Overlooked Heroes

I Was Hoping to Write a different Honorary Unsubscribe this week, but couldn’t because I couldn’t get information. Debbie Crawford, a 25-year veteran paramedic in Denver, died this weekend. The scuttlebutt is that her PTSD got so severe, she committed suicide — she could no longer handle the stress of the job. If that is indeed what happened, and I don’t know for sure because none of the media outlets in Denver has covered her death at all, that’s truly a tragedy.

Debbie Crawford
Debbie Crawford

Emergency Medical Services personnel are often treated as the bastard stepchildren of emergency responders; we heard again and again, for instance, about how many cops and firefighters were killed trying to save people in the 9/11 collapse of the World Trade Center, but rarely are the medics mentioned in the same breath. That’s often because EMS is a “third service” or even privately run (including, of course, volunteers!), yet medics are among the folks who run toward disasters, not away from them.

When someone is terribly injured, the cops and firefighters bring in the medics; it’s the medics who have to deal with keeping those people alive until we can get them out of dirty, stressful environments to a nice, clean hospital. They could be screaming in the worst pain imaginable, and medics are hampered by politics (we can’t let them give DRUGS!), policy (you need HOW many doses? If you don’t use them by the expiration date, we have to throw them away!), or the very conditions that caused the problem in the first place: bombers, shooters, crashes, building collapses. The very definition of traumatic stress. And society blows them off like they don’t matter (unless you’re the one who needs them right now, eh?)

Disposable Personnel

So if Deb committed suicide because she couldn’t get help coping, it makes me terribly angry. And no one outside the medical community seems to care. I contacted the Emergency Medical Services Association of Colorado, who are supposed to represent the state’s medics. They had posted an “ain’t it awful!” message on Facebook about Deb, so I asked them, “What I want to know is, why don’t ANY of the news outlets in Denver have anything about her death?” And their response was, “Because the press generally does not cover suicides.”

Really. So, if a Denver COP committed suicide due to job stress, that wouldn’t be news? Well of course it would be. So why isn’t it news when a street medic dies that way? Well, it certainly is.

Now, again, it’s possible that the scuttlebutt is wrong, and that wasn’t the reason. That’s why I couldn’t write it up as an H.U.: I wanted the facts, and just couldn’t get them.

So next time you hear about the “heroes” who run toward disaster, and are only told about police officers and firefighters, step forward to ask: “What about the medics?”

If you wonder, on 9/11 at the World Trade Center, 414 of those killed were emergency responders trying to save the victims of terrorism. They included:

  • 341 firefighters and 2 paramedics from the New York City Fire Department
  • 37 police officers from the Port Authority of New York and New Jersey Police Department
  • 23 police officers from the New York City Police Department
  • 8 emergency medical technicians and paramedics from private hospital units dispatched through the 911 system, as well as commercial ambulance groups brought in as mutual aid, and
  • 3 New York State Court Officers.

We need to remember all of the people we employ to respond to society’s disasters. So if that list is incomplete, let me know so I can correct it.

And Deb: rest in peace. We’ve got it from here.
– – –
Update: Sure enough, it was talked about online so much, some Denver media outlets finally covered the story. And sure enough, Deb’s family confirms that job stress was a factor: she did it hours after responding to a particularly bad accident, a light rail train vs. a pedestrian.

“She didn’t kill herself,” someone said after hearing about this. “The job killed her.”

– – –

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19 Comments on “Overlooked Heroes

  1. And don’t forget the countless average men and women who weren’t uniformed medics, who weren’t “just doing their job”, however important said job might be, who helped save lives on 9/11, whether by treating the wounded or assisting in evacuation, and who died when the towers came down. It wasn’t just emergency responders who died saving lives on 9/11 — it was average civilians as well, civilians who went to work that morning never expecting to be in that position.

    Hear hear. -rc

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  2. So sorry to hear about that. May her soul rest in peace.

    Our county has a mixed volunteer/professional fire/ems service. We are served by two volunteer companies, Cabin John VFD and Rockville VFD. Both have ambulances — and I have twice needed emergency transport, once after a motorcycle accident (CJVFD) and once after a roller skating accident (okay, so I didn’t actually make it onto the rink) (RVFD).

    I make it a point to answer their appeals for funds every year.

    Support your local volunteers!

