September 29, 2025 • 44 mins
This episode is the fourth and final episode of a four part series on stigma.
This episode is done in collaboration with Central Coast Overdose Prevention (CCODP) and was made possible by California Overdose Prevention Network Accelerator funding from the Public Health Institute's Center for Health Leadership and Impact.
First responders face unique mental health challenges due to the high-stress nature of their work, but stigma often prevents them from seeking help when they're struggling. Dr. Casey Grover, firefighter/paramedic Jesse, and firefighter/paremedic Evan discuss the psychological toll of being the ones who save lives, including PTSD, addiction, and the struggle with vulnerability.
We also hear from Dr. Reb Close, who worked as an Emergency Medicine physician for over 20 years.
• First responders naturally prioritize others over themselves, often neglecting self-care
• "Normalization of deviance" occurs when first responders gradually develop unhealthy coping mechanisms
• PTSD is a permanent brain change that many first responders experience but fear admitting
• Female first responders face additional challenges and scrutiny in male-dominated professions
• The pressure to appear perfect creates barriers to seeking help, even when struggling severely
• First responders often judge themselves more harshly than they judge others
• Addiction can develop as a way to self-medicate trauma and stress
• Recovery is possible when first responders become willing to be vulnerable and uncomfortable
• Those with established careers have the social capital to break stigma by sharing their experiences
If you're a first responder struggling with mental health or addiction issues, please know that help is available and seeking it early can prevent tremendous suffering. You are not alone, and recovery is possible.
To Contact Dr. Grover: ammadeeasy@fastmail.com
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome to the Addiction Medicine Made Easy
Podcast.
Hey there, I'm Dr Casey Grover,an addiction medicine doctor
based on California's CentralCoast.
(00:22):
For 14 years I worked in theemergency department seeing
countless patients strugglingwith addiction.
Now I'm on the other side ofthe fight, helping people
rebuild their lives when drugsand alcohol take control.
Thanks for tuning in.
Let's get started.
Today's episode is the fourthand final episode of our
(00:44):
four-part series on stigma,specifically the stigma that
healthcare providers face whenthey struggle with mental health
conditions, fading confidenceor even addiction.
And I have to give twoshout-outs before we start.
This episode is done incollaboration with Central Coast
Overdose Prevention, which is anonprofit I helped found here
(01:04):
on the Central Coast.
Overdose Prevention, which is anonprofit I helped found here
on the Central Coast ofCalifornia, focused on
advocating for addictiontreatment.
And this podcast was also madepossible by California Overdose
Prevention Network Acceleratorfunding from the Public Health
Institute's Center for HealthLeadership and Impact.
Now let me share the why behindthis episode.
(01:25):
Being a first responder is hardand it takes a toll on those in
the profession.
The suicide rate forfirefighters and doctors is
higher than that of the generalpopulation, and it turns out
that in one study, about 50% offirefighters admit to binge
drinking regularly, and wewanted to end this series on
(01:47):
stigma with a discussion abouthow people who save lives as
first responders often need helpthemselves, and it's really
hard to ask for help when you'rea hero.
This episode is an interviewwith two of my colleagues Jesse,
who is a firefighter and alsothe executive director of
Central Coast OverdosePrevention, and Evan, who is a
(02:09):
firefighter at the same stationas Jesse, and if you remember
the name Evan, it's because hespoke to us at the end of 2024
on this podcast about hisaddiction to opioids while he
was a firefighter and how he gotthrough it.
The three of us speak about themental health challenges of
being first responders and howhard it is to ask for help and
(02:34):
bonus.
Dr Reb Close, the founder ofCentral Coast Overdose
Prevention and one of myaddiction medicine colleagues,
shares her experience as afemale first responder during
the episode as well.
Before we start, I just want togive you all a little more
context to understand thisconversation.
Both Evan and I have beendiagnosed with post-traumatic
(02:56):
stress disorder from our work asfirst responders and just to be
specific about the timeline,evan developed his addiction to
opioids while he was afirefighter and he got treatment
for it while he was afirefighter too.
And Jesse and Dr Close sharetheir thoughts and feelings
about the stress of being afirst responder in general To
(03:17):
anyone working hard taking careof other people.
I hope you will consider askingfor help if you need it.
And with that, here we go Onthis call.
We have one doctor and twofirefighters, right, we signed
up to serve others.
We are naturally empathic, we'realtruistic, we want to give
(03:39):
back and we're selfless.
Right, you guys work crazyhours.
I've worked plenty of crazyhours myself and what's really
interesting is, I think it'sthat personality that's willing
to give and wants to help thatis so selfless sometimes that
the self-care gets ignored.
That sets us up to not build inwhat we need to stay
(04:03):
emotionally well.
I can tell you I was justchatting with my therapist this
week and yes, I have a therapist, she's awesome I was chatting
with my therapist that when Ifirst started as an ER doc, I
would never take breaks, wouldnever take lunches, and about 10
years in I was like I should bea little nicer to myself.
Maybe I should eat lunch, andI'm now having to start to build
(04:28):
in breaks in my day just to beable to take care of myself.
But I think that's why I wantedto be a doctor.
I wanted to go 110 miles anhour and take care of everybody.
You know, just like Jesse, youwere saying you're going to go
in and save every kid from thefire.
It's hard because we're wiredto want to push ourselves to do
our best.
Speaker 2 (04:45):
Yeah, then you throw on top of our careers a family
too.
So not only when we're at workwe're taking care of everybody.
When we get home we feel likeit's our duty, because we've
been working so much to be thatdad and be that father, be there
for our families, that wealways put ourselves last and we
don't take care of ourselves.
Another thing I was thinking asyou guys were talking that
popped in my head is an issue inour line of work is a
(05:06):
normalization of deviance.
So someone struggling with likePTSD might find ways to
self-medicate and they slowly doit.
So for example, say afirefighter.
He is struggling with PTSD.
He doesn't know what's going on.
His mind's going crazy.
His wife knows something's upwith him, but he doesn't know
why it's so hard for him.
(05:27):
When he's at work he's himself,he's around his peers, he does
the job, but when he gets homehe's a shell of himself and he
doesn't know why.
So he starts drinking, and he'sdrinking at home and he seems
to be happier.
So then when he's drinking athome it becomes a little bit of
an issue.
But he's self-medicating.
He starts feeling a littleweird at work.
So then maybe he starts, youknow, one day at night he might
(05:50):
have a sit, he gets away with it.
So you know, that shift I gotaway with this, or maybe next
shift I'll have a couple of sits.
But then all of a sudden youcome to work and you've had a
little too much, so you'venormalized that deviance and now
you've overdid it.
Instead of recognizing that youhave PTSD and you have a
substance abuse issue andgetting the help, because you're
so afraid of the stigma andwhat people will think you're
(06:13):
self-medicating.
And then it goes into work andthen all of a sudden, people are
losing everything.
Then they lose everything.
So that individual might'vebeen getting divorced, that was
one thing, but now you throw adivorce on top of loss of career
.
So then what's your self worth?
How are you looking at yourselfat that point?
What happens then?
A lot of people just shut downand it gets worse or, you know,
(06:36):
they end up taking their lifejust off of stigma and
undiagnosed PTSD from the job.
Speaker 1 (06:42):
So let's unpack that a little bit, evan, because I
think you're spot on.
It doesn't happen quickly.
So I did 14 years in emergencymedicine and something started
to change around, like year 10.
And I had a bad shift.
Oh yeah, yeah, it was a nightshift.
I don't like nights.
That's what it was and kind oflike you were saying, it comes
(07:04):
on slowly and then, yeah, youstart pushing limits slowly and
then, unfortunately, when itreally comes to a head, it's
months, if not years, ofsomething growing and festering.
That's a lot harder to fix.
I mean, I will tell you, ptsdis a permanent change in the
brain.
(07:24):
It can get better, but it nevergoes away.
And actually we have a doctorthat is coming to our area in
emergency medicine.
I just was chatting with hercolleague to colleague and I was
like you have got to take careof yourself in this job.
I didn't know this was going todo this to me, me.
(07:45):
The other thing you mentioned,evan, that I want to talk about
was stigma and around colleagues.
Oh my gosh, having to admit tomy colleagues that I had ptsd.
I'll be honest, I lied about itfor six months.
I could not bring myself totell my colleagues that I had
ptsd.
I was totally embarrassed.
I was afraid I was going to bejudged like, oh grover weak.
I finally had to own it becauseI couldn't lie anymore.
I just I ethically, wasically,was like I have to be honest.
Speaker 3 (08:06):
Yeah, I tend to wait until so a call like that and
I'll share the one that Evan andI had in December.
But you go through a call andyou get PTSD.
I tend to like suffer insilence because I don't want to
admit that I am weak or lessthan or I'm anything but an
(08:28):
alpha going to mitigate theproblem, anything but a hero.
I don't even want to admit itto myself that I'm a real person
.
So I'll suffer in silence andI'll shove it down and I'll just
either be quiet or sometimesreally happy to distract myself.
Or my face is in my phone, justsocial media 24-7, bathroom,
shower, everywhere, because Idon't want my mind to just go
(08:51):
like you know what I mean andlike.
So you just go, go and then youself-soothe with sometimes
healthy stuff, sometimes socialmedia, sometimes TV.
Sometimes you take your kidsand you embrace them and you
just you do everything in theworld that week with them.
Sometimes it's with your wife,sometimes it's not.
There's tobacco and alcohol andmarijuana and maybe other drugs
(09:11):
and whatever else we do.
That's not good, but for me atleast, like this call we had in
December.
It was full arrest in PebbleBeach, nothing gruesome.
We all had really horriblecalls.
There was no blood, nothinglike that, but it was a chaotic
scene and we didn't have controland a patient.
(09:34):
The outcome wasn't good and soyou didn't feel good and he
replayed it.
And we have such lack of gracebecause we feel we have to be
perfect on every single call andon spot, and at 8 pm and at 2
am and at 3 pm and whatever.
And we're not, because we'rehuman.
And so I at least for that callI had serious PTSD about it.
(09:57):
I was fragile, even ask Evanlike he would dude, I was not in
a good place and it was hard tolike hide it because it was
right here on my shoulder, mysleeve, my emotions, and I
couldn't even understand theprocess, like why am I doing
this?
Even my wife no offense, she'slike geez, doesn't sound like
that big of a deal, but it'slike you don't understand and
that's not to her, she's not inthe field.
