Helping local heroes
In the days after terrorist attacks reduced the World Trade Center buildings to rubble, a village began to sprout up amid the ash. Emergency personnel, firefighters, police and volunteers created a self-sustaining shantytown of trucks, tents and portable toilets. As long as there was work to be done, this was home. While recovery teams labored into the night searching for victims — often colleagues — volunteers worked just as hard to keep them fed, hydrated and rested.
“For every rescue worker there seems to be several volunteer service workers,” writes firefighter Dennis Smith in his memoir “Report from Ground Zero.” “One cannot walk forty feet in any direction within the twelve-block perimeter of Ground Zero without a volunteer offering water, soda or an array of energy bars.”
For a rescue worker absorbed with the task at hand, food and drink can be sufficient support. Later, however, emergency workers often need more — some counseling, someone to listen, a few moments of peace. Although they are trained to respond to difficult and dangerous situations, fire, police and emergency personnel are not always taught how to cope with their own emotional responses to traumatic events.
As Sept. 11 painfully showed, disasters can be devastating not only to victims and their families, but also to their rescuers. In addition to witnessing terrible events, emergency workers eventually must deal with severe emotional reactions to the events. The traumatic effects can sometimes last for years, emerging when least expected.
Most municipal governments have systems in place to provide emotional and logistical support to first responders. Cities and counties often have critical-incident stress-response teams — mental health professionals and members of peer responder groups — that are tapped when a crisis occurs. In addition, local governments make room for a network of volunteers — from organizations such as the Washington, D.C.-based American Red Cross and the Alexandria, Va.-based Salvation Army — to offer support. Major events such as terrorist attacks and wildfires often bring peer responders from miles away, who provide much-needed relief on the front lines as well as an understanding ear.
Although Sept. 11 added a new dimension to many governments’ emergency response plans, the general approach to supporting emergency responders remains the same: Give them what they know they need, and anticipate what they will need later.
Relying on the Red Cross
When a disaster occurs, many municipalities support their emergency responders by working in concert with one of the Red Cross’ 986 chapters located throughout the nation. In fiscal year 2001, the Red Cross responded to nearly 73,000 disasters, including fires, hurricanes, floods, explosions and transportation accidents.
“Our chapters develop, establish and maintain relationships with the emergency responders in their community,” says Gregory Smith, senior officer, external relations, for the Red Cross’ Chapter and Disaster Services department. “We provide [emergency responders] with the same services, usually meals or meal assistance to the individuals affected and to the emergency responders themselves. Another of our disaster response functions is mental health. A cadre of trained mental health professionals is available to respond to the [local] emergency responders, our own emergency responders, as well as victims.”
Within a month after the terrorist attacks, the New York City chapter of the Red Cross had set up three respite centers at Ground Zero. The centers offered rescue workers a wide range of amenities, including first aid, mental health services, massage therapy and chiropractic care, showers, computers with Internet access, televisions and lounge chairs. However, it was often difficult to get many police officers and firefighters to do more than grab a quick bite and leave.
“A lot of people don’t want to let down their defenses,” Red Cross volunteer Yael Saso said soon after the attacks. “Some don’t want to talk right now, especially those who have handled the bodies. However, they seem glad that somebody has asked how they are doing.”
Lessons from the heartland
Many cities recognize the fierce brotherhood that exists within each of the police, fire and emergency response professions. Often, counseling efforts fall on deaf ears unless they are coming from someone who also has “been there.”
Perhaps no other group in America could relate to the Sept. 11 attacks as much as the survivors and families of the 1995 bombing of the Murrah federal building in Oklahoma City. Because of their unique experience, New York City officials and the Red Cross agreed to allow Oklahoma City survivors to volunteer without going through the training required of others working at the site.
Two of the first volunteers were Diane Leonard and Ken Thompson, who both lost spouses in the Oklahoma City bombing. Speaking to families and rescue workers, they served in New York City’s Family Assistance Center and at Red Cross centers. Kathleen Treanor, who lost three family members in the Murrah blast, offered support to exhausted workers. “You can see the pain and weariness in their eyes, the horror of what they’ve seen,” she said at the time. “It breaks your heart, because you know what lies ahead for them.”
