Criminal Profiling Topic of the Day: Hospital's Purgatory

As I watched the disturbing video of the collapse of Esmin Green, the 49-year-old Jamaican woman being ignored while she lay on the floor in the hospital emergency room, I felt sad. I also felt a bit mad at the hospital employees and I also felt a bit sorry for them.

I worked in a hospital emergency room for ten years. I have seen patients laying on the floor. The first time you see someone on the floor, you rush over to help the poor fellow. Then, you find out he is drunk off his butt. Even though he smells like hell and is reeking of urine, you try to help him back to his bed (or chair or stretcher). He tells you to "Fuck off, Bitch!" and throws a punch at your face. At this point, you let the nurse know he is still

laying on the floor and isrefusing help, and she grumbles, "Yeah, he has been tossing himself onto the floor all night." She finishes helping another patient and then ten minutes later struggles to get the man back into his bed, threatening to use restraints if he keeps up his antics. He can be heard telling her very loudly, "No, no, I don't need no tying down, I am going to stay in bed." Twenty minutes later he is on the floor again, only this time his pants are half down and his naked butt is hanging out.

Night after night, there are patients like this. Night after night, there are patients who use ambulances as free bus rides. Night after night, there are patients who come in and fake symptoms to get drugs. Night after night, there are drunk, drugged, violent, and belligerent patients who do all kinds of strange things including lying on the floor. From what I have seen, the staff tries to keep up with the prone patients, checking on their vitals, and hauling them off the floors (which often requires two or three of the staff to handle their dead weight or their feistiness).

But, sometimes, the staff becomes hardened, tired, fed up, and angry: sometimes they feel abused and they roll their eyes and don't bother to rush to check on the patient. The "Cry Wolf" syndrome gets to them and they stop hurrying over every time they see a patient lying on the floor.

Is what happened to Ms. Green acceptable? No, I can't say that it is. It is pretty terrible. But, it is somewhat understandable as well. The hospital staff failed Ms. Green (they should checked on her condition and not left her sitting for so many hours nor on the floor dying). The citizens failed Ms. Green (they shouldn't have such ill funded hospitals trying to serve so many people). The community failed Ms. Green (because there are a lot of messed up people abusing drugs, alcohol, their bodies - and the hospitals that they use excessively and overload the personnel and available beds). The insurance companies, the AMA, and medical bureaucracies failed Ms. Green (because they are crooks ...I won't get started on this). The church failed Ms. Green (because they left a member of their own congregation without anyone to help her which doesn't seem very Christian to me). The family failed Ms. Green (where were all the older kids and sisters and brothers and father/fathers of the children?). And, maybe, Ms. Green failed herself (because we don't know what choices she had made that brought her to this unfortunate moment we see on tape).

So, there is lot of blame to go around and a lot of considering all of us have to do when it comes to unhappy endings like this. Along with the knee-jerk reaction which is easy to experience toward the hospital staff, we need to look at the whole picture and see if what the video shows us is but a part of the whole dismal story.

Criminal Profiler Pat Brown