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  3. My brother in law, a paramedic/firefighter, for a large district in metro St. Louis county, reminds us that he is paid for two things; running into places everyone else is running out of, and for remaining calm when others can’t. While he doesn’t talk about his job often, he has at times mentioned some of his calls. He worked the accident where three 17 year olds from his nieces class died. He worked the call where a family of four, including two infants, died of carbon monoxide poisoning. He was sent TAD to Ferguson the night the Grand jury came back on the Michael Brown case. They were forced by police to stand down from a call due to gun fire in the immediate area. I could never do the job he and all EMS personnel do. They truly are unsung heroes.

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  4. Sorry for the loss of your fellow First Responder. In Emergency Management, we always consider EMTs as First responders along with fire and law enforcement. The press only considers reporting on events that further their own agenda. No longer are they interested in informing what is really happening in the community. You guys get my total respect for the thankless hours spent and risks taken for those who need your services. Bless you all.

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  5. 60 minutes did a story several years ago about non police/fire emergency responders at the Twin Towers who were going through hell trying to get some form of financial assistance to deal with incident-induced health problems, particularly lung problems. Even though donations had poured in, the burden of proof of need pushed on these unfortunates was so high that they were going broke trying to stay alive.

    When I was a kid, a hero was someone who did something extraordinary–way out of the norm–and was someone I wanted to emulate. Heroes were rare.

    Nowadays everyone who ever put on a military or police or fire uniform is automagically a hero. (OMG–That would include me!) When everyone’s a hero, no one’s a hero, and those who do something extraordinary–way out of the norm–get lost in the noise.

    I think somehow the word “hero” has changed completely from when I was a kid.

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  6. There are some of us that recognize that PTSD is a real problem and we know there is treatment. A difficulty we all fight is getting the diagnosis of PTSD and finding the money for treatment.

    I live near Tulsa, Oklahoma where veteran’s groups are working to raise funds for treatment for veterans and also include firemen, police and EMS technicians. As we get funds we pay for treatments without discrimination. They are all included.

    With today’s economy and competition from so many who asking for donations it is a tough, frustrating, uphill battle but we continue.

    Don’t give up the ship! Go talk to the veteran’s organization and enlist them in the effort to treat all who serve.

    Thanks for not discriminating. -rc

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  7. The media certainly does report on suicides at times. Take, for instance, Leelah Alcorn of Ohio, a teenage transgender girl who jumped in front of a semi truck back in December. She wasn’t famous in life, and I wish she could have lived even though her death helped shine a light on the plight of the transgender community.

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  8. See if you can get your EMS Assoc. of CO group to set up a counseling group for people who suffer from stress due to their job. We found that the best people to counsel cops suffering from PTSD, or whatever you want to call it, were other cops. The Tampa Police Dept. started a program some years ago to send volunteer officers through a training course to counsel other cops. We required any officer who killed a suspect to attend and urged others to do so. Sergeants were the ones who referred most to the program.

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  9. As a 40 year public safety worker with more than 35 as a paramedic and EMT, I can certainly empathize and validate the type of treatment — or in this case — non-treatment that EMS personnel get. All the usual reactions from the individual and the services seem to be the same… peer support, bar room debriefs, and the occasional CISD (or similar) which had very little true effect on lessening stress or even slowing the rate of suicides.

    I have survived I am happy to say, though more mentally than physically, the 40 years of exposure to the “worst of the worst” — but it was not without its psychological challenges and some very emotional days. We as a society try to pin tags on everything and the post 9/11 world pinned hero on cops and firefighters; now it,s soldiers — regardless of how they served. EMS personnel pretty much have been left out. Why you say… because have and continue to be treated like second class public safety workers. Yes, some of it is their own fault thanks to the volunteer syndrome and lack of real standards for employees across the nation.

    This young lady is but one of hundreds dying and 10s of thousands who continue to suffer from lack of respect — that leads to lack of professional psychological support programs. When you are left to generate your own support and you know that you have nowhere to turn for help and your future is bleak from an industry standpoint, you can only expect depression. Don’t be afraid to intervene with a co-worker, don’t be afraid to confront them and ask the hard questions. Don’t be afraid to step up and admit your problems. Most importantly, don’t forget that there are others out there that need you. Oh, and by the way, the press only cares about selling stories, not about your life. So if it’s not dramatic news that sells — you will never see it.

