Part 32: Critical Incidents

Over the summer, before fall classes began, one of the emergency health services faculty members at UMBC asked me to participate in a study he was conducting for his Ph.D.

Jeffrey Mitchell was a pioneer in the study of a form of post-traumatic stress called critical incident stress. Nearing completion of his doctorate in psychology at the time, Mitchell was gathering data on the prevalence and other characteristics of critical incident stress among EMTs and paramedics.

Mitchell is co-founder and president emeritus of the Ellicott City-based International Critical Incident Stress Foundation, which today helps first responders in crisis all around the world. But none of this existed back then; critical incident stress was not yet widely understood.

EMS crews, as well as police officers and firefighters, are often exposed to experiences that by definition are extraordinary – outside of the ordinary. A person may be suddenly immersed in an emotionally charged situation that shocks the sensibilities, and then just as suddenly it’s over. But like a bottle of soda that’s been shaken, all those pent-up feelings and rush of adrenalin have nowhere to go.

The stuff is too disturbing to talk about at home over dinner, and men aren’t accustomed to talking about their feelings at work. The unspoken rule was to shrug it off, choke it down, don’t shed tears.

Left unaddressed, critical incident stress can manifest itself in various ways: job burnout, alcohol and drug abuse, relationship problems and divorce, and suicide.

Mitchell and I sat in an empty classroom on the third floor of the Academic IV Building as he explained the subject matter and asked a series of questions.

He inquired about my job history and experiences, the types of organizations I worked in, and a raft of other questions.

“Do you own a motorcycle?” he asked.

I did until I moved to Baltimore, I said.

First responders often engage in risk-taking hobbies and activities, such as scuba diving, skydiving, and mountain climbing. Do you engage in anything like this?

No skydiving, no scuba, nothing like that.

“Skiing? Dirt bike riding?” he asked. “No risky activities?”

“Well, once I hopped a freight train from Memphis to New Orleans,” I said. “That was pretty stupid.”

Do you have trouble sleeping?

“Sometimes,” I said.

“Do you ever experience intrusive and disturbing thoughts or images?” Mitchell asked.

A series of nightmarish scenes rapidly flashed through my mind – mangled bodies, dead babies, splatters of blood and mutilated flesh, the cop asking me to check the car wreck victim’s pockets for a wallet…”But officer, he only has one pocket left.”

“Of course,” I sighed. “Who doesn’t?”

Mitchell asked a few more questions and then thanked me again for my participation in his project.

“That’s it?” I asked. “No cookie?”