For members of the Oklahoma City Police Department who traveled to Ground Zero, the journey was particularly poignant. New York City had sent search and rescue teams to Oklahoma City in 1995. “Several people who had been here for us died in the World Trade Center,” says Jack Poe, chaplain of the Oklahoma City Police Department. “A lot of our people felt that it was good to go back to return the response.”
Beyond that, “it was important to get rescue people to talk to rescue people,” Poe adds. “There was some common ground when we were there.”
The Oklahoma City Police Department sits only six blocks from the Murrah building site, and Poe remembers how, on that unforgettable April morning, the blast knocked officers out of their chairs. Although the Washington, D.C.-based Federal Emergency Management Agency and other large agencies were soon involved, the municipal fire and police departments — as is usually the case — were the first to respond.
“When that bomb went off, it sent glass through that building like razor blades,” Poe recalls. “We had Vietnam veterans who said they had never seen carnage like that.”
Fortunately, the police department had already instituted a stress response program called CHAPPS — Cops Helping to Alleviate Police Problems. Begun in 1984, the program was designed to help officers deal with shootings or multiple-fatality accidents. It is a peer-driven program, in which both fellow officers and professional trauma specialists participate in what are called “critical incident stress debriefings.” After the bombing, the city received a federal grant to hold a four-day debriefing workshop for rescue workers. Debriefings include both individual counseling and group lectures, and the CHAPPS program also allows officers to bring in their spouses and children for counseling. Most important, the workshops urge officers to talk about what they have experienced, Poe says.
In the midst of responding to a disaster, the brain is focused primarily on survival, Poe says, yet responders still experience the event through all their senses, which can “imprint” it on their psyches.
“A sound or a smell gets associated with [the event], and later they smell it or they hear something, and they start crying,” Poe says. With the help of the debriefings, “they start to know what those triggers and anchors are.”
The debriefing workshops validate the traumatic experience for officers. They explain that if officers feel unexpectedly sad or start crying when they see, hear or smell something that triggers emotional memories — even if it is three or five years later — they are not going crazy, as many often feel, Poe explains.
But Poe cautions other local governments that there is sometimes a rush to debrief officers immediately after an event. At the end of a tough day or week, officers and other responders often are not yet ready to talk. If an event is still unfolding, officers do not want to lose objectivity while they are investigating a crime scene, Poe says. He adds that the term “debriefing” — although common among emergency responders — can turn people off.
Waiting a month or two after a traumatic event often will yield a more fruitful result, Poe says. The best combination of professionals to have on hand during a debriefing will consist of a facilitator, a peer support person, a chaplain and a trained mental health professional, he says.
Offering hometown support
For a metropolis like New York or Oklahoma City, coordinating and executing the response to a major disaster can be difficult. But for a rural county, responding to a large event can be overwhelming, drawing on every resource the county and its neighboring municipalities can summon. Yet that is exactly the situation Somerset County, Pa., faced twice in a single year.
Somerset County is a quiet domain of hills and farmland in southwest Pennsylvania. Yet the county’s tranquility was shattered on Sept. 11 when United Airlines Flight 93 — the fourth plane hijacked by terrorists — crashed near the tiny town of Shanksville. The Shanksville Volunteer Fire Company, which operates out of a simple metal-sided building, and Somerset County emergency personnel were the first on the scene.
The county experienced its next major emergency-response event in July 2002, when nine coal miners became trapped in a flooded mine shaft not far from Shanksville. During that three-day catastrophe, a multi-agency team of emergency workers found a “super drill” to open a shaft to the men, all of whom were rescued safely.
For both events, local emergency workers were on the scene first, but were quickly superseded by national or state agencies. For the Flight 93 crash, the county emergency services department was responsible for resource management during the initial recovery and evidence-gathering period, led by the Washington, D.C.-based Federal Bureau of Investigation (FBI). When the FBI finished its search, county officials helped to coordinate an all-volunteer, multi-agency investigation that gathered and secured residual evidence and human remains.
