The National Police Association Podcast with Guest, Dr. Andrew Dennis, Trauma Surgeon, SWAT Team Member & Author
Hi. This is sergeant Betsy Brantner Smith with the National Police Association, and this is the National Police Association podcast. I have a guest today that I've I have known for, literally decades, and he is a guy responsible, for, saving literally saving cops' lives, both with his own hand and, as well with some concepts, that he started talking about decades ago called tactical medicine for cops. We're gonna talk all about that because he's got a new concept that I think is brilliant, and, it needs to be talked about not just in law enforcement circles, but it needs to be talked about to you, the public. Doctor Andrew Dennis, welcome to the show.
Dr. Andrew Dennis:Thanks for having me.
Betsy Smith:Hey. So, you go through all this education, and then you decide to, not just be a physician, but you thought you'd get involved in law enforcement. Talk about how that happened.
Dr. Andrew Dennis:It's a very long convoluted story, but I'll start in Illinois when I started my, my residency in general surgery here in Chicago. During my fellowships, I went back to the police academy. In Illinois. I got certified as a police officer. And largely because early in my residency, I had taken care of a police officer in Southern Illinois or Southern Cook County that had been shot and injured.
Dr. Andrew Dennis:Some of the, the officers that I was talking to learned my background in prehospital and public safety prior to becoming a physician, and they said, hey. You know, would you be willing to come out and hang out with us and maybe train us a little bit and participate with us? I said, sure. In my all my spare time of a 100 hours plus per week as a surgical resident, I give it a shot. So that that was the beginning of the conversations.
Dr. Andrew Dennis:And just to just kinda speed forward a little bit, I ended up as part of the Northern Illinois Police Alarm System. I started my career in Illinois as a law enforcement officer in Des Plaines, moved to the Cook County Sheriff's Police Department, and then eventually to the Illinois State Police where I am now.
Betsy Smith:Now when I was, I started in, 1980. I'm super old. And, we took a little course in the academy on, first aid that kinda and it was about the same course that, I took when I was in 4 h. So it wasn't there wasn't much to it. And, we didn't have tourniquets.
Betsy Smith:We didn't have any of that stuff. In fact, we were told, do not if you're shot or someone else's shot or badly badly injured, you, officer, are not qualified to use a tourniquet. You'll damage somebody. You'll do all these things. So we were kind of taught in the eighties seventies eighties, wait for the paramedics.
Betsy Smith:And that didn't fare well for, injured law enforcement officers, did it?
Dr. Andrew Dennis:No. Actually, it's really interesting. That's a really interesting history because you're right. Tourniquets if we wanted to talk about tourniquets for one second, they had a very bad rap historically. We know in the in the Vietnam era, thousands of soldiers died from extremity hemorrhage that were that was a 100% preventable.
Dr. Andrew Dennis:And over the years, the mythology of tourniquets and the really has changed largely because the data has changed. We studied them. And with the conflicts that have ensued over the last 30 years, we've actually been able to acquire data and learn that they're not all bad, especially when transport times in the civilian sector are short. Tourniquets can absolutely save lives. Now do most people require a tourniquet?
Dr. Andrew Dennis:They don't. Keep in mind, I'm a trauma surgeon. As a trauma surgeon, I'm really just a plumber, if you will. It's blood that keeps you alive. It's a liquid, and it flows through pipes, and my job as a trauma surgeon is to fix the pipes, because that's what's gonna kill you.
Dr. Andrew Dennis:So this is near and dear to my heart. This is what I do every day. You're right. Most police officers are taught a first responder level training at the academy, if that. Some are taught a little bit more.
Dr. Andrew Dennis:Most don't keep up that certification. So, yes, they may have had it, but most agencies around this country, they're lucky if they retain any a small part of it. Also, remember what's the first thing that I ever learned in EMT school when I was 16 years old was, don't go anywhere until the police make the scene safe. So the cops are waiting for the medics. The medics are waiting for the cops to say it's okay, and ultimately, someone is potentially dying.
Dr. Andrew Dennis:And and that creates a very, difficult situation for not only the victim, but for the rescuers as well.
