Health and wellness
By Bernie Van Tighem
There is a sort of cliché that Americans and many Canadians say to returning military: “Thank you for your service.” Some soldiers appreciate it; many hate it because they figure that it’s easy to say but doesn’t begin to reflect an understanding of what they’ve been through.
By Bernie Van Tighem
I have been thanked for my service when I have told people that I am a firefighter; while it makes me proud to hear, these are my thoughts about this phrase.
I have been a firefighter and emergency medical technician for 30 years. I started as a volunteer firefighter and ambulance technician in Manitoba. It didn’t take me long to realize that I had found what I was meant to do. The early ’80s in southeastern Manitoba were a great time and place to be a firefighter. We had an oil patch with few safety regulations – that meant fires and lots of calls. It was exciting and active, and I loved it. I soon realized I had much more to offer. I took extra training; I even signed up to join the local volunteer ambulance group (the first dual member in the area) and I applied and was accepted for a one-year program at the Manitoba Fire College. This was what I was meant to do and I was going to be the best I could be. This is also where I met the love of my life but I had to chase her to Alberta before she realized I was serious. When we married in 1988, it was the beginning of a partnership I am sure she might not have signed up for had she known, but she is the reason why I still walk this Earth, whether she knows it or not.
My battle with mental-health issues began early in my career but I didn’t realize it until later. I attended a horrific train derailment on May 4, 1987, in which two people were roasted alive; I responded to the early morning tones and immediately the difficulty of the call became apparent. The fog was so thick I had to feel my way from the house to my truck and the two-block drive to the fire hall took several minutes. Upon arriving I found the management team sending apparatuses to a reported train derailment east of town to each of the four or five crossings in town. I was on the last truck sent out and we headed to the west crossing, opposite the direction we were dispatched, just to close the loop. It was looking like a false alarm.
We arrived at the intersection just west of the train crossing on the TransCanada as the sun was starting to lighten the area, but the fog was still as thick as soup. We couldn’t see a thing. Our officer reported back there was no sign of a derailment but as we turned onto the highway to return to the hall it became apparent we had found it.
Railcars were every which way, sideways and on end; there was a glow of intense fire as far as I could see out the windscreen of the rescue van. I could feel the heat as I left the rescue van. We had no pump, hoses or water; extinguishers would be useless. We had notified command and resources were on their way. As the fog lifted we got a better look. Railcars tossed everywhere, fire in the ditch appeared to be burning diesel but there were no head-end engines to be seen. The engine arrived, we got things going, hoses laid out, water supply established; size-up showed no dangerous goods, which was a relief but then the engineer arrived, having walked back from where the engines finally managed to stop and said those fateful words, “Are the guys in the truck alive?”
What truck? We began to search and found under a potash car in the southwest ditch the remains of a B-train. When we got the fire knocked down I was in the crew wading up to our waists to approach the tractor cab and it will forever live in my mind. The cab was split open, one man in his seat, still belted, suspended over the fire, roasted and charred beyond comprehension. The other, out of his seat, floating in what had been burning diesel, swollen and split like a hot dog; I helped pick up the pieces. Both occupants had been charred or boiled alive. We manually searched the water in the ditches for their missing appendages. We placed them and their bits into body bags. We went for lunch. We were somber.
In those days we didn’t debrief. We sucked it up and moved on. My trip into a mental-health nightmare had begun, and I had no clue.
I moved to a large city fire department in Alberta in 1988. I also worked part time for a neighbouring small-town service that did both fire and ambulance. We serviced a large area including a foothills Indian reserve. I responded to several attempted murders and suicides and at least one murder. I was at an attempted suicide call, which resulted from a sexual assault to a minor, at which I was called upon to assist an RCMP member who was fighting an assailant for control of his firearm. The assailant was the father of our patient; he had been abusing her and she had tried to overdose. We didn’t like him very much nor he us. We got away, transported our patient and left the RCMP to manage the situation as they do so well.
Another ambulance call I attended involved responding when my partner was already on scene for a person whose head had been crushed by a log. She was covered in his blood attempting CPR, screaming for my assistance. He was suffering from injuries incompatible with life. In the end she was more my patient than he was. I was not ready for that. In the city it was actually less stressful; we had many more people to manage the calls and it was almost a break from the volunteer gig. Almost.
One night in the city, our captain alerted us to an unfolding tragedy on the other side of town. We sat around the radio all night. The department was moving crews in for relief; at one point it seemed like we might be called next. We weren’t but we got to listen to our friend die that night – senior firefighter Morley James cut down in the prime of his career by a murderous arsonist. I went home and didn’t talk about it – as fire fighters do. My wife woke me later and gave me heck about that. From then on, I was supposed to talk with her about these calls. I began sharing more, but not all – I felt I had to shelter her from the bad (I still do). But she knew; and she was supportive, and that helped beyond measure.
Of course there were many more calls with both departments, some bad, some worse. Some calls managed to impact the whole family. One summer day as I was returning to my small town from a shift in the city, we were paged to a drowning of one of our dispatchers. I responded in the first unit; the other crew member with me was her husband. He was a captain on our department and she was my wife’s good friend. Marilyn Skene passed that day in a dive training accident with other members of the department present. There was a three-day body recovery and it was very hard on us, while my paid department supported my part-time department with its dive team. After this call I attended my first peer debriefing; I don’t know if it helped, it was more like the crying together for three days with my mates that really released me from the suffering.
I began to develop anger issues and I talked myself into believing I needed a change. I quit the career department and we moved to another small town so I could instruct at the provincial fire training school. It was a good move, but while there I had a bit of a breakdown due to additional stress from a family tragedy. This was confusing and very frightening and I went for help. I ended up being diagnosed with severe depression and anxiety as a result of untreated PTSD; I dreamt weekly about a train derailment. Who would have thought that would be an issue?
