"Staying Alive" is filled with illustrative and entertaining real-life stories from my practice. This one was cut from the final manuscript, but an incredible story nonetheless.
I had been a practicing physician for a sum total of 6 weeks.
My wife and daughter and I had moved to this small, semi-rural community, with dreams of bucolic quiet country living. After years of rigorous training, I was going to be a simple country doctor.
I saw patients in the evening one day per week, on Tuesdays. It was about 7pm on a Tuesday night.
I was sitting in my office, minding my own business, when our receptionist appeared at my door, and said the following sentence that I will never forget, “There’s a guy at the window with a shotgun. He wants to die, and he wants you to help him.”
I was pretty sure I heard her correctly, but just the same, I asked her to repeat what she had just said. Once again she said, “There’s a guy at the window with a shotgun. He wants to die, and he wants you to help him.”
That’s what I thought she’d said!
I still didn’t quite believe her, though.
From my office door, you just needed to cross a narrow hallway, and you were at one of the entrances to our reception area. From this entrance, I peered around the doorway. What I saw gave me a chill.
The receptionist was absolutely telling the truth. There stood a man with a shotgun in his right hand roughly pointed in our direction (he held the gun at his side, not in firing position).
What she hadn’t told me, and I now saw, was even more worrisome, though. In his right hand there was a gun, but in his left hand he had a Busch beer. You have to be in a really bad way to drink that stuff.
So, who was this man? We would find out later that he was the husband of one of our patients, but not a patient himself. He had recently learned that he had some serious health issues, and he was despondent. He had come to town with the idea that he would go to the police station, which was in the same complex as our office, and he would get into a shootout with the police, who he hoped would kill him. Unfortunately, there were no police at the station when he got there. He had hastily concocted a Plan B, to come to our office, in the hopes that we carried some lethal medication, and that we would give it to him.
Anyway, back to our story.
My first thought was, “I need to tell whoever’s in charge about this.” My next thought was, “Oh no, that’s me!” Yes, much to my shock and horror, I was, in fact, the one in charge.
And, as the one in charge, I needed to do something. This was difficult at first because I was starting to get a little lightheaded. In such circumstances, extreme vanity can be a real help, because as it dawned on me that I might pass out, I also thought, “That wouldn’t look real good now, would it?” So, I took a deep breath or two, and didn’t pass out.
I went back to thinking what I should do (as the one in charge).
The first priority, I decided, was to contact the police, and then to get everyone in the building out of harm’s way.
There was a nurses’ station just off the other side of the reception area, and I knew there would be a nurse, and a phone, in that room. Also, just outside the nurse’s station there was a hallway that connected immediately to a door that opened to the health center’s waiting room (where a number of patients were waiting). The gunman had walked past this waiting room when he had entered the building, and had gone to the front desk.
Avoiding the gunman, I went down a hallway that took me through a clinical area, and to the other side of the nurses’ station.
I instructed the nurse to contact 911, which she did. She was then to leave, as was the rest of the staff.
Next, I went to the waiting room, and instructed the patients there to leave the building.
An interesting thing happened at that point. One of my patients had come in the hopes of getting a refill of a prescription for the narcotic pain medicine, Percocet, for a recurrence of his back pain. Despite the gunman’s presence some 15 feet away (you could see him through a window from where we stood) this patient still thought he could get a quick prescription. He approached me and explained his issue. I explained that he needed to get the hell out of the building instead.
With the police called, and almost everyone out of the building, I returned to the nurses’ station, and tried to decide what to do next.
Just having completed four years of medical school and a three-year residency, I had thousands of hours of training under my belt. Much of it was still fresh in my mind. I combed my memory for the information I needed. In an instant, I began to picture scenarios, pages from textbooks and notebooks, many details of which I could still recall, to find some nugget from my training that would help me decide what to do. My mind went to my psychiatry training (I had worked closely with dangerous patients at Washington DC’s St. Elizabeth’s Psychiatric Hospital in medical school) and to my favorite psychiatry textbook.
Nothing came to mind from my years of training. Instead, my mind returned time and again to scenes from movies and TV shows (many of which were comedies) where suicidal characters were “talked down” from ledges.
“No!” I thought. “This can’t be!” After all this, after years and years of expensive medical training, it couldn’t be that, in this time of extreme need, that all I could come up with were scenes from sitcoms.
And yet, that’s all I had. I decided I would engage the gunman, as I had seen people do on TV. Maybe I could, in fact, “talk him down.” If nothing else, I could calm him, or just distract him, until the police arrived.
I took a deep breath, adjusted my lab coat, and moved to the doorway opening to the reception area, about ten feet from the gunman. I introduced myself, and asked if I could be of help.
