Tonight at a neighbors Christmas party, I had the honor to spend several hours talking with Randy and Gary. Both served our country in Vietnam.
Gary served one year “in theatre” as a Sargent in the Army. He told me stories about how he and his fellow soldiers were assaulted day after day – by Americans. Guys would pick fights with them just because they “looked military”. I’m happy to report that Gary and company were undefeated in bar room brawls.
Gary told me about friends who were “messed up” when they got home, but insisted he was fine. Yet, with eyes watering, he shared story after story about how he and his friends were attacked and forced into fights they never wanted – at home. It seemed as though Gary was more effected by what happened after he returned than what he saw when in combat.
Randy, a small and soft-spoken gentleman with intense eyes, made the biggest impression on me. Randy spent three years, two tours, as a Marine in Vietnam he re-enlisted shortly after a field promotion to Sargent when his superior, and most of his team, were killed in action. He wanted to go back and, with an intensity in his eyes that I have never seen before, told me that he “made good – two for one”.
Almost six years ago, Randy was diagnosed with bone marrow cancer – an aggressive and incurable form – and given less than five years to live. He has gone through many rounds of chemo and stem cell transplants. Today, he looks very healthy, but moves rather slowly and speaks very softly. He says, at this point, no one knows how much longer he has left. As he shared this information with me, Randy took a sip of his beer, looked me square in the eye and said “I don’t know how much longer I have left, but I’m not done yet”.
Randy honestly believes he was exposed to something, perhaps Agent Orange, while in Vietnam that lead to his diagnosis. However, he does not cast blame. Randy feels that, while it really sucks, this is just part of serving his country.
Randy, Gary and I spent the evening talking, drinking, laughing and sharing stories. Through the course of the night, I eventually told them about my “past life” as a fire/medic. Most of the stories we shared involved “off-duty” partying, but certainly we all shared some of our more intense experiences. For the record, my stories did not hold a candle to what they experienced.
At the end of the night, both men shook my hand and thanked me for a great evening. Randy, however, held my hand. He looked me square in the eyes with the intensity I had seen earlier and said, “Thank you for letting me share my story with you”. He said he does not very often get the opportunity to talk with someone who is willing to listen and who understands his background. An incredible compliment from an unbelievably strong and brave man.
This filled me with pride, satisfaction, gratitude, and humility. This is a true American hero – thanking ME for simply talking to him……
And then, still firmly gripping my hand, with a firm thump on the shoulder and a renewed intensity in his eyes, Randy said to me: “And thank you for your service and what you did for our community”……….
With that he turned, waved to the host of the party, and walked out the door……
It occurred to me last night as I was laying in bed trying to fall asleep, that this week marked a major anniversary for me. On July 30, 2000, I ran my last call……
That call was not the “worst” call of my career – far from it. But it was quite memorable. Intense.
I spent 20-ish minutes in the back of an SUV that had been broadsided and rolled onto the passenger side, trying to protect and treat a young woman while the rest of my crew cut the vehicle apart around us. As I tried to start an IV (yes, I was successful) and administer oxygen, I remember her repeatedly trying to punch me in the head – she had a significant head injury – and all of the dust and debris blowing through the car as Flight for Life landed on the road behind us ….Oh yeah – she was also seven months pregnant.
As we watched the helicopter fly out, the A/C on scene gave me shit about not shaving that day. I told him to F-off and then told him I quit, but agreed to finish the shift. Of course, he knew it was my last shift anyway, so we all laughed. Then went back to the station for lunch.
That was my last call…..
I ran my first call on January 19th, 1988. A commercial plane crash. I was a college student who had signed up for the county search and rescue team so I could learn how to rock climb. I obviously had no idea what I had really signed up for…..
I was studying for an accounting exam when I got the call. It was about 830pm and we were in the middle of a “mild” blizzard. The plane simply hadn’t shown up at the small, mountain airport as expected. Radar had it until just a few miles out. So, we did not know exactly where to look – only a general flight plan to go by and a lot of unpopulated mountainous terrain to search.
