Sunday, November 15, 2009

Bigger than you and me

I went to my third firefighter graduation at my department this week. This is the ceremony where the new recruit who have been training for the last 5 months are finally given their badges and released to start running calls. It's a big deal for those who are participating, because it's the realization of a goal that used to seem to far into the future, but what's less talked about at the time is what a big deal it is for the department.

My first graduation was as an outsider, when my brother was just joining up. I didn't know anybody there except him, and I didn't have any particular interest in firefighting at the time, but I remember being very moved by the ceremony. Afterwords my eyes were a little wet as I congratulated him and it was a silent drive back to college for me as I thought about what I'd seen.

My second was as a participant, a new firefighter excited to start doing stuff that mattered. After my brother pinned my badge on me, I could hardly wait to get out of the building and to start doing all those things I'd been training for all those months.
Now I've just been to my third, as a member of the department welcoming in the new blood. It's emotional, but in a different way: I'm proud to be part of such an organization, one that was important enough and meaningful enough to these outsiders that they decided to invest and sacrifice of themselves in order to be part of it as well.

And it will keep happening. Year after year, new men and women will take up the mantle as the most experienced ones start to step down. Logically it would seem that this adds up to a department that is of a constant status. Like a glass of water, some is poured out, some refilled, and you're always looking at basically the same thing. But this is inaccurate; any organization like this is actually cumulative. It's more like a river: individual drops of water travel through on a seemingly set course, but slowly the water as a whole continues to erode a new path for itself, shifting the banks and making it's way as a result of all the drops that has ever flowed through it.

The department will always have one chief, but it's current culture and structure is the result of layer upon layer of past leadership. We will always have new recruits, but our training and policies improve every year as a result of experiments on and suggestions from each group of orange-helmets that step up to do their part.

The continued existence and renewal of this entity, this fire district, is an ongoing validation of the fact that what we are doing here is worthwhile and necessary. The life of this department reaches far into the future, as long as there are people in this area to protect, and each firefighter through his participation gains for himself a piece of the immortality that such organizations by their nature preserve for their alumni.

It's bigger than you and me, and in a way this humbling realization makes you want to pay tribute to such a cause. But what to do? What do you give an entity with no emotion or consciousness? How do you show loyalty to an intangible abstraction? In my opinion, the only show of appreciation that has any lasting effect is the kind of participation that only makes us better.

Do nothing to detract from our reputation, but in all encounters give others reason to respect us. Teach the new generations of our ranks not just with the knowledge that you were taught, but also with the wisdom gained from your own mistakes, and let them start off knowing more than you did. Most importantly (for my department anyway), continue to provide a helping hand as long as there is even one person out there who needs it.

Monday, October 12, 2009

Pedagogy of the fire-ground

In a fire department, there are a lot of skills for new guys to learn. Fire suppression, apparatus operation, efficient communication, emergency medical care, vehicle extrication; the list goes on and on. One thing that I think should be placed higher on that list is pedagogy. If you're really great at vehicle extrication, you can make a difference when you're on the scene; if you're really great at TEACHING OTHER FIREFIGHTERS about vehicle extrication, then you make a difference every time one of the firefighters who learned something from you is cutting up a vehicle. The effects of a good teacher are like ripples that carry throughout a department as those who learn from the instructor teach others the way that they learned.

Let me give an example where we see three teaching styles on the same subject, and maybe it will be clear why this is such an important topic.

SCENE 1
Instructor: "don't forget this, it's important: when you are going to have the apparatus parked in one place for a while, engage the 'High Idle'".

Student: "Why is that? What does it do? Is it really important?"

Instructor: "What did I just say?"

Student: "When the apparatus is staying put for a while, engage the High Idle"

Instructor: "So what do you do when you're parking and you're going to leave the engine on?"

Student: "Engage the High Idle"

SCENE 2

Instructor: "don't forget this, it's important: when you are going to have the apparatus parked in one place for a while, engage the 'High Idle'".

