Crime Scene

   The small black woman before you is inconsolable, her body writhing in agony and her voice shrieking in words you don't understand. But here at 1 a.m. in this neighborhood 7-Eleven store, confronted by the bloody remains of her spouse and restrained by police, her situation is clear. Her tears, her sobs and her body movements communicate eloquently in the sad, universal language of grief. She motions you toward the body of her husband, frantically imploring you to bring him back to her. She holds up her hands as though praying to you. You feel awkward, clumsy and pathetically inadequate.

   Evil thrives in the worst of times. You'd do anything for this lady, but there's no palliating her anguish. Her husband, a slightly built Ethiopian immigrant not more than five feet tall, has been working the night shift in this store. Police say that, according to his boss, he had secured his green card and was working to become a citizen. Night work pays a little extra, and he had saved for a year to bring his wife and child to America. According to a partial witness, somebody entered the store tonight and demanded cash. The store owner's policy is for clerks to keep a limited amount in the till and insert the rest in a safe under the counter.

   The policy is common in convenience stores, and the man's assailant should have understood that. He or she chose to punish the clerk anyway, with a single shot to the forehead. But there are also bloody wounds in both shoulders and both knees, as though the victim had been tortured prior to his death. This is not about money; it's a hate crime.

   You can feel the lady's pain, and you want to reach out to her somehow. But your partner, much more experienced than you, hurries you off the scene. "It's a crime scene," he says, "and you don't belong here." The cops shouldn't have even called you in. There's no physical exam, no confirmation of death, no physician contact and no care at all for the survivor.

   Like my partner, I was pretty sure this man was deceased. But our protocols say we should have at least patched him and confirmed the absence of life signs. I thought we owed him and his family that much.

   Your system likely has protocols to guide you through these kinds of things, and suggest specific observations that indicate an obvious death on scene. Absent those signs, this guy should be presumed dying, not dead. Except in special circumstances, like DNRs, dying patients and their families look to us for our earnest attempts at resuscitation.

   The cops clearly didn't want us behind the counter. There was a lot of blood smeared on the floor, and we were going to have to step in it, not to mention dragging the victim out of there. It seemed as though they were just calling us in to make a pronouncement.

   Did they actually say that? If they did, they're accepting a ton of risk. You can't blame the cops for wishing you didn't have to get in there and complicate their jobs. You can't blame them for wishing this hadn't been a homicide, either. But it is what it is. What they're asking you to do is accept their responsibility for choosing not to resuscitate. Any smart young attorney, fresh out of school, could crucify all of you for not doing your jobs. It's an old cop trick, but trust me. You're doing them a favor and serving these innocent victims by performing your duty the best you can. If they insist you stay out from behind the counter, respect their wishes. Their responsibility at a crime scene (and their authority) is a skosh larger than yours.

   What about the wife? Shouldn't we at least have spent some time with her?

   It seems that way, based on the information provided here. The PD might have been able to access a victims' advocate who understood the language of her ancient, fragile culture. I think it would be a good idea to ask your partner what he was thinking. He may have had access to emerging information you didn't (like a police order to leave due to a suspect thought to be at large). Crime scenes evolve constantly, just like medical ones do.

   I talked to him after the call. He said there was no missing information; he just didn't want to upset the PD.

That may be a good thing to discuss in more detail, possibly with a supervisor present. It doesn't sound right.

   Thom Dick has been involved in EMS for 40 years, 23 of them as a full-time EMT and paramedic in San Diego County. He is the quality care coordinator for Platte Valley Ambulance Service, a community-owned, hospital-based 9-1-1 provider in Brighton, CO. Thom is also a member of EMS World Magazine's editorial advisory board. E-mail boxcar_414@yahoo.com.