Episode Transcript
[00:00:00] Speaker A: Foreign.
[00:00:11] Speaker B: Welcome to the Comeback with Boomerang Healthcare, your podcast for relief, recovery and restoration. I'm Dr. Peter Abachi.
[00:00:22] Speaker C: And I'm Dr. Sarah Guzet. As doctors, we know healing isn't just about treatment and it's about having the right tools, mindset and support to move forward.
[00:00:32] Speaker B: You can have pain, you might be injured or even hurting on the inside, but with all that you got going on, you can still have a really great life.
And that is what we're here for. This is the Comeback. Let's get started.
Well, we are really excited today to talk about, talk about first responders and we have a great guest, Scott Sorenson, who's joining us today.
Scott is a retired fire captain and founder of Cardinal Point Advisors and Mission Critical Consulting. Welcome, Scott.
[00:01:10] Speaker A: Thank you.
Great pleasure talking to you guys.
[00:01:14] Speaker B: You know, when we think of first responders, you know, we think of hero, heroic activities, we think of sacrifice, we think of giving. You know, we think of life champions really. And um, and at the same time we know the, the challenges, the struggles, the toll it takes physically, mentally, maybe even spiritually. There's so much that we want to talk about today and, and this is going to be the first of hopefully many episodes that we do focusing on, on first responders which play such an important role in our society. To our health, to our, our well being, to our families, our children, our government, everything that you can think of.
So thanks for being here today, Scott.
[00:02:00] Speaker A: Truly my pleasure. Thank you for having me.
[00:02:02] Speaker C: We are so excited to have you here with us and wondering if we can start off by just having you tell us a little bit about yourself and about your career as a firefighter.
[00:02:11] Speaker A: Yeah, you bet.
So I've always been interested in being a firefighter. My inspiration when I was a very young was the old TV show Emergency.
And I saw the firefighter paramedics at Station 51 doing their job. And I thought that that was just the right thing for me.
When I was 21, I worked up enough courage to walk down to the local volunteer fire station at Orange County Fire Department in Sunset beach and asked if I could join. And they took me. And so as I was getting the training and getting ready to actually respond on calls, I was just enjoying every bit of it. And the very first call I went on, I'll remember this distinctly, car crash on Pacific coast highway in Sunset Beach. And coming back to the station after that, I said, this is what I'm going to do for a career. And I literally quit my job and just jumped into full time Fire science, EMT school, paramedic school, and then got hired as firefighter paramedic.
[00:03:12] Speaker B: What was the kind of, the training part, the physical side of it, you know, what was that like?
[00:03:18] Speaker A: Yeah, so when you're, when you're going through a fire academy, they're teaching you all the skills and so you need to know about pulling hose and doing firefighting operations, putting water on the fire.
There's a lot of techniques that you utilize in order to do that.
You're throwing ladders, a lot of techniques that you need to use to throw a ladder properly and safely use it.
Your forcible entry. We have EMS skills and really you're using the fire apparatus to the best of its ability and know how to use all of that and all the tools that come along with it, along with your policies and procedures for how you do it. So usually every one of these things that you use, you know, breathing apparatus for one, you have a step by step procedure on how to do it. And so in an academy, they'll teach you the steps to do that and then you practice it. And then once you get your procedures down right, and you can pull hose well and throw ladders well and throw your air pack on and, and use tools, then they start putting you through scenarios. And now you're doing it kind of in a live simulated situation.
So then they can see how you're doing now under increasing pressure.
Right. It's one thing to be able to put on an air pack quickly when you're practicing. It's another thing when you're going to a fire and you need to get all your procedures and make sure that you have your protective gear on and your hood and your collars are up and, and that you're able to do these things perfectly well under pressure in an emergency situation. And you train for that in the academy.
[00:05:04] Speaker B: How long does that take?
[00:05:06] Speaker A: So it depends on what kind of academy you're going through.
So we had, when I first started, this was a Firefighter 1 Academy at Rancho Santiago College.
It was a, I believe, about a six month program for the manipulative part. They had two years of prerequisite classes. And then you go through the actual academy and, and if I remember correctly, that was about six months.
[00:05:33] Speaker C: I'm curious what a typical shift looks like for a firefighter. And you know, over time, how does that take a toll on your mind or on your body?
[00:05:43] Speaker A: Yeah, so a typical shift would be it's something that a lot of people don't realize. It's a work day Right. And so even though our work consists of going to emergency calls, we also have semi structured day typically. And so what we'll do is we'll come in and the very first thing we do is we make sure that our equipment's working perfectly. There's just no worse feeling than rolling on an emergency call right when you get into work and something's missing or something's not operating correctly. And so the very first thing we do is we check. We do a complete checkout on all of our equipment. So the engineer is going through the apparatus, doing a full mechanical check, doing lights, brakes, engine checks, pump checks, and making sure the apparatus is in perfect shape first thing in the morning. And then they're also doing any equipment inventory on the rig, making sure that we have everything the firefighter has their responsibilities for that morning check. So they're going to be checking the EMS gear, making sure that the defibrillator works, the EMS equipment is there, and that we know that when we hit that first call, we're going to have everything not only on the rig, but it's working in good operational order. From there, we were tip. We're always going to be doing training.
