Fires Help Spur New Health Resources for Calif. Responders

The Press Democrat, Santa Rosa, Calif.

She didn't know it, but retired paramedic Susan Farren's timing was impeccable.

A bout with kidney cancer in 2016 ended her long career on ambulances. Her experience with the illness opened her eyes to research showing first responders are more susceptible to certain diseases and health problems. A common factor is stress.

Once healthy, she sold her house to get the seed money to start First Responders Resiliency Inc. in early 2017. The nonprofit program teaches police, fire and emergency workers how stress affects the body and practices to withstand the pressures from their jobs.

That year, the October fires erupted amid a dry, inland windstorm. Infernos burned across Northern California, scorching more than 245,000 acres and killing at least 44 people from the North Bay to the Sierra Nevada foothills. In Sonoma County, the Tubbs fire tore through suburban Santa Rosa neighborhoods in the middle of the night and was for hours a dangerous and terrifying rescue mission for first responders.

"After Tubbs, the thing I became most painfully aware of was how much pressure and stress these firefighters had to absorb and suppress and go home and pretend they were normal," Farren said. "It was very much like seeing soldiers come back from war."

Many in the fire service in Sonoma County describe the 2017 firestorm as a major turning point for a profession already conditioned to work hard under dangerous circumstances. The destruction was so broad and on home turf.

And the siege of annual wildfires since then have accentuated the heavy burden.

"I've been in the fire service for almost 40 years and I've never seen the level of impacts on firefighter safety that I've witnessed over the last four to five years," Sonoma County Fire District Chief Mark Heine said.

First responders tend to have higher rates of behavioral health conditions, such as depression and post-traumatic stress disorder than the general population, according to the Substance Abuse and Mental Health Services Administration, a branch of the U.S. Department of Health and Human Services.

Under normal circumstances, the jobs insert these workers into difficult and dangerous moments, from car crashes to fights, medical emergencies and fires.

But the past several years have brought megafires to Sonoma County nearly every year, and imposed a more taxing kind of normality.

The 2019 Kincade fire that threatened to overrun Windsor forced the evacuation of nearly 200,000 people from the Santa Rosa Plain to the ocean. And last year's Meyers, Walbridge and Glass fires laid siege to opposite ends of the county, claiming almost 500 homes in blazes that dominated local life from August into October.

All the while, a pandemic has raged, putting firefighters on the front lines as emergency medical responders nearly every day. As is, about 80% of the work of a municipal firefighter involves emergency medical response for people who call 911.

Authorities are taking steps to address the toll such work can take on the firefighting ranks.

Santa Rosa Deputy Fire Chief Travers Collins said the city revamped its behavioral health programs for its employees last year. A key moment that underscored the need for specialized care came after a city firefighter who experienced profound psychological trauma sought out care but found providers unfamiliar with the type of trauma first responders experience, Collins said.

"That, for me at least, was one of the pushes to ensure that when our members are brave enough to ask for help, we give them competent help," he said.

Sonya McVay Straub, a local sports rehabilitation therapist, is one of those seeking to expand the field of specialized treatment for first responders.

When the Tubbs fire broke out Oct. 8, 2017, a police officer made the rounds in her Larkfield apartment complex and pounded on her door.

Straub specialized in working with race car drivers but had begun a side practice providing free care for veterans. She had come to work with veterans who worked in law enforcement and the fire service and had learned about the toll those professions take on a body. So once her family had evacuated to Marin County, she turned around and drove back to Santa Rosa hoping she could somehow help.

She ended up working alongside the Red Cross and providing support for firefighters and others who came in for rest between shifts.

"I'm treating and taping the best that I can and giving some mobility or structured rehab exercise to get them back on the line," Straub said. "I'd bring boxes and boxes and boxes of heat packs, make sure they had Advil."

She recalls meeting a firefighter "dragging his leg behind him, telling me, 'You have to get me back out there.' "

Three years later, Straub is now running The 6 Foundation, a nonprofit focused on rehabilitation for veterans, first responders and trauma survivors.

Straub said she wants first responders to be treated more like professional athletes. For both, the mind and body need constant care so they can stay at their best.

The organization will soon open its new Santa Rosa location on Donahue Street near Railroad Square, including larger facilities with outdoor space.

Straub, who now lives in Ukiah, said she recently got a call from a nurse at a local hospital asking for help for some of the front-line medical staff faced with punishing hours work and mounting stress.

"The conversation with the nurse was eerily like the conversations I have with firefighters and police: I'm exhausted, my body isn't working," Straub said. "I'm in this hyper vigilant space for so long, but I still have to work, I still have to save people."

Marine Corps veteran Karlie Kaasch, 27, of Duncans Mills, first came to Straub for lingering discomfort from her time in the military. She'd sought care before for back and knee pain but it wasn't until seeing Straub and her team that she began to experience relief.

"They found healed fractures in my back that I knew nothing about," Kaasch said.

Kaasch is taking classes at the Santa Rosa Junior College firefighter academy and volunteering with the Monte Rio Fire Protection District. Her first time fighting fire was on the Walbridge fire, which in August menaced Russian River communities and destroyed homes in the forested hills west of Healdsburg.

Kaasch comes from a long line of west county firefighters, and has seen how her family members are able to stay calm in challenging circumstances.

Embracing what she hopes to be the start of her career in the fire service, Kaasch said she wants to stay strong for the long haul.

The tendency for tight-lipped stoicism among law enforcement officers, firefighters and other first responders means it can be difficult for them to talk to others about the hardships of the job.

"If you figure in our career, we're going to see anywhere from 30,000 to 50,000 people having the worst day of their lives," said Collins, the deputy fire chief, "that adds up. That's going to have a toll."

Collins credited Santa Rosa for investing in new programs to bolster behavioral support services for its employees under extraordinary pressure from disasters and day-to-day work.

The tagline for First Responders Resiliency Inc. is "putting PTSD out of business" — a catchy phrase but one Farren wants to be taken literally. The program aims to teach people how to manage the stress before it becomes unbearable and has potentially lasting impacts on health.

"If stress is the number one contributing factor to disease, then dealing with the stress is the number one factor to reducing disease," Farren said.

In the past 2½ years, the organization has trained 4,000 people plus their families, according to Farren.

Her organization has a contract with Cal Fire to train tens of thousands of firefighters across the state to help them understand the science behind how stress affects the body to help them anticipate the impact.

They have run courses for the Santa Rosa Police Department and other local agencies, Farren said.

Farren said they teach techniques including combat breathing, mindfulness, meditation and practices such as yoga and qi gong.

They discuss methods like these to help first responders shift from the state of high alert they are trained to maintain on the job, get rid of that energy and develop practices to promote calm and well-being, she said.

"Your nervous system doesn't know the difference between on duty and off duty," Farren said. "We train it to turn off."

Last week, Farren led a presentation on her program for the Sonoma County Fire Chiefs Association and recently led training programs for the Santa Rosa Police Department.

Heine, the Sonoma County Fire District chief, said mental health is "a major concern for most fire chiefs right now" and will be a primary focus for his department this year.

The impacts of the work are cumulative and they cannot be ignored, he said.

"We did sign up to risk our own lives, in a calculated manner, to save lives," Heine said. "But I don't know it was an expectation that you'd be putting your life on the line on an annual basis, and during a pandemic."