Student: "Why is that? What does it do? Is it really important?"

Instructor: "That let's the engine generate more electricity so it's able to handle more things being on at once like warning equipment and panel lights, etc."

SCENE 3

Instructor: "don't forget this, it's important: when you are going to have the apparatus parked in one place for a while, engage the 'High Idle'".

Student: "Why is that? What does it do? Is it really important?"

Instructor: "well, what does your car do when it's idling?"

Student: "It's just running at a low speed"

Instructor: "And what does the term high-idle suggest?"

Student: "That it's running at a slightly higher than low speed?"

Instructor: "Good, that's right. Now, why would that be helpful?"

Student: "I don't know, I guess it's using more gas, that's actually BAD. Maybe it's maintenance related, do long periods of low idle damage the engine or something?"

Instructor: "Interesting thought, but no, you're thinking to specifically to the engine. What about all those blinking things on the apparatus?"

Student: "Warning lights?"

Instructor: "And what do they need in order to keep blinking?"

Student: "Electricity. I guess the high idle probably generates more electricity."

Instructor: "Right. All those lights take a toll on the battery, and if you leave it in low idle the load manager will eventually start switching lights off to conserve energy, which is a big deal if you're on a highway or something where you need all your warning equipment going."

Now let me give you a scenario: The student is now pumping the apparatus at a large vehicle fire, and the lights start to shut off one by one. High idle can't be engaged because it doesn't work when the apparatus is pumping. What will the student do about his quickly diminishing warning equipment? If he's been taught by the instructor in scene 1, probably nothing, as he won't even know there's a connection. This kind of teacher just bugs the hell out of me. Anytime someone answers a question with "Because I said so", they're doing the student a disservice. You can't think adaptively without having the necessary information to synthesize into a solution. If the student was taught by the instructor in scene 2, he'd probably suspect that he should be engaging high-idle, but he's been told he can't do that when pumping, so what should he do? After thinking about it, he'd probably have to resort to choosing which lights he needs least and manually shutting them down. He's been told what he needs to know, and he's doing the most he can with the information he has. But the student who learned from the instructor in scene 3 knows the mechanics of his truck. By having a long dialog on the subject, he's been forced to think it through and knows what the players in this equation are. He knows that the high-idle works by increasing the engine speed, thus generating more electricity. He also knows that pumping the apparatus involves using the engine to power the pump. Putting this information together, he'd probably figure out that all he has to do is gate down the water he's flowing out of the truck and throttle up the pump, causing the engine to work harder, and generating the extra electricity he needs.

Good firefighters aren't born, they're made. Let's recognize the great makers, and realize that within a department great teaching means better everything else.

Monday, September 14, 2009

Modern Emergency Medical Care

You know what I've found about being a firefighter? Fire's don't happen very often. Oh we get plenty of calls, but they're mostly made up of heart attacks, traumatic injuries, and breathing trouble.

That's why my department requires that every member obtain their EMT-B certification, and that's what I'm spending most of my time training for this fall.

At least, that's what I WILL be training for. A lot of the training we've been through so far in EMT class has centered more around just trying not to get sued. More than other jobs, being an emergency rescuer is fraught with opportunities for legal action against you. Driving an emergency vehical, you can easily get caught up in a car accident; there's a law suit for failure to use due regard. Caring for a patient may involve you having to make a split second decision that causes someone's condition to worsen; now there's some legal action regarding negligence. Maybe you drop a patient off at the hospital and the paperwork to transfer doesn't quite get completed properly. The ER's busy and the nurses don't check in on the patient for 15 minutes, by which time his situation has grown dire; now you're going to court for abandonment. I could give example after example, because I've heard hundreds of them; enough to scare me into almost not wanting to put myself in the position of having to care for someone because of the legal risk if something goes wrong.

