We must have heard it one hundred times over the last three days. Kip Teitsort, national expert on violence in healthcare, was in town to teach Twin City Ambulance's four DT4EMS instructors an advanced level instructor course.
"This is just a moment in time." Kip would remark as he paused during a skill to show us how the elbow was controlled or how the attacker was now off-balance. Over and over he said that phrase. "This is just a moment in time."
To paint things more clearly you need to understand a bit about Kip. He's a man who was both a paramedic and a police officer. He's got 30 years of training and several black belts in multiple martial arts systems, and has instructed police and SWAT officers in defensive tactics. He's also taught self-defense to scores of healthcare providers all across the country - his current focus.
Kip has intensity and energy that never waiver, which he needs to match his passion for protecting healthcare workers from violence and assaults. If he were a bad guy, he would be the stuff of nightmares. At 6'10" and almost 300 pounds I physically dwarf Kip, but I do not exaggerate when I say that I could literally not lay a hand on him if I wanted to. Because I have had little exposure to martial arts and self defense until a year ago, I've never had the opportunity to meet someone whose hands move with such blinding speed and who so effortlessly removes one from any weapon he or she may wield. It matters not how you attack Kip; you're ultimately on your way to the mat... again.
The training knife I had just tried to skewer Kip with was dangling from two of my fingers while my wrist was twisted at an impossible angle... I was bent over as far as I could be, looking at my peers upside down and Kip calmy said "From here we have choices- this is just a moment in time." He then let go and smiled. It was not the smile of a man who had bested an immeasurably inferior student, but the hopeful smile of a man who was looking for signs that we were "getting it." His ultimate lesson is this: If one masters fundamentals and embraces a moment in time, one may find oneself escaping a violent encounter rather than being hospitalized by it.
There were really only five fundamental physical principles and we all already knew them - we've been teaching them in the basic "Escaping Violent Encounters" course for over a year now. Kip had simply applied them to more complex scenarios, his prowess underscoring the importance of practice. Disappointingly none of us will ever match the skill of Kip Teitsort, but all of us, with practice, might be prepared for a critical moment in time.
As I contemplated moments in time I considered time's somewhat linear nature. I thought about how every call flows from moment to moment- the moment of onset. The moment of dispatch. The moment of arrival. Each call is a dynamic entity, constantly changing. Scenes change, too, but we rarely see scenes or calls in terms of a chain of causal moments. We look at them most clearly in the past-tense as if they were stories we'd just finished reading - pre-shaped lumps of stone. And it's a shame because if we'd master the moments, we'd rarely fail. We'd be ready for everything if we held fast to the knowledge that anything could happen at any moment. And if we were so wise as to be cognizant of the fluid nature of patient encounters, we'd more quickly recognize the critical moments in clinical care AND in scene safety.
Consider this. Kip was showing a video of an EMS call in which a bystander began to make a general nuisance of himself, walking through the scene and snapping comments at the responders. We watched and critiqued the way the firefighters handled not the entire call, but each moment of the call. Without appreciating the body language of this bystander and without appreciating their own body language, several firefighters unwittingly instigated disaster through shear escalation. Kip called out "watch the moment of first touch!" as a firefighter reached for the now irate passer-by. The firefighter grabbed the man's shirt and the fight was on. Even though the firefighters outnumbered the man by five to one and quickly took him to the floor, the battle of the media was lost. Caught indelibly on security footage is a fire lieutenant repeatedly kicking the man who was struggling on the ground with the other firefighters, all while the original patient was left alone and untreated. The lieutenant nearly started a second physical altercation by poking his finger into the chest of another bystander. A chaotic scene, yes, but one made up of multiple moments in which the responders could have avoided a PR disaster or a lawsuit simply by altering their own actions. After all, can we ever really control anyone other than ourselves?
Fortunately a moment in time in EMS self-defense need not always include control of the elbow or a sidestep or a take-down. It could be as simple as the moment we leave a scene because a subject is threatening us. It could be the moment we say "I'm sorry you're upset, sir. Let me see if we can't get you what you need right now." It might be the moment we eye up the house as we arrive, notice the lights are all off, and wait two minutes until police arrive on scene with us. It might even be the moment we ignore a verbal insult from a drunk because, at the end of the day, it's not personal.
Moments in time.
I'm a little sore today after 24 hours of having my butt handed to me by my fellow instructors and especially Kip. I was shot several times with an Airsoft pistol, poked in the ribs with a plastic knife, and tossed to the ground more than once. Yet I'm also 24 hours wiser about the moments that make our jobs more dangerous. As I said, I can never be Kip Teitsort, but I can keep practicing and teaching other providers about being safe. If we're successful in delivering the message - Kip's message -the healthcare personnel we get to teach will learn about taking full advantage of each second of each encounter. They'll give great care, great service, and stay as safe as possible simply by mindfulness of each moment in time.