(10:19):
So what happened, okay, whathappened, okay, did one get out
of your way?
Like how is that a bad thing?
But it's just.
I think sometimes even get ourown family to understand what it
is we do every day If they'renot a part of this field I think
is a struggle.
But if there's a way we canhave more grace with ourselves
and self-soothe in a morehealthy ways, then I'm all for
(10:43):
that.
But maybe it starts withtalking about it and having the
courage to be embarrassed thatyou're not that perfect hero,
you know.
Speaker 2 (10:51):
Yeah, 100%.
That call affected me as welland when I told my wife she was
like well, you've had way worsecalls, you've had like people's
heads blown off and stuff.
And I'm like okay, well, shedoesn't understand that it
affects you.
Every call affects youdifferently.
Like that one was more ofemotional, emotionally taxing.
(11:12):
We were prevented from doingour job and then the guy
perished.
When we have both been onmultiple calls like this when
people we were successful withresuscitation, and this one it
was just totally different.
So it affected us differently.
And jesse was the paramedic onthe call with another medic, but
that's a whole different story.
But this medic we were with isnot the most proficient
paramedic.
So Jesse was taking the leadand then the way everything
happened was just emotionallytaxing.
(11:35):
And then having to talk to PDafter and then thinking about
the outcome of like people thatwere there and family, like
where is this going to go?
And lead it was.
It was really emotionallydraining and when you try to
talk to someone like a familymember or anything like jesse's,
saying they don't understand,like we would check on each
other but you're just kind ofdeal with it and then you store
up all these calls untilsomething happens.
(11:56):
And it really hit home when yousaid on your phone, jesse,
because I don't even know whyI'm looking at my phone half the
time.
I'm just scrolling throughyoutube or I'm like googling
49ers.
Like for the 10th time a dayI'm like I already know what's
going on with the 49er.
Why am I just doing this?
Because I need to like have mymind off stuff.
I'm just like staring at thisphone so my mind doesn't think
(12:17):
about things.
It's just I don't know why.
It's hard because no one reallyunderstands.
And then we see, see it,because, like after we went on
that call, multiple people cameup to us personally and one guy
was like dude, you know how manyfights I got in on calls?
Why did you snap his shoulder?
And I'm like, of course, that'swhy we don't like admit that
we're struggling or want to talkabout these things, because
(12:38):
we're judged by our peers and Ithink they could have done
better even though they weren'tthere.
So you show a sign of weaknessin this line of work and it's
like they pounce on it.
So we're so ego driven to bethese tough guys and these
heroes, we're afraid to admitthe weakness.
And that goes into substanceand alcohol.
If we're afraid to talk about acall where we missed it, the
(12:58):
last thing we want to do isadmit we need help.
Speaker 1 (13:00):
Yeah, it's interesting that you mentioned
that.
So let's just again brieflyunpack some of what's happening
in our brains.
So you guys have maybe heard metalk about big T's and little
T's.
So a big T is a reallysignificant, difficult, painful,
traumatic event.
I took care of a young womanwho hung herself and I see the
(13:21):
image of her neck a few times aweek.
The ligature marks around herneck.
I still get flashbacks.
That was probably 11 years ago.
I mean, I just saw it there.
It's always on my right side,it's always right there.
Anyways, that was for me.
It was a big T, that was like abig, horrible case and the
little Ts are the smaller stuff.
(13:41):
And, Evan, that comes back tosome of the microaggressions you
were saying around things likecolleagues really doing the
opposite of giving support whenwe need it.
You know, for me I reallystruggled from a little t
standpoint, like a small microtrauma when patients would get
angry with me when they came tothe ER for chronic symptoms and
I was like I don't know how totreat 12 months of abdominal
(14:04):
pain.
That's not in my skill set andI was like I don't know how to
treat 12 months of abdominalpain, that's not in my skillset
and they get in my face and getmouthy and you're a bad doctor
and you could, you should havebeen helping me and that really
went with me.
And then they all snowballtogether over time and it adds,
and it adds.
Speaker 3 (14:17):
You know, coming back to like this alpha male
experience in the ER, theoperating room, yeah, you have
to be tough, you have to bestrong, show no weakness and
it's really toxic oh yeah,working in pebble beach is
beautiful and we have, you know,just civilians or little kids
(14:41):
will come up and want to checkout the ladder track and some of
the parents will ask, oh mygosh, are you ever scared
climbing that track?
And a handful of guys are like,oh heck, no man, I love being a
firefighter.
I'm on it, I'm 100% honest.
I'm like heck, yeah, I'm scared, especially when you throw that
ladder up in the middle of likenowhere and you're climbing
that thing and the wind'sblowing.
(15:02):
It is scary, but you know we'renot supposed to be scared, right
?
We're supposed to go and justhandle biz, and we would.
When you know it matters andadrenaline's rushing, we're not
even going to question it.
But it doesn't mean it's easy,you know, or less scary.
Just strive to be perfect onevery call and come home and
(15:24):
then be able to turn it off andthen be with your kid, be
present with your kids andpresent with your wife, and you
know that's a hard transition todo.
Have you ever driven with noradio, just nothing.
The window down, try it for 15minutes, like if you forget your
phone.
You'll be like either needingto get check in to rehab or feel
(15:48):
real therapeutic, but your mindgoes everywhere and I think we
do that a lot as firefighters.
Speaker 1 (15:54):
Yeah, I have an interesting question for the
group.
So obviously the three of usare men.
Do you guys have a sense ofwhat the experience is like for
female firefighters?
Speaker 2 (16:01):
Yeah, I haven't worked with too many female
firefighters I think three in mycareer but I did in my old
department.
One of the females I worked withreally struggled with fitting
in.
She wasn't the best at thephysical part, so from my
experience she was just overlynice to everybody to gain their
friendship.
(16:23):
But she struggled with thephysical side and then that made
her kind of like an outcast asfar as like all the men could do
all the physical side, and thenthat would have made her kind
of like an outcast as far as,like all the men could do all
the physical stuff.
She struggled with it butpeople failed to realize that
like we're all a team and shebrought a key component to the
team and that she was reallygood at writing grants and she
was a very good paramedic andshe was very good at writing
PCRs.
So like, as time went on shebecame more of a part of the
(16:45):
team.
How I look at it as a companyofficer is like you have someone
that's on your team that mightbe weak at some things but
someone's good at at leastsomething right.
So whatever they bring to theteam, utilize your team to
accomplish the task.
That's been my experience, atleast with my old department,
which this individual hadstruggled fitting in.
Speaker 3 (17:03):
I worked with a firefighter in San Diego and she
was a fantastic firefighter.
But I asked her that samequestion and this was a few
years ago.
It's still, I think, very mucha man's world a little bit.
But I asked her I'm like so howis it, how is it being in the
fire service as a female?
And she's like I know that Igot hired because I'm the right
(17:23):
person for the job, but Iquestioned that a lot Like.
Sometimes she's like did I gethired because I'm the right
person for the job?
But I question that a lot Like.
Sometimes she's like did I gethired because I was a female,
but she was the right person forthe job?
On top of that, she had theextra added burden of
questioning if she should evenbe there and she should.
She was baller, she was one ofthe best firefighters I've ever
worked with.
But I think it's harder forfemales in the fire service.
(17:44):
Just my opinion.
I'm not one so I don't know,but I think it's harder for
females in the fire service.
Speaker 1 (17:47):
Just my opinion.
I'm not one, so I don't know.
Yeah, and I obviously can'tspeak for my lovely bride and
partner in crime, the verybeautiful Dr Reb Close.
But I have to say I learned alot about the experience that
female physicians have beingdifferent from mine and that
there's an extra level ofscrutiny At the like oh, does
the female doctor really know asmuch?
(18:07):
She was very honest that whenshe came in as a new female
physician at her hospital shegot extra questioned.
She got more people making sureshe knew what she was doing.
It took her quite a bit of timeto really feel like she wasn't
the new doctor anymore and whenwe've gone back and compared our
notes, you know I was a newdoctor too.
It seemed like I was acceptedfaster and granted that's an
(18:29):
anecdotal case of two physiciansin the same hospital.
I read a piece written by afemale ER doctor talking about
imposter syndrome.
I hadn't heard the term and shewrote a very beautiful piece
about I know I'm here.
I know I went to medical school.
I know I did my residency.
I know I'm here.
I know I went to medical school.
I know I did my residency.
I know I know my stuff.
But sometimes people question meand I question me.
(18:52):
And when people question me itmakes me question me even more
and it was this like viciousfeedback loop that this poor
doctor was in of reallystruggling with.
You know, is she the rightperson for the job?
And it sounds like for thefirefighter colleague that you
have she was, and for my lovelybride, she was absolutely the
right doctor for our emergencydepartment.
She served 20 years there.
(19:14):
But I think it's interesting andit'd be interesting to get some
female voices in a futurediscussion around this.
But you know, the three of usare, you know, strong, strapping
men and we have this moreexperience of being afraid to be
vulnerable.
I'd be really curious to seehow it is, as a woman in a
male-dominated field, like beinga firefighter, that they are
even more scared of beingvulnerable because they're
(19:36):
already under scrutiny to yourpoint, evan because biologically
they're going to have lessmuscle mass and be built
differently and they might benot as tall.
I'd be really interested to seeif female firefighter struggle
in a different way, and I thinkthe answer is yes and it would
be very interesting to explorethat perspective.
Speaker 2 (19:52):
Yeah, I agree.
Yeah, the lady that I workedwith in my old department is now
an administrative chief, so sheused her strengths.
She had the weaknesses with thephysical part and she'd
expressed it to me.
I'd work out with her and tryto like help her, like, for
example, throwing ladders orstarting a chainsaw.
We just kept doing reps and shegot the physical side down.
(20:13):
But she was so smart, like Imentioned, you know she used her
strength and she's a battalionchief now with one of the
departments.
So very nice I remember talkingto her about that and she was
friends with my wife as well andtried to help her.
But like you come in, like yousaid, with that scrutiny, you're
already like at a disadvantagein some people's eyes, because
some people automatically thinkthis is like a man's job and
(20:35):
then so they start out with acouple points down in some
people's eyes.
So they're already having toprove themselves not only being
a new person, but also like areyou the right person for the job
?
Like jesse lady jesse workedwith and she happened to be and
then same in my situation.
But yeah, it's got to be toughto start out like that.
