Stream of Consciousness

Stream of Consciousness on Ground Zero and TAK Response

By: Sam Bradley, EMT-P

I received a gift today. It was one of those large patches that honors the World Trade Center disaster. Embroidered within it are the patches of FDNY, NYPD and the Port Authority. If was left for me at our county EMS agency by someone in Public Health. It was to show her appreciation for a lecture I did recently for the County Medical Reserve Corp on my Ground Zero experience. The focus of the discussion was on critical incident stress in disaster. I spoke to a packed house. It was nice to know that, after almost nine years, people still care.

After thirty years in prehospital care I learned how each patient interaction, no matter how mundane or redundant, creates a certain level of stress. Others will reach you on a much more personal level. Then there are those that change you forever. A major airline crash and responding to the traumatic arrest of one of my fellow paramedics did it for me. I discovered the meaning of post traumatic stress system syndrome by experiencing it.

By the time I joined a federal disaster medical assistance team in 1997, I had taken a significant amount of training in CISM and felt prepared ... better than most, I thought. In fact, I was put in charge of CISM for the 16 of us that responded to New York to provide medical support for people working on the “pile”. I learned a lot over those two weeks: Lesson #1: It’s hard to manage everyone else’s stress when you’re in the thick of it yourself. Lesson #2: You can’t defuse people (or yourself) when you’re all in a “work” mode.” Lesson #3: Everyone will react differently to events based on their own experiences and coping skills. Lesson #4: Going to a memorial service to honor one of the fallen firefighters was difficult, but gratifying. Lesson #5: Meeting his family, learning more about him as a person, and making him one of our own was even better. Lesson #5: Hot french fries and cold martinis (with three olives) after a shift at 0100 was the best part of the day. We could share experiences with the other half of the team and make peace with it ... as much as that was possible. Lesson #6: Talking to firefighters who were already psychologically (and, most likely physiologically) crippled tore my heart out. Lesson #7: Trying to assimilate back into “real” life was extremely difficult. Lesson #8: I was really pissed then. Lesson #9: I still am. Lesson #10: I’d do it again in a heartbeat, but I’m not the same person I was. My temper is shorter, I’m much more skeptical, and I have way less tolerance for stupidity. Many of those that deployed with me have left the team and disaster work. Some of them went on to experience other deployments like Hurricane Katrina. Each of those events takes a piece of our sanity, yet we’re driven to go back for more.

Memories, feelings and odors from Ground Zero lurk in the far reaches of my mind, but, comparatively, I’m lucky. I met a pastor from Iowa several years ago. He had also been at Ground Zero. At the time I met him he would become incapacitated whenever he heard heavy earthmoving equipment, or three blasts of a horn. That was the signal that a body had been found. Everything stopped and we paid their respects as a flag was draped over the remains and firefighters accompanied the body as it was put in an FDNY ambulance and taken away. This happened several times a day. I tried to assuage myself with the knowledge that one more family may have closure ... so many never would.

I digress. Why am I still angry? Because 343 firefighters and cops died along with thousands of civilians? That we still need to have government physicals every year to see if the poisonous air we breathed has turned our cells to cancer? That standing in the pile one day doing ALS medical support for a caving operation gave me the distinct feeling that we weren’t alone? That so many Americans have forgotten that day like it was just another bad “B” movie? That we hear more about a pop star’s latest addiction or infidelity more often than the ongoing suffering of those firefighters and their families? Because there are radical extremists that still focus their lives on destroying ours because they don’t agree with what we believe? Yeah ... all of the above.

It mattered to me that those people came, almost nine years later, to listen to my story. To know that firefighters, law enforcement, EMTs, medics, nurses and docs are willing to go out there every day and brave those dangers, face their demons, and fight the good fight tells me that the bad guys will never win. They can take our lives, but not our spirits. They sought to weaken us with fear, but initial shock turned to resolve and a level of patriotism this country hasn’t seen in a long time. I am proud to have had the honor to take care of those people at Ground Zero and form a posthumous friendship with a young firefighter that died way too soon on September 11, 2001.

This brings home the importance of being physically and mentally prepared for what we face, not just in disaster work, but every day on the streets and in our ERs. Situational awareness can’t be taken for granted. The bad guys are still out there and first responders are their targets. That’s why I believe in TAK Response and the efforts of all the experienced professionals who are coming together to make sure that every cop, firefighter, disaster worker and medical practitioner is aware, well-trained, and safe. It’s a new world … a much more dangerous one, and we need to prepare each other for 21st century threats.

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