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Pandemic Stress

Apr 22, 2020

On September 12, 2015, the Valley Fire exploded in Lake County, California. By the following morning, the fire had made a 12-mile run as it destroyed 2000 structures, burned four firefighters and killed five people. Two months later, at a fundraiser to help fire victims, several of my fellow firefighters who worked the fire that first night were invited on stage to receive a plaque of gratitude. Or so I thought. After I accepted the plaque, I walked backstage and read what was engraved: “Heroism Award, presented to Cal Fire Division Chief Linda Green.” Taken aback, I didn't know what to think about that word – hero.  

A few weeks later, I told my therapist about the event and casually mentioned that I was not a hero. I had just started working with her, so I couldn’t anticipate her response.  She spent the next 10 minutes explaining what a hero was and that my actions, that first day and night, were heroic. I didn't believe her and left her office still thinking, “I'm no hero.”

As her message sunk in over the following days, I realized I didn't really understand what a hero was. As I tend to do when I seek understanding, I started to do my own research. Certainly, there are the classic heroes from Beowulf to Harry Potter to Joan of Arc, the heroes of folklore and fables.  

Modern heroes are quite different, with good days and bad. They are average people doing their jobs and living their lives until a massive challenge shows up. They're overwhelmed in times of crisis; they don't know what the outcome is going to be – but they keep showing up.

Fast forward to 2020 and the COVID-19 pandemic.  We have doctors and nurses who keep showing up. They don't have all the answers. They don't know the best treatment options. Conspiracy theories and slanted media rule the airwaves. There's no vaccine, at least, not yet. However, these modern heroes keep showing up. They intubate the sickest patients, not knowing if they're ever going to get them off that ventilator, but they keep showing up.  

It is heart-wrenching, knowing that many people are going to die without family next to them. Some COVID-19 victims are being buried in pauper's graves, because there's no family to claim them. Yet these doctors and nurses keep showing up because, every now and then, they get a win when a patient recovers enough to leave the hospital.

Out on the street, paramedics and health clinic nurses, police officers and firefighters, grocery store clerks and homeless advocates alike, keep showing up. The men and women staffing the 911 call centers and the suicide hotlines show up. Long-haul truckers move essential supplies as if lives depend on those deliveries, because sometimes that’s true.

Here's the flip side of that sudden and forced heroism. There's a doctor out there somewhere who has internalized blame for what's going on. Or a nurse. A parent. A co-worker. They're thinking, “If I'd only been three seconds faster doing X, Y, or Z.”

“If only I hadn't gotten sick and had to take 14 days off to heal.”

“If only I had known just how contagious this bug was, that person wouldn’t have died.”

If only….

I had similar thoughts the morning after the Valley Fire, on which I was the Incident Commander that first day. As the sun rose the following morning, I could see clearly what destruction had been wrought, friend’s homes reduced to rubble, burned-out cars scattered along the highway. It occurred to me as I drove along that smoky roadway that I had somehow killed 100 people that night. Over the next several days, I second-guessed the evacuation orders I had given as reports of hundreds of missing people circulated through the media. I questioned the equipment orders I had placed; some of the first 40 engines I had ordered didn’t arrive until the following day. And like everyone else, I wondered where the hell those 50 mph winds had come from? The reasons changed, but my feelings did not.

By January 2016, I had moments when I felt like the Incredible Hulk. Mild-mannered one minute, rage-aholic the next, oftentimes over the most inconsequential issue. I arrived home from work one evening, and my sister had parked her car at an odd angle in the driveway, blocking my normal spot. By the time I walked into the kitchen, I was full of fury and unloaded verbally on both my husband and my sister.

A month later, I tried to write a check to pay the dentist, but every time I would sit down to write that check, my hands started shaking. A year would go by before I finally connected the dots and understood why I couldn't write that check. It was for $100, and my brain linked that number to the 100 fatalities I thought I had caused the previous year.

As the months passed, I was beginning to think I was going crazy. One day, life would be good. The next day I might as well have been in the pit of doom.  Finally, being diagnosed with post-traumatic stress disorder brought a short-lived wave of relief.

I bring this all up for a reason. For several reasons, actually. For all of those doctors, nurses, paramedics, firefighters, police officers, 911 dispatchers, grocery clerks, janitors, peer support teams, and yes, even the local politicians who are trying to get the right equipment into the right hands. They don’t have the luxury of time right now to process what is going on. They don’t have time right now to realize the effect that it’s having on their families. They don’t have time because there are real names and faces attached to each and every one of those COVID-19 statistics, just as the naysayers who believe it’s much ado about nothing have real names and faces and families too.

When the worst of this pandemic is over, when there's a vaccine, when life becomes whatever the next “normal” is, only then will our first responders and essential workers have time to process everything. Some people will tell them to “just get over it” and forget about all of that pain. Some people will laugh at their startled or muted behavior. Some people will tell them that they’re drinking too much. Supervisors will wonder why they are late – again. Some of those same people making extraordinary efforts today will be demoted or fired sometime in the next couple of years. There will be loud arguments, domestic violence, divorce, substance abuse, and yes, even suicide.

Not yet, though. All of those people so critical to fighting COVID-19 are still operational. They are doing the best they can under extraordinary circumstances, and it’s hard to truly appreciate that effort in the here and now. Eventually though, they will need to process their pain, and they will need to grieve, and heal.

Five years ago, my life turned upside down due to my post-traumatic stress injury. Thankfully, there was a system in place to catch me as I fell, and I had the support that I needed. My need to make a phone call, to ask for help, was not overpowered by the paranoia I was feeling. My suicidal ideation did not occur at the same time as my substance abuse. I was fortunate I survived.

In that light, the survival of all these first responders, these helpers, these healers, these champions of the common good, cannot be taken for granted. No doubt some of today’s incident commanders will suffer post-traumatic stress injuries. My hope is that they get to experience what’s on the other side of that horrific pain – it’s called post-traumatic growth, and it’s a beautiful thing.

These men and women, regardless of their job title, paid or volunteer, have earned every accolade and honor that may be bestowed upon them (or not) in the future. Reluctant though they may be to wear the title, they’re all heroes.

Even so, they’re not superheroes; they’re human. Let’s take care of them.

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