His Brain on Meth

Police were called to a home where a naked 27-year-old man was causing a disturbance. He reportedly threw a dresser at the police when they tried to subdue him. To keep him safe and protect those caring for him, he was hogtied. To hogtie someone, the police cuff the wrists behind the person’s back and cuff the ankles. Then, the wrist cuffs and the ankle cuffs are connected together, behind, with a third set of cuffs, forcing the subject into a position with his back arched and his ankles fastened to his wrists behind his back. After restraining this man, the police loaded him in their squad car and headed for the emergency department.

I was called out to the ambulance loading dock because the police and ED staff were having trouble getting him out of the back of the police car. Hogtied, naked, sweaty and still fighting, he had thrown himself forward, off the back seat. His head was wedged under the back of the front seat with his rear up in the air. All I saw when I peeked into the car was his naked butt with his scrotum sticking up by his crack.

When we finally got the man onto a hospital gurney, I noted he was not moving any more. A quick check showed he had no pulse and was not breathing. This changed the nature of our situation profoundly. Instead of controlling a drug-addled patient, we had a patient in cardiac arrest.

We moved him immediately off the loading dock into the closest room in the emergency department where the police reluctantly removed his cuffs. I was then able to quickly assess him and give some orders including starting CPR, inserting an IV and getting him on the monitor. Since he was not breathing, I immediately passed a breathing tube into his windpipe and got him on a ventilator. As we got all that done, his heart, which had actually not stopped but had just gone to a very slow rate, was now fast and he was starting to wake up. Though that was good news for him, it also required immediate sedation so he would not pull out his IVs and breathing tube.

A more careful examination showed him to have abrasions on his extremities where the cuffs had been placed and a dislocated elbow, which had probably been suffered at some point during the fight to restrain him. After I stabilized him for admission to the ICU, I got his elbow back in joint and splinted. His testing was all negative except for methamphetamines in his urine.