had to pull out the fat person blood pressure cuff just to fit around his huge biceps. He does a muscle man flex and smiles showing me a gold tooth. I’m feeling very uneasy about this. I give Kevin a look that he understands. “I’ll be back in a second.”

“Hey, where you goin’?” He’s quick with predatory instincts, watching every movement – nothing escapes him.

“I just have to get the computer from the front.” It’s a half truth which I hope he doesn’t see through.

Walking up to the front of the rig I turn on the portable radio on my belt. Opening the front door I grab the computer and turn off the rig radio which can be heard from the patient area in the back. I stand in front of the engine compartment so I can keep an eye on Kevin through the windshield as I call in to dispatch on my portable.

“Medic-40 go ahead.” The radio crackles back to me.

“Medic-40, please send PD to our location, code-2, our chest pain call just turned into a 5150 with suicidal ideation. We’re code-4, for now.” The code-4 tells my dispatcher that we are not currently in danger. The ‘for now’ tells her that I don’t know how long that’s going to last.

I’m standing outside of the back doors as Kevin is doing further assessments on Lil’G. Kevin knows the drill: we have to stall as long as possible so PD can get here to write up the green sheet (5150). Without it we have fewer of the options we may well need in this case, like restraints and chemical sedation.

I’m watching Lil’G as Kevin continues with the 12-lead EKG. Lifting up his shirt I see the multiple GSW (gun shot wound) scars.

“Lil’G, how many times you been shot?” Anything to distract him and buy us some time.

“Yo, I been shot four times, stabbed two, and sliced up a couple. It’s hard man, growin’ up in the 70s.” He’s not referring to the decade – to him the 70s are the street numbers in his corner of the hood.

“You ever do time?” I’m thinking prison ripped could explain the boxer physique.

“Yeah, I did six year, fo’ bangin’. You know; sellin’ a little, had sum ho’s, and a little bit a shootn’.” He’s not talking about shooting up with heroin. “Yeah, I got a strike on me.” In this state it’s three strikes for felony convictions and you’re in prison for good.

Kevin’s still trying to stretch out the assessment as I’m typing on the computer. “You got any medical problems?”

“Yeah, I got PTSD, bipolar, paranoid schizophrenia, and depression, but I ain’t takin’ no meds for it.” FUCK ME!!! I’ve got a bipolar psych patient who’s off his meds, built like Tyson, and thinking about killing himself. I really need a raise.

Lil’G could shred both Kevin and I if he put his mind to it. Not to mention tear the ambulance apart. We’re walking a fine line here and we have to keep him on the good side of his bipolar disorder. I’ve watched manic bipolar patients cycle from happy to violent a dozen times in the course of a single transport. If this guy cycles on us we’re fucked.

Despite the lethal potential of Lil’G he’s actually pretty engaging. He has a fast wit and keen observation skills. He decides I look like the silver terminator from Judgment Day, in reference to my hair style and clean cut white boy appearance. Seeing as the terminator impersonated a cop through most of the movie I’m not sure I like the reference.

“Yo man, that’s your new name, I’m gonna call you T2.” He has a full bodied laugh with muscles rippling to the diaphragmatic contractions. Great, I have a street name.

And just like that Lil’G cycles on us. Yet not to a violent nature – quite the contrary. Right there in the back of the ambulance he starts rapping. With perfect tempo and surprisingly colorful depictions he tells us what’s on his mind in the only way he knows how.

I’m on the microphone… gotta do it quick.

But never give a care… I ain’t scared to hit a bitch.

Gotta hit her from the back… nigga back side.

I don’t give a fuck nigga… it’s time for a wild ride.

 

Call me Lil’G… when you see me.

I see niggas on the street… trying to be me.

I got these knuckles man… I make ‘em laugh man.

Never give a care… put ‘em in a bath man.

 

Gotta do it good… cuz you know what’s right.

I never give a care nigga… cuz I’m hell’a tight.

I come from 69ville… nigga eight-five.

Never give a care… boy I don’t duck and hide.

 

I’m born on the east side… I’m going east bound.

You a block head… whose name is Charlie Brown.



