January 3, 2015

Energy, But Not the Hippie Kind

You and your partner respond to a small house on the report of a pediatric sick case. Upon arrival you find an 8 year old who seems to have the flu. Not a big deal – the kid is sick, but not sick-sick. Mom seems especially fearful, though, and Dad seems to be angry. He is pacing around with tension in his jaw and neck, his eyebrows are tense and together, and his hands are carried as fists. He is overbearing in his efforts to be involved in the call and his voice is louder than normal conversation. You explain what is going on, and that the child isn’t in danger. You calmly and confidently explain the best way to treat the child’s symptoms and ask if the parents have questions. Mom’s fear seems to be lessened to a great extent, but Dad is still all kinds of fired up.

Weird, right? Why is Dad so upset?

There used to be a show on TV called “The Dog Whisperer.” It was a reality show about a trainer, Caesar Millan, who could get most out-of-control dogs to behave. I don’t know much about dog training, his methods, or whether his ideas are accepted. One thing he said, though, resonated with me. It is the concept of energy. Not everyone holds this dog training theory as true, but it serves as a fine model for this topic.

Millan explains that “energy” is the main way that dogs communicate: Energy is what I call beingness; it is who and what you are in every moment. Dogs don't know each other by name, but by the energy they project... This isn’t energy as a kinetic force, or as a hippie-style energy field. Energy isn’t how much work you’re willing to do, or if you feel like vegging on the couch. Millan is talking about the outward expression of one’s mindset and emotional state. 

Patients and bystanders project their energy, as well. Some patients have fearful energy, some are calm, and some have aggressive energy exploding out of them. Think about the last five cops you saw. I bet you saw some mix of bored, impatient, irritable, and aggressive energy coming from the cops, right? Ever come home, see your spouse, think “oh, shit,” and start thinking about what you may have done that s/he is mad about before a word is even said? Your spouse was projecting angry energy. Have you ever watched someone and thought, “They are in a hurry…” They were projecting rushed or impatient energy. You can tell when a stranger is angry, or when a person is about to blow up at their kids. We can easily recognize the energy that people give off.

The important thing in EMS is to recognize energy and see that it matches the setting. It makes sense for a parent to be fearful when their child is injured. It makes sense for a police officer to be aggressive during a felony traffic stop. But when the situation is more secure, people’s energy should calm and become more stable. Acting fearful in a secure environment is weird. There may be more story that you are missing. A calm bystander in a dramatic environment is weird. Why are they so calm?

I’m not going to get into signs of different energies – you already know them, being a minimally functioning member of society. Even children can recognize fear, anger, calm, and other emotions. 
Credit, via Wikimedia Commons CC BY 4.0
The point that I want to make sure you understand is that we are taught in school to look for things that make a scene safe or unsafe. Whether there are weapons visible, whether the dog is locked away, and those kinds of very basic things. The energy of the scene is probably more important, however. Patients and bystanders are armed all the time and dogs are present on many scenes. But there is a difference between a man with a knife in his pocket (or even a concealed firearm) when his energy is calm and relaxed versus when he is agitated, confused, upset, or angry. A lady with a quiet, controlled dog on a leash is a different story from the lady screaming threats and profanities at you with the dog straining at the leash. The energy state that is projected by the person makes a huge difference in the relative level of safety.

The ability to listen to your subconscious when it is trying to tell you that something is wrong on the scene emotionally (energetically?) is critical to keeping you safe. 

Increase your safety by paying attention to the emotional energy that people are giving off.

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