Critical Incident Stress: How Bad is This Gonna Get?

     Have you ever left a scene, but the scene won’t leave you? It may feel like you are going crazy, but the good news is you’re not. In the last three years working with the 10-33 Foundation here in Kansas, I have gotten to reassure lots of people that, not only are they not crazy, but what they are experiencing actually makes sense under the circumstances. Even some of the most unsettling symptoms are reasonable when you realize what Critical Incident Stress can do.

     The 10-33 Foundation has a tri-fold brochure that we use during Critical Incident Stress Debriefings. It lists common signs and symptoms that someone may experience following a traumatic event.  We also began sharing this brochure (which I call Critical Incident Stress 101) at KSFFA fire schools last year.  More than once, I’ve seen a skeptic scan over the material and watch as eyes light up in surprise as something jumps out. We’ll stand there talking while pieces of the puzzle start coming together…and hope rises.

     Hope is a lifesaver.

     At a fire school last year I had the privilege of meeting “Joe”; a firefighter who had been left by his family doctor with a message that there is no hope once you have experienced severe reactions to a traumatic event. It sounded like this: “PTSD is just something you’re going to have the rest of your life”. So when I asked Joe what he had gotten to do about working toward his healing and recovery, he looked at me kind of funny. No one had ever told him that there are ways of reducing the severity of the symptoms he had been enduring for years.

     We’ll come back to Joe in a minute, but first it is important to highlight something that usually gets overlooked:  it takes a clinical level mental health provider to officially diagnose Post-traumatic Stress Disorder (PTSD). It’s that last letter—the D—that has to come from somebody with the right combination of letters behind their name.  Those are the folks who are trained to apply the PTSD criteria found in the telephone book size diagnostic manual. 

     Does this clarification change the symptoms that are turning the responder’s world upside down? Not for a moment, but if our state legislature hears the truth that PTSD is a work-related injury for firefighters, that one letter could make a big difference in the future. 

     Back to Joe…like so many other people, he thought that PTSD only applied when post-traumatic stress symptoms were experienced by combat veterans. Post-traumatic stress can be experienced by anyone who had endured a critical incident or traumatic event.  It can be the result of a single event or it may be experienced as events stack up.

     What we know for sure is that everyone has what we refer to as a “10 Event”. The most traumatic event we have lived through. It’s the thing that happens and the world is never quite the same after it.  Everybody has their own 10 Event. Some are the result of being a firefighter. Some aren’t. Your trauma threshold might have been set by a childhood incident. It could be from the death of a marriage or from the death of someone you loved. For Joe, it was that last one…a loss he didn’t see coming. 

     It seemed like a good day, getting to hang out with a buddy he hadn’t seen for months. Suddenly, things changed; a loud bang. Confused, Joe looked up from his phone, scanning his own shirt front and trying to make sense of the evidence that his friend had lost all hope. Training overrode shock spurring Joe to assess the damage the bullet had done to his friend’s body. A call for help. Minutes like hours.  Reinforcements arrive. A LifeFlight bird lifts. A friend is gone. Numb hours of clean up. 

     The magnitude of Joe’s trauma is still felt today, but there is a difference. 

     After that fire school meeting, a camel’s back straw landed on Joe—in the form of running rescue on a fatality wreck whose victim was the same age as his buddy—it hit him hard. His wife immediately noticed the ‘thousand yard stare’ he returned home with after the call; that vacant look in the eyes of someone who can’t even put into words yet what they’ve just lived through. 

     Joe knew he needed to reach out to someone. He remembered the name: The 10-33 Foundation. He knew there was someone he could talk to that would understand what he was experiencing. He put his hope into action through the website contact request and was called by a 10-33 Team Member.

     What Joe has come to understand is that he is not alone.  He has hope.

     If you would like to have a copy of The 10-33 Foundation Critical Incident Stress tri-fold brochure, please email dptaschek@1033foundation.org

     Dawn Ptaschek is The 10-33 Foundation Executive Vice President for the Midwest Region. She is a Fire/EMS family member and a Licensed Professional Counselor in Kansas.