How would you react to this call?

[Laura Anne]

I'd treat the infant like any other patient...as a patient.

I'd treat the boyfriend like any other patient...as a patient.

I'd treat the mother like any other patient...AS A PATIENT.

That's part of what makes us the professionals we are. You cannot let you're emotions rule your decisions on care. I am not saying be unemotional or not to show any empathy, but get the job you're called for done emergently and proficiently. Afterwards, handle your emotions in whatever way you have handled an emotionally traumatic patient before.

Did anyone ever think the mother may have been suffering from a severe case of post partum depression? Is there any other cases of abuse towards her other children, or was this an isolated case? What was the fight about? Was it his child? How did she get the black eye? What's her previous past medical history? Perhaps someone else can provide more info or answers to these questions?

What she did was wrong and it turns my stomach just as much as the other person(s), but try to look at it from every angle before passing judgement.

[JPINFV]

^

I am not a psychiatrist. It is not my job to sit with the mother and ask her about her feelings and thoughts when the baby is my patient. Assuming it is depression, both the mother AND the baby will not both be in my ambulance. One or the other in a case like this. If it IS depression, then it still gets reported to local social services and the state. This way a proper evaluation is done and the proper actions are taken. There ARE mental illnesses that require children to be taken away from their parents for the childs protection. Munchausen Syndrome by Proxy is a very good example. Being psychotic [medical] and insane [legal] are two different things.

[CBEMT]

"I'm telling you, she got combative during transport, I covered the kid with my own body and pushed her away in self-defense. She fell, hit the side door, it popped open, and BOOM, she's under the back wheels. I swear."

[Laura Anne]

^

I am not a psychiatrist. It is not my job to sit with the mother and ask her about her feelings and thoughts when the baby is my patient. Assuming it is depression, both the mother AND the baby will not both be in my ambulance. One or the other in a case like this. If it IS depression, then it still gets reported to local social services and the state. This way a proper evaluation is done and the proper actions are taken. There ARE mental illnesses that require children to be taken away from their parents for the childs protection. Munchausen Syndrome by Proxy is a very good example. Being psychotic [medical] and insane [legal] are two different things.

I do not expect one to be a psychiatrist on the truck, but none the less, post partum depression/psychosis is a medical condition that may need intervention. You never transported a depressed patient before? And who ever said anything about having the same two patients in the same rig? That's just absolutely ridiculous. Perhaps where you are resources are limited, but here I'd triage out the scene, dispatch another rig for the patients, and begin care on the infant due to the severity of the injuries. Care of the child should be given over to the father.

Munchausen by Proxy? Is that what you think she had? People with that disease do not cause harm in view of others. It's a condition in which they are seeking recognition for their childs unknown illness. They bask in the spot light of being a grieving parent(mostly the mom/women caregivers)...hence smothering them and poisoning them, not bashing their head in during a fight with another person.

Post partum depression is more of a chemical imbalance of hormones post birth of the child. Immediately after the birth, the hormone levels drop dramatically, causing the possible emotional imbalance. It is very common in women to suffer this, and 1 out of every approx 1,000 will have suffered from peripartum psychosis, which is taking a pre-existing depressed person and having them go through labor and delivery. Others are just having stress or possibly another factor that increases the severity of their emotional problems.

Bottom line: What she did is wrong and she will forever pay the consequences of her actions. Does it piss me off? Of course it does, but coming from the side of the professional medical provider on scene, each person needs to be treated. That's our job.

[Just Plain Ruff]

Give me a freakin break. She swung him in an intent to injure her boyfriend during a fight.

There was no other way around it, she took the closest weapon she had and hit her boyfriend. unfortunately the weapon of choice seemed to be a little boy.

Let's not go into this post partum depression crapola here, I knwo it's a valid syndrome and illness but this was a woman who was out to hurt her boyfriend not a woman who was so post partum depressed that she didn't know what she was doing.

I'm all for treating post partum depression and I know it's a valid illness but to link post partum depression to a woman who used her kid as a Mace to hurt her boyfriend is someone who deserves to go to jail and DOES NOT DESERVE OUR SYMPATHY.

I have no place in my heart for two types of people - child abusers and pedophiles.