Speaker 3 (20:50):
It's also, though, equally tough when they're not
the right person, and it doesn'tmatter if they're male or
female, if they're not the rightperson for the job.
If you can't physically do itor emotionally do it, then don't
do it.
But some, I think, get hiredand talk about the fake it till
you make it, and I think it justwhen rules are bent, or sweep
(21:12):
that on the carpet a little bit,just get somebody through.
I think that's where it'sdifficult to see that, because
that's a safety thing.
And then we take thatpersonally, and you know, we all
want to go home at the end ofthe shift to our family.
That's the goal is to go homeat the end of the shift to our
family.
That's the goal is to go homeat the end of the day.
And so if we feel like there'sanything that could stand in the
way of that, like incompetenceor just not being able to do the
(21:35):
job, it increases the anxiety,at least in my perspective.
Speaker 1 (21:42):
One quick interruption from me.
Jesse Evan and I spoke aboutour experiences as male first
responders and how women canface challenges in
male-dominated jobs.
I wanted to hear from a femalefirst responder on her
perspective, and so I asked mycolleague and spouse, dr Reb
Close, who worked as anemergency medicine physician for
over 20 years, for herperspective.
(22:04):
For over 20 years for herperspective.
So I realized that I actuallyhave a female first responder
that I can ask about this.
The very lovely, very beautifulDr Webb Close Happies to be my
spouse.
Reby, what did you experiencethat you felt was unique being a
woman as a first responder andemergency physician?
(22:26):
You felt was unique being awoman as a first responder and
emergency physician.
Speaker 4 (22:29):
So I think for me what really stands out is that I
always had to prove that firstI had to prove I was the doctor.
Like I literally had to wear awhite coat, or nobody assumed
that I was a physician.
I mean, I'm only 5'2" I, youknow I just I don't command the
prowess of an older man.
(22:51):
And so, truly, especially whenI first came to Monterey I mean
some of the surgeons, some ofthe internal medicine physicians
that I worked with at the time,literally I had to prove myself
.
Literally I had to prove myself, and you know I would call them
(23:16):
for consultations and, wow, Ibetter have my stuff on point,
or they, just they were going toblow me off.
And so I got very comfortablewith learning that it was an
uphill battle just to havesomebody believe that what I had
to say had any relevance, therewas anything behind it that
mattered.
Speaker 1 (23:31):
I remember you talking about in residency.
You were trying to really, youknow, get guts and I'm going to
be tough and I'm going to seethe hardest patients.
How did you feel when you weredone with your training?
Speaker 4 (23:43):
Well, it was kind of the same.
I had to carry my weight.
I had to make sure that I, youknow, was seeing as many
patients as everybody else was.
Really pushing myself was I'lltake it, I'll go.
I got it, the ambulance wascoming and I got it, and you did
.
You had to show that you wereworthy of being in that position
.
Speaker 1 (24:02):
How did you feel it was different for you as a woman
versus a man?
How did you feel it was?
Speaker 4 (24:05):
different for you as a woman versus a man.
Well, and again, I think thisgoes back to just you know.
I mean, I'm little.
When I started I was young,which is funny.
You're still very beautiful,Thank you.
It's really easy not to take meseriously.
I have a really kind of casualattitude and I had to prove that
(24:28):
I could hang, I mean and truly,at some points that would
involve foul language and sayingthings that were really off the
cuff and very crass, to kind ofprove I could hang with the
boys.
Speaker 1 (24:36):
Yeah, did you ever have a time that you felt like
you couldn't keep up?
Speaker 4 (24:40):
Yeah, it was near the end of my career, to be honest,
in emergency medicine.
That was part of it.
It wasn't a male-female thing,it was just when I felt like I
wasn't pulling my weight.
That's actually when I leftemergency medicine.
I was like you know what?
This uphill fight?
I had been on it foressentially 20 years and my job
and truly this is how I felt ismy job could be better done by
(25:03):
somebody else, and so I steppedout.
I stepped out before I wasforced out, for lack of a better
way to put it.
I took myself out of the gamebecause I felt I didn't have
what they needed and fortunatelyI found a specialty that needed
me.
Speaker 1 (25:19):
Were you disappointed when you felt like you couldn't
keep up anymore?
Oh gosh tremendously.
Speaker 4 (25:23):
I always had a lot of trepidation going into my
shifts.
I was worried I wasn't going tobe smart enough, I wasn't going
to be fast enough, I wasn'tgoing to, I was going to miss
something, I wasn't going to doit right.
I needed to do more.
I always had that minute one inthe career, but at the end it
was I'm going to let down mycolleagues, I'm not going to
carry my weight, I'm not goingto be what they need me to be,
(25:48):
and so that's why I left.
Speaker 1 (25:50):
Yeah, just if you're wondering, the ER staff still
speak very highly of you andmiss you.
Speaker 4 (25:55):
Well, and it's the thought process I have regarding
the aging process and it'swould you rather go out too
early or too late?
And that was part of my thoughtprocess with leaving emergency
medicine when I did is I wantedto leave when people still liked
me before they found me toeither be a hazard or an
annoyance, or dragging thedepartment down.
(26:15):
That was my plan.
Speaker 1 (26:17):
Did you ever struggle at all with your mental health
while you were in the emergencydepartment?
Speaker 4 (26:22):
Mainly just my confidence.
You know the imposter syndromeof am I enough?
Am I fast enough?
Am I smart enough?
Can I do this?
Could it be done better bysomebody else?
I am very fortunate to havenever had what I consider
serious mental health issues butthe imposter syndrome.
(26:42):
I would literally at times gointo the restroom and look
myself in the eyes and givemyself the mantra to remind
myself that I deserve to bethere and I could do it.
Speaker 1 (26:52):
Do you think my colleagues judged me when my
PTSD became an issue?
Speaker 4 (26:59):
In my heart, the answer is yes.
I know they kept anything underwraps because they know you and
I are, you know, tight at thehip if I get to pick.
So, in other words, nobody'sgoing to tell me.
Speaker 1 (27:10):
They were courteous to you because we were married.
Speaker 4 (27:12):
Yes, a hundred percent, which is smart, because
I wouldn't have respondedreally positively knowing what
you were going through.
Speaker 1 (27:19):
No, and I, some of my colleagues sent me really
heartfelt notes of oh my gosh,I'm so sorry, and some of my
colleagues said nothing.
Notes of oh my gosh, I'm sosorry.
And so my colleagues saidnothing.
Thank you so much to Dr Closefor her thoughts and input.
And now we'll go back to theconversation between myself,
(27:40):
evan and Jesse.
So I want to ask you both aquestion.
So I remember as a new doctorin the emergency department at
my hospital I felt like I couldnot make a mistake.
I could not ask a question, Ijust needed to figure it out
myself for everybody.
I was going to assume I was theincompetent new guy and I
wonder how much of that cultureof we're all tough, the ER is
(28:03):
hard, get going.
See patients, we just got threeambulances.
Why are you taking a break?
I wonder of how much of that weall just assume is normal and
we probably should reconsider.
I'm assuming it's the same as afirefighter.
When you're new, you know youjust got to power through the
shift yeah.
Speaker 2 (28:22):
And then when you get experience too sometimes like
jesse and I and the fire serviceaspect, we have some years
under our belt and some peopleare afraid to admit they don't
know something, because if youalready have this experience,
you don't know that.
But I've gotten to the pointnow where I'm like, yeah, I
don't know, but we could learnit together, look it up, and
that's so much easier on my mindand like faking it or saying
something that's not correct,and then they find out later
(28:43):
that you're just making stuff up.
That just goes back to stigmaas well.
You're so afraid to look like afailure in front of your peers
that you're willing to makestuff up.
It's like we don't knoweverything.
As a ER doctor as well, there'sno way you can know everything.
We're so tough on ourselvesbecause we're expected to just
perform and do this job at ahigh standard that when we fail
(29:07):
or just make a simple here's aninteresting question for the
group.
Speaker 1 (29:14):
Do you think we as first responders and I guess the
emergency department we're kindof continuation of first
responders?
Do you think we judge othersmore when they are struggling,
or do you think we judgeourselves more when we are
struggling?
Speaker 2 (29:31):
And that's a good one .
I'm guilty of judging others.
I try not to, but I think maybeit might be like a slight
insecurity I have, and I thinkeverybody's guilty of it, and
it's really bad in the fireservice that when someone's
messing up or can't perform, totalk about them or point your
finger at their mistakes, orthat I can't believe that guy
can't do his job.
When you know someone thatyou're judging, you might not be
(29:54):
able to do the certain tasksthey're doing either, but you
weren't called upon to do thattask and perform in front of
everybody and you weren't theone that felt so.
It's easier to judge someoneelse, but I am kind of tough on
myself too.
I've relayed that to Jessebefore and he's like no dude,
you're doing great, you're fine,but I think I'm like 50-50,
which I need to be better aboutnot judging others 50-50, which
(30:15):
I need to be better about notjudging others.
Speaker 3 (30:18):
Think about all this stuff, and I couldn't even
imagine as a physician at CHOMP.
But think about all this stuffjust being on the truck Water
rescue, paramedicine, firetactics, wildland tactics,
confined space, trench rescue,low-angle rescue, high-angle
rescue, rope rescue there's somuch.
If I had a pediatric fullarrest, I'm a hundred percent
going to be in my phone lookingat the Monterey County EMS app
(30:40):
confirming that the medicationI'm giving is correct, cause I
don't run a lot of those calls.
But if I mess up in theslightest to answer your
question, doc, I'm harder onmyself.
I have more grace on mycolleagues than I am.
A judger by like my Myers-Briggspersonality is an INTJ and I
judge like crazy.
But I judge myself even harder,even my colleagues around.
(31:03):
I saw one guy was doingsomething and he made just one
little mistake setting up theoutriggers and he's like oh God,
stupid, I can't believe you didthat.
I'm like, bro, what do you do?
You got out of order.
You're all good Like you did 20million things right and one
little thing was off, but wejust beat ourselves up to the
point where it's almostdebilitating.
To be honest, it's too over thetop.
(31:24):
We do not know how to giveourselves grace.
Speaker 1 (31:28):
Well, I mean, it's hard because when we talk about
giving ourselves grace, thethree of us hold people's lives
in our hands.
I mean, you guys told me alittle bit about that one call
that went so badly.
I remember, jesse, you reachedout like what was I supposed to
do?
And yeah that's.
I think one of the thingsthat's so hard about being a
first responder or being in themedical field is when you
(31:50):
actually make mistakes.
