I was in Las Vegas, Nevada participating in medical currency training with a Las Vegas regional hospital, the city Fire/Rescue system and the contract ambulance service. This was around 1993, every two years our Paramedic, nationally accredited medical certification needed to be re-certified and certain performance and knowledge skills needed to be accomplished to reestablish our abilities endorsement. I am 28 years old, at the peak of my tactical game. I am a SSgt, very in tune to our talents and their use and have been getting more and more involved in updating our techniques, procedures, equipment and regulations.

We (about 15 of us PJ’s from units all over the country are in Vegas), all of Pararescue have been performing this training with major cities and regions because they have the societal problems “street knife and gun clubs” and the large systems to support our needed medical training requirements via critical patient contact. Before this trip to Las Vegas, I had pulled medical rotations in Albuquerque and Miami.

As we showed up for this training in Las Vegas I was impressed with the academics the Doctors taught us and we all noticed the professional caliber difference between the local government run Fire/Rescue Departments and privately funded ambulance service. There was a sizeable drop in experience and character of the private run for profit ambulance company employees.

After our week of academics and another week of rotations working in the Emergency Room and Intensive Care Units, we would pull a final week of 12-hour shifts with one of the two rescue services and try to get a great call (one with someone significantly injured in a car accident, gang or domestic incident) to add to our experience, ever making us a more capable and proficient combat medic.

I showed up at my scheduled date and time; 5:45 AM at the private Las Vegas ambulance service and met with the two men I would spend the next twelve hours with. An EMT-basic driver and the paramedic of the rig, I was to work with the paramedic and start IV’s, intubate and push the drugs the patients would need.

As the two men showed up for work, the paramedic had a disturbed attitude when he heard he would be having (me) a ride along medic with him. The EMT-basic was an overweight guy who seemed like he was muddling through life. These situations are ours as ride along guys to ease their concerns and humble ourselves until they got comfortable with us. We are guest of this system and they could kick every Pararescueman out of the training if we were difficult to work with or got in trouble.

As medics our standing orders and procedures are consented by a physician’s license to practice. Similar to what our unit physicians did for us in in later years of OEF and OIF as far as networking our eventual ability to administer whole blood. A Las Vegas civilian physician has to coordinate and take responsibility for our ride along training.

On our way to the ambulance after the shift start up meeting the Paramedic told me I would be sitting and watching all day and not touching anybody. He said something along the line of, you Pararescueman think you are “hot stuff” and I am “way bader” then you guys. “What a putz”, I said in my head, it was probably going to be a slow shift anyway.

The ambulance company has apartments all over town where they stage their ambulances, they are controlled by a operation center to respond to geographic locations of the city within minutes. They do this just like Fire Departments place their Fire stations in select locations to respond quicker. The ambulance system also had other motives, if they beat the government Fire Rescue to an incident their contract will be renewed and the city may hire them and eliminate its Fire rescue capability all together. They bill by the number of patients they touch. This contracting trend seemed to be gaining momentum in the mid 90’s at many major cities across the country. I fully support this type of capitalism…if its run right, provides a creditable service.

At the first apartment we arrived at and wait for a dispatch, the paramedic started kicking the furniture and degrading the EMT-basic verbally. He did not say anything to me. This guy was nothing but negative and a bully; someone had pissed in his corn flakes or something. I needed the accumulative hours and made the best of the down time, reading a book and working on some work related material I brought with me. We only had one call that morning a geriatric DOA from sometime the night before, a family member had found the obese female covered in vomit and feces. There was nothing we could do for her. We handed the responsibility of the corpse off to the coroner’s office.

We went and got some lunch and went to another apartment to wait for a call. The guy portrayed himself as an idiot as he yelled at the television watching the Jerry Springer Show, he easily could have been a guest. He had a substantial gut and a platinum blonde mullet. The EMT-basic never challenged this guy and just went along with his bullying and verbal ragging. At about 3:30 PM we received a call of a domestic violence case with injury in a very bad and low income part of Las Vegas. We took our time driving to the site, the EMT-basic driver tried to get there quicker and the paramedic told him to, “slow down, this is the same girl we always see.”

As we pulled up to the apartments and we grabbed our medical gear, the paramedic just grabbed a clipboard with a treatment refusal form on it. Two police officers were standing around a caucasian forty-year-old woman; very rough looking, crying and she had a major shiner on her right eye. She was a heroine and crack addict; she had no hair from the chemotherapy treatment she was receiving for uterine cancer. She had lost most of her teeth due to her heroine addiction. She supported her addictions by prostituting and a John had worked her over good. Yes, she looked as bad as this brief summary of her life that I describe. How does G-d, let his children become like this? I said a silent little prayer for her.

Desensitized to her condition, this was not the first time these men have met her; she was a regular with the Las Vegas ambulance service. The paramedic walked straight up to her and shoved the treatment release form in her face and told her to “sign it!” Towering over her, she was visibly disturbed sitting on the apartment curb. One police officer told him to “take it easy” the paramedic talked to the officer as if the woman was not there. “she is wasting all our time, she is a waste”, he turned to the women, “sign the form like you always do, you know you want to.” She signed the form and the three of us walked back to the ambulance.

As we rounded the back of the ambulance the paramedic turned and spoke to me for the first time since early that morning when he told me, I would not touch a patient. Callously he said, “if that bag tried touching me, I would beat the crap out of her too.”

That was the straw that broke my back…

Oh heck no, that is all I wanted to take (I could have taken much more from this putz), I decided not to. I dropped the medical gear I had in my hands and shoved him against the ambulance, after pounding his head against the ambulance a couple of times, I punched him in the mouth and threw him to the ground, I climbed on top of him and commenced to speed bag his face a few times. Similar to Forest Gump fight at the Black Panther Party. The energy of this lady and countless other patients he had probably mistreated channeled through me.

I did not say a word as I attempted to harm this man, what could I say that my fist would not articulate to him for me? He was a horrible person and I was letting him know it. I did not feel I could just leave the situation, I had to hold him accountable and this is how I chose to do it.

The cops ran over and forearm shivered me like a linebacker blindside hitting a running back off him, they cuffed me and through me in the back of the squad car. The paramedic lost his tough boy facade and started whining and crying that I attacked him. The EMT-B said, “I was unprovoked and they had problems with me all day.” The cops interviewed me and I told them what had happened. The private paramedic company medical director of the region came to the scene and vowed that no Pararescueman would ever perform medical training in Las Vegas again. This paramedic I assaulted, “was one of his best.”

Really?

I was released without being arrested, charges were considered, but never filled. I was ordered to immediately return to my unit. When I arrived back to Patrick AFB, I was flooded with calls from my co-workers around the states upset about how I screwed up a good thing with our training in Las Vegas. Some said, that I made us look bad, others said, that area was great for R&R as compared to other ride along locations of St. Louis, New Orleans and the outskirts of New York. It was almost a decade before Pararescueman from outside of Nevada were allowed to train in Las Vegas again with a different ambulance service.

Almost 30 years later, I love the smile this story brings to my face.

Authored By: Joseph Barnard, Retired Pararescueman Officer

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