That is a Combat Disorder….

by Firefighter Captain Joel Holbrook

If you ask anyone who knew me growing up, “tell me something about Joel?” They would reply, “He always wanted to be a firefighter.”

I am not sure what my fascination was, but it was something I wanted to do when I grew up. But, like most teens, there were other things I wanted to do as well. So, before graduation, I enlisted in the Marine Corps. I was deemed medically unfit, due to a childhood diagnoses of Tourette’s Syndrome.

So, not to be knocked down, I applied at Ohio University. I was accepted and soon started the September after graduation in 1991. This was short lived, though I excelled at the social aspect of college, the academic aspect was not so fruitful. I soon found my demise as I was asked to leave due to grades.

I soon realized, I needed to get things in order, so I decided to apply to the local fire department. It was a para-military organization, and after all, it was all I wanted to do. To everyone’s surprise I graduated in the top of my class, which was four; we had started with 22 only 12 weeks earlier.

I can recall my very first run. It was to a local nursing home on a medical assist. When the engine arrived, I remember walking into the person’s room. There on the floor lie an elderly male, in cardiac arrest. But, no efforts were being made because it was determined the patient was obviously deceased. Wait a second, I thought, this is not right. We are supposed to try to help this man. Afterwards, I asked the senior man on the crew why nothing was done. His reply was without emotion, “Son, this isn’t Hollywood. People die everyday, shake it off and move on.” At 19, this was my first dose of reality.

Fast forward. In November of 2013, I woke up as usual. I showered and headed off for work. I was about five minutes from work, when out of the blue, I started having chest pains, shortness of breath, and extreme vertigo. Honestly, I felt I was having a heart attack. I made it to work, walked straight into the engine bay. As I walked around the back of the engine, my crew looked at me and asked what was wrong. I told them, and within minutes I found myself in the back of the ambulance. It was a shock, being in the back as a patient and not as a caregiver. Suddenly, the realization of, “holy shit, what is happening?” hit me. My guys were great, even the rookie who missed his IV (not due to lack of skill, but because of nerves). After all he was sticking his Captain. Believe me, I felt well enough to give him a rash of shit all the way to hospital!

Once at the hospital, I was given the full work up. EKG, CT and chest x-ray. They also drew enough blood to satiate even the thirstiest of vampires. I was admitted (the first time ever in my life) for observation and scheduled for a stress test the next morning. Later the next day, the cardiologist came in and explained to me that my heart was perfectly healthy. Good news, all those years of working out actually had paid off. However, something else seemed to have triggered the event. He felt it was stress. He explained that over time the body throws in the white flag and basically mimics other physical issues as a cry for help. He ordered me to follow-up with my family doctor.

Two days later, I met with my family doctor. It was the longest appointment I had ever experienced. I spent over an hour and a half in the room discussing my event, my blood work, and eventually my lifestyle. I was being given a psychological assessment. He asked about my 21 years in the fire service. He wanted details, so I gave them to him. While talking to him, I had not realized how much baggage I had “shaken off and moved on” with.

In my 21 years, I had seen four co-workers die. One of which, I had taken an active role in his resuscitation. This guy was in my wedding and I had watched his son on my days off. Another co-worker died from an in the line of duty injury. Ironically, his wife was pregnant when he died; his son was born two rooms down and two hours after my daughter on April 11, 2001. One, of the brothers was struck on the interstate working a car crash and the other died of cancer. I had seen teenagers decapitated, kids hanged and shot, more cardiac arrest than I can count. House fires, I have pulled people out of burning buildings, both dead and alive. I have seen people mangled in car crashes. I have been fortunate enough to deliver one child in my career. I have seen the consequences of drug abuse and domestic violence.

After answering his questions, he looked at me. “I am amazed at the explicit detail, in which you can recall, each and every event! Have you ever talked to anyone?” My reply, “Nope.”

“Why?” he asked. I told him that we talk in the engine house and I talk about it with my wife. He said, “No…. have you ever sought professional counseling?” Um…. “NO!”

Then he hit my upside my head (figuratively, with a brick). “You have PTSD, post traumatic stress disorder.” I laughed at him. He very offensively says, “What’s so funny?” I replied, “That is a combat disorder!”

combat collage

Shocked, he asked what I meant. I explained to him that PTSD is a disorder suffered by returning military veterans. After all, I know people who are classified as wounded veterans. These are men (and women) who have served our country in combat and lived to tell about it. Now that is stressful. Nothing like my job!

He says, “Maybe not this week or this month, BUT, after 21 years, things add up. Think about it. You see people at their worst moment, you see death, you see violence, you see destruction, you work in an environment of split second decisions!”

I finally conceded, which was the hardest thing ever. As I sat and stared, the doctor asked me what I was thinking.

I replied, “I can not be labeled as a psych patient.” He assured me that I was not a psych patient; I simply had to learn to accept I had a diagnosis, no different from diabetes or asthma. It was treatable and well researched.

I soon realized that after all these years of worrying about my physical health, my family, my finances, and my career growth, I had unintentionally overlooked my mental health. I had neglected my mental health for 21 years. I was prescribed an SNRI [Serotonin–norepinephrine reuptake inhibitor] to help get the process started. I explained to my supervisor and my crews what I had been diagnosed with. I made it known that I was no longer going to stress over the issues I had no control over. I let them know I would have good days and bad days. I asked for their support. They accepted my issue with open arms.

I explained to my family what I was dealing with, and that I would have good days and bad days. After all, I had not been aware that my pent-up history was affecting them as were my outbursts coupled with my withdrawn existence inside the walls of my house. I love my family more than life itself. If anything was worth saving it was keeping my family in a cohesive bond of love and support.

Two months after beginning treatment, things began to make sense. I now understand why so many fellow workers are alcoholics, why so many have divorced, why so many suffer injury, why so many live reckless lifestyles. It’s a coping mechanism, for all the negativity seen at work. I would suspect more than 75% of the fire service suffers from un-diagnosed PTSD.

I am telling my story, not for sympathy, but for awareness. Go to your doctor and ask to be evaluated. I never would have suspected this stress disorder was something I would have ever been diagnosed with. The “it won’t happen to me” or the “I know how to deal with my stress”, doesn’t cut. Swallow your pride and face your issues head on. We cannot care for those we have sworn to serve, if we don’t care for ourselves first. Be Safe

About the Author: Joel Holbrook is 41 years old and has been a Firefighter since the age of 19, seventeen of those years as a career firefighter and paramedic. He currently holds the rank of Captain/Shift Commander and is responsible for the daily operations of my shift. Joel works for a suburban department south of Dayton Ohio, they respond to 6,200 calls annually. He has worked for five departments during his career. Joel has been married for eighteen years and has a son (17) and a daughter (12).

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