Firefighters deal with accident and murder victims and are often first on the scene at horrific road smashes. Many suffer post-traumatic stress, but that’s not the only danger they face. Richard Willingham reports. The ghost gum stands tall and proud in the backyard, a picture of urban serenity. Beneath its branches sits a green and white painted wooden chair, the kind of seat that would not be out of place on your grandparents’ verandah. Glen Cavanagh still can’t get it out of his mind. This was the chair upon which the young woman stood to climb up into the branches of the tree. She was still hanging there when Cavanagh arrived. All this time later, the veteran firefighter recalls this as the moment his descent began.
A firefighter of 30 years, Cavanagh stops several times as he talks, to hold back tears, apologising as he relives the moment the girl’s father arrived home to be met by a fire crew. “He was on the floor in the foetal position, then he was up dry retching, he was hanging all over me, he was crying.”
You want to cope, says Cavanagh – you want to get on and do your terrible job.
“But it’s not the dead body. It’s the family. It takes chunks off your soul.”
A day in the life of a firefighter.
Children dream of growing up to become one. But the reality is that many people would struggle. The modern firefighter’s job is far from the celluloid image of pointing hoses and rescuing cats from trees. Murdered babies, drug overdoses, suicides and the clean-up from train and car accidents – these are the day-to-day realities of the job. And like soldiers returning from war, many firefighters carry mental scars, including a number who, like Cavanagh, live with post-traumatic stress disorder.
For decades firefighters have avoided talking about the emotional burden of their work – reluctant to seem vulnerable (even to themselves) and afraid that this vulnerability might be held against them in the workplace. But slowly this is changing. As evidence grows about the cost of these stresses, mental and physical, firefighters are speaking out.
Firefighters have their own neat metaphor for what can happen when you do the sort of work they do: they talk about a bucket. Each of them carries one, and over time it fills up with the things they have seen, the things they have had to do. Sometimes the buckets overflow. For 54-year-old Cavanagh, the bucket that had started to fill as soon as he saw the dead girl in the tree, began to overflow years later in the middle of a road. A fuel truck had T-boned a car, rupturing its tank and incinerating the car and its driver. The details are too grim to go into here but Cavanagh remembers them all.
It took the crew a long time. These days Cavanagh worries a lot about his family. He worries each time they drive away to work or school or wherever they are going. He knows that it is irrational.
Firefighting has always been a tough job, far tougher than many imagine but the gig became a whole lot tougher in the late 1990s when the Metropolitan Fire Brigade began to phase in a new set of responsibilities, the emergency medical response, known simply as EMR, to firefighters’ roles. Where previously ambulances would have been the first on the scene, now fireys trained in emergency first aid were dispatched to triple-0 calls including for heart attacks and drug overdoses. These days fire crews often arrive before paramedics and start working to save the patient. And often they are charged with cleaning up the mess.
As reforms go, the introduction of EMR has been a significant success. Fire crews have much quicker response times than ambulances. But it has come at a cost to the firefighters who are at the frontline of the state’s emergency services. Veteran firefighters say before the introduction of the EMR people could go years without seeing a dead body. Now it can happen on a near weekly basis for some crews.
Then there is the “biological washdown”. This clinical-sounding euphemism describes the task that falls to firefighters after fatal car crashes, after disasters, after someone steps out in front of a train. Basically they get to scrape up the pieces and spray away the than fires to fight gore. It often happens after dark. Some fireys now refuse to work night shift for this reason. “They are sick of picking up body parts,” says one senior firefighter who helps counsel struggling colleagues.
Post-traumatic stress disorder is better known as PTSD. Symptoms include flashbacks, nightmares. Sufferers will try to avoid situations that might trigger an attack. They become anxious, shorttempered, easily aroused. Hypervigilant. Always prepared for the worst. Some self-medicate with alcohol and other drugs. Different people respond differently. For some it is an instant reaction to a traumatic event. For others it might take years after the initial event before the symptoms surface. For others there is no one event, just a culmination of years of service.
