I spent a bunch of time watching nearly every “follow-thru-a-shift/day/whatever” First Responder show that I could find because they turned out to be such a great way to watch how humans actually behave under intense stress/distress and what contributes to each kind of reaction.
One of the things was that anything with a cognitive effect - cold, head trauma, hypoglycemia, stroke, alcohol, drugs - can make you not just really “stupid” but really weird-stupid, really fast.
And cold will do it faster than you think! My favourite example was a British one where the person who needed rescuing was actually an off-duty police-constable who had gotten into danger on the water, and he actually had done everything right, except that he hit a point of being Too Cold from the cold water and became absolutely obsessed with getting the car-keys out of the little single-person boat that was actually Stuck. And like, obsessed, unreasonable, blankly-not-comprehending-arguments, “I got to get my KEYS”.
You could see the first responders pausing and being like how do we deal with this, as he wades back into the cold water to try to haul the boat out. Eventually they decided it was worth giving freeing the boat a shot as clearly their next step was physically dragging him away.
tl;dr they did eventually get the boat out and he got his keys and stomped off to his car - they stayed on-scene to monitor him, since he also started otherwise-rationally changing into the dry clothes that he had in his car, because like I said he had prepared properly etc, and then we cut to the interview afterwards.
And the guy is like: no actually I have no idea what the hell came over me. That was 100% the stupidest, most dangerous thing (the going back for the keys) I have ever done in my life, and I realized it as soon as I’d got the dry clothes on and sat in the warm car for about ten minutes - I stopped shivering and then went what the hell was I doing?
The interviewer was like, was it at least a nice car?
And the guy was like NO IT WAS NOT. IT WAS NOT A NICE CAR. IT’S A COMPLETELY MEDIOCRE CAR AND I’VE GOT ANOTHER SET OF KEYS AT HOME. But at the time I absolutely and without even a hint of doubt knew that I had to get my keys and I was willing to fight everyone there if they tried to stop me. I remember that clearly, I remember that it was the absolute most important thing that ever existed, and then as soon as I got warm again I realized that was absolutely absurd.
He noted it had completely changed how he understood and approached interactions with others in altered states of consciousness, because he now fully understood that they could not be rational and they simply were seeing the world through a completely different window and it wasn’t their fault.
And like that was one of my favourites but there were lots like that, and as the poster up a few notes, even just emotional shock can have a cognitive-state changing effect - and additionally, both exsanguination (heavy bleeding) and cardiac emergencies (like heart-attacks) have very real potential effects on how for instance if your brain is getting enough oxygen to make you a sensible human vs “that person sure is in an altered state of consciousness, they are”.
People are sometimes more meandering in that state of emergency than they are at any other time … . because bleeding to death can feel a lot like being drunk, and having a cardiac emergency can come with bodily effects that make your brain genuinely stupid.
Plus also we like to believe that adrenaline gives us the power to think really clearly for a moment, and sometimes that’s true, but it’s really more accurate to say that adrenaline gives you the power to think really fast. Which means unfortunately if your brain is firing off along the wrong route, metaphorically speaking, it’s a long way down that route before you even have a moment of “hang on wait - ”
(This would apply to the above anecdote about the fire, for example!)
For me this was amazingly useful for writing because it’s really quite difficult, otherwise, to get portraits of how people react to things that are this intense - and how different and disjointed they can be from how people act when not in those situations. You really can have the calmest, most reasonable, most carefully pacifistic person in the world who then hits their head and becomes a violently combative patient; you can have the most sensible person in the world who does something amazingly stupid because their core temperature dropped too low; you can have someone go from sullen uncooperative non-verbal and hostile to the absolute opposite from the application of a tube of glucose paste.
There are ways to up your likelihood of behaving sensibly under this kind of pressure that mostly come down to “practicing over and over and over in calm and controlled simulations of the thing” as it starts training your automatic reactions - this is why fire-drills work.* It’s why real in-depth first-aid training (rather than the one-day certification) involves endlessly Doing Scenarios - I did a year of Junior Lifeguard when I was a kid and I still can feel those habits coming on when a relevant situation comes up.
But yeah. This is ALSO ALSO why well-trained emergency services dispatch have a rote list of information they ask and just keep asking and asking and pushing at until they get a precise answer to that question - because most of the people calling them are absolutely in altered states of consciousness!
This has the result of creating a quite amusing momentary brain-pile-up if you happen to be someone who was drilled by rote as a child on How To Call Emergency Services back in the days when things like “where am I” etc were not easily found out - I was drilled by first responder family members as a wee thing that the moment they picked up and said hello, you recite your location, THEN what service you need (assuming you’re calling centralized dispatch - otherwise they will assume that since you’re calling fire-emergency you need a firetruck :P), THEN describe the problem, THEN say who you are … .
… so that if the line dropped or got cut off or something bad happened to your ability to communicate by telephone (a real hazard in a small northern town in the late 80s and early 90s) the dispatch had the MOST important information immediately (where to find you), before moving onto the others that were somewhat less important in descending order.
Of course now if you’re calling from a landline they know exactly where you are, and even with an internet-phone or a cell they have somewhere to start (no, it’s not an instant location; no, it’s not totally “we have no idea” either); and the dispatchers are trained to walk people who have not had that same training thru giving them the right info. So if you just respond to their “hello please state your emergency” (or whatever) with the descending order of “I’m at [location] and need [whatever service], [specific details of what’s going on to the best of my knowledge], this is my cell number in case we get disconnected and my name is Meredith” their train of thought skids sideways a bit and they have to realign.
Still saves time! But it’s funny.
*[it’s also why the current form of active shooter drills in eg schools actually doesn’t; the drills themselves are basically designed to mimic the actual event too closely and thus mostly result in traumatic experiences for the children in question, and not necessarily in retained safety habits under stress. Conversely, at least when I was in schools, fire-drills were honestly actively boring: the bell rang and then we had to all line up and our teacher was really anal about Exactly Following Rules and then we all filed out of the classroom and went and sat on the hill and it was all very unrealistic in terms of how a real fire FELT … .which. was the point. Anyway I digress.]
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