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Sufferer 42 y/o... crap I hate this

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CoastMed

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I was diagnosed with PTSD about 8 years ago. I ignored it. The nightmares and flashbacks stopped. Actually everything stopped. I wasn't angry, sad, happy, or really anything else. I figured that it must be fixed. I grew up in a family of war veterans and firefighters. Every male in my faimly reached a point in their lives when they stopped having emotions. I honestly just thought this was a sign of maturity or something. I've actually started getting some help now and am told this isn't normal.

I hate it. It's like this albatross around my neck. I figured if I ignore it, I can go on functioning, but it didn't work. I sought psychiatric care more for my ADHD which I've known I had for, shoot, probably 30 years at this point. The psychiatrist was good. He kept digging, unwilling to just say "Yeah, you got ADHD, here';s some Adderall." I mean, he did prescribe Adderall, which is a game changer for me. But he started to pull back those layers, and I hated it.

He asked me about my career, how I slept at night, if I'd ever had nightmares and flashbacks. If I avoided anything. He dug into my stories, which I hate telling.

Here's what I think, but I'm told it's incorrect.

I think I couldn't hack it mentally as a paramedic. I lasted 12 years. One of my last calls was a 9 person shooting. It was horrible, and I was the only medic on scene for the first 20 minutes, literally just watching people die, unable to do anything to stop it. I had no ambulances. The newspaper and the county EMS agency used me as a scape goat and blamed it on me. We were understaffed by 6 ambulances that night. If we had just 3 more ambulances on the street, I think everyone would have survived.

Anyway, I went on with my life. Had some flashbacks, some nightmares, a few anxious nights, but eventually figured out I could just quell the storm with distraction. And it worked... I'm told a little too well now.

In 2018 I went to work in a remote bush hospital in West Africa. Bearing in mind that I'm a Physician Assistant now, not a doctor, I was way outside my comfort zone. I did the best I could, but in those years, I had more children die from cerebral malaria than I can count. I was scared and I hated it there. I was ill-equipped for the job that I was thrust into. I never planed to be treating children with cerebral malaria, doing trauma surgeries, caring for high-risk maternity cases, and managing any number of critical care cases. I thought I was there to manage blood pressure, treatment some intestinal infections, and maybe do some casts.

By the time my tour of duty there was over, I went from frustration and fear to just being numb. I mean, I felt nothing. I was at a point that my own family could die, and I wouldn't have the capacity to cry. I dare say I'm better than I was. I've had some space, but I still don't feel much. That is until one night and I was watching that marvel Series about falcon, or whatever, you know, the guys with the cool metal wings. Anyway, that dude that the government was trying to make the new captain America, he was a war vet. Dude had a difficult military life, but came out of it a hero, maybe a damaged hero, but a hero.

So at first I was enjoying the series until they started making him into a villain. Something flipped. I went off the handle. I felt rage like I hadn't felt in I don't know how long. I was capital T triggered. I saw a guy who dutifully served his country, went through hell, came back alive, agreed to continue his service to his country, but now he was a villain! He wasn't a villain, the guy was broken, just like me. He had been through hell, just like me. he once was someone who cared deeply and would have exchanged his life for any of those who died under his command.

That hurt like hell for me. Not that I see myself as a hero, but I know why i went into the military, why I chose to work in one of America's most violent cities as a paramedic, why i chose to leave my well-compensated position, a job that I loved, to serve in West Africa. When I got home, I was changed. I should have never been there. I should have never done any of it. Nobody freaking cares. I worked way too hard to just be mediocre, at best, at my job.

Anyway, I sometimes doubt I can be fixed, like I don't deserve to be. I can't even be sad when someone I can't save somebody I was supposed to. I try, oh man do I try! I honestly don't know anyone who is more obsessive about details, or studies medicine more consistently. I put every once of mental and physical energy I have into giving my patients the best care possible. But part of the problem is, i see every single patient's body, no matter how well they are, as being potential time bombs. My assumption, m train of thought with every single patient is, "what are you going to die from if I don't discover it?" I mean, I'm talking about ear infections.

I know why I do this, I can't help it. This mentality has made me a fine clinician and intensivist, but the result has been severe burnout. I can barely drag my ass out of bed to go pull a shift in a freaking urgent care clinic anymore. I'm only 42. I have AT LEAST 25 years left in my career. I really don't know how to make it. I'm looking for the exit sign, but this is all I've ever done. I've only ever practiced medicine. I have no other skills.

