(fire truck sirens)
(dramatic music)
- A lot of product gets sold
in and around these
neighborhood streets
that we work in.
We're right in the middle
of one of the biggest
selling areas.
- I woke up just so confused.
Like I didn't know where I was.
I still had the
needle in my arm.
I was kinda upset
because I wasn't high anymore.
- Some of the most troubling OD
calls we go on is
when we pull up
and we find a young
mother with her
18-month-old baby
in the backseat
and a needle in her arm.
- The next thing I
remember is I woke up,
the drugs had actually
overpowered the Narcan.
I had to be Narcan'd
again in the ambulance
and then a third
time at the hospital.
- Everyone of them
is somebodies son,
or somebodies daughter,
or somebodies mother,
or somebodies brother,
or somebodies wife,
and I remember all of them.
- Out of all the
calls I've been on
I think the hardest
ones are when
I actually have
to tell the family
that their loved one's dead.
- They went were
they're serving needles
and they're risking
their safety to go
into a place to save
my life when I could
have been just another statistic
a drug addict on the
street that died.
(dramatic music)
(muffled talking)
(dramatic music)
(indistinct conversation)
(firetruck exhaust sounds)
- I became a firefighter
because I like to help people.
I'm sure that's a
very common answer,
when you ask people,
but ever since I was
young I've always
really liked to help people.
When I was a kid,
a big red fire truck was
always one of my favorites
so, when I found out you could
actually get paid to do this,
to be a fireman,
and as soon as I found out that,
I was like, "now
that's the job for me".
- This work is very demanding.
It's very rewarding.
Two days are never the same.
So it challenges you
on a lot of fronts.
To stay mentally sharp,
To stay really
physically prepared
for a lot of things,
a lot of the ups and the downs
and the stress, and
the stress mentally
and physically so it's
a lot of preparation.
You see the house
fire fully evolved
and we go in, and
then we come out.
But there's a lot of prep work
so it's a very rewarding job.
(firetruck sirens)
- When I became a firefighter
I thought that the
majority of our work
would be fighting fires.
That's changed now,
we serve all different
types of calls,
all different types of people,
all different responses.
I never thought that
the majority of our
calls would be overdoses
and drug related calls.
And I never expected
that to be the case.
- I don't think I've
ever actually sat down
and counted "yup that's one
for the day, that's two".
So no, on a very busy
night where we're running
25, plus, calls.
We can go easily on 10,
10, 11, 12 overdose calls.
(engine roaring)
- [kid] Bye!
- [paramedic] Bye!
(engine roaring)
- [Paramedic 1] They
made a drug bust
in this house over here.
$450,000 in cash.
- [Paramedic 2] Six.
- 650?
- Yeah.
- This white house right here?
- Yeah.
- We had the shoot out.
- At this fire
station we're in a
unique situation.
This seems to be the epicenter
of the heroine epidemic.
If you want to buy heroine
this is where you come to.
Yesterday the guys came in said,
"There's somebody OD'ing
on our front bench."
I go, "Really?"
Walked out and there's somebody
OD'ing on our front bench.
So it's not uncommon
for me to walk
out pick up a needle,
sit at the picnic table
and pick a needle up
out of the flower bed.
There are many, many areas,
I can draw a circle around
this fire station and
we could go out and
pick up needles all day.
So, it's a free open air drug
market, it operates 24/7.
- [fireman] Fire department.
You guys okay?
- [unknown] Yeah.
- [fireman] All right.
Just checking.
- [fireman] Yeah I know you
had to walk down, you know, so.
- (woman laughs) No we've
been here since (mumbles)
- No, no, dude, we just
came to check on you guys.
- [unknown male]
I was petrified,
I thought it was the police.
- [fireman] No, nope.
Hey we're here, like I said,
we just came to see if
you guys need anything?
If you were okay?
- [unknown male] No, you
just woke me up brother!
- [fireman] Sorry, I didn't
mean to ruin it for you!
But if you need anything,
don't hesitate to call.
Stop over to fire
house on Clinton Avenue
if you ever need anything.
- I grew up in
this neighborhood.
My parents still live
in this neighborhood,
my brother lives in
this neighborhood.
