EMS & PTSD: Behind The Mask – A Blog by Tales From The Boo Boo Bus

THE INTRODUCTION: Welcome to the first post in our new blog series! In an effort to bring more attention to PTSD and to reduce the stigma attached to it, Doc Reaper will be writing about her struggles with PTSD. This is intended to be raw and emotional, but most importantly REAL. Bandage-one may write as well, but to reduce the possibility of revealing his identity he will not be speaking on the actual events he's experienced. For those of you unfamiliar with "Bandage-one" and "Doc Reaper", they are admins on the Facebook Page, Tales From The Boo Boo Bus. Bandage-one is a Paramedic from Canada, in his early twenties, with 3.5 years experience. He also works in EMS and teaches college students. Doc Reaper is Paramedic in the USA with 8 years total experience in EMS. She is also a Combat Medic in the US Army National Guard with 8 years experience there. Both battle PTSD daily. Neither can reveal identity for fear of repercussions.  And in case you couldn't tell, Bandage-one is a dude, and Doc Reaper is a chick. THE MESSAGE: I struggle with PTSD. There. I said it. I've struggled for 6 long years. It has ups and downs. But it does not define me. It does not control me. It's just some creepy ass cat that likes to follow me around all the time, and sometimes it cuddles up to me and purrs, and other times it scratches and bites. We don't talk about this in EMS. Not usually. But screw you, I'm talking and no one is stopping me. We are so afraid that we will turn into whatever the hell it is we think our "psych" patients are. We see them, and we KNOW we never want to go there. So we don't talk about our bad day. Or bad week. Or bad year. We hide it, slap on a smile and make it through one more day. We do our best to keep the lack of sleep (Thank you nightmares) from affecting us at work. We try and mask the terror we feel when faced with our triggers. Brakes squealing. Blood spurting. Screaming and Gunshots...we fight past the movies that start playing in our heads, treat the patients, and deal with the aftermath at home. Usually with a beer. In my case rum. And as if that isn't awful enough, many of us face repercussions with our employers should we seek counseling! Yeah, because someone having a bad day can't possibly still be a good EMT or Firefighter, or Medic right!? The very profession that has caused our wounds and scars turns its' back on us all to often. OK, that got a little ranty there. But it's the truth dammit. Maybe not everyone's truth. But it's our truth. I have had an awful time the last 4 weeks. I have nightmares from the second I fall asleep until the second I wake up. I can't make them stop. I have PTSD from multiple incidents. Primarily though, I was attacked and nearly killed by someone I trusted 6 years ago. And so, 4 weeks ago I experienced a trigger related to that incident. I'm sorry, but that is something I cannot share. But it opened the floodgates. A week ago I experienced "sleep paralysis" for the first time. Didn't even know it was a thing. I was asleep. I couldn't move. I couldn't breathe. It felt like someone was holding me down. I kept trying to wake up, but every time I thought I did, it was just another dream. Finally, when I woke up, I was still unable to move or yell or do anything for a few minutes. Absolutely terrifying. I was so disoriented from it, that I wasn't sure if I was truly awake. I called several people but no one answered. Finally, I called a fan from our Facebook Page. He talked to me, and calmed me down, and comforted me. Most importantly, he did not judge me. The nightmares continued throughout the week after that, ruining my sleep and dragging my poor brain down. Work is the only place that I can forget. I love my job. Not just for the distraction. I love helping people. I do mostly Interfacility Transport at the moment (I'll go back to 911 in a little less than a year, just wanted to learn this side); and even the discharges to home are enjoyable for me. I am brought to tears weekly. But I wouldn't trade it for the world. At work yesterday I felt very strung out. There was pressure in my chest. I could ignore it while we were actually doing things, but just sitting-it was hard. I'd been talking all day with a friend. A fellow Soldier and EMT. A fellow sufferer of PTSD. My Counselor. We talked about our struggles throughout the day. And about some of the "incidents". While driving home he said something that struck a nerve with me. I broke. My chest hurt on an insane level, the pressure was intense. I couldn't catch my breath. My vision started to black out. I pulled over. I finally realized- "So this is a panic attack." I was terrified. I called my friend. He talked to me and consoled me. Distracted me with happy thoughts. Horses. They are my happy place. They seem to be his too. After nearly an hour I was finally ok. Soaked in sweat (which sucked, since it was around 25 degrees Fahrenheit) and exhausted. Not gonna lie, I feel a bit of humiliation at having suffered a panic attack. Something our patients have that we diagnose as "BS". We just hold their hand and coach their breathing and before you hit the ER doors, "Poof! All better!" because there was NOTHING actually wrong with them in the first place! Right? Wrong. There was absolutely something wrong with me. My emotions and brain were so stressed and raw that I had a physiologic reaction. A heart rate of 140. Respiratory rate near the 60s. Completely out of my control. And the only cure for that reaction was comfort and understanding (some Ativan would have been cool too though). I can kinda see why people call 911 for those now. I cried. I choked on tears and spit and I just cried. And my Counselor just listened. Listened to me expelling all the pain and agony of the last few weeks via sobs and tears. crying2_edited-1 -Doc Reaper P.S. If you comment please go easy. This is the most painful thing I have ever written. It's scary putting this out there for everyone's judgement. Don't bite my offered hand please.

