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I used to volunteer with an EMS/ALS (Paramedic Ambulance) squad when I lived in Virginia. We got called to the worst of the worst. 9/11 at the Pentagon, Car accidents, gun-shots, stabbings, etc. I was a very gung-ho person at the time, and thought that nothing could shake me. Boy, was I wrong! My second to last day on the squad, we were called to an LvA (locomotive vs. automobile) incident. I had been called to one before, and it was bad, but I wasn't prepared for what was coming. I had expected, as anyone being called to an LvA would, complete and utter devastation. I had prepared myself mentally for that. What I found on scene was earth-shattering. Not only was there not complete devastation, the car was still mostly intact. The train had only come in contact with the driver's side rear of the car. There were 5 occupants in the vehicle, 3 adults, and two children. The cases involving children were always extremely hard, but this one simply broke me. Mom and Dad were riding up front. Grandma and the kids were in back. Dad was driving, and Grandma was sitting directly behind him. When we got to the car, 4 of the 5 occupants were DoA. The 5th, a 5-year-old girl named Michaela, had managed to crawl into the front seat. She had curled up with her already dead mother. She had suffered severe head and internal bodily injuries, and was bleeding profusely from numerous lacerations. I asked her name, she said “Michaela.” I asked how old she was, she said “Five.” I told her everything was going to be OK. She looked me right in the eye, and said “It hurts.” Then...just like that, she was gone.
For the first time since joining the squad, I didn't sleep that night. Every time I tried to close my eyes, all I saw was her blank stare.
The next day, I couldn't even get into the bus. I stood there, next to the ambulance, shaking. Much like I am now...My shift supervisor noticed the abnormal behavior right away and pulled me aside. I broke down. I went through 2 solid days of PTSD debriefing, therapy, the whole nine. I had prided myself on being able to deal with anything. Now, I couldn't even drive across a railroad crossing without breaking into tears. That was my last call.
When I moved to NY, things got better for me. I rediscovered Poetry. I found release in music. I rediscovered my faith. I started doing meditative relaxation. Things were looking up for me. I'm in a place now, where I have a great support network around me. Great friends, great family. I'm grateful every day for them. If it weren't for my friends and family...well, I hate to even think about it. I know that finding release in music, poetry and meditation has helped me redevelop my relationships with my friends and family after that day though.
Some days are better than others, but every time I close my eyes, I still see her face. She is engraved in my mind and heart forever.
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Basically, anyone in a position like that, Fire Rescue EMS/Police/Military, etc, needs to have a strong support network, a good release mechanism, and an ability to thoroughly process the days events, otherwise they can haunt you forever in the form of nightmares, daymares, flashbacks—all of the symptoms of PTSD discussed earlier in the thread.