EMTs and paramedics have long been encouraged to suppress their feelings, but that culture of stoicism is changing. Here's how a Montco ambulance service is making it happen.
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It started out as a typical call for Emergency Medical Technician Brett Szabo.
"This gentleman was short of breath," Szabo said, "but he was awake and talking to us."
By the time Szabo had transported him to the hospital though, the patient had died.
"They declared him dead at the emergency department," Szabo said. "It took me really hard that I was having a conversation with someone one minute, and then the very next minute, they're gone from this Earth."
Szabo, who's worked as an EMT for over 12 years and is studying to become a paramedic, has responded to countless emergencies just like this. But for some reason, this one hit him especially hard.
"I broke down -- I truly did," Szabo said. "I stood in the ambulance bay and had myself a panic attack."
And Szabo isn't alone -- studies have found that Emergency Medical Services clinicians, which includes both EMTs and paramedics, face a higher risk of anxiety, depression, post-traumatic stress disorder, and suicide.
But recently, the ambulance service where Szabo works -- VMSC EMS in Lansdale, Pennsylvania -- has been working to address those challenges. Two years ago, VMSC launched a wellness program for its first responders to improve their physical and mental health.
The program is part of a growing shift in the national EMS community away from the stoicism of past years and toward a more open culture -- one that was evident as Szabo struggled to recover from his panic attack.
"I was surrounded by the people that understand what was going on," Szabo said of his coworkers. "They were able to talk with me. I was able to get out why I was feeling the way I did, why I felt like it was affecting me so much more this time around than for the hundreds of other calls that have played out this way."
When Neil Brady began his multi-decade career as a paramedic with the Philadelphia Fire Department in the 1970s, attitudes were different.
"Early in my career, I think the motto that we were told was to essentially forget the last call," Brady said. "You had a job to do, you treated the patient, and you were encouraged to leave it behind and move on."
That mindset has made it difficult for EMS workers struggling with their mental health to get help. John Scheetz, an advanced EMT with VMSC who's been working in the field for 30 years, says PTSD is a major problem in the industry.
"There's a lot of things that you see that aren't the best thing to see, but somebody's got to see it, and somebody's got to be there to deal with it," he said.
The problem is, Scheetz says, until recently, PTSD and mental health issues weren't something a lot of first responders talked openly about.
"Traditionally, it's just been very difficult to get any sort of help in this industry, right? Because there's this whole machismo to the industry of like, 'You're not allowed to cry, you're not allowed to have a problem, you're not allowed to be injured, or mentally deficient to do the job.' So the net result is you have a lot of people with a lot of problems that manifest in a lot of different ways. It's probably one of the reasons why substance abuse is such a big thing. You have a lot of providers that self-medicate, typically with alcohol."
But the culture has started to change -- at least in some places.
Brady, now VMSC's chief strategy officer, says there is greater openness today than when he was in the field.
"I think people are being encouraged to talk about those situations that affect them significantly that they're carrying with them to the next call and how to emotionally deal with that," Brady said. "I think it's extremely important to be able to clear your mind from that perspective."