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  1. Thank you. It helps to see you’re not alone. Thank you.

  2. Herbert Roberson

    34 years in the fire service and I could never have expressed it any better!

  3. It’s awsome that fire/ems can help each other through this. I have been told multiple times by “outsiders” that we “chose this line of work. So we should have been mentally prepared. There is no reason to take it so hard. Just suck it up”. May God bless you all

  4. Thankyou so much. It helped me realize I am not alone.

  5. I am not ‘aware’ of anyone in my EMS or other circles that has PTSD (not saying they are not there). I do not understand PTSD. Thank you for writing this. My wife sometimes has anxiety attacks, and I have experienced chest pain from non-work anxiety. While I do not understand all the mechanics of anxiety and PTSD I certainly acknowledge that these issues are as real as hypoglycemia, MI, and trauma.

    Now let me say this: I have over 30 years (started as an EMT at the tender age of 15) experience in EMS, rural and urban, 911 and transport. I have never had any negative work related psych experiences. Therefore I can not ‘understand’ how PTSD works on an intimate level. Sure I have had calls that I thought about a few times, but they never negatively impacted me. No lost sleep, overriding thoughts, loss of appetite, family problems, etc. You certainly will experience fellow providers who do not sympathize with your condition, and that is unfortunate.

    What is different about people like me and people like you? I do not know. I have empathy for the suffering of patients and family, but it does not affect me on a personal level. Once I walk away from the human drama, I am done with it. Which one of us is ‘normal’ (if there is such a thing)? Sometimes I think I could be diagnosed with a form of psycho-social disorder BECAUSE I am not affected by the suffering of others.

    What forms of therapy or medication have you tried, or not, to manage the PTSD? I wonder if hypnosis would be effective?

    How do you feel about CISD? Dr. Bryan Bledsoe believes it to be counterproductive to long term mental health but he is in the minority.

    Footnote on the sleep paralysis: This exact thing has happened to me twice but was not associated with bad dreams etc. while I was at the station. That station was well known to have a deceased member’s ghost (seriously!) that played tricks on the providers, awake and sleeping. Others reported similar sleep paralysis experiences.

  6. i am 5 years into EMS in the boston and south shore regions of Massachusetts. Sure, I’ve experienced big hardships in life before going into EMS and it is why I joined the circle. I knew I could handle it. I’ve realized over the years that even the smaller things in our profession tend to become a trigger into some form of PTSD for me. Bringing a patient to an ER and learning they’ve outlived their entire family tree…getting to know so many patients who are regular customers, becoming so close to some, and seeing them pass over and over again. Then there are the calls from what we all call the battle zones. Sure some may not deal with gun shots etc, but when you get your code blue or your stabbings, or seeing the children at months old who are dying and all that. To not bring it home is sometimes impossible, but then we get home and no one understands. They say, buck up tough guy/gal, stay strong it’s your job,…

    This article is a beautiful yet dark insight into the reality. No matter how strong one is inside, religiously, literally; etc…this gets us all eventually.

  7. Brandi Dimmick-Baker

    I too have been right where you are. Suffering harm at a friend or loved one is one of the hardest thing to work threw. No matter how hard I try it creeps up on me when I am least expecting. Work threw the grieving cycle. Identify where you are. With the knowledge we have we can use it to help yourself, but we must still do the work. Your not alone. As a fellow abuse survivor it has made me a advocate. I have used my surviving to help others find strength and courage. We are survivors. You will get threw this. Keep up the good fight. Don’t give up. Sometimes meds help get threw the darkest parts, but we still have to do the work. Other times its a band-aid, covers the gaping wound but it needs true medical attention. Hugs.

  8. Doc Reaper I think you are very brave and I want to thank you for sharing. I have been an EMT for ten years and it’s nice to see this topic be talked about. You are not alone.

  9. Doc whether you realize it or not, by writing this, you took a huge step in dealing with your PTSD. It will never go away and there will always be triggers but you can make it more manageable and talking about is the first step.
    I too am a paramedic going on 10 years in civilian EMS and I am medically retired after 17 years from the Navy where I started as a corpsman and ended assigned to a Marine unit as their field medic. I served in in both gulf wars. I suffer from PTSD. It crippled me for a while. I found after a particularly severe attack, that writing helped immensely and talking even more. Now I don’t recommend talking to civilians because they will NEVER understand but talking to peers will always help. Writing in places like this is also a wonderful and therapeutic. Writing can be very cathartic!!
    I would encourage your readers and followers to stay in touch. Reach out to each other and to me. My phone number is on my page and it’s always on. Thank you Doc for your service, your sacrifice and your continued dedication to healing and helping people. Thank you for having the amazing strength to share your story!!
    Hugs!!! ~~Mama Doc

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