Stress and Injuries

The minimum national requirment for EMT Basic licensure is 130 hours. Roger Williams Medical Center, considered to train the elite of east coast EMTs has a 180 hour curriculum. All instructors are career firefighters or rescue specialists for FEMA. They know where of they teach.
Seeing as how the class has such a high reputation I was more than a little nervous for the first two classes. After an avalanche of paperwork and release forms we finally got down to the meat and potatoes of emergency medicine. The instructor, an EMT Cardiac from West Warwick, discussed how to protect onesself against blood and other body fluids which can carry disease. Gloves, paper gowns, masks, goggles, respirators, the whole bit. Its known as Body Substance Isolation, basically making sure none of the fluids come into contact with your skin. Having been a firefighter First Responder for the past three years, none of this was new to me. We went over all of the snooze legal obligations and took a break.
People in this class come from all walks of life. College kids, nurses looking to make extra money on ambulance runs, volunteer firefighters from the middle of nowhere, a former Air Force Rescue Technichan (considered to be the elite of the elite in the resuce world), and regular firefighters like myself. All of us are there to be trained in how to save lives, use simple and complex items to give our patients that much more of a chance of surviving whatever precipated their need for us.
Stress is high in a profession where you have to see everyone at the worst moment of their lives. We learn basic meditation and relaxation exercises in order to alleviate some of the strain. Then they show us pictures of gory wounds that would make John Wayne Gacy gag.
It wasn't until Friday that I learned about my best friend, Lance Corp. Ryan Henderson, USMC. He'd been sent to Iraq, working along the Syrian border last March. I'd received one letter from him, saying he'd been in an accident but he was okay. Friday I got a phone call while doing landscaping with my father's company.
Hender, we never called him Ryan but for some reason my dad said "Ryan's been sent to Germany, his Hummer got blown up. One of his legs is all torn up and the other one is broken."
From there I drove right to Hender's parents house. I was still covered in shit from working all day but I drove right over. From talking to his father, who hadn't slept in the week since it happened, I learned that a 105mm shell had been rigged as a mine that blew out the side of his Hummer, tearing apart his arm and both legs. His buddies suffered even worse, one lost an arm and the other three probably won't make it. Over the course of the next 24 hours he was airlifted to three different medical implacements. The first was manned only by two military paramedics but it had a satelite phone. Hender, managed to con or threaten them into giving him the receiver and called his father a good two hours before the Corps notified his parents of the attack.
Now, he's waiting in Ramstein Air Force base's hospital. The medical center where his father said "they send all of the really bad ones."
I went down the street to my friend Eric Perlman's house. He was upstairs on the phone so I grabbed a beer from his fridge and waited for him to wander down. When he finally came down, we did the usual hand shake and back slapping. Then the phone rang.
Hender had finagled another satphone in Germany and called for Eric. I grabbed an extension. He sounded good, in pain but good. His first words were "The Gerber tool you gave me came in handy the other day." I had given a multi-tool that I had used on rescue calls. When I asked for what he told me he used it to pull shrapnel out of his leg. Being the classy and oh so understanding guy that I am, my response was. "Oh, thanks, I don't want blood and shit all over it." He told us that we owe him dinner when he's well enough to move around again. I told him we'd take him to the Capitol Grille, a ritzy steakhouse in Providence. He corrected us, saying he would take us. Even with bits of stell and junk in his leg he wants to buy....trying to pay for even a beer with Hender is a battle lost long ago.

As soon as the Air Force or the Navy has a flight available, Ryan will be transported to the Walter Reed Medical Center for more surgery and to finally get stitched up by plastic surgeons. I plan on taking the first avaiable flight to Baltimore to see my friend.

