by Veronique Moseley
Editor’s Comment: This is a MUST READ for every public safety and emergency service family!
Ross and I work hard on our project Behind The Seen in the area of prevention of mental health issues among emergency services workers.
We have been told many times that our sessions, our Facebook messages, our articles and conference presentations provide HOPE. Much of our life is an open book, but until last month, the chapters were always somewhat edited to remove high emotional content. That’s been done to avoid triggering others and to provide consistency in our messages when advocating changes to mental health support for emergency services.
Last month, hundreds of followers saw the raw version of Ross during an episode. Mask off. The posting of his text and a video filled with anger and indignation, but more significantly, a deep pain he has not previously expressed publicly that caused a tidal wave of concern and support. Thank you to all those who responded with care: as you read my reflections below you will understand the significant value of genuine support.
It is not the first time that our family has gathered and waited in fear. Many looked at the video he posted and became frightened for him when they focussed on the way he looked: gaunt, exhausted, in pain. But we as his family just saw the Ross we were used to a few years ago. The man he was before the regular counseling, before we changed our whole lifestyle to be less stressful, before regular doctor’s visits and before he learnt to trust that support is always at hand.
It was a bump in the road – a severe one. A bump that might have been avoided if things were different. A bump that has me very fearful for those with PTSD who do not have strong supports.
The events I recount below start from the moment Ross and I entered the hospital. He had not been in contact with me for 12 hours. When he finally came home I suggested we go to the hospital and talk to someone about the events leading up to his episode.
It was 3am.
“Can you tell me a bit about your medical history?” asks the triage nurse as she intently focuses on her keyboard strokes. “Sure” he says quietly. “I had my appendix out as a kid, I’ve had a cartilage removed from my knee and I’m allergic to penicillin”. She nods at the screen in front of her. “Okay, so that’s all?” He looks at me as if to ask if he’s forgotten anything. Silence.
Nurse briefly turns to look at him. “Nothing else?” He looks puzzled for a moment and shrugs his shoulders, then shakes his head to indicate no. Nurse turns back to her computer screen, fingers tapping the keyboard at lightning speed to complete the required paperwork.
I turn to him to remind him he’s forgotten to tell her something, but his head is down, eyes fixed on a tiny spot of dirt on the floor. A lonely, unshaven figure with sunken cheeks and red rimmed eyes slumped into the chair, staring intently at something undeserving of such attention. The epitome of vulnerability and exhaustion. Before I have a chance to ponder the total contrast between the man sitting here, and the man directing his crew on the fire ground three years before, my attention is diverted by the sound of a chair scraping on the floor. Nurse is getting up.
My turn to speak. “He’s forgotten something”. She sits back down, ready to strike the keyboard once again. “He has Post Traumatic Stress Disorder”. He turns to me slowly and works up a tired half-smile. “Oh yep, that’s right, I have PTSD”. I smile and make light of it, “Yep, it could be just a little relevant to our visit here”. He nods as the smile fades and his attention is once again taken by some tiny bit of fluff or dirt on the floor.
Nurse has finished her report and asks us to go to reception to update some details. He’s just not focussed enough to talk to reception, so I answer the relevant questions while he sits in a chair behind me. The waiting area is unusually quiet with just one other patient and a cleaning lady busily mopping the floors. On the receptionist’s last question I turn slightly to check on him.
If I thought I had seen a man at his most vulnerable earlier in the triage station, I was wrong.
Bent over, head in hands, body heaving and tears flowing so hard they form tiny streams through his fingers. Silent, heart wrenching, uncontrollable sobs. I leave the receptionist as she is halfway through a sentence and wrap my arms around him. “It will all be okay, I know it doesn’t feel that way right now, but it will”. Reassuring whispers and shoulder rubs that do little to slow the tears, but are enough for him to lift his head and look at me with eyes that, despite their wet redness, talk of fear and helplessness: “They’re even watching me here,” he says in a hoarse whisper. “I can’t get away from it”. I look at him wondering if this is an exhausted mind now in overload and seeing things. “Who is watching you?” He points slowly at a wall towards the end of the waiting area. “There! Look, over there!”