So, here I am…..a college student with no clue, snowshoeing through the wilderness, in the middle of the night, during a blizzard looking for a plane crash. We found it – thanks to footprints left by a survivor who literally hiked out to a nearby farmhouse. Over the course of just a few minutes, the scene went from dark and quiet – only the sound of a handful of rescuers trudging through the snow and their headlamps – to a level of commotion and controlled chaos that I had never before experienced. Flood lights and generators appeared very soon after, followed quickly by all the tools of the trade – axes, pry bars, the “jaws of life”……
We worked through the night extricating people. Half the people on the plane survived – the other half did not. Only one of the survivors was seriously injured – the rest pretty much walked away from it. Literally and figuratively.
After many hours, the first crew on scene, us, was relieved by the next crew. I sat down in the snow with a few others not too far from the plane, but out of the reach of the lights. We ate sandwiches that had been brought in…..Then we hiked back out. About two miles, if I remember correctly.
The trip back was again dark and quiet. But, as we crested the last ridge, we were inundated with noise and light. As the first group out, we were immediately attacked by TV reporters looking for a story.
By lunch time the next day, roughly 5 or 6 hours after leaving the plane, I was back in class listening to classmates and professors recount the stories they had heard on the news about the crash. None was very accurate. I passed my accounting exam – but only just barely…..
Both of these calls shared one very obvious characteristic – surreal. I think most of the really “bad” calls share that trait. Surreal. Many times I remember going straight from an especially nasty call to the grocery store to get food for the next meal……..Just 30 minutes earlier I had someones life in my hands and now I’m standing in line to buy lunch meat……Surreal. Towards the end of my career, the surreal-ness of it all became more and more apparent. Impressive even. Towards the end, it even bothered me at times. How could we move on so quickly from the most horrific things imaginable and get back to a normal day? I just pronounced that guy in his living room and had to tell his wife – but man am I hungry! Oh hi old friend who I haven’t seen in a couple of years…..What’s new? How are you? Oh, and by the way…..your mom and your dad are both upstairs in their bed – both dead. Looks like one shot the other but I can’t tell which one did it….But it’s great to see you…..
Yes, that actually happened. No, the conversation did not go exactly like that….but, believe it or not, it was very close. Surreal.
Maybe, as things became more surreal, I should have noticed and realized something was happening. Something was changing. Maybe that was a sign.
I think it is quite safe to say that my struggles with PTSD started with the plane crash. I remember going back to my dorm room and trying to get some sleep before class…..All I could hear was the very loud hum of the generators and tools. And all I could smell was the jet fuel that had been spilled all over the mountainside. I won’t go into what I saw when I closed my eyes….
My struggles however did not end with my last call.
During the years between my first call and my last, I saw and dealt with things I could never have imagined. The kids are what really got to me. I don’t know if I saw more pediatric horrors than any other medic – several medics have told me I did – but I did see more than I could take.
As I look back at that part of my life, at that career, it was an amazing experience. Every moment of it. I loved it! And I learned more about myself in those years than I ever would have had I pursued any other career. However, it did take its toll. I continue to work every day to win the battle with PTSD. I am succeeding. Everyday.
My only regret – I did not recognize the signs that something was wrong before I left an incredibly rewarding career that I loved. If I had known, if someone I worked with had known…….I would probably still be doing the job.
What do I want you to take away from this post? It all adds up and compounds starting with the very first call you run. And every single one of us is susceptible to PTSD.
Every. Single. One.
So, pay attention to yourself. Pay attention to your co-workers. Learn about the signs of PTSD and don’t be afraid to talk about it. Share what you learn with your co-workers. If you see someone who is struggling, step in and help. Most importantly, be open to others helping you.
The career you save may be your own……
I have never heard of such a day, but I just saw it on Facebook, so it must be for real – right?
