The emergency department (ED) is a place where practically anything can happen. I was doing night shifts 2 nights a week at a large tertiary level public hospital. The area is rough and is one of the poorer neighborhoods in town. The area is well known for frequent muggings and drug vendors and users. There was one story of a mugger that they say "works" a particular corner 2-3 blocks from the hospital. He is infamous, and everyone is well aware that you simply can't take that route home. I have seen everything in the ED from motorcycle accidents where both victim and perpetrator are in the ED together at the same time to hungover patients vomiting all over the floor. In the ED, I do everything, starting with clincal history and physical examination and ending with the clinical write-up and submitting the papers to the nurses station for the patient to get medicated. I get the information from the patient and present the case to the attending for approval of my plan. They make any changes and sign off as the main treating doctor. This means that I am, for the most part, seeing the patients first. This includes the agitated and violent patients. Yes, there is hospital security, but sometimes the patient gets violent right in the middle of an examination or while you are passing them in the hallway. The hospital security is not always with you at all times, and they may take a few minutes to solve these situations. In that time, I am the one dealing with the patient. The other night, a very drunk middle-aged man came in. He was clearly agitated. His family members were trying to physically restrain him. At one point, he started smacking the hall with his hand. I thought he was going seriously injure himself. Then he stopped, looked around him, and fell flat on his back. He appeared unharmed by the fall and laid there for a while. Awhile later, I saw one of my classmates being chased by the same man. This time, the patient was throwing punches as my classmate quickly dodged and began moving away. Behind the patient was his brother, chasing and trying to hold him down. Unfortunately for another classmate, they got a punch in the throat. Thankfully, soon thereafter the patient was restrained and the situation was under control. Fortunately everyone was left relatively unharmed with no long-term damage. However, talking to the classmate who was being chased, he described how the patient grabbed him by the arm and threw him across the room. My classmate choose to do what I believe was wise and not confront the man. What if the situation had been different? Do you think it would be okay for a doctor to defend themselves? Every situation is different, but if the need should arise, would it be ethical and professional in this type situation for a doctor to punch back? Let me know in the comments below what you would one! Has the type of thing ever happened to you? What would you do if it did? Source