So we have training scheduled every day. To some extent, it's either gonna be company training that we're gonna do amongst ourselves, or we might be scheduled for a class where we'll go to the training center and meet up with other companies to do larger training such as a hazmat refresher, fire prevention refresher, EMS refresher, things like that. And so knowing that we have a full rig, checkoffs, we have training, we always try to get a workout in and we try to schedule that.
We put a time down, usually first thing in the morning and then just see how it goes with calls.
And then we always need to schedule lunch. And that's our, that's our sacred hour right there is.
[00:07:38] Speaker B: I want to know about the firefighter workout.
[00:07:40] Speaker A: Yeah, right.
[00:07:41] Speaker B: What do you guys, what do you guys do? Come on, share.
[00:07:44] Speaker A: So, so physical fitness is actually an important part of the job.
It's a very physical job. It's demanding. It's, it's, it can really beat up your body. And so the more fit you are and durable that you are, the better, longer you're going to get in the, in the career. And so at a firehouse, you're typically going to see all sorts of workout equipment. You're going to see weights and cardio and depending on the department, the health and wellness programs that they have developed, you'll see, you know, different varieties of physical fitness equipment available.
[00:08:20] Speaker B: You know, it's interesting. You were talking about the process that you go through of checking all the equipment. My in. In my training and my background. Before I became a pain specialist, I started off doing an anesthesia residency. And that's the first thing you do when you go in the room is you'd go through a whole system check of all your equipment and circuits and everything to. To make sure everything is ready because, you know, you don't want to start putting somebody to sleep. And. And even though I never really went into private practice as an anesthesiologist, I still was, well, you know, ingrained on how to do that in my. In my training.
And to this day, it's been decades, you know, since I've actually done any operating room anesthesia. But to this day, I still have nightmares every once in a while that I'm in the room and there's something wrong with my setup or my circuit and all. All heck is happening, and everybody else in the room is oblivious to it. They're just kind of, you know, joking around and stuff, and. And I'm pan. And then I wake up.
And I think that the word that anesthesiologists use is vigilance. And I think I just. I heard that when you were describing your process with what you do and such a strong connection, because it's really. It's that process of vigilance is how you keep people safe and alive and protect all these hundreds and thousands of people that you guys, you know, take care of every day. So it's great.
[00:09:45] Speaker A: Yeah. There's certainly no worse feeling than getting on an emergency scene and reaching for something, and it's not there.
Mistakes happen. That usually happens. Your first call out of the gate. You know, you walk in the fire station at 7, 7:15 in the morning.
Crew's going off. They just got beat up all night last night, and somebody forgot to put in a nasal cannula or oxygen mask. And we haven't even had a chance to check off the rig yet.
Mistakes happen, and we pull a call first thing in the morning before we even get a chance to do our checkoffs, and then, oh, shoot, we're missing something.
Doesn't happen very often, but I can certainly relate to that feeling of dread when you're looking around and you can't find what you're looking for.
[00:10:37] Speaker C: Curious about how long a typical shift is and how do individuals find time, if they do, to your point, to even catch their breath. Or take care of their body.
[00:10:49] Speaker A: Yeah. So on the firefighting side, most departments have gone over to a 48, 96 schedule, which means you work 48 hours in a row and then you get four days off. So you'll come in in the morning on a, let's say a Monday morning. If your shift starts at 8. There's a saying in the fire service. If you're on, if you show up on time, you're late. So most people are showing up between 7, 7:20 for their 8am shift.
They'll relieve the offgoing crew, get a pass along and then, and then your workday starts. And so that's where we're starting our checkoffs, going through our morning routine and you go through that first 24 hour period. You spend the night at the firehouse. There's dorms at the firehouse, so we have beds there, showers, we, it's, it's just like another home.
And then we'll work the second shift and then when the morning comes, at the end of your second shift, we, there's a crew waiting for you and then you hop in your car and you go home.
[00:11:50] Speaker B: One of the things that I think about when I think of the fire station or the crew or when I see them, you know, on the fire truck drive, you know, driving down the street, it's very much a team, right. Your, your success with how you perform individually is so connected to how you work as a team. And maybe you could say a little bit about the, the team dynamics of, of first responders and being a firefighter.
[00:12:16] Speaker A: Yeah, you bet. There's tremendous amount of team dynamic. And it's funny, there's, I see a direct parallel to what I, what I like to do for fun, which is sailboat racing. When you're sailboat racing or when you're firefighting, you have an individual responsibility, right. And so in firefighting, let's say we're going to be doing an initial attack on a structure fire and you're the first in unit, so you're being the ones that are actually going to go into the burning building. When you pull up, the captain has a job, the engineer has a job and the firefighter has a job. And so when you're trained to your individual job and responsibilities, but then you are working together to also get that done. So when everybody's doing their individual jobs, you know, the captain is walking around the building doing a size up, determining what, what the problem is, calling for resources, looking out for hazards. The engineer is preparing the engine to get water into the hoses, calculating their hydraulic pressures and planning a water supply, the firefighters pulling hose and preparing to make entry. And if we need to make forcible entry, then that's going to be another problem.
