From time to time, I help out with EMT classes at a nearby university. I often conduct training scenarios based on practical experience, a counterpoint to the textbook ideals. So I recently found myself in an alley behind the building, playing the part of an injured and irate patient.
My goal for the students' scenario was to give them the chance to practice some human psychology, not just medical assessment. I wanted them to handle someone who was angry and not compliant, to establish rapport and help the patient get needed treatment. I also wanted them to think about the safety of the scene and continually evaluate whether the patient represented a threat to them. I wanted to create some real stress and let them experience how to handle it. The program runners gave me the go-ahead to curse and generally act like a jerk.
I'm not a very physically imposing person. Fortunately, my job exposes me to many different people, some of them unfriendly. I just did what they do, and I threw myself completely into the role. I adopted body language that was confrontational and claimed a lot of personal space. I spoke too loud and cursed a bit. Perhaps most importantly, I gave students my best Nick Offerman glare, looking intently at them and not breaking eye contact even after social norms would have demanded it.
The results were kind of amazing. The students knew me in passing, but it was like I was an entirely different person. The adjective I heard most often afterwards was "scary." Several said that it felt very weird to see me joking and laughing like myself again as we debriefed after the scenario.
What surprised me was how liberating it felt to behave like a complete asshole... so much so that it was a little troubling. Being a jerk can feel very powerful, especially when you take advantage of other people's desire to avoid confrontation. I never touched or threatened violence toward anyone, but by broadcasting subtle signals that I was unpredictable, I put myself in charge of the situation and placed everyone else in a tough spot.
I've learned many ways to deal with people who are "acting out" in some way or another on emergency scenes. The patient I simulated wasn't even an extreme example of what I encounter in the field. But by putting myself into his role, I actually walked away with more insight into why some people act as they do. It's easy for me to forget how powerless people can feel when they're involved in an emergency - either as the patient, family, or bystander. Being a jerk is one way of forcing others to grant you a little of the authority and control you've just lost.
It will be interesting to see if that influences me the next time I find myself face to face with that kind of patient.