Betsy Smith:You know, that's such a great point because that that's one of the things that we ran into, you know. You you you you waited, you know, you didn't run into a fire if you were a cop although cops end up doing that all the time. But you're right. We had to secure the scene, and and make things safe so that the EMTs or the paramedics could come in and take control of that patient. And then, of course, sometimes we're the patient as well, you know, the police officer, and that's something that you brought, you know, to 1st and foremost, to my native Illinois was that concept of tac med, tactical medicine, that concept of, police officers being able to engage in buddy aid so I can help my injured, fellow officer or even self aid.
Betsy Smith:Talk about the evolution of that.
Dr. Andrew Dennis:So now you really made me feel old just for the moment. That was that was in 2007 that, I had some early conversations as part of the Illinois Tactical Officers Association with some of the leadership there. And we came across the problem that we realized that not only were police officers not trained to help others, but we really weren't trained to help ourselves. And so survival became a big part of law enforcement training. And part of that goes back to even the whole concept of what I wanna talk about with you after this is that we've moved into a survival over service mentality.
Dr. Andrew Dennis:And so over time, that's kinda generated the whole warrior mindset and the whole warrior identity, but I did rest for a second. So it's important. So so in 2007 ish, we realized there was a problem. There weren't I was the only I was actually the only surgeon I knew. There were several ER docs in that world that were kind of venturing into that space.
Dr. Andrew Dennis:But because of my background in public safety, and my history in law enforcement and pub and EMS, I I realized that this was something that we should be talking about. So I actually wrote a course called medical tactics for law enforcement. I talked to you about this before, you've been part of it, and this was 2,010, 2009. We published a book called Officer Down, a practical set a practical tactical guide to surviving injury in the street. And, and then I got on the road, and I created a cadre of instructors.
Dr. Andrew Dennis:And over the 6 years that we were really going hard with this course, we taught 78100 federal, state, and local law enforcement a officers and agents around the country. And we taught them what we called medical tactics for law enforcement, which is a concept of not only understanding the physical injury, the physics of the injury and the physicality of the injury, but recognizing that your mindset plays a whole lot into how you how and if you're going to survive. So, we married that course. Those beauty of that course was to marry the mindset, give you a true frame of reference, give you perspective, and then give you the countermeasures upon which to act on. And then we also provided you with some of the critical tools to walk away with.
Dr. Andrew Dennis:And so we married the whole thing into 1 into 1 course where you got the the psychological prep, the physical prep, and then you walked away with the tools to apply them. And it was a 2 day course, and it was extremely successful.
Betsy Smith:It was extraordinary as well. I mean, it was it was life changing, I know for a lot of, my friends and my officers. And as you were, you know, as you got this reputation for being this, not only a skilled physician, but a a cop and a police trainer, You caught the attention of the entertainment industry. We gotta mention that as well. Talk about that.
Dr. Andrew Dennis:Yeah. So I was the associate producer, executive medical adviser for the Dick Wolf shows in Chicago, the Chicago 1 shows. Starting with PD as a consultant, then Fire as a consultant. And then I was the associate producer, and I wrote and produced all the medicine on Chicago Med up until this year. So 10 seasons of Chicago Med and 2 2 seasons of the other shows prior to that.
Dr. Andrew Dennis:And and then that spun off into a bunch of other Hollywood shows that I've worked on, Empire, Force, Red Line, etcetera. So, yes, in a 1000000 years, I'm a trauma surgeon. I work at the county hospital in Chicago. I grew up on the Jersey Shore and went to medical school in Kansas City. In a 1000000 years, I never would have thought I would have ended up on red carpets, but that's been a whole lot of fun as well.
Betsy Smith:Did you ever get to appear on any of those shows?
Dr. Andrew Dennis:I did. I appeared several times. Not I tried to avoid the camera, honestly, most of the time. A lot of times where you see very technical things where we're using hands, I had to shave my arms a couple times to match the actors, but you saw my hands, in the scene. My wife also we did this as a pair.
Dr. Andrew Dennis:My wife, is an obstetrician, and she did all the OB and all the, the the maternal fetal medicine that went on to the shows, and we did a lot of baby deliveries on Chicago Med. So she was on there. She she actually acted as a plastic surgeon once. And then my last season, I I we I performed in a in a vintage part of the we we we filmed the vintage piece that was supposed to take place in the 19 forties, and we shot it like it was in the forties. And I was doing lobotomies through people's eyes.
Dr. Andrew Dennis:It was disgusting.
Betsy Smith:So here that says a
Dr. Andrew Dennis:lot, is to say.
Betsy Smith:Gosh. Because they used to do that. It's it's it's insane. You know, so here you are. You've you've done so many things.