What's different today about our society that means we sue at the drop of a hat? When did we become entitled to have nothing ever go wrong in our lives? After all, that's where this originates, right? Something bad has happened to me, I think someone else could have prevented it, so I'm going to sue for all kinds of damages because I shouldn't ever have to experience hardship or trouble in my life.

Don't get me wrong, I'm not speaking out against actual maliciousness or incompetence. If someone is driving 40 MPH over the speed limit to get to a call and strikes a pedestrian, that was negligent. If an ambulance worker shows up to a scene, decides he doesn't like the patient, and leaves him to die, that was abandonment. But the cautionary tales I've heard are nothing like that. They're all based around split-second decisions where a tough choice had to be made, and someone made it (right or wrong), and the end result was a lawsuit against the ambulance company, the fire department, and the responder personally.

It's a mess. Unfortunately, complaining about it on my blog won't change anything. I, along with every other emergency responder, have to continue in this field knowing that every action I take may have ramifications that could land me in court. We all have to function with a certain amount of cognitive dissonance in that we have two relationships with our patients; one as allies working for their well-being, and one as adversaries trying to cover our asses. I guess all I can say is "be careful out there".

Friday, August 14, 2009

Learning how to Learn

I am convinced that pride is the one thing that stands in the way of people achieving greatness.

Sounds silly doesn't it? After all, only those who are great would have reason to be proud, right?

Not exactly. Let me give you a few examples:

Recruit class, vehicle extrication practical; my crew is working with a Captain from the special operations division of the fire district. He sends me to retrieve a tool from the rescue squad on scene. When I return, he spends the next 5 minutes lecturing us on why we should be "moving with a purpose" at all times while staring directly into my eyes. The message was obvious; he felt like I wasn't moving quickly enough, and that it reflected some sort of attitude problem (like I didn't care about the tactic, or didn't have any respect for him or something like that). In truth, I didn't have an attitude problem just at the moment, but I didn't think I had been moving slowly the rest of my crew was witnessing him calling me out, so I was on the verge of developing one quickly.

My first vehicle fire, and it's in a different station's run box; I ride to the call with my younger brother (who's been doing this for a few years before me). The "fire" is really just a little smoke coming from the back axle of the vehicle. My brother tells me to go get the pressurized water can while he runs over to size it up. The engine from this station is different than the one at mine, and when I go to the compartment where it should be, I find that because of a different body design much of the equipment on this engine is stored in a different place. He yells over to ask what's taking so long, I tell him I don't know where the water can is, and as he rushes over and grabs it himself from another compartment he says in a frustrated voice "Exactly where it's SUPPOSED to be!". Words like "How the HELL am I supposed to know where anything is when the trucks are different!" fly through my head, but I stifle them.

Truck checks 2 weeks ago, at my home station; A week before the Sr. Firefighter at our station had admonished me for driving too slowly to a call a few miles down on the street that runs in front of our station. I stepped up my game and tried to put a little more speed on when driving to calls. Today the station captain is chastising me for driving too quickly and telling me to ease off on my adrenaline dump. In frustration, I want to say "Fine, that's the last time I drive, you can find someone else who's willing to freely spend their own time covering the station while the residents are out". I don't say it, of course.

A structure fire last week near my home; a good friend of mine who was my instructor in recruit class is first on the scene. It's a small fire, so it's quickly out. When I get inside, he tells me to go back out and get a scoop shovel from the engine to start carrying debris and ash out of the house. I set down the pike pole and radio I'm carrying and head outside to comply. On my way back in, I'm met at the garage door with a radio being thrust into my chest and a low growl saying "You need to hold onto your shit!". Having just had a fight with my wife over the phone not 30 minutes ago, my temper is already on edge, and I have to bite back the words I want to spit back in his face.

Each one of these scenarios has a common thread. I screwed up, and someone tried to correct me. Unfortunately, it doesn't always work. We all want to be good at what we do, and when someone points out our flaws, our pride is wounded. If you let it, that feeling of embarrassment and hurt can prevent you from becoming the capable, competent professional that we already want to think of ourselves as. It can, in fact, cause you to stubbornly continue doing things wrong just to prove to yourself that you weren't in the wrong to begin with. In every situation above, I wanted to lash out and tell them that I was doing fine and to lay off. The only problem is, I was wrong.

