Rescuing the Rescuers 

Last week, Lee Ann Dagastino was looking for a van, a minivan, an RV, or anything that her team could borrow to drive to Gulfport, Mississippi. Only they aren't going for any sporting event. Dagastino is a member of a state-certified Critical Incident Stress Management team. Activated by the Mississippi Department of Health, the Tennessee-based team sent eight of its 25 members to the Gulf Coast shortly after Hurricane Katrina hit.

"We debrief, defuse, and do one-on-ones with firefighters, EMTs, paramedics, police," says Dagastino. "We also ran into some helicopter pilots and the morgue team."

Started with a federal grant in 1988, the Memphis-based team consists of rescue personnel, as well as a clinical psychologist and a licensed clinical social worker. In a way, they are the first responders for first responders. They peer-counsel police officers, EMTs, and firefighters after horrible tragedies: They worked the Oklahoma City bombing, 9/11, and the 2004 West Memphis bus wreck.

During their trip to the Gulf Coast last month, for instance, they talked with firefighters who survived Katrina, but just barely. The firefighters closed their station's bay doors and then used their fire engine and a rescue truck to brace the building. The 40-foot storm surge carried the vehicles away and trapped the firefighters inside the station.

"These young men are strong; they're healthy. They look at you and very matter-of-factly say, 'You know what? We were resigned we were going to die that night,'" says Dagastino. "Some of them were trying to write letters to their families to leave behind. They tried to stay together so that if they died, their bodies would all be found in one place."

Team member Leah Cooney says there's a certain mindset among rescue workers. In a situation like Katrina, they've sent their spouses and families away, but they're stuck there because it's their job. And they're not going to leave.

"Rescue personnel -- whether male or female -- are all macho," says Cooney. "We don't need any help because we are here to help you. But when the reality of what's going on sets in, you start getting personality changes."

The stress can make rescuers quicker to anger and can lead to substance abuse or other poor, even fatal, decisions. In New Orleans, in the wake of Katrina, two police officers committed suicide.

"We tell rescuers all the time that they're having normal reactions to abnormal situations," says team coordinator Glenn Faught.

During the formal group debriefing, the team will sit down and ask the rescuers what they saw, what they did, how they're feeling.

"The problem is that they sometimes don't connect thoughts and feelings and they become very disassociated from what's going on. You get into emotional difficulty that way," says Dagastino. "Sometimes, they'll be telling you, 'Well, my house is gone; my car is gone; everything I own is gone; the clothes I'm wearing are borrowed,' and then they laugh."

But since the rescue was still in the early stages, most of the counseling they did was informal.

"We cleaned up right beside them," says Cooney. "We go down there in tennis shoes, shorts, T-shirts and ball caps because if you go down there trying to look or act better than them, they're not going to talk to you. The point is you need to be one of them."

The team also made sure to bring along junk food and cigarettes, since a quick run to the store for a little pick-me-up was definitely out of the question.

"Sometimes all they need is a coke and a chocolate candy bar," says Cooney. "Everybody's thinking, They don't have water. Let's send water and Gatorade. It's a firehouse. They want junk food."

And sometimes, she says, taking care of the body's needs will fix their emotional needs.

"We ask them, 'What do you need?' 'Gloves, okay,'" says Faught. "We try to keep giving stuff so they can open up and say, 'It's really bad out there.'"

The team pays for much of its work out of members' own pockets. They say it cost them about $1,000 in gas to take the RV -- they had to run the generator because there was no place to plug in for electricity -- and that they've probably spent $3,000 to $4,000 so far.

"For the last trip, we're getting reimbursed for travel and food," says Faught, "but as far as time off work, we have to take vacation and sick days."

As of this writing, members of the team are once again working in Gulfport and the surrounding area. Which is why they needed to borrow a minivan. But they're hoping to get federal status with FEMA soon so they won't have to beg and borrow.

"If we were federalized, we could requisition all kinds of vehicles and supplies and equipment or whatever we might need," says Dagastino. They would also get paid.

She expects this trip will be a little different from the last one.

"I think a lot of [the rescuers] were running on adrenaline. I think their feelings are starting to come back. At first, you just emotionally numb-out to get through the situation."

Let's hope they remembered the chocolate bars.

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