BRATTLEBORO — “I was supposed to go to their wedding.”
That's what their friend told me after the ambulance had pulled away.
Police officers and firefighters were milling around, collecting evidence and directing traffic. I wanted to say something comforting.
This man had, like me, happened upon this accident scene. But I was an EMT, with blood-stained clothes from trying to help.
And I didn't know them. I didn't know the woman in the back of the ambulance, nor did I know the man - an only child, the friend told me - whose body lay lifeless by the car. I didn't know they were supposed to get married in a few weeks.
It was a beautiful summer day. They had been on their way to visit friends.
The friend started crying. And so did I.
* * *
I still remember the call, which came while I was driving over a steep hill in a snowstorm. I still remember the crunch of the snow under my feet. The smell of gasoline, oil, sweat, and blood mixing together. The sheet trying valiantly to shield the victim's body from the prying eyes of passing motorists. The children asking for their mother.
I will forever know that, sometimes, people get in their cars to go to school, to go to the store, or to go to a friend's house, and they don't live to see their destinations.
In an instant, orphans and widows are created. The world no longer seems safe. Lives are changed.
Sometimes, it's not just the lives of those involved in the car crash, but the lives of those who come to help.
* * *
News headlines read: Afghan Officer Fires on U.S. Troops, Kills 9; Kentucky Cop Hit and Dragged During Traffic Stop; Female Correctional Officer Attacked by Inmate; Firefighters Hurt in Blaze Rescue; and Jersey City EMTs Attacked by Man Suspected to be on PCP.
Such stories are reminders of the personal hazards and absolute dangers of work in uniformed services. Of course, uniformed service professionals (USPs) - police officers, firefighters, emergency medical service workers, and others - are aware that their occupations are dangerous ones in which there is some risk of harm in calls for service.
“Most emergency service workers experience more trauma in their first year on the job than the average person does in a lifetime,” says Gil Bernard of the Massachusetts State Police.
And that trauma takes its toll in the form of Post-Traumatic Stress Disorder (PTSD), which can cause intense fear, helplessness, and horror. Other common stress reactions include feeling numb, having trouble sleeping, thinking over and over about an event, and avoiding reminders of the trauma.
These reactions are also common in people who experience other kinds of trauma: domestic violence, childhood abuse, assault, natural disasters - anything where one might experience or witness an event that involves actual or threatened death or serious injury or threatened injury to yourself or someone else.
The traumatic event does not have to happen to you. Witnessing someone getting mugged, for example, can be traumatic. Sometimes hearing about an unexpected or violent death of someone close to you can cause PTSD.
The circumstances that people may find traumatic are numerous and varied. They may be events that happen to them, ones that they witness, or ones that they learn about later.
For USPs, exposure to traumatic work events such as a gunfight or a knife attack, a car crash or a four-alarm fire can lead to these symptoms.
And PTSD can also occur in children. They might look agitated and disorganized. They might not have the words to express their feelings, but they will act things out through their play - for example, after an automobile accident, a child might repeatedly crash Matchbox cars and revisit the accident in drawings. Scary dreams are also common. Children will need a lot of adult support to understand their experience.
What all traumatic events have in common, however, is that they cause feelings of intense fear, helplessness, and horror.
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Natural recovery from post-traumatic stress reactions can occur through emotional processing that happens in daily life. Repeated opportunities to activate the trauma memory, and thinking and talking about the event with others, can help. Speaking about the traumatic event helps people in uniform to organize the memory in a way that makes sense to them and facilitates recovery.
Those of us with PTSD sometimes create rules: We can never own that kind of car; the kids are not allowed to swim at the gorge; I don't like to drive in the snow. My personal experiences as an EMT have caused me to live with a heightened sense of vulnerability, of the fragility of life.
Over time, I have learned how to do the things I need or want to do, and do not let my sense of fragility control me.
* * *
“I received a call to speak with an individual who was feeling depressed,” remembers Frank J. Gallo, a retired Cranston, R.I., police officer.
“When I arrived with another officer, a man holding a loaded shotgun to his head confronted me unexpectedly. Before the man could point the shotgun at me, the other officer and I distracted, and then disarmed him.
“After a brief struggle, we restrained him. After the event, the individual told me that he called the police so he could shoot at us, and we would kill him.
“It was scary at the time, but it also taught me to be more aware of the suicide-by-cop phenomenon,” Gallo recalls.
Not everyone will recover easily from such traumatic events. Some people get “stuck” in those experiences.
Instead of, “I don't like to drive in the snow,” a person will think, “I can't drive in the snow. Something terrible will happen.” The memories become overwhelming and interfere with the person's ability to do basic, everyday things, like going to work or taking care of the family. When that happens, it's important for the individual to recognize the situation and seek help.
“I think probably the most difficult thing to do is reach out and ask for help,” says Dana, a former patient at the Brattleboro Retreat's Uniformed Services Program, who is both an Army veteran and a law enforcement officer. “Not to be embarrassed about it. It's an injury as a result of witnessing and experiencing trauma. It's a normal reaction to an abnormal situation.”
Monday, June 27, was National Post Traumatic Stress Disorder Awareness Day, started by North Dakota Sen. Kent Conrad after he learned of the North Dakota National Guard's efforts to raise awareness of PTSD.
The Guard wanted to honor one of their members who suffered from the disorder and took his own life after returning from a second tour of duty in Iraq.
“For many, the war does not end when the warrior comes home,” Sen. Conrad said at the time. “All too many veterans face PTSD symptoms like anxiety, anger, and depression as they try to adjust to life after war. We cannot sweep these problems under the rug... PTSD is real.”
Yes, it is normal to feel overwhelmed and upset in the aftermath of a traumatic event, to be changed by the things you experience.
If you are struggling to move on, to rediscover meaning in your life, or to move closer to the day when the memories become less palpable and the nightmares less vivid, help is available.
As Dana says, “Life gets a lot better when you reach out for help and start working on it.”