I scan the area he is pointing at, see nothing, and ask him to explain where again. Then I see it. A sign near the triage area that says, “This area is under video surveillance”. I read it out loud and he says, “See, I’m not imagining things, this is REAL, and I can’t get away from it, even here someone is filming me!”
A realization comes over me about the events that have led to this episode. He has been trying to process the recent revelation that he has been under video and desktop surveillance for more than two years. The people who ordered that surveillance were the ones who had been telling him they were there to help him.
People who have no medical qualifications making judgement on his mental health by sifting through more than 11,000 items gathered through desktop surveillance, video taping and reporting on friends and family visiting, trips to the shops, journeys to medical appointments. Emails between people who claim to be there to support him ordering surveillance, questioning his medical team’s advice regarding work capacity, using photos posted from years ago as evidence of activity in present day, and so on.
The very system that he thought was genuinely encouraging him to get well has used whatever information they gained to erode credibility and invade his privacy. A few weeks ago, he had received 5 kilos (11 pounds) of documentation plus several CD’s – all centered on him. It was a shock. The way in which the information was obtained, the deliberate misinterpretation of facts and the people involved, all too much to process.
Now it makes sense to me. The severity of this episode.
He is now on constant alert because of the surveillance. His feelings of safety are threatened, knowing someone has been watching him and his family. They were watching, but he didn’t know. Besides the threat, he would have feelings of helplessness that (especially as a male) he is unable to protect his family from this “invasion”. Not to mention the absolute humiliation of being treated like a criminal just because you have an injury, exacerbated because as an emergency services worker he was once a respected “protector” in the community.
Being unable to continue in that role has an enormous effect on identity, something that needs work in recovery in addition to dealing with the symptoms of PTSD. Watching the surveillance videos and knowing how physically close these people came to him and his family (I physically brush past the person’s arm in one of the videos) made him feel angry, but more significantly, it made him feel powerless to protect self and family. It added to all the feelings of loss and grief that being medically discharged can bring.
The sobbing subsides as he takes a deep breath and wipes his face with his arm. I wipe the tears away and, once again, am startled to notice how gaunt a person can look after just 12 hours. Or has he looked this way for a while, and I missed it? The time for self-doubt is short-lived as he grunts, “Oh, for fuck’s sake, meat!” I look at him, wondering what on earth he’s thinking now. Meat? He glances sideways, but points in another direction, “There, on the TV”. Sure enough, the TV has a kitchen show with someone chopping up a huge slab of meat on a bone – one of his triggers. I’m starting to feel like I’m in some surreal “Murphy’s Law” movie. I hadn’t even noticed the TV. How odd that, of all the things it could be showing, it would be this!
He shifts his attention to the cleaning lady mopping the floor. Another deep breath and that hoarse whisper again. “I wish she’d hurry up, that repetitive sound is getting to me” Sound? I hadn’t noticed. But focussing, I hear the faintest, almost imperceptible swishing sound of the mop as she moves it back and forth. I look at him. Once again, slumped back into the chair, his eyes following the movement of the mop. I grab his hand and hold it. A slight squeeze indicates he’s aware of my presence, but for the next ten minutes we sit in silence observing the cleaning lady obsessively mopping a stretch of shiny hospital floor.
His name is called out and a middle-aged woman shows us to a small room. She’s friendly. Her job is to do an initial assessment to pass on to the psychiatrist. He tells her he just needed to get away, he couldn’t handle anything anymore. He still can’t.
“They say they want to help, but they don’t want to help me at all. They look me in the eyes and say they’re there to help, and then send an email to book in surveillance”. He relays the experience of disbelief and anger when he read the documents sent to him under freedom of information. “I trusted them! But it was all an act. They had no intention of helping me at all”.
