The Trauma of Trauma

If you've been reading this blog for a while now, you know that although most of it is dedicated to our efforts to launch our TV program about the fire service, from time-to-time, I also address major issues that are faced by fire-rescue personnel (as well as police and EMT's/Paramedics).

On this quiet, early summer Sunday morning, an important tweet arrived on my phone. It was an excellent article by the "Gainesville Sun" newspaper in Gainesville, FL. Now, as it happens, one of the partners in Dalmatian Productions and by far, my best friend (other than my wife) for the past 38 years, serves the as the Chief Pilot for the Alachua County Sheriff's Office. While he doesn't fly medical calls, we responded to some of our first serious trauma calls as rookies in a combination department near Greensboro NC.

In the article is relates how the same Alachua County Fire-Rescue squad team responded to two horrific MVC's this past week, just several days apart. This is coincidental due to the fact that ACFD firefighters work a 24/48 shift; which is 24 hours on duty, followed by 48 hours off. Thus, the first of these crashes occurred on Monday and the second, on Thursday, when they had returned after Monday's work.

All too often, people see fire-rescue personnel as big, gruff, impersonal "heroes," who don't have emotions. However, this couldn't be further from the truth. I have never met a fellow firefighter who didn't have emotions; who wasn't happy after a saving a life or saving someone's home, as well as sad and hurting after losing a patient or victim. Just look at some of the perceived toughest firefighters in the world in the FDNY, the Fire Department of New York, and watch the news footage that followed the horrors of 9-11.

Back when Rich and I were rookies in NC (though he had some experience riding along with XXX), we were all gung-ho, just like most rookies. It's one thing to put out a fire in a small shed or knock down a truck fire on the interstate. However, when you respond to a hard-impact vehicle collision with traumatic injuries or that has entrapped a deceased occupant, the wind comes out of your sails very quickly!

At first, the adrenaline, which started pumping while the dispatcher is still announcing the call and pumps up even more as your apparatus sails down the streets and highways with red lights spinning and sirens screaming, keeps you going. You may pause for a moment or two to get instructions from your OIC (Officer-in-Charge), assess the situation or grab tools or equipment. However, once your task is done, the patients/victims are removed from the scene and you've begun to clean-up, the adrenaline drains from your system and the reality of what you've just seen and done creeps over you or may hit you full-force! You re-live every movement, every action. Your mind's eye replays the footage as if you're watching it on best and largest HD TV ever made. And the bile starts to crawl up your esophagus.

One late Saturday night, Rich and I and our driver, responded to an MVC with an overturned pickup on fire and the driver trapped. It was probably only a mile from the station, but the chief was screaming for us to get there because of the trapped occupant. We arrived within a couple of minutes and had water flowing within another 30-45 seconds. More firefighters showed up to hook us to a hydrant and another drove our tanker to the scene. 

When we first started knocking down the fire, we could still hear the occupant calling for help. And while I strengthened my stance and held the hose as well as I could while Rich was on the nozzle, my heart was tearing apart. In just another few seconds, he had slipped into unconsciousness and we knocked the fire down enough for our colleagues and the EMS crew to access our patient. We stood there, in the same position, ready with more water. When they removed him and placed him on the gurney, we used our hose to wet down the sheets that covered his badly burned body. When he was finally removed from the scene, we picked up, but in a fashion we never had before. It was like we were moving in slow motion. And the stench of burning flesh covered us.

When we returned to the station, we cleaned the hoses and the truck. When we were done, I hightailed it to the men's locker room and promptly puked my guts up. I tore my turn-out coat off, and stripped off my bunker pants. Every inhaled breath flooded my lungs with the odor of our victim and his burnt flesh. As I came out of the locker room, our driver that night, one of the paid firefighters came up to me. "Is this your first 'roast?'" he asked. I nodded in return. "You'll get over it," he said. "Just suck it up."

This incident occurred in 1978, two years before the term, "PTSD" was recognized by the American Psychiatric Association and then, it was applied to veterans. It wasn't until an American Airlines DC-10 crashed on take-off from Chicago's O'hares Airport in 1985, striking several building and a trailer park, did some realize that first responders who can see death and destruction every day, might suffer from this psychological/psychiatric disability as well.

Since then, many communities have brought in specialists to work with first responders after major traumatic events. And over the years, we have all come to realize that one or two days of talking it over is not going to solve the problem either. Again, we turn to our brothers of the FDNY who worked the piles at the former World Trade Center, in fervent attempts to find survivors, then remnants of victims to bring closure to as many families as possible. And even though they didn't fight flames or perform staircase rescues, many, still today, suffer from horrible effects of PTSD and have been debilitated by them.

It's time that the public understands, (and we must as well) that first responders are not the same as the super heroes of comics, movies and television. We hurt, we suffer and yes, sometimes we cry, when we see the events we are sworn and dedicated to mitigate.