PTSD in the ex-serviceman.

Late one evening on a night shift I was called to a report of a male who was ‘feeling suicidal and unable to cope’.  We were also told that the man was known to the police for violent outbursts.  The police were not attending unless we asked them to after assessing the patient as they felt that their presence provoked him.

These jobs still make me apprehensive, who’s to say that the gent would not be equally provoked by my mate and me?  To some people a uniform is a uniform whether police, ambulance, fire, prison service, all symbols of a despised authority.  Let’s hope he wasn’t like that.

I approach all threats carefully, that is drummed into us from day 1 at training school: be aware of the surroundings, possible escape routes and hope that my calm friendly nature will diffuse any tense situation.  When all else fails, drop the gear and run! As I say to my mate, you don’t need to outrun the aggressor, just your crew mate!  Unfortunately he is younger and quicker than me.

We arrived and I knocked on the door, heavy response bag on my shoulder.  There was no answer.  My mate quickly asked for an address check to confirm we were at the right place as I knocked some more.  Once we knew we were at the right place I tried the handle, it was unlocked.  In these situations where there is a reasonable suspicion that a person is in danger or come to harm we are allowed to enter without a specific invitation.

I walked along the short hall, shouting ‘hello, ambulance’ over and over as I went and generally making noise so I didn’t accidentally sneak up on and make a volatile person jump.  As we went past the kitchen and a bedroom we put the lights on and checked each room.  All the horror films I have ever watched seemed to flood my mind with images of killers jumping out on the heroes from a darkened room.  This is definitely not the time to have a vivid imagination.

I went into the last room off the hall and saw the man, Alan (name changed for confidentiality), sitting on the sofa with his head down on his chest.  From the door I could see he was breathing, the rate was normal and his complexion had a normal, healthy appearance.  From a physical point of view I could relax a little, he didn’t appear immediately at risk.  I shouted ‘hello’ again and his head snapped up.  He looked startled but didn’t make any immediate moves so I introduced myself and my mate.

“What the **** are you doing in my flat?”  He shouted.  I explained we had been asked to come see him as the police were concerned for his welfare.  He admitted he had spoken to the police on the phone about a long running problem with his neighbours, he couldn’t remember but thought he probably had said if they (the police) didn’t ‘get off his back’ he would kill himself.  He seemed to calm down a little so I asked if we could talk and see if there was anything we could do to help.  As I glanced round his room I saw empty lager cans on the floor but no obvious weapons within easy reach.  On the shelf were a photo of him in an army uniform and several items of military memorabilia.

He started to tell me that he was alcohol dependant (must have seen me look at the empties) and that it was the only thing helped him damp the horror of some of his memories from the army.  We discussed counselling and Alan said he had some and it was good but after 5 sessions he had been told that was all the funding would allow and could have no more.  His GP’s answer was to give him medication to damp his emotions, presumably for the rest of his life as there didn’t seem to be a plan to get at the root cause and help him deal with it.

I would like to be able to say that we had a calm talk and I came up with a care plan which would lead to a happy ending.  I would really like to be able to say that.  However…back to the real world…at several points during the chat Alan became very aggressive and threatening to me.  Alternating between tearful remorse and shouting threats “Who the **** are you to judge me? What do you ******* know?”  I find this hard to deal with.  For one thing I never judge anyone, I’ve lived long enough to realize you can never tell what another person has been through and just accept that they are as they are.  It was quite scary too, thought I might have to run for it a few times, luckily for me at the height of the aggression the tearful recrimination phase took over.  I have a great deal of respect for anyone who serves in the armed forces, I’m aware that I’m able to sit here typing my opinions because people in the armed forces have suffered and sacrificed to protect this lifestyle.  I’ve never been in the armed forces so in that respect Alan is right: what the **** do I know?  This is a kind of dilemma for us: if a drunk assaults an emergency worker who is trying to help him then he is quite rightly reviled and we feel justified, obliged even, to press charges.  If, however, an ex military person assaulted me I would feel guilty about pressing charges, after all he acquired the PTSD serving his country.  Thankfully it has never come to that yet.

The best we could do for Alan that night was refer him to the out-of-hours GP service and ask them to refer to his own GP and ask for a review of his needs.  Far from ideal but the best plan we could come up with due to the late hour and his refusal to come to hospital for an emergency review.  Hope things work out for him but the chances aren’t good.

There was no time to dwell; the next job was waiting for us as we cleared….

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