It’s my turn to work a shift in the dreaded and lonely walk in clinic that is about half a mile from my ER. These clinic visits are not challenging and the diagnosis becomes repetitive.

“Yes, you have a cold…it’s not strep”
“No, that thing hanging in the back of your throat is normal and called a Uvula”
“No, that’s not a melanoma…it’s a blackhead”

On rare occasions there were times of unexpected excitement.

One day, there was only one patient in the entire three bed clinic. I walked into the room and on entering was immediately warned by this big, serious looking and scary guy that he had been stabbed in the arm but I wasn’t to report it to the police. He knew and I knew that the law stated that I did have to report this attack. His “I could squash you any second” demeanor and my radar that he has hurt people before made me question my duty.

I didn’t argue with him as I examined him quietly and thoroughly. I didn’t even dare bring up the subject of making a report. The wound was quite large and it was still bleeding and I suggested that he really should go to the ER where we are better equipped to take care of these kinds of wounds.

“No” he stated flatly and firmly. I wasn’t sure if he was talking or if one of his many screaming face tattoos was talking for him.

“Well I guess we could take care of this here if you want…” I stopped talking when I noticed his agitation becoming worse. I think he wanted me to shut up.

I did explain what I planned to do with the still bleeding wound then I left the room to get my supplies. How odd it was to work in this tiny clinic rather than the ER. I never liked it and rarely had to work this shift but never had I felt so separated than now.

Acting like a good ER doc and doing the same thing I would have done in the ER I secretly called the police to make them aware of the situation. I gave them a heads up about potential trouble as well. The law is a good one.

I returned to the room and in atypical silence I cleaned, explored, then cleaned and cleaned again this large open wound. The rest of his exam indicated that he hadn’t severed any nerves so this was primarily a matter of irrigation and closing the wound in the proper layers. This was a slow, meticulous process so I asked the nurse if anyone was waiting to be seen and I was told it was Norman, our beloved hospital chef. I liked Norman, he was more than a cook, he was a diplomat of the cafeteria. He was thin and tall yet moved and spoke quickly and always got the last word. He could make anyone smile with his humor and style of speech.

I thought about Norman as I got closer to finishing the repair. What a bad mix these two would make, Norman, prancing and making light of life while this guy would growl inside probably preferring to pet a dead dog.

A police officer that I knew arrived in the waiting room and I noticed that Norman was still sitting upright and properly in his assigned chair. I quickly blocked the aggressive pace of the officer and called him to the side.

“This guy’s big and didn’t want this reported. He won’t be too happy to see you… Is anyone else coming?” The translation of course was “buddy, you need back up”

I was hoping for a gentle diplomatic approach but this officer was of over 50 enjoyed provoking people even though he was out of shape. I was disappointed when I saw the officer smile softly and ignore me. I realized that my concerns were being turned into a challenge by this surly officer.

Things didn’t go well from the start. The patient was supposed to wait in the room and have the officer see him while he was still seated but the inexperienced nurse brought the bundle of muscle mass out to the waiting room. His fury was evident by his faster breathing, tightened muscles and scowl on his face. He did however sit down and cooperate. I left to finish my paperwork but within minutes I heard voices rising in anger.

Returning to the waiting room I found the officer of 5 ft 7 face to face with the fellow of 6 ft 5 or so in violent verbal confrontation.

“Sit down or you’re under arrest!”

These were the last words before the patient started to scuffle with the officer. The officer was thrown to the wall but the patient (now bleeding from torn sutures) lost his balance allowing the officer to gain control and fall on the patient. They struggled on the floor as I turned to ask the receptionist to hit the panic button, a straight line to the police station…she was not there…the place was deserted as Norman was missing as well.

I watched the event in slow motion, blood splattering the pretty wallpaper, framed pictures and carpet. I finally realized that I had to get involved when the police officer was losing control of his earlier favorable position and it looked like the patient was grabbing for his gun.

Without thinking, I jumped into the rugby pile and covered the gun with my hand so the guy couldn’t grab it. The addition of my weight helped pin the guy down better and that helped the officer get control of the situation. Somehow within a very short timeframe the officer was able to handcuff my patient and call for help. He was gruff and liked trouble but this officer was very capable at the end.

I stood up, breathless, scared and covered with blood all over my nice white coat and my favorite tie. The room looked like a murder scene yet the officer acted as if nothing of importance had occurred. I think he was in better shape than I thought.

My next thought was the fact that the patient was bleeding again but fortunately the officer said he would take him to the ER for repair. What a relief, this guy would burn me with his eyes.

Other officers arrived and the area cleared out very rapidly. I wanted to yell out “Thanks for stopping by, remember, my name is Dr Ketterman!” Ketterman was my partner.

I found the receptionist and nurse in the back room then I went back to the waiting room to figure out if it could be cleaned or if we had to shut down the clinic for that day. During my survey I found the tall but now stooped and small Norman hiding under the counter. I had to coax him out and even when he came out he refused to be seen. He left still shaking visibly.

Norman used to kid me whenever I came to the hospital cafeteria but he was never the same after that incident. He no longer teased or playfully joked and he rarely came to see his audience in the cafeteria line. At that time I didn’t know that he needed someone to talk to.

For me I was young enough to think it was kind of cool. For poor Norman, it was an emotionally distressing life event.