After the Call and the Awards, Then What? Kevin and Paula’s Story

This is the story of the call that changed my life. I was filling in at Company 17. Engine 17 is a par 4 engine located on a barrier island of Virginia Beach known as Sandbridge. It was a beautiful spring day. We had just finished our dinner and were cleaning up when the call came in: “Car in the ditch, possible ejection.” We geared up and responded. The call was less than a mile from the station, so dispatch comments were few while we were responding.

On arrival, we found a car in the drainage ditch. The vehicle was on its side and horribly mangled. One passenger was ejected, another was hanging outside the car, and an unknown number of people were in the car.

The captain took command and called for an entrapment response. The firefighter in the right jump seat began patient care on the ejected patient. The driver and I quickly stabilized the vehicle and began assessing patients. The first patient I encountered was a young boy who was partially ejected. His eyeball was protruding; he was guppy breathing, and his skull felt like mush. I held c-spine while the driver went to get a backboard. This is the image that haunts me.—Kevin Wirth

As I looked over to the driver, I said to him, “This is really bad.” I locked up for a couple of seconds, the first time in my career I can remember this happening to me. I have been a career firefighter for 22 years. I have seen burned bodies, beatings, rapes, stabbings, shootings, and mangled bodies in wrecks, drownings, suicides, and everything in between. Nothing compared to what I encountered on this scene. As I removed one child, another appeared. I saw them stacked like cord wood. I remember a hand coming up from the bottom of the pile. I held it and told the child that we were there, we were going to get them out, and they were going to be okay. The scene was silent. There was no crying, no whimpering, no screaming. It was just plain eerie.

The ladder company and the rescue company arrived. We proceeded to flap the roof to gain access to the remaining passengers. One by one, each child was removed. There were five children unrestrained in the back seat, a child in the front passenger seat, and the driver. Each patient was either unconscious and broken or deceased. The injuries were indescribable, and the images imbedded in my brain will never go away. I can still see an image of the scene after all the patients had been extricated and transported. It was like a bomb had gone off—car parts and medical equipment were strewn everywhere—and white sheets with bodies underneath them.—Kevin Wirth

After the call was cleared up, Deputy Chief T.J. McAndrews directed all units to go to a nearby station to have an informal debrief, CISD. He told us we had done a great job and that this was one of the worst pediatric calls in the fire department’s history as far as loss of life and critically injured patients were concerned.

I recall the backfill piece telling us to hurry up because they wanted to get back to their station. I remember telling them that this was the worst thing I had ever seen. I said, “This is kids’ blood all over my gear.”

They weren’t there; they didn’t understand. It was just another call in their minds. I wish it was just another call!

After the debriefing, we returned to Company 17. It was a somber ride back. On arrival at the station, we commenced normal duties—decontaminating ourselves, the truck, and our equipment. We restocked supplies and worked to get the truck back in service.

When I got a spare moment, I called my wife. It was late. I told her it was the worst call of my career. The tears were running down my face. She asked if she could come down and visit. I had to tell her she couldn’t because the road was still closed. I told her I would talk to her in the morning.
The rest of the night was a blur. We went back to the scene for standby as the wrecker removed the car from the ditch. I do not remember returning to the scene, but I was there.

I was relieved from duty the next morning. I packed up my gear and went home. Driving past the accident scene was unavoidable. I arrived home to an empty house. I was thankful for Grady, my dog; he was my comfort when I got home. I held him and cried. Paula, my wife, had already left for work. I did not want to be alone, so I drove over to my parents’ house. They had always supported my career choice, but I never shared with them the details of the calls. I sat on their floor with my dog, spilling my guts and crying.

There was no escaping the call. The local media was reporting on the call—updates on the patients, pictures and videos of the crash site, and photos of the children when they were happy and healthy.

