Law enforcement and medicine: The ties that bind both professions

Law enforcement and medicine: The ties that bind both professions

Sometimes, I feel like I belong in law enforcement. There was a time in my life that I seriously considered a career where I would haul in the bad guys and make society a better place. Of course, every American male youngster fantasized that he would one day drive the Aston Martin, get the girl, defuse the bomb, and sip on a martini that was shaken, not stirred. I was no different. I was 10 years old then when my pal Lewis and I were secret agents with the requisite weapons, invisible ink and secret codes. At the risk of disclosing that I have a tincture of obsessive compulsiveness, I still retain the files of our secret organization. While Lewis has expressed concern that these files in the wrong hands could threaten international order, I have reassured him that the enemies of mankind will be unable conquer our layers of sophisticated encryption. At risk of being accused of hyperbole, Israeli and American intelligence agencies studied our secret files as a template for the Stuxnet worm.

I have had many patients who are law enforcement professionals. I respect them and the work they do. I have had patients who served in the FBI, the Secret Service and all levels of local law enforcement. I feel a kinship with these folks. Like a community gastroenterologist, much of what they do is routine. We both endure endless paperwork that often seems to serve no useful function. We both are exposed to extremes of the human condition. We both get scared. We both serve a public that is sometimes skeptical of our biases and motivations. We both may need to make urgent decisions relying upon our training, experience and instincts. We both deeply understand that sometimes the right decision leads to a dark result.

Last November in Cleveland, 2 people were killed by police after a harrowing high-speed chase. It was a tragic finale that left many painful and raw questions. Thirteen officers fired 137 rounds that killed two citizens who were ultimately found to be unarmed. Understandably, there was outrage in the communities, and the matter continues to be under investigation. As expected, the initial facts were murky and in dispute. Anger and haste are poor catalysts to develop the truth.

I have no opinion at this time if law enforcement personnel should have held their fire and pursued a non-lethal strategy of capturing these two individuals who were fleeing from them at high velocity. A dispassionate investigation will determine this.

But, while it absolutely necessary to investigate this tragic episode, as a doctor, I am very sensitive about being judged after the fact by investigators who have endless manpower, resources, audio and video evidence and months of time to evaluate the propriety of a split second decision. A catastrophic outcome is not evidence of negligence, despite the ease of reaching this conclusion, particularly by those who have been injured and their families. In addition, a fair judgment on what transpired must consider the context of one who had to make an immediate decision to act. If an investigation requires a 4 month inquiry involving dozens of professionals to conclude that an officer erred, could the policeman be expected to reach the same conclusion in 2 seconds in the field?

When football referees review a call on the field, sometimes the call is reversed. Of course, the review offers instant replay in slow motion at various angles, none of which were available to the official who first made the call. Get the point?

None of us envies a cop who faces a situation where he must discharge his weapon. Sure, there is training, but as every professional knows, one can’t train for every contingency. This is not a board exam; this is real life with lethal consequences and no time to ponder the alternatives. Was the suspect reaching for a weapon or an innocuous item? I can’t imagine the lifelong trauma one would endure after killing another person, even if this was a necessary act. I suspect it would be a greater trauma if a policeman didn’t pull the trigger when he should have, and missed the opportunity to save innocent lives.

I was raised to respect law enforcement, and I do. While their job is tougher than mine, I can personally relate to their profession. We both serve and protect the public. We both make decisions based on what we know at the time, which is often less than we want to know. We agonize when something awful happens and wonder if we contributed to the outcome.

There’s something else that binds our professions. We both are often judged retrospectively by those who weren’t there when we were blinded by white heat and couldn’t see then what later seems to be in such clear focus.

We learn from our errors and misadventures. As readers know, I believe that the negligent must be accountable for their actions and resultant consequences. The process to determine this, however, must operate at the highest level of fairness and integrity. Too often, this standard is not achieved or even reached for.

And now, my thoughts wander back to Miss Moneypenny, ‘Q’, boat chases and ejector seats, when I contemplated a profession that I know now is better left to other others.

Michael Kirsch is a gastroenterologist who blogs at MD Whistleblower.

Image credit: Shutterstock.com

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  • http://www.facebook.com/mahesh.jain.921230 Mahesh Jain

    You have a very positive view of law enforcement officials, they may be true and honest at times committing genuine errors of judgment but more often then not, it is not true. As I have seen in India, they are just a brute force devoid of necessary professional skills and intelligence. They principally rely on brutality to discharge their function.

  • http://www.facebook.com/profile.php?id=1538565203 Jeanine Broderick

    I have several friends in law enforcement and have found that even when interacting with strangers in that profession they tend to be compassionate individuals who truly want to be helpful to society.

    I understand there are individuals who do not fit this mold. I do think it varies, also, by culture–somewhat regionally within countries and certainly between countries there are those where law enforcement provides a legal method of intimidation.

    But I think you have hit on something far more important and broader than the two areas where you have so eloquently spoken of them. That is the attempt to affix blame.

    Right now I am preparing for a presentation to high school students on bullying and am explaining the commection between bullying and emotional stance in the presentation. So often the solution is ignored in favor of attempting to fix blame for something that has happened, something that we have no power to change and that which we have the power, ability and knowledge to change (the future) is pushed aside in this pursuit of pointing the finger of blame at another.

    In the bullying presentation I talk to the children about the tie between emotional state and behavior and that someone who is bullying another is not in a good-feeling emotional state. The bullying is an attempt to regain some of their power and usually not used until more socially acceptable atttempts to feel better have failed (often failed repeatedly). I also point out that the bully is often being bullied–perhaps at home. This often leads to pointing the finger at the bully at home but then I ask, “Who taught that bully to be a bully? and who taught the bully who taught that bully?” It quickly becomes clear that the true source was long ago dead and buried. Spending time attempting to affix blame when we could just as easily spend that time ensuring it dos not happen in the future, which is productive and working toward societal goals, makes far more sense to me.

    I encourage you to expand this conversation to all unproductive attempts to fix what really cannot be determined. I could spend the rest of my life attempting to determine if a person with training I have not had, life experiences I have not had, and in a situation I was not in made the right decision in a single moment and never be able to re-create the situation accurately enough to be 100% sure I was right–which is what all that time and effort is attempting to do–to determine if the officers were 100% right.

    What happened is sad but all the effort being put toward attempting the impossible won’t change what happened and won’t prevent situations like it in the future. If it is that complex we aren’t going to learn something we can use to train others to improve the future. There are things we already know that we aren’t using that can improve the future.

    If we take a broader perspective we could make so much more progress.

    ♡ Jeanine