But when everybody's ever doing anything individually, collectively we're solving the problem.
Right. And so it's a really wonderful scene to just observe. Right. And it might look to the untrained eye, it might look like people are just running around, but in reality, you know, you're performing the tasks that you've been trained on since the academy. So, so if you're on the engine company, you're using your SCBA skills, you know, that you've learned from the very first day, your hose pulling skills. If you're on the truck company, you might be throwing a ladder, using your skills to walk on the supporting beams, you know, and so you're not over plywood and potentially falling through a roof if it's burned out using chainsaw safely, you know, on a slippery, steep, wet roof. And so all of these things that you've trained on, you're now performing out in the field under pressure with a that are time sensitive and you're utilizing it as part of a team under a command and control structure. Right. And so we have an incident command system that actually directs this operation. So we'll have one person in charge. Typically that would be a battalion chief on a multi unit response and then that battalion chief is giving orders to captains of apparatus and then the captains are running their crews to perform those tasks in priority that the battalion chief is asking for.
[00:14:54] Speaker C: That definitely sounds very well orchestrated. And I imagine when you're on a call, there's no time to debate who's going to do what. And so it sounds like there's this really strong sense of, you know, camaraderie and responsibility.
And I'm also curious if that also lends to the social support because so much of what you do is also emotionally and psychologically stressful. And I'm curious what that's like in the firehouse.
[00:15:18] Speaker A: Social support and psychological stress. It's something that we can talk about a lot more now than we did before when I was getting into the fire service.
So when I first started in the fire service in the late 80s, early 90s, the experienced firefighters were a lot of them were Vietnam vets and they came from that culture. Not that they were necessarily all in Vietnam, but the fire service being a paramilitary organization, we carried a lot of culture through that and especially through those who had served as veterans on the psychological side, what does that mean? That means suck it up. That showing an injury or some sort of dysregulation from having had a traumatic experience out in the field that just wasn't really culturally acceptable back in the day. And we had a big shift in that and a big national conversation in both law enforcement and firefighting when suicide became the number one cause of death for firefighters and law enforcement. And then that was only surpassed in law enforcement by Covid. And so when that happened, that really, that really said a lot to the community.
And there's been a tremendous, tremendous improvement on how we address mental health. And we've got a long ways to go, no doubt about it. But what we've done is we've really shifted gears to recognize how important mental health is as just as physical health is. And how we deal with it is still, it's still dependent on departments culture and, and even down to a cruise culture, how close you are to your crew. Right. There are some crews that you work with for years, your friends on and off duty, you might confide things or have conversations that you know are more open. There's crews where you know, it's, it's overtime person of the day. You haven't developed that kind of relationship or maybe people that you just don't have that connection with and you're not going to be able to have that same kind of conversation. So it's really, it's really variable.
[00:17:28] Speaker B: Maybe you could tell the listeners what are some typical services that are available now, maybe that weren't available before that a firefighter who's feeling pretty stressed about work can, can get access to.
[00:17:42] Speaker A: So there's a number of different services that you could do. So if you want did not want the work involvement, you could try private medical insurance.
And that's an aspect that some people utilize either private medical insurance to access some personal counseling.
A lot of times if they feel that this is going to be maybe going further, and especially if this injury or situation could lead to time off. Right. The trauma and the stress is so much that when they come into work they're feeling triggered, they're feeling anxiety, their brain is just not engaged or they're making mistakes.
These might be indicators where they need a little time off and then some targeted treatment.
And then when that happens, you're typically going to have to jump in the workers comp system. And that is a whole new animal. It's the workers comp medical system is completely different than your private medical system. And then we have a kind of A middle road.
And a middle road is you want to acknowledge that you have some work related stuff going on. You may not necessarily need time off or medical support. And most employers have an EAP, an Employee Assistance Program.
What we see in the EAPs is a tremendous variety of capabilities. On the lower side, you might get three visits a year with a therapist who may or may not be trauma informed.
[00:19:16] Speaker B: That doesn't sound like very much.
[00:19:18] Speaker A: Yeah, they may or may not be trained in a lot of the effective modalities such as emdr, brain spotting or neurofeedback. And so we find that in most of the EAPs, they can't get the actual therapeutic treatment that they could. You know, that's really going to fix the problem. They're either not getting to the right person or they're not getting enough visits. There's other EAPs that are more focused towards first responders. They understand that you're going to typically need more visits first of all. And then you also need to be with a culturally competent therapist, somebody who understands your work schedule. You know, their, their job's not hitting the floor when you, when you're explaining your work schedule or even your working conditions and the things that, that we experience out in the field and that, that type of therapist, you know, can really understand what we're going through and then also have the tools in their toolbox to be able to do the work and, and process the trauma and, and heal.
