By: Malissa Durbin
It is four o’clock in the morning and Richard is startled awake. As he pulls himself from sleep, he is met with the scent of fresh dew on grass. As he gains more awareness, he sees himself walking through the tall grass of an apple orchard. He vividly remembers seeing dew on his Wellington work boots as he searches for the body of a young girl thrown from her car nearly thirty years prior. The girl was ejected from her vehicle, had flown through numerous apple trees and was completely disfigured when Richard found her. It had been thirty years since that incident occurred and it was not different from many, many others he had experienced. The incident was not significant to him at the time, just part of the job. Why then is he remembering it so clearly now?
Dave recalls the difficulty of pulling a small child away from his sobbing mother after a car accident that had “opened the child’s skull”. “That mom just wouldn’t give up and wouldn’t let us take her dead son, but we knew that we had to take the kid from her arms. You don’t forget things like that.”
A firefighter hears the call ring out of a vehicle/pedestrian accident and instinctually flips on his sirens as he would have on any other day. But, the next words that he hears stop him in his tracks. “Possible fatality accident, pedestrian is a small child” he recalls. The firefighter pulls to the side of the road. He’s been to dozens of similar calls, but today, he can’t take one more. It’s at this very instant that he realizes he is no longer able to see the horrors of this job.
While some of the reactions above may be different then what you experience every day as a first responder, the stories are not. First responders are necessarily faced with the most gruesome, tragic and heart rendering events that occur in our society. They are expected to put people back together, pick up the bodies of the dead, protect our families and put their live in danger to save others. But, they are also expected to walk away, dust their hands as if to erase the tragedies that they have experienced and go home to their families smiling and ready for the next work day. Many first responders are able to do just that. They leave work every day feeling like they did the best they could to help others and feel rewarded for doing so. But others, especially those who have experienced very personal traumas or have been doing the job for many years, feel the effects of the traumatic stress and it begins to wear on them.
How does the job affect first responders? That is best answered by asking them directly. “It affects all facets of life,” states a retired firefighter with over thirty years on the job. “It affects sleep habits, how you interact with people, how you interact with your family and how you think about life.” Other first responders indicated that their jobs greatly impact their marriages, their children and other personal relationships. “It changes small things that you wouldn’t imagine.” Becky, who served as registered nurse in the emergency room and who currently serves as an EMS administrator, recalls how she would require her children to go to the second floor of her home where she could see them every time that she backed out of the garage. “I wouldn’t allow my children to have a pool and we couldn’t have a hot tub because I knew what could happen.” When you are a first responder, you know the risks that are out there and you know how quickly things can go very bad. It makes you anxious when your kids are on the road or when you see an ambulance go by. It makes you wonder if it is your family.
Being a first responder is different from other jobs because you are dealing with life and death on a daily basis. One New York firefighter described the way of life as a “John Wayne culture” and stated, “You have to get over yourself and do your job”, but in the same interview admitted, “Do we hide a lot of our fears with beer and jokes…yes.” For the majority of first responders, they are able to do all the components of the job without suffering adverse reactions. However, for some first responders, they are adversely affected by the horrors that they see on a regular basis. Many mental health professionals describe the cumulative effects of traumatic stress on first responders as a wearing down of their psychological immune system. The first eighty-nine calls that they are dispatched to might not affect them, however, the ninetieth call might.
For some first responders who experience traumatic stressors, the traumas that they experience may begin to plague every facet of waking life and consume their sleep. Some individuals struggling with the horrors that they have seen or experienced may be diagnosed with Post-traumatic Stress Disorder (PTSD). Putting a complex disorder into few words is difficult, but at its most basic form, PTSD is an anxiety disorder that can result after exposure to an extreme traumatic stressor such as the threat of death to someone else or oneself, or to one’s own or someone else’s physical, sexual, or psychological integrity. The person’s response to the event must involve intense fear, helplessness, or horror. If you are reading this wondering, “What would that look like for me or my buddies?”, PTSD often manifests itself in the form of re-experiencing the original trauma(s) through flashbacks or nightmares, avoidance of stimuli associated with the trauma, and increased arousal – such as difficulty falling or staying asleep, anger, and hypervigilance. Sometimes first responders will describe their symptoms as consistent anxiety over something happening to themselves or their families, as being easily agitated or cranky, as being jumpy or easily startled, and as beginning to pull away from others or an emotional numbing. While having a few of these symptoms does not indicate a diagnosis a PTSD, if you recognize yourself in this list, or if you recognize the symptoms in someone you care about, it’s time to get some professional help.
“We don’t talk about feelings and stuff like that at the PD” explains Mike, a young police officer, “If we are going to talk about what we saw, it is usually in the form of a joke.” A veteran at the New York Fire Department explained that in his 25 plus years of service, he has never heard another firefighter say that they have nightmares or struggles with a call that they have went to. It is just not part of the culture to talk with the crews about the hard stuff. Dave, an active Fire Chief, explained that he used to be of the mindset that providing mental health services to police and fire really was not necessary. However, through education, he has changed his way of thinking and his department has many safety nets in place for individuals who are struggling with the stresses of the job, family life, or just need some support. He feels that by putting services in place and by beginning to be more open and talk about what is truly happening with his guys, they are benefitting.
First Responders spend their lives taking care of others, but it is essential that they also take care of themselves. Three veteran firefighters and a police officer with over ninety years of combined experience provided some input on how to take care of yourself. One retired firefighter who has personally felt the effects of PTSD explains that first responders should know what resources they have available if they start to struggle with the stress of the job. On a more personal level, a New York firefighter explained how he separates his job from his family and social life. “You can’t walk around with armor on all the time. It weighs you down. You have to take that stuff off when you leave the job.” The same firefighter also detailed that he feels that his priorities guide his daily decisions and that his wife and children always come first. In addition, he leans on his faith in God and his belief that “Life is good. Every day that you wake up is a bonus!” Dave, an acting Fire Chief reported that he feels that his close relationships within the department are critical to his success. “I trust the people here completely. I have some close friends that I can talk to honestly and they provide me the honest feedback that I need.” He also reported that his family is the most important part of his life. Overall, the message was this, know who you are, know your priorities and stick to those.
When Richard, a retired firefighter who has been diagnosed with PTSD was asked whether he would do it all again even if he knew what he would go through, he said, “Yes, I would just make myself more aware of PTSD so that I knew what I should be doing to take care of myself.” “I don’t want to go back to where I was before PTSD because I know so much more now”.
Malissa Durbin, M.Ed., is a Nationally Certified School Psychologist who currently works for the West Valley School District in Yakima, Washington. She has also served as a private consultant to schools, behavior specialist, and adjunct faculty at Central Washington University. One of Malissa’s personal and professional interests is the diagnosis and treatment of Post-traumatic Stress Disorder in emergency services.