Everyone of the individuals above has been a firefighter for a long time, much longer than me. I probably wouldn't take advice from any of them when it comes to calculus, music, or software; but on the fireground, I'd pay attention to any one of them, even if it hurt my feelings just at the moment. Not moving quickly can mean someone dies before we can get them out; knowing where equipment is on different trucks is part of the job, and an important one; driving too fast can get you landed in court when you kill someone during an emergency response; and you need to keep your radio on you at all times because it's the only way the incident commander can get a-hold of you if there's an emergency. I know these things, but my actions indicated disregard for those truths, and my friends and brothers on the department were just trying to make me a better firefighter by pointing these things out. It's up to me to get past my desire to already be the best and take correction to heart.

Take pride in doing a job that helps people; but leave it at home while you're doing it.

Friday, July 17, 2009

Cross Country

I just got back from a 2-week vacation to California with my wife, where we visited some family. While out there, it was nice to relax after the long recruit class I finally completed last month, but I also wasn't completely away from the fire service. Every city has a fire station, and ever since I've become involved in the service I've tried to visit them wherever I travel. I try not to make a nuisance of myself, but if there are firefighters outside who don't seem busy, or if I can see them hanging out in a dayroom, I'll stop to introduce myself and ask about the station.

So while on vacation this time, I happened upon a small station in a residential area of San Mateo where the firefighters were outside washing a couple very-nice looking trucks. After stopping and talking to them a while, I found that this was a unique station in that both of the apparatus had a specialty, one being the US&R (Urban Search and Rescue) truck for the area, and the other being an engine specifically tasked with carrying all the specialty equipment needed for a RIC (rapid intervention crew). I took a video of them both with my iPhone and have posted it below if you're interested.

I guess the really cool thing is how being part of my local fire department makes me also part of a world-wide community. These guys didn't know me, didn't have any obligation towards me, but took time out of their shift to show me around their apparatus and answer all the questions that I naturally had for them as a member of a more rural department. One of them was even willing to give me one of his personal duty shirts from the department to contribute to my brother's collection. It's the sort of instant friendliness that can only come out of a knowledge of similar experiences, and it's one that I am truly glad to have become a recipient of.

video

Sunday, June 14, 2009

Fire and Rain

It's been almost a week since my very first structure fire. I guess I've had a hard time sitting down to start writing about it. For days, I had been hoping for that first fire. Every time my pager went off, I was praying to hear some extra tightness in the dispatcher's voice as the words "structure fire" came over the radio. A week ago, it finally happened. But it wasn't exactly what I had in mind.

I was in bed, early in the morning, when the tones dropped. The first words to come over the radio were "commercial structure fire", and I was in my vehicle before they were even able to say anything else. My adrenaline and excitement were almost overwhelming. It was only just as I was reaching the highway that we got any further information from the dispatcher. Someone hadn't made it out yet. My excitement turned to dread, and although as personal vehicles we have no right to break traffic laws (preventing me from speeding), my fingers began to clutch the steering wheel even tighter than they had when I was merely suffering from adrenaline.

The first units on the scene gave a size up indicating that the house was already significantly involved in the fire. Still no sign of the man inside. All anyone knew was that he should be somewhere in the back right corner of the house. In the sky ahead of me, I could see the pillar of smoke rising up into the clouds. Although this was my first non-training fire, I knew enough to realize just how serious the fire must be given that huge visual indicator.