I still live in
this neighborhood.
When I was a young kid,
it was a lot different
than it is now.
Families, everybody
lived together,
everybody was happy, you know.
Everybody trusted each other
and took care of each other.
It's a lot different
now, you know,
kids can't play on the
street, there's needles.
You know vacant houses with
needles, all over the place.
There's violence, you
know, there's homelessness,
there's drug dealers
on the corner
and people fighting
and problems like that.
It's not as safe
as it use to be.
The neighborhoods
kind of held hostage
you know by this war
with the drugs and
the money that it produces and
the problems are all
associated with it.
And it's not a good
thing, you know,
all the goodness that
comes out of this
neighborhood is
all overshadowed by
the drugs and the violence
that accompanies it.
(car seatbelt dinging sound)
- Amos fourteen Andrew ALS.
(dispatcher speaking
indistinctly)
(ambulance sirens)
- [dispatcher] 3391...
(ambulance sirens)
- Working a rural community
is really difficult.
You know everybody
for the most part.
Especially in this town,
you're very close knit.
You know your neighbor,
your neighbor knows you.
Very small town less
than maybe two thousand.
We cover about a hundred
square mile secular area.
(ambulance sirens)
Compass is a couple
different towns,
the farm land, it
could be the woods.
I grew up here, and I
want to help my community,
I've always wanted to be
somebody that people are calling
because they need help.
They don't call me because
they're having a good day.
They don't call us because
they're having a good day.
They have probably had the
worst day of their life
and probably want somebody
to come and help them.
And I want to be that person
that they have helping them.
(doors opening)
(doors closing)
- [paramedic] Good?
(ambulance sirens)
- [dispatcher] (indistinct)
(door closes)
(dog barks)
- [unknown] Got
one down on book.
- [fireman] How long
she been down buddy?
- [unknown male] I don't
know, I just came up,
she came upstairs not
even twenty minutes ago.
Twenty minutes ago?
She's been like this
for over twenty minutes?
- [unknown male]
I wouldn't know.
She said she was
coming to lay down.
- [fireman] Any other
medical history?
- [unknown male] Um...
- So often in healthcare we use
the term compassion fatigue.
And especially in
society, as well,
when something becomes our norm
no matter how upsetting it is,
no matter that, you know, we
have children that are dying.
When it's regular and constant,
it gets too tiring
to continuously care.
And so we get tired
and it becomes noise.
(people talking indistinctly)
- [parademic] We're going to
have to go to the hospital.
- [unknown] Why?
- [parademic] Because
you overdosed.
How many bags did you take?
Just so we--you're
not in trouble.
We just want to help you.
- [unknown] I'm not
in trouble am I?
- If the people who see it
daily who can not ignore it.
Whether that is police,
or fire, or EMS.
We can't ignore that.
It can't become our
background noise.
'Cause we're nowhere
near a solution on this.
We've had more death
from this disease
than all the people
who died of AIDS
during the 1980s and 1990s.
We have far surpassed that,
and that was an epidemic
that we thought we
would learn from.
(door closes)
(engine idling)
- [dispatch] She overdosed
193 (indistinct over radio)
- [unknown male] Come upstairs.
(muffled voices)
(static noise)
(indistinct conversation)
(dispatcher muffled)
- [Paramedic 1] He's
still breathing.
Let's get him right
out in the hall.
- [Paramedic 2]
Hang on one second.
- [Paramedic 1] Oh
he's freaking cold.
Oh he's moving.
(fumbling noises)
- [Paramedic 2]
What did he take?
- [unknown woman] I don't know.
- Hey buddy?
- Do you have the
bottle or something?
- What's your name?
- [unknown woman] I
think these pills.
- What's his name again?
- [unknown woman] These
pills, I don't know, I--
(muffled talking)
(dispatch static)
- [paramedic] He's never
been known to use any?
Heroine or opioids?
I mean, he's not in trouble,
it'll just help us
treat him if we know.
- [unknown woman] No.
- [fireman] Where'd
he'd get these?
- [fireman] So we go
on a heroine overdose
is how they put it
out on the radio.
Unfortunately we've
become so proficient
at doing this we don't even
have to talk to each other.