I explain to her, “He’s talking about the rehabilitation consultant and the case manager who consistently say they’re there to help, but obviously they’re not. We’ve seen the evidence of that now by the emails they exchange.” She nods. It’s a familiar story to her.
She reassures him that she, and the other staff at the hospital are genuinely here to help and support. “Do you feel like you might want to stay here for a while?” He looks down for a moment. Looking up at me, he has tears again. “I don’t know. Yes, probably.” She takes away the need for an immediate decision as she says she’ll get one of the doctors to see him and have a chat.
As she shuts the door, he looks at me, tears welling up again. “What do you think?”
That’s a hard one. What do I think? I think they’re breaking him. I think I’m getting angry. I think it’s so unbelievably cruel that he works so incredibly hard to manage his PTSD and rebuild his life and yet total strangers are actively and knowingly destroying him every time he takes a step forward.
I think it took him years to put his hand up for help and place trust in others to help and support him. I think these profit driven people have forgotten they are dealing with human beings. I think about all the people this is happening to who do not have a partner, or who do not have support around them.
I think I am scared because what is happening to my man, to me and my family and to hundreds of other injured emergency services workers is REAL. And now I have tears, too. Because all of a sudden I understand the place he was in yesterday when he broke.
To heal, a person needs to trust those who claim they are there to help. If healing has been based on trusting those who support you, what will happen when you find out that they were not really there to help at all? That you bared your soul, made yourself vulnerable to someone and then you find out that they are doubting what you say, twisting facts to suit themselves and calling for surveillance. Can you really trust ANYONE?
What do I think?
He is scared, but so am I. I’m just not sure what the best road forward is to get him through this.
“Let’s talk to the doctor first”.
Finally, the psychiatrist arrives. A lengthy discussion during which I’m reminded why every fleck of dust, the sound of mopping and fleeting TV images were being focussed on.
Hypervigilance. The body’s response to danger. He had been in an agitated state of fight or flight for weeks, but I had been so busy with work, I hadn’t noticed. Because I was so busy, he didn’t want to add stress with his concerns, so the mask went on. He couldn’t protect his family from surveillance, but he could protect by hiding his own pain.
For a fleeting moment I feel guilt. Might this have been avoided if I didn’t focus so much on work over the last few weeks? When I think about this later I realize the fall would have happened anyway, it just might have been a softer landing.
I return my focus to him. He needs to be here. The psychiatrist explains the effects of external stressors and the various options available to him. He explains the events of the last few weeks as someone ripping the scab off a wound that was healing. At the time it really hurts, but with rest, the right medication, and counseling, it will start to heal again. Finally, he reassures him that besides family support, he will have 24 hours a day access to a mental health team member.
We go home and with the help of medication, he finally sleeps soundly. Healing time for Ross will mean getting back into routines, keeping a close eye on stress levels, re-establishing trust and more frequent counseling for a little while. The wound will heal.
For me, healing time is needed too.
Partners and family members go through a lot and need to look after themselves.
I wrote these reflections in the week after Ross’s episode – my way of healing. But as I sit here a month later, with neither Ross or I still fully recovered from the effects of that surveillance, writing those details as a private journal simply isn’t enough.
This isn’t just about one firefighter struggling with PTSD. This is about a system that continues to add unnecessary stress to vulnerable human beings and their families who are doing their very best to manage PTSD and still live meaningful lives. So I write this in the hope that someone, somewhere will have the power or influence to ask relevant decision makers: how can we change compensation systems to avoid hurting those who, prior to injury, protected our families and our communities?
About the Author: Veronique Moseley and her partner, Ross Beckley, run Behind The Seen – Emergency Services See What Others Don’t. Join the conversations about mental health and emergency services on Facebook.
Read Veronique’s other compelling article, First Responder Stress and the Family Blame Game.