The other vic­tims

Did it ever oc­cur to us how first re­spon­ders to hor­rific dis­as­ters of­ten suf­fer in soli­tude?

Gulf Times Community - - FRONT PAGE - By Heidi de Marco

The day a gun­man fired into a crowd of 22,000 peo­ple at the coun­try mu­sic fes­ti­val in Las Ve­gas, hospi­tal nurs­ing su­per­vi­sor An­toinette Mul­lan was fo­cused on one thing: sav­ing lives.

She re­calls dead bod­ies on gur­neys across the triage floor, a trauma bay full of vic­tims. But “in

Many stud­ies have found el­e­vated rates of post­trau­matic stress dis­or­der among nurses, fire­fight­ers and paramedics. A 2016 re­port by the In­ter­na­tional As­so­ci­a­tion of Fire Fight­ers found that fire­fight­ers and paramedics are ex­hibit­ing lev­els of PTSD sim­i­lar to that of com­bat vet­er­ans

that mo­ment, we’re not aware of any­thing else but tak­ing care of what’s in front of us,” Mul­lan said.

Proud as she was of the work her team did, she calls it “the most hor­rific evening of my life” — the cul­mi­na­tion of years of sear­ing ex­pe­ri­ences she has tried to work through, mostly on her own.

“I can tell you that after 30 years, I still have emo­tional break­downs and I never know when it’s go­ing to hit me,” said Mul­lan.

Calami­ties seem to be mul­ti­ply­ing in re­cent years, in­clud­ing mass shootings, fires, hur­ri­canes and mud­slides. Less than two weeks ago, a gun­man burst into the news­room of the Capital Gazette in Annapolis, Mary­lan, killing five jour­nal­ists and in­jur­ing two oth­ers.

Many of the men and women who re­spond to th­ese tragedies have be­come he­roes and vic­tims at once. Some fire­fight­ers, emer­gency med­i­cal providers, law en­force­ment of­fi­cers and oth­ers say the scale, sad­ness and some­times sheer grue­some­ness of their ex­pe­ri­ences haunt them, lead­ing to tear­ful­ness and de­pres­sion, job burnout, sub­stance abuse, re­la­tion­ship prob­lems, even sui­cide.

Many, like Mul­lan, are stoic, for­go­ing coun­selling even when it is of­fered.

“I don’t have this sense that I need to go and speak to some­one,” said Mul­lan. “Maybe I do, and I just don’t know it.”

In 2017, there were 346 mass shootings na­tion­wide, in­clud­ing the Las Ve­gas mas­sacre — one of the dead­li­est in US his­tory — ac­cord­ing to Gun Vi­o­lence Archive, a non­profit or­gan­i­sa­tion that tracks the coun­try’s gun­re­lated deaths.

The group, which de­fines mass shootings as ones in which four or more peo­ple are killed or in­jured, has iden­ti­fied 159 so far this year, through July 3.

The “first re­spon­ders” who pro­vide emer­gency aid have been hit hard not just by re­cent large-scale dis­as­ters but by the ac­cu­mu­la­tion of stress and trauma over many years, re­search shows.

Many stud­ies have found el­e­vated rates of post-trau­matic stress dis­or­der among nurses, fire­fight­ers and paramedics. A 2016 re­port by the In­ter­na­tional As­so­ci­a­tion of Fire Fight­ers found that fire­fight­ers and paramedics are ex­hibit­ing lev­els of PTSD sim­i­lar to that of com­bat vet­er­ans.

Ex­perts have found a dearth of re­search on treat­ment, in­suf­fi­cient prepa­ra­tion by em­ploy­ers for trau­matic events and sig­nif­i­cant stigma as­so­ci­ated with seek­ing care for the emo­tional fall­out of those events.

“When we have th­ese na­tional dis­as­ters or have a guy take a truck and run peo­ple over … those are added stres­sors we aren’t pre­pared for,” said Jeff Dill, a for­mer fire­fighter and li­censed coun­sel­lor.

Dill said the emo­tional toll of th­ese large-scale hor­rific events is mag­ni­fied be­cause ev­ery­one is talk­ing about them. They are in­escapable and be­come emo­tional “trig­ger points.”

“An­niver­saries are the hardest,” he said.

Some em­ploy­ers are work­ing on de­vel­op­ing greater peer sup­port, he said, but it of­ten comes after the fact rather than proac­tively. “We met a lot of resistance early on be­cause of the (stoic) cul­ture,” said Dill, who trav­els the coun­try teach­ing men­tal health aware­ness work­shops for fire­fight­ers and other emer­gency per­son­nel.

He said the cul­ture is slowly shift­ing — par­tic­u­larly be­cause of the rise in mass pub­lic shootings across the coun­try.

In 2015, Gary Schuelke, a po­lice watch com­man­der, raced to the scene of a hol­i­day party in San Bernardino, Cal­i­for­nia, where he and his fel­low of­fi­cers faced a fusil­lade of gun­fire from a pair of homegrown ter­ror­ists.

