If you are devastated, though, you aren't really in your normal frame of mind. And while it was inappropriate for Patrick to accost Rafe in his ER bed, I don't think he was homicidal - he didn't even physically touch him. He got in his face and yelled at him. What Patrick knows is that Rafe, who doesn't have a license, took his uncle's car without permission, and while possibly high on drugs, caused an accident that resulted in the death of his son and the kid never stopped or even called for help. And maybe as a doctor Patrick should know better, but Rafe was alert and speaking - he didn't appear to have life-threatening injuries. I think plenty of parents in the same situation would get in the kid's face and yell at him. I don't think it is that out of the norm.