By King Jerome
Sitting in the parking lot of a Little Caesars restaurant on my day off, my family witnessed a motorcycle-vs.-car MVC right in front of us on the main road. The motorcyclist flew off his bike, hit the ground and began to seize. My wife started to panic. I, on the other hand, started to laugh. The look of horror and confusion on my wife’s and kids’ faces was a sure sign that something was going on with me.
Why would I have reacted this way to seeing a serious injury incident?
From OIS to PNB
A quick backstory: Although I have only been in the fire service for a few years, I previously served in law enforcement. When I was a police officer, I witnessed an officer-involved shooting (OIS). It was the first time I had ever seen someone die – and in such an incredibly violent manner.
I remember the whole thing as if it was yesterday. It was not the first time I have been around gunfire or some conflict. I was used to the sound of gunfire at the range. During the OIS, I wondered why the gunfire sounded so different – muffled, as if I were wearing hearing protection in a controlled environment. At that moment, I rationalized that the officer was not using standard-issue ammunition, and I even wanted to believe they were rubber or less-than-lethal rounds. And when I looked at the body on the ground and the pool of blood that began to surround the man, I froze, trying to rationalize what had just happened and if I really just witnessed someone die.
After that day, any time this incident came up in conversation, I would feel light-headed. I ignored this reaction, though, figuring I was just feeling warm and in need of some fresh air.
Fast forward a few years to when I started in EMS. I never anticipated that I would see so many patients dying or already dead. The first time I experienced a pulseless non-breather (PNB), I was fresh out of EMT school. My paramedic partner had to walk me through every single task to assist him because I froze up, just like I did with the OIS. But after working a few PNBs, that shock factor was pretty much gone.
Personal reactions to trauma
Events like these are known as “Big T” trauma, explains Dr. Brooke Bartlett in her article “Invisible wounds: How trauma affects the brain.” Little did I know, such unaddressed traumas would soon begin to pop up in different areas of my life.
This is how those traumas affected me – and what I see in many first responders around me.
Decreased empathy: One of the main changes I have seen in people who have experienced trauma is decreased empathy. I admit that there are times when I get annoyed when I go on a call for a person who feels concerned about their heart because a drugstore blood pressure monitor indicated that they have an irregular heartbeat. The same goes for calls that we run a lot, like a lift assistant or patient with anxiety. It’s easy to have an “eyeroll” attitude, so I have to remind myself that this could be the worst day of the patient’s life, even though how they are feeling may not be life-threatening.
Annoyance when others panic: Another sign I noticed in myself was annoyance when people panic. I would live with an expectation that my family should not act scared or frantic when something traumatic would happen to other people, not directly affecting them. I would be in restaurants and become upset with family and friends if someone began to choke, and they would look at me to help. Although it was not right, that is how I acted.
These days, to combat that initial “why are they overreacting?” feeling, I take a deep breath and remain calm. With a quiet voice, I like to reassure others that the patient is in good hands, without making any promises I know I cannot keep. For example, let’s suppose the reactive person is not a family member or someone directly connected to the patient. In that case, I’ll try to gently inform them of what is happening physiologically to help them understand why I am reacting calmly to the situation.
Anticipating bad scenarios: The last thing I recognized is that I would jokingly anticipate patient outcomes on calls, even about friends and family members whom I knew were suffering from an ailment. For example, my wife asked me what I would do in a scenario where someone woke up to find their baby unresponsive and CPR failing to work after a significant time. My reaction: “Pfft, that baby is gone!” I didn’t think was a real scenario until a few minutes later when she shared, teary-eyed, that our niece’s baby had just died of SIDS.
These days, when something tragic happens, I avoid offering unsolicited comments. If they ask for my thoughts on the situation, I will inform them of what I know and have seen from my personal experience; otherwise, I’ll keep my own comments to myself.
PTSD warning signs
While the signs of PTSD can vary from person to person, the Mayo Clinic shares these signs to watch for – signs that I have seen through my own experience and that of my coworkers:
- Avoidance: First responders with PTSD may start avoiding places, people or activities that remind them of the traumatic events they have witnessed. They might isolate themselves from friends and family or avoid talking about their experiences.
- Hyperarousal: Hyperarousal means being constantly on edge or easily startled. First responders with PTSD may have trouble sleeping, be irritable or have difficulty concentrating. They may also experience hypervigilance, always being alert and looking out for potential threats.
- Emotional changes: PTSD can lead to emotional numbing or feeling disconnected from others. First responders might struggle to experience positive emotions or find it hard to express their feelings. They may also have intense feelings of guilt or shame related to the traumatic events.
- Intrusive memories: First responders with PTSD may have flashbacks or intrusive memories of traumatic events. These memories can be vivid and make them feel like they are reliving the event. They may also have distressing nightmares related to their experiences.
- Physical symptoms: PTSD can manifest as physical symptoms. First responders might experience headaches, stomachaches or muscle tension. They may also have an increased heart rate, sweating or difficulty breathing when reminded of traumatic events.
It’s important to note that experiencing some of these signs does not automatically mean someone has PTSD. However, if you or someone you know is exhibiting these signs, I highly recommend seeking professional help. Mental health professionals can provide a proper diagnosis and develop a treatment plan tailored to the individual’s needs. Remember, seeking support is a sign of strength and can help individuals on their path to recovery.
Furthermore, don’t wait like I did to seek some help. I knew it was time to do something once my kids began to show unapologetic apathy toward traumatic events. I realized that my children had been absorbing that attitude from me.
You’re not alone
I hope that my story can shed some light on the impacts of traumatic events on first responders – or really anyone – who may have symptoms of trauma but ignore them because they think it can’t happen to them. It can happen to anyone.
About the author
King Jerome is a full-time firefighter/paramedic in Manitowoc, Wisconsin, and author of the Firehouse Heavyweights blog.