Paula called me several times that day to check on me. Fortunately, Paula is also a firefighter. I was able to tell her things about the call that most people would never be able to tell their spouses, to protect them. After the atrocities we saw, it would be horrible to go home and just hug your kids and kiss your wife without being able to describe what happened. To be able to talk to a spouse who understands the profession and who has been in the similar situations is therapeutic.
—Kevin Wirth

Going back to work on the Tuesday after the five-day break was different. The incident was still fresh in my mind, as if it had happened yesterday. I returned to my regular assignment at Company 11. No one else on the shift was on the call. There was no “kitchen table” debriefing that day. No “How are you doing?” For them, it was just another day back from a break.

I needed to talk about it with someone, but I felt no one would understand. I was on a shift where you didn’t show weakness; no one wanted to feel or be perceived as weak. I didn’t want to be judged. I didn’t want the stigma of being weak. Boy, do I wish I knew then what I know now! I would have reached out for help.

I was also told that morning that I was scheduled for a mandatory CISM led by the EMS department. All providers on scene were invited. We were told it was MANDATORY. We arrived at the CISM to find everyone that was on scene crammed into a classroom. I do not recall what was said during this meeting. I recall thinking there is no way I would ever say I have a problem in this setting. I didn’t know how to be feeling. Maybe the way I felt was normal; maybe it would get better in the next days, weeks, months—I did not know it would take years.—Kevin Wirth

A week after the call, I reached out to District Chief Michael Barakey, who was the incident commander on the call. I asked him to stop by the station so we could talk. He wasn’t just my chief; he was my friend. I knew he had many years in the department, was a paramedic at the local Children’s Hospital, and had seen more than his share of trauma. I told him that I didn’t know how to deal with this call, that I had never felt feelings like this before, and that I didn’t know how I should be feeling. He said my feelings were normal and tried to reassure me that things would get better.
—Kevin Wirth

The crew of Engine 17 received awards from the Virginia Beach Fire Department and Hampton Roads Chamber of Commerce for the incident. I did not attend or want the awards. I did not want to relive that day. Four people still died. I understand that it took quality work to save the others, but children still died.

District Chief Barakey nominated our crew for the International Association of Fire Chiefs (IAFC)/Motorola Solutions Benjamin Franklin Award for Valor. This nomination ultimately began my downward spiral. Some people worried that I wouldn’t go to the ceremony because they knew how I was feeling. However, I felt that saying no to an honor of this magnitude would be frowned upon by the department and would not be forgotten. Had I known then what was in store for me afterward, I would not have gone.

When I received an e-mail containing a copy of the nomination, the write-up was vivid, the pictures were graphic, and I was immediately taken back to that evening. I was overcome with grief and the horrible images that I had repressed. I stood crying in my kitchen. I said to Paula, “I don’t know if I can do this.” She said, “We will get through it together.”

The weeks up to the trip were filled with anxiety, sleepless nights, horrible thoughts, and seclusion. The thoughts that had been “put away” were coming back to the surface.—Kevin Wirth

The Atlanta trip, that’s when things went bad. I stopped sleeping the month prior to the Atlanta trip. When we learned of the award, it brought back the details that I had suppressed. I had put it away, but it was still there. I’m not sure if it was the award or the entire trip.

We were “on display” for three days in Atlanta. Straight off the plane—breakfasts, luncheons, dinners, the hand-shaking, practice for the award ceremony, to the stage itself. The presenter reading the award was crying … and then in the booth afterward … and then during the interviews. It pulled off all the scabs that had begun to form. I told Paula, “I’m not doing this anymore. I’m done.” Each event pulled more and more of the scab off and reopened the wound that was healing.

I was a recluse. I did not leave the hotel room except for the events that I was expected to attend. Not once did anyone ever ask, “How are you guys doing?” I was told recently, “Since you guys were there, they must have thought you were okay.”

The award was meant to be positive, and I am honored to have been a recipient. I never felt anything but admiration and respect toward us.

After returning from Atlanta, the expected return to “normal” life never happened.—Kevin Wirth (See “September-December 2015: Waiting for ‘Normal.’”)

After months of suffering and despair, Paula forced me to get help. I contacted the EAP and went to see a counselor. After five sessions, this counselor provided coping skills and recognized the symptoms of PTSD. He recommended that I see a therapist who specialized in trauma. He also suggested finding someone who did eye movement desensitization and reprocessing (EMDR) therapy and neurofeedback therapy for sleep disorders.