International studies have shown that firefighters are at a greater risk of PTSD than the general population due to their line of work. The director of the Australian Centre for Posttraumatic Mental Health, David Forbes, says they are also at particular risk of entrenching the problem. “If you have PTSD and you are a firefighter and your job is to continue to fight fires, it’s really continuing to expose you to something that can continually reactivate these triggers.”
Alongside PTSD sit other risks. Forbes says work-related depression is as widespread as PTSD among emergency services workers. Anxiety is common.
Substance abuse is also a problem. The ripples keep expanding. In 2013, a report from Newcastle University’s Centre of Full Employment and Equity (commissioned by the powerful United Firefighters Union) found that “given the psychological impact of firefighting higher prevalence of PTSD . . . depression, anxiety and alcohol or drug use there is a probability that firefighters may be more likely to commit suicide”.
Unsurprisingly, the families of firefighters often share the burden. Brian O’Connell has been a firefighter for 25 years. Like Cavanagh, he has battled PTSD. (The trigger for him was when a colleague was seriously burnt during a fire.) In the end, he says, he could not think straight. He was easily agitated, his mind a washing machine. He remembers one day staring out the window, drinking coffee, thinking about “absolutely nothing”. His young son asked him to play, then, getting no response, started to plead. O’Connell was shocked at the anger that rose up in him.
Anger that had nothing at all to do with his son, but that affected the boy even so. Every firefighter approaches trauma differently. Some share their work experience with loved ones, others deliberately keep work and home life separate. For most, de-briefing with colleagues is the easiest. But in the end, there is a growing recognition that sometimes this is not enough. At 58, Danny Ward has been an affable and popular member of the Metropolitan Fire Brigade and the firefighters’ union for more than three decades.
Like most firefighters he loves his job. He speaks passionately about his pride in what he and his co-workers do – and about the bonds that build among the largely male officers, as well as between their families. But he also knows the toll that the job can take. Sleepless nights and mood swings began to affect his marriage. Bouts of severe anxiety gnawed at him. For years he suppressed his problems. He acknowledges now that there was a stigma about seeking help.
“They [older firefighters] never spoke about things like we speak about now. It sort of just built up inside you. You didn’t speak about it, you were this macho man and you were a fireman, you were invincible.”
Finally he reached out. First he saw a GP about his anxiety. But it was a psychologist who really provided the relief.
“It was a weight off my chest,” Ward says.
It is a decision he says has improved his life and that he hopes others will follow – before their buckets become too full. “It has to have a build-up. I don’t care how strong you are, you can’t keep doing the job that we do without feeling something inside.”
Ward was referred to the psychologist by a worker from the MFB’s peersupport program, a 24-hour, confidential service staffed by firefighters. It is just one of the services the brigade offers. Andrew Zammit, acting deputy chief officer South-East Metro, says the MFB has been working for 20 years to boost support services.
As well as peer-support – and associated external referrals – the brigade offers an employee assistance program and chaplaincy to help officers with personal and work-related issues. Then there is the so-called critical incident debriefing that is made available whenever an officer attends a potentially traumatic scene. There are also training programs that promote personal resilience and educate managers on how to recognise and manage stress in their teams.
The first problem is that the services rely on members coming forward, sometimes after being told by colleagues that their behaviour is unusual. “The key thing is they actually have to put up their hand to self-present,” Zammit says.
The second problem is that often they don’t. Or won’t. Many workers say they are reluctant to accept this sort of help, some because they fear that their admissions of trauma or mental fragility will be used against them by management during pay negotiations. It is an allegation rejected by the MFB officials and those who run the programs, who insist support is anonymous and confidential. The brigade says it is well aware that the work can be risky and stressful, and says the health and welfare of its employees is a priority. Some fireys say it is not enough of one.
Damian O’Toole has seen a lot in his 26 years with the MFB. He joined the brigade at 23, thinking the job would just be fighting fires. Now he is one of Melbourne’s most qualified firefighters, an expert in urban search and rescue and high angle rescue, a skill that can see him hanging from Melbourne’s tallest structures, sometimes rescuing people who are trying to die, sometimes securing parts of damaged buildings that might fall on people below. He is now also one of a handful of fire investigators at the MFB.
O’Toole speaks slowly, wrapping the chord from the microphone around his fingers. He has seen some of the worst in human behaviour. He has seen murdered babies. On his first week on the job, he was sent to a triple car crash in which a four-year old was killed and a driver decapitated.