For some reason, our receptionist, who had originally alerted me to the gunman’s presence, remained in the reception area.
The gunman repeated his request. He wanted to die, and was hoping that I had some medication on hand with which he could complete the job. I told him that I would see what we had.
Before we got any further, however, the phone, which was right in front of the gunman, began to ring. The receptionist made a quick move toward the phone, but then thought better of answering it, which would place her directly in front, and just a few feet from the gunman.
The ringing phone, as well as our hesitance to answer the phone, appeared to agitate the gunman. He growled, “Answer the phone, I’m not going to hurt you.”
Despite his kind offer, we were still hesitant. As much to relieve the tension of the situation as anything, I suggested that the gunman should pick up the phone himself. He answered the phone.
A patient on the other end of the phone began to present their complaint to the gunman. The gunman repeated what the patient said, “ok, you have a sore throat.” I’m not making this up. He appeared to be considering how to handle the patient’s issues.
I suggested that the gunman tell the patient that they would need to call back. He did this and hung up the phone.
I told the receptionist to leave. It was now down to me and the gunman.
I again attempted to engage him in conversation. The problem though, as I saw it, was that, in my current location, I was too exposed and vulnerable to make any quick moves with the gun. I could back out into the nurses’ station, now behind me, and then easily get to a hallway. I worried that I would lose track of the gunman, though, and he could come around the hall from two directions, and surprise me.
There was the other exiting doorway from the reception area, which was just a few feet from one of the building’s exits. The problem was that, to get there, I would have to move left about 10 feet, all of which would put me even closer to the gunman. On the other hand, he would be in my sights the entire time, and if he made any quick moves with the gun, I would just have to be quicker. This was the option I chose.
As we spoke, I inched my way towards the doorway and the exit, hoping he wouldn’t notice (or wouldn’t care).
I don’t remember what we talked about. After what seemed like an eternity, I reached the doorway. From there, I could speak with him, and if he made any quick moves, I would duck out the exit to the driveway.
I guess my skills at “talking him down” weren’t real good because in the next moment, the gunman made a move. He placed the barrel of the shotgun to his forehead, and the stock on the floor and with his arm extended, he reached for the trigger.
I felt paralyzed. Should I approach him, and try to grab the gun? Would I get shot doing that?
Before I could move, he pulled the trigger. BOOM! The blast shook the building. I saw the shot spray upwards.
It all happened so quickly.
And there stood the gunman. He had missed. I don’t know how. He was unhurt. There was a hole in the ceiling.
At that point, I reasoned, I had tried and failed to “talk him down.”
I left the building.
Staff members were waiting behind the building, in a safe area behind a shed. Having heard the shotgun blast, they were relieved (I think) to see that I was ok.
Shortly thereafter, the first policeman arrived. As we were discussing the situation, the gunman appeared. He was about 50 feet away, in the parking lot, at the end of an incoming driveway. He still had the shotgun. The policeman drew his gun.
I realized that now I was directly in the line of fire with two guys with guns drawn on one another. I slipped around the corner of our building to get out of the way.
A new problem arose. Cars were coming in the driveway and entering the parking lot. I went around the building, to the street in front of our office, where the entrance to the driveway was.
By that time, another policeman had arrived, and was about 50 feet behind the gunman, off his right shoulder.
As I got to the driveway entrance, a car attempted to enter. I waved the driver off. She opened her window. I described the situation, and pointed out the gunman and the second policeman, who were in plain view. The driver asked, “But how am I supposed to get my son to his cub scout meeting?” Again, I am not making this up. There was a cub scout meeting in the community building (the police station was attached to the community building, across the driveway from our medical office). I told her to leave.
The next thing I knew, a Ford LTD was lumbering up the sidewalk toward me. I didn’t know what to think. Was he going to run me over?
What had happened was that one of our town folk, a gentleman named John Norris, who was a retired police officer, had been listening to his police scanner, and had heard what was happening. Seeing that people were trying to enter the parking lot, he had hopped in his car, and was positioning the car to block the driveway.
John and I directed our attention towards the standoff. Eventually, the gunman put his shotgun down, and the second policeman ran in and tackled him.
The standoff was over.
The gunman was taken to a hospital for evaluation. He was back on the street, and back in our community, just a few days later (he went to trial only months later), but that’s a whole other story (believe me).
I am thankful that no patient has ever again chosen me as their Suicide Plan B.
And maybe, just maybe, had this gentleman (the gunman) had a doctor that he liked, and trusted, and could get in to see easily, he would have sought treatment rather than choose the path that he did.