I started with a therapist twice a week for several months. When you go to therapy for a mental injury, there is no REST. You relive the event; you talk about the event; and when your hour is up, you can’t just turn your brain off. You continue to process the event that brought you to this place for hours and sometimes days. It takes A LOT of work. You feel beat down, discouraged, sad, and every other feeling you can feel. You must be honest with your therapist and yourself; the feelings you have are not stupid. It’s just the way your brain is processing things at the time.

I was very fortunate to find a therapist that I “clicked” with. This is not always the case. If you do not feel comfortable, you need to move on to someone else. My therapist has a soft spot for firefighters because, when she was young, she was pulled out of a fire in her home by firefighters. After working with me, she decided to advance her education and become an EMDR for First Responder specialist. She knows the need is out there.
—Kevin Wirth

Realizing I needed medication to get through made me feel defeated. Unfortunately, sometimes the signs and symptoms are brought on by a chemical imbalance in your brain. Psychiatric medication is trial and error; you may get the right one on the first try, or you may need to try several before you find one. It is a long, discouraging process that can take months, and the medications can sometimes make you feel worse. I finally found a medication that worked. It took months, but I was fortunate to have a doctor who listened and worked hard with me to figure out what was the best treatment.

My sleeping difficulties have led me to the following observations: Doctors and psychiatrists need to learn why a firefighter is having problems sleeping and why the sleep cycles are off. Sleep medications can suppress the body’s natural ability to process images and heal by interfering with the ability to dream and process events that have occurred. Treating only the symptoms, such as insomnia or disordered sleep, fails to address the underlining problems of professional trauma (PT) and repeated exposure trauma (RET). This can lead to increased suicidal tendencies. Sleep deprivation is a recipe for disaster. Sleep medications can mask the underlying reason or reasons for the sleeplessness.

Just going on medications does not get to the root problem. Psychiatric medications without proper therapy are just a temporary mask for the true underlying problem that still must be addressed.–Kevin Wirth

So, what did it take? Months of not sleeping, bursts of anger, anxiety attacks, crying for no reason? What it took was a caring wife who said, “We need to get you some help. You need to go talk to a professional.” Yes, life had gotten so bad that someone else had to tell me. I didn’t see the need or, I should say, I didn’t want to admit I needed help. I was told that our mind takes mental snapshots of the trauma we witness. Processing these snapshots is how we heal from our trauma. The goal of processing these images is to turn those images from an ultra-high definition 4K picture into a fuzzy old black and white photo that is hard to make out. I don’t believe that my images of that night will ever be erased from my memory, but I can tell you that they have faded.

I am glad to inform you that I am still on the job. I see my therapist twice a month for maintenance. I am feeling better every day. I still have bad days, but I have learned to cope. There are triggers; there are sleepless nights and anxiety attacks, but they are not debilitating. Speaking to the recruits and sharing my struggles have been healing. I feel a purpose to help others avoid a similar fate.

I started to take care of myself again. I started running. I successfully trained and ran a half marathon in September. I started eating better and lost 50 pounds. I fixed my cars and have enjoyed them all summer. These successes may seem trivial, but for me, they are huge milestones. I am enjoying life again.

We talk about keeping our heads on a swivel on the fireground, but we also need to do it around the fire station. We need to look out for each other and know the warning signs. We can no longer feel afraid to talk about our feelings. Being comfortable and talking it out with our fire department family starts the healing process.

I fully believe that early intervention after high-stress incidents is critical for a positive outcome. We need to educate our forces and their families from the beginning to the end of their careers. Family and friends will see the changes before the sufferer does.

It is ultimately the affected firefighter who needs to ask for help, but programs need to be put in place for those in need. NFPA 1500, Standard on Fire Department Occupational Safety, Health and Wellness Program, Chapters 12 and 13, lays out the building blocks for the treatment of behavioral health. Departments need to document the atypical, high-stress incidents and provide appropriate treatment with professionals who specialize in traumatic stress injuries.