Welcome to the Family

One of the deputy state fire marshals is waiting at the front of the room in, preparing a Power Point presentation on the use of explosives for rescue and demolition appilications. He's a chubby guy with graying hair and the shoulders of a former gym rat. Make no mistake about it, even though he's pushing 60 he still could probably drag a hose or throw you over his shoulder in full gear. He's a cherry looking guy with a white uniform shirt and two pagers on his belt. The other guy is dressed in SWAT pants and a sweatshirt with a denim collar and elbow patches. A massive Glock on sits on his hip next to his badge. Stencilling on his shirt identifies him as a member of the Fire Marshal's Office Bomb Squad. He's a young guy with a crew cut and the body of an ox.
As the two instructors set out their teaching aids-- det chord, primer chord, dummy C4 and gelignite, sizemographs and an assortment of non-sparking hand tools-- twenty or so firefighters from Holden and Clinton file into the room, hands are shook, pagers turned down but never off. Brght orange packets make their way around the room as I take my seat.
Dave, a firefighter EMT I work with in Holden looks up at me and says "Get me some coffee, rookie biatch," in a goofy voice. We try to ignore the blare of the movie playing in the adjacent room, since we're in a senior center we assume it's half deaf patrons are just about getting ready to head home to bed.
The presentation started off with a lukewarm safety lecture, basically don't smoke or play with an open flame around the explosives. From there we moved on to how to set up sizemograph meters to measure the intensity of a planned explosion. Basically you dig a hole and bury the unit or sandbag the hell out of it to protect it from any flying debris known as flyrock. The deputy marshal is in his element, going on and on about all the techno gizmos on the meter while the bomb squad guy picks at his nails. We learn how to propperly store and care for explosives, how to build the reinforced boxes and truck compartments to store them in. Over and over we are told "NEVER KEEP DETONATORS AND EXPLOSIVES IN THE SAME COMPARTMENT!" No shit though, right?
When the bomb squad guy gets up to tell us how to rig and render safe all of the equipment, we all sit up a bit, this is why we're here. The other stuff was just window dressing. He runs through how to rig the primer chord to the det chord and the det chord to the detonator and the detanator to the explosive. We use non electric detanors so it is safe, though not preferable, to leave all radios and pagers on during use. Basic safety precaution has everyone turn off their radio but when you're trying to blow a dam to alleviate stress from a mudslide or start a controlled avalanche, its a good idea to keep in touch with the rest of your crew. We learn how to jury rig a detonator out of batteries and how to diffuse our new creations.
All around MacGyver shit.
Afterwards we head out to Wong's Bar for beers and to rehash how much we don't like certain firefighters and members of the department. I'm told I'm the only recruit to ever be invited to an after drill party. I wear that honor proudly while trying not to show it. When I finish my Tsing Tao beer I realize that I only had enough cash for one.
When the waitress comes to replenish drinks I tell her I'm all set but Mike speaks up. "No he's not, I got his, and any food he wants." I tell him that its okay but his only reply is, "Bullshit, no one comes out with us and has just one drink let alone goes hungry." I take the drink but decline the food, not wanting to come off as a jerk.
Soon I get a plate of fried pork strips pushed my way. Jackie, the only woman of the group tells me to eat or she'll kick my ass. I devour a few handfulls of the meat while a group of skin heads with safety pins in their eyebrows and leather jackets saunters into our private room. They're loud and trying to make asses out of themselves but when they see the twelve of us they shut right up and leave after their complimentary tea.
The deputy chief invites me to join his squad for the upcoming firemen's muster, telling me, "We need a young guy to be the workhorse, you seem built for it." After three years of powerlifting I have more than enough brute force to drag a horse or a dummy in full gear.
When the bill comes I take out my last five bucks and promise Mike a drink next time we go out. He just waves his hand and says "Ehhhh, we're brothers now." Jackie downs whats left of her Mai Tai and says "Welcome to the family."

