International Critical Incident Stress Foundation, Inc.
International Critical Incident Stress Foundation, Inc.
By: Michael Worthen
Throughout our careers we see and experience some of the worst of the worst. Some if not most of us tend to carry that mental burden with us until the end of our careers or until we can no longer take the mental toll these burdens have incurred on us. It was the culture, not so long ago that you were told to “suck it up”, “get over it”, or “you’ll be ok”. In my humble and sometimes unsolicited opinion, that is the biggest lie you will ever hear or the biggest lie you will ever tell yourself. The topic of mental wellness and self-care, for so long, were considered taboo amongst 1st responders because of the stigma that was associated with it. That stance is rapidly changing. I wrote this article in the hope that it may help those who find themselves in the same predicament I found myself in not so very long ago and to let them know there is hope. This is my story –
My name Is Michael Worthen. I serve as an EMS Battalion Chief for the Nevada National Security Site, formerly The Nevada Test Site, and began my career nearly 28 years ago. I first became intrigued with EMS and the Fire Service, by a TV program that debuted on April 18th, 1989. William Shatner narrated this show, and of course, I am talking about Rescue 911. After watching a few episodes showing how first responders saved everybody at the end of the show and that it always had a positive outcome (well, it seemed realistic enough though, right?), this is a career that I wanted to do. I didn’t know the mental toll that this career would take on me throughout my career, for Rescue 911 never showed us this aspect of our profession. Throughout my career, I have worked for a private ambulance company, two HEMS programs, and finally, a Fire Department.
I landed my first job at a private ambulance company in Las Vegas, Nevada, called Mercy Ambulance. I was having the time of my life, doing what I wanted to do, serving my community by helping the sick and injured. I started personally experiencing many things I only previously known from TV or books. I began experiencing the benefits of a rewarding career, but I also began experiencing the challenging calls and outcomes that our profession also frequently encounters. In my career’s early stages, I’d commonly stop by the bar after a shift, have some beers, and a couple of shots to blow off some steam. This ritual was the only way I knew how to relieve a little bit of the stress from what I was seeing and feeling. As my career progressed, I started to experience other stressors on top of what our job already holds. These stressors, not only from patient interactions, but also the loss of my brothers and sisters I had worked alongside who ultimately committed suicide. These added another level of things I dealt with and for which I felt I had to “stay strong.”
In addition to dealing with the operational challenges we must all periodically face, other difficult and traumatic experiences were waiting for me. On April 3rd, 1999, while working as a Flight Paramedic for Flight for Life, the helicopter that was returning to its base in Pahrump, Nevada, crashed outside of Indian Springs, Nevada, killing all three of my coworkers and friends. I would experience that same event 3 ½ years later when Mercy Air Las Vegas would crash just south of the Nevada California border on September 8th, 2002. I again lost three of my friends and coworkers. As the cumulative stress continued, I felt stuck; I couldn’t possibly tell anybody what I felt as they would perceive my pain as a weakness. This fear added more stress to my dilemma. I was indeed in a place from which I couldn’t escape.
As these events unfolded, I lost the resiliency to adequately and appropriately deal with my feelings and emotions. Earlier, I eluded to “having some beers and a couple of shots” well that had now progressed and advanced to me drinking to excess at least 3-4 times a week and when things became really “dark”, even alcohol was not enough. I continued down this path for approximately the next four years. The more that I had to suppress the more I used to forget. This substance abuse was a double-edged sword. It wasn’t long before the shame and guilt of not being able to tell anyone what I was feeling combined with the shame and guilt of my alcohol and substance abuse, made coping with things virtually impossible. They had an unbearable potentiation effect. There came the point I hoped to overdose, so “it” would all go away. This insanity continued, until I chose, through a series of events, to get clean on January 9th, 2006. I have remained free of all substances since that time.
There were times during those very dark days that I contemplated suicide because the pain I was experiencing was debilitating and too much to handle. Being caught between two negatives is sometimes our personal and professional realty. Rescue 911 left this part out. I know that I am not alone in experiencing this precise scenario. Many of you have taken the time to read this article and could be experiencing a similar struggle. This writing is the 1st time I have publically shared these tribulations with anyone. My hope in showing how I handled them or didn’t, also demonstrates there is hope. I share these experiences for one purpose. To help one of my brothers and sisters in the fire service, law enforcement, EMS, or Coroner’s Office, who is similarly so caught up in the “Stigma,” they do not know which way to turn.
What is the solution? I don’t think there is one single solution to a very complex issue. It is a combination of resources that can and will help combat the mental health crisis in our respective fields. The implementation of Critical Incident Stress Management (CISM) programs within your department is an invaluable resource. Peer support teams add another option for those that don’t feel comfortable in a group setting. With the topic of mental health at the forefront of the first responder field, EAP’s have now stepped up their game and have mental health professionals specialized in trauma intervention and Critical Incident Stress Debriefing (CISD). There was a point early in my career that I would shy away from EAP’s because how can they possibly understand what I go through on a day to day basis. That is certainly not the case anymore today. In fact, my most recent interaction where I was a participant in a CISD was due to a fellow co-worker completing suicide. I found the CISD and its effects very beneficial, not only on a personal level but more so on a group level. Personally, I was able to process the circumstances surrounding the event and the emotions that accompanied it a lot easier with the well guided CISD than if I was to try to navigate through it on my own. On a group level not only were we able to accomplish one of the CISD goals, which was to restore our ability to function, but we became closer as a unit and our group cohesion was vastly improved.
I have become a big proponent in taking a proactive stance in combating these issues. What I mean by that is to arm and prepare the next generation of emergency service workers (Firefighters, Police Officers, Paramedics, ER Physicians, Nurses, and Coroner personnel) with the tools they need to prepare them for the not so great parts of our careers. We need to make, as a part of their curriculum, a section solely dedicated to self-care and resiliency. I have recently proposed this idea to one of the top EMS institutions in Southern Nevada, and it has been very well received. We are currently in the process of adding that subject matter as part of their curriculum. By giving our young men and women these tools, hopefully, they will be able to adapt in a healthier way than what some of their predecessors had to do. I believe that the more proactive we are, the less reactive we will have to be.
In closing – I am here to tell you that if you are struggling, please reach out to a coworker, a friend, or family member, you owe that to yourself. We all have a tough job, and we should be able to foster an environment in which it is ok to talk to a peer and let them know when something is bothering us. We should be able to have the freedom without any ramifications or criticisms that we were bothered by “that” call. We should have programs in place for individuals to seek out further assistance that is beyond the scope of a CISD team or a peer support group, and that is of the utmost confidentiality. Addressing these thoughts, feelings, and behaviors are extremely important, for my experience has taught me that you need to be able to deal with your emotions, or they will eventually deal with you. We also each have the responsibility to take care of one another. We are there for each other when we get physically hurt on the job, why should it be any different when we get mentally injured on the job, it shouldn’t! We also have the responsibility to mentor those who are just entering our respective fields and help change the attitude within our culture concerning our mental wellbeing. Hopefully, together, we all can contribute to #CRUSHTHESTIGMA.
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