I need to be fixed, but I look at my dad and my uncles and grandpas (God rest their souls) and I see their zombie-like ambivalence over everything except for the occasional trigger, and I wonder if that's the best I can hope for. A life of service, the flame burned too hot too fast, and what it got me was emotional numbing.

That isn't to say I can't put on a good show. I'm funny. I can be goofy and play with my pediatric patients. I probably seem normal to most people that don't know me well, but I'm becoming increasingly aware that something's wrong.

Well, if you read this whole thing, that's pretty freaking amazing. Thanks. My therapist says I need to talk about this stuff with people, but people in my circles, we don't do that. I can't talk about it with my wife, so I'm giving this a try to see if it helps.

peace folks. Hope you guys are all on a journey to amazing mental health recovery
 
so ya.
Veteran and 23 year dispatcher here.
And EVERYTHING you say makes perfect sense.


I think I couldn't hack it mentally as a paramedic. I lasted 12 years. One of my last calls was a 9 person shooting. It was horrible, and I was the only medic on scene for the first 20 minutes, literally just watching people die, unable to do anything to stop it. I had no ambulances. The newspaper and the county EMS agency used me as a scape goat and blamed it on me. We were understaffed by 6 ambulances that night. If we had just 3 more ambulances on the street, I think everyone would have survived.
nope. this isn't a case of "couldn't hack it."
This is a case of What the f*ck -- how does any human process this kind of crap?
And let me guess -- when you finished the shift you just went home and tried to forget?
Because yep.
That's what we are expected to do.

But. That's not how humans work and like it or not we are humans.
If T hasn't said it yet.. the true definition of PTSD is "A normal reaction to an abnormal situation."
Watching a shit ton of people die because of under staffing?
Ya. That's abnormal in the real world.

Sadly for us it's often treated like just another Tuesday

I was scared and I hated it there.
Well of course you did.

I saw a guy who dutifully served his country, went through hell, came back alive, agreed to continue his service to his country, but now he was a villain!
Yep

My assumption, m train of thought with every single patient is, "what are you going to die from if I don't discover it?" I mean, I'm talking about ear infections.
Yep
I need to be fixed, but I look at my dad and my uncles and grandpas (God rest their souls) and I see their zombie-like ambivalence over everything except for the occasional trigger, and I wonder if that's the best I can hope for.
Here's the difference between you and them. Back in the day no one knew what ptsd was, or how the mind worked, or the impact things have on people. It was all about Suck it up Buttercup and move on.

But in our world now we know that there is damage from trauma and it can be healed.
It's just a shit ton of work that feels like it's ripping out your soul along the way.

when I discovered this place it was such a relief. Finally I had people who got it.
It was shocking to see how much of a difference that made in my therapy.
It didn't make it easier - but it made it better.

So welcome to the Island of Misfit Toys!
 
so ya.
Veteran and 23 year dispatcher here.
And EVERYTHING you say makes perfect sense.
That's not the usual response I get.
And let me guess -- when you finished the shift you just went home and tried to forget?

I try to forget, then feel guilty about trying to forget because these patients deserve better than that
If T hasn't said it yet.. the true definition of PTSD is "A normal reaction to an abnormal situation."
Watching a shit ton of people die because of under staffing?
When you are young like i was when I first started in emergency medicine, you've got all this responsibility. You're always the calmest one in the room. That's the goal. You detach, assess, and act. These are our "normal" situations. If you can't detach, you can't do the job. I once wondered if I'd ever be able to become emotionally detached, then when it happened, I couldn't get it back. It's like I killed that part of my brain, and now, when I want it back for the good stuff and the "normal" stuff, it's not there anymore. If I'm being honest, I wonder what that means for my future. Its getting in the way of actually doing my clinical job that should shouldn't carry that much stress.
Here's the difference between you and them. Back in the day no one knew what ptsd was, or how the mind worked, or the impact things have on people. It was all about Suck it up Buttercup and move on.

Tell me about it. I often wish I had been shot on one of these scenes so that I could have received some sort of compensation, even like a little time off to recover. I wasn't physically injured. I was emotionally damaged. Instead of recognizing that, our companies, govt agencies, and governing boards treat us as damaged goods, fit for the incinerator. They use us up until we start to mentally fracture, then discard us, use us as scapegoats, then blame us for the damage we incurred. Doesn't matter how many years of devoted service we gave, how good we were at the top of our game, or how much potential we had before it started to fall apart. They just act like you've always been damaged and somehow slipped under their oh-so sensitive screening process. God my heart goes out to my brother and sister veterans and first responders. You all deserve so much better than this.

