Nobody wakes up in the morning and plants their feet on the floor groggily and thinks, “You know what? I am going to drown in front of 20 of my brothers while on an ocean rescue call tonight.”
After five days of my teaching recruits that week in 90- to 95-degree temperatures and four hours of search and rescue training that afternoon, the stage was set for my next spiritual rebirth.
The call came in as a drowning with multiple people in the water. This location is a well-known area for drownings because of a large rip current that splits two sandbars. As we were dropped on the call as the first-due unit, I thought, “Sweet, this is my bread-and-butter time to do some hero stuff.” With 20 years of diving experience and being more comfortable in the water than on land, this should be a no brainer. We will show up, kick some tail, and be home in time for dinner.
On arrival, we were greeted by a large crowd frantically demanding we save the struggling swimmers. After multiple attempts to get the victims to safety, I was tasked with trying to get a rope bag to one of my members who was with the victims. As I waded out to my waist, I couldn’t get over how angry the ocean was. After the first attempt to get the rope out failed, I tried to pull the rope bag in and got hit by a large wave and was dragged under, inhaling a good bit of saltwater. So, as I was being sucked out in five- to seven-foot seas in the rip current past the three victims I was trying to save, it occurred to me that I really hadn’t seen this one coming at all. Not for a second did I think, “This is your last alarm, man; time to make your peace.” It wasn’t until I dumped out of the rip 120 yards offshore with my body doing things it had never done before that I really grasped the severity of my situation.
With hands curling into my sides and legs board-straight, unable to kick, I knew something was going horribly wrong. I didn’t know if I was I stroking out, having a heart attack, or just cramping up. Rhabdomyolosis was the culprit, I later found out. If you had said, “Tuna (that’s my nickname—ironic, right?), you are going to drown in front of half your battalion tonight and Rhabdo will be what finally takes you out,” I would have laughed and told you that you were crazy.
As the conditions got worse and my body started to shut down, my brain went into hyperdrive. I thought about the life insurance policy and the union line-of-duty death payout, and I knew that at least my family would be taken care of financially. The one thing that haunted me though as I realized I was probably not going to get out of this jam was, “I can’t believe I am not going to see my son being born.” It was this thought that kept me focused until I couldn’t continue. As a tranquil calmness washed over me, I felt at peace just like they talk about on TV. I had always said if I’m going to punch out early I want it to be trying to save someone’s life on the job.
So, as I took my last breath and welcomed whatever came next, it was a beautifully violent surprise to crash up onto the beach in the arms of a brother firefighter who had risked his life to save mine. I remember very little about the next 24 hours other than the outpouring of support and love shown to me from my fire rescue family. It wouldn’t be for another five days until I would realize just how badly that call would affect me.
Just under a week after I was released from the hospital, my two-year-old daughter wanted to go swimming in our pool. I grabbed my swim trunks and her toys and headed outside to have some fun in the sun. I jumped in and swam to the deep end and waited for her to come in. My daughter loves to make a grand entrance. I was laughing at how she always chose to do belly flops over any other entry into the pool, and that’s when it started. It came on so fast that I couldn’t really tell what was happening. After a few seconds, I knew exactly what was occurring and couldn’t believe it was happening to me. My body and mind were screaming at me “GET OUT OF THE WATER RIGHT NOW OR YOU ARE GOING TO DIE!” It was so overwhelming that it is hard to explain or truly describe the severity of the sensation. I told my wife to take my daughter inside and to leave me alone for a while. After a couple of hours, it was painfully obvious that I had a legitimate problem that I was going to have to overcome.
Having always thought that anxiety or panic only affected those with weak minds, I didn’t know how to deal with or fix my situation. I preach and teach the warrior mindset to my recruits and how if conditioned right your brain can be the best weapon in your arsenal. I refused to believe that my brain was betraying me. I spent four weeks stress inoculating myself with swimming and holding my breath underwater trying to overcome the crippling anxiety with which I was being plagued. It wasn’t until I started doing some research online about panic attacks and anxiety that I realized that I was going to have to fix my brain before my body would fall in line.
