Engine Company EMS: Talking About What Happens at Work

Speeding ambulance

By Michael Morse

Funny thing about post-traumatic stress disorder (PTSD): nobody who has it wants it, some claim to have it but probably do not, most people with it don’t know they have it until it cannot be ignored, and everybody has an opinion about it. Simply stating that you have it doesn’t mean that you do, but it also doesn’t mean that you don’t. PTSD is a diagnosis, not a statement. I was diagnosed with PTSD. Lots of people with PTSD are never diagnosed. I don’t like talking about it; it makes me uncomfortable. So I talk about it. Being uncomfortable isn’t the end of the world. Suffering in silence very well could be.

A few years ago, I was struggling. I wasn’t crippled; I was able to show up for work, do the job, and make it home, but the idea of spending five or more years on the job seemed impossible. In fact, the thought of spending even one more year responding to other people’s emergencies was enough to ruin any peace of mind that I could muster. I dreaded going to work, not because I was afraid of what waited for me but rather because I was simply sick of dealing with it. I was spiritually, emotionally, and physically tired of doing what I once believed was the greatest job in the world. The idea that I was trapped became overwhelming. I spent every moment of every day wondering how long I would last.

Living in Darkness After the Smoke Clears

Halton: Post Traumatic Growth

I had heard of PTSD but never thought it applied to me. Nothing bad had ever happened to me, so how could I have that? Then I gave it some thought. The result of those thoughts was an article titled “Only Twenty.”

I wrote it in 20 minutes. Memories that I hadn’t given a second thought to flooded back, one after the other, vivid recollections, sights, sounds, smells, feelings—all right there, waiting to be exposed. Apparently my trouble-free mind was far from that. Just because the things I witnessed had happened to other people did not mean they had no effect on me. Just because I was first in line to check for pulses on the mangled remains of far too many bodies did not mean that I was hardened.

I wasn’t hardened. I’m not hardened. I’ll never be, and I don’t want to be. I managed to respond to whatever came my way, and did the job, and loved it, no matter how difficult or heart wrenching. I never allowed my emotions to get in the way. I found a place to put them while I did what needed to be done, and figured they were there to stay. That modus operandi worked while I was working, even when my heart was no longer in it. It almost got me through my entire career.

Damn emotions, always getting in the way.

Yeah, I was suffering. I don’t like talking about it, but the facts were hard to ignore. We have a long life to live if we are fortunate enough to live it without it ending abruptly. Yet living it with the baggage of 20-plus years of suppressed feelings might be worse. I got help. I learned to live with it. Best of all, I got better. Not everybody who struggles is as fortunate. Firefighters, law enforcement officers, and EMS personnel are dying by their own hands as a direct result of the things they experience. Many are dying in silence and alone. They may be afraid to speak, afraid to let anybody know that they are afraid of what is going on inside their heads. They don’t want to let anybody down, don’t want anyone to know that they are human, and fear being left out of the pack. Speaking up about their problem may seem worse than dying, so they don’t speak up, and they die.

PTSD is not a death sentence. We can, and do, get better. We don’t “get over it,” we learn how to live with it. We take our experiences and sort them out, leave the mess and hold on to the message, grow stronger, get better, and keep on living.

Post-traumatic growth (PTG) refers to positive psychological change experienced as a result of adversity and other challenges in order to rise to a higher level of functioning.

First responders have come a long way since the dark ages of “what happens at work stays at work.” We no longer have to suffer in silence. The majority of us are willing to listen to anybody who is struggling to cope with the things we see. Those who choose to live in the dark ages and ignore the warning signs emanating from their brothers and sisters are slowly fading into obscurity. There will always be people who perceive themselves better than the rest of us, stronger, more experienced, and capable. There will also always be people who know that all of us are capable of exactly what we are capable of, and are not afraid to help another human being reach their potential. Having each other’s backs is something that all first responders can relate to.

Michael Morse is a former captain with the Providence (RI) Fire Department (PFD), an author, and a popular columnist. He served on PFD’s Engine Co. 2., Engine Co. 9, and Ladder Co. 4 for 10 years prior to becoming an EMT-C on Rescue Co 1 and Captain of Rescue Co. 5.