As a teenager I was frustrated with high school. It all seemed to stupid to me. I hit the breaking point learning about how to perform factorial calculations math. It all seemed so stupid and pointless that I dropped out of high school and spent months in a small apartment, funded by my part time job, reading philosophy, psychology and religion books, looking for the meaning of life. Eventually I moved into a Zen Buddhist temple and was a resident student for two years.
After two years I was ready to bring my practice back into the world, so I finished off my last high school credits in night school and enrolled to take the one year Ambulance and Emergency Care program at a local college. During that year, my mom died of breast cancer that had spread to her lungs. Watching people suffer and die all day while riding out as a student, and then coming come to watch my mom die made it a tough year. My mom never saw me graduate, but I did and got a job right away working for the Toronto EMS service.
My first four years were spent doing ‘BLS’ (basic life support) in those days (early 90’s) we didn’t have defibrillators or carry any drugs. I was bored and considering other careers. In 1994 however, a competition opened up for positions in the highly coveted ALS (advanced life support) program. This is what we all wanted to do. 250 of us wrote the test, only 40 passed. Then we undertook scenario testing and only 13 of that top 40 passed. After oral board interviews with the program doctors I was ranked number 7 and entered the program in a class of 12. Only 9 of us made it through, and it was grueling, but I made it and became one of the few ‘elite’ ALS medics working on the streets in our city. After 4 more years I had become a field training officer and was a Course Director at our Base Hospital, teaching medics, nurses and doctors how to run cardiac arrests through the Advanced Cardiac Life Support program. I had a column in our national magazine, and I was on the founding board of directors for our provincial paramedic association.
The job took it’s toll. As an ALS medic, we were called to the worst street calls. There were days when I saw too much, and then I’d take a few days off sick until I was ready to return. I remember seeing horrible, horrible scenes and coming home in a daze. One patient cut out his intestines and threw them on the floor before dying. Another jumped from an apartment and it took us hours to find his head (in a tree … the birds showed us where it was as the sun came up). I saw kids injured and beaten horribly, I saw hellish scenes of torture and abuse. I saw the caustic destruction of drug addiction. I saw people kill themselves (or almost kill themselves) and others in unspeakable ways. I saw innocent families mowed down by unaffected drunk drivers. I saw the quiet, hidden tragedy of our seniors hidden alone in nursing homes to die forgotten. I watched a house with a child trapped in it burn to the ground and later pronounced the charred remans ‘dead’. I saw good friends lose it and quit the profession. I saw a lot.
After four more years of ALS, our department started a mobile intensive care unit program. Instead of sending doctors and nurses on transfers between hospitals, they would teach a select group of us to use all the hospital equipment and do the transfers ourselves so that the doctors and nurses didn’t have to leave the hospitals where they were needed. I applied and made it, then went through the crazy training again. This was the top of the profession. There were only 30 of us in the program, and less than 200 critical care paramedics in all of Canada. We were doing things that paramedics had never done before (like running intra-aortic balloon pumps on our own in the back of ambulances) so, of course, we were under the microscope.
I thought it would be great – and it was! – but the stress went up to 11. We routinely took the patients who were ‘too sick’ for the hospital they were in to hospitals with higher levels of care. We transferred the smashed, the burned and the broken. After a few years we started transporting kids too, and the stress went off the scale. All I saw, day after day, was the worst of the very worst. My wife and I hit hard times together, but we struggled through it, raising our family and trying to make life flow even though there never seemed to be either enough time or money to actually make it work.
The service I worked for had us work 12 hours shifts, and every six weeks we switched back and forth between days and nights four times. Imagine working in North America for ten days, then flying to Australia to work for ten days, and then back and forth again, and again, every ten days. I was constantly jet lagged, never fully awake and never fully asleep. It wore me down. It wore us all down.
When the stress got too much, I got sick. It’s how my body protected me. It wasn’t the best way, but it was pretty much the only way available to me. In 2003 I got a chest cold that I just couldn’t get rid of. I went through a course of antibiotics with no effect, my doctor scratched his head and said “I guess I’ll call it atypical pneumonia, but there’s nothing I can do for it. It has to take it’s course”.
Then I got a call from work; SARS had hit Toronto. One of the other medics in the mobile intensive care program was in the hospital on a ventilator and they expected him to die. That was it. I knew I had SARS.
I was ‘quarantined’ in the spare bedroom of our house. I made a will. The base hospital had a bed for me when my fever hit 40 degrees celcius, but it never did. It was a false alarm – it turned out I did only have atypical pneumonia, not SARS. So I went back to work, shaken and scared. But everything had changed. We were a service under attack. It felt like we were in a war. The public were afraid to call us, afraid to go to the hospital, even when they were having a heart attack. Our kids were ‘uninvited’ to birthday parties and we were ordered not to leave our homes on our days off so that we didn’t spread SARS if we had it.