I will never judge anyone again for being afflicted by mental issues. If they are real to you, then they are real. No one will ever appreciate the angst and fear felt by someone unless they themselves have experienced a similar reaction.
A recent event at my house involving a dear friend really hammered home how selectively oblivious we are to the dangers we face every day, or the emotional penance paid. I got a phone call from a friend who is a fellow captain and recruit academy instructor, and he was nervously laughing when he told me that my wife had almost kicked his butt that afternoon. I was on shift, and he was attending a recruit class graduation when he decided to stop by my house and ask for help with his new tie. When my pregnant wife with a two-year-old in tow looked out the peephole and saw nothing but a Class A uniform, she feared the worst. She knew that firefighters in Class A uniforms descend upon your house to deliver the news of your loved one’s death or critical injury while on the job. At least that’s what the movies “Ladder 49” and “Backdraft” had taught her. When she opened the door and blurted out, “What happened to him?” my friend said it was like being slapped in the face as he realized what my wife thought he was there for. When I spoke to her a few minutes later she was able to laugh about it and admitted to almost strangling my coworker.
The next morning, a very real conversation took place between me and my wife. She very simply said, “When you go to work, it’s an exciting, fun-filled shift with your friends and brothers, but for me, it’s 24 hours of hoping that my husband and the father of our daughter comes home in one piece.” It was that statement that really took me back. How is it that only others can see the potential for harm in our profession, yet we deny it will ever happen to us?
Year after year, police officers, firefighters, and the stars on the show “Deadliest Catch” top the list for most dangerous jobs in America. Most people will admit that their job is dangerous, yet when asked if it will be them that pays the ultimate price, they will deny it or downplay the danger. Firefighters are no exception to this rule. We have been conditioned to accept the risks. Our adrenaline and a toolbox full of skills and knowledge are what protect us mentally from fearing death or its counterparts.
We have a way of compartmentalizing our fears and shrugging off our near-misses in a manner that few other professions are allowed. NASA and the U.S. military use Post Incidents Review Boards and Post Action Reviews/Debriefings as the foundation of their training. These hypercritical review panels are the driving factor for such low reoccurrences of similar accidents. This style of factual analysis is very sterile and to the point. The only reason this type of review is so successful is the fact that all involved in these incidents believe in the system and have checked their egos at the door. Until there is full compliance within the review system, it will not function to its full potential.
So, when the call that nearly took my life transpired, I did not try to play it off. On the contrary, I made an immediate vow to share my experience with all my brothers and sisters. We owe it to each other to pass on the knowledge acquired from these experiences to help our own, not to make the same mistakes. What started out as purely a “lessons learned” type mission grew into something bigger and more meaningful than anything I could have ever imagined.
In the following weeks, I spent many hours analyzing the call and the events that led up to the call. I reviewed my department’s policies and standard operating procedures as well as others regarding these types of calls. As technical information piled up, I could not ignore the fact that the human element had played the most dramatic role that day. It was that same human element that was still having a profound lingering effect on my mind and body. As I compiled my list of mistakes and their effects on the call, it became even more clear that extreme ownership was the only tact to take. I created an hour-long training module about the call and all the things that I would do differently and why. It wasn’t until after I had delivered this module to an empty classroom a few times that I realized that all I could focus on was the emotional aftermath and how profoundly it had changed me.
So, I changed my focus to sharing how this call and others had affected me mentally and physically. Showing humility and vulnerability was new to me, and it was the very thing that would spark my new quest in life. Wouldn’t you know it? An amazing thing happened! Guys and gals would walk into my office at some point in the day and thank me for sharing my story and share how they were dealing with similar issues. This became a every shift occurrence, and it was only then that I truly grasped the massive scale of firefighter post-traumatic stress disorder (PTSD) and how little we understand it.
The inherent grief and sorrow were understood by me at an early age. My mother died of cancer when I was nine years old. That five-year fight took its toll on the whole family. By the time I was 17, I had lost all four grandparents and two best friends. These emotional hurdles set the tone for a volatile relationship with happiness and my ability to cope with death.