Betsy Smith:You could kinda be coasting, but you have a a new concept that you wanna bring to public safety. And, I think it's so extraordinary that I I want people to know about it, and I want you to explain it because we're in an atmosphere now where, there's a lot of separation sometimes between law enforcement officers and our community. You know, we've really gotten beat up the last 10 years, especially the last 4 years. And, and you have a great concept that I think could, not only save lives, but can help save this profession. Let's talk about that.
Dr. Andrew Dennis:So I came to a point in my career. I'm 24 years in at the county as a trauma surgeon, the same number of years as a law enforcement officer in Illinois. And I've started reflecting back going, asking myself, alright. What have I learned, and what can I teach? Now I've had the opportunity and the privilege to work alongside some remarkable people.
Dr. Andrew Dennis:I would call them heroes. Many would call them heroes, whether they're doctors, nurses, cops, paramedics, firefighters, it doesn't matter. They all qualify in my world as that and in many others. What I've realized though over the last several years, and we've all lived this, is that we have seen a shift in our environment. We've seen a shift where there's a rift between society and law enforcement.
Dr. Andrew Dennis:We have a mental health crisis in law enforcement. I mean, just over the last 2 years, over 12 Chicago police officers have taken their own lives, and this is not just the fire part our police department. It's the fire department as well, and it's public safety around the country. So we have a crisis in mental health. We all know about that.
Dr. Andrew Dennis:It's it that's made some headlines at least in the world. I don't think it's drawn enough attention, but it's certainly a problem. The other thing is that we've we've lived through a very dynamic time where the world has changed in front of us. People the the Norman Rockwell picture of the police officer with the little child pulling at him, that doesn't exist anymore. And I've asked myself why.
Dr. Andrew Dennis:So I'm a I'm a surgical scientist. I'm a researcher. I ask questions. I research. I I I look for ways to study things, and I and I try to publish on them.
Dr. Andrew Dennis:And if they have legs, then I try to bring it to the next level. So what got me thinking was, okay, what are the problems? Problem 1 is that we have a perception problem in law enforcement. The public does not perceive. And remember, perceive is how you identify with something, how you interpret it.
Dr. Andrew Dennis:The public does not perceive law enforcement to be friendly. They see them as enforcers. And when you break it down and you're a police officer, you have to ask yourself what tools you have. Also, when you put that in the context of the number of the numbers and types of calls for service, most people call 911 because they cannot they have a problem that they cannot solve themselves. And so they're calling for help.
Dr. Andrew Dennis:A good portion of service calls are medical, mental health emergencies, and then there's crime. So there's really 3 types of service calls in for simple for simplicity's sake. Well, if you're a cop and you get to a service call and it's not a crime and there's no one to be detained, there's no one to fight with, there's no one to stop the crime from happening, take a report, do the forensics, whatever, then it's either a medical emergency or a psychological emergency. And we've learned through several years through the last several years that psychological emergencies demand our attention, and we they it demands that we be trained to deal with them. Because in the years where I was researching tasers and we were you know, taser's first statement was tase often, taze early, and that was when officers were showing up to mental health emergencies.
Dr. Andrew Dennis:And so it automatically became a violent encounter once it may have had to be that way, but often, there may have been other pathways. I'm not saying there always were, but there there we never explored those pathways. We never trained for those pathways. So we're now identifying that as an issue. We now see that and we're not do we see we're being mandated to provide training for the officers and provide tools to bring to the environment and to the into society with us, whether they're co responders, or other means.
Dr. Andrew Dennis:And every agency is tackling this a little differently to address mental health. But the other part that we respond to are medical emergencies. And when you think about it, it's the law enforcement officers that are out in the wild all the time. Firefighters, they're in a they're cozy in their lounge chairs, in their stations, for example. Games.
Dr. Andrew Dennis:Other video games. You name it. And they're awesome. They're remarkable guys and women, but they're not the ones that are typically the first on the scene. It's the law enforcement officers that are first on the scene.
Dr. Andrew Dennis:If you're the flip police officer, and you're the first one there, and you address the scene, and the scene is safe at that moment, and your team comes in, and you're able to to grid perimeter and deal with it, and someone's dying on the street. If you are not equipped or empowered to treat that person, you will stand there and wait till the EMS gets there. And that is a gap in time that can be quite substantial depending on where you are. One of the biggest complaints, and this through me, actually. I just learned this last year.
