It’s 0400, and the alarm goes off. The synapses crackle to life. Adrenaline, rushing through your brain. The amygdala fires off and muscle memory takes over. It’s a blur as you rise to wakefulness and body your way through the hall to the ready room and from there, the crew carrier, the engine, or the ambulance. This is the life of the first responder. One moment, dead asleep, exhausted. The next, firing on all cylinders, your mind racing, reviewing your SOP’s internally. The teeth clench, the eyes narrow in anticipation, double-checking your loadout and praying that nothing goes sideways.
Different emotions run through different minds as you race to the incident. Some might experience seeping dread, just hoping that today isn’t The Day, hoping you’re not the one who disappoints your brothers and sisters in your team. Or maybe it’s an overwhelming excitement, exhilaration at pitting yourself against the worst the Earth can throw at you.
These are intense emotions - indeed, among the most extreme that anybody will experience. When you’re racked out in your bunk one moment, and inside a burning structure the next, it’s unavoidable that there will be a mental toll. The human mind is not meant to perform in this manner. When this pattern is repeated over an extended period of time, and combined with traumatic events, harm is inevitable. One of the most common is “Burnout”, something almost all Firefighters/EMS are familiar with. When someone has become “burnt out,” they’ve simply had to deal with extreme circumstances with a high rate of reliability for too long. Some may experience chronic exhaustion, barely able to focus. It’s not just a purely mental phenomenon, either - the neural pathways can become burnt out, themselves. Adrenal glands stop functioning properly. The brain itself is no longer able to process as quickly.
Others will acquire an inability to relax - constantly keyed up, continuously running on the ragged edge, overreacting to even mild stimuli. In some ways, it looks like a combination of sleep deprivation and PTSD - and in more than a few cases, that’s exactly what it is.
If we accept that there are physical and mental costs of this lifestyle, then what can we do to mitigate?
The best defense is to practice adequate self-care. You must get good sleep to perform at your best. Sometimes it can be tough to sleep after seeing some unpleasant sights or witnessing some unfortunate turns of events, in which case you may need to consult a doctor or therapist. If you aren’t well-rested, the deleterious effects of being woken up late in the shift will be far worse. Make sure you eat enough nutritious food. Avoid binge drinking when off duty, as alcohol will exacerbate the adverse effects of fatigue. During the moments you can, try to do things that relax and focus you, in a non-stressful way. This may include hobbies, sports, or even just sweeping the ready room in a certain ritualistic way (it may sound odd, but it works for some people). Many firefighters have mantras or particular religious passages which they repeat to themselves to focus and calm the mind during times of stress; This can be helpful.
Unfortunately, we all know that it may not always be possible to fulfill all of these best practices. Sometimes, you may not get enough sleep or enough food - these are just the realities of the job. However, that just makes it more important that you do follow these practices when you have the opportunity. Try to find an attitude of self-care and mindfulness and bring it to everything you do, from search and rescue to sweeping the ready room floor. You can think of this as preventative maintenance for your mental health.
Make sure to participate in After Action Reviews - they can sometimes be an effective way to process what’s happened during the incident and return the mind to a more neutral state. Sometimes, some individuals feel uncomfortable speaking up in formal group settings and prefer to maintain a stoic silence. There will be times where you have little to share, but making an effort can have surprisingly beneficial results. Reaching out to family and friends is also an essential part of mental health. And of course, your coworkers will always be there to support you. Chat with a buddy or a trusted supervisor can do wonders for your mental state. If you find yourself grappling with consistent mental issues, your best bet is to seek professional mental health care in the form of a therapist, counselor or psychiatrist.
Going from 0 - 100 on a regular basis is a rough way to live. Unfortunately, such things must be, so long as we defend lives and property. But it doesn’t mean we simply have to suffer stoically. The simple truth is, we need each other if we’re going to survive. Nobody wants to be That Guy - the one who everybody else always has to take care of. But assuming you aren’t That Guy - and if you’re self-aware enough to try to avoid being That Guy, you probably aren’t - you might sometimes let your ego take control, insisting that you can manage anything yourself.
But there will be days when you need a hand, and there will be days when your buddy needs you to pick up some of his slack too. This isn’t weakness - this is the strength of teamwork.
Mark Lamplugh is a fourth-generation firefighter and former captain with the Lower Chichester (PA) Fire Company. He is the Chief Executive Officer with 360 Wellness Inc. (www.360wellness.org) and a Executive Director of the Frontline program with Sprout Health Group (www.frontlinerehab.com). Lamplugh is also nationally recognized in Crisis Stress Intervention through the American Academy of Experts in Traumatic Stress. He has helped hundreds of firefighters, police officers, veterans, EMS personnel, and civilians nationwide find help for addiction, alcoholism, PTSD, and mental health support. He can be reached for comment at firstname.lastname@example.org.