You know one of
the crew members,
one of my guys asked me one day,
"What is the difference
between people living and
"dying from a heroine overdose?"
And I told him I said,
"The only reason
people live through
"a heroine overdose is because
"someone is there
to call for them."
When we find a person
dead it is usually because
no one was there
with them to call.
They stop breathing,
their heart stops beating,
and they pretty much
die and go to sleep.
I mean, we found people
that were blue, no breaths
at all, heart rate 150,
and that surviving patient
we can administer the
Narcan start to pushing it
into their system through IV
and easily enough they sit up,
"What happened?"
And they're never, they've
never used heroine.
This is always the thing,
"I didn't use heroine."
We know.
It's hard to admit,
for these people,
that they used and that
they're in this position,
but we know.
- Drugs in rural areas
are actually making
what once was a very safe
place, more dangerous.
Everybody thinks that drugs are
only in the cities or suburbs
but in reality, they're
out in the country.
(foot steps)
- [paramedic] Check his pupils.
See if he's breathing
and he's got a pulse.
[Offscreen] The training
for this is very important
because we want to
fight how we train
and train how we fight.
A lot of that goes for how
realistic the training is
and how you can actually
make a difference.
So what you saw was
my partner and I
going in from being
dispatched into
confirming that it
was a heroine overdose
or some form of opiod overdose.
Administrating the Narcan,
performing the bag
valve ventilations.
Waking them up and
trying to keep them calm
to the point that they
understand what's going on.
In the rural setting, drugs
could range from heroine,
to fentanyl, to
methamphetamines, cocaine...
But what a lot of people
don't think about is
the pills that are in
our medicine cabinets
that are prescribed to us.
A lot of people are abusing
things like the oxycodone,
morphine, gabapentin is
one of them that's been
pretty big these days.
Okay answer this
honestly we are not
the police I need to know
have you taken any drugs today?
- I think as macho
men no one really
wants to address, they
don't want to admit
that these things bother them.
Over the years you've seen
guys fall victim to alcoholism.
I've seen, since I've
been on, known 5,
maybe 6 guys that have
committed suicide.
- Many of us, personal
friends of mine,
myself, you know,
we have problems
with alcoholism, drug
abuse, ourselves.
We have, very few of us
have positive outlets for it
because it's tough to develop.
I mean this isn't stress
from work in an office.
This is seeing people die and
having lives in our hands.
- (chuckles) I mean you can see
I've put on a little
bit of weight,
since I've been doing this,
so, you know, unhealthy
habits eating-wise,
drinking is a very
easy one to get into,
thankfully I never
got way into that,
but I've definitely
had those nights
where you get home and you
have a couple too many.
And definitely many peers.
I've had peers who have
overdosed in the past,
guys that struggle with
alcohol use all the time,
you know, I'm grateful that I
didn't fall into those depths
and I was able, I have a good
support group that caught me.
- All right so tonight we're
covering mental health and EMS.
I've been seeing things over
the past couple of years
and wanted to kind of
get this topic started
so I've been doing stuff
the past five or six months,
kind of looking into this.
If you guys want to give me
your thoughts and opinions
throughout the
class just pipe up.
The more interactive we have it,
the easier it is and
the more fun it is.
The topic of mental health had
been on my mind for a while
and in May I lost
one of my bosses,
at the other agency that I
work for, to suicide and...
Totally unexpected
nobody saw it coming,
nobody saw the warning signs,
and that kind of made
me jump into the,
"let's look into this",
"let's start
talking about this".
I created a survey
which almost 250 people
filled out that sort
of lead up to the class
that I taught on mental health.
A few months ago one
of my co-workers said,
"Yeah we know we're
all messed up,
"why are we talking about this?
"Why do we need to
know that, you know,
"we all have issues
about these calls?"
So I kind of wanted to
get the discussion going
and a lot of stigma
about mental health and
not being able to
talk to people.
You know.
Here it says there's
no shame in admitting
that you're human.
I'm trying to bring
about some discussion
and make it so that
(drowned out by speaker)
- To watch an eighteen
or twenty year old,
their life slip away, and they
had everything going for them
in the world other
than this issue,
and now they've lost their life.