True or not, this is a great time to say thank to all the 1st responders out there: Paramedics, Firefighters, Police, and we cannot forget the Dispatchers. No – Dispatchers are not “in the streets”, but in many ways I think their job is even more difficult. They are certainly part of the “front lines”.
So, if you are a 1st responder – Thank you for all that you do and all that you sacrifice.
If you are not, then find one and give them a hug…..You never know how much one might be needed right now.
If you have been keeping up with this blog over the last two or three weeks, you know there has been a lot going on my world. Some of it very sad and tragic. But, for me personally, a lot of it has been very positive and demonstrated how much progress I have made. In this post, I want to share some of the big milestones I have reached.
With everything that has happened recently, I have had many conversations with many different people about my journey specifically and, in more general terms, PTSD in First Responders. Every single one of these conversations has been very positive and productive – even though the topic is dark and depressing. My story has been so well received and the support given to me so overwhelming……If you are one of the people I shared my story with directly, either in person or via some of the digital lines of communications we all rely on these days, THANK YOU for listening and helping me. Even if you didn’t know you helped, simply talking to you and seeing the understanding and acceptance in your expressions had a tremendously positive effect for me.
After “retiring”, I spent close to 10 years ignoring red flags and denying that anything was wrong – and that does not include the last several years of my career when there obviously was a problem. Acknowledging to myself was difficult, but not nearly as difficult as sharing my struggles with others. Telling my wife was a big step – of course she knew something was not right, but she did not know if there was something wrong with me or if our marriage was falling apart. Telling her and discussing it with her made a tremendous difference for me and for our relationship. Once she understood, even to a small degree, it was easier for her to support me and realizing the problem was not with our marriage took a lot of pressure off of her. Our marriage is so much stronger today than it was just a few years ago. Even if I would have never done anything else, talking to her was the best decision I have ever made. Well, besides marrying her in the first place.
For a long time, probably a year or two, my wife was the only one who knew the truth. I did my best to hide my “issues” from everyone. The next big step was to actually seek professional help. Walking into my therapist’s office for the first time…..Wow. That was brutal! But I knew very quickly that I had found the right person. The first session or two, we just talked – got to know each other. We did not get into the details of my career or my difficulties after leaving. Of course, we did talk about some of the “symptoms” I had been experiencing over the years, but it was more about helping her understand me – and me feeling comfortable with her. I will get into the details of our sessions in future posts because it is very important stuff, but for now I will just say that it has been very hard work. Extraordinarily rewarding, but hard.
After almost a full year of visiting my therapist every Friday night, I was ready for the next step. I told one of my closest and oldest friends. This was very difficult because I did not know how he would react. Would it freak him out so bad that he would shut me down and avoid talking about it? Would he lose respect for me and think me weak? Would this ruin a 30 year friendship? Well, none of that happened. We are as close, maybe closer, as we always have been. He was 100% supportive. He did not understand what I was going through – but that didn’t matter. He desperately wanted to help me, but didn’t know how. Sharing my story with him was a big deal for me. His not knowing what to do didn’t bother me in the least. Having his support and knowing he wanted to help meant the world.
Several months later, I told a small group of very close friends – another big milestone. I had not really planned on telling them that day, but had wondered what I would do, how I would react, if it came up. After not having seen each other in a long time, we were having lunch together. One in the group expressed some frustrations with another mutual friend of the group, describing some of his behavior over the last few months. We all knew he had spent time in Afghanistan and she wondered out loud, looking directly at me, if maybe he was suffering from PTSD. Inevitably, my eyes starting to water and I knew what was coming. I was able to quickly explain that I would discuss his situation shortly, but first I needed to explain something about me. Then the flood gates opened. I sat, in a busy restaurant, with three very good friends (including two of the most attractive women I know), sobbing uncontrollably. Once again, I had no idea what type of reaction to expect. Would they all get up and leave me sitting there? Would they try to ignore me and act like they didn’t know me? Would they be embarrassed by me? Once again, none of that happened. They were very supportive and comforting. They helped me work through the “episode” and never once gave any indication that they were embarrassed. Now, they each check in on me every now and then just to make sure I’m doing ok.