People's lives have realconsequences and you know, I had
oh I had one really bad caseand I was working in the
emergency department.
I was the only doc working.
I had probably seven, eightpatients.
I was taking care of them,three of whom were really sick
and needed me, and then we got afull CPR in progress and I
(32:11):
totally mismanaged everythingand the CPR in progress ended up
dying.
I think the person was probablyin the process of dying and
there was nothing we could do tostop it, but a couple of the
nurses filed a complaint.
We're, like Dr Grover,absolutely mismanaged this.
This person is dead because ofme and I didn't actually realize
it was a part of my PTSD fromthe ER and I was journaling
(32:33):
about it the other day and, man,my nervous system lit up like
crazy and I was like, oh okay,time to talk about that with my
therapist, so I probably need tobring it up with her.
But yeah, I think when thestakes are so high, it's really
hard.
Speaker 3 (32:50):
I think about a pilot .
You know someone who has thissuper high stress.
The risk is super high.
If you mess up, you can't messup.
There's no grace for a pilotLike you are correct, right,
right, and they come home andthen they're gone for long
periods of time, so theirmarriages are just going on
without them and they get homeand you're almost like a guest
(33:11):
in your own family when you gethome, but you're trying to
integrate and turn it off.
And who are you?
I don't know the answer.
I just know that that stress isso high.
But you're right, lives are atrisk.
If we have a bad day at work,people are going to die.
That's a real thing.
We really do not sleep at nightbecause of that and you get
(33:33):
better at your job and moreconfident and maybe you don't to
look at your phone as much andyou have a good working
camaraderie with your crew.
So you got each other.
But you never know what you'regoing to get.
And that kind of stress toperform at your best and if you
don't, someone will die.
Man, what happens when we don't?
Because we don't all the time,it's impossible.
(33:56):
So how do you handle it?
You keep it inside.
You maybe go for a pill, you gofor a bottle, you go for a.
I don't know.
I think you do all of that andsome are healthier than others,
but that stress is real, and Ithink we just have a really hard
time admitting how hard the jobcan be emotionally.
We want to help others, but wegot to help those that help
(34:18):
others, but we don't even admitthat we need help ourselves, and
so we're just.
It's like this man, I'm goingto just go until I'm like
sliding into, you know, home andjust giving it my all, because
you know I'm not beingthoughtful about my life, my
longevity, my sustainability, myfamily, because I'm just trying
to survive.
And you can only go so far withthat before you start looking
(34:41):
for other stuff.
And I think our colleagues havedone that in many realms, like
police, san Jose fire, whateverwe go for stuff that's not
healthy and we want to stop that, but we just don't know how.
Yep.
Speaker 2 (34:55):
The stigma is so bad that we have peers in the
medical field and in the fireservice that are so afraid to
admitting to their colleaguesand their family that they have
a problem.
And a lot of our families whenI was going through my family
all knew but I was so afraidlike the people I love the most
and care about the most knowabout my issue but I was so
(35:15):
afraid for people at work tofind out.
That was like the end of theworld for me and guys get to the
point where they would ratherdie, take their own life, than
to admit to their peers thatthey're struggling and get help
and sober up and everythingwould be fine.
But they're so afraid of thatstigma because they hear about
(35:35):
another guy that got in troubleand around the kitchen table
everybody's talking smack aboutwhat he did to his family, just
like when I got in trouble andeverything happened and I heard
people, what they said about meand what the comments they would
make to me.
People are so afraid of thatstigma that they're willing to
take their own life.
And if we could come up withsome kind of program or just to
(35:56):
get out and talk to people likeI think that idea of trying to
reach firefighters or paramedicschool, firefighters in training
and get that into their headbefore they get into the field
and experience all this PTSD andbecause I mean it's a high
percentage of people in themedical field and fire service
that have it and then recognizethese signs when they come up
(36:16):
and not be afraid to ask forhelp and reduce that stigma,
even if we saved one life.
You know it's happening all thetime, like all over firefighters
taking their own lives, medicalpersonnel taking their own
lives, ambulance paramedics are.
If we could just like plantthat seed in the younger
generation of upcoming peoplethat are in this career path.
If we could plant that seed,that seed in the younger
(36:36):
generation of upcoming peoplethat are in this career path.
If we could plant that seedthat it's going to get help.
It's not worth taking your lifeLike there's resources out
there and there is a light atthe end of the tunnel and I've
lived it.
You know you've lived it.
Jesse's been through stuff andwe've lived it and we're better
now.
We understand, but you can getthe help you need.
Speaker 1 (36:56):
It doesn't have to be the end.
Yeah, I mean, you think aboutit.
At its core, addiction is whena person loses control of using
something to try to change howthey feel.
Right, evan, you were doing itwith opiates.
We talked about it on mypodcast and you know we've
talked about colleagues thathave struggled about it on my
(37:18):
podcast, and you know we'vetalked about colleagues that
have struggled.
It's so interesting becausesomebody asked me once what's
the best predictor thatsomeone's going to get sober and
stay sober, and my answer was awillingness to be uncomfortable
and be vulnerable and in ourline of work, that is the
antithesis of what we are taughtto be right.
(37:39):
When you are ready to actuallylisten to the fact that we can't
sleep because we get badmemories from bad calls all
night, and when we drink fivedrinks they go away.
When we are willing to actuallyconfront that, that's when the
healing happens.
And, jesse, you were saying aswe were getting started, there's
so many vices that distract us.
It's Netflix, it's pornography,it's sports betting, it's
(38:01):
alcohol, it's cannabis, it'snicotine, it's compulsive
shopping.
There are so many ways that wenumb as humans, and my patients
tell me about it all the timeand I hope I don't offend anyone
by this comment.
It's a lot easier to numb, getback up and go to work and
(38:22):
pretend that nothing's wrongthan to actually face it.
Speaker 2 (38:23):
Sure, and it's almost like something drastic has to
happen to open your eyes, causeI remember being in the deepest
of my addiction my marriage isin the rocks, I'm about to lose
everything.
But I thought, well, I have acareer, I have a house, I don't
need help.
Like I lose everything.
But I thought, oh, I have acareer, I have a house, I don't
need help.
Like I'll just keep it rollingfor a couple more months.
And it's like it took me gettingarrested to open my eyes and
then, finally, I was willing toget the help I needed.
(38:45):
And that's when I was like, oh,wow, oh, there is a light at
the end of the tunnel.
I really did have an issue,because we get into denial and
also, like we said multipletimes, that stigma of everybody
finding out we think you know, Idon't need help, we're always
helping everybody else.
So for us to admit we need helpis we've failed failed as a
husband, I failed as a father, Ifailed as a firefighter, you
(39:07):
know, even though I was alreadyfailing at those things.
But I was in denial because Iwas somewhat holding it together
.
Speaker 3 (39:14):
I don't know how, but can I ask you a question, evan?
You mentioned and I thought itwas really you hit it on the
head Like we can barely evenadmit if we didn't run a call
100%, how are we ever going toadmit if we're really struggling
with a substance use issue?
And so my question for you andyour experience because I'm sure
(39:35):
there's opportunities that youhad to say something but you
didn't and it took you hittingrock bottom.
We want to avoid our colleaguesfrom hitting rock bottom, yeah,
but how do you instill insomeone who's going through that
, before they hit rock bottom,to have the courage to get and
(39:59):
ask for help and admit weakness?
And I think we would struggleto do that.
And I'm just curious on whatyour experience or thoughts are
on that.
Speaker 2 (40:08):
You know, when I think back of my personal
experience, I could have easilyjust went into my chief's office
and I could have said I'madmitting to a problem right now
and they could have not got mein trouble.
I could have went and got thehelp.
I could have took a leave ofabsence from work or even
continued pay, like I did Wentand got the help that's paid for
(40:28):
through our insurance and theunion Came back, kept my job.
Everything would have beengreat.
But instead I pushed it until Iwas dealing with a criminal
case.
I was dealing with my licensefor work, so I had a lawyer for
my license, a lawyer for thecriminal case, a lawyer for work
.
Everybody finding out, gettingarrested.
You know, everybody would havefound out anyway.
(40:49):
But if I would have just knownthat it would have been that
easy just to go get some help, Iwould have avoided all of that
and going to jail.
But it's just that.
That was my biggest fear.
So I don't know the right answerto how we can reach our
colleagues, but I feel likegoing and speaking and all three
of us having different pointsof view on it and different life
(41:11):
experiences, if it's not onlyourselves and friends and
colleagues and everything that'sgoing on I know it's a hot
topic right now because it'sgoing on everywhere and if we
could go out and speak our ownexperiences and just really set
a foundation, I really like theidea of, like I mentioned, the
younger generation, or evenspeaking to people that are
(41:32):
struggling now and that therereally is help.
Because I know people knowthere's help but they're worried
about the consequences, notonly the peers finding out and
then admitting they need help,but the consequences of their
license, of their career, youknow, and some of them might be
even hiding it from theirspouses.
But I think, just starting withsomething small and laying a
(41:53):
foundation and see how thatworks, and then you know, maybe
if we go speak, do a little evalafter to what we can do better
or what people got from it or ifthey even liked it at all, and
if they didn't we could change.
And then the next time we gospeak somewhere we can ask them
again.
I kind of like that after wetake fire classes they want an
honest eval to make the programbetter.
So to make the program better.
So maybe we could do somethinglike that, build off of it.
Speaker 1 (42:17):
So well, gents, we're going to have to start wrapping
up.
My wife keeps wandering intothe kitchen to get snacks, which
means I need to start makingdinner, but what?
I will say Evan, you and I, whenpeople look at us, they don't
see PTSD I'm going to try to befunny here they see your
fabulous mustache and the factthat you're like six, three, and
then they see Dr Me with allthe accomplishments and
(42:40):
leadership roles I've had, andthey see your rank in the fire
service.
Right yeah, we have the socialcapital to be vulnerable, to
break down that stigma and allowothers to say that guy's super
successful and if he can bevulnerable, maybe it's not so
scary for me.
And we've met the three of ushave met a couple of times now.
(43:01):
I think that's where we'regoing to make a difference is
when we ourselves are willing tobe vulnerable, to inspire
others to say when I need help,I'm ready to ask for it.
Speaker 2 (43:12):
Yeah, then getting the stories out there of what we
went through and how our livesare better than ever now.
If you're struggling, we wentthrough that and we got the help
we need and our lives arebetter.