I would like to thank the following: (1) my wife Paula—I don’t know where I would be without her intervention and support; (2) my shift, who listens and supports me; (3) Flogging Molly, mostly Matt Hensley, who has checked in on me and has supported me continuously for the past few years; (4) Lee Forshner from Dropkick Murphys, who has helped me more than he realizes; and (5) my parents, for their support and prayers and always being there for me—Kevin Wirth

September-December 2015: Waiting for “Normal”

By Kevin Wirth

When we returned from Atlanta, I was hoping for and anticipating a return to normal. Instead, these months were filled with sleepless nights, hyperactivity, anxiety, depression, hypersensitivity, a lack of vitality, and a fear of being alone.

Insomnia. It started a month before the Atlanta trip and lasted about 14 months. I was terrified to even go to bed, knowing that I wouldn’t sleep. It was never, how many more hours can I sleep? It was, how many hours do I have to lie here until I must get going? I call this the “hamster on the wheel syndrome”—the mind does not shut down, it just keeps bouncing from one thing to the next. I had a sleep study done and was diagnosed with sleep apnea. They gave me hope that when I got my CPAP machine, all would be better. Not the case. I just lay in bed hour after hour with a mask on my face waiting to get up.

Anxiety. Is the glass half empty or half full? My answer was, “It does not matter because the glass is going to break anyway.” I was on edge. I have a whole new respect for those anxiety attack calls we all have been on. Anxiety takes your breath away; it makes you feel like you’re suffocating. I would get so anxious and upset in the mornings after not sleeping that I would cough and dry heave in the shower to the point of almost passing out. I would become overwhelmed by the smallest problem and be unable to adapt and overcome obstacles. The smallest kink in my day would debilitate me, and I would accomplish nothing. I would worry about everything and become irrational: A bump on my dog was cancer. A pain in my chest was a heart attack.

I was unable to do the things I love. I have always loved music and attended many concerts. After the accident, I would get so overwhelmed with simply getting a ticket and driving to and entering the venue that I stopped going to concerts. Crowds were unbearable, whether at a concert, a grocery store, or anyplace with lots of people. I would get claustrophobic and felt like I would explode. A friend turned me onto wearing headphones at a low volume to tune out my surroundings.

Depression. On many occasions, I would just find myself crying, for reasons I could not explain. Depression came in waves: One minute, I was feeling fine; the next, I was in the lowest pit. I never felt suicidal. I did feel that I was a burden to Paula, my family, and close friends and that they would be better off without me in their lives. On many occasions, I would call my thoughts stupid, and Paula would reassure me that they were “irrational,” not stupid. I felt depressed and out of control. I saw no end in sight. Paula put up with my darkest days. She supported me and reassured me that I would get better.

Fear of being alone. I feared being alone. I would have extreme anxiety if I was home alone. Thankfully, Paula and I were on the same shift. If she worked a trade or had a class out of town, I would not go to bed. I would just pace around the house, trying to find something to do to distract me. Paula transferred from the hazmat team so she would not have to be away at classes. I would never call in sick because that meant I had to be home alone. I was never alone at work, so it was perfect.

Vitality. I always had pride in myself. I set goals and enjoyed the success of achieving those goals. Prior to the incident, I had completed three full marathons, countless half marathons, and an ultra-relay race. I loved to surf. I loved working on my classic cars. Post-accident, I stopped running, I stopped surfing, and the cars stayed covered. I did not have the energy to exercise, so I would get discouraged and feel defeated when I quit after the first mile. Surfing was overwhelming, and I began making excuses why I shouldn’t go—the waves were flat, the tide was wrong, or it was too crowded. The cars? I just did not care anymore. Repairing them turned into a daunting task that I dreaded.

Hyperactivity. I had to be doing something every minute. I couldn’t sit still. I would plan out my day; and when things went other than perfect, it was the end of the world. I was unable to adapt.

Hypersensitivity. I became hypersensitive. I went from being strong mentally to excessively sensitive. The slightest conflict or mistake would make me question myself for days. I found myself always apologizing for things, even if they weren’t my fault or if I felt I had let someone down.