If you find yourself firmly in an emergency, possibly critical, and had seconds maybe half-seconds to react, how would you react?

As the noon day sun began its decent toward the western horizon, “Bubba” and I walked from the red pick-up truck toward the hospital’s main doors and lobby.  I handed the shotgun to the CFO of the psych-A&D hospital, asked “Bubba” to sit back down, and told him I would hasten the admission to the AAU:  Adult Psych Acute Unit.  After only a few seconds of getting approval from a dismayed, nervous Business Office Director to handle the necessary paperwork back on the unit, I walked with Bubba to the private room.  When I returned to the Intake Office, my supervisor — she also in utter dismay and gasping relief — asked “What were you thinking!?”

Ten Hours Earlier

For three and a half years I worked in the intake office for a private psychiatric-chemical-substance-abuse hospital with three units and four programs:  child, adolescent, and adult. Our hospital also had one of the first Dual-Diagnosis programs in the state and nation.  I was also working toward a master’s degree in Marriage and Family Therapy at the nationally recognized local seminary.  This job was one of my all-time favorite jobs; never a dull moment or a day the same as before.

On this particular afternoon everything started about 2 a.m. that morning.  It was my rotation to be on-call for un-referred assessments for possible after-hour admissions.  I get the page from our nursing staff about a heavily intoxicated male seeking entry into our dual-diagnosis unit.

If anyone is familiar with this type of situation, then you know in a matter of minutes or hours, the heavily inebriated patient could do a complete 180 and figure by their sudden omniscient wisdom that they no longer need any help.  This is often a recurring cycle transpiring over several years in their life; they have a “situational revelation” and can “pull themselves out of the funk.”  Sound familiar?

By 3 or 4 a.m. Bubba (as I will call him here) promises me over and over he will show up at our hospital’s admissions doors.  That is the last I heard of him after an all-night phone conversation, assessment, and pre-admission call.

Eleven o’clock a.m. rolls around.  I arrive at my designated time tired having been on-call all night.  Pamela, my supervisor, briefs me on the day’s events so far…”Bubba has not shown up for his admissions appointment at 8 a.m.”  He has not called to let us know he’ll be late or is coming the following day; nothing.  Experience has shown us time and again that dramatic-drunks often fail miserably on their promises or commitments.  Disappointed, sure, but not surprised.  Work continues and the hospital has 3-4 other morning and afternoon admissions lined-up; two of them already waiting in the front lobby.  I will call Bubba a little later to ask what has happened.

Why Do I Have To Wait!?  *Slurred Expletives!*

Some hours into my shift, the receptionist in the front lobby calls me:  Bubba is here and ready to be admitted.  I thought great; better late than never!  I had already walked back and forth through the lobby because one of our tasks involved pre-certification for admission.  I had noticed a slim bony man, I assumed was Bubba; and he had noticed me.  I returned to the lobby and introduced myself.

I explained we had everything arranged about four hours ago, but now we were in the middle of admitting these people who made their appointments.  “Sorry Bubba, you are going to have to wait your turn.”  He acknowledged and then mentioned that he just knew I was the man he had talked to all night because of my long-hair in a pony-tail.  He said kindly that “I liked you when we spoke and now I really like you and your style.”  The smell of whiskey reached my nostrils.  I thanked him, returned to my office,  and let the business office know that the 8 a.m. appointment was now here.  The business office manager laughed.  I knew exactly why:  a drunk’s or addict’s clock is way different from the world’s.

Twenty minutes later the lobby receptionist frantically calls me saying that Bubba has been getting agitated and just walked out to his truck to get his rifle…you better get out here!  As I arrive she points to the front parking lot, “He’s out there.”  I follow.

I reach Bubba at his red pick-up truck – flood-lights across the roof – as he removes his shotgun from off his rear window gun-rack.  “Bubba…hey man.  There is no need to do that.  I’ll get you on back to the unit, but you have to leave the rifle.  That is going to freak some people way out. You won’t make many friends that way” I said calmly.  He laughed but frustratingly asked “Why tha hell do I have to keep waiting so fucking long?  God damn, you told me last night I was ready for admission!”  I grinned at him, “You’re right.  That’s why I wanted you here at 8 because we had these other people needing help too.  We’re about ready; I’ll take you on back but I should carry the shotgun.  I don’t look as intimidating“ and I winked at him.

We stood there for what seemed five minutes talking then he handed me the rifle.  We walked back into the front lobby.  I handed our CFO the weapon. Tantrum avoided.

Back in the lobby I listened to everybody’s scared, shocked, dismayed, emotional explanations of “What were you thinking?  Why didn’t you stay inside and wait for the police to arrive?”…and as I set in my desk chair reflecting, it hits me like the percussion from a 1,000 pound bomb:  everyone is right.  Bubba could have turned on me and began a shooting spree.  I could have made my mother son-less and my sister brother-less.  It could have gone bad…really bad.  I felt weak and dizzy thinking about what if.

Crisis Averted or Crisis Managed?

Why did I do it?  Why did I just walk out there after him without a second thought?  In hindsight I know exactly why.  If I hadn’t known Bubba from Adam, I likely wouldn’t have dared gone out the front doors.  But then I thought, what if I hadn’t and he had walked into our lobby, made our nice receptionist his first victim, then walked back through the business office and made them his second, third, and fourth victims?

None of that crossed my mind the moment she called me “Get out here quick!”  Creating a rapport with Bubba all night, then later that afternoon, I realized I was the ONLY ideal person to go out there, calm him down, and stop a potentially horrific scene.  In those half-seconds, in that particular crisis, I was his “best friend”.

When I reflect back on what could have happened, for several reasons I am very happy I was there, at that specific time, and acted on my instincts.  If I had reacted aggressively or in fear, or any differently, I’m not sure things would have turned out so well.  According to everyone else at the hospital I did a brave stupid thing.  But did I….really?  Was I lucky?  Was I extremely lucky?  Was Bubba lucky?

How should people in “crisis” be handled, no matter how self-absorbed they might be?

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