You can't fathom that.
You can't wrap
your head around it
and realizing how much
it effects their families
and themselves and watching
the death toll rise.
It takes a huge chunk
of your mental health
not being able to do
anything about it.
But to see young kids dying
is probably the worst.
- This is going to
take a toll not only
on, you know, their
career, but them personally
and one of the biggest
concerns we have is,
not only are we just seeing
people dying unnecessarily,
we're going to lose a
group of professionals
because their careers
will be cut short
because repeated trauma
like this and seeing it over
and over and over again?
Burns people out.
You can't go to work
everyday knowing
that you're going to
see a young person,
who has no other
medical problems
other than struggling
with whatever chemical
that they're
struggling with, die.
That's not something that
you can have happen to you
everyday in your
career and expect that
it isn't going to change
you, and shorten what you do
from a career standpoint.
- I find myself in
a unique situation.
My son, Cody, died from
a heroine overdose.
I work in the busiest
company in the city
that deals with
heroine overdoses.
- I remember it like
it was yesterday
I got a phone call
from a friend of mine
who was working
at the fire house
that responded to
Cody's overdose
and told me that he had died.
- Cody got, I believe,
addicted to heroine
because when he was
in twelfth grade
he broke his foot in football
and they prescribed
him pain medication
which ultimately
lead to an addiction.
Then when he was
working at Pizza Hut
his manager decided,
"hey, I got something
"cheaper that works
just as good",
and that was it.
Once you do it you're hooked.
- I don't know how
he does his job.
I don't know how he gets
up everyday and comes here
and he's constantly reminded
not just from our calls
but from calls
throughout the city.
Overdose calls, you know,
people unresponsive.
I don't know how he does it.
I think his desire
to help people,
and maybe save
someone else's life,
that's what motivates him,
and I think that's
what drives him,
is just the hope
and just the prayer
that he could help someone else
because he wasn't
able to be there
for his son through
his overdose.
- My brother, Shawn, he was
seven years older than I was.
His addiction started
because of an injury,
serval years before
the big issue started.
He broke his ankle,
and they started prescribing
him the oxycodone.
The different pain medications
to help him get
through the injury
and that kid of got him started
on the path of getting addicted.
1408 copy.
CPR in progress with
one Narcan on board.
When my pager went off, I got
up just like I normally did
because I wanted to
go help somebody.
1408 copy.
CPR still in progress
with two rounds of Narcan.
Fortunately stopped myself
before I got to the front door
and realized that was
my brother in there.
And there was other
people responding
and I said, "that's my brother
I'm not going in there."
Knowing that I can't see that.
Because I know I'd never
be able to unsee it.
They worked on him in the house.
Tried Narcan, they gave him
an IV, they intubated him,
got him in the ambulance and
took him to the hospital.
And I knew he wasn't
coming out of it.
So now it was about how do
I go and handle my parents?
And how do I handle
basically getting ready
for my brothers death?
It really didn't
affect me until,
I'd say probably about
three months after,
after the funeral was all done,
after the condolences were done,
kind of getting back into life.
I went on a call with
one of our paramedics
that ended up turning
into cardiac arrest,
and as soon as I was doing
CPR on the individual,
I look down and all
I can visually see
is my brothers face.
So I felt like I was
doing CPR on my brother
and I think it was just a subtle
message in my brain saying,
"you're not dealing with
this appropriately."
And that really messed
with me to the point that
I actually was on the hairline
of quitting EMS as a whole.
And that's when I
went and got help,
and said, "something
is definitely wrong".
And if it wasn't
for my co workers,
or the volunteers here,
pushing me, saying,
"Go get some help,"
I probably wouldn't be here.
- This used to be a business.
Especially when I first
started, where it was very,
there was a lot of
machismo, you know,
it was very alpha, you know,
you weren't allowed to be
affected by this stuff.
Thankfully that's
starting to change.
It's becoming more
okay to talk about
the fact that these
things do wear on you.
Personally, I see a therapist.
I have been diagnosed with PTSD.
I'm not ashamed
to talk about it.
I take medications and
I talk about this stuff.
- Lately there's been
a lot of talk about
PTSD amongst the
fire department,
police department,
fist responders.