He’d seen a lot on the force over the years, but this call was dif­fer­ent — and not just be­cause of the nu­mer­ous ca­su­al­ties. His son, a young po­lice of­fi­cer, was there with him.

Schuelke and his son, Ryan, chased the as­sailants’ car as the bul­lets whizzed by. It was the younger Schuelke’s first time ex­chang­ing fire with sus­pects.

Af­ter­ward, when both were safe, “I asked him, You do­ing OK?” Gary Schuelke re­counted. “If you’re not, it’s cool. You can talk to me about it. He said, ‘I’m good, Dad. I’m very happy to be part of tak­ing down the bad guys.’”

Ryan was “just like I was when I was in my 20s … chas­ing bad guys and making ar­rests,” the elder Schuelke said. He said he had de­cided early in his ca­reer to try to “com­part­men­talise” his work ex­pe­ri­ences so they wouldn’t af­fect his per­sonal life.

Still, cer­tain calls have stuck with him. Like many first re­spon­ders, he is par­tic­u­larly af­fected when kids are hurt or killed. He still re­calls his first homi­cide, a 13-year-old girl shot in the hip.

“She bled out and took her last breath right there in front of me,” Schuelke said. “That was the first time I was like, man, this job is real.”

Gen­er­ally, no-one fo­cused on of­fi­cers’ men­tal health back then, he said, but ex­pe­ri­ence has taught him how im­por­tant it is to do just that. After the 2014 ter­ror­ist at­tack, which left 14 would-be rev­ellers dead, his depart­ment quickly set up a “de­brief­ing” meet­ing for the of­fi­cers in­volved.

“I made it a point in that meet­ing that I was go­ing to talk about the fact that I was scared,” said Schuelke. “Not try to be ma­cho in there and act like noth­ing both­ered me about it.”

In 25 years as a fire­fighter, Randy Glober­man was called upon time and again to cope with other peo­ple’s trau­mas and dis­as­ters. He never re­ally took ac­count of how the ex­pe­ri­ences af­fected him.

“You spend all your ca­reer sup­press­ing that stuff,” he said.

Then came the Thomas Fire, con­sid­ered the largest in Cal­i­for­nia’s his­tory, which dec­i­mated hun­dreds of homes in Ven­tura and Santa Bar­bara coun­ties. As his fel­low fire­fight­ers were de­ployed to save what they could of their com­mu­nity, Glober­man faced the real prospect of los­ing his own home.

For 36 hours, armed only with a bucket and wa­ter from his Jacuzzi, he fought to keep the flames back. He was fran­tic. “I was kind of a mess,” said Glober­man, 49. “I felt sick, I felt sad. I went through all sorts of crazy emo­tions.”

In the end, he was suc­cess­ful — his home sur­vived — and he went back to work, re­spond­ing just months later to mud­slides from the de­nuded, rain-soaked hills.

But Glober­man strug­gled emo­tion­ally, and, as ex­perts say is of­ten the case among first re­spon­ders, it af­fected his fam­ily life.

“My kids would do some­thing silly that would oth­er­wise make me laugh, but in­stead I would start cry­ing,” he said.

He ex­pe­ri­enced sev­eral episodes in which he felt as if he was hav­ing a heart at­tack. “It would come out of nowhere,” Glober­man said. “I felt like I was los­ing my mind.”

He thinks now that his own near dis­as­ter unleashed “demons” he didn’t even know he had from in­ci­dents through­out his ca­reer. And he felt he couldn’t ask for help.

“A lot of the sup­port you’d get from a nor­mal in­ci­dent wasn’t there,” he said. “Other than a few peo­ple, ev­ery­body worked on the fire for about a month straight.”

He strug­gled through it on his own. Anx­i­ety med­i­ca­tion seemed to help. He said he’s not proud of hav­ing used it, but “after five months, I can hon­estly say that the demons don’t seem to bother me any­more.”

Mul­lan, the Las Ve­gas nurse who did not seek coun­selling, said she is not sure she has “pro­cessed” the mass shoot­ing al­most a year later.

“Cer­tain things trig­ger emo­tions that I didn’t ex­pect,” Mul­lan said.

At a re­cent lun­cheon she at­tended, vic­tims from the shoot­ing shared their sto­ries.

“It hit me like a ton of bricks,” Mul­lan said. “And, yes, I did cry.” — Kaiser Health News

RE­MEM­BRANCE: A memorial sign near the In­land Re­gional Cen­ter in San Bernardino hon­ours the 14 peo­ple killed and 22 oth­ers se­ri­ously in­jured dur­ing a shoot­ing on De­cem­ber 2, 2015.

IN THE LINE OF FIRE: Gary Scheulke, a po­lice watch com­man­der, raced to the scene of a hol­i­day party in San Bernardino, Cal­i­for­nia, where he and his fel­low of­fi­cers faced a fusil­lade of gun­fire from a pair of homegrown ter­ror­ists.

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