Where's my magic sword?

by lsusr2 min read27th Sep 202112 comments

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ChinaNarratives (stories)Altruism
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When performing first aid, you must never leave a patient until you have passed them off to someone more qualified than yourself. This is a corollary to primum non nocere (first do no harm). Helping someone and then abandoning them can be worse than just being a bystander.

Once upon a time, when I was at the lightrail station in the International District, a young woman approached my brother and me. She was holding the hand of a blind elderly lady. The old woman did not speak English. The young woman did not speak Chinese. This was obviously a quest hook. I could almost see the giant yellow question mark floating above her head. My brother and I accepted the escort mission.

If this were a videogame, we'd get a quest marker indicating on our map where we're supposed to take the blind woman. Real life isn't so kind. My brother and I speak enough Chinese to ask "Where do you want to go?" Unfortunately, the dialect of Chinese the woman spoke was not the dialect we spoke.

My brother and I speak Mandarin. The lady spoke Cantonese. The difference between Mandarin and Cantonese isn't like the difference between British English and American English. It's more like the difference between English and Russian. You know the saying "a language is a dialect with an army"? Well, a language without an army is a dialect. Chinese so-called "dialects" are mutually unintelligable languages when spoken.

We asked where she wanted to go. She said "lusi". [Click here for an approximate pronunciation]. We were confused. "Lusi" isn't a word in Mandarin. "Lu" and "si" are words in Mandarin but that's less helpful than you might expect. "Lu" has like 50 different meanings and "si" is just as bad. To make matters worse, "lu" sounds a lot like "" and "si" might mean "shi", depending on one's accent. "Lusi" could mean anything from "aluminum lion" to "lawyer". (In case you've ever wondered why Chinese doesn't use phonetic writing, this is one of the reasons.)

Fortunately, there is a large Cantonese-speaking population in the International District. (This is not a coincidence. The lady was part of that Cantonese population.) We visited a tea shop to find someone who spoke Cantonese. Our translator confirmed that the blind lady did indeed want to to go to "lusi" and was confused as we were what "lusi" was. But the translator did provide an additional clue: the woman wanted to go to the pharmacy.

We escorted the woman toward the pharmacy, trusting that a cutscene would activate and we would receive additional instructions. Sure enough, it did. As we approached the pharmacy, she stopped following us and instead went for the brick wall of the building. She followed the wall to the entrance of which she had the key. I made sure she got safely back to her apartment. She thanked me 謝謝. I collected my experience points and returned home.

On my way out of the building, I stopped by Luke's Pharmacy.

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When performing first aid, you must never leave a patient until you have passed them off to someone more qualified than yourself.

How did I get almost 40 years into my life before encountering these words?! Seems like they should be engraved on the box of every first aid kit ever. I spent a few years with the freaking Boy Scouts, for crying out loud, and nobody ever explicitly taught this!

(I notice I am confused) ... (and a little angry)

The premise you may be missing is that it's a necessary thing to teach. It could be that common sense works in a supermajority of cases. If it was a car accident, it's likely an ambulance will be coming anyways. If they just have a cut finger, you disinfect, bandage and you're done - no need to pass them off. The edge cases where somebody makes a wrong call are probably pretty rare, all things considered. 

It's definitely part of Red Cross CPR and first aid training courses. IIRC part of it is also related to the practical advice to make sure you or someone else has called the proper authorities before you start trying to help someone, because otherwise you'll just be stuck there indefinitely with no one to relieve you and start providing more or better care than you can.

For what it's worth, I am an Eagle Scout and I didn't learn this from Boy Scouts either. I learned it from a firefighter.

This isn't a feature of military first aid either, though on reflection I can't really conceive of a situation where it would be a relevant decision point given the procedures otherwise.

I am vaguely aware of this norm but don’t really understand it. It seems like it should depend on what sort of help your giving them.

I think the norm only applies to patients who are in serious danger. If the patient is conscious and can basically look after themselves, it doesn't apply. Also, it doesn't necessarily apply if help is not coming / the rescuer is in danger themselves if they stay. (This aspect might be more controversial. But situations like that are pretty rare in civilization anyway.)

But in the situation where (1) more help is likely to arrive, (2) the patient is unconscious, or otherwise in serious danger if left alone, and (3) the rescuer is not in serious danger from staying, I think the norm applies.

(It's definitely a bit Copenhagen Ethics, but I think there's an embedded assumption that rescuers are unlikely to refrain from helping someone out of concern that the person will become their problem. This is especially true of licensed medical professionals, for whom the norm most applies, and I think may even be a condition of their license, or a legal duty, in some cases.)

I did leave out some important qualifiers.

I think Copenhagen Ethics is the correct perspective to apply in this situation because if you're helping someone other people look at the patient and think "this patient has already been helped". By providing assistance and then abandoning a patient you can do more harm than good by preventing others from helping.

The last sentence didn't seem to make sense until I realized that 

maybe "Luke's Pharmacy" is the missing lusi - or rather Lu-cy.

I think that since lady also said something about pharmacy, it's more likely that "lusi"="Luke's".

When performing first aid, you must never leave a patient until you have passed them off to someone more qualified than yourself.

I think this is bad advice. Sometimes the patient has a small cut. A dab of antiseptic and a plaster and their treated. In a triage situation you might be rushing back and forth between several patients, trying to stem the bleeding until the ambulances arrive.

If you and a friend were out walking, and your friend broke their leg, you might want to attach some sort of crude splint, then leave your friend there as you walk for help. (if you have no phone or no signal) 

Then there is "more qualified than yourself". Does this mean the most qualified person in the world can't ever pass the patient off to anyone? Even if its just an injury any novice could treat?

In many situations, appearing helping and then wandering off will be strictly better than doing nothing. (an action optimised towards the goal of helping is generally better than the null action)

Helping someone and then abandoning them can be worse than just being a bystander.

I'm sure this is sometimes the case, but its not always the case. I would say its the case <1/2 the time. Mostly trying to help someone should help them.

If you and a friend were out walking, and your friend broke their leg, you might want to attach some sort of crude splint, then leave your friend there as you walk for help. (if you have no phone or no signal) 


See my other comment for my more detailed thoughts, but note that wilderness situations are a specific exception to a lot of usual rules about emergency care. (E.g. "Wilderness First Responder" is a specific type of class/certification different from normal first aid, because it deals with unusual situations where rescue is not immediately available.)