But in our world now we know that there is damage from trauma and it can be healed.
It's just a shit ton of work that feels like it's ripping out your soul along the way.
when I discovered this place it was such a relief. Finally I had people who got it.
It was shocking to see how much of a difference that made in my therapy.
It didn't make it easier - but it made it better.
My worry is that I don't know if I have the capacity. I've finally accepted that there is something actually to this, but now I'm concerned that it can't be fixed at this point.
 
Welcome, @CoastMed - Glad you found us.
My worry is that I don't know if I have the capacity. I've finally accepted that there is something actually to this, but now I'm concerned that it can't be fixed at this point.
This is a pretty common fear among those trying to recover from/live with PTSD. That doesn't mean it's not valid or real - just, you're not alone in this feeling.

I still get this feeling, from time to time.

I can promise you that the only way to find out? Is to start trying. And connecting. Which you're doing by being here, so that's already a step in the right direction.
 
Welcome. Not EMS, but other long-term trauma, and what you wrote fits right in here.

That isn't to say I can't put on a good show. I'm funny. I can be goofy and play with my pediatric patients. I probably seem normal to most people that don't know me well, but I'm becoming increasingly aware that something's wrong.
This is a big one for me. Survival = continuing at any cost and putting the best face on it that we can. Until now, at least. Healing seems to involve taking that face off (for brief periods and in safe contexts, while maintaining the ability to put it on the rest of the time, when we need to). To see what's underneath, and to get help with it.

I hope you can keep asking for help and support until you find what you need. I'm glad you found this place. It's been huge for me in understanding my ptsd (both because of the people who understand and write about specific circumstances like mine, and because of the people whose circumstances are totally different and who show me how much of our trauma responses follow a pattern)). Anyway, welcome.
 
Welcome @CoastMed !

To twist a Freud quote - the voice of PTSD will not rest until it is heard. Learned that 45 years down the road...

Take time to deal with this @CoastMed. It will not go away with out treatment, the only way out is through.

Throw yourself into getting better the same way you have thrown yourself into your career. This community is a place that can help with the day to day stuff as much as anything else can.

I know how invaluable this site and the people here have been to me the last couple years. Hope we can help you in some way....
 
That's not the usual response I get.
yep. thats why this place is so very, very amazing. You can finally talk with people who actually get it. They aren't blowing smoke up your ass. They actually get it.
I try to forget, then feel guilty about trying to forget because these patients deserve better than that
I remember EVERY bad call I took. Especially the kid ones. For a long time I felt like if I didn't remember them then it would somehow make the person disappear for the entire universe. It was all on me. Ask me about my saves and I have to think about it. Ask me about the really bad calls and I remember every.single.word.

You're always the calmest one in the room. That's the goal. You detach, assess, and act. These are our "normal" situations. If you can't detach, you can't do the job. I
Yep. I spent almost 20 years training on the floor, then ran the training department before I left and it just kills me (now) to think I had to teach those innocent trainees how to distract, dissociate and just try to get thru the day without admitting it was killing them.

Because we simply didn't know the damage we were doing.
No one did.

nstead of recognizing that, our companies, govt agencies, and governing boards treat us as damaged goods, fit for the incinerator. They use us up until we start to mentally fracture, then discard us, use us as scapegoats, then blame us for the damage we incurred.
Yep. I've been completely ostracized by dispatch. What can I say, we are a superstitious lot - when one goes down it means it could happen to someone else, so they bail. No one wants to face the damage that leads to a breakdown.

and I had to fight with the VA for FIVE years to get acknowlegement and benefits over the crap I went thru in the military -- because they just hope you will die if they delay you long enough
My worry is that I don't know if I have the capacity. I've finally accepted that there is something actually to this, but now I'm concerned that it can't be fixed at this point.
It can be fixed
If you are willing to do the work.
I won't lie -- NOTHING you have ever faced is going to be as hard as this. Because this is when you start to make peace with all those calls, situations, nightmares, etc. And it is going to suck in sooooo many ways.

But.
It does get easier
You learn how to let go, how to make peace, how to feel again
It won't be easy
But it CAN be done
Did I mention it's gonna suck? LOL

And luckily you've found an entire group of people who get it and can be there with you as you go thru it.

You've been brave many, many, many times in your life - for others.
Now it's time to be brave for you.
 
Thank you for all you did - you were put in impossible situations and had to do your best and sometimes that wasn't good enough through no fault of your own. But you also did a LOT of good. And you tried, with your whole heart, and that's so much more than most people do. It's really amazing actually. So yeah, thank you.
 
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