Physical Agility

Its seven thirty am, I haven't been up this early in months. The armory looks like something out of a bad movie, still covered in snow and ice, little slits for soldiers to fire their weapons from. A huge stone edifice now empty because the 115th Artilery Company is blowing the hell out of Iraqis as I walk up the front steps.
We all meet in the confrence room, surrounded by pictures of former army commanders. Three old guys in red polo shirts with "Fire PAT" stenciled on the left breast are standing around along with a paramedic from Boston EMS.
There are guys from all over Mass who want to be firefighters. Some of them have been EMTs and Paramedics with private ambulances companies for several years. One or two of them were rescue divers with the coast guard and at least one guy used to be a marine.
My stomach is burning, the Friday before hand I had come back from dinner with my girlfriend and found a puddle of blood in the toilet after I took a dump. After I take the pre test run through today, I have to go home to begin the prep work for a colonoscopy. At twenty years old, I have to get a camera shoved up my ass because of stress.
And I want to be a professional firefighter.
I watch as a potential firefighters from all over Mass are running through a battery of tests designed to simulate the most common activities performed by firemen. When I'm up, I have a stomach full of boiling ice, kind of like when you drink to much beer--cold and hot at the same time.
The first event has me raising and lowering a sixty pound weight to simulate extending a forty foot ladder. I blow through it with five and a half seconds to spare. Its not hard, I've always spent hours at the gym beating the shit out of my upper body. The next event is the killer, I have to pull a length of rubber tube through a U shaped maze to simulate dragging a fully charged hoseline. We get twenty seconds to do it. Beforehand, my father; who had taken the fire tests in Rhode Island; told me to wrap the hose around my shoulders and chest so I have to pull less of it. I get down low and pull it around myself twice like some kind of sash. Even with that little edge I finish one second over the propper time. Good thing its only a practice. Next I drag a 150 pound bag of sand through a maze, once again its no problem because of my time at the gym. I power through an event that has me beat the shit out of a rubber pad with a sledgehammer. Finally I raise and lower eighty pound weights as though I'm tearing down a ceiling.
When I get back to Rhode Island in the afternoon I have to go to the doctor for my prep work. I sit there getting the "Oh he must have cancer--he's so young" looks from all of the old people in the place. Trying not to notice, I bury my nose in a Clive Cussler novel.
That night I go to bed wondering if they'll find some malignant lump in my ass. The next day is no better so I try to blow off stress by working out like crazy. Deadlifts, leg lifts, curls, I move on to arms and blast myself with ab routines. In the afternoon I have to suck down laxitive cocktails to cleanse myself for the coming exam.
At six the next morning, my father took me to get probed. We parked near the helicopter landing pad behind the hospital and I thought of how I watched a Coast Gaurd chopper land there on TV a few years back. It was cold, really cold, pre dawn Rhode Island in the middle of winter.
In the office, I tried unsucessfuly to engross myself in some novel but found I couldn't concentrate, nervous and tired from a night of total intestinal evacuation. A few old people were there and, again, I got the "Oh thats too bad" stares. I tried to relive the excitement of the fire test the day before but found I was too nervous--the possibility of rectal cancer does that to you.
I don't really remember the exam, just feeling really drunk from whatever drugs they pumped into me. Apparently at one point I demanded pictures of the inside my ass because while I was in recovery, a nurse came out and handed me a set of six snapshots that allowed for a new type of introspection.
After finding out I was cancer free, but still suffered from an ulcer, hemroids and allergy to wheat, my first action was to purchas the largest plate of pancakes I've ever seen. Six huge flapjacks heaping with butter and syrup. My favorite meal from then on has been pancakes, its the go to food.
Cancer free, I returned to take the actual fire physical agility test one month later. More than a little nervous from lack of energy from the recent events, I had spent the every day of the last month in the gym. Often I would go twice a day with swim and track training thrown in for good measure. For two weeks I ran with a 75 pound dumbell on my shoulder while the football players laughed at me and pretended to work out.
Of course, I was scheduled last out of a group of 35 prospective firefighters. Three of whom failed on the dreaded hose pull. Four more crapped out on the darkened maze. When I finally got up I was a bundle of nerves. As before I blew through the ladder raise event. I squeaked through the hose pull with a second to spare and drove through the seldge hammer event so fast the machine nearly broke. The 150 pound sand bag slid from my grasp and nearly pulled off a finger nail but I managed to pass with three seconds to spare. The darkened maze proved more difficult. Having been a volunteer firefighter in Rhode Island I had worked in blacked out environments but always in bunker gear. During the test all I had on was a helmet and a vest to simulate full gear. Two by fours were thrown through out the maze at odd angles and with out the padding of bunker pants I slammed a knee into a board so hard that the test proctors asked if I needed the paramedic. But I still passed. When I limped out of the maze, my knee was already blowing up, again they asked if I needed the medic but it would be an instant dequalification, so I hopped to the last event and raised an 80 pound weight and then pulled down on a 65 pound weight five times. I had to perform twenty eight repitions of this procedure over the course of four minutes to pass. As my knee took on the size of a watermelon I pushed and pulled for all I was worth, beating the hell out of that machine and getting covered in metal shavings durring the process.
After receiving a form that said I had passed I drove right to the Holden Fire/Rescue headquarters still covered in sweat and grime. The secretary laughed and asked me to wait in the hall because I apparently smelled pretty rank and processed my papers.
One of the proudest moments of my life was when I called my father on the way back from the station. He had wanted to be a firefighter in Rhode Island and had passed all of the tests but had not been hired because he lacked EMT training. He had always wanted me to go for the fire department and now I was well on my way to becoming a professional firefighter.

Current Workout Plan

When someone falls into the sea, miles from land and rescue personel, the coast guard dispatches a chopper team to the last known position. Within minutes, a rescue swimmer plunges from the helicopter into the water to search for the victims of whatever maritime diaster percipitated their call out.

The swimmer is equiped with either a dry suit or wet suit depending on water temp and weather conditions. No scuba gear is issued, only a mask, snorkle, fins, and CO2 vest. Swimmers are expected to be able to swim and survive in any sea for a half an hour at the least.