I achieved a tremendous milestone two weeks ago when I announced to the world (well, the world of Facebook), that I have PTSD. I am no longer hiding my situation. Now, every close friend, every past and present co-worker, every acquaintance who has found me, knows. I’m not sure this is the biggest accomplishment in my journey, but it was a really big deal. Why? Because the biggest reason I denied and hid my situation for so long was my fear of the reaction. The potential for ridicule and embarrassment. First responders, after all, are not supposed to need help – we ARE the help.
But you know what? It didn’t happen. This announcement has caused people to reach out to me to let me know they are here to support me and to make sure I’m ok. This announcement has led to very important conversations with people, friends, who now understand that every first responder is susceptible to PTSD. And it has not led to one single negative reaction……
The culture in the world of EMS needs to change so people like me are comfortable talking about their problems before it’s too late. I gave up a career that I loved because I didn’t know what else to do. I didn’t know where to turn for help – or even that there was help available. Others have given up even more.
What’s my next milestone? I’m not sure. I know that I have not reached the end of my journey, but I have come a very long way. I intend to continue discussing my experiences and plan to work harder to educate people. Maybe my next milestone is hidden in that statement somewhere…..
Tonight I had dinner with an old friend and former co-worker. I worked a lot with this guy when I was new in the business. He was very influential in my decision to move from private EMS to a fire/EMS service. I have always considered him a good friend and a real “fireman’s fireman”……Fourth generation in fact.
He also worked with, and knew very well, the two friends who took their own lives recently. I asked him to meet with me so we could talk about the cultural problem facing not just our department, but all fire and EMS agencies. He is in a position now that he can play a large role in making changes – I wanted to share my story with him and make sure he and the rest of the command staff see the issue at hand.
I was very nervous to share my story, even though he is a good friend. He is still part of the culture that turns the other cheek and hides emotions, after all. I wasn’t sure he would “hear” me and I just didn’t know how he would react to me and my emotions.
Two great things came out of our long conversation. First, and most importantly, he told me about the department’s plans to change the culture. They acknowledge that there is a problem and understand that it is not just about education. They understand that this type of cultural change will not, cannot, happen overnight but that it will take time and dedication to the cause. I left truly feeling they are on the right track and fully “get it”.
Second, he did hear me. He listened. He was sympathetic and understanding. He did not judge me or look at me differently. Our friendship did not change. His respect for me as a person and as a fire/medic remains the same. This all means a lot to me – I have always been worried about what “the guys” would think if they knew about my struggles. Turns out – it doesn’t change anything.
So, if you are like me – struggling in silence for fear of other people’s reactions – please believe me when I say, the reaction will be positive. I have told a lot of people in the last week or so and have experienced nothing but support and understanding. You do not have to tell the world, but it may help to talk to someone. And they will listen….
Some time ago I wrote about one of the most horrific calls I ever responded to as a paramedic. (The Overwhelming Burden of Empathy http://wp.me/p2CkoS-1i) It is one of those calls that lives with you forever. In the years since this tragedy, I have very often wondered about the family. How are they now? Did the marriage survive? How are the other kids? Was Dad able to recover. These questions still haunt me.
A few nights ago, as we celebrated the life of a fellow firefighter/paramedic who took his own life, I had a conversation with one of my former ambulance partners: my partner on this particular day. He told me that this call is at the top of his list of “three calls that I will take with me to my grave”. He seemed to want to talk a lot about the call – which brought up a lot of emotion for me, but I figured it was therapeutic for him too, so we continued to re-hash the details of how the call ran and who did what. I teared up several times, but manged to keep it together. Eventually he shared with me his real reason for brining up this particular call…. Through a long string of coincidences, he has found the family……
He wasn’t really trying to find them – it just so happens they live, in the same house as they did at the time, very close to a good friend of his. The connection was made this past Christmas when my former partner was visiting his long time friend. My partner noticed a large pine tree in the neighborhood park was decorated for the holiday. My partners friend explained that this was done by a neighbor in remembrance of the son they lost to a tragic accident many years ago. It did not register immediately for my former partner, but as he left the neighborhood he realized where he was……When he spoke with his friend again, he asked more questions, and has all but definitely been confirmed that this is the family.