By the time I arrived, the whole of the House was mostly a wall of flames. I knew roughly what the odds were of someone still being alive in a situation like that, but I didn't want to admit that to myself. The crew I was assigned to was given the task of going in the back door to find this man. Reading the faces of my crewmates, I knew that this was probably a body recovery operation and not a rescue, but I didn't want to admit that to myself either. The flames were too intense for us to make a good entry, though, and eventually the roof came in. At the same time another crew of firefighters was cutting a hole in the wall of the house where they expected the man to be. Given the condition of what was left of the building, I was now certain of the outcome. But it wasn't until the hole was open and I saw the body that any real emotion hit me.

One of the division chiefs (the one who ran my training class) was standing by asking us to use the hose line to protect the body from the still raging flames, hoping to prevent any further damage for the sake of the family. I tried to focus on directing my water streamed towards hotspots in the room, but my mind was elsewhere. why wasn't he able to get out? why did it take so long to report the fire? How much fear must he have gone through, waking up in a blaze like that? how long was he conscious enough to experience it? Could we have saved him if we had arrived five minutes earlier? Did he feel any pain?

The man's charred remains held no answers for me. The gear on my body and the hose line in my hand, weapons to combat an enemy who had already won. I remembered bitterly how I had wanted so badly to get to fight a fire. well, I guess I got exactly what I wanted. As silly as it was, I felt a deep guilt for ever wishing for such a disaster to come into somebody's life, as though I might have prevented this incident by not desiring it so badly.

For the next couple hours we doused the entire building in water and foam, all to prevent it from reigniting. During that time I tried my best to focus on the task at hand and not to glance over at that corner where I knew the corpse lay. I kept a mantra going in my head, steeling myself for the time that I knew would be ahead when we would have to move the body from the building.

Finally the moment came, and other firefighters moved vehicles and strung up tarps to prevent the bystanders from witnessing what was about to occur. Me, I wanted to put my hands on the victim. I wanted to be the one to shoulder the unpleasant task of extricating the body from the smoldering remains of the house. As some sort of a self imposed penance, I wanted to force myself to deal with the consequences of the fire that I had been hoping for. And I did. The man, and a dog that had been trapped in the room with him, were both moved with as much dignity as possible into the vehicle that would carry them away.

I will be happy if I never have to do that again.

But with the pain and frustration and guilt came another emotion: relief. Ever since I started training to become a firefighter, my biggest worry had been that when I finally came face to face with gruesome and unjust death I would be unable to cope and unfit to perform my duties. I can think of very few scenarios that are worse in my mind than a fatality resulting from being trapped in a fire. yet there I was, witnessing one of the worst (I hope) calls I have or will ever have to deal with, and I was okay. Not happy, not calm, certainly not dispassionate, but able to perform efficiently the tasks assigned to me. Although I do not believe any amount of experience will stop me from feeling some sympathy for victims and patients, I know now that I can handle it. In the midst of my surprise and sadness at the loss of somebody's father I am relieved just to know that I can do my job.

I think I've had enough excitement for this week.

Tuesday, June 9, 2009

Getting Real

I've had a lot of fun playing hero. The gear was cool, the calls were fun, but last night I got a perspective adjustment that hit me like a 2x4 between the eyes.

We had just gotten back from a gas odor call. Although the emergency itself was not of any particular interest, it was the first time I've actually gotten to ride to a call on the fire truck. Now THAT is a cool experience. Driving fast, sirens blaring, people making way for you on the road; not gonna lie, that's fun. So we made sure everything was safe while the utility company sent a truck out to fix the gas line, no big deal.

Just as we're getting back off the truck in the station, the tones go off again. Everybody smiles, excited that the night is turning out to be so lively. We all pile back into the engine as we listen for the dispatch.

"Engine 801, engine 1408, motorcycle accident..."

My smile drops. This could turn out to be a little more intense than I'd expected. My brother is driving the engine, and I can feel our speed increase a little as further information comes over the radio. It doesn't sound good. One motorcycle, ran into a guardrail, victim is not moving.

I start rehearsing in my head every thing that will need to happen once we arrived at the scene. We'll need the medical pack and the backboard for sure. I pull my latex gloves on in preparation, half anxious to help, half hoping someone else will take care of the victim so that I don't have to.