[00:20:24] Speaker C: We often see a really important connection between untreated trauma and chronic pain. Did you see any of that or did you or any of your colleagues experience that?
[00:20:34] Speaker A: I think I'm the poster boy for that. I laugh sometimes when, I laugh to myself sometimes when I talk to clients and they're talking about their injuries and as we're working to help them get through workers comp. Because most of the time I've had that injury, I've broken all sorts of things, torn all sorts of things.
[00:20:52] Speaker B: Head, head to toe. Huh.
[00:20:54] Speaker A: Major back injury. It's, it's hilarious. Whenever I go to the doctor and fill out a introductory chart, it's like it's all marked, you know, and then. Plus I've had the, the psychological injury as well. I've had ptsd. Know what it's like to go through that, having, you know, many of the signs and symptoms.
[00:21:10] Speaker B: How did you first come to realize that you were having ptsd? What, what sort of tipped you off?
[00:21:18] Speaker A: So I think that there were, there were actually two separate incidents in my career. Two, two separate times. I should Say one time, the first time was we were on a car fire. And just a regular old car fire that's burning up, no big deal.
And I had, I was the firefighter at the time. And so all the windows were blown out on this car. And I start putting the fire out on the driver's side through the windshield and then through the driver's window and around the back. And now I'm on the passenger side and I'm trying to get under the dash and I can't see anything. It's just all smoke and steam. And it was like, it was like straight out of an Indiana Jones movie. It was like right when the smoke and steam cleared, there was a burned out body face like right in front of my mask.
Scared the out of me. So, you know, it was just, it was something I wasn't expecting. If it was something you're expecting and kind of planning on, you know, you can prepare yourself. But it was the startling of that. Right? So, okay, so we shift gears and now that's a different situation. Right. But I noticed there was an issue on my next car fire. And the funny thing is this car fire was a little bit of smoke coming out of the dash. We're in a parking lot at five in the afternoon. It's, it's bright, I can see everything.
And I would not go near that car. I was on the passenger side and I would straight stream it from the back. But I wasn't going in there, even though I saw that there were no bodies in there.
And so I'm like, okay, that's, that's unusual.
And so I talked to my captain and said, hey, listen, something's just off with me.
Do we have any resources? And so he activated our peer support. I talked to one of our captains on peer support. He gave me a little plan to work on. I did that. Everything was great.
So that was my first introduction to this about what can happen to your mind even though your eyes are seeing something different.
Right. And how that affects your body. The second time, which is really kind of the most, I would say, comprehensive part of an injury and treatment was I was on a train accident at Santa Clara station where a person had brought her child down and laid on the tracks as the train came in.
So as a result of that call, I had some ptsd, but I didn't know it, and I didn't know it for a long time. And so that actually sat with me for years and years and years and years and years.
And then over time I started to develop Some symptoms.
My sleep was really terrible. In fact, got to the point where I just thought it was normal. Like everybody wakes up at 2 in the morning.
Every 2 in the morning, I'm waking up.
I was starting to lose joy in things that I love to do.
I started to drink more.
I started to be more irritable, especially around kids when it was completely unnecessary.
And it was actually my partner at the time who pointed that out and just said, hey, listen, you know, you've had a little bit of a change, and I think it's a good idea if you were going to talk to somebody.
And so I did. And fortunately, our department had a contract with a great therapist who specializes in first responders, and we can just walk in. And so I did, I got evaluated. I was diagnosed with ptsd.
And then we started going through the, the counseling portion, which took a few months before. We worked up to emdr, and then we got up to EMDR day and we started going through not only this call, which was number one, but then number two and number three. And what was spectacular, and I just couldn't believe it, was that talking about the number one call, that train accident that had been there for 15 years, it was still 100% emotional as it, as it would have been that day. Right.
That's the first time we went through the emdr, and then we took a break. Second time we went through it, it was about 60% as emotional. We took a break and it was about 20% as emotional. And the fourth time I could talk to you about that call, like I'm talking to you now, where previously I would just break down. And so it really was an amazing demonstration of the treatments that are available and how the really good clinicians utilize those treatments to heal trauma, which really, when I explain this to my clients, so, you know, when people are injured, I get physical injuries and psychological injuries.
The, the way I describe it is it's just like a physical injury.
It's just a different part of your body.
And so the clinic, you know, the, the clinician needs to get in there and do what they do to process the trauma. It takes time. It's just like if you had a bad knee injury and you're going to go to physical thera.
You know, you're going to physical therapy. You're. It's painful, it takes time. There's no magic bullet, there's no switch. They're just going to flip and make things better. But when you do the work and you have good expectations, you know, good, reasonable expectations, on how this works. Know that it's going to take some time, but put some trust in the process, Put trust in the people who are there, who are these skilled professionals. You should expect to see healing, you should expect to feel better, you should expect to get back to your normal self. And so this is where I've become really interested in what you guys do.