There is a light at the end ofthe tunnel and, like you said,
you coming in as a doctor, jesse, coming in me, coming in with
just the way we look and ourcareers and our families and
everything that's going well forus there is help and you can
(43:35):
actually get help and everythingcan be better.
You just have to want to.
You have to want it and bewilling to get the help.
Well said.
Speaker 1 (43:45):
To those healthcare providers out there treating
patients with addiction.
You're doing life-saving workand thank you for what you do
For everyone else tuning in.
Thank you for taking the timeto learn about addiction.
It's a fight we cannot winwithout awareness and action.
There's still so much we can doto improve how addiction is
(44:05):
treated.
Together we can make it happen.
Thanks for listening andremember treating addiction
saves lives.
I'll see you next time.
Welcome to the Addiction Medicine Made Easy
Podcast.
Hey there, I'm Dr Casey Grover,an addiction medicine doctor
based on California's CentralCoast.
(00:22):
For 14 years I worked in theemergency department seeing
countless patients strugglingwith addiction.
Now I'm on the other side ofthe fight, helping people
rebuild their lives when drugsand alcohol take control.
Thanks for tuning in.
Let's get started.
Today's episode is the fourthand final episode of our
(00:44):
four-part series on stigma,specifically the stigma that
healthcare providers face whenthey struggle with mental health
conditions, fading confidenceor even addiction.
And I have to give twoshout-outs before we start.
This episode is done incollaboration with Central Coast
Overdose Prevention, which is anonprofit I helped found here
(01:04):
on the Central Coast.
Overdose Prevention, which is anonprofit I helped found here
on the Central Coast ofCalifornia, focused on
advocating for addictiontreatment.
And this podcast was also madepossible by California Overdose
Prevention Network Acceleratorfunding from the Public Health
Institute's Center for HealthLeadership and Impact.
Now let me share the why behindthis episode.
(01:25):
Being a first responder is hardand it takes a toll on those in
the profession.
The suicide rate forfirefighters and doctors is
higher than that of the generalpopulation, and it turns out
that in one study, about 50% offirefighters admit to binge
drinking regularly, and wewanted to end this series on
(01:47):
stigma with a discussion abouthow people who save lives as
first responders often need helpthemselves, and it's really
hard to ask for help when you'rea hero.
This episode is an interviewwith two of my colleagues Jesse,
who is a firefighter and alsothe executive director of
Central Coast OverdosePrevention, and Evan, who is a
(02:09):
firefighter at the same stationas Jesse, and if you remember
the name Evan, it's because hespoke to us at the end of 2024
on this podcast about hisaddiction to opioids while he
was a firefighter and how he gotthrough it.
The three of us speak about themental health challenges of
being first responders and howhard it is to ask for help and
(02:34):
bonus.
Dr Reb Close, the founder ofCentral Coast Overdose
Prevention and one of myaddiction medicine colleagues,
shares her experience as afemale first responder during
the episode as well.
Before we start, I just want togive you all a little more
context to understand thisconversation.
Both Evan and I have beendiagnosed with post-traumatic
(02:56):
stress disorder from our work asfirst responders and just to be
specific about the timeline,evan developed his addiction to
opioids while he was afirefighter and he got treatment
for it while he was afirefighter too.
And Jesse and Dr Close sharetheir thoughts and feelings
about the stress of being afirst responder in general To
(03:17):
anyone working hard taking careof other people.
I hope you will consider askingfor help if you need it.
And with that, here we go Onthis call.
We have one doctor and twofirefighters, right, we signed
up to serve others.
We are naturally empathic, we'realtruistic, we want to give
(03:39):
back and we're selfless.
Right, you guys work crazyhours.
I've worked plenty of crazyhours myself and what's really
interesting is, I think it'sthat personality that's willing
to give and wants to help thatis so selfless sometimes that
the self-care gets ignored.
That sets us up to not build inwhat we need to stay
(04:03):
emotionally well.
I can tell you I was justchatting with my therapist this
week and yes, I have a therapist, she's awesome I was chatting
with my therapist that when Ifirst started as an ER doc, I
would never take breaks, wouldnever take lunches, and about 10
years in I was like I should bea little nicer to myself.
Maybe I should eat lunch, andI'm now having to start to build
(04:28):
in breaks in my day just to beable to take care of myself.
But I think that's why I wantedto be a doctor.
I wanted to go 110 miles anhour and take care of everybody.
You know, just like Jesse, youwere saying you're going to go
in and save every kid from thefire.
It's hard because we're wiredto want to push ourselves to do
our best.
Speaker 2 (04:45):
Yeah, then you throw on top of our careers a family
too.
So not only when we're at workwe're taking care of everybody.
When we get home we feel likeit's our duty, because we've
been working so much to be thatdad and be that father, be there
for our families, that wealways put ourselves last and we
don't take care of ourselves.
Another thing I was thinking asyou guys were talking that
popped in my head is an issue inour line of work is a
(05:06):
normalization of deviance.
So someone struggling with likePTSD might find ways to
self-medicate and they slowly doit.
So for example, say afirefighter.
He is struggling with PTSD.
He doesn't know what's going on.
His mind's going crazy.
His wife knows something's upwith him, but he doesn't know
why it's so hard for him.
(05:27):
When he's at work he's himself,he's around his peers, he does
the job, but when he gets homehe's a shell of himself and he
doesn't know why.
So he starts drinking, and he'sdrinking at home and he seems
to be happier.
So then when he's drinking athome it becomes a little bit of
an issue.
But he's self-medicating.
He starts feeling a littleweird at work.
So then maybe he starts, youknow, one day at night he might
(05:50):
have a sit, he gets away with it.
So you know, that shift I gotaway with this, or maybe next
shift I'll have a couple of sits.
But then all of a sudden youcome to work and you've had a
little too much, so you'venormalized that deviance and now
you've overdid it.
Instead of recognizing that youhave PTSD and you have a
substance abuse issue andgetting the help, because you're
so afraid of the stigma andwhat people will think you're
(06:13):
self-medicating.
And then it goes into work andthen all of a sudden, people are
losing everything.
Then they lose everything.
So that individual might'vebeen getting divorced, that was
one thing, but now you throw adivorce on top of loss of career
.
So then what's your self worth?
How are you looking at yourselfat that point?
What happens then?
A lot of people just shut downand it gets worse or, you know,
(06:36):
they end up taking their lifejust off of stigma and
undiagnosed PTSD from the job.
Speaker 1 (06:42):
So let's unpack that a little bit, evan, because I
think you're spot on.
It doesn't happen quickly.
So I did 14 years in emergencymedicine and something started
to change around, like year 10.
And I had a bad shift.
Oh yeah, yeah, it was a nightshift.
I don't like nights.
That's what it was and kind oflike you were saying, it comes
(07:04):
on slowly and then, yeah, youstart pushing limits slowly and
then, unfortunately, when itreally comes to a head, it's
months, if not years, ofsomething growing and festering.
That's a lot harder to fix.
I mean, I will tell you, ptsdis a permanent change in the
brain.
(07:24):
It can get better, but it nevergoes away.
And actually we have a doctorthat is coming to our area in
emergency medicine.
I just was chatting with hercolleague to colleague and I was
like you have got to take careof yourself in this job.
I didn't know this was going todo this to me, me.
(07:45):
The other thing you mentioned,evan, that I want to talk about
was stigma and around colleagues.
Oh my gosh, having to admit tomy colleagues that I had ptsd.
I'll be honest, I lied about itfor six months.
I could not bring myself totell my colleagues that I had
ptsd.
I was totally embarrassed.
I was afraid I was going to bejudged like, oh grover weak.
I finally had to own it becauseI couldn't lie anymore.
I just I ethically, wasically,was like I have to be honest.
Speaker 3 (08:06):
Yeah, I tend to wait until so a call like that and
I'll share the one that Evan andI had in December.
But you go through a call andyou get PTSD.
I tend to like suffer insilence because I don't want to
admit that I am weak or lessthan or I'm anything but an
(08:28):
alpha going to mitigate theproblem, anything but a hero.
I don't even want to admit itto myself that I'm a real person
.
So I'll suffer in silence andI'll shove it down and I'll just
either be quiet or sometimesreally happy to distract myself.
Or my face is in my phone, justsocial media 24-7, bathroom,
shower, everywhere, because Idon't want my mind to just go
(08:51):
like you know what I mean andlike.
So you just go, go and then youself-soothe with sometimes
healthy stuff, sometimes socialmedia, sometimes TV.
Sometimes you take your kidsand you embrace them and you
just you do everything in theworld that week with them.
Sometimes it's with your wife,sometimes it's not.
There's tobacco and alcohol andmarijuana and maybe other drugs
(09:11):
and whatever else we do.
That's not good, but for me atleast, like this call we had in
December.
It was full arrest in PebbleBeach, nothing gruesome.
We all had really horriblecalls.
There was no blood, nothinglike that, but it was a chaotic
scene and we didn't have controland a patient.
(09:34):
The outcome wasn't good and soyou didn't feel good and he
replayed it.
And we have such lack of gracebecause we feel we have to be
perfect on every single call andon spot, and at 8 pm and at 2
am and at 3 pm and whatever.
And we're not, because we'rehuman.
And so I at least for that callI had serious PTSD about it.
(09:57):
I was fragile, even ask Evanlike he would dude, I was not in
a good place and it was hard tolike hide it because it was
right here on my shoulder, mysleeve, my emotions, and I
couldn't even understand theprocess, like why am I doing
this?
Even my wife no offense, she'slike geez, doesn't sound like
that big of a deal, but it'slike you don't understand and
that's not to her, she's not inthe field.
(10:19):
So what happened, okay, whathappened, okay, did one get out
of your way?
Like how is that a bad thing?
But it's just.
I think sometimes even get ourown family to understand what it
is we do every day If they'renot a part of this field I think
is a struggle.
But if there's a way we canhave more grace with ourselves
and self-soothe in a morehealthy ways, then I'm all for
(10:43):
that.
But maybe it starts withtalking about it and having the
courage to be embarrassed thatyou're not that perfect hero,
you know.
Speaker 2 (10:51):
Yeah, 100%.
That call affected me as welland when I told my wife she was
like well, you've had way worsecalls, you've had like people's
heads blown off and stuff.
And I'm like okay, well, shedoesn't understand that it
affects you.
Every call affects youdifferently.
Like that one was more ofemotional, emotionally taxing.
