Trauma and tumult, partners

Steve Barnes

The man rushed to the hospital as quickly as prudence permitted. His daughter-in-law had assured him that his son, her husband, was clinically stable: blood pressure and heart rate only slightly elevated, both almost certainly owing to his not inconsiderable pain. The patient’s blood oxygen level was normal, as was his respiration rate. He was receiving pain medication, though not so much as to impede a diagnosis, which, given the nexus of the discomfort, everyone with a whit of experience, the wife included, suspected: diverticulitis — an infection in the large intestine. Hurts like the dickens, but imminently treatable, though it could take a bit of time. Might even involve some surgery, though a steady infusion of antibiotics is often enough to carry the day. Whichever treatment approach, what better, safer place for his son to be, the father reasoned, than one of Arkansas’ biggest, best-equipped, most sophisticated medical centers?

The metal detector was the first thing he saw. It was just inside the emergency room entrance, and a first cousin to the ones at every airport. To the side, a desk with two uniformed security guards, their belts laden with handcuffs and batons and radios. A plastic tub was shoved across the desk and: “Empty your pockets.” Not even “please.” “How are you today?” would be so — so — what? Nineteen-seventies?

Only a couple years ago, when COVID was raging, the hospital in mention wanted only to know if you were wearing a mask, not concealing a firearm.

Then, the poster in the emergency room bay, which, in capital letters, commanded all who entered to pay ATTENTION: “Our hospital is a healing environment. Aggressive behavior will not be tolerated.”

For the benefit of the crude or feeble-minded, the sign offered some — “Examples of aggressive behavior: Physical assault, verbal harassment, abusive language, sexual language directed at others, threats, unwanted touching.

“There is ZERO TOLERANCE” — the hospital’s capitals, again — “for all forms of aggression. Incidents may result in removal from this facility and prosecution.” In conclusion, the hospital “supports staff in pressing charges for aggressive behavior they encounter while caring for patients.”

Welcome to 2023. Where have you been? asked a hospital executive, when the patient’s father inquired about the security level. Muscle is the rule, not the exception, the administrator said, especially in emergency room areas. Maybe the smaller hospitals could do without on-site security personnel, he said, but not in urban Arkansas. Not any longer, not “in this time of … tumult.”

For the state’s largest teaching hospital, the tumult began “several years” past, said Leslie Taylor, communications director at the University of Arkansas for Medical Sciences. The campus has its own certified police department and metal detectors at the ER entrance. Perhaps a couple times a year, she said, UAMS officers arrest someone attempting to bring a weapon onto campus.

As a trauma center, Taylor said, “we treat victims of gunshots and violent crime and we want to ensure the safety of patients and our team members.”

In a time of tumult, every ER treats gunshot victims, or stabbing victims. And men and women and children brutalized by other means, and whose crazed assailants will follow them into the treatment area, or try, and in the process attack or otherwise confront a nurse or technician or physician. The legislature this year made assault against clinical personnel a felony.

The tumult that can reach an emergency room doesn’t begin there. The societal ills in which tumult thrives can afflict the youngest as easily as their elders. At about the time the father hurried to his son’s side, UAMS was announcing a $1 million grant from the U.S. Justice Department. The money will fund a three-year initiative that will attempt to reduce violent crime “in and around” public schools in Pine Bluff. Three other much smaller communities already participate in a similar program, which UAMS says trains officials “in how to respond to mental health crises and how to coordinate between law enforcement and school personnel in handling threats.” Pray that it works.

And here’s the state’s largest health insurer, Blue Cross, donating $2,500 to 75 Arkansas schools to establish “calming rooms,” wherein students struggling with depression, anxiety and other behavioral disorders can shelter during times of emotional stress. Pray that it works, too.

The father’s prayers were answered in due course, as were those of his daughter-in-law and other kin including, presumably, the patient himself. No surgery, just three days of intensive antibiotic therapy, then back into the outside world, in its time of tumult.