I had the pleasure of attending the Brothers Helping Brothers Health & Wellness Conference this year (my inaugural) ... and I had no idea what I was getting myself into.
The true courage, commitment and selflessness in that room - speakers, guests and organizers alike - is astounding. I know I am not alone in saying I am truly changed after 3 days in exotic Beavercreek Ohio and feel honoured to have been present.
It's a small room - maybe 120 attendees each day if I had to guess - incredible considering the phenomenal line-up that Nick and Jimmy have a knack for putting together in terms of speakers. But the intimacy of it leaves you feeling connected, involved and more than a little honoured.
There is an ever-present air of pure, unadulterated truth - not with the intent to focus on the traumatic experiences first responders are expected to swallow throughout their careers, though there is a fair amount of that for context for sure, but to draw out what happens afterwards. What happens after the magazine cover commercializes trauma, after the horrors of 9/11, after a career or family or brother or entire crew is lost. What to do with it. What is important. What to look for in yourself and in your brothers and sisters and family. And most importantly, how to speak up, how to ask for help, how to offer help, and how to get help; The result is a collective understanding and wholehearted acceptance that the only shame is staying silent.
I am not a first responder. I am a proud firewife entwined both personally and professionally into the firefighting community. There are so many takeaways and personal moments from this conference - and I'm sure everyone you speak with will have a different list. I've taken a crack at my Top 5. I hope you find it helpful and find inspiration to attend and/or support next year's Brothers Helping Brothers conference.
Please don't hesitate to make additions, comments or leave questions by comment below or email me privately at firstname.lastname@example.org.
Note - order is random, not necessarily prioritized by importance
1. Sleep is Everything.
Sleep 'hygiene' was a recurring theme. Dr. Sarah Jahnke, Center for Fire, Rescue & EMS Health Research and Brandon Dreiman, Indianapolis IAFF Local 416, both discussed the importance of sleep and how it is connected to every aspect of our health and wellness. Both recommended reading Why We Sleep by Matthew Walker [BOOK, PODCAST], which I spent the entire 9 hour drive home doing (listening ... not reading) because I was so fascinated.
Adults need between 7 and 9 hours of sleep a night. Sleeping 6 or less hours is linked to numerous health conditions including certain forms of cancer, Alzheimer’s disease, diabetes, being overweight or suffering from obesity (even if you think it doesn't affect you). Lack of sleep also correlates to increase in heart attacks and strokes, a marked drop in testosterone levels for both men and women, increased stress and anxiety (associated with higher levels of depression), and results in an increase in suicidal ideation and suicide itself [STUDY LINK]. The less the sleep, the bigger the correlation.
Conversely, healthy sleep boosts your immunity, physical fitness, and mental health, improves memory and creativity and even helps protect from cancer. Fun tip - for maximum workout effectiveness, hit the gym or attempt a PB at 1:00pm.
There's so much to dive into here, so definitely drive 9 hours to listen to the book, but here are the good Doctor's 5 tips for improving your sleep:
Go to bed and wake up at the same time every day - even on weekends. This is tough when you're on shift of course (or if you're a parent...), but it's important to make an attempt to get back to schedule as quickly as possible. When you lose sleep, you can't get it back.
Don't stay in bed if you're not sleeping. If you've been in bed and awake for 25-30minutes, get up and go to another room until you're sleepy, and then go back to bed and try again. Staying in bed while awake trains your brain that this is the place you stay awake... versus being the place where you sleep.
Coffee has a half life of 5-6 hours and a quarter life of 10-12 hours. That means that if you have a coffee at 2pm, you still have 1/4 cup in your system at 12am - 2am. Even if you think you're the type that can still fall asleep with caffeine in your system, Dr. Walker says it actually affects how deeply you sleep - your brain can't fully fall asleep like it should, leaving you unrested even after a full night's sleep. He recommends wrapping up your caffeine intake earlier (I now aim for 11am).
Alcohol is a sedative, which can 'knock' you out initially, but it takes away your ability for naturalistic sleep. It also fragments your sleep so you wake up more often during the night, and keeps you from getting necessary REM sleep (when you dream and the part of sleep that is critical for mental health and emotional restitution). So, if you must drink ... hit the pub for brunch so it doesn't affect your sleep!
It's easier to sleep in a cold room, most optimally 18 degrees Celsius at night (16-18 degrees if you like it even colder). Get your extremities warm and your body core temperature cool before getting into bed - having a shower or bath before bed will do this, and don't worry if you have to wear socks or keep a hot water bottle in bed. BUT, pre-set your thermostat for a warmer temperature for the morning - about 21 degrees Celsius for when you wake up.
+ the tips we know ... Keep your room darker than dark (if you can see where you're going when you get up to pee, it's not dark enough), put on some white noise (or pink noise, which is apparently more conducive to sleep), and stay off the electronics, which are actually designed to keep your brain awake.
2. Speak Up.
There is no medal for suffering alone. Pushing down and ignoring overwhelming feelings affects not only you, but everyone around you - at work, and at home.
Travis Howze, former Marine, Police Officer and Firefighter, explores a few reasons why we may not want to speak up and get help:
- The mentality among police and firefighters that 'we are the people who help other people - we are not the people who ask for help'. This isn't toxic masculinity, but rather a connection to the role in service and need to be strong for everyone around us. It's noble, but harmful.