As far as he is concerned, he and his colleagues need more help than they are getting. Yes, he says, there has been some improvement in the level of support firefighters receive after major traumatic events. But it is not enough, nor is it consistent, he says. This week he attended a murder trial of an infant. The paramedics he was with had peer support workers there alongside them. He did not. It was only the next day that colleagues asked how him it had gone.
While he appreciated their concern, he notes that the support was informal and given in the spirit of camaraderie. Firefighters have also called for more financial support. In Victoria they can make a work insurance claim for PTSD, but many complain the process is arduous.
There is a push to follow the lead of some Canadian provinces where PTSD has been recognised as a side-effect of the job and laws have been made to remove the onus of proof on emergency service workers if they develop the disorder have been introduced. The Canadian experience has fuelled a conversation among their emergency services workers about their mental health. Edmonton Fire Rescue Service chief officer Ken Block says the laws, introduced in Alberta a year ago, have led to a high level of awareness of the condition and to early intervention. This, in turn, has meant quicker recovery for firefighters and a speedier a return to work.
The Victorian Labor Opposition has pledged that if it wins this year’s state election on November 29 it will launch a two-year $200,000 trial of specialist oneon-one counselling for firefighters battling PTSD. But for the state’s firefighters, it is not just the past that haunts them. Increasingly it is the future.
Studies have shown that firefighters are at much higher risk of developing specific types of cancer, often due to the thousands of chemicals they are exposed to in blazes. It is not just large industrial accidents that pose a threat. Regular house fires also release hundreds of harmful substances that can be absorbed through clothing, despite the best designed protective equipment.
jobs, in the same truck, going to the same call. When is it my turn?” O’Toole has four children and, along with his wife, dedicates much of his spare time to his local football club, South Croydon. He loves his job, but family is what he lives for. It is his outlet away from work. How will he look after them if he is not here?
“By the time I retire I will have given 37 years to this. How many times have I been exposed – and what have I got?” For help or information call Suicide Helpline Victoria on 1300 651 251 or Lifeline on 131 114, or visit beyondblue.org.au A University of Cincinnati study in 2006 – based on 110,000 firefighters found that firefighters were twice as likely to get testicular cancer as nonfirefighters and had “significantly higher” rates of prostate cancer and nonHodgkin’s lymphoma. MFB staff report concern from firefighters about cancer is “massive”. Nearly every firefighter knows a colleague who has battled cancer. Not just older workers. Young men too. It preys on the mind.
It was a Wednesday afternoon in August 1991 and Chris Cleary had been a fireman for just over 20 months. He was out driving with his mother when they saw the plume of black smoke billowing from Melbourne’s docks. The thick toxic smoke – which prompted authorities to evacuate a local primary school and warn people to stay inside with windows and doors closed – was spewing from a chemical fire at Coode Island. For days, firefighters, including Cleary, battled the blaze, seeing the world through a coloured haze, boots often mired in a toxic sludge. When Cleary, now the father of two young kids, looks to the future, he can still see toxic clouds, and not just those from the big fire. Change is coming, but slowly.
In 2011, the federal parliament, with the backing of all parties and independent MPs, passed laws removing the onus of proof on firefighters in the ACT and at major airports to show that 12 types of cancers were caused by their work. Governments of differing political persuasion in Western Australia, Tasmania and South Australia have since followed suit.
So far, Victoria has not. Victorian Greens MP Colleen Hartland is pushing for the state to provide easier cancer compensation for firefighters. The Labor Opposition backs the idea and has promised to introduce some type of protection should it win office on November 29. The government, however, have blocked attempts to introduce the plan, arguing it wants more evidence. Damien O’Toole fears it is just a matter of time. Two of his best mates have already contracted cancer on the job.
“We’ve all been exposed to the same THE AGE .com.au On web and mobile Watch firefighters discuss life on the frontline and how it affects them.
“They [older firefighters] never spoke about things like we speak about now. It sort of just built up inside you. You didn’t speak about it, you were this macho man and you were a fireman, you were invincible.” Danny Ward, firefighter