I remember a case a couple of years ago where the police stopped a man who was violent and suicidal who had his 5 week son in the car with him. the man got out of the car with the child in his arms. He then took the child by the feet and slammed the childs head into the concrete, (child survived) but the cops opened fire and killed the dirtbag. The bleeding hearts were upset at the cops for killing the man. Do we chalk that one up to mental illness and say, OH it's ok, he had an imbalance.

I'm sick and tired of giving excuses to every little syndrome out there. Oh, you have an imbalance, sure, it's not your fault you are a child molester, oh you have an imbalance, well you didn't know k illing someone was bad.

theres a case going on right now where a 43 year old deaf woman, kidnapped, killed and dismembered a young woman and dumped the body parts along a road. She's deaf. They are arguing that her being deaf should preclude her from getting the death penalty because she can't put on a valid defense due to the "Lost in translation" legaleze to plain english. Being deaf didn't preclude her from killing this young woman so why should it preclude her from getting the chair.

So as you can see, I have strong opinions about things, I'm ranting and raving but come on.

[Laura Anne]

Give me a freakin break. She swung him in an intent to injure her boyfriend during a fight.

Nope, I won't givce you a break. This is what debate is all about, seeing more than one view, whether right or wrong and discuss it. 8)

There was no other way around it, she took the closest weapon she had and hit her boyfriend. unfortunately the weapon of choice seemed to be a little boy.

So, now that I have you going, how can you be sure her intent was to actually grab the child and use it against the boyfriend? Mind you, you weren't there, nor was I , but the bruises to her face are a pretty good indicator that she was struck by something and/or someone. Perhaps she grabbed anything she could while the boyfriend was pummeling her face in and it was the child? I am just throwing ideas out there because again, none of us really will ever know the true story.

Let's not go into this post partum depression crapola here, I knwo it's a valid syndrome and illness but this was a woman who was out to hurt her boyfriend not a woman who was so post partum depressed that she didn't know what she was doing.

Since when is a medical condition considered crapola? What else in your medical world do you consider not to be a true 'medical condition'? You even say it yourself that it's a "valid sydrome and illness". Peripartum psychosis is a level deeper than post partum and it DOES exist. So if you don't think so, but the world of medicine states it does.

I'm all for treating post partum depression and I know it's a valid illness but to link post partum depression to a woman who used her kid as a Mace to hurt her boyfriend is someone who deserves to go to jail and DOES NOT DESERVE OUR SYMPATHY.

I have no place in my heart for two types of people - child abusers and pedophiles.

Again you state that you recognize it as a medical condition but you'll post that you'd turn your head to it because it's crapola. Interesting.

You are letting your emotions dictate your care rendered to individuals? You feel you can discriminate due a persons medical history? Very interesting.

Regardless of what kind of people you allow in your heart, if these types of people were your patients, you should treat them as your patients.

It's up to the courts and to God to decide the fate of the mother. She's probably paying for her illegal actions in more ways than any that have been posted.

I remember a case a couple of years ago where the police stopped a man who was violent and suicidal who had his 5 week son in the car with him. the man got out of the car with the child in his arms. He then took the child by the feet and slammed the childs head into the concrete, (child survived) but the cops opened fire and killed the dirtbag. The bleeding hearts were upset at the cops for killing the man. Do we chalk that one up to mental illness and say, OH it's ok, he had an imbalance.

Never once was it stated that murder or abuse in any fashion was OK, so let's keep to the facts. Sorry that this case happened, but bad cases happen all the time. Keeping your head screwed on straight and doing your job appropriately is what will keep not only you, but others safe from you. If you can't do this, you endanger everyone around you. Do what needs to be done afterwards to release any emotional battles you have, but on scene, do your job.

I'm sick and tired of giving excuses to every little syndrome out there. Oh, you have an imbalance, sure, it's not your fault you are a child molester, oh you have an imbalance, well you didn't know k illing someone was bad.

Of course they know it is bad and that's why she any others who are sick go to jail. Once again, I am not using anything as an excuse, but rather a direction of opposition to proove the point that regardless of emotional ties you may have, or your personal point of view/bias towards the situation, you have to remain professional.

theres a case going on right now where a 43 year old deaf woman, kidnapped, killed and dismembered a young woman and dumped the body parts along a road. She's deaf. They are arguing that her being deaf should preclude her from getting the death penalty because she can't put on a valid defense due to the "Lost in translation" legaleze to plain english. Being deaf didn't preclude her from killing this young woman so why should it preclude her from getting the chair.