My partner tells me that, according to his friend, the family is doing quite well. The marriage survived – which is a real shock to me, but great news.
After allowing this to sink in for a few minutes and giving me a chance to get myself together, my partner then offered to for us to meet the family – if they are willing, of course.
This threw me for a complete loop. I never in my wildest dreams thought I would see them again. I was completely speechless. Frankly, I still am and really don’t know what to do…..
I saw my therapist for our regular appointment a couple of nights later. Of course, this a the major topic of the entire hour. At the end of our time, she told me that she thinks meeting the family would be incredibly therapeutic for me. She advised that I give it some time – maybe a couple of months – to prepare myself emotionally and then meet the family.
I can’t say that I disagree with the therapeutic aspect of the meeting – assuming the meeting is positive. My greatest fear is I will learn the family does not feel we did everything we could or even did our best and, to some degree, blames us for the outcome. This would be devastating. Almost as troubling is the concern that meeting us would take the family back to that horrific day – bringing back all the pain and suffering they endured that day and in the following weeks and months. Also, I am worried about the effects such a meeting would have on me – especially if it does not go well, but maybe even if it does go well. Obviously, it will bring back all the memories and emotions I have fought so hard to get under control. Could meeting the family actually diminish some of the progress I have made in the last couple of years?
So, what would you do? Would you meet the family with the optimistic belief that it will be, in the long-term, a positive and therapeutic experience? Or, would you take solace in knowing the family is still together and strong, and simply move on without meeting them?
I truly do not know what I am going to do….
Today I am thinking about suicide…..
No – I’m not actually considering this option, but I am thinking about what must go through a persons mind as this decision is made. This past week, for the second time in about 6 months, a friend and former co-worker decided that he had had enough; That he could not take any more; That his family would be better off with out him and his “issues”. And for the first time in my life, I get it. I actually understand the decision.
I have never understood what could cause a person to make this ultimate decision. My first experience with suicide, before I got into the world of EMS, was so horrific and unforgivable…… What this man (a neighbor) did to his family……. I have never been able to forgive him or anyone else who has taken their own life. Until now.
I cannot and will not ever forgive my neighbor – or most people who make this choice – but I can easily put myself in the shoes of my two friends/co-workers. I can fully appreciate the feeling that it is too much to tolerate. I have often told my wife that she does not deserve to put up with me and my “issues” and wondered silently if my wife and kids would be better off if I was not around. (Not permanently, but just not in their daily lives). Frankly, had I not “retired” when I did – I could very easily have decided to end it all long before these two friends did.
The purpose of this post is not to justify or glorify suicide. The purpose is to say – I get it. But it is not the answer. There are much better ways to deal with your struggles. I am proof.
I realize that most of my posts here have been rather negative; describing my problems, not telling of my successes. The truth is, I have made a lot of progress and I am here to tell you that there is hope. There is help! And it’s OK to ask for help. It can be a long and difficult journey, but it is a much better alternative.
I will not tell you that I am “cured”. But I will tell you that I am MUCH better. My anxiety levels are much lower. Nightmares and flashbacks are lest frequent and less intense. When something does “trigger” an emotional response, I am able to handle it and move on. I do still have things to work on, but my quality of life is much improved.
Simply acknowledging that there is a problem will make a huge difference. Getting over the self-consciousness of what everyone else thinks is another big step in the right direction. Truth is – you don’t have to tell everyone. Of course, you need to tell SOMEONE that you are struggling….but that could be a spouse, a close friend, a therapist…..even me. For a long time, my wife was the only one who knew; Then my therapist (who is a God-send, by the way). Eventually I told close members of my family and very close friends. Even keeping my secret, for the most part, I have been able to overcome many of the hurdles associated with PTSD.
