Inner Dialogue and the Brotherhood

Fire/Rescue StreetSense ❘ By Kate Dernocoeur

The murder of George Floyd in Minneapolis on May 25, 2020, was another item on a too-long list of appalling incidents that demonstrated such a wicked degree of callousness that it is in a league of its own. Surely, things don’t go as stunningly badly as they did for George Floyd without someone at the scene (besides onlookers) thinking, “This is so wrong … this has to stop.”

From my first viewing of the video, it was apparent that the officer at the front of the police vehicle was conflicted about what to do. He walked back and forth between the increasingly agitated crowd on the sidewalk and the top cop, the one with his hand in his pocket and his knee on Floyd’s neck. (It was especially disheartening to discover that all three of the other officers in the George Floyd case were brand new to the streets. Anyone with emergency service experience knows intuitively that they were stymied from openly questioning the actions of Derek Chauvin, who was showing them the ropes and his version of how to manage these situations.)

Inner Dialogue and Situational Assessment

Stay long enough in this field, and you will almost inevitably witness some degree of less-than-sterling performance of the sworn duties of the medic, the police officer, the firefighter. Anyone with a conscience knows it’s wrong to violate the public’s trust in us. In such instances, it’s likely that some measure of inner dialogue—the things we say to ourselves—is present. Inner dialogue is normal and a very handy tool during stressful or exciting times. We certainly encounter plenty of them.

It’s useful, for example, during situational assessment, sort of like having someone else along during a mental 360° walk-around who can see and hear what you’re experiencing but through alternative lenses. (Whether or not you choose to listen to it is up to you.) Inner dialogue provides a forum to both confer and also argue privately, inside our own minds.

For example, you might say to yourself, “What in the heck have I gotten myself into?” on your way to the departmental officer’s exam or to propose to your beloved or when you charge into other uncertain challenges. It plays a role in everything from personal motivation (“When I get enough seniority, I’ll never behave like what I’m seeing here.”) to recognizing and understanding emotions (“This situation is bad; it’s getting worse, and I feel helpless to speak up.”) to gaining a better understanding of ourselves (“I didn’t sign up for anything like this.”).

It can also be a helpful assessment guide for how to think about the things we see. Everyone carries prejudice and bias. We all have gradients of care. If you don’t believe it, watch how much harder people try on pediatric cases or when a colleague needs help. Professionals know this, but they also recognize a level of care below which they vow never to go. Although this line is usually supported by a well-tuned moral compass, it can also be (mis)guided by an element that isn’t often discussed: the culture of the “brotherhood.”

Emergency response occurs in a tightknit world. A well-known element of the often-wonderful brotherhood is a long-standing tradition of keeping what happens among ourselves to ourselves. We know that perfect delivery of our duties is impossible and that we’re only human. Everyone makes mistakes.

The Negative Side of the Brotherhood

However, there’s a limit. Like obscenity, you know it when you see it. Yet, everyone knows that speaking up when inner voices are notifying you a line has been crossed is hazardous terrain. According to tradition, those who break the brotherhood’s code of silence don’t deserve its protective cloak. We are collectively indoctrinated that violating the code is grist for all sorts of retaliation. It can be hellishly scary, for example, to discover you’re “going bare” (that is, your “brothers” won’t back you up anymore). When the team is offstage, away from public scrutiny, behaviors against people regarded as whistleblowers tend to pop up, intended to weed them out. Who willingly gives up a place or position that required years of effort to attain?

So, it’s typically hard to speak up, even if you want to. There is a sad litany of examples of times when those in service to their communities were bad actors, and this is true whether it’s police, fire, or EMS. One recent example: Medics on a Hillsborough County (FL) ambulance crew didn’t properly assess a postpartum, vomiting 30-year-old woman found “crying hysterically, complaining of a headache and sensitivity to light.” Without taking vital signs, the lieutenant in charge deemed her to be drunk and not in need of ambulance transport. Her mother drove her to a hospital, where she died of her stroke. In addition to the wrongful (in)actions of the crew, such dereliction of duty is costly: An initial $300,000 settlement is being followed by a $2.45 million claim to be decided next year.1 Were there participants in that case whose inner voices disagreed with that lieutenant? Probably so.

Culture Changes Required

Here’s a sure bet: People in all the emergency services need both the courage and the permission to speak up when things are going south and while wrongdoing is still preventable. Making this an across-the-board reality will require a difficult culture shift at all levels in the emergency services. It’s clear that such a thing is possible because the aviation industry did it years ago; at one time, it was career killing for others on a flight crew to speak up if the pilot, the top dog, was making an error. It took time, but that doesn’t happen anymore.2

The same can be true in our world. We must ensure that wrongful acts are routinely brought into the light. This won’t happen until everyone can feel safe and supported for pointing out bad moments before they get worse.

Here’s what needs to happen:

  1. Pay attention to your inner dialogue. It’s a powerful tool and can be life-saving for both you and those you serve.
  2. Build a local emergency services culture that is inclusive of all the members of the brotherhood and relentlessly respects the mandates of correct, compassionate care.
  3. Identify the bad actors in your department, and don’t let them stick around long enough to get away with, well, murder.

RELATED 

The Brotherhood of Firefighters

Taking Responsibility for Department Integrity

Does Brotherhood Really Exist?

Endnotes

1. Bowen, CT. “$2.75M settlement reached for paramedics’ inaction prior to woman’s death,” online at Tampa Bay Times, at https://www.tampabay.com/news/hillsborough/2020/06/25/hillsborough-okays-275-million-settlement-for-paramedics-inaction-prior-to-womans-death/, accessed September 23, 2020.

2. There are various references to this cultural shift. Among the first was Naked Pilot: The Human Factor in Aircraft Accidents by David Beaty.


KATE DERNOCOEUR, retired firefighter/NREMT, still serves as a medical examiner investigator as well as a SARTECH-II with Kent County’s SAR K9 unit in western Michigan. She retired from the Ada (MI) Fire Department in 2019 and was a paramedic for the Denver (CO) Paramedic Division (1979-1986). Her emergency services career began in 1974 with the Vail (CO) Mountain Rescue Group. Educated as a journalist who also earned an MFA in creative writing, she has written extensively for EMS publications, including JEMS, since 1979, and was a frequent speaker at EMS conferences from 1984-2004. Her book Streetsense: Communication, Safety and Control was released in its 4th edition in 2020. She also coauthored Principles of Emergency Medical Dispatch with Dr. Jeff Clawson, MD (first edition, 1988), among other books. Her blog, “Generally Write,” is at www.katedernocoeur.com.

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