Dr. Andrew Dennis:One of my social workers told me this, and and he said that one of the biggest complaints that he gets from our patients is that they were injured, EMS was responding, but not there yet, but the police were there. And the officers were just asking questions with their hands in their pockets, waiting for EMS to get there. And in their mind, they were dying, and the cops are just staying there watching them die. Now, again, that needs to be put into perspective, but that is a true perception of a lot of people. And, Greg, I work at inner city.
Dr. Andrew Dennis:I work at the county hospital. But nonetheless, that is a statement that is heard over and over again. So we have a bridge. We have a time gap that needs to be addressed. Why are we not trained and equipped to do so?
Dr. Andrew Dennis:Because if you can't help somebody, that actually can contribute to that to the to a mental health crisis of your own. It's learned helplessness. It is a feeling of not being able to help somebody and watch them struggle or even die. And and and and that leaves a lasting mark. That is extremely impactful.
Dr. Andrew Dennis:And that are those are the memories that that keep people waking up with over and over and over again. That's post traumatic stress injury. And that can be prevented as well. Because doing something or feeling like you're doing something can be at least at the very least be a very powerful tool. So by training and equipping law enforcement officers to bridge that gap in and to to train them and equip them to provide rescue in addition to enforcement.
Dr. Andrew Dennis:That's where I'm leading with this. That's where I'm going. I think that we've, you know, the we've relegated the hero card to the firefighters for a long time, but it's the cops that are there first. And so why should they not get the credit? We do so many heroic acts.
Dr. Andrew Dennis:We save so many lives on a regular basis, and we don't talk about it. We don't get credit for it, but the credit goes to the firefighters and the paramedics. And and that's good, but that also belittles a lot of effort, on the law enforcement side. So if you were to add rescue to LEO, you get LEO. Right?
Dr. Andrew Dennis:So, you know, Hero and LEO. That's really what I'm talking about. I'm talking about creating a program or at least a discussion. Let's even let's go back a little bit. A discussion about training police officers to bridge the gap and even go further than that if they choose to or the agency chooses to, and become EMS providers.
Dr. Andrew Dennis:So an integrated EMS approach to law enforcement. Because if we're only seen as the enforcers and we're not seen as the rescuers, the bridge the the gap between society and law enforcement will only widen.
Betsy Smith:So how much extra training do you you know, what are you looking at? Like, e m EMT or paramedic? Or what are you what's your vision of this for your average cop?
Dr. Andrew Dennis:Well, I'll go farther than that. What I am talking about exists. There are pilot programs. There are well established programs all over the country where EMS is owned by law enforcement, not the fire service. Remember, the fire department took on EMS not because they wanted to.
Dr. Andrew Dennis:EMS is the bastard stepchild of most fire departments. The fire department merged with EMS because there weren't enough fire calls to support being firefighters alone anymore. In Chicago, and I can speak from Chicago, because I live in this environment, I work in this environment. Every engine in the city of Chicago is an ALS paramedic equipped engine. Every truck is a BLS EMT equipped truck.
Dr. Andrew Dennis:They often beat the ambulances there. You only have 80 something ambulances, and you have far more trucks and engines around the city than you do than you do ambulances. So you please get there first, then the fire department, and then EMS gets there.
Betsy Smith:How do you marry up officer safety with being that that true first responder that is trying to save a life? In other words, if we get somewhere and we're still not sure if somebody's gonna try and take our life, how do we also respond to save a life?
Dr. Andrew Dennis:Well, the concept I'm talking about does not stand alone. You're still the police. Your job is to make it safe. Your job is to eliminate the threat. None of that changes.
Dr. Andrew Dennis:I'm not advocating for anything but that. But once the threat is neutralized, once there are people to be taken care of, and they can be friend, they could be society, they could be colleague, it could be anything or yourself, then to not have equipment or training, I think we're doing society a disservice. I think we're doing our profession a disservice, and I think that it's not something that's hard to overcome. And I'll give you a couple examples. The proofs of concept that exist out there.
Dr. Andrew Dennis:The Illinois State Police is the best example, not only because I've worked for the state police and because I'm the medical director, and I am, but I'm also proud of this agency because since before I got there, every state trooper is an EMR, emergency medical responder, which is basically an EMT equivalent without the ambulance side of it. Every trooper every squad car that every trooper drives, because they get their take cars to take home, is a basic life support non transport EMS vehicle in addition to being a squad cop. So every trooper is an EMS professional on a in addition to a law enforcement professional. They're a lira. Right?
