Oh.

She met us at the door, with a suitcase in each hand, what we call a Positive Samsonite Sign. Angry Partner had been muttering to himself since we were dispatched. She was easily as large as both of us combined.

“I don’t feel safe,” she whined in a voice more suitable to someone 1/3 her size. The staff member from the group home, visible over her left shoulder, simply shrugged and turned away. He and AP both new her well. I, as a rookie, hadn’t met her before.

Before we could ask any more questions, she pushed between us and began a leisurely stroll down the steps to the waiting ambulance, with a suitcase in each hand. As we stared, she walked directly to the back of our rig, opened the doors, placed her suitcases inside, then turned to us. “You’ll have to lift me. I have bad knees.”

I heard the door of the group home slam behind us.

“I don’t feel safe,” she moaned again in the ambulance.

They don’t teach much psych stuff in basic EMT classes. Perhaps it’s because they don’t think we’d believe it. Perhaps they don’t know what to say; I often don’t. Part of me wonders if they withhold it so that our senior partners can get a good laugh out of us rookies.

“Why, what’s wrong? Is someone hurting you at the group home?” I doubted it, but it’s not impossible.

“No, the voices keep telling me to hurt myself.”

OK, definitely not in the manual. A quick glance around the ambulance confirmed that there was nothing handy which she could use to hurt herself or me.

“Well, just ignore them. We’re taking you someplace safe.”

“The voices are telling me to throw myself out of the ambulance.”

I could see AP watching me in the mirror. Something told me he’d been here before.

“You can’t,” I answered. “The doors are locked.”

“Oh.”

“Gakkkk.”

I looked up to see my patient attempting to choke herself with her own hands.

My rookie brain sprang into action. Choking = no airway. No airway = dead patient. This is NOT GOO- wait a minute! You can’t choke yourself to death, it’s like a toddler holding his breath to get what he wants. The absolute worst case is that you will pass out, loosen your grip, and wake up again.

I felt the ambulance swerve slightly, and I looked up to see AP laughing at me in the mirror. He saw me jump, and had probably seen the entire train of thought pass across my face.

*sigh* “Knock it off. We both know that won’t work.” She did.

We arrived downtown at Local Psych Facility with 10 minutes left in our midnight shift. We assisted the patient out of the truck, and my partner took her suitcases. I sensed he wanted to get this call completed as soon as possible.

The patient began to shuffle across the parking lot with both of us in tow. Halfway to the entrance, she suddenly spun on her heel, shouting, “I’m going to throw myself in front of a car!” and began to run toward the street. I didn’t know she could move that fast!

I dropped my clipboard and began to sprint after her. My partner froze and dropped her luggage. Before I’d gone two steps, I heard him bellow. “YOU CAN’T!”

The patient and I both stopped in our tracks and turned to him. Angry Partner stood with his arms crossed and his feet spread in his best parental I’ve-had-enough-of-this stance. “IT’S MIDNIGHT! DO YOU SEE ANY F***ING CARS?”

Our patient looked around briefly at the empty city. “Oh,” she said, and resumed her shuffle towards the door.