    CISDs are “Critical Incident Stress Debriefings”, which supposedly deflate traumatic stress in responders by “debriefing” (talking about it) with others. I agree their value is dubious, but maybe slightly better than nothing. As for my agency, we’re so small that we develop genuine friendships, and do watch out for each other. And I can’t think of a story more dramatic than “Pretty blonde rescuer so stressed out, she shoots herself” — blood and gore always sells, even better than sex. -rc

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  10. I do have one explanation for part of this. Many news agencies rarely report suicides because hearing about suicide can be contagious. Many studies have shown that even hearing about suicide in a negative light can increase the number of suicides out there.

    But I do agree that we need more mental health resources for everybody, especially those who help others.

    I’d like to see those studies. Meanwhile, see the next comment. -rc

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  11. Thank you for posting. Two media outlets have tonight run a story on the tragedy.
    http://www.9news.com/story/news/local/2015/02/18/family-says-paramedic-job-stress-contributed-to-suicide/23600857/
    http://kdvr.com/2015/02/17/denver-paramedics-join-together-to-remember-veteran-ems-worker/

    Thanks. They confirm that job stress is a factor — she did it hours after responding to a particularly bad accident, a light rail train vs. a pedestrian. -rc

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  12. I agree that the first responders are grossly overlooked. Just driving to a scene where help is needed has been fatal at times. Many people argue the definition of “Hero” and I see no reason to fuel endless debate. I just say my hat is off to you and all first responders. Thanks!

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  13. I worked as a medic for ten years. Thankfully my wife noticed the behavior changes in me over a couple years, and encouraged me to “just go talk to somebody”. When we went to our doctor, she immediately recognized PTSD. I got out of paramedicine about a year later. That and some good coping techniques from my therapist, and my awesome wife who talked me into talking, are what saved my life. It is a hard, stressful job, with little respect from those who don’t do it. I’m doing pretty good now. Not as many nightmares. I know how to handle most triggers. And I want to find a way to reach out to all of my EMS family and encourage them to “just go talk to somebody”. Your doctor, religious leader, anybody who can help.

    It is OK to ask for help! Even though the personality types that paramedicine attracts are the problem solvers, not the ones with problems. But a wise old medic told me something in my school days that I firmly believe. You can’t take care of others if you can’t take care of yourself. No job should cause a suicide. Please get some support if and when you need it.
    Keep up the incredible work, Lifesavers!

    Thanks for a success story from someone who has been there, John. -rc

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  14. The problem lies with mental health period. There is a worse stigma for mental health folks than there is for drug addicts. I worked in EMS since 1990. I now work in mental health/addiction medicine. I have watched my coworkers kill themselves…. or medicate or get married and divorced over and over again. I see anger is the first and primary sign of something bubbling under the surface.

    I am a female. I was the only female to graduate my paramedic class. We are young and impressionable when we first enter this career. We are idealistic and think we are going to change the world, and we think that we will never end up like “that guy” who is old, burnt out has a crappy negative attitude.

    The profession is hard. And it is held up by macho attitudes and “tough” mentalities. I would not necessarily call the popular guys in any department bullies, but they do set that kind of tone and teach others how to act.

    Our supervisors and administrators teach us how to act by their words and actions. So do those who have experience and seniority. We are impressionable at such young ages when we enter the profession as I suggested earlier.

    The job takes a toll in a slow insidious manner, and we are not really taught nor see example of people taking care of each other on a regular basis.

    I by no means am “weak” nor incapable of handling myself in stressful situations. I was a NCAA Division I top ten school collegiate athlete that helped lead my team to the final 8 College World Series. I played with the best of the best. I was inducted into the Hall of Fame in 2013 with records that still hold up 28 years later. I know discipline. I know how to handle myself in stress.

    Nobody really prepared me for what I was about to see, hear, smell and feel in my career. I loved my EMS family. When we lost our flight crew on Thanksgiving Day I felt like I was going to die on the inside… that pain of loss. I didn’t grow up with loss. I did not know what to do with that.

    Then came the in-the-line-of-duty memorial service that nearly dropped me to my knees and hit me in the gut so hard I could not barely breathe. But you see, I was a well conditioned athlete who knew how to keep my crap together. And I sure as heck wasn’t about to let my coworkers know things bothered me.

    I have been working around an incredible psychiatrist who also worked in addiction medicine. Miguel no offense but where do you get your information about suicide being contagious? And if you are in Irvine then you could look up Dr Valeh Karimkhani. aka Dr K. She is also an Army Reserves Psychiatrist who has done two tours in Iraq and one in Kuwait. I think if it were not for me being able to be around her the last 5 years or so I would not have made such huge strides in calming the noise in my head.