Dr. Andrew Dennis:They are they go out every day, and they respond to crashes. They're on the highways. A good portion of the troopers are on the highways, and people are pretty happy to see a trooper roll up. We do, as a state police, over 400 medical rescues every year that we barely talk about.
Betsy Smith:And that's one of the things when you look at, like, a state police organization like Illinois. People think about Illinois, they think about Chicago, where you're at. But most of the state of Illinois, and it's a big state, is rural. And as an Illinois state trooper, you're very often a half an hour or more from an ambulance even getting to to the crash scene that you're at or the heart attack or or whatever it is. So this does seem like a no brainer, especially in rural, and, and smaller suburban areas, doesn't it?
Dr. Andrew Dennis:Sure. And so the Illinois State Police is an EMS agency. It's actually an Illinois Department of Public Health accredited licensed nontransport basic life support with advanced life support skill sets agency in the state of Illinois. So we meet every standard that's required of an EMS agency. We're actually the 2nd largest EMS agency behind the city of Chicago in numbers.
Dr. Andrew Dennis:Think about that. We're cops. In COVID, we ran the largest mass vaccination sites in the nation as the state police. We've we've know what we can do. It's a great agency in that respect.
Dr. Andrew Dennis:And, yes, every one of those troopers in Central and Southern Illinois brings that squad car home, brings that tool set and that skill set often to baseball games, to the community. It's just means of community engagement. There's a lot of benefit to this. This side
Betsy Smith:It's kind of the ultimate in community policing, if you will.
Dr. Andrew Dennis:Yes. But Illinois State Police is not the only one. The Los Angeles County Sheriff's Department has had an integrated EMS program for decades. Television shows, 240 Robert has been was written about it. So they've been out there.
Dr. Andrew Dennis:The New York City Police Department, ESU, runs an EMS program. The, where I came from, what and what got me thinking about this early was, actually, I grew up in Monmouth County in New Jersey. Sean Golden is the sheriff in Monmouth County. Most of the EMS in Monmouth County is run by volunteers. And over the last several years, volunteers have been very hard to come by.
Dr. Andrew Dennis:And so the ambulance calls go out, and no one's showing up. So the police department started stepping up because they were out on the streets, and they started equipping squad cars as EMTs, and the Monmouth County Sheriff's Office just stood up 7 basic life support ambulances marked up as sheriff's vehicles, and they're transporting in lieu of the basic life support squads because they're solving a problem. So it's see a need, fill a need. And every region and area will have different needs. You can't universally apply one model to this.
Dr. Andrew Dennis:There are lots of ways to skin this cat, but the upside when you really dissect it is huge. Now one caveat. This upside does not it may bridge gaps with society. It may offer areas for community engagement. It may soften the uniform if the cops are out there teaching CPR like we do as the state police.
Dr. Andrew Dennis:It may improve officer wellness. It may increase recruitment. All of that are upsides for law enforcement side. But what it also does is create common ground for the society that wants to defund the police, because this allows us a common space to have an open discussion, and help each other. And so that's where that that's all the upside.
Dr. Andrew Dennis:Now it doesn't solve poverty, it doesn't solve biases. It doesn't solve socioeconomic issues. None of that will be solved. But what it does do is create a pathway for common ground to open dialogue, to create to build relationships. And that's where the future has to go.
Dr. Andrew Dennis:We've got to embrace more than enforcement. Otherwise, we will be relegated to just being enforcers, and we'll be we will be relegated to be not liked, not welcomed, yet we we we could be.
Betsy Smith:Absolutely. I I wish we had about another hour to talk. We've got about a minute. If if a political leader or a citizen or a police leader is listening to this and they wanna get in touch with you and and have a discussion about this, how can they reach out to you?
Dr. Andrew Dennis:The best way is just to hit me up through my email, which is, adennis@medicaltactics.com, or through my county email, adennis@cookcountytrauma.org.
Betsy Smith:Or you can I I can't thank you enough for everything that you've done for my profession, for my my home, and and what you continue to do, for the citizens of Illinois and beyond? And we really thank you for spending time with us today. And if you would like more information about the National Police Association, you can visit us at nationalpolice.org.
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