I received no treatment for PTSD but I did get medicated. My trip into a mental-health nightmare continued. The many traumas I was exposed to over my career were coming out. I was not trained properly to deal with my reactions and now they affected me and my family.
I have very few memories of a lot of the events in my life; PTSD has stolen them from me. My wife has to do more, as I find myself unable to manage many issues. My wife has been my rock, even though I didn’t share everything. I think she knew and supported – it helped. And I still had no clue.
My next move was to Yellowknife, while still not being treated for PTSD. I had antidepressants and talk therapy but that was it. In Yellowknife I became a member of Yellowknife Fire Rescue and then two brother firefighters were killed in a shed fire – Kevin Olson, 10 days on the job, and my good friend Cyril Fyfe, with more than 18 years. I was angry. Confused. I had no concentration and therefore no memory. I was unable to carry on and so I left, following a pattern I had not yet consciously noticed, caused by my response to untreated PTSD.
I moved to the Kootenays in British Columbia where I had a job as a regional co-ordinator of fire and emergency services. That job lasted less than two years before I had another breakdown. I found I could cope well as long as there was no stress. No stress? Where does one find that? By this time my wife and I had raised two awesome girls, in spite of their dad’s problems. I still received no treatment for PTSD but remained medicated. My trip into a mental-health nightmare was not over, and I still had no clue.
– – –
I find myself fire chief in a small-town department. The chief in these departments is first on scene for every call; it is a stressful situation – always on call with few days off. Many calls and events conspired to cause me more stress and it began again. I have no concentration, irritability, no memory, inappropriate stress reactions, anger and depression. I am thinking more and more about those news reports all too often nowadays about firefighters who have taken their lives. I have many reasons not to do the same. In fact, I often find myself thinking about all those reasons when it hits me: they ask you when you call for help if you are thinking of hurting yourself. I say no, but really, maybe I am just reversing that discussion and listing the reasons why I won’t. What happens when I can’t list those reasons . . . ? I call in sick; it’s time to face the monster.
I know I can get better, I know there is help. This is Canada, one of the greatest countries with the best medical system in the world. If any country will take care of its first responders when they need help, this one would. Each Canadian province is set up with government agencies specifically there to help injured workers, are they not?
Only, I soon discover, it’s not as simple as it seems. For me, WorksafeBC is no help; I’m told I have a complex case that does not meet its narrow terms.
I went our local health board. First I was told I had to wait more than a month to see a counsellor. I called and said that would not work, that I was in crisis, and it was pushed forward a couple of weeks. The counsellor I saw did only talk therapy. More delay while I wait to see a psychiatrist. I get in to see a psychiatrist and find out that yes, the therapy I requested is what I need but it’s not offered here – maybe I could find it privately, I’m told. In the meanwhile, we’ll prescribe you some additional medication. I was gobsmacked.
So, I fired them and went and found my own help.
I’ve found a psychologist in Alberta who can help. My wife, my rock, had a friend who had been assisted and got me the number; she never stops supporting. I have had a few sessions; we’ve made some changes to my diet and exercise and started on exposure therapy. I had to do it on my own but it finally seems to be working. I have run out of insurance money and hope to keep going somehow. I’m still off work. Long-term disability pays a fraction of my wage.
For those of you with a peer facing these issues, it’s important to stay in touch. Don’t just invite them to the occasional function – you need to check in every once in a while, just drop a line. It doesn’t have to be much but PTSD sufferers need to have that reassurance. If it were not for the support from my peers in the Fire Chiefs’ Association of BC (FCABC) checking in on me, I would have felt like I had been abandoned.
I recognize we have a long way to go in emergency services in recognizing and caring for our peers with regard to mental-health issues. I have been robbed of my memories, my family has been robbed of a husband and father – PTSD doesn’t just affect the responder.
We need to make sure we take care of the responder with PTSD the same way we do the responder who slips a disc or fall through a floor. It’s just an injury. I am giving a presentation on the topic at the FCABC conference in Richmond in June. Maybe this will be my new career.
PTSD awareness is at an all-time high. Alberta has presumptive legislation now, as does Manitoba. New Brunswick and Ontario may be on the way. A study out of the University of British Columbia found that emergency personnel such as doctors, nurses, paramedics and firefighters experience post-traumatic stress at twice the rate of the average population. But the resources for the firefighter in Anytown, Canada, are not defined and easy to access. We need an overriding framework, something driven by one agency, such as the Government of Canada or the Canadian Association of Fire Chiefs in partnership with the provincial associations to identify treatment modalities – who offers what and where. And, most importantly, how to identify those needing help, and how to get that help to them. We need each province to recognize that police, fire, EMS, prison guards, dispatchers and the like are more likely to suffer from PTSD, and that it needs to be presumed to be caused by their work.
We need (as I am now finding out) to show everyone how to be more resistant to developing PTSD. The Road to Mental Readiness (R2MR) program (recently adopted by the Ontario Association of Fire Chiefs) needs to be delivered to every first responder. We need to not only change the conversation, we need to change the actions. We need to eliminate the stigmas associated with mental-health issues. Stigma keeps sufferers from admitting a problem. Stigma keeps sufferers from getting help. Stigma kills first responders.
We need to recognize in our training and response that we see things people are not meant to see. We can be taught to manage that and we can actually develop post-traumatic growth instead of post-traumatic stress. Imagine that, responders who become more resilient the more difficult the challenges they face.
We can get there, and doing so would truly be a thank you for your service.
Bernie Van Tighem is the director of Fire Rescue and Emergency Services in Elkford, B.C. Contact him at firstname.lastname@example.org and follow him on Twitter @VE7BVT