After an encounter....see a doctor!!!

Dr. John Meade

Director of Tactical Medicine, Suarez International

In the most recent set of developments in the prosecution of George Zimmerman for shooting & killing Trayvon Martin, we see the release of some of Zimmerman's medical information. Let's analyze this in light of the advice we in Suarez International give our students about what to say & do after a fight for your life.

Specifically, let me address certain medicolegal issues from the multiple perspectives, including those of an Emergency Physician, reserve cop, and SI Instructor.

I have selected a few quotes from published news stories to illustrate my points.

Also today, a trove of documents are being examined by lawyers for both the defense and prosecution as part of discovery in Zimmerman's trial -- including 67 CDs worth of documents, video of Martin on the night of the shooting, his autopsy report and videos of Zimmerman's questioning by police.

Some people still believe that the sanctity of the doctor-patient relationship is inviolate. Sorry, but when you are involved in any violent encounter, everything you say to me "can and will be used against you in a court of law". Not just what you say, but how you say it, as well as what you don't say. Even more, my opinion about the whole situation will carry a huge amount of sway with a judge and jury. As a presumably objective person without particular interest in a case, and as a certified expert, I will be impelled to not only testify as to facts, but my interpretation of everything. If I believe you, good for you. If I think you are lying or exaggerating, bad for you. If you luck out with a doctor who believes in self-defense, bonus! If you happen to get some bleeding-heart liberal doc who hates guns, you better play up your victim status.

The morning after the shooting, on Feb. 27, Zimmerman sought treatment at the offices of a general physician at a family practice near Sanford, Fla. The doctor notes Zimmerman sought an appointment to get legal clearance to return to work. 

Zimmerman refused emergency medical care after the event. Much was made of this in the press, saying that if he was beaten in such a manner that he was in fear for his life, how did he not need to go to the Emergency Dept? It helped contribute to the surge of opinion against him, undermining his claim of self-defense. 

I think many of us alpha-types tend to minimize our injuries and illnesses. We joke about them, and say "it will buff right out". We want to continue being the same tough guy that survived, or in fact triumphed, in the immediately preceding lethal force encounter. It suits our egos to downplay any injury, and we don't want to appear weak. 

Instead, we need to understand that different rules apply to different portions of the encounter. While actually in a fight, we must indeed ignore our own pain and bleeding in order to win. Once the fight is over, we have a different battle on our hands. The battle to ensure that we are viewed as the victim who turned the tables on the aggressor, and survived. This may mean actually pointing out every little bump, bruise, strain and emotional discomfort to support our cause. 

A medical report compiled by the family physician of Trayvon Martin shooter George Zimmerman and obtained exclusively by ABC News found that Zimmerman was diagnosed with a "closed fracture" of his nose, a pair of black eyes, two lacerations to the back of his head and a minor back injury the day after he fatally shot Martin during an alleged altercation.

You will note that the day after the shooting, Zimmerman was found to have several significant injuries, and these seem to support his claim that he was being beaten aggressively by Martin. Why would he downplay these things initially? Denial? Macho? Wanting to put it behind him and move on with his routine? Yeah, how is that working out for him?

Am I telling you to lie or pretend to be hurt when you are not? No, as a physician, I despise having a patient lie to me. As I mentioned before, my opinion will be part of whatever proceedings happen down the line, so you don't want me to have a negative one about you.

What I am telling you is that we who tend to internalize our feelings, hide our pain, and be the strong silent types are our own worst enemies at a certain point. After the shooting, or stabbing, or empty hand incident, we must realize we are still in a fight, but with a different set of rules. It is time to ask for medical evaluation and treatment immediately!

What can you gain by this? First, you tend to limit the amount of in-depth questioning that the officers and detectives can do with you. You give your very brief information to the cops, and say that you need to go to the hospital. When they try to ask more, you say you want to be helpful but you really need to go to the hospital and would prefer to have your attorney present after that for any more discussion. No cop wants the liability of delaying emergency medical care for someone.

Secondly, you gain the fact that you are making it clear that you suffered legitimate injuries. If you don't have a cut or bruise, perhaps you are just feeling lightheaded, having chest pain, nausea, or "are all shaken up from this". Again, I am not telling you to lie. After such an encounter, it would be shocking if you didn't have some combination of adrenaline-induced shakiness, hypertension or weakness. Just go. And don't do like Zimmerman, and end up seeing his family doctor's physician assistant the next day, where it is documented you really just wanted a note to be allowed to return to work. Go to the Emergency Department, and have it documented you are there as a crime victim!

Lastly, when you see the doctor, you need to avoid minimizing your concerns. Imagine you are making a case for your own disability hearing. You don't need to try to get an Oscar for Best Performance by a Crime Victim, but you need to ensure that the medical report that is written contains the information that will help your case. If you are asked if you hurt anywhere, list them out! Even if it is documented only as a list of places that you hurt without apparent injury, it is recognized that early injuries might not show. The doctor want to refer you to an ENT doctor to check out your broken nose? Go! A couple days off from work is reasonable, so ask for it!

Don't allow your toughness to make it tough on you afterwards! In our Trauma Medicine for the CCW Operator classes (TMCO) we train you how to survive all aspects of the fight, from the pre-fight clues, to the actual encounter, to the after-fight medical care. We also cover this material on “How to interact with the police afterwards” in great detail. Sign up for a TMCO class near you!

Comments

[Tim]

this is great advice. I have recently seen a case here with a woman involved in a melee who had 2 small caliber handgun wounds she was not aware of.

[LawDog]

Good article. As a practicing criminal defense attorney, I agree with the good doctor's legal assertions.

[Sheepdog_CT]

Thanks doctor. Appreciate your wisdom and expertise. Semper fi!

[Dick Hime]

Thanks Dr. Meade. I'll be sharing this with my future CCW Qualification Classes. Excellent advice. Well done.
A Missouri CCW Instructor