Everything changes upon first touch


In the police academy, I was taught an intoxicated person was most likely to resist an arrest, become assaultive toward officers or want to “fight”, upon first- touch.

That was an educational lesson that proved remarkably true in my experience on the streets as a cop.

I would like to expound on that concept just a bit and say: Everything changes upon first touch.


 As a trained and skilled EMSer, you are not only at home within chaos, you thrive there. The untrained-unexperienced non-EMSers, the chaos, the incomprehensible, this tangled line of knots, that is medical or traumatic emergencies, you see with perfect clarity the way to untangle the most obscure line.

As being such, imagine the following scenario:


It’s a blistering hot early morning when you and your partner are dispatched to a report of an electrical burn. You smell the steam from the pavement from the earlier washing of your rig, as you enter the passenger side of the ambulance. The reflection off the pavement causes you to squint, and you don your sunglasses.


As you sit, pull the seatbelt across, you think of how hot the metal clip is, and wonder why you hadn’t left the ambulance running on such a hot summer day, regardless of how admin bitches about the fuel.


You notify dispatch you’re en route, reaching for the map-book, you realize how unfamiliar the area is you are responding to. That voice in your head makes you consider how this must be a real call because we are never in that area. It’s too wealthy you think to yourself.



Through the familiar audible scream of the siren, dispatch advises the caller is a 13-year-old male, who says his father has been “shocked.” Dispatch does some digging and comes back with stating the caller is reporting the patient is his father; has suffered severe electrical burns while servicing an air- conditioning unit.

Arriving at the scene you notice a single-family residence, with a large driveway and meticulously manicured lawn and landscape. Your ADD minds drifts for a fleeting moment thinking of “how nice it must be” to reside in such a palace, as your partner notifies dispatch of your arrival.  


Rhythmically, side, compartment, and rear doors opened and shut, as you gather equipment. Turning toward the moment of truth, a door of the residence propped open; the proverbial flashing entrance sign “this is the way scooter’ drws you in. Trying to remain on the concrete driveway, you shimmy past a parked white refrigeration service van. Your brain immediately  green checks that golden nugget of scene survey information with the box labeled “This is appropriate for what I would expect.”


You announce your presence and are invited begged inside by a nervous voice, inherent to a scared kid. You try to act “cool” as you swallow the dry lump that just appeared in your throat. The very tone and rate of the kid’s speech provides a visceral feeling of the distress level. It penetrates your alpha-in-control persona armor, like a powerful strobe-light on the darkest of night.


Like a soldier on the modern battlefield, moving briskly across the fatal-funnel threshold, slowed slightly by equipment; You are immediately bombarded with information you must now assess, prioritize, categorize, and react to.

This one screams in your face, a dire traumatic injury, a line so tangled, death is imminent without serious ALS interventions.


Faster than the most sophisticated computer, your brain processes your findings. The patient, a man in his 40’s, is seated, marionette-slumped, on a living room chair. The greyish tint of his skin was the “we-better-boogie-with-this-guy” sign you noticed first. He was mumbling, rocking back and forth, holding his right arm.

Through trembled voice and broken words, the patient gives consent. You carefully move his guarding left hand from his right wrist. The voice in your head says you are looking at a wound made with a blow-torch, not an electrical current. The various exit wounds you find about his body confirm the source as electrical. That same voice in your head asks, “How is he alive?” finding out it was by 220v and he was connected to it for several minutes.



Like an officer reflexively drawing his weapon in a life-threatening moment, equipment magically appeared in your hands, readied for use. The simultaneous treatment and packaging of the patient for transport was completed with finesse, at a speed of the top NASCAR pit crew. All the while you are asking the standard questions; obtaining the level of consciousness, history (past and present), medications and allergies.


Picturing your own, and caught completely off-guard, you feel your parental-heart drop, as the child says “I’ll tell you who the president is, if you will give my dad something for the pain.”


Your experience and training tells you to hurry, but your heart compels you to pause. You are suddenly transported back to EMT school, sitting in class, as the instructor comments on how during an emergency, the family suffers too.

Having packaged the patient for transport, you turn your attention to the child. He is pale, his hands shake. You can tell he is doing his best to be brave, holding back tears, as he responds to your question about his age.


You place your hand on his shoulder, squat to his level to look him in the eye. In your most calming voice you tell him you will provide your “best care possible” to “take care of” his father. You watch his facial expression change from utter desperation, to hope, as you give him specific instructions. In that moment, as if no other person on the planet existed, for you, but him, you tell him to call his mother, and tell her which hospital you are taking his father to.


You take your hand from his shoulder, turn back to your partner, and grab your equipment from the floor before grabbing the foot of the stretcher and loading the patient.


The rest you see is history, literally His-Story,  MY story.


From the time I was in Kindergarten, I knew I wanted to be a policeman. I never played with ambulances or firetrucks, it was patrol cars. I would pretend to be “Ponch” from CHiPs while riding my bike, jumping the curbs. I didn’t watch the famous Fire/EMS programs like “Emergency” with Johnny and Roy. My go-to shows were Adam 12, Hillstreet Blues and Miami Vice.



That summer day when my father was electrocuted, I was the one who called 911. He had sent me out into the service van to cool the fan motor he had taken out of the central air-conditioner. I was holding it with my dad’s shirt because it was too hot to hold otherwise. While holding it in front of one of the vents, I caught movement from my peripheral vision. I looked up and saw my dad open the door and it closed again as he went back inside. I thought I was busted. I had been putting the van in reverse, backing up a few feet, then pulling forward again, like I was a bigshot. I mean hey, at 13, with keys to the van, right?


Suddenly, the door opened again. This time it was due to my father falling forward onto the ground. I don’t know if I even turned off the engine. I got out and ran to my dad. He was so unbelievably heavy. Couple that with, I was so small for my age, getting him into the house was nearly impossible. I was terrified. I had never experienced anything like that in my lifetime. I was so scared he was going to die. I mean, here was the strongest, smartest man I knew, crumpled, broken, and he could barely speak.


That medic who took a moment in time, to touch me, and talk to me, changed my life in the literalist of senses, it completely changed my path. As the surgeries mounted, and dad started to recover, I had this feeling, this pull, I needed to become a paramedic. I felt I needed to pay back the powers that be so to speak. More importantly, I wanted to be “that guy” who put his hand on some other scared kid’s shoulder. So, I did, nearly 27 years ago, I started in EMS.


After being a medic for several years, following my lifelong dream, I went to the academy and became a police officer. Unlike EMS training were personal safety was given a few minutes of lip-service at best, in the police academy, officer safety is THE cornerstone.  One of the most important personal safety points I took away from suspect control training (Defensive Tactics), was the understanding of first touch. It was commonly taught an intoxicated person would most likely resist, assault, or “fight” officers upon first touch. My years on the street as a police officer proved that training factual.


After spending 20 years researching the subject or violence in healthcare, my training and experience as a police officer, martial artist and paramedic, I found something I didn’t expect.



Consider how many criminal assaults occur AFTER the “patient” is touched. My research has revealed the single most common situation in which a criminal assault occurs in healthcare, is during a restraint situation. And, it occurs upon first touch.


Contrast that with, I wouldn’t even be here, writing this, for you, had that medic not touched my shoulder that day.


While I didn’t draw the parallel then, I certainly do now. When it comes to human interaction, the consequences positive or negative; everything changes upon first touch. For better or worse, that touch changes the dynamics of the interaction instantly.


One touch can, as in my case, transform the provider into a hero for a scared kid. On the other hand, it could turn you into a victim, or a criminal.


So, one touch can change a life completely. Upon first touch, every-flippin-thing changes.