Smoke Showing: Recognizing the Signs of Violence Before It’s Too Late

“Where there’s smoke there’s fire!” This expression has served humanity for centuries when signaling trouble. The statement paints a vivid picture of a looming hazard on the horizon, and perhaps there is no place where this imagine fits better than in the fire service. It is a perfect metaphor for our profession.

Smoke is, and always will be, a valued indicator to the presence of a fire. As firefighters, we know that we may not always see the smoke, but if we do, then there is (or at least was) a fire! Throughout our history, smoke was the one hint that foretold responding crews they were about to earn their namesake. However, as the modern fire service has evolved, “seeing smoke” is no longer the go-to sign when it comes to portraying our most clear and present danger. 

These days, the mission of a firefighter has advanced far beyond simply fighting fires, extending to helping people during all types of crises. Whether it’s a basic medical need, a complicated structural collapse, or a mass-casualty incident, firefighters are tasked with engaging for the public good. We are an all-hazards response unit, and most of us are mentally prepared for this adaptation and equipped for the challenge. Yet there is a particular facet of our assignment, intertwined within the realm of day-to-day operation, where firefighters are being caught unaware and unprepared for their role. 

All-hazards response

Violence is becoming more evident, and firefighters are facing it head-on. Unlike years past, where violence was largely avoided as a result of either the community’s benevolence or a distinct differentiation in civil duties (i.e., “it’s a police matter”), firefighters today are often confronting violence and violent people. Sometimes it is an armed assailant; other times it’s a confused patient or an aggressive bystander. In any case, the potential for harm from violence is heightened, and firefighters are expected to wade straight ahead into the melee to meet their civil service obligation.

As risky as the job description might sound, let me say there is nothing wrong with the expectation of our response. It is a necessary part of the emergency service puzzle, highlighted by several high-profile incidents, such as school shootings, exposing significant vulnerabilities in the previous standardized operational strategy. The boxes distinguishing independence in call types have blurred, and there are more and more crossover areas where interagency dependency is required. Firefighters are not surprised by this obligation and, in fact, have embraced the notion. Respectably, they are willingly throwing their hats into the ring for the sake of their communities. The issue for the fire service in general is not that firefighters are engaging into a new, hostile work environment, but that they are depending solely upon an age-old method of identifying the threat: waiting to “see” smoke. 

A different kind of smoke

Once a police officer and now a firefighter, I too find myself consistently looking for “smoke,” but it is not the kind you would imagine. It has a different color, a different volume. It produces a different turbulence, and it represents a different health peril. The smoke I’m referring to is the kind that a violent person produces prior to their violent action.

As a byproduct of my police training and conditioning, I’ve learned through first-hand experience that combative people emit visual clues or “smoke” to tip off their growing internal fire. And the sooner firefighters can learn to detect and discern these warning markers, the better prepared they will be for their inevitable rendezvous with violence. Firefighters nationwide must equip their psyche with a new type of “smoke” detector: training on situational awareness to potential violence. 

The patient-provider problem

The first place to focus when addressing the notion of seeing “smoke” is to expose the blind spots obstructing our view. The beautiful thing about an actual fire is that when you see the smoke, you know the fire is active. There really is no wondering if something is burning, just “what” and “how big.” But when confronting a potentially aggressive or hostile person, unless you are a student of interpreting body language and discerning “situational awareness” red flags, the smoke is much harder to decipher. Frankly, if you’re not specifically looking for it, you probably will miss it all together. 

When analyzing why we fail to see the smoke, it’s easy to understand how the blinders can develop. As an EMS responder (which many of us are), we are charged with attaining the confidence of our patient. They must allow us into their personal space to treat their medical conditions and grant us insight into their private lives to uncover patterns of destructive behaviors. We encourage the individual to disclose confidential information so we can make accurate assessments of their current and future medical needs. This requirement puts us at a significant security handicap. 