I think this is the first
time that people are starting
to recognize that PTSD doesn't
have to be a one time event.
It is actually an accumulative
event of tragic things
you've seen in your life and
things that have happened.
Whether you're in the military,
you're a police officer, you're
an EMT, or a firefighter.
I'm sure doctors
and nurses have it.
I think a lot more people that
are in the service industry
and help people that are in
need may have PTSD at some level
because it is taxing to
see people suffering.
- [paramedic] Hey there
how are you doing?
You nodded off there.
- [unknown woman] Yeah.
- [paramedic] Yeah
you nodded off.
How much did you use?
- [unknown woman]
(slurring) What do you mean?
- [paramedic] Couple bags?
- [unknown women] Yeah.
- [paramedic] All right.
Did you get anything?
- [paramedic] 128 on 72.
- [paramedic] That's good.
(dispatch beeping)
- What I hear in the stories
of first responders is that,
we don't want to admit
our own suffering.
And there's a kind of
vulnerability that comes
with saying this is really hard.
And it's really
weighing me down.
If we can do that in community
and make it an acknowledgement
of our humanity,
that we are human beings and
that actually it's expected,
as a human being, that
we are going to have
these kinds of responses.
Can help people be
able to release it,
rather than to have it
accumulate day after day,
week after week,
month after month,
in a way that eventually
causes burn out.
(engine idling)
- [paramedic] It's okay dear.
Hold my hand.
(woman crying)
It's okay.
It's okay.
- [unknown woman] Sorry.
- [paramedic] No, don't
be sorry, it's okay.
It's okay.
(woman crying)
Slowly in through your nose
and out through your mouth.
There you go honey.
Just relax it's
going to be okay.
You're not in any trouble.
She said she did
a couple of bags,
she's been clean
for a little while,
but she's real upset right now.
- [paramedic] Did you
guys give her anything?
No, she's got a needle
on top of her purse.
- [unknown woman]
(gasping) I'm sorry.
- [paramedic] It's
okay. It's okay.
It's going to be okay.
(woman crying)
Just breathe.
(woman breathing)
- How is it that we take
people who sought out this work
because of their compassion,
because of their big hearts,
and put them in situations
that are devastating?
That an over time have
accumulative effect upon
how they feel physically,
how they feel emotionally
and also on their mind set
how they see the world?
They see things that don't fit
at times with their beliefs
about how things should go,
and that can be very difficult
for people to process
and make sense of.
So ultimately what
seems to help people,
is if they find
someway of making
the meaning of the experience
and trying to either improve
the system in some way,
or help others that
have been affected.
That seems to be a
critical part of healing
in the face of all this trauma
and sadness that
healers experience.
- I do remember coming to,
aspirating and vomiting,
and seeing his face carrying
me down these stairs.
Two fire fighters were
down in front of me
with his arms
underneath me, hooked,
and then I went back out
and I woke back up
in the ambulance.
- Krista is a person
that we saved,
on Orchard street, I
believe the street was.
She was friends with Cody.
- [Krista] John and Carrie
Vagg and their daughters
came to my wedding,
and I got to share the best
day of my life with them,
and I would not be
here without John.
I wouldn't have my son.
I have a one year old
who's never seen me use.
I have a beautiful
husband and a home
and that's not where
I was five years ago.
I was in jail and I had nobody.
- [John] I've seen you know one,
(pastor speaking)
good story in 200, you know.
The odds are so slim,
that somebody
actually makes it out
and makes something
of their life.
I'm very impressed to see
that but I always worry.
As stressful as this job can be,
that's what keeps
me going personally.
Our hope that we can affect
somebodies life positively
and there's always hope.
I say it all the time,
that hopes springs eternal!
And you never know what
it is that can help them.
Maybe it's just a kind word,
maybe it's a pat on
the back, saying,
"you can do this, you
can help yourself,
"you can get fixed," you know,
and you never know
and we'll never know
and we don't ever find out,
for the most part, if
someone's helped themselves or
made it out of this debilitating
crisis that they're in.
(firetruck siren)
But there's always hope.
(gentle piano music)
(firetruck sirens)
(gentle piano music)