“It’s not what we see, it’s what we experience.” PTSD in the Fire Service

I stood in line waiting to pay the cashier. My eyes scan the magazine covers, the liquor bottles, the lottery cards; then I see it. Two little faces, a picture snapped as they played together. The simple 9 by 13 copy paper, with that picture and then text asking for money to cover the expenses of two funerals. Twins, just 3 years old.

I wasn’t thinking. In the rush to take action sometimes we miss the simplest acts. Plan A didn’t work, move to plan B. I wasn’t thinking. That water was cold. A decent sized pond in early spring is a cold one. I don’t remember feeling the cold. I don’t remember giving a second thought to jumping in. I know I can’t swim but these bystanders, family members, police officers, paramedics; they don’t. I have a life jacket, what could possibly go wrong?

I have got to do something. We have got to do something. We need to fix this. This is what we do, we solve problems. They are all watching, we better solve this one quick. Moving through the water I feel something, “I found something!”. Just an electrical conduit. “Is the power shut off? Can the power be shut off?”. Nobody knows. Well, haven’t been electrocuted yet so it must be safe. Right?

I move into deeper water. Can’t see anything, can’t feel anything. Keep searching. Not using the best grid pattern search. Could be anywhere. Pond is pretty big really. Use some logic, look at the bank. Footprints in the light orange clay mud of the bank. Looks like boot prints. Way too big. Several people have been in the spot, no telling how many. Nothing that matches what I think I am looking for.

Think about how this could happen. Playing in the grass? Standing on the bank? The walkway out to the dock? Boots. There is a pair of boots on the walkway. If there are boots on the walkway then I want to search there. Water is deeper. I don’t feel anything. Nothing but cold, empty water. “Hand me that net!” Anything to extend my reach. Pawing at the water below me with the net, reaching, hoping.

Something! I feel something with the net! I reach for the something. I don’t know if my head went under to grab it. I don’t think so. Maybe. I don’t know what I did with the net. Reach into the dark water and grab it. Smooth, cold, yes; this is it.

“I got um.” Part joyous, part relief. Mostly pain. I have been doing this job a long time. Longer than the father standing on the bank has been alive I think. I hand the child off to the paramedic who is reaching out and rushes the child to the shore. A flurry of activity. Lots of hands doing anything that can be done.

I walk past that. I kinda wish I could just keep walking. This is not going to be good. I can hear the sobbing. The screaming, “why?” What we wouldn’t give to be able to answer that. “Chief, you ok?” “Yeah, I’m good.” I wasn’t; they probably knew that I wasn’t. I take the long route back to my truck. Drop my life jacket. Take a few deep breaths; stifle the scream that I want to let out. Then I knelt down and prayed.

I prayed for the victims and the family. I prayed for my crew; guide their hands, support them in the days ahead as this scene plays again in their mind. And I prayed for me.

Every one of us carries stories like this in our heads. Painful stories we cannot erase. Memories and emotions that can boil back to the surface when we see, hear, smell, or feel something that triggers our minds. The teenage girl with hollow looking eyes and shallow gasps trapped in her car, the perfectly healthy 3 year old little boy choking on food that you just can’t get cleared. If you are new to emergency services, you will develop them too. As I have heard it summed up, “It’s not what we see, it’s what we experience.” Police officers, firefighters, EMTs and paramedics; we see people at their best and at their worst. We see what humans can due to each other and we see what we can do to ourselves. Our mission is to make things better; sometimes we can, sometimes we can’t. Sometimes all we can do is shift our efforts to the survivors; the grieving spouse, the screaming mother, the inconsolable father.

Let me be the first to say that I am not a psychologist, I am not grief counselor, or a CISM team member. But it is obvious that we have a problem with mental health in emergency services. A German study in 1998 found that over 18% of the 402 firefighters they interviewed reported symptoms of PTSD; and 27% had a mental disorder. Flash forward 20 years and we see a study from the International Association of Firefighters that reports over 22% of those subjects in their study had symptoms of PTSD. A survey of more than 4,000 first responders found that 6.6 percent had attempted suicide, which is more than 10 times the rate in the general population, according to a 2015 article published in the Journal of Emergency Medical Services. The National Firefighters Foundation reports that in any year, a department is four times more likely to experience the suicide death of a member than a line-of-duty death.

So what can we do? As leaders in our fire departments we need to watch out for our people, we need to be cognizant of the big five:

1. Isolation from others

2. Disturbed sleep

3. Increased irritability

4. Decreased interest in significant activities

5. Self-destructive or reckless behavior.

Any of these ring true? We also need to take an honest look at ourselves and check for the following;

1. Intrusive memories or thoughts of a traumatic event

2. Avoidance of thoughts, feelings or external reminders of the event

3. Feelings of numbness

4. Hyper-vigilance or exaggerated states of fear

5. Persistent, negative beliefs about yourself and the world.

PTSD in emergency services is very real. Undoubtedly someone around us having signs or symptoms of this condition. It is essential that we as fire service leaders talk about this topic, that we teach others to look for it, and that we take action when we see someone struggling.

The National Suicide Prevention Lifeline, 1-800-273-8255

Share The Load, Fire/EMS Helpline, 1-888-731-3473

 

Chief Dave Cline

 

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