Compared to the goal of our counterpart in emergency service—the police officer—firefighters are forced to try to become the patient’s “friend” to gain their cooperation and, in so doing, we forfeit our greatest protective asset—distance. In contrast, a police officer is trained to keep their distance until the time to engage emerges, and by then the officers have already committed psychologically to a physical altercation. This is a burden for us. How likely are we to be effective at treating a patient if we cannot get up close and personal to sympathize? Paradoxically, on the surface, our mission would seem to direct us to sacrifice our safety bubble, whereas the patrol officer’s does not.

This is the crux of the problem for those of us EMS providers. We are too focused on seeing the subject through the “patient-provider” perspective to accurately evaluate the smoke. Our functional job necessity of “personalization” leads us straight into jeopardy, handcuffing us to any and all uncontrollable circumstances, good and bad. Our Hippocratic Oath has become paralyzing, and we miss out on detecting the demonstrative expressions of potential and probable violence.

This seems unfair. But what else are we supposed to do? In this situation, we are merely playing the game by its rules. We have to get up close and personal, and we have to give the patient the benefit of the doubt, right? Yes. Yes, these are the rules of the game, and yes, it is unfair. But none of that changes the mission. We signed up for this job, and although the times are changing, we have to be able adapt and overcome. 

Recognizing the signs of smoke

So how do we adapt and overcome? Begin by learning to identify signs of smoke—indicators to predict what could happen next. Think of them as “watch-outs scenarios” for potential violence, akin to the 18 watch-outs in the wildfire arena. We must recognize the warnings, or we will find ourselves faced with a life-threatening event. We need to be able to work closely with patients and still be purposeful and prudent about watching for “smoke.”

Figuratively speaking, there are patterns of smoke that arise when it pertains to a person’s violent disposition. First of all, it’s important to note that there are cues that are purely the body’s subconscious physical expression, and there are those that are the mind’s conscience direction to the body to act out. Some you cannot distinguish unless you are up close, and others can be noticed better from afar. For this reason, the entire crew needs to be committed to evaluating the environment. Furthermore, don’t be fooled into thinking only one person in the room is capable of violence and that it is just the patient. Be observant and pliable to all possibilities.

Physical signs

The physical displays of “smoke” will emerge before the other signs. This is why we as EMS attendants need to be perceptive from the outset. The body will produce several physical transformations. And in the same way we don’t just look at one element of actual smoke to determine the fire’s next move, we must not look at just one physical alteration. We need to put the puzzle pieces together to view the big picture, and these physical clues, taken as a whole, give us a good projection of any potential violence in store.

I’m not a scientist, but I’ve spent much of my life studying people and their mannerisms. From my days working in a bar to those serving as a police officer, I learned to monitor a hostile person’s physiological features preceding their aggressive outbursts. Frequently, breathing patterns emerged as a precursor to trouble. Breaths can become slow and deliberate or intensify rapidly. What’s important here is not to know exactly what the breathing pattern is trying to compensate for, but to notice that the rate has changed. The change itself is the “smoke” we should recognize. 

Also, skin color can be another physical presentation. If a person is becoming blotched around their neck, that person is experiencing a stressor. Or possibly they are nervous about what they might be planning. Again, similar to breathing, the sudden change in skin condition is the clue we need notice. 

Lastly, watch the patient’s eyes. Eyes can tell a lot about what an individual is thinking. “Darting” eyes that scan the room could mean the person is looking for a way out of their present predicament. They may plan to run, or perhaps they are planning to fight or even looking for a weapon. Either way, they are closer to acting. 

“Fixed eyes” also tell a story. A fixed gaze suggests an evaluation is in process. Potentially the person is planning an assault. They might be trying to comprehend an undesirable request, or maybe they are irate. A fixed stare attached with a scowl is a sure sign of agitation.

Also take note of someone who will not make eye contact, especially during direct questioning. This could reflect emotional detachment and preparation for an upcoming act. 

As you can see, there is no single matrix broadcasting pending violence. Situational awareness to potential violence is not a scientific method, but rather an art form, and just as an admirer at an art gallery trains their eyes to discover the artist’s intention, so should we. Ironically, we practice these exact same physical evaluations when we are performing a medical assessment. We’re just interpreting them from a different viewpoint—patient care. We must learn to connect the dots in this context. These are only symptoms, but when they are combined with other clues, they signal definite “smoke” in the air. 