Jan
0

Suicidal Ideation 3/3

“Medic-40 copy code three.” The dispatcher’s abrupt call snaps me out of my otherwise boring day surfing the web on my iPad. It’s been quiet today – not too many calls have been getting sent out. Crews across the county have been sitting idle for the last few hours. Scottie is off today so I got assigned one of the float EMTs – we call that “mystery meat.” This is the first time I’ve worked with him and I got tired of listening to his diatribe six hours ago – so I’m happy to have a call.

“Medic-40 go.”

“Medic-40, code three for you. 1055 Vincent St. for the 22 year old male with a noose around his neck. You’ll need to stage for this please. PD is en route.”

“Medic-40, ten-eight” (we’re en route). Plugging the address into my iPad I see that we’re only ten blocks away from the call. We’ll be there in just a minute.

Almost immediately the radio crackles again. “Medic-22, we’d like to jump that call for 40.” Finally something interesting to relieve the boredom of the day and everyone else wants a piece of it. I’m not sure where 22 is but we’re close enough to make it in stellar time and I really want something to break the monotony of the day. Not today guys.

“Medic-40, we’re pretty much on top of it, we’ll take the call. Thanks Medic-22.”

As we pull out of the parking lot where we have been sitting for the last few hours a fire engine screams past us headed towards the call – we pull in behind them with our lights and siren singing a duet. I like going to calls with the fire engine clearing traffic for us. People tend to clear out of the way a lot faster for the BRT than they do for a little ambulance. It’s like having a big brother who’s a linebacker clearing the hallway between classes in high school – we just follow along in the wake.

Two police cars pass us as we turn into the residential neighborhood and the BRT follows them straight to the house. So much for staging and waiting for police to secure the scene. I’m usually happy to stage and wait for police to call us into the scene – it’s safer. But in this case there are only a few possible outcomes; the person is dead and has been for a while, he just hung himself and cutting him down now could save his life, or it’s complete BS.

As we get out of the rig the firefighters are headed into the house with their bags. We decide to just walk up and see what’s going on before pulling the gurney and equipment out. Walking to the front door a woman exits the house with her hands covering her face, crying. I step through the front door and into the living room to an officer coming down the stairs with a young man in handcuffs.

The officer comes over to us. “He wasn’t hanging; just lying on the bed with a noose around his neck. He said he wanted to hang himself but couldn’t find anything to tie the other end of the rope to. We’ll have a green sheet for you in a few.”

According to the American Foundation for Suicide Prevention:

  • Over 34,000 people in the United States die by suicide every year.
  • In 2007 (latest available data), there were 34,598 reported suicide deaths.
  • Suicide is the fourth leading cause of death for adults between the ages of 18 and 65 years in the United States (28,628 suicides).
  • Currently, suicide is the 11th leading cause of death in the United States.
  • A person dies by suicide about every 15 minutes in the United States.
  • Every day, approximately 90 Americans take their own life.
  • Ninety percent of all people who die by suicide have a diagnosable psychiatric disorder at the time of their death.
  • There are four male suicides for every female suicide, but three times as many females as males attempt suicide.
  • There are an estimated 8-25 attempted suicides for every suicide death.
Jul
0

Simple Restraint

 

 

 

sim·ple

1 : of humble origin or modest position <a simple farmer>

2 : lacking in knowledge or expertise

3 : mentally retarded, not socially or culturally sophisticated

re·straint

1 : a restraining force or influence

2 : something that is fastened to limit somebody’s freedom of movement

3 : restraint is calm, unemotional, behavior that does not provoke

As we round the corner there are three police cruisers pulled over with officers standing around. There’s a man cuffed in the back of one car with an officer doing some paperwork using the trunk as a desk.

It’s evening in the big city of my mostly urban county. The city police are on full deployment; everyone in the department is doing 12 on 12 off shifts. With PD layoffs on the horizon due to a city budget deficit and impending civil unrest due to a trial of a former police officer, the tension in the city is palpable. The police are backing each other up on every call with a show of numbers on the street.

They called EMS for an individual on a 5150. This refers to article 5150 of the state health and welfare code that states an officer may detain someone for 72 hours for psychiatric evaluation if they are deemed to be a danger to self or others. 5150s are theoretically used when a person threatens suicide or has some sort of behavioral crisis of a psychiatric nature. In practice, it tends to be used when PD can’t find grounds to arrest someone but wants them off the street.