I understand there is still a stigma associated with PTSD. But, if you are struggling, you need to talk to someone. I am here to help – whether you want to talk to me, or if you want some help finding a professional……Just let me know what I can do to help you make a choice your family won’t regret…..
I have not posted anything recently because I simply haven’t had anything to say. Which is actually a good thing. My anxiety level has been very low. And I haven’t had an emotional “episode” in months. I’ve cut my therapy sessions from every week to every other week and, in fact, between my schedule and my therapists schedule, more appointments have been cancelled in the last 3 months than attended. As I said, this is all really good. It means that I have made progress. I can go several weeks in a row without a therapy session and survive.
Unfortunately, I’ve had a setback…….
In the last week, I’ve had a couple of fairly minor emotional episodes. One triggered by a news story that set me off before I could hit the button to change the radio station while I was driving. I was able to work through it quickly and move on. (Proof of progress!).
The second was triggered by a song on the radio that caused me to snap at my son for no good reason. (For the full story on this particular song, see my previous post: On the turning away….A trigger, a flashback, an incident at church, a sermon, and a Pink Floyd song…Update: Recently I had a great conversation with the young man mentioned in the post. This was the first time I had seen him since. Of course he did not remember me from the incident but was very appreciative of my help when I told him about it. He is happy and as healthy as he has been in years.) I have not been able to listen to this song since the episode described in the post. On this particular evening though, I was in a great mood and feeling really good. I was busy doing something around the house and the radio (actually Pandora) was playing in another room. I noticed immediately when the song came on but quickly decided that, since things had been going so well, I should be able to handle it and went about my tasks, without really paying attention to or even thinking about the song. Part way through the song, my son interrupted what I was doing to ask for help with something. I snapped at him. It was at that point that I realized the song had effected me. I noticed then that my entire mood had changed. I apologized to my boy and went to help him. But the fact that the song had effected me really bothered me for the rest of the evening.
These two incidents really bothered me. They really were not a big deal compared to many of the emotional episodes I have experienced, but it did feel like a set back. Last night during my first therapy session in a few weeks, I talked about the episodes and described the feeling of taking a step or two back. My therapist pointed out that I was able to process them and move past them quickly without letting them “take over”. She told me what a great indicator this is of the progress I have made over the last two and a half years. I commented that I had hoped I had moved beyond these types of episodes and that I was “over it”.
Her response: This is all part of your story now. You cannot change this – it will always be a part of you and who you are…..
Her comment hit me like a ton of bricks. I had the very sudden realization that my PTSD will never go away. I will never get over it. Of course this makes complete sense and I think I probably knew it at some level. However, I had never consciously thought about it in this way. I think I expected that at some point, it would not longer affect me. That after “X” number of therapy sessions I would no longer have to worry about a song on the radio or a news story that has nothing directly to do with me or any of my experiences; That I would be able to go to a party and not have to be concerned that someone might say something or ask me a question about my experiences that I was not prepared to answer…….
Apparently, this is not to be…….ever.
Sitting in my therapists office, as this sunk in, I broke down. It hit deep and it hit hard. Later, watching a TV show with my wife, the point was driven home even more dramatically. The title character, talking to another character whose girlfriend had just been killed, ended the show by saying: “The pain you are feeling will never go away. It will always be with you. It will be the first thing you think of every morning when you wake up. But, some day, it will be the second thing.”
Wow. I now understand that this is my life. This is who and what I am – who and what I will always be. To some degree, PTSD will define me for the rest of my life.
Of course, I completely lost it. I haven’t lost it like that in a long, long time.
During my meltdown, a very powerful question came to mind: Was it worth it?
Was it worth it to spend more than a decade of my life responding to and dealing with the most horrific things anyone can imagine? Was it worth it to work so hard to save people who could not be saved? Was it worth sacrificing my mental health and, to some figurative degree, my life?
Today……I’m not sure……