Recently, Editor Brittani Schroeder interviewed Sean Paul Bedell, a retired firefighter and paramedic, about his experience as a first responder, the psychological effects of serious calls, the evolution of mental health supports, and how he found a cathartic release for years of internalized trauma.

Brittani Schroeder: Can you tell me about your background as a first responder?

Sean Paul Bedell: Both my father-in-law and my brother-in-law were firefighters, so I had exposure to the fire service through my wife’s family. Early on in our marriage, we moved to a rural community where my neighbour was also a firefighter. So, while I can’t remember exactly how I eventually joined the department, I’m very glad I did.

I worked my way up through the ranks of that fire department and really enjoyed it. I became a lieutenant and then a captain. It was a busy rural department, so we had a lot of calls, mostly motor vehicle collisions and medical emergencies.

The medical calls were the ones that really sparked something inside me, and I realized I enjoyed the medical side of things. Enjoyed might be the wrong word, but I was good at it—not everyone is cut out for that kind of call. Of course, not all medical calls turn out well, but I felt a deep sense of belonging in the community as I helped in a medical emergency. My superiors, my chief, delegated and sent me on those types of calls and had me be the lead on scene even before I was an officer, which was great.

So, I applied to paramedic school. I was a little on the older side when I was making this career shift—I’m a lot on the older side now—and it was a real challenge for me to make that shift and get accepted to the program. They only took 24 students; they had a waitlist, and the application process was very in-depth, including fitness testing and a written exam. Looking back, I understand why it’s designed that way, but it was a lot to take in at first. I made it into the course, and I was hooked on paramedicine. I started work the day after graduation, which happened to be Canada Day. I was a paramedic for over a decade with thousands and thousands of calls. Far more calls than I ever would have imagined.

Schroeder: How was your experience going through the program and then getting out onto the road?

Bedell: I always try my best, and I was always a very serious student. I was an overachiever even before firefighting and paramedicine. I learned that the training really kicks in when you’re a paramedic and a firefighter, because you can’t let the adrenaline of the moment overwhelm you. I remember shortly after graduating, arriving on the scene, and my first thought was, “Someone needs to call 911.” And then I realized that was now me.

Schroeder: As a first responder, what types of mental health support were available to you and your peers?

Bedell: In my first few years as a firefighter, it was just an unwritten rule that you weren’t allowed to show emotion after a call. You couldn’t share the things that bothered you. You had to be the literal tough guy or girl after a call. At that time, we didn’t have any critical incident debriefing whatsoever.

I discovered that I needed to talk things out a bit. Not so much the details of the call, but how I was feeling because of it, so I talked with friends and family. I realized after I did that a few times that I was just transferring my burden and my feelings onto innocent people, and that was wrong of me. Those people would start asking me, “Why didn’t you do this?” and “Why didn’t you do that?”. There’s nothing worse than asking a first responder that, because they’re already second-guessing everything they said or did on their calls, especially if it’s not a positive ending.

If it was a great call where we did everything right and the patient outcome was good, we talked about those calls until we were blue in the face! Everyone listens to those stories, and it was a bit like team building, a sense of camaraderie. So, there were stark differences.

I was never officially diagnosed with PTSD, but I did have struggles here and there. There are a few calls that, to this day, have stuck with me. If I drive down certain streets in Halifax, I’m taken right back to some horrible events. There’s a particular way the snow can blow, and it brings me back to a certain call. These can come out of the blue, too. Like, what did I do to trigger it? Nothing. But yet, boom, there is a flashback. I think I would’ve benefited from the critical incident debriefing that there is nowadays.

I remember a call I was on, and I’d like to say “TRIGGER WARNING” here. The call involved a family boating accident where there was a drowning, and another firefighter and I attended this one. We got the man out of the water, followed all our protocols, and performed CPR, but in the end, it was just too late. It turned out that we both knew the individual, but we didn’t recognize that until after we’d gone through everything we could to save him. Whether it was the training that took over, or he wasn’t wearing his glasses or something, we just didn’t focus on who it was until after.