You know, it's, you know, Dr. Bachi treats physical injuries, you know, through his, through your specialty and your practice, you know, and Dr. Gozay, you know, you treat the mental trauma and as you alluded to before, there's a connection, right? And so, you know, I've had the physical trauma, I've had the mental trauma.
And then the question is, and it's something that I have never been able to articulate is what is that connection? And if I were to maybe do more work on the psychological side, how would that help me on the physical side?
[00:27:36] Speaker C: Fantastic question.
So, you know, in our work, both for Dr. Abachi and myself, we study and we apply the mind, body connection, connection to our patients all the time. We know that pain is not just a physical experience, it's also a psychological one. And kind of to your point of what you said earlier about, you know, you started to see some changes and they slowly became your new normal, right? The waking up at 2am, the being short, I bet you it was so gradual you didn't even notice it at first. And I'm glad that you were able to, right, hear somebody else tell it to you and be able to hear that and be like you might be onto something. And when it comes to trauma, for example, PTSD often has a delayed onset and it's not always from a single event. You were able to identify a major event, but while you were doing the work, you identified several other ones that can add up and kind of give this chronic experience because your body and your mind is paying attention to everything that you experience and it's keeping track and it doesn't forget.
And so just like the second time you walked up to a car when it had a fire, your body remembered and was like, no, we're going to be more cautious this time. We had a really bad experience last time and so now we're extra guarded and hypervigilant and we might even avoid it. And I'm so glad to hear that you were able to talk about that and go get some help. But I think it's so important to kind of bring back of what you're going through psychologically has a physical impact. And vice versa. Individuals who have depression, for example, and don't even have a physical injury will still report high levels of headaches and backaches and GI pain. It has a physical experience.
Both of those are being processed by your brain. Your brain is in charge of not just physical sensations, but also psychological ones.
[00:29:21] Speaker A: Many of my first responders that I work with who have stress injuries, a lot of times they report cardiac symptoms. It's not uncommon for them to check themselves into the ER thinking that they might have some sort of cardiac issue going on. And when they're given the full cardiac clearance, you know, that really, that really tells us a lot about, you know, what could be going on and, you know, where we could potentially direct them, you know, get them. Let's say, let's, let's, let's get you to a good doctor who understands first responder emotional trauma.
Right. And, and maybe we need to look at getting you into some therapy to see if there's, you know, what kind of connection there is to potential psychological injury and the physical symptoms that you're having.
[00:30:06] Speaker C: I think that's so important. And to your point, you know, when we do have patients having those cardiovascular symptoms coming up for them to go get it ruled out, let's make sure there's nothing else going on. But oftentimes it does point to some psychological distress. And trauma isn't just the physical event that happened to you, it's also the wound that's left behind. And to your point earlier, of much like a physical condition, you need to get it treated. You need to go and you need to write, do the homework, do the therapy, whether it be EMDR or CBT or brain spotting or maybe a combination of some sort, you would need to be engaged and work on healing. Just not that that trauma, but also the entire wound that's impacting your body both physically and psychologically.
And so I'm curious, you know, for you, what was it like to retire? I mean, I'm just so curious of what that journey was like for you. Was it, was it a relief? Was it a loss? Was it a little bit of both?
[00:31:03] Speaker A: You know, I'll call it a little bit of both.
So part of my story is that I suffered a back injury on duty in 2020 during an extrication. And over time, it just continued to spiral down and get worse and worse to the, to the point where towards the end of my career, I probably should not have even been coming in. It was, it was the back injury was that bad. I knew that if I When push came to shove, if I had to do something physical I could do was absolutely going to knock me out for a while, but I could recover and continue on. I needed to make it to my, to the minimum retirement age of 50. I just, I had to do that. There was no other alternative. And so I just, I dragged my carcass into work and, you know, hope that nothing was going to happen. And so, But I loved my job. I absolutely loved my job. I mean, I was really at the pinnacle of my career. I had seniority, my friends were chiefs, and so I had great relationship with the administration, had my choice of stations, got to work with crews that I loved. And I was really kind of at the pinnacle of my career and was going to do another five or six more years up until the point where we had a couple of big successive fires, which just knocked me down to the point where I couldn't get up. And so I did make it to the 50 age, barely ended up having to go out on industrial disability retirement. And it's funny because there's a lot going on.
If you get injured on the job and have to go out on industrial disability retirement and typically that happens going to be later in your career, although it can certainly happen at any time. What are we looking at? We're looking at a person in their 50s, early 50s, who is probably going through some sort of generational change, right? What do you call midlife crisis? Just in general, independent of your. Your.
[00:32:53] Speaker B: And you still got your life ahead of you, right?
[00:32:56] Speaker A: Yeah. Right. I mean, you.
Right. But. But biologically, I mean, or socially, this is just a kind of a time in life, right? A time period where a lot of people reflect on where they've been, where they're going. Right. You have that.
You now have your career ending and usually against your will.
Right. Nobody wants to go out on industrial disability retirement. So the plans that you've made to work your 30 years and go out at this time on a service retirement, those have now changed.
Your financial future has now changed because you're not going to your original plan, your identity has changed. Most first responders, their identity is I'm a firefighter, I'm a cop.