- We feel like people won't understand what we're going through
- Training. The 'suck it up' mentality that has prevailed for many years. Travis would call this "Cowards at the Helm" (check out his new podcast), where a supervisor does not lead by example. Do something different.
When my husband was a rookie, his department held a session for family members around mental health (I was surprised to discover very few departments do this). One of the key takeaways for me and that may be difficult for some to hear is that your family member may not want to speak to you about their inner turmoil - you just may not be that person for that particular job regardless of how much you want to be. The important thing to stress is speaking to SOMEONE.
Speak honestly to your family, to your firefighter crew / co-workers, to a clinician or therapist, to your management, and to yourself. Check in regularly. Phone-a-friend. The most important thing to remember is that the courage is in the speaking, and shame is in the silence.
It is also important your family know you are going through something. We WANT to help, but need you to show us how and open the door. (Travis has a secret codeword his wife knows to get him out of stressful or triggering situations ... you should ask him about it).
Lastly, get HELP and don't give up if you don't find the right person right away. Commit to finding them. Retired Captain Mike Dugan of the FDNY reiterated the importance of a clinician when it came to developing the tools to help him cope with his PTSD following 9/11, and went through a few before finding someone he could truly connect with (#1 was a little inexperienced for him, #2 had a squeaky, high pitched voice, and #3 was just right).
3. Know What to Look for
So, here's where I reiterate that I am by no means an expert in this area. Please consult a clinician, or one of the many resources available if you think you or someone you love might be suffering with PTSD. Everyone's circumstance are individual; the below is a collection of notes I was able to jot down and subsequent research.
A big takeaway for me was a reminder to consider motivation of behaviour versus just dismissing someone as rude, or angry, or as a 'dick'. That guy you know who can be difficult to work with and be around may be telling you he's suffering. Here is a non-exhaustive list of PTSD indicators:
- Recurring nightmares; difficulty falling and/or staying asleep; avoidance of sleep
- Abuse of drugs or alcohol; coming to work under the influence
- Outbursts of anger, irritability
- Taking unnecessary risks on the job
- Constantly on guard
- Morbid and offside jokes (beyond the firefighter norm...)
- A loss of interest in activities
- Use of the word 'burden' (i.e. 'I'm sorry to be a burden')
4. Decon, Decon, Decon!
I'm going to keep this one short because it's basically my soapbox (badump-ump), and stick to a few reiterating facts and resources I'm sure I will expand on later -
- A nasty cocktail of toxins are entering through your skin, and causing cancer, DNA mutation and fertility issues [check out sootsoap.ca/facts for more information and background on these toxins]. These include PAHs, PFAS/PFOS and toxins such as benzene and formaldehyde ... etc., found in smoke, soot and even in your own gear.
- That smoky smell = toxins. Dr. Jeff Burgess, Associate Dean of Research at the University of Arizona and firefighter research guru, referenced a study showing smoke odour on the skin of firefighters was associated with a 40% increase in PAH in post-fire urine. Smell comes from somewhere. If you still are smelling THAT smell, you're not done washing or you're not washing with the right soap.
- Children of Firefighters are 27.4 times more likely to be diagnosed with cancer than a child in the general population. This is 1 in 204 cancer diagnoses in children of firefighters versus 1.7 in 10,000 in the general population, based on a study on career firefighters' children in Kitsap County, Washington. These toxins are dangerous to you, and dangerous to your family and friends.
- Deputy Chief Frank Leeb of the FDNY, decon champion, shared many more amazing cancer prevention tips and reminders. Check out Tips from Training #10 HERE.
The bottom line is that the information is overwhelmingly on the side of contamination. It's time now to be diligent and to DO something about it.
5. YOUR Health is YOUR Responsibility.
Your department, union and associations have individuals helping to improve protocol to prioritize your mental, physical and even spiritual health, and to all of you making that a priority for your crew(s), thank you. There are numbers you can call, time you can take off, resources you can take advantage of. Your benefits are enviable. You will also hopefully be provided with multiple sets of gear, ways to clean that gear, processes and procedures for when and where to do so, and given the tools and products available to help you live your cleanest fire life.
But at the end of the day, your health is YOUR responsibility. It is YOUR responsibility to speak up when you need help and to call that number or tell a friend or find a therapist or clinician. It's YOUR responsibility to keep your body healthy and make the changes needed to live a healthier lifestyle for yourself and your family. It is your responsibility to ask for information where there are gaps. Your health is YOUR responsibility. Just like no one will prioritize sleep for you, present healthy and nutritious food to you, or magically make your muscles work without you putting the effort in, no one is going to wash those toxins off your body but you. It may be that no one ever hands you a bottle of decontaminating soap. Should they? Probably. Do you need it? Most definitely. Will they? I truly don't know.
There is a lot of change happening in the fire service (or at least we're sure talking about it a lot) - and gods know how y'all feel about change! But what has become drowningly apparent is that we cannot afford to wait for that change to catch up to the need.
Your Health = Your Responsibility.
As I process my own personal experience with health and wellness in the fire service over the past 5 years with the Brothers Helping Brothers conference last week, I find I am tired. I'm a little emotionally worn, frustrated, afraid, and completely and utterly invested. I have taken on this fight (and man is it a fight!), and I will keep fighting out of pure passion and pure carnal, emotional need. But I need you to fight with me. Champion change in your department, and take charge of your own health. Lead by example. There is nothing more important.
Stay safe, stay healthy, and sleep well.