Your personal events will have a defining effect on everyone uniquely. That is why we as firefighters must be cognizant of the fact that each one of our brothers and sisters are going to potentially react differently to the same traumatic incident. Everyone’s paradigm and belief system play a major role in their ability to process certain emotions and stressors. It was this fact that was so interesting to me and what really sent me searching for answers.
I have always been a “heart on the sleeve” kind of guy, and for that reason people inherently share with me things that they are uncomfortable sharing with others. I cherish these interactions, and I am humbled to be part of their journey through this rewarding yet sometimes heartbreaking career. These emotional interactions are what started me on my quest for knowledge and a better understanding of how we can proactively treat and, better yet, prevent PTSD.
After the third or fourth time that guys and gals had sought me out to tell their stories, I realized that those interactions could reveal some of the answers I was chasing. I created an interview process that allowed me to make valuable correlations between the personal and professional triggers experienced by those individuals and the visceral response they had to the incident. Targeting different groups of firefighters has also revealed some very telling information. Officers, probationary firefighters, and retirees all can have common trigger mechanisms yet might also have very different triggers based on the current position in their career. There are different stressors that are introduced when you get hired, promote up the chain, and finally retire. All phases of a firefighter’s career will create subtle yet noticeable differences in the ability to cope with issues.
One of the ways I have become proactive in this arena is creating a baseline of my crew’s mental and emotional state at the beginning of every shift. I do this by having short personal conversations before we start our day. By quickly chatting with everyone on a personal basis, I can surmise quite a few things. Are they “with it”? A quick handshake tells me that hand and eye coordination is good. A quick look at their eyes tells me if they were up all night with their newborn or just haven’t been sleeping well. Sleep deprivation plays a major factor in your ability to handle stress. Finally, the overall tone of the conversation and their demeanor gives me a pretty good idea of their mood and mindset. Understanding that we must be 100 percent emotionally and mentally ready to face the rigors of each shift is the first step. After running a “bad call” or a rough shift, I will repeat this process, and whether they are trying to hide it or not, I will know that something in their demeanor is different.
There are several things that I am looking for in these conversations, and these things can manifest themselves in different fashions. Avoidance of a call or subject is a very telling sign that something is bothering them. Reexperiencing the event or the need to repeatedly talk about the call and a specific aspect of the call is another sign. Withdrawing from socially interacting with others is also a troubling sign, especially if that person is normally a very social creature. Once I have determined that one or more of these signs are being exhibited, I will be on high alert and will closely observe and monitor them. This where this process really pays off. Having already created a judgment-free zone at my firehouse, I now have the ability talk with the individuals in a candid fashion about the way the call affected them. It is within this process where we have a good chance with some genuine talk and follow-ups of preventing these triggers and emotions from ever evolving into PTSD. There are multiple advantages to starting every shift this way.
The latest research is pointing to hereditary genetic coding in our DNA that predisposes humans to either vigilance or vulnerability to PTSD. This research is groundbreaking for firefighters. Normalizing the feelings and emotions they are experiencing is one of the first steps on the road to preventing PTSD. We are in a war with an invisible enemy. Mental anguish and the subsequent fallout from untreated emotional turmoil is killing firefighters at an alarming rate. We are now being armed with powerful ammunition in the form of pragmatic scientific revelations that can change the tide of this endless battle.
As officers, coworkers, brothers, and sisters, I challenge you to shatter the old mindset that deems that the showing of emotion is a sign of weakness. I want you to understand that only the STRONG can be honest with themselves and others about the way they are feeling. It is extremely courageous to show emotion in the face of persecution, and that persecution comes by way of being judged by your peers. To be clear, the fact remains that we still have a job to do, but when the call ends, and we are consumed by a myriad of emotions, that is the time to be proactive and begin the healing process.
The goal of my work is to create an environment in the fire service of trust and understanding. This environment will be the first true step in preventing PTSD. For way too long, we have functioned in a reactionary fashion to this silent killer. Hopefully, this article will shed light on and better educate first responders on our ability to proactively overcome the precursors of PTSD prior to their taking root.
Nathan Gardner is a captain in Palm Beach County (FL) Fire Rescue.