No time to think about it though. The engine stops and we all jump out, each grabbing the equipment we were assigned. I throw the backboard off the engine over my shoulder and immediately start striding towards the cluster of people I can see already pulling the victim back onto the roadway. Secretly I don't want to look; I've never seen any trauma before, and honestly, I'm scared of how I might react. Will I get sick? Will I just freeze? But this is what I signed up for, and I know it, so I try to stay focused on what I need to do instead of processing what I'm seeing.

I throw the backboard on the ground and start tearing off the straps. In theory, I know what is supposed to happen next; we will put this guy on a backboard and load him into the ambulance. This isn't the same as working with a dummy though; the weight of his limbs is eerily familiar. Exactly what my leg would feel like if I lifted it with my arm. Just by touch, I can tell this is a real human. And he is dying.

The injuries are extensive, and the odds don't look good, but we start CPR in a desperate attempt to save him. Now, I'm well trained in CPR; we went through all the mechanics and techniques during recruit class. But it's just not the same on a human. I don't think I ever realized just how fragile our bodies really are.

I can feel my companions working around me. Dressing wounds, clearing clothing, a well oiled machine working at a feverish pace. I don't want to think about it. I just keep my eyes on my hands, pumping his chest, trying to keep enough blood moving to save him. I know if I think too hard about what I'm looking at, it will be too much. I'll see the damage done to him and to think "what would that feel like?". But speculation is not a luxury I can afford at the moment.

The medics call for everybody to clear the body for a second so they can check his vitals. I sit back on my knees, hands in the air to show 'I'm clear'; and that's when the feeling really hits me. This guy is not going to make it. Eyes vacant, skin pale, he stares blankly at the sky. The medics glanced forlornly at the paper printing out of their machine. "One more round, and then we'll call it." Frustrated and a little shocked, I start compressing the chest again with renewed vigor, somehow convincing myself that if we were to just try hard enough we might make a difference.

Just believing something doesn't make it so.

"Thank you everyone", the medic says, "that was a really good attempt".

I feel sick.

As I walk back to the engine (slowly now, all urgency gone), I try to figure out how I feel about the whole situation. Somebody is dead, and in a very traumatic way. Do I feel bad about it? Yeah, I guess so. I'm a little stunned for sure, but somehow not "devastated" the way it seems like I should be. It's a strange bit of cognitive dissonance. It's almost like I WANT to feel bad, but I can't summon enough emotion and feel any amount of depression or loss. Just a vague sense of malaise and failed effort. What's wrong with me? This is somebody's son, someone's friend, who is never coming back. Why can't I feel for them the way I should?

And yet, I feel terrible. Terrible for not being able to make a difference. For not being able to save a life, and for not feeling bad enough about the loss of a fellow human being.

I don't know what to think. So I don't.

My brother pulls me aside later and asks how I'm doing. I answer him honestly, I'm doing better than I thought I would be, but somehow I'm unsatisfied. He had some advice I hope I can take heart: "This is not your fault. You didn't cause of the crash. You didn't cause his injuries. You came here to help, and you can't win them all. Be happy about the ones you CAN save, but don't get hung up on the ones you can't."

He's right. The amount of death and loss that firefighters encounter is staggering. Empathy for one's fellow man is an admirable and virtuous trait, but it comes at a cost. If your friend were to lose a parent, you could cope. You could bear a part of their pain and sadness. Maybe even the suffering of a few friends simultaneously. But if an emergency worker were to take on the guilt, pain, loss, and sorrow of every loss of life they witnessed, the burden would be too great for any one soul to bear.

So I just don't think about it. Well, that's a lie. I try not to think about it. The first fatality I ever witnessed will probably stick in my memory for the rest of my life. But no amount of sorrow or depression will save his life or heal any of the family members he left behind. I've done everything I can for him, God rest his soul, and now the only thing left to do is focus on those will need help in the future.

That's life.