I say that story now because after that call was the first time I received a critical incident debriefing. I don’t think it was perfect at that time because we were all new at it, but if I hadn’t had that, I would be having nightmares to this day about that call. This was the late 90s, and since the debriefing was in its infancy, I think we just sat around in chairs, we were asked a couple of questions, and it was emotional. But then I left everything from that call, all those thoughts and feelings, in that room when I walked out of it. Afterwards, I wished we’d had it before, for other calls.

After I joined the paramedic service, we did M&Ms, which were morbidity and mortality sessions. After particular calls, you would present the details of the case to your fellow paramedics, and it would be a learning opportunity for everyone. It was different from debriefs because there was no emotion involved. It eventually led to doing debriefing, and to this day, I will say that I benefited from talking to others about what I’d experienced. It also helped to be able to think about it objectively and understand with the help of others that I did the best I could in those circumstances.

Schroeder: You’ve just released a book that deals with the topic of first responder mental health. What was that writing process like for you?

Bedell: This book was written in the first person, so people automatically think it’s me, but it’s not. As I was writing, it was like a cathartic release of things that I’ve been harbouring for years.

I feel like I excised a lot of the grief and trauma out of myself and made sense of it. Let’s be honest: as paramedics and firefighters, we’re dealing with life-or-death situations, and it takes a toll. You wouldn’t be human if you didn’t have some kind of feeling about it. So, though this is a work of fiction, I was able to put things in perspective for myself, which I didn’t even know I needed.

Even if no other soul reads the book, it’s been helpful for me, and that was my real motivation. If others read it and feel compassion for the character, share some hope and frustration with him, then that is a secondary benefit.

The title, “Shoebox”, is meaningful for a couple of reasons. First, the character ends up working in Sheet Harbour, N.S., and the paramedic base he works out of is a mobile home. I worked in Sheet Harbour with 48-hour shifts, and our base was a mobile home. We always said it felt like we were working out of a shoe box. The other reason behind the title, which the cover also portrays, is that all the memories we keep, the triggers we file away, get put into a shoebox like souvenirs until someday, for whatever reason, it tumbles off the top shelf of the closet, and all this stuff falls out of it. Then you have to deal with it.

Schroeder: What do you hope people can take away from the book?

Bedell: First responders—whatever their specialty or focus is—when those folks come to help you, which is what they’re made to do and what they live for, remember that they, too, are human with all kinds of other things going on in their lives. They’re not just a hero in a uniform. They may be to you on that day, on the worst day of your life, but they’re bringing all kinds of stuff to the call with them. And regardless of how that call goes, they’re going to take a little piece of you and that call with them forever.

Schroeder: As a seasoned first responder who has now retired, what advice would you share with new first responders just starting out in their careers?

Bedell: It’s great to want to fix things, but not every call is fixable. We can be right there when someone runs into distress and have all the equipment at our beck and call, and we may still not be able to help. Don’t take it personally and don’t internalize it. Stick to your training and your protocols, do what you’re trained to do to the best of your ability. The universe is not always in our hands, as much as we like to think it is, but if you stick to those, that’s what will help you sleep at night.

When bad outcomes happen, talk to someone about it instead of dwelling on it. Fellow medics, fellow firefighters, anyone. There are a lot of resources out there for you.

I’d also just want to say thank you. People don’t always have a chance to say thank you, that you make a difference in people’s lives, that your work is valued and respected. Especially when people are caught up in the moment. I can tell you from years of doing this that your work is appreciated.

Schroeder: For the first responders who have been on the job for many years, what would you want to say to them?

Bedell: Just remember that it’s okay to show concern and emotion for yourself, your patients and the people you work with. It’s not a sign of weakness to either ask for help or to share. In my opinion, it’s actually going to show strength, being able to recognize what bothers you.

For me, I’d have little angry or sad outbursts, and I couldn’t really put my finger on what it was. But then, years later, I realized it was because a call I did was still playing on my mind. So, it’s a real show of strength, commitment and professionalism to admit that working with another human being who may not have a good outcome can bother you.

I can’t think of a single paramedic or firefighter who would judge another for crying after a call. There’s not a single one of us who wouldn’t just wrap our arms around you and say, “It’s okay. I got you.”