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……
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…..