(11:12):
We were prevented from doingour job and then the guy
perished.
When we have both been onmultiple calls like this when
people we were successful withresuscitation, and this one it
was just totally different.
So it affected us differently.
And jesse was the paramedic onthe call with another medic, but
that's a whole different story.
But this medic we were with isnot the most proficient
paramedic.
So Jesse was taking the leadand then the way everything
happened was just emotionallytaxing.
(11:35):
And then having to talk to PDafter and then thinking about
the outcome of like people thatwere there and family, like
where is this going to go?
And lead it was.
It was really emotionallydraining and when you try to
talk to someone like a familymember or anything like jesse's,
saying they don't understand,like we would check on each
other but you're just kind ofdeal with it and then you store
up all these calls untilsomething happens.
(11:56):
And it really hit home when yousaid on your phone, jesse,
because I don't even know whyI'm looking at my phone half the
time.
I'm just scrolling throughyoutube or I'm like googling
49ers.
Like for the 10th time a dayI'm like I already know what's
going on with the 49er.
Why am I just doing this?
Because I need to like have mymind off stuff.
I'm just like staring at thisphone so my mind doesn't think
(12:17):
about things.
It's just I don't know why.
It's hard because no one reallyunderstands.
And then we see, see it,because, like after we went on
that call, multiple people cameup to us personally and one guy
was like dude, you know how manyfights I got in on calls?
Why did you snap his shoulder?
And I'm like, of course, that'swhy we don't like admit that
we're struggling or want to talkabout these things, because
(12:38):
we're judged by our peers and Ithink they could have done
better even though they weren'tthere.
So you show a sign of weaknessin this line of work and it's
like they pounce on it.
So we're so ego driven to bethese tough guys and these
heroes, we're afraid to admitthe weakness.
And that goes into substanceand alcohol.
If we're afraid to talk about acall where we missed it, the
(12:58):
last thing we want to do isadmit we need help.
Speaker 1 (13:00):
Yeah, it's interesting that you mentioned
that.
So let's just again brieflyunpack some of what's happening
in our brains.
So you guys have maybe heard metalk about big T's and little
T's.
So a big T is a reallysignificant, difficult, painful,
traumatic event.
I took care of a young womanwho hung herself and I see the
(13:21):
image of her neck a few times aweek.
The ligature marks around herneck.
I still get flashbacks.
That was probably 11 years ago.
I mean, I just saw it there.
It's always on my right side,it's always right there.
Anyways, that was for me.
It was a big T, that was like abig, horrible case and the
little Ts are the smaller stuff.
(13:41):
And, Evan, that comes back tosome of the microaggressions you
were saying around things likecolleagues really doing the
opposite of giving support whenwe need it.
You know, for me I reallystruggled from a little t
standpoint, like a small microtrauma when patients would get
angry with me when they came tothe ER for chronic symptoms and
I was like I don't know how totreat 12 months of abdominal
(14:04):
pain.
That's not in my skill set andI was like I don't know how to
treat 12 months of abdominalpain, that's not in my skillset
and they get in my face and getmouthy and you're a bad doctor
and you could, you should havebeen helping me and that really
went with me.
And then they all snowballtogether over time and it adds,
and it adds.
Speaker 3 (14:17):
You know, coming back to like this alpha male
experience in the ER, theoperating room, yeah, you have
to be tough, you have to bestrong, show no weakness and
it's really toxic oh yeah,working in pebble beach is
beautiful and we have, you know,just civilians or little kids
(14:41):
will come up and want to checkout the ladder track and some of
the parents will ask, oh mygosh, are you ever scared
climbing that track?
And a handful of guys are like,oh heck, no man, I love being a
firefighter.
I'm on it, I'm 100% honest.
I'm like heck, yeah, I'm scared, especially when you throw that
ladder up in the middle of likenowhere and you're climbing
that thing and the wind'sblowing.
(15:02):
It is scary, but you know we'renot supposed to be scared, right
?
We're supposed to go and justhandle biz, and we would.
When you know it matters andadrenaline's rushing, we're not
even going to question it.
But it doesn't mean it's easy,you know, or less scary.
Just strive to be perfect onevery call and come home and
(15:24):
then be able to turn it off andthen be with your kid, be
present with your kids andpresent with your wife, and you
know that's a hard transition todo.
Have you ever driven with noradio, just nothing.
The window down, try it for 15minutes, like if you forget your
phone.
You'll be like either needingto get check in to rehab or feel
(15:48):
real therapeutic, but your mindgoes everywhere and I think we
do that a lot as firefighters.
Speaker 1 (15:54):
Yeah, I have an interesting question for the
group.
So obviously the three of usare men.
Do you guys have a sense ofwhat the experience is like for
female firefighters?
Speaker 2 (16:01):
Yeah, I haven't worked with too many female
firefighters I think three in mycareer but I did in my old
department.
One of the females I worked withreally struggled with fitting
in.
She wasn't the best at thephysical part, so from my
experience she was just overlynice to everybody to gain their
friendship.
(16:23):
But she struggled with thephysical side and then that made
her kind of like an outcast asfar as like all the men could do
all the physical side, and thenthat would have made her kind
of like an outcast as far as,like all the men could do all
the physical stuff.
She struggled with it butpeople failed to realize that
like we're all a team and shebrought a key component to the
team and that she was reallygood at writing grants and she
was a very good paramedic andshe was very good at writing
PCRs.
So like, as time went on shebecame more of a part of the
(16:45):
team.
How I look at it as a companyofficer is like you have someone
that's on your team that mightbe weak at some things but
someone's good at at leastsomething right.
So whatever they bring to theteam, utilize your team to
accomplish the task.
That's been my experience, atleast with my old department,
which this individual hadstruggled fitting in.
Speaker 3 (17:03):
I worked with a firefighter in San Diego and she
was a fantastic firefighter.
But I asked her that samequestion and this was a few
years ago.
It's still, I think, very mucha man's world a little bit.
But I asked her I'm like so howis it, how is it being in the
fire service as a female?
And she's like I know that Igot hired because I'm the right
(17:23):
person for the job, but Iquestioned that a lot Like.
Sometimes she's like did I gethired because I'm the right
person for the job?
But I question that a lot Like.
Sometimes she's like did I gethired because I was a female,
but she was the right person forthe job?
On top of that, she had theextra added burden of
questioning if she should evenbe there and she should.
She was baller, she was one ofthe best firefighters I've ever
worked with.
But I think it's harder forfemales in the fire service.
(17:44):
Just my opinion.
I'm not one so I don't know,but I think it's harder for
females in the fire service.
Speaker 1 (17:47):
Just my opinion.
I'm not one, so I don't know.
Yeah, and I obviously can'tspeak for my lovely bride and
partner in crime, the verybeautiful Dr Reb Close.
But I have to say I learned alot about the experience that
female physicians have beingdifferent from mine and that
there's an extra level ofscrutiny At the like oh, does
the female doctor really know asmuch?
(18:07):
She was very honest that whenshe came in as a new female
physician at her hospital shegot extra questioned.
She got more people making sureshe knew what she was doing.
It took her quite a bit of timeto really feel like she wasn't
the new doctor anymore and whenwe've gone back and compared our
notes, you know I was a newdoctor too.
It seemed like I was acceptedfaster and granted that's an
(18:29):
anecdotal case of two physiciansin the same hospital.
I read a piece written by afemale ER doctor talking about
imposter syndrome.
I hadn't heard the term and shewrote a very beautiful piece
about I know I'm here.
I know I went to medical school.
I know I did my residency.
I know I'm here.
I know I went to medical school.
I know I did my residency.
I know I know my stuff.
But sometimes people question meand I question me.
(18:52):
And when people question me itmakes me question me even more
and it was this like viciousfeedback loop that this poor
doctor was in of reallystruggling with.
You know, is she the rightperson for the job?
And it sounds like for thefirefighter colleague that you
have she was, and for my lovelybride, she was absolutely the
right doctor for our emergencydepartment.
She served 20 years there.
(19:14):
But I think it's interesting andit'd be interesting to get some
female voices in a futurediscussion around this.
But you know, the three of usare, you know, strong, strapping
men and we have this moreexperience of being afraid to be
vulnerable.
I'd be really curious to seehow it is, as a woman in a
male-dominated field, like beinga firefighter, that they are
even more scared of beingvulnerable because they're
(19:36):
already under scrutiny to yourpoint, evan because biologically
they're going to have lessmuscle mass and be built
differently and they might benot as tall.
I'd be really interested to seeif female firefighter struggle
in a different way, and I thinkthe answer is yes and it would
be very interesting to explorethat perspective.
Speaker 2 (19:52):
Yeah, I agree.
Yeah, the lady that I workedwith in my old department is now
an administrative chief, so sheused her strengths.
She had the weaknesses with thephysical part and she'd
expressed it to me.
I'd work out with her and tryto like help her, like, for
example, throwing ladders orstarting a chainsaw.
We just kept doing reps and shegot the physical side down.
(20:13):
But she was so smart, like Imentioned, you know she used her
strength and she's a battalionchief now with one of the
departments.
So very nice I remember talkingto her about that and she was
friends with my wife as well andtried to help her.
But like you come in, like yousaid, with that scrutiny, you're
already like at a disadvantagein some people's eyes, because
some people automatically thinkthis is like a man's job and
(20:35):
then so they start out with acouple points down in some
people's eyes.
So they're already having toprove themselves not only being
a new person, but also like areyou the right person for the job
?
Like jesse lady jesse workedwith and she happened to be and
then same in my situation.
But yeah, it's got to be toughto start out like that.
Speaker 3 (20:50):
It's also, though, equally tough when they're not
the right person, and it doesn'tmatter if they're male or
female, if they're not the rightperson for the job.
If you can't physically do itor emotionally do it, then don't
do it.
But some, I think, get hiredand talk about the fake it till
you make it, and I think it justwhen rules are bent, or sweep
(21:12):
that on the carpet a little bit,just get somebody through.
I think that's where it'sdifficult to see that, because
that's a safety thing.
And then we take thatpersonally, and you know, we all
want to go home at the end ofthe shift to our family.
That's the goal is to go homeat the end of the shift to our
family.
That's the goal is to go homeat the end of the day.
And so if we feel like there'sanything that could stand in the
way of that, like incompetenceor just not being able to do the
(21:35):
job, it increases the anxiety,at least in my perspective.
