EMT Diary Training Academy Part Three: Stress Management
This article is from the archive of The New York Sun before the launch of its new website in 2022. The Sun has neither altered nor updated such articles but will seek to correct any errors, mis-categorizations or other problems introduced during transfer.

Long hours, terrorist threats, fear of exposure to disease – all these things can wear EMS workers down. During the third week of the eight-week FDNY EMS training academy, we get a lecture on stress management.
Since September 11, 2001, Counseling Services Unit (CSU), the psych branch of the FDNY, has seen 8,000 of New York City’s 12,000 firefighters. All the counselors have Master’s degrees in social work and experience in either EMS or fire suppression. No Ph.D.s here, but none of us want ivory towers anyway. We need counselors who understand what we go through every day. The counseling is free, it’s open to us and our families, and the issues we can seek help for don’t have to be job
related, they can be about anything. This is preventive medicine; the FDNY doesn’t want us to burn out and quit.
And there’s a high burnout rate in EMS. Most people last only five years. Ray Angelo, a local firefighter who’s also a critical incident stress de-briefer, tells us that whenever there’s been a critical event, such as a mass-casualty incident, or something smaller that for whatever reason has affected an EMT or firefighter profoundly, he’ll organize a therapy session within 48 hours of the event. Brooklyn born and raised, he’s an odd mix of firehouse jocularity and Psych 101, complete with grammatical mistakes and pronunciation errors.
“What we do at CSU ain’t the only way to cope,” he says. “What society as a whole does also helps. Take wakes. When someone dies, it gives everyone a chance to come to grips with things, talk about the deceased. Or take Jewish people.They sit shivers.”
We look at the Power Point slides showing the different ways a person can cope. Alcohol, drugs, spousal abuse (these are bad); sports, recreation, talking (these are good).
“Listen,” he says, “I don’t care who you get help from: CSU, your union rep, the clergy, I just want you to get help if you need it. Don’t sit there until you start having nightmares from whatever happened, or you’re drinking too much, or popping bennies.”
“Popping bennies?” I say to Connelly, my seat mate.
“Or sleeping pills. Or fighting with your wife. Talk to someone. It’s not ‘sissy.’ It’s like how some people, they see an electrical spark, they call our Engine Company. Then we get there, and they’re all sorry they called. They’re embarrassed. But I’d rather they call us for the spark than we get there and the whole building is in flames.”
We watch the requisite hokey 15-minute video produced by CSU, of EMS workers at each other’s throats because of the daily stresses of the job. In the film, Margie and Joe are partners. Margie, stressed-out, crumples up her paperwork and throws it to the ambulance floor. When Joe asks her what’s wrong she snaps back at him to mind his own business, who is he to talk, he’s been hitting the bottle a bit too much after work himself. Then they get a call for a pediatric cardiac arrest and fly to the scene, but they return to the stationhouse pissed off. The baby was, unbelievably, already 5 days dead. The mother was emotionally disturbed, and had waited days before calling 911.
“Dammit Joe,” Margie says. “I took this job to save lives, not to look at decomposing bodies.”
Unfortunately, as flippant as it may sound to the unaccustomed ear, the situations the actors deal with are realistic, and I enjoy the movie. But the propaganda is also pretty obvious.
“Gee, Margie,” Joe says, “you seem a little stressed. Maybe you should go down to CSU.”
“What?” she says, insulted. “And see a shrink?”
On cue, their lieutenant walks in and rests a hand on Margie’s shoulder. “They’re there to help, Margie.”
Margie agrees and leaves to make her appointment, and we see the lieutenant, whose marriage is on the rocks, cope with his own personal stress by getting on his knees and praying. As the piano music to “Lean on Me” fades in, we see Angelo’s name listed in the credits as one of the scriptwriters. Angelo is a burly man who, like everyone else at the EMS Academy, speaks perfect Brooklynese. He talks about his experiences pulling charred human remains out of fires. I recall an old partner telling me about responding to a motorcycle crash. The victim’s left arm was found 15 feet away, next to a lamppost. “You own your experiences,” he says. “Whether you like it or not, the calls you go on become a part of you. Every gruesome injury, every dead baby.” Connelly whispers to me about a call he went on for a baby found dead in its crib by its mother. He attempted resuscitation, to no avail. “It shook me up bad,” he says. Angelo says, “You’ll deal with some ugly situations. Stress will accumulate. You’ll need to clear your plate.” I whisper to Connelly that what bothers me is the elderly left alone, neglected. Those calls really get to me. Angelo says, “Remember, what bothers some people might not bother others.” I whisper to Connelly, “I’ll take all the crib deaths if you take all the neglected elderly.” He puts out a hand. “Deal.” Angelo sums up. “Listen. I’m just a fireman. I went from being a hero to being a zero, back to being a hero again. Now I think we’re back to zero.” Referring to the slew of tabloid articles about firefighter mayhem, the drunk driving and sex scandals, he waves a dismissive hand. “The public I could care less about. Nobody cares about us like we care about each other. And nobody understands us like we understand each other. Sometimes not even our families. So when you need help, seek it, any way you can.”
Amen to that, I think, and lead the class in giving Angelo a round of applause.
“And you get an Oscar for your hokey movie,” I say.