Words used to describe firefighters: Brave. Heroic. Strong. You can also add … Human.
Firefighters, Police and EMS personnel fall under the umbrella of Emergency Services. The coping that goes on after a traumatic event is typically an internal process, but the subject has gained considerable public interest in the wake of the Newtown shooting.
As impossible as it is to imagine what those 20 unfortunate parents are grappling with, the devastation for First Responders is equally unthinkable.
In the words of Connecticut State Police Lt. Paul Vance, “The crime scene itself is something that has made an indelible mark in all of our minds.”
Witnessing traumatic events puts Emergency Service personnel at a high risk of developing Post-Traumatic Stress Disorder, a term more commonly associated with members of our military. Studies have found that between 7 and 37 percent of firefighters meet criteria for a current diagnosis of PTSD.
The term more familiar to firefighters is Critical Incident Stress, defined as “a normal reaction suffered by a normal person to an abnormal event.” Critical Incident Stress not properly dealt with may develop into PTSD.
To its credit, the Fire Service has accepted mental conditioning and post-incident support into its training culture. Critical Incident Stress Management (CISM) Teams are sprouting up all across the country.
Most CISM Teams are volunteer, not-for-profit organizations that provide support following a critical incident event. The CISM Team, comprised of firefighters, police, EMS and mental health professionals, intervenes in several ways. Among them are individual support, crisis management briefings, defusing and debriefing. Defusing is a group or individual meeting of those involved directly after the event; Debriefing happens 24 to 72 hours after the event. The approaches vary slightly, but their purpose is the same: Provide a safe, non-threatening environment for people to vent and receive counseling.
On Dec. 14, the day of the Newtown shooting, an all-volunteer CT CISM Team covering the entire State of Connecticut was dispatched after reports of a “developing large-scale event,” but before details of the shooting emerged.
The first shots rang out at about 9:30 a.m., and the last person hiding in the school was found inside an inner closet at about 1:30 p.m. Once Sandy Hook Elementary School was cleared by police, the remaining 600-plus students were evacuated to the nearby firehouse and reunited with their parents. A leadership team from the CT CISM Team assembled at the town’s EMS Headquarters several miles away. The chaos at the firehouse was not conducive to planning or conducting the anticipated interventions.
The CT CISM Team contacted all affected agency chiefs including the Police (both State and Local), Fire, EMS, Town Dispatchers, School System and Town Government.
Local Fire and EMS personnel had little direct contact with victims – only two ambulances transported patients while one injured adult walked to the firehouse for treatment.
That wasn’t the case with Local and State Police. Several Newtown Police Officers had the unbearable task of triaging the victims, checking each fallen child and educator for signs of life. Meanwhile, Fire personnel at the small firehouse were overwhelmed with parents trying to reunite with their children.
As media, politicians, well-intentioned visitors and freelancing social support workers descended on Newtown, the CT CISM Team brought in more members when specialties or background peer support were needed. In all, approximately 50 Emergency Services Personnel (ESP) were contacted on the day of the shooting.
The next day, the CT CISM Team provided individual support and facilitated a large diffusing session for more than 100 Emergency Services personnel, plus some Federal Agents assigned to the investigation.
In the following days, small one-on-one follow-up debriefings were held, along with debriefings of members of Newtown EMS, the Sandy Hook Fire Department and finally CT CISM personnel themselves. Even the debriefers were debriefed by facilitators and members kept out of the incident just for that purpose.
The outpouring of support was constant, and in many cases, overwhelming.
From the CT CISM website:
“Walking out of the firehouse in the rain late Monday evening following the debriefing conducted there, one couldn’t help but see to our left – the entrance to the Sandy Hook Elementary School. The memorial was being observed by about 100 people at that hour, lighting candles, hanging more ornaments on the 20 full-size Christmas trees and adding to the flower pile that had to run about 10 feet deep and several hundred feet long down the sidewalk. Over the top doesn’t even do it justice.”
Now that national media outlets have left and the deluge of teddy bears are starting to wane, Newtown tries to find its “new normal.” Emergency Service personnel, too, are trying to settle back into their routines.
I can’t imagine recovering from what First Responders in Newtown have seen, but on a personal note, coming into the Fire Service with no prior experience has left its own indelible impressions.
I replayed my first traumatic scene that involved CPR over and over again in my head for about a week. I shared the experience with my wife but honestly it’s not something I want her to relate to. By a little or a lot, things like that change you.
But something unexpected happened after that call. Still on scene, one of our members said, “I know this is the first bad call for a lot of you guys,” then one by one asked us if we were ok. He followed up with a phone call the next day to let us know about a short meeting before that Monday’s drill “so people can get anything off their chest that might be bugging them.”
It bugged me, but the support helped a lot. I know I’m still a newbie, still developing that all-important cool demeanor and thick skin, but I’m confident that my responses to these types of situations will become more “normal” over time.
Beyond critical incident support, Haddam Volunteer Fire Co. recently welcomed James Cooke as our new chaplain. Historically, the chaplain handles ceremonial tasks in the Fire Service, with additional counsel to members wishing to discuss tough calls or personal problems. As Director of Pastoral Services at Hartford Hospital, James is a considerable asset to the Fire Company.
Volunteer firefighters are exposed to the same dangers and job-related stresses as their career counterparts. Compounding stress levels in rural departments, firefighters often know the victims or their families, and because they typically run fewer calls than city departments, they may not be as emotionally desensitized.
Fortunately, the support processes in place are vast improvements over the prevailing “suck it up” attitude of 30 years ago. We’ve finally accepted the fact that humanity is the driving force behind every act of heroism. It’s why we want to help, but it can be the cause of hidden battle scars and private grief.
The good news for First Responders is they’re not alone.