September 2025 Pick of the Month

We Are Our Own Bodyguards

Jack was taciturn, almost monk-like--the kind of resident who brought you three stickers at a time and told you precisely what you needed to know about all three patients in one minute. Jack was (and I am sure still is) muscular and stands six feet two inches tall. As a resident, he frequently wore a black T-shirt and black pants on his night shifts. On one such shift, his attending was a woman who walks with a limp because of her spastic paresis and foot-drop in the right leg, caused by multiple sclerosis-induced demyelination. Needless to say, she is not fast on her feet. Well respected by residents for her philosophy and dedication as a teacher, she usually accompanies her residents when they first see the patient. On this occasion, Jack and the attending walked together to see yet another patient who was petitioned for bizarre behavior. The patient, a large man, was visibly angry about being detained, pacing in the room like a caged tiger. Upon their arrival, he immediately lurched toward the attending, pointing his finger at her chest, shouting, “I am going to fuck you up.” With the movement of a six-foot-two-inch-tall feather, Jack wisped his frame between the attending and the hostile patient, and stood there as a pillar. No posturing, no bravado, and no man-on-man staring contest. Just an impervious, emotionless barrier. Jack pretended to be writing notes in a handbook. His body language conveyed, “I am not challenging you, but I am not moving, and you are not going to touch my teacher.”

Jack felt, in my view correctly, that he had to use his body as a shield for a vulnerable teacher of emergency medicine from potential physical violence from a patient. That teacher is my wife*.

So, it will come as little surprise that I have picked Prevalence of violence against health care workers among agitated patients in an urban emergency department from Driver et al., from Hennepin County Hospital as the AEM POTM. The upshot of their findings is that the vast majority of violence inflicted upon emergency care workers goes unreported.

So, for now, we remain dependent upon the Jacks of our world.

*This was written with her consent

Jeffrey A. Kline, MD
Wayne State University School of Medicine
Editor-in-Chief