Sean Ryan, an Albemarle County firefighter and instructor, was the picture of health. He worked out, drank more than a gallon of water a day, and felt strong and fit. Like all of the County’s emergency fire and rescue staff, he had a physical every year, always with a good report. When the County added LifeScan screening to their health benefits, Ryan was shocked when the ultrasound identified a sizable mass on his left kidney. He went to his primary care physician, then to a specialist. Ryan had stage 3 kidney cancer, went through surgery and immunotherapy, and today is cancer-free.
“Another 18 months or so and I would have been in significant trouble,” he said. Looking back, he said, there were a few clues, but it was easy to dismiss them as side effects from his demanding job. “Kidney cancer can cause back pain and fatigue,” he said, “but in my job, we often have those symptoms.” Another clue, an elevated white blood count, he attributed to the strains, cuts and bruises that he often endures in a day’s work. His overall excellent health helped with a quick recovery, and he returned to work, while also maintaining his rigorous fitness routine.
Ryan’s experience illustrates the importance of early detection for everyone, and especially for firefighters, who have a 9 percent higher risk of a cancer diagnosis and a 14 percent higher risk of dying from cancer than the general population, according to the National Institute for Occupational Health and Safety. The tests he took offered a more thorough screening than an ordinary yearly physical. That’s because of the ultrasound imaging, which provides detailed information about all the internal organs. Specialized blood tests identify markers for prostate cancer in men and ovarian cancer in women. “We’re hoping this testing will help firefighters catch problems early, before they become a problem,” said Crozet Chief Gary Dillon.
The LifeScan wellness screening offered to County firefighters yearly in January or February also takes into account the high level of physical fitness they must maintain, with a six-part fitness analysis that examines strength, endurance, metabolism and flexibility as well as heart and pulmonary function under stress. It also makes personal exercise and nutrition recommendation and includes more familiar tests to assess cholesterol, body fat, vision and hearing.
Based on his own personal experience, Dillon added another screening for the Crozet crew. “I was surprised to find I had a skin melanoma,” he said. His was found early and identified at a dermatology visit. He asked a dermatologist to offer skin screenings at the Crozet fire house, and those will continue each May. “The County pays for LifeScan,” he said, “but we fund the skin cancer screenings out of the Crozet Fire Department budget. It’s a minimal charge, and a small price to pay.”
Suzanne Herndon is a firefighter for Albemarle County, one of a couple of staff members who monitor the physical fitness program under the guidance of Health and Safety Battalion Chief John James. In a way, Herndon said, she’s a good example of how those dedicated to public safety can improve their strength, endurance and flexibility.
“You know those people who just love to work out from an early age?” she asked. “That would not be me.” Herndon said her one athletic experience in high school was to try out for the cross country team, where she was the slowest by far, but also the most improved at the end of the season. She left athletics behind in college, and when she decided to become a career firefighter she knew she’d have to make some changes. She hired a trainer and also depended on the very fit crew she joined for encouragement. Herndon is 5’2” and wanted to be able to carry heavy ladders and hoses, as well as the weight of victims, and found ways to compensate for her small stature.
“All of us work out every day,” she said. Herndon sends out possible daily work-outs to all the departments, researching experts in firefighter fitness for suggestions.
Herndon is involved in the county-sponsored mental health programs, too, and she’s come to understand that her peers––both career and volunteer––are likely to put the needs of others before their own. “We’re a tough bunch,” she said. There’s some advantage to this, of course. Those responding to a fire or an accident must be willing to risk their lives to protect someone else, but there are disadvantages, too. “When it comes to mental health, those who work in emergency services are pretty sure that no outsider will understand their lives.”
That’s why Albemarle County provides resources inside its close-knit fire and rescue community for those performing under intense pressure while grappling with grief or family problems, and those deeply affected by the inevitable trauma of their job. Through a couple of programs, they can find someone who truly does know what they’re going through. Chief James heads up this program as well as the physical fitness piece. He’s a Crozet resident who’s seen firsthand the value of providing mental health resources that are familiar and trusted.
When it comes to counseling, “I was a skeptic,” he said, “but now I’m a believer.” Like many first responders, James has been through a lot of things he can’t forget, and last winter was diagnosed with PTSD (post-traumatic stress disorder). “It’s not always one big trauma,” he said. “Sometimes it’s an accumulation. Those of us who work in high-stress professions like this do a good job of hiding it.”
For them, there’s a peer support network throughout the county. Those who want to offer support provide a photo and a short bio telling a little about themselves and their own experiences and strengths. The submissions are collected in a binder, and anyone interested can make a choice. “Obviously, not everyone is the right fit for everyone else,” Herndon said. “This way, you just pick the one you’re most comfortable with.” Both James and Herndon are watchful for what they describe as “bad calls,” those that involve a fatality, a child, a suicide, or other especially disturbing emergencies. Herndon said that this kind of incident inspires them to immediately reach out to those involved.
James said the County also contracts with a clinician embedded with the fire departments. Chris Platania, a licensed professional counselor, agrees with James about the pile-up of stressful events. “We think of PTSD as the result of one huge trauma, but each incident of stress, anxiety and sorrow leaves its own mark,” she said. “Discussing these as they come up is helpful.” By getting to know in advance the men and women who deal with the ups and downs of daily life along with grisly accident scenes and the loss of property and human life, she makes herself more accessible.
“Someone may recognize they need to talk to a therapist, but by the time they are able to find an opening, it might be months,” she said, “and they may give up. I can quickly give them some specific, solution-focused ideas, and also help them with an appointment for long-term counseling, usually within a week or two.” Platania visits the County’s fire departments, sometimes simply to introduce herself to the volunteers, and sometimes to offer training to help them identify warning signs in themselves and their crew members.
“Knowing me makes them more comfortable,” she said. “I know this because each time I visit or conduct a training, I’ll get several calls afterwards.” She also goes on “ride-alongs” in response to a call for the same reason. These experiences help her understand what the volunteers face every day.
So far, she said, “I’ve been limited in what I’ve experienced. We joke that my scheduling a ride-along with any crew is a good way to make sure there are only routine calls.”
Platania became interested in helping first responders during the months around August 12, 2017, when she listened to the struggles of her friends in law enforcement after the violent “Unite the Right” rally in Charlottesville. She’s had a contract with the city of Charlottesville for four years, and with Albemarle County for a year or so.
She’d like her clients––and everyone who’s exposed to continuing doses of trauma––to know that stress can manifest itself in physical symptoms: a racing heart, a sick stomach, unexplained weight gain or loss, abuse of drugs or alcohol. When firefighters recognize the symptoms and call her, she knows her training is effective, and that the strategy of embedding mental health professionals works. “I normally ask new clients why they felt able to call me. The most likely answer is that someone who had already sought help encouraged them.”
Albemarle’s deputy chief of member services Heather Childress, who oversees many of the health programs, recalled the time when not much was understood about the complex threats to the health of firefighters: “In the old days, we’d just stay in our bunker clothes after a call. Now, we have special wipes and require showers, so our people aren’t absorbing toxins. When you know better, you do better, and we’ll continue on that path.”
She said the increased focus on prevention, early identification and mental health should encourage new recruits and inspire veterans to continue. “I can’t say enough good things about how these programs are carried out throughout the county.”
It all comes down to this, Childress said: “We want employees to know how much we value their wellbeing.”
There will be a meeting for all those interested in volunteering for the Crozet Fire Department Monday, July 10 at 7:30 at the Crozet Fire Station.