Friday, March 6, 2015

Two Ways To Make Better Emergency Decisions – Part One: A Primer in Preparedness

If you had to leave the building right now,
where do you go?
“You should improve your impulse control.” Usually, that means restraining our impulsive purchases. Turn off the “one-click ordering,” don’t “stop by for your free test-drive,” and ignore everything offered you at the grocery store check-stand. Those are good steps to take, especially if you find that you’re headed toward an eventual storage locker rental.

But there are other impulses that are essential to our health and well-being. When backing out of a parking spot, or changing lanes in traffic, feel free to respond quickly to the sounds of beeping horns or shouting pedestrians. It’s appropriate to duck or turn in response to loud, sudden noises. Definitely dive for the toddler who’s managed to unbuckle the safety belt and stand up in the shopping cart. Don’t let those occasional spikes of adrenalin go to waste. React.

But not all our reactions are intuitively appropriate. That is, some impulses may not result in the best outcomes. The adrenalin rush fuels our need to fight, to flee, or to freeze. Sadly, though, it does not always lead us to choose correctly among those options. In an emergency, we often find ourselves needing to act without thinking through the potential consequences of our actions, and the results can be very different. For example, if the pedestrians shouting at you are warning of what you’re about to hit—the brakes are the better choice. If they’re warning of what’s about to hit you—you might want the accelerator.

The first of the “Two Ways To Make Better Emergency Decisions” is…

Prevent Emergency Decisions
Emergencies are an inescapable reality. There will be moments in which we need to act immediately in order to prevent damage or injury to others or ourselves. But even in those moments, we do not have to make emergency decisions, if we have already decided what we will do in case of a particular emergency.

Do yourself and your loved ones a favor:
complete and file your advance directives.
As a bank teller, I was trained and drilled in the actions to take in the event of a bank robbery. When a man leveled his pistol at me through the window one day, despite the adrenalin-fueled impulses I felt, I followed the protocol that we had practiced. The need to focus my mind on “doing this the way I was taught” helped prevent me from fighting, fleeing, or freezing. The correct response was to calmly follow-through on the requests made by the man holding the gun.

Later, though, as a police chaplain, I was reminded frequently of the potential risks of accompanying our officers into the field. One night on a hotel balcony, several occupants of a particularly rowdy room wanted to join the officer and me in the narrow, confined space outside their door. The officer repeated his request that only the one we were to contact should come out, until a young man inside the room called me by name. Inexplicably, the officer let him come out to visit with me. A moment after, when those inside the room decided that wrestling with an armed law enforcement officer seemed like a good idea, the young man of my acquaintance, now behind the officer, began to reach for the officer’s pistol. I remember thinking about my training, but I didn’t think about it until after I had taken the appropriate measures to restrain the subject.

I'm not sure "See Your Chiropractor"
belongs above "Notify Your Insurance
Company," but you get the idea.
Not every emergency involves firearms. But almost every emergency can be anticipated. The necessary decisions can be thought through, and preparations for various contingencies can often be made. In three very common situations, though, I find that there has been almost no forethought, much less preparation. Our fantasy is often that “we’ll never have to make that decision,” which we often phrase, “we’ll cross that bridge if we come to it.” Most of us will face a chasm or two like these in the course of our lives. Don’t wait until you’re there to realize that there is no bridge.

Childbirth Complications
We can spend most of an evening in some circles discussing, theoretically and hypothetically, “Do we believe that abortion should be an option if and when a mother’s life would be endangered by continuing to carry her as-yet-unborn child?” I’m sure there are plenty of interesting opinions we could share over dinner. But when the doctor says, “I can’t save them both. What do you want me to do?” the answer is time-critical. When our son was just about to become the subject of such a conversation, the doctor had already worked out the way he was going to phrase it. “I’m going to have to break him, or her, or both.” We were within thirty seconds of having to give him an answer. But since he was our third child, we’d had plenty of time and opportunity to discuss what we believed. We literally had the answer ready before (several years before) the doctor needed to ask the question.

Complications at the Other End-of-Life
There is almost no end to the research, education, and information available on the techniques and technologies that continue to complicate what has never been a simple subject: how hard do we want the medical community to work before they let us die? In polite company we might ask, “To which among the many life-prolonging therapies, procedures and medications would I feel comfortable submitting myself or a loved one? From which of them would I hope my loved ones protect me when I am no longer able to make my own wishes known?” This needs to be discussed in detail, and more frequently than you might think. New options are constantly becoming available. It would be good to hear about them from your doctor, at least sometime before he needs to turn to your assembled family and/or friends and ask, “What was her preference? Do we hook her up, or let her go?”

An excellent resource for putting together
your advance directives. 
Planning for Violent Crime
Would-be pacifist that I am, I frequently contemplate, and discuss as often as anyone will allow, “How do I feel about the terrible possibility that I might have to employ violence in response to violence toward myself? toward others? toward my loved ones?" The time to decide whether you’re willing to use force in response to force is before you ever face such circumstances. Simply put: hesitate in deciding and you might as well not decide. Even a momentary delay will usually prevent any subsequent action from being effective, no matter how extensive your planning and training may be. I mean to address here, however, only those momentary circumstances in which immediate action must be taken to protect yourself or others. In communities where law enforcement resources and responses are limited, these questions apply primarily toward criminal behaviors. For others, where law enforcement resources and responses are excessive, the same questions apply in our approach to law enforcement officers themselves. In both cases, however, advance preparation leads to more careful response, whether we choose to support, to obey, to resist, or even to confront those threatening violence.

In part two, I’ll discuss the second of the two ways to make better emergency decisions. Even more important that what we do ahead of a crisis is what we do amidst the crisis.

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