After a few weeks I got another call from work – a patient I had transported had died from SARS and I was again quarantined for about a week, away from my family. A supervisor drove an hour to my home to deliver N95 masks for me and my family to wear so they wouldn’t catch SARS from me if I had it. Another week – no SARS – so back to work.
Now I was jittery. I couldn’t think, I couldn’t sleep. I jumped in alarm when people walked into the room. Horrible thoughts of tragedies I had seen, and also that my mind just made up, played relentlessly through my head. I was a walking ghost and it was a titanic struggle just to get out of bed. I was wired up and exhausted at the same time. One day at work, we were the closest unit for a 6 year old diabetic girl unconscious in her school, so the dispatcher asked us to jump the call until a street medic unit could back us up. I attended to the girl and doubled the dose of IV sugar by mistake – no harm to the patient, fortunately – but I had no idea I had done it until the crew that took over the patient asked me where the rest of the IV sugar was.
I realized I had become dangerous, so I booked off. I went home and felt out of control. If you drank 40 cups of coffee and then 40 cups of vodka, you’d probably get close to feeling what I was feeling. I was up all night, horrified of going back to work the next day. I was crying as the sun came up that morning when the face of my college instructor came back to me. I was in class again, looking at the list of symptoms she was reading from the black board for Post Traumatic Stress Disorder. That was it! I wasn’t crazy! It was PTSD. Thank God I knew what was going on.
I spoke to our staff psychologist, but as I’ve since learned, staff psychologists for emergency workers who are paid by the employer are in a conflict of interest situation. Their boss doesn’t like it when people go off on stress leave. Our staff psychologist told me I seemed stressed, but it wasn’t the employers responsibility. He suggested that I take an unpaid leave and try to relax.
So I went and saw my family doctor again and he diagnosed PTSD. A workers compensation psychologist and then another long term disability psychologist confirmed the diagnosis. I started to get treatment and was off for a year. After a year our workers compensation board denied my claim. In Ontario (and many places elsewhere I have since learned) the compensation boards have set up the perfect Catch-22. If you have something horrible happen to you when you are OFF the job, then it’s not compensatable because it didn’t happen on the job. But if it happens when you are ON the job, then it’s considered a normal part of your job duties, and they don’t compensate for that either. In my case, they said there was no ‘physical injury’ so there was not way that they would ever compensate me for PTSD anyway, even though physical injury is not necessary to diagnose PTSD.
I spoke with employees at the workers compensation board and they told me, (off the record) that they would never compensate anyone with PTSD due to SARS because it would set a precedent that they felt would start a flood of claims, so they had to deny me. In addition they felt I owed them $18,000 because (according to them) I’d been off for a year now without any reason to be. So it was time to go back to work, even though my psychologists advised against it. Still … baby needs new shoes, right? So I started to prepare to go back.
But everything had changed. The job had changed, I had changed, and I didn’t want to go back. I had planned to go into teaching, and had been toying with the idea for a while. I was completing a Bachelors of Health Sciences and had a completed a teaching certificate at our local college. A job came up working for a Canadian college in a different country teaching paramedicine, so I applied and was accepted. I quit and we moved. Given enough time and proper treatment I think I could have gone back, but I didn’t get the chance. The newspapers in Ontario reported on my story (see http://www.tema.ca/news.php?news_id=16). There was minor outrage among the public and a major cry of frustration on our paramedic list servers. Dozens of other paramedics wrote to me with the same story of being starved out by the workers compensation board and abandoned by those that were supposed to be helping them. As one medic wrote to me “the safety net that we always thought was underneath us turned out to be black lines on the concrete”. In the end, the way my employer and the workers compensation board treated me (and many others like me) ended up being as damaging as the death and trauma I had seen as a medic.
As I settled into the rhythm of teaching, and created some space between myself and all that had happened, I began to become aware that I was in a pretty rare position. The fact is, I’d been on the front lines – I lived on the hard side of the public safety net. I could talk about my story with any medic, doctor, nurse, firefighter or soldier and they’d know that I was one of them. Maybe the details of my story were different, but we’d all lived in the same fire. I’d also gone through chronic and acute critical stress, and I’d been thrown around by the system that was supposed to be helping me. I was a survivor, and other survivors recognized me the way cancer patients recognize and respect each other.
I realized that I had something that I could offer to others, so I began a Master of Arts in Counselling Psychology and through the course I kept my focus on critical stress and learned all I could. So a part of my way of sharing the gifts I received through all I’ve been through has been to create this website. It’s free. It’s for you. It’s a way for you to learn from someone who’s been there and spent years studying exactly what it was that happened, and how anyone who finds themselves overwhelmed by critical stress can get themselves out again.
On this site I’ll be developing an overview of how to deal with critical stress for you, and I’ll point you to other resources that can help. You’re not crazy. You’re not weak. And you’re not alone. I’ve been thrown down that hole and crawled out, and you can too. So come with me, and learn what I know. There’s a way out.