Sooooo, because this person has a different type of disability, you're using it as a basis of comparision. I guess I'd say what I said above; the person who is the patient in my care would get my professional care, irregardless of disability. But, the case stated above doesn't indicate any place for EMS care, so other than the judicial systems' descision, it doesn't really show any relevance to the aforementioned points of EMS ALS intervention.

So as you can see, I have strong opinions about things, I'm ranting and raving but come on.

By all means, rant and rave away. I am not trying to purposely upset you, but play the other side of the debate. That's all. 8)

[JPINFV]

I do not expect one to be a psychiatrist on the truck, but none the less, post partum depression/psychosis is a medical condition that may need intervention. You never transported a depressed patient before? And who ever said anything about having the same two patients in the same rig? That's just absolutely ridiculous. Perhaps where you are resources are limited, but here I'd triage out the scene, dispatch another rig for the patients, and begin care on the infant due to the severity of the injuries. Care of the child should be given over to the father.

Post partum depression is more of a chemical imbalance of hormones post birth of the child. Immediately after the birth, the hormone levels drop dramatically, causing the possible emotional imbalance. It is very common in women to suffer this, and 1 out of every approx 1,000 will have suffered from peripartum psychosis, which is taking a pre-existing depressed person and having them go through labor and delivery. Others are just having stress or possibly another factor that increases the severity of their emotional problems.

[response is for both sets of quotes]

Oh, I've transported a many psychatric patients. By far, the schizoaffective patients (SAD) seem to be the most interesting. It's always the SAD patients that have the interesting stories. Are mental health issues an illness? Sure. We're seeing more and more biological causes and effects from SAD, bipolar, schizophrenia, and a host of other disorders all the time. However, suffering from a mental illness does not always excuse one's actions. Since you cannot transport the mother against her will, you will need to contact the authorities to place her in custody. Scratch that. As I sad earlier, this is a case of child abuse [regardless of if it was psychotic in nature or malice in nature], at least in my state, and probably in most, you are mandated to file a report and contact the authorities.

Munchausen by Proxy? Is that what you think she had? People with that disease do not cause harm in view of others. It's a condition in which they are seeking recognition for their childs unknown illness. They bask in the spot light of being a grieving parent(mostly the mom/women caregivers)...hence smothering them and poisoning them, not bashing their head in during a fight with another person.

I was using it only as an example of a condition where a mother would be seen as unfit to care for her child. The fact that she ended up swinging her child I think pretty much omits that as a possibility.

[EMS49393]

Her fibromyalgia made her do it. :roll: Long gone are the days when we were held accountable for our actions. It's nice to live in a world where we can just blame some garbage can diagnosis syndrome as permission to act like a total jacka**. Long live the blame game.

[Just Plain Ruff]

good points laura but you have made a tremendous amount of assuptions about me and they are wrong.

you really seem to think you know how I treat my patients and you do not so I'd appreciate it if you would not assume so much.

you state here: Since when is a medical condition considered crapola? What else in your medical world do you consider not to be a true 'medical condition'? You even say it yourself that it's a "valid sydrome and illness". Peripartum psychosis is a level deeper than post partum and it DOES exist. So if you don't think so, but the world of medicine states it does

when are we going to stop playing this oh my goodness she has a syndrome or he was just suffering from some sort of issue. -

my reply - when did I ever state that this syndrome was not a valid syndrome - I believe I said that it is a syndrome but that it's used too much in the world of the blame game.

You then go on to state this in your reply : Again you state that you recognize it as a medical condition but you'll post that you'd turn your head to it because it's crapola. Interesting.

You are letting your emotions dictate your care rendered to individuals? You feel you can discriminate due a persons medical history? Very interesting.

Regardless of what kind of people you allow in your heart, if these types of people were your patients, you should treat them as your patients.

It's up to the courts and to God to decide the fate of the mother. She's probably paying for her illegal actions in more ways than any that have been posted.