Walking up to the police car I see a man in his twenties cuffed in the back seat. One of the officers sees me and gives a quick report. He says that this man’s mother and aunt called because he was emotionally disturbed about the situation in the city. He kept going on about wanting to kill some cops and shoot up the nearby police sub-station and he’s off his psych meds. Given what’s going on right now I can see the logic in getting this guy off the street for a while before he does something really stupid and gets himself killed in the process.

I open the door to the cruiser to get a read on the guy. The smell of alcohol flows out as the door opens. Great! Drunk cop killer in the making and off his meds. He’s taller than me and has great muscle tone – maybe prison ripped (prisoners have nothing better to do than work out, so when they’re released they’re amazingly well-built). He also has good veins. Not a junky; could be a fighter.

“Hey Lawrence, how ya feeling today?” This 20 second introduction is my chance to get an idea of how I’m going to be treating him over the next half hour. Do we have a nice conversation on the way to the hospital, do I have 5 cops hold him down while I sedate him for my safety, or something in-between?

“Yo! Why they do me like dis? I ain’t done nutt’n man…”

“Hold up, hold up, I gotta axe you sum questins man.” I match his street vernacular. I’ve got to cut him off quickly before he spirals out on me. Some may see that as insulting but it honestly speeds communication and builds rapport in the hood as long as you can do it well and with sincerity. All of the medics in county can speak street. My wife thinks it’s a riot and tries to get me to do it for friends. Something about an Irish/Scottish guy speaking street is a bizarre juxtaposition.

“Yo! Lawrence how much you drink today?”

“Man, I dun know, jus a couple, shit man why they do dis to me, man I din do nutt’n…”

I cut him off again, louder: “Lawrence! Chill man, chill. Couple a what? When you get your drink on man, what you drink?”

“Pints, jus a couple pints man. Vodka man das what I always drink.” Well, at least we’re communicating now and not yelling at cops. I’ve seen what I need to see. “Aw-rite, Lawrence, yo sit tight man, I’ll be back min’it.” Like he’s going to sit any other way in cuffs.

I close the door and tell my partner that we’ll need restraints for the gurney and tell the officer that we’ll be going to the hospital for medical evaluation prior to getting him transferred to the county emergency psych services. They’ll need to draw some blood to get a blood alcohol level and tox-screen on him. His speech is a little slurred, he ramps up pretty quick, and he had twitchy eye movements. Maybe he’s just a scared guy in a bad situation or maybe he’s a bipolar/schizophrenic who will cycle faster than I can keep up. Either way I want him strapped to the gurney for my protection.

My partner comes back with a big round-eyed look. Oh shit! “Dude, someone snagged our restraints, I checked the rig, we don’t have any stashed.” CRAP! We have the same rig every day, we used the leather restraints yesterday. Unfortunately it happens often that another crew will take equipment from a rig while it’s parked at deployment. Then it becomes a domino effect and you have to see what was removed every morning. It’s my fault – the restraints are in a fairly hidden place so I didn’t think to check to make sure they were still there this morning.

There’s no way I’m transporting this guy without restraints. Fine, we go old school. I go back to the rig and pull two triangle bandages, which are usually used to make a sling for a broken arm. Today they get used for restraints. My preceptor back in the rural county where I interned showed me how to use triangle bandages to make back-up restraints by tying interlacing lark’s head knots. This technique doesn’t cut off circulation but if the patient struggles it cinches down – the more they pull, the tighter it gets. In that county we had a state penitentiary and sometimes had to transfer prisoners more than 30 minutes to the nearest hospital. Being in such close quarters with a guy that’s doing 25 to life for murder, redundancy of restraints becomes a priority.

I have the officers help us to put Lawrence on the gurney, take off the cuffs, and tie his wrists to the rails using my modified restraints. All the while Lawrence is complaining about the injustice how his rights are being violated.

Now that he’s out of the police cruiser I see just how big he is. If I have to overpower this guy it’s going to be hard to do without hurting him. I don’t want to use drugs to knock him out; he’s been drinking and  may have other drugs on board which could interact with my sedative. It’s embarrassing to bring a patient into the ED while bagging them because you knocked out their respiratory drive. I better play this soft, I don’t want him ramping up on me.

I get him loaded into the rig and jump in on the bench seat next to the gurney and tell my partner to just drive. I want this over fast. I take a set of vitals. He’s within normal limits on everything. Well, at least that’s good; no crack or meth.