Right. And that is a huge part of where you are. I mean, I'd be introduced as Scott the firefighter. Right. That's gone. Your family dynamic has changed. Right. And so where, you know, you're gone and people are probably used to you being gone on your shifts and, and probably glad now you're around all the time, you know, Bugging your family and you have to re. Establish your relationships in a different way and all of this is happening at once. Oh, and by the way, you're in a lot of pain and you're trying to get through the workers comp system, which is usually failing you. And so you have all this literally all at once. And it can be really challenging.
[00:34:20] Speaker B: Wonder if you could maybe speak to what it's like in your, your, you know, your personal life with your family. You know, how do you communicate some of these things? How do you bring your work home or not?
You know, how did you sort of reconcile what you were going through physically and emotionally with your work, with, you know, wanting to be, I'm sure, a great parent and. Oh, and, and, and you know, the whole family side of, of your life and your personal side.
[00:34:53] Speaker A: Yeah, I think I was pretty typical for most first responders, which is we want to leave work at work. And so, you know, when we, when we go on calls, especially, you know, ones that are more traumatic, these aren't things that we're, we're typically sharing with our families.
You know, we, we just want to, you know, part that is part of the suck it up attitude. Right. And, and so if you could leave work at work, come home and enjoy your family, that would obviously be a preferable thing to do. I could tell for myself. I would never want to burden, you know, my partner with, with what I'm experiencing at work. You know, and so when we encounter some tough stuff, it's not something I want to, to image, I want to put in their mind. Right. It's something that, you know, I would just want to kind of keep within myself. And when you're working, typically you're so busy, you're either so busy at work or you're at home making up for lost time or doing all your, you know, daily activities at home. You really are just kind of immersed in the present and dealing with your family, doing social stuff, working around the house, you know, doing your errands when you have some time off that you don't really bring work home with you. And so it can be a little isolating that way you can come home and go, oh, we just had a multi fatality fire or a car crash or a child die or something like that.
It's not something.
[00:36:25] Speaker B: You can't just walk in the door.
[00:36:27] Speaker A: And say that, yeah, yeah, hey, check this out.
That's usually not a good conversation to have. And it's something that, that people don't want to burden their partners with and they'll typically hold it aside.
[00:36:39] Speaker C: Absolutely. And sometimes also talking about it Right. When you're not ready. Right. And so not wanting to feel forced to have to share. And so you might still be processing it yourself. And so I imagine that also, you know, comes up for some individuals where they're not sure if they want to share and you know, to your point, you know, whether it be burden the partner or the family, but also not sure what kind of support you're looking for. Right. And majority of the time they're not a trained specialist. And so and not wanting to trigger each other, it can have quite a strain in family dynamics.
[00:37:09] Speaker A: Sure, sure. And you know that we, we've done a better job getting ahead of this with defusings and debriefings. And so when we encounter calls that we know are going to be particular that are particularly stressful, a supervisor can call for a defusing or debriefing and then that will activate a higher level peer support to be able to start processing that trauma on a ground level where we're going to bring in, you know, all the crews that were involved, fire, law enforcement, ambulance, paramedics, dispatchers, and then go through the process of defusing or informal debriefing and then also offer further resources for individuals if they want to pursue more treatment or evaluation down the line.
[00:37:56] Speaker C: I'm so glad to hear that, that we're making that space for these first responders to, to have that's safe and to your point to kind of like process that with. With an expert and then I imagine too is there some encouragement for those that need it to seek, you know, additional counseling individually, things like that in those situations.
[00:38:14] Speaker A: I don't know about encouragement. I would say it's making the resources available and it would. So if, if we're doing a defusing or debriefing, it would end with hey listen, it's up to you how you're feeling and if you want here's some resources, here's access to, you know, counselor and you can that because everybody's going to have completely different experiences in on a scene. I remembering one particular call where this young man in the middle of the night was walking across the expressway and got hit by a vehicle going full speed.
We were, we had a truck company on scene who was the first is in their district. We were on the medic engine coming in and everybody's working, everybody's, you know, trying to save this young man's life. He was obviously had devastating injuries and coming back from that Call my, my firefighter medic, you know, told me that there was something about that call that was particularly bothersome for him and it was really affecting him. So we called for a diffusing. We had the truck company come over, you know, and, and we did that right then and there in the middle of the night.
It turns out that he wanted to seek further treatment after that, and so he did that on his own. The truck captain also, I found out later, had really been triggered by that call. And he had an experience that was unique.
Among the six firefighters that were there and the two paramedics, he had the, the. He. He was the only one that experienced this. On this call.
When this young man was being put in the ambulance and everybody's kind of on top of him, working on him.
He was standing next to the police car with the young man's belongings and on the police car on the hood was his cell phone. And mom called.
[00:40:05] Speaker B: Wow.
[00:40:07] Speaker A: He didn't know what to do.
Do you answer that or do you let it go?