My reply - when did I ever say I'd turn my head to that? You also say that I discriminate due to a persons medical condition - I NEVER said anything to the contrary - again there you go with the generalization and the accusation that I discriminate. Please stop that.

You then stated: Never once was it stated that murder or abuse in any fashion was OK, so let's keep to the facts. Sorry that this case happened, but bad cases happen all the time. Keeping your head screwed on straight and doing your job appropriately is what will keep not only you, but others safe from you. If you can't do this, you endanger everyone around you. Do what needs to be done afterwards to release any emotional battles you have, but on scene, do your job

My reply: you again accuse me of not keeping my head on straight and not doing my job which again is not fair. Not sure where you get off saying that I endanger everyone around me. You are out of line on that one.

Now you have really stated a large amount of generalizations about and you do not know me. YOu have accused me of not being professional towards patients, not keeping my head and discrimination.

I'd appreciate it if you would not make those kinds of generalizations about me. I have not made those kinds of genearlizations about you yet you felt it totally appropriate to make them about me.

so I will respond appropriately and professionally.

It's getting out of hand. I never once said that post partum depression was not a valid illness but I'm sick and tired of people using any sort of excuse to get out of taking responsiblity for their actions.

It used to be that at one time people took responsibility for the actions that they did instead of regressing back to some syndrome of the day.

Post partum depression is a syndrome and an illness but it's being used too often these days to explain away many terrible things. And how do you know those bruises weren't caused by her boyfriend after she used the kid as a paperweight to hit him.

I can tell you that if the mother of my child used my child as a weapon against me then she'd look a heck of a lot worse than she did.

There is more to this story than what we've read and I don't really care why she took the actions that she did but in the end she got what she deserved, prison time.

I hope you read my first post on this when I said I'd take care of the child and then take care of her after the kid was taken care of.

I have never let emotions get the best of me on a call and never ever will. You just assume that I do please don't make that assumption.

We can agree to disagree but when you resort to generalizations and assumptions and accuse me of things in your post that I am totally not about I do tend to get a bit upset.

[Laura Anne]

Dear Ruff,

I seem to have ruffled your feathers a bit. It's nothing personal. It's more or less a reply for all to read and not all points I made were directed towards you, but I can see where the word 'you' was interchangeably misinterpreted. Sorry about that, I used 'you' both towards you and as a collective group. Sometimes my comments were directed to get a repsonse for your comments, some were directed towards the group(you all).

As far as the valid point, I was quoting you. You did say it was valid, hence "valid syndrome and illness." Yes, I agree the courts do use mental illness to get their clients off.

The discrimination comment came from your comment on postpartum being crapola. It's discriminatory towards the type of illness she may have had. Why would one type of medical condition be considered crapola, and another not? That's where I coming from with that comment.

The endangerment comment was in reference to people allowing emotions to overrun them on a call. You get a crew member that can't function like a medical care provider because they get all wrapped up into the emotional aspect of things, it can turn out dangerous. Again, the comment was meant for everyone, not just you. It was meant as a learning tool; to keep your cool and head screwed on straight on a call. Sorry if this was taken as directed completely at you, but I see where you're coming from.

'I'm sick and tired of giving excuses to every little syndrome out there' is where the statement of professionalism came from. I never said that the medical condition she may have been suffering from is an excuse or that it makes her actions ok. Regardless of your personal point of view towards the situation, you have to remain professional. I will apologize for this generalization because I do not know how you are on in front of patients, but I can only go by your words on these posts. I would hope one would not say this in front of the patient/ other providers.

The bottom line being that she got jail time is something I also agreed with. I wanted a bit of a debate and it was taken to a personal level. Sorry you took it that way, but the comments were directed as 'you' to the group, not just you the individual.

F.Y.I

Nothing was ever stated about her ever giving any excuses or any medical condition. I was simply trying to point out to everyone that one must have all the facts before lynching her. No one here has all of them and probably never will. Just trying to get people to think outside the box. :roll:

Dear JPINFV,

I take it for granted that we have Pd on 99% of all calls here, therefore they'd be there and probably have her in custody already, or yes, I'd call for Pd to make the report. Like you said, child abuse cases all need to be reported regardless of nature of incident. 8)