For nearly three weeks, Somerset County officials provided a host of resources for emergency responders, including portable toilets, emergency generators, lighting and fuel. They cleaned out hardware stores for miles, collecting different-colored recycling containers that were used to differentiate evidence.
“We had over 300 [trained] volunteers from western Pennsylvania,” explains Richard Lohr, director of Somerset County’s Department of Emergency Services. “For two days over a weekend, people worked in groups of ten, shoulder to shoulder, picking up any part of the plane that was left and flagging what they thought were body parts.”
Critical-incident stress-management teams, sent from a regional emergency response group covering southwest Pennsylvania, were on hand throughout the process, Lohr says, offering mental-health support that was often just disguised as friendliness. “You don’t realize what they’re doing, but they do it,” he says. The response team had created a village around the resource center, offering food and drink, massage therapists, counselors and rest areas, Lohr adds. “It was a place just to relieve the mental stress.”
Learning from the past
The next disaster for emergency workers who responded at events such as Shanksville, Ground Zero and Oklahoma City may produce a compounded emotional effect. In New York, for example, firefighters responded to the crash of American Airlines Flight 587 only two months after the terrorist attacks. The plane crashed in the Rockaway, Queens neighborhood, which is home to many firefighters and police officers.
“The Rockaway community was hit hard between the firefighters and civilians who were lost at the World Trade Center,” says Jimmy Trudden of the Broad Channel Volunteer Fire Department, which responded both at Ground Zero and in Rockaway. “For this to happen in this neighborhood, it’s tragic. I can’t put it into words.”
Local governments must understand what their emergency responders have witnessed in the past to provide adequate emotional support in the future. Last summer, for example, a raging wildfire in Glenwood Springs, Colo., brought back vivid memories of a devastating 1994 blaze. That fire, located on nearby Storm King Mountain, quickly overran firefighters, killing 14. Last summer, when fire raged on the same mountain, federal response agencies set up a resource center to help the firefighters work through any emotional issues.
Mike Piper, chief of the Glenwood Springs Fire Department, has witnessed the brutal effects of imprinting. “There are guys that work for me … who worked on that  fire,” Piper says. When last year’s fire began, “you could see that emotion come out, like ‘Oh no, not again,’” he says. “Smoke in the air evokes terrible memories of what happened in 1994, and to top it off, it was on the same mountain. The good news for us was that we had no one injured and no one killed, and people moved on.”
When Piper worked with another fire department, he remembers observing a traumatic response to a difficult call. “Sometimes something triggers an emotional response that they had from a previous catastrophic event,” Piper says. “We had a firefighter who had lost his daughter in the Oklahoma City bombing, and we were on a call to a vet clinic where there were a lot of dogs trapped, and the guy just broke down. We had to get him home and get him some help.”
Although it is far from universal, emergency responders who have witnessed a traumatic event that resulted in many deaths may be more likely to need greater psychological attention when confronted with similar stressful events, Piper says.
Like other municipalities, Glenwood Springs can call on a countywide critical-incident stress-management team when counseling is needed. After the 1994 Storm King fire, for instance, the team provided access to psychologists who worked with the firefighters individually, if the firefighters wanted it. “Basically, it’s just about having somebody to talk to,” Piper says. “Getting it out on the table gets it out of that imprinting phase. But people deal in their own ways and they don’t always participate.
“The old adage that fire, police and emergency room people are cold and callous is false,” Piper says. “We put up a big show, and we use humor to diffuse some of the horrors we see everyday. But this is why we hang around with other firefighters and police officers, because no one else understands.”
At the site of a disaster, Oklahoma City’s Poe says, “you need to just be there, get food and water to them, and get them to talk a little bit if they will. Let them deal with what they want to deal with. But at least you made contact.”
Kim A. O’Connell is a freelance writer based in Arlington, Va.