And that incident really stuck with him to the point where he ended up seeking treatment to where, you know, process that trauma and relieve that stress. So, point being is that you can have all sorts of people on an emergency scene. It's going to affect people completely differently.
You know, that particular call, for me, it was just another trauma call. You know, you go back, you eat dinner, you, you know, have breakfast, you go home, you go enjoy your family and say, oh man, that was absolutely tragic and terrible. For others, it had a much more visceral effect and actually got them to the point where they realized that they actually needed some treatment to go help them get over that because of, you know, whatever they experienced on the call, plus what they've had in life experience up to that point. Right. We don't know what's going to trigger previous experiences.
[00:41:09] Speaker C: I think oftentimes to your point. Right. We don't know how big that iceberg is below.
Right. And what else has been happening and then to have that experience. And so I am curious for you, as you, you know, kind of left that line of work and stepped away, what helped you to recover and redefine your life both physically and emotionally?
[00:41:31] Speaker A: Yeah, so physically it was, it was pretty dramatic. The first thing was sleep.
Like I actually got to have sleep and consistent sleep, you know, regularly. It took me a while to get used to it, but that was probably life changing.
On the emotional side, I was very fortunate to have had the psychological treatment to work through calls and some of the ptsd that was associated with that.
And, and so I had actually, you know, was feeling pretty good that way. What was the major shift was my identity and what I was going to do in the future because I through and through, I'm a firefighter and that's what I loved to do. I love to get up in the morning and go to the firehouse. I love being there and I think it was true for me. What I hear from other retirees is that when you finally retire, it's not, you're not missing the calls, but you're missing the people.
I miss the people and the day to day life in the firehouse.
On the physical side, it was also remarkable. Just the lack of daily abuse. Not getting up and down off the rig 20 times a day. Put it wearing your air pack for an hour or two at a time, you know, lifting, carrying, you know, all that kind of stuff you, you have to do in real time, right? You don't have a choice because that's the job you're doing at the time. And when you're in pain, you just push through it.
When you're off duty, you don't have to do that. You're not subjecting yourself to the same kind of stuff.
Usually when you're doing something physical, it's optional or at least it's not time sensitive so that you can either get help or figure out other ways. And so a lot of the pretty significant pain I was feeling 247 towards the end of my career, a lot of that went away because I wasn't constantly aggravating it.
[00:43:33] Speaker B: I can just feel your passion, you know, for not just your work, but the people that you work with.
And now you're, you're working as an advocate, you're helping people who need help, you're helping people get resources. You're, you're making connections for other first responders, other firefighters.
Maybe as we wind down, you want to kind of share a little bit about, about what you're doing now and you know, kind of the next, the next stages of what's been, you know, amazing, amazing life journey.
[00:44:11] Speaker A: Yeah, you bet. So when I, when I injured my back and jumped into the workers comp system, it was a, it was a challenge. What I didn't realize at the time is it's a completely different medical system than your private medical insurance.
So let's, let's say like a typical meniscus tear, right? If you're skiing off duty, you tear your meniscus. It's a pretty linear process. You go to the doctor, they order X ray and mri. You follow up with the orthopedist and if the meniscus is surgical, they put you on the schedule. And that's the expectation that most of us have.
The workers comp system is completely different. If you have the exact same meniscus tear but you happen to suffer that on duty, you're going to go to the doctor, an occupational medicine doctor, they're going to give you an X ray and physical therapy because there's medical protocols that these doctors follow to treat work related injuries. And essentially outside of a lifelong threatening injury, it's four to six weeks of conservative therapy before you can go to the next step, which is an mri. So then let's say you do your four to six weeks of therapy, you go to the mri, you go back to your achmed doctor, they say, oh, we have a meniscus tear, let's go to the surgeon. Takes a couple of weeks to process to get to the surgeon. Surgeon looks at you, yep, we need to do surgery. They put in a request for surgery and a couple of weeks later you're on a schedule. So essentially you could be down the road two months before you're put on a surgical schedule in the workers comp system. So this is the same for physical injuries and then there's also protocols for psychological injuries. In my experience, when it hurt my back, I got the conservative therapy just fine, but they wouldn't allow me the mri. The doctor had misdiagnosed me with a lower back strain and wouldn't order the mri. Finally, when things got so bad where I couldn't work anymore and I had to be taken off duty due to the injury, the doctor ordered the MRI and then it was denied by our third party administrator. So most municipalities have a company that they hire to manage their workers comp, to approve or deny care.
And in this case the third party administrator had denied the mri. And so that was it for me. At the time. I was sailing out of my career at 42 years old with a diagnosis of a lower back strain and I could barely get up and down off a chair. I was walking up and down stairs one legged. I mean it was, it was pretty bad. I had a friend who's a doc who had a scanner in his practice. He said, just come on in and I'll hook you up. And that's where they found four herniated discs.
So with that I got some epidural spinal injections. But then they denied all my physical therapy after that. So I had to do my own physical therapy, to try to work my way back to full duty. So I was doing swimming, Pilates and yoga all on my own time to eventually work my way back to full duty. In the process of this, I'm thinking, this is absolutely insane. Like, here I am, a fire captain trying to do everything I can to do work way back to full duty. They're denying MRIs, they're denying physical therapy didn't make any sense.