Speaker 1 (21:42):
One quick interruption from me.
Jesse Evan and I spoke aboutour experiences as male first
responders and how women canface challenges in
male-dominated jobs.
I wanted to hear from a femalefirst responder on her
perspective, and so I asked mycolleague and spouse, dr Reb
Close, who worked as anemergency medicine physician for
over 20 years, for herperspective.
(22:04):
For over 20 years for herperspective.
So I realized that I actuallyhave a female first responder
that I can ask about this.
The very lovely, very beautifulDr Webb Close Happies to be my
spouse.
Reby, what did you experiencethat you felt was unique being a
woman as a first responder andemergency physician?
(22:26):
You felt was unique being awoman as a first responder and
emergency physician.
Speaker 4 (22:29):
So I think for me what really stands out is that I
always had to prove that firstI had to prove I was the doctor.
Like I literally had to wear awhite coat, or nobody assumed
that I was a physician.
I mean, I'm only 5'2" I, youknow I just I don't command the
prowess of an older man.
(22:51):
And so, truly, especially whenI first came to Monterey I mean
some of the surgeons, some ofthe internal medicine physicians
that I worked with at the time,literally I had to prove myself
.
Literally I had to prove myself, and you know I would call them
(23:16):
for consultations and, wow, Ibetter have my stuff on point,
or they, just they were going toblow me off.
And so I got very comfortablewith learning that it was an
uphill battle just to havesomebody believe that what I had
to say had any relevance, therewas anything behind it that
mattered.
Speaker 1 (23:31):
I remember you talking about in residency.
You were trying to really, youknow, get guts and I'm going to
be tough and I'm going to seethe hardest patients.
How did you feel when you weredone with your training?
Speaker 4 (23:43):
Well, it was kind of the same.
I had to carry my weight.
I had to make sure that I, youknow, was seeing as many
patients as everybody else was.
Really pushing myself was I'lltake it, I'll go.
I got it, the ambulance wascoming and I got it, and you did
.
You had to show that you wereworthy of being in that position
.
Speaker 1 (24:02):
How did you feel it was different for you as a woman
versus a man?
How did you feel it was?
Speaker 4 (24:05):
different for you as a woman versus a man.
Well, and again, I think thisgoes back to just you know.
I mean, I'm little.
When I started I was young,which is funny.
You're still very beautiful,Thank you.
It's really easy not to take meseriously.
I have a really kind of casualattitude and I had to prove that
(24:28):
I could hang, I mean and truly,at some points that would
involve foul language and sayingthings that were really off the
cuff and very crass, to kind ofprove I could hang with the
boys.
Speaker 1 (24:36):
Yeah, did you ever have a time that you felt like
you couldn't keep up?
Speaker 4 (24:40):
Yeah, it was near the end of my career, to be honest,
in emergency medicine.
That was part of it.
It wasn't a male-female thing,it was just when I felt like I
wasn't pulling my weight.
That's actually when I leftemergency medicine.
I was like you know what?
This uphill fight?
I had been on it foressentially 20 years and my job
and truly this is how I felt ismy job could be better done by
(25:03):
somebody else, and so I steppedout.
I stepped out before I wasforced out, for lack of a better
way to put it.
I took myself out of the gamebecause I felt I didn't have
what they needed and fortunatelyI found a specialty that needed
me.
Speaker 1 (25:19):
Were you disappointed when you felt like you couldn't
keep up anymore?
Oh gosh tremendously.
Speaker 4 (25:23):
I always had a lot of trepidation going into my
shifts.
I was worried I wasn't going tobe smart enough, I wasn't going
to be fast enough, I wasn'tgoing to, I was going to miss
something, I wasn't going to doit right.
I needed to do more.
I always had that minute one inthe career, but at the end it
was I'm going to let down mycolleagues, I'm not going to
carry my weight, I'm not goingto be what they need me to be,
(25:48):
and so that's why I left.
Speaker 1 (25:50):
Yeah, just if you're wondering, the ER staff still
speak very highly of you andmiss you.
Speaker 4 (25:55):
Well, and it's the thought process I have regarding
the aging process and it'swould you rather go out too
early or too late?
And that was part of my thoughtprocess with leaving emergency
medicine when I did is I wantedto leave when people still liked
me before they found me toeither be a hazard or an
annoyance, or dragging thedepartment down.
(26:15):
That was my plan.
Speaker 1 (26:17):
Did you ever struggle at all with your mental health
while you were in the emergencydepartment?
Speaker 4 (26:22):
Mainly just my confidence.
You know the imposter syndromeof am I enough?
Am I fast enough?
Am I smart enough?
Can I do this?
Could it be done better bysomebody else?
I am very fortunate to havenever had what I consider
serious mental health issues butthe imposter syndrome.
(26:42):
I would literally at times gointo the restroom and look
myself in the eyes and givemyself the mantra to remind
myself that I deserve to bethere and I could do it.
Speaker 1 (26:52):
Do you think my colleagues judged me when my
PTSD became an issue?
Speaker 4 (26:59):
In my heart, the answer is yes.
I know they kept anything underwraps because they know you and
I are, you know, tight at thehip if I get to pick.
So, in other words, nobody'sgoing to tell me.
Speaker 1 (27:10):
They were courteous to you because we were married.
Speaker 4 (27:12):
Yes, a hundred percent, which is smart, because
I wouldn't have respondedreally positively knowing what
you were going through.
Speaker 1 (27:19):
No, and I, some of my colleagues sent me really
heartfelt notes of oh my gosh,I'm so sorry, and some of my
colleagues said nothing.
Notes of oh my gosh, I'm sosorry.
And so my colleagues saidnothing.
Thank you so much to Dr Closefor her thoughts and input.
And now we'll go back to theconversation between myself,
(27:40):
evan and Jesse.
So I want to ask you both aquestion.
So I remember as a new doctorin the emergency department at
my hospital I felt like I couldnot make a mistake.
I could not ask a question, Ijust needed to figure it out
myself for everybody.
I was going to assume I was theincompetent new guy and I
wonder how much of that cultureof we're all tough, the ER is
(28:03):
hard, get going.
See patients, we just got threeambulances.
Why are you taking a break?
I wonder of how much of that weall just assume is normal and
we probably should reconsider.
I'm assuming it's the same as afirefighter.
When you're new, you know youjust got to power through the
shift yeah.
Speaker 2 (28:22):
And then when you get experience too sometimes like
jesse and I and the fire serviceaspect, we have some years
under our belt and some peopleare afraid to admit they don't
know something, because if youalready have this experience,
you don't know that.
But I've gotten to the pointnow where I'm like, yeah, I
don't know, but we could learnit together, look it up, and
that's so much easier on my mindand like faking it or saying
something that's not correct,and then they find out later
(28:43):
that you're just making stuff up.
That just goes back to stigmaas well.
You're so afraid to look like afailure in front of your peers
that you're willing to makestuff up.
It's like we don't knoweverything.
As a ER doctor as well, there'sno way you can know everything.
We're so tough on ourselvesbecause we're expected to just
perform and do this job at ahigh standard that when we fail
(29:07):
or just make a simple here's aninteresting question for the
group.
Speaker 1 (29:14):
Do you think we as first responders and I guess the
emergency department we're kindof continuation of first
responders?
Do you think we judge othersmore when they are struggling,
or do you think we judgeourselves more when we are
struggling?
Speaker 2 (29:31):
And that's a good one .
I'm guilty of judging others.
I try not to, but I think maybeit might be like a slight
insecurity I have, and I thinkeverybody's guilty of it, and
it's really bad in the fireservice that when someone's
messing up or can't perform, totalk about them or point your
finger at their mistakes, orthat I can't believe that guy
can't do his job.
When you know someone thatyou're judging, you might not be
(29:54):
able to do the certain tasksthey're doing either, but you
weren't called upon to do thattask and perform in front of
everybody and you weren't theone that felt so.
It's easier to judge someoneelse, but I am kind of tough on
myself too.
I've relayed that to Jessebefore and he's like no dude,
you're doing great, you're fine,but I think I'm like 50-50,
which I need to be better aboutnot judging others 50-50, which
(30:15):
I need to be better about notjudging others.
Speaker 3 (30:18):
Think about all this stuff, and I couldn't even
imagine as a physician at CHOMP.
But think about all this stuffjust being on the truck Water
rescue, paramedicine, firetactics, wildland tactics,
confined space, trench rescue,low-angle rescue, high-angle
rescue, rope rescue there's somuch.
If I had a pediatric fullarrest, I'm a hundred percent
going to be in my phone lookingat the Monterey County EMS app
(30:40):
confirming that the medicationI'm giving is correct, cause I
don't run a lot of those calls.
But if I mess up in theslightest to answer your
question, doc, I'm harder onmyself.
I have more grace on mycolleagues than I am.
A judger by like my Myers-Briggspersonality is an INTJ and I
judge like crazy.
But I judge myself even harder,even my colleagues around.
(31:03):
I saw one guy was doingsomething and he made just one
little mistake setting up theoutriggers and he's like oh God,
stupid, I can't believe you didthat.
I'm like, bro, what do you do?
You got out of order.
You're all good Like you did 20million things right and one
little thing was off, but wejust beat ourselves up to the
point where it's almostdebilitating.
To be honest, it's too over thetop.
(31:24):
We do not know how to giveourselves grace.
Speaker 1 (31:28):
Well, I mean, it's hard because when we talk about
giving ourselves grace, thethree of us hold people's lives
in our hands.
I mean, you guys told me alittle bit about that one call
that went so badly.
I remember, jesse, you reachedout like what was I supposed to
do?
And yeah that's.
I think one of the thingsthat's so hard about being a
first responder or being in themedical field is when you
(31:50):
actually make mistakes.
People's lives have realconsequences and you know, I had
oh I had one really bad caseand I was working in the
emergency department.
I was the only doc working.
I had probably seven, eightpatients.
I was taking care of them,three of whom were really sick
and needed me, and then we got afull CPR in progress and I
(32:11):
totally mismanaged everythingand the CPR in progress ended up
dying.
I think the person was probablyin the process of dying and
there was nothing we could do tostop it, but a couple of the
nurses filed a complaint.
We're, like Dr Grover,absolutely mismanaged this.
This person is dead because ofme and I didn't actually realize
it was a part of my PTSD fromthe ER and I was journaling
(32:33):
about it the other day and, man,my nervous system lit up like
crazy and I was like, oh okay,time to talk about that with my
therapist, so I probably need tobring it up with her.