Behavioral signs

For purposes of clarity, I’ll refer to “behaviors” as any corresponding action, physical or otherwise, where the subject has taken a deliberate means to accomplish an end. Behaviors can fall on a wide spectrum, covering movements ranging from small muscles to large muscles, fine motor skills to gross motor skills, and include observable attitude manifestations. Behaviors will almost always trail the body’s sympathetic nervous system, and they typically confirm what the physical cues were foretelling.

Allow me to use an analogy to demonstrate my contention. As a former football player who played defense, there were certain things I looked for when trying to make a tackle. Muscle tension was always a no-brainer for me to expect impending contact. What this meant was prior to impact on a field, you always braced yourself, and if my opponent was bracing himself, then I knew he was preparing for a collision and not intending to try to “juke” (fake) me. It’s a rudimentary example, but it certainly illustrates the concept that physical preparation precedes a physical act.

To the firefighter who finds him- or herself in a situation where violence is rapidly approaching, look for large muscle movements in the upper body structures, like the shoulders lurching upward and chest popping forward; neck straining and teeth clinching; arms tightening and fists balling. Each of these characteristics may not be seen every time, but at least one or two will present themselves consistently before a person attempts an assault.

Finally, noncompliance is an overt behavior, and when we see it repeatedly within the same interaction, we should assume the potential for violence is elevating. In addition, a conversational tone that becomes short and impatient might indicate the party is getting agitated. Again, I will not say it is an inevitability, but I will say it is likely.

Putting it all together

When behaviors are linked with physical appearance changes, they are extremely reliable. However, if the behavior is the first sign of “smoke” you witness, then you probably weren’t paying close enough attention. And if you are waiting to observe the behavior first before you begin to take protective measures, then you will be late in reacting to violence. Mastering the art of interpretation by associating the physical to the behavioral elements will ensure that firefighters are effectively spotting the smoke, and that they are prepared mentally to meet the safety priority. 

It’s a team activity

Remember, each crewmember must be abreast at noticing physical and behavioral changes, and not just the firefighter tending the patient. From a distance, all of these physical clues will also declare themselves if you are watching. Surprisingly, from an offset, you have a broader perspective and can watch the subject’s hands, hear their word choices, and distinguish their posturing, receiving the full image. Your lens is wider and, like in other fireground duties, you are not task-oriented, freeing you to perceive more and devise a more diversified reaction plan. 

Practice makes perfect-ish

Situational awareness to potential violence is not something you’re born with; it’s learned. It’s a skill acquired through a tough process of constant focus and refinement. And even with dedicated concentration to the art, you still will not be perfect at identifying every possible red flag. But the more you practice, the more proficient you will become and, consequently, the safer you and your crew will be. 

Unfortunately, situational awareness to potential violence is not something we routinely train for in the fire service; but fortunately, it is something we can exercise daily to recover ground exponentially. The important part is to start growing the skill into a useable tool that you trust. With dedicated investment spent in this arena, firefighters will be better equipped to handle the emerging “new” threat they face. No longer will they be caught unaware or off guard.

The reality is, communities are counting on us to serve their vast emergency needs, and our families and crews are equally counting on us to return home safely. Balancing this equation is the job for each firefighter. We need to be willing and able to function effectively in any hazardous environment, especially those where violence does occur. 

Because the emergency service world is drastically changing, we must catch up to the curve quickly. This mandate must be an industry-wide precedent. For professionals trained to see smoke, consider this “that dark pillar, billowing toward the sky,” and with every new call for service, we get that much closer to probable peril where the smoke column becomes pronounced and the endangerment unrestrained. However, by adhering to some practical assessment principles and practicing intentional observation techniques, we will be on the front end of protection. We will no longer be hoping to avoid violence, but we will be creating our own safety net, returning to the days of truly “seeing the smoke” and recognizing the trouble it’s signaling.