As I’m talking to him I start to realize his slurred speech isn’t the normal alcoholic slur and his mental associations aren’t the angry disenfranchised minority gang banger rhetoric. He’s actually inquisitive and asks questions about things with genuine simplistic curiosity.

“You got kids man?” Laying on the gurney with wrists tied down. I have the strangest conversations in EMS.

“Nah, no kids man, I got dogs. Dogs are betta.”

“What kine a dogs you got? You got any pit bous man? I love them pit bous!”

“Nah, I got a hound dog and two small dogs. My wife wans a pit bou though.”

“They took away my pit bous man, I love thos dogs man, how can they jus take a man’s dogs away, I love thos dogs.” He’s getting upset, starting to cycle, I’ve got to steer this in a good direction quick.

“I hear ya. Pit bous are good dogs man. I see ‘em all the time at the shelter. I volunteer to wash them at the shelter, give em a bath, man they so happy when they clean. That way they smell good and get adopted faster.”

“Nah man, you lie’n to me. You no volunteer and shit.”

“Hell yes I volunteer, couple times a month. I just go down an wash dogs all day. You wanna see some dogs you go down an’ do it too. You get to play with dogs an make ‘em happy and clean so they get adopted sooner.”

“Nah man, I jus wanna take ‘em home wit me.”

“Nah man, check it – you take one dog home and you jus gave a home to one dog. You get 100 dogs clean and happy so they get adopted, you jus gave a home to 100 dogs. How you think you gonna feel then?” He thinks about it for a while, a little too long of a while, and then his whole face lights up. He tells me how happy that would make him feel to help 100 dogs.

Laying in front of me is not a violent gang banger who wants to kill cops. He’s a seven year old in twenty-something body. The slightly slurred speech, the simple questions, the delayed comprehension – he’s developmentally challenged.

I pull the trauma shears off the wall and make a show of cutting his modified restraints off. He seems like he’s calm now – no cops around making him jumpy – and we both like “pit bous.” Besides, I don’t want the other crews at the ED seeing my restraint method and giving me shit for not checking out my rig this morning.

As soon as I cut the hands free his arms come up towards me. Damn those are big arms. Fuck, no not that, anything but that! He gives me a hug.

We finish the ride to the hospital with more talk of dogs while I finish off some patient information on the laptop. While pushing the gurney into the ED he’s hanging on my shoulder, worried that I’m going to leave him.

“Nah unkol, you cain’t leave me man! Why you gotta go unkol? Thas what they all do. Who’s gonna take care of me man?”

I can only imagine the life he’s led. Growing up in the hood with a disability must be horrible. No men in his life, raised by Moms and Auntie, with three generations of women living in the same house. He’s an easy target for the predatory behavior of his peers. He quickly tries to mimic them in dress, attitude, language, and drug and alcohol use to attempt to fit in or at least stay out of the cross hairs of the more malicious predators. He’s an innocent mirror; reflecting the attitudes of the people around him. They’re angry at the cops so he’s angry at the cops.

“Nah, Lawrence, check it man. These people can take better care of you than I can. They hep you man, I promise. It’s like the pit bous man. If I take you home I only help one person. If I stay on the street an meet 100 people like you, I help 100 people. You get me man?”

He gets it – he’s not happy about it, but he gets it. I give the report to Katie, his nurse. I’m glad she’s here today, she’s the perfect personality to at least make sure he’s looked after while in the hospital. They call a security guard and he takes up a post outside of a room. Lawrence will have to be within sight of him until he’s transferred out. I get Lawrence moved over to the bed. He’s sad and doesn’t want to talk to me any more. He closes his eyes and pouts. I look at the 5150 form written by the officer and take another look at Lawrence to burn the image into memory making the visual association of name to face.

I’ll see him again, if not on the streets then in the news. Someone will convince him to do something stupid and he’ll do it just to please a male father figure. He’s a big intimidating guy at first glance and but he’s simple-minded. The police will be inclined to tase him or shoot him than fight with him or talk to him.

I walk out of the room and the rest of the nursing staff gives me shit for adopting a gang banger. I’m glad this is the last call of the day. My uniform smells like Lawrence, I’m tired, and I’m running low on triangle bandages.