But yeah, I think when thestakes are so high, it's really
hard.
Speaker 3 (32:50):
I think about a pilot .
You know someone who has thissuper high stress.
The risk is super high.
If you mess up, you can't messup.
There's no grace for a pilotLike you are correct, right,
right, and they come home andthen they're gone for long
periods of time, so theirmarriages are just going on
without them and they get homeand you're almost like a guest
(33:11):
in your own family when you gethome, but you're trying to
integrate and turn it off.
And who are you?
I don't know the answer.
I just know that that stress isso high.
But you're right, lives are atrisk.
If we have a bad day at work,people are going to die.
That's a real thing.
We really do not sleep at nightbecause of that and you get
(33:33):
better at your job and moreconfident and maybe you don't to
look at your phone as much andyou have a good working
camaraderie with your crew.
So you got each other.
But you never know what you'regoing to get.
And that kind of stress toperform at your best and if you
don't, someone will die.
Man, what happens when we don't?
Because we don't all the time,it's impossible.
(33:56):
So how do you handle it?
You keep it inside.
You maybe go for a pill, you gofor a bottle, you go for a.
I don't know.
I think you do all of that andsome are healthier than others,
but that stress is real, and Ithink we just have a really hard
time admitting how hard the jobcan be emotionally.
We want to help others, but wegot to help those that help
(34:18):
others, but we don't even admitthat we need help ourselves, and
so we're just.
It's like this man, I'm goingto just go until I'm like
sliding into, you know, home andjust giving it my all, because
you know I'm not beingthoughtful about my life, my
longevity, my sustainability, myfamily, because I'm just trying
to survive.
And you can only go so far withthat before you start looking
(34:41):
for other stuff.
And I think our colleagues havedone that in many realms, like
police, san Jose fire, whateverwe go for stuff that's not
healthy and we want to stop that, but we just don't know how.
Yep.
Speaker 2 (34:55):
The stigma is so bad that we have peers in the
medical field and in the fireservice that are so afraid to
admitting to their colleaguesand their family that they have
a problem.
And a lot of our families whenI was going through my family
all knew but I was so afraidlike the people I love the most
and care about the most knowabout my issue but I was so
(35:15):
afraid for people at work tofind out.
That was like the end of theworld for me and guys get to the
point where they would ratherdie, take their own life, than
to admit to their peers thatthey're struggling and get help
and sober up and everythingwould be fine.
But they're so afraid of thatstigma because they hear about
(35:35):
another guy that got in troubleand around the kitchen table
everybody's talking smack aboutwhat he did to his family, just
like when I got in trouble andeverything happened and I heard
people, what they said about meand what the comments they would
make to me.
People are so afraid of thatstigma that they're willing to
take their own life.
And if we could come up withsome kind of program or just to
(35:56):
get out and talk to people likeI think that idea of trying to
reach firefighters or paramedicschool, firefighters in training
and get that into their headbefore they get into the field
and experience all this PTSD andbecause I mean it's a high
percentage of people in themedical field and fire service
that have it and then recognizethese signs when they come up
(36:16):
and not be afraid to ask forhelp and reduce that stigma,
even if we saved one life.
You know it's happening all thetime, like all over firefighters
taking their own lives, medicalpersonnel taking their own
lives, ambulance paramedics are.
If we could just like plantthat seed in the younger
generation of upcoming peoplethat are in this career path.
If we could plant that seed,that seed in the younger
(36:36):
generation of upcoming peoplethat are in this career path.
If we could plant that seedthat it's going to get help.
It's not worth taking your lifeLike there's resources out
there and there is a light atthe end of the tunnel and I've
lived it.
You know you've lived it.
Jesse's been through stuff andwe've lived it and we're better
now.
We understand, but you can getthe help you need.
Speaker 1 (36:56):
It doesn't have to be the end.
Yeah, I mean, you think aboutit.
At its core, addiction is whena person loses control of using
something to try to change howthey feel.
Right, evan, you were doing itwith opiates.
We talked about it on mypodcast and you know we've
talked about colleagues thathave struggled about it on my
(37:18):
podcast, and you know we'vetalked about colleagues that
have struggled.
It's so interesting becausesomebody asked me once what's
the best predictor thatsomeone's going to get sober and
stay sober, and my answer was awillingness to be uncomfortable
and be vulnerable and in ourline of work, that is the
antithesis of what we are taughtto be right.
(37:39):
When you are ready to actuallylisten to the fact that we can't
sleep because we get badmemories from bad calls all
night, and when we drink fivedrinks they go away.
When we are willing to actuallyconfront that, that's when the
healing happens.
And, jesse, you were saying aswe were getting started, there's
so many vices that distract us.
It's Netflix, it's pornography,it's sports betting, it's
(38:01):
alcohol, it's cannabis, it'snicotine, it's compulsive
shopping.
There are so many ways that wenumb as humans, and my patients
tell me about it all the timeand I hope I don't offend anyone
by this comment.
It's a lot easier to numb, getback up and go to work and
(38:22):
pretend that nothing's wrongthan to actually face it.
Speaker 2 (38:23):
Sure, and it's almost like something drastic has to
happen to open your eyes, causeI remember being in the deepest
of my addiction my marriage isin the rocks, I'm about to lose
everything.
But I thought, well, I have acareer, I have a house, I don't
need help.
Like I lose everything.
But I thought, oh, I have acareer, I have a house, I don't
need help.
Like I'll just keep it rollingfor a couple more months.
And it's like it took me gettingarrested to open my eyes and
then, finally, I was willing toget the help I needed.
(38:45):
And that's when I was like, oh,wow, oh, there is a light at
the end of the tunnel.
I really did have an issue,because we get into denial and
also, like we said multipletimes, that stigma of everybody
finding out we think you know, Idon't need help, we're always
helping everybody else.
So for us to admit we need helpis we've failed failed as a
husband, I failed as a father, Ifailed as a firefighter, you
(39:07):
know, even though I was alreadyfailing at those things.
But I was in denial because Iwas somewhat holding it together
.
Speaker 3 (39:14):
I don't know how, but can I ask you a question, evan?
You mentioned and I thought itwas really you hit it on the
head Like we can barely evenadmit if we didn't run a call
100%, how are we ever going toadmit if we're really struggling
with a substance use issue?
And so my question for you andyour experience because I'm sure
(39:35):
there's opportunities that youhad to say something but you
didn't and it took you hittingrock bottom.
We want to avoid our colleaguesfrom hitting rock bottom, yeah,
but how do you instill insomeone who's going through that
, before they hit rock bottom,to have the courage to get and
(39:59):
ask for help and admit weakness?
And I think we would struggleto do that.
And I'm just curious on whatyour experience or thoughts are
on that.
Speaker 2 (40:08):
You know, when I think back of my personal
experience, I could have easilyjust went into my chief's office
and I could have said I'madmitting to a problem right now
and they could have not got mein trouble.
I could have went and got thehelp.
I could have took a leave ofabsence from work or even
continued pay, like I did Wentand got the help that's paid for
(40:28):
through our insurance and theunion Came back, kept my job.
Everything would have beengreat.
But instead I pushed it until Iwas dealing with a criminal
case.
I was dealing with my licensefor work, so I had a lawyer for
my license, a lawyer for thecriminal case, a lawyer for work
.
Everybody finding out, gettingarrested.
You know, everybody would havefound out anyway.
(40:49):
But if I would have just knownthat it would have been that
easy just to go get some help, Iwould have avoided all of that
and going to jail.
But it's just that.
That was my biggest fear.
So I don't know the right answerto how we can reach our
colleagues, but I feel likegoing and speaking and all three
of us having different pointsof view on it and different life
(41:11):
experiences, if it's not onlyourselves and friends and
colleagues and everything that'sgoing on I know it's a hot
topic right now because it'sgoing on everywhere and if we
could go out and speak our ownexperiences and just really set
a foundation, I really like theidea of, like I mentioned, the
younger generation, or evenspeaking to people that are
(41:32):
struggling now and that therereally is help.
Because I know people knowthere's help but they're worried
about the consequences, notonly the peers finding out and
then admitting they need help,but the consequences of their
license, of their career, youknow, and some of them might be
even hiding it from theirspouses.
But I think, just starting withsomething small and laying a
(41:53):
foundation and see how thatworks, and then you know, maybe
if we go speak, do a little evalafter to what we can do better
or what people got from it or ifthey even liked it at all, and
if they didn't we could change.
And then the next time we gospeak somewhere we can ask them
again.
I kind of like that after wetake fire classes they want an
honest eval to make the programbetter.
So to make the program better.
So maybe we could do somethinglike that, build off of it.
Speaker 1 (42:17):
So well, gents, we're going to have to start wrapping
up.
My wife keeps wandering intothe kitchen to get snacks, which
means I need to start makingdinner, but what?
I will say Evan, you and I, whenpeople look at us, they don't
see PTSD I'm going to try to befunny here they see your
fabulous mustache and the factthat you're like six, three, and
then they see Dr Me with allthe accomplishments and
(42:40):
leadership roles I've had, andthey see your rank in the fire
service.
Right yeah, we have the socialcapital to be vulnerable, to
break down that stigma and allowothers to say that guy's super
successful and if he can bevulnerable, maybe it's not so
scary for me.
And we've met the three of ushave met a couple of times now.
(43:01):
I think that's where we'regoing to make a difference is
when we ourselves are willing tobe vulnerable, to inspire
others to say when I need help,I'm ready to ask for it.
Speaker 2 (43:12):
Yeah, then getting the stories out there of what we
went through and how our livesare better than ever now.
If you're struggling, we wentthrough that and we got the help
we need and our lives arebetter.
There is a light at the end ofthe tunnel and, like you said,
you coming in as a doctor, jesse, coming in me, coming in with
just the way we look and ourcareers and our families and
everything that's going well forus there is help and you can
(43:35):
actually get help and everythingcan be better.
You just have to want to.
You have to want it and bewilling to get the help.
Well said.
Speaker 1 (43:45):
To those healthcare providers out there treating
patients with addiction.
You're doing life-saving workand thank you for what you do
For everyone else tuning in.
Thank you for taking the timeto learn about addiction.
It's a fight we cannot winwithout awareness and action.
There's still so much we can doto improve how addiction is
(44:05):
treated.
Together we can make it happen.
Thanks for listening andremember treating addiction
saves lives.
I'll see you next time.
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