The Gods were not happy with me.  I had handed in my notice with my previous Fire Department after going through a nasty divorce and becoming a single father of my five year old son.  The new department offered much better pay and the all important Kelly day needed to take care of my little man.  The day in question was my very last day with the County.  I had just got to the station and had barely got my gear on the rig before the first call came in.  It was a cardiac arrest, a GI bleed, the messiest and most frustrating of medical emergencies.  The all important airway is overcome by the stomach contents rendering intubation attempts impossible.  After twenty minutes of cardiac algorithms and futile attempts at ventilation, the termination of the code is met with the heart shattering wails of the patient’s wife.

That was victim number one of that scorching August day.  Mid afternoon, a call came in for a missing homeless lady, who lived in the woods.  Each step towards her urban camping spot brought greater confirmation that she was deceased.  The smell of rotting human flesh was confirmed by the gruesome scene in her makeshift home.  Later that same afternoon, a car had swerved off the road and into a bus stop, where a woman was waiting to go to work.  The lady’s body was no match for the hurtling mass of steel when it finally came to rest over her body.  She was still fighting for her life when my neighboring crew got to the trauma center.

The last call of the shift was at 3am.  A man had run out of a burning house, still on fire himself.  When we got on scene, the only part of his body not horrifically burned were the soles of his feet.  After climbing a fence and muscling him back over, he was rushed to the local trauma center where he fought for an hour before succumbing to his injuries.  In just 24 hours, three people had died and one more was fighting for her life.  This was just one day in a career that usually lasts 25 to 30 years.

The point of this macabre anecdote is that First Responders see trauma that can never be forgotten.  These events can be in two forms.  The catastrophic event, like 9/11 or the Pulse shooting here in Orlando can create massive trauma.  The lesser known and accepted version is the cumulative form.  These smaller yet equally tragic events chip at the person incrementally.  As time goes on, the weight of these events start to pile up.  What once may not have bothered someone may now start to cut a little deeper.  As you advance into your career, you realize that the Hollywood code saves rarely occur in the real world.  The sense of helplessness watching a person die in front of your eyes magnifies with each event.

The military has done a good job of recognizing the effects of this trauma.  Sadly, the Fire Service, EMS and Law Enforcement are lagging behind, with acceptance of this being held as a sign of weakness.  The reality is that there are many First Responders who will witness much more trauma in their career than many soldiers.  This needs to be acknowledged in our profession.  Pretending that this trauma and tragedy doesn’t have an effect on the men and women that serve their communities is unacceptable.  This old school mentality is leading to huge amounts of depression, alcohol and drug abuse and even suicide.  It is time that PTSD and the associated mental health issues are brought to the forefront.

In his book, Tribe, Sebastian Junger talks about how a group offers strength and support.  This is particularly true in the Fire Service and Military.  These men and women spend a large percentage of their life with the same group.  The laugh together, cry together and see the same horrific scenes together.  When a person leaves the tribe, that support structure is lost and that’s when symptoms can manifest out of nowhere.  This could be leaving the military, retiring from the Fire Service or even injury.  Finding a tribe both at work and outside of work is imperative in dealing with the demons that haunt you.  Humans are innately tribal and find solace in groups of their peers.

One of the worst philosophies toward treating this affliction is by using medication.  As with many chronic diseases, this just serves to mask the symptoms instead of treating the cause.  The only tried and tested treatment that has proven to be successful is exercise.  This may be in the form of sport or fitness training.  People who immerse themselves in taking care of their bodies have been shown to deal with PTSD much better than any other treatment modality.  Green Beret and UFC fighter Tim Kennedy attributes his investment in his body as the reason he can deal with the horrors he has seen in combat.  I myself can testify to this.  After 12 years seeing the results of horrific accidents and human cruelty, martial arts, strength training and recreational sport have helped keep me balanced.

These images will never go away.  Detroit FD Engineer Dave Parnell’s quote “ I wish my head could forget what my eyes have seen” sums it up perfectly.  They are burned into our memories to carry to the grave.  A drive around the streets we serve is a constant reminder of the tragedy we have seen.  That being said, there is hope.  The human body and mind a resilient when nurtured.  Finding your tribe, that group of people you love to be around, is the first step toward finding balance again.  Giving your life purpose is the second.  Having a reason to get up in the morning, making a vow to eat clean food and exercise will prime the body and help flush out the hormones contributing to depression.

We must look out for our brothers and sisters that may be hurting and make this issue as acceptable as it is in the Military.  You took an oath to carry the burden of your service but no one said you had to do it alone.  It is time that this mental trauma was highlighted among First Responders and that treatment and support become readily available.  It is unacceptable to hear of our brothers and sisters taking their own lives or succumbing to addiction.  We are a tribe and its time to start taking care of our own.

Image Artist - Agnes Cecile