Training for this position is intense to say the least. In addition to being nationaly registered paramedics the swimmers need to be in peak physical condition.

The following is the manditory fitness plan for US Coast Guard rescue swimmers. It is also the premier workout for public safety dive teams and the work out that I currently follow.

Day One
Chest:
Bench Press-- 4x5
Incline Press-- 4x5
Butterfly or Cable Fly-- 4x5

Shoulders:
Military Press-- 4x5
Shrugs--any combination of 20
Plate or Dumbell Raise-- 4x5

Day Two
Biceps:
Straight Bar Curls-- 4x5
Preacher Curls--4x5

Triceps:
Tricep Extensions-- 4x5
Tricep Raises--4x5

Forearms:
Gripper--20
Day Three
Legs:
Squat alternating with Deadlift-- 4x5
Leg Raises-- 4x5
Leg Curls--4x5
Calf Raises-- 4x5

Back:
Standing Row or Lat Pulldown--4x5
Seated Row--4x5

Day Four
Cardio
Swim one Mile
or
Run one Mile
or
Bike for 30 minutes


All days have thirty to thirty five minutes of low impact cardio in addition to an ab routine consisting of 50 crunches and 100 alternating crunches

The First One

Everything was black—not just dark but a greasy cloak that blotted out even the light on his chest. One long continuous roll of thunder hammered his eardrums. He was deaf and blind, wanted to scream but knew it would make no difference Even though he couldn’t see his two buddies he knew they were there, on their hands and knees just like him.
Under his bulky gear, his uniform was drenched. Each breath sent shards of ice into his lungs. His arms and legs were lead, his lips cracked from the beginnings of dehydration. If his vision returned, it’d be blurred by sweat.
Crawling along, he thought of all that could go wrong. For a brief moment he wondered if he’d ever see his family again. The weight of the huge vibrating snake in his left hand provided some comfort—at least he could follow it back out.
Just crawl, shuffle the knees and keep your right hand on the wall.
He crawled for an eternity, his head wrapped in black linen, submerged in oil. The searing heat, the blindness and the raving of a thousand deranged voices terrified him. His mouth was full of gravel.
Something thumped into his shoulder and the crown of his head. Collision with some unseen barrier sent a wave of panic through him, his stomach threatened to climb up his throat. Trying to crawl back would cut him off from his crew; leave him even more vulnerable than he already felt. That was all it took for the nightmares of his unconscious to breach his mind’s flimsy defenses.
I’m lost.
I’m gonna die.
The barrier spun around before his wide eyes, a pale shaft of sickly yellow light cut a trench through the pitch. Eyes and teeth gleamed dully in the deep haze.
“Watch it, dipshit,” even with the earsplitting fullisade he knew there was no malice in the admonishment. A huge meaty paw clapped him on the shoulder. “You’re doing good.” He nodded at his smiling buddy, hoping the fear didn’t show in his eyes.
Abruptly the blackness returned as the eyes and teeth spun back around. A series of short jerky movements played out in front of him and more of the dark ooze choked his straining eyes.
Something pounded him on the shoulder from behind and a voice yelled: “Hold on to it, probie!”
The three rose to their knees and hugged the surging canvas tube to their chests. His hands rubbed raw and the muscles in his shoulders threatened to tear free from the bone under the stress. The hose was possessed, bucking and twisting in his grasp. More than once he was afraid it would escape and with it the respect of his two peers. His bruised fingers dug into it with renewed vigor.
First the roar got worse; it was less a sound and more a living force intent on pummeling his organs into jelly. And still he saw nothing but a twisting, dancing night.
Slowly the black faded to a dirty gray, deep and angry as the beast died. Wisps of greasy fog wrapped around his face and moisture beaded on his mask. He could make out shapes: the guy on the nozzle, a mangled chair and coffee table. The color had been scorched from everything in the room—soot covered everything like some kind of demonic snowfall.
The roar cracked into a hiss and finally nothing at all but the sound of his own breathing, heavy and ragged in his head. Light was pouring into the dead room from a jagged hole chopped through the ceiling.
All at once the spasmodic seizures of the hose ceased. He slumped back on his heels and let out a long, exhausted breath.
The eyes and teeth had morphed into a sweat crusted, ash streaked face bisected by a wide but slightly crooked grin.
“Not bad for your first time.” The man said as he mask dangled from his shoulder.
When his own mask came off, he could only choke on the still acrid air in response.

5/1/05 Nick Stabile