I called friends in my department, I called friends that I know around the state.
Every single person I talk to has either had that experience or know someone in their apartment who's had that experience.
And so I said to myself at the time, you know, I don't know what I can do about this, but I'm going to try to figure out why this is happening to me and my friends and my colleagues and see if there's something we can do about it. And so I dove into workers comp. I befriended workers comp attorneys, the former head judge of the workers comp system in California, claims adjusters, risk managers, anybody who would listen to me or talk to me. I wanted to pick their brain and find out how the system worked. And what I had realized, or come to realize, is that there are things that we can do to help ourselves. But the problem is we don't know the language, we don't know the system, we don't know the process. And we're also injured and don't necessarily have the bandwidth to invest in learning this at the time. And so what I did is I developed card appointment advisors. And what we do is we contract with law enforcement unions and firefighters unions and associations to help their members through workers comp. We're their advocate and their guide. We know the process, we know what can happen, we know how to prepare for it.
And we also bring in resources as necessary to help people through the process, so anything that they. They might need. So we've been doing that for about 10 years. We're working with over 40 unions and associations, mostly in the Bay Area, but our geographic coverage is from Monterey to Sonoma to Tahoe to Fresno and in between. And we're looking to expand further, and it's been a very successful transition. Back to your question of how does it feel to retire. Well, I'm not retired, but I get, I would say, even more satisfaction with my desire to serve because it's one thing to go on an emergency call and help, and I absolutely loved that. And I got a lot of satisfaction out of that. I feel Like I even getting more by supporting the first responders so they can go out and do that. It can be effective in their jobs, they can get back to work, they can be better at their family, and we can overcome some of the inherent problems in the workers comp system that we have. They're diagnosed, treated, healed, and get back to work as quickly as possible.
[00:49:31] Speaker B: It's great work, Scott. I'm sure so many people are appreciative of the impact that you're having in their lives, their families, and will continue to do so. For people who are interested in connecting with you, working with you, what are some ways people can find you?
[00:49:48] Speaker A: Yeah, I think the easiest way would just be to go through the website and contact page and that's cardinalspc.com cardinalsampaulcharles.com there's a contact page and a phone number. And if somebody needs help understanding work's comp system, you know, give them guidance through it. This is what we do. In fact, the way, the way we have expanded our business is strictly word of mouth. And so I get calls from first responders all the time whose unions were not contracted with. And we just help them. There's no charge, no nothing. We just help them any way we can. Typically, people see the value in that and then invite us to a union meeting to see if this is something that could benefit, benefit their entire workforce in their department.
[00:50:33] Speaker B: Fantastic.
[00:50:35] Speaker C: Amazing work, Scott, and I really appreciate you sharing your, your story and your expertise. And as we wrap up, curious if you have any closing words or advice for individuals who might be, you know, starting their career in firefighting or kind of going through some of the challenges now. Any, any advice you'd want to leave for them?
[00:50:56] Speaker A: Yeah, I think so. I think, you know, there's, there's a few things that, that I heard when I grew up, when I was growing up through the career and that I've also passed down as well.
One is, is you need to take care of yourself. If you're not taking care of yourself, you can't take care of others. And that's both physically and psychologically.
Most people are doing a great job taking care of their bodies.
Injuries happen. But, you know, if you're fit and you stay on top of your fitness, that's going to be a good thing. What we don't do is stay on top of our mental health. You can't, you literally can't go through a career in public service without picking up some stuff.
It's just, it's impossible. Whether it's Producing symptoms or not, that's, that's up to the individual. But one thing I would recommend is find a really good trauma trained therapist who has the tools in their toolbox and see them once in a while, you know, and download as you go along. There's a, there's an analogy that you can go through this career and you're just picking up rocks and throwing it in your backpack, right? And that's what we typically do. And we're shouldering this, this weight as we go through our careers. And typically you don't do anything about it until the backpack breaks. Right? The wheels have come off. Our, our symptoms are, are really significant. Right?
This looks like, you know, relationship problems, drinking problems, anxiety, depression, sleep problems, discipline. People get into criminal issues sometimes because their judgment is just not what it should be or what it typically is. And that's when the backpack has broken. And my best advice would be to find a way to unload it along the way.
And so if you're keeping your body healthy, especially taking care of your back, Dr. Abachi, you see the results of this all the time. As much prevention as you can do for core strength and back health, along with regular mental health checkups, you're going to be very well served by doing that.
[00:53:04] Speaker C: Thank you so much for that and for all the discussion today. So, Scott, it was wonderful having you on the show and I want to thank everyone who's joining us and tuning in on the comeback with Boomerang Healthcare. We're grateful to have you here. If you've enjoyed today's episode, be sure to subscribe so you never miss an update. You can also follow us on social media for more tips, information and inspiration, such as Scott's story today. Until next time, keep moving forward. Your comeback is just getting started.