    I also have a very vigilant spiritual practice. I did not grow up with “God” or any sort of religion so I had no means to make sense of all the horrific things I had seen. I have a spiritual advisor/counselor of sorts that I work with. I also go to the sweat lodge at least twice a month. That has really allowed me to work through all the crap in my head.

    Mental health is flawed in this country as it is. Add to it public servants and pride, forget about it. We need to come from a place of no shame and no fear.

    If I told you I stole drugs from patients and wound up homeless in my addiction because all I wanted to do is sit the noise off in my head and make the bad dreams go away… I wanted to die. But I knew first hand what suicide did to families so I did not take my life. I was left here, hell on earth with no solution. I was labeled “a bitch: or “angry” and instead of looking at the warning signs, they just chose to let me go.

    I can’t say that I blame them back then…. we did not really know how to handle the rescuer fatigue and slow insidious nature of the work tearing us down bit by bit. I think not much has changed since the 90’s.

    What a sad sad day….

    I’m glad you got help. Things have changed, but maybe not enough. Maybe I’m lucky, but I work in a really good system, and after we have a really bad call, we talk about it, do a debriefing so we know what happened, etc. And we are there for each other. -rc

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  15. Perhaps if the local news Did cover suicides, there wouldn’t be so many of them. Especially if the coverage included the suicide prevention number on the screen as part of the coverage.

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  16. I’ve probably mentioned to you a time or two that my father was an EMT for a private ambulance company back in the late ’80s. When I was a kid, he used to tell my brother and me funny stories about the things they did, like the fact that the office manager (a family friend) had to change the run sheets so that they said “Signature” instead of “Sign Here” because my dad kept putting “Pisces”. My mom, who was the dispatcher, once told the guys that “if I was ever in trouble, you would be the last people I would call.” It wasn’t until I was older (like thirteen or fourteen) that my dad started telling me stories about the runs themselves, about the sorts of things he did on his calls, and my mom told me that pretty much right after she said that, an emergency call came in, and they instantly got serious and took off.

    I have nothing but the deepest respect for EMS — especially around here. They probably saved my life when I was twelve and my mom and brother found me curled up in the fetal position on the sofa, my stomach hurting so bad I couldn’t move (turned out my appendix had ruptured). When my dad (who quit the ambulance company in ’87 to join the Navy, which is how our family ended up here) was involved in some sort of accident while bicycle commuting to work — an accident so bad that he ended up with massive head trauma despite the fact that he was wearing a fairly new helmet at the time — the paramedics were the only first responders who actually made it to the correct location. The elderly woman who lived behind us could be extremely crochety and rude on the occasions when they had to come and pick her up or check her over, but no matter who was there or what she said to them, they always treated her with courtesy and care.

    As for the reason suicide stories don’t get run in the media…yes, some do, but that’s usually because the suicide is that of a famous person or because the media can always point to the ~reason~ and push their agendas: the dangers of cyberbullying, LGBT+ rights, poverty and abandonment, what have you. The media aren’t interested in mental health unless a person’s mental health affects other people by causing them to kill other people. Personally, I think it should be the other way around. I know of a couple of people who heard about the reasons behind Leelah Alcorn’s suicide and it made them more terrified to tell their parents they were on the LGBTQA spectrum, not less; conversely, I know of a couple of people who heard about the reasons behind Robin Williams’ suicide and immediately went out and sought professional help for their depression. If more people knew about things like this, maybe someone could have helped Debbie before it got to this point.

    My deepest sympathies to you and to Debbie’s family.

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  17. There are many military veterans suffering from P.T.S.D. AND RECEIVING NO treatment due partly to the stigma of “MH” care &/or just Lost in self medication. As an x army medic Vietnam vet people need to know the toll extracted from these first responders. Support each other and groups debriefing. Know the signs and symptoms and who to refer to for professional assistance.

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  18. Often these medical professionals are the first responders to arrive and save the lives of those who have overdosed on heroin or other illegal substances. Drug addiction recovery in these cases would not happen if not for their heroic actions.

    The drugs don’t have to be illegal to cause an overdose: sometimes its supervised patients in huge pain who take too much of their prescribed medications. We’ll save them, too, when we can, and often we can’t tell which is which. -rc

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