Spotlight: Mike Rathier – EMS & Fire

The Spotlight series highlights individuals in first responder life who have felt an impact, made an impact, and shared an impact with others. We need to share our stories to know we’re not alone and we can do this… together!

Caroline: This month’s Spotlight introduces Mike Rathier, former EMS chief and EMT firefighter. Mike grew up in the first responder world with his grandfather as a deputy chief in Westminster, MA. Mike has been a first responder himself for nineteen years. He is currently taking classes to become one of our FRC coaches. Mike, thank you for taking the time to do this Spotlight.

Mike: Not a problem.

Caroline: Now, you mentioned that we – those in the first responder world – don’t know how to ask for help and sometimes don’t know how to accept it. Today’s theme is, “It’s okay to not be okay.” So let’s talk about that now. What, in your mind, is the key barrier of first responders asking for help?

Mike: We, as a community, get too proud of what we do, I think. For us to ask for help, it’s like we’re letting people down.

Caroline: First responders are looked at as the helpers. They’re here to help on your worst  days. It can create that self-image that you shouldn’t show weakness.

Mike: Exactly. I think that’s what a lot of first responders see it as, a moment of weakness. 

Caroline: Do you think it’s more that they don’t want to show weakness because they think they’ll be seen as inadequate or do you think it’s more that they’re going to hurt the public image of their field?

Mike: I think it’s a little bit of both. If you think about it, when a first responder goes down in the line of duty, you see an outpouring of support. I think a lot of first responders think that if they go to seek help, it reflects negatively on those who lost their life in the line of duty and it takes away from their support.

Caroline: So it’s almost like, “No, I’m just feeling a little depressed. It’s not like someone died. You don’t need to help me.”

Mike: Right.

Caroline: That’s a good point. What else do you think might be a barrier to them? Do you think that there’s also a lack of understanding on how help happens?

[Trigger Warning: sensitive call involving a child.]

Mike: Yes, absolutely. There’s definitely miscommunication on that. So, I can speak to that little bit myself. In 2019, when I used to work for the medical examiner’s team, I went to a kid call. The parents basically, without going into too much detail, killed their 16-year-old autistic child, who wasn’t just autistic but had a lot of mental illness and was very dependent on them. They left the child in a room for an entire day before they called us or called for any assistance for this child. I have two children that have autism so, to me, that was very heartbreaking. 

Caroline: That was an especially hard call for anybody but especially to someone who has empathy for that.

Mike: Right. So, for about a week, I didn’t sleep. I actually ended up having a huge mental breakdown. My work refused to give any peer support for it. They said, “There’s no one trained to help you with this, and you were doing the job, so suck it up and deal with it.”

Caroline: That’s unfortunately a lot of the stigma, especially for police, fire, and EMS: suck it up and deal with it. There’s a lot of that with all first responders. We’re working on that. 

Mike: Yes! So, I stepped back a little bit more. Having been doing this job for so long, I’ve seen a lot of trauma. In 2014, before I knew of any programs to help, I actually attempted suicide because of the trauma I had gone through on the job and off the job. Then, I went to On-Site Academy, which is a first responder organization out here with counselors that deal with trauma. They are first responders and actually understand what we’ve gone through. That helped out tremendously.

Now, we’re in 2022, and the suicide rate for EMS has tripled in the last two years. I think a lot of that is because EMS, and first responders in general, since the pandemic have been overworked and underpaid. There’s not enough education for us to seek that help and to understand that it’s okay to not be okay.

Caroline: So, you experienced quite a bit yourself with your own trauma that you’ve seen as a first responder and what that did to you. How was the turnaround for you with On-Site Academy and everything that you went through when you finally started getting the help? Was that like a light bulb went off or was it a long, ongoing process?

Mike: It’s a very long process, at least in my case. Growing up, I dealt with a lot of trauma that I didn’t realize was going to affect me until I went to calls where I’m doing CPR on a child or I’m holding a guy’s head together. A lot of that trauma resurfaced and I’m still dealing with a lot of it. But what I realized is that it’s okay to talk about it. It’s okay to find someone that understands and talk to them. That is one of the hardest things that I had to realize. We don’t have to keep it bottled up. Eventually, bottling it up is going to affect a lot.

Caroline: It bleeds out on everything. 

Mike: Yes.

Caroline: It sure does. It is typically an ongoing thing. I don’t know if departments are hesitant to provide help for staff because they know it’s not going to be a quick healing process or maybe they want to sweep it away… But I think that’s something that a lot of people need to realize, that this is not just a quick one-and-done. You don’t just show up at On-Site, spend a week or two or however long they prescribe and say, “Yup, you’re good, back into the world. Start over, you’re great.”

You carry it with you, and this whole process of getting help is not learning how to get rid of it – we can’t get rid of trauma. We learn how to live with it, and we learn how to continue living and living well if it’s dealt with properly. And I think that’s maybe – am I hitting the nail a little bit on the head – what some of the barrier is? People don’t realize that, yes, you’re not going to just “get over it,” you’re going to learn to live through this.

[Trigger warning: graphic detail]

Mike: I think you did hit the nail on the head. A lot of the perception is that you can do a week at On-Site Academy and everything is great and you process that trauma that put you there, but it’s not just one trauma. I’ve done this job for nineteen years. There’s so much trauma that I’ve gone to, there’s so much that I’ve seen, that the average person doesn’t see and they don’t understand.

I think why a lot of us don’t seek help is because when you go to a counselor and they haven’t done the job, they say, “Oh, I get what you’re saying. I completely understand…”

[I say,] “The hell you do. I’m sorry but you don’t work where I work. You don’t see what I see. So, you’ve done CPR on a child. You’ve held a guy’s head together to get to the ER and save his life, because he couldn’t take it anymore and decided to cut his throat open. No, you haven’t seen this. So, don’t tell me you understand.”

I think that’s where a lot of people fall short. They find counselors that do first responder therapy but they’ve never worked the job. So, they continue to say that they understand but the person leaves the counseling session worse than when they went in and they feel they weren’t listened to.

Caroline: The flip side of that is when you see someone who’s trying to help you and – not only do they not understand because they’ve never done it – but also, they’re a little traumatized by what you’re telling them. They’re in shock from the things that you tell them because you’re trying to work through something and they can’t handle the details.

So, it makes it difficult to feel comfortable “talking shop.” They won’t understand that gallows humor. Pretty much all forms of first responder life have some sort of gallows humor. They’re going to joke about something that is completely inappropriate in the public’s eye but they do it as a coping mechanism. It’s not that you’re making a joke about someone’s trauma, but you’re working off the moment.

A person gets burned and you ship them off to the burn center and (after) say, “Well, she’s going to have a hard time getting a date.” You can’t talk like that to someone who has never been in the industry because they’re going to think you’re an awful human being and that’s a terrible way to think. The person that’s making a snide remark like that isn’t really that insensitive. It’s kind of a coping mechanism to not have to think about the weight of the situation.

That could be a huge barrier to wanting to seek help because [they think,] “Who’s going to understand what I’ve been through? What professional is going to understand the trauma that I’ve seen?

Mike: Absolutely, and it’s funny you bring that up. I make quilts and pillows for families that have lost loved ones; I use the shirts of the loved one who passed. 

Caroline: That’s fantastic!

Mike: I was talking about how I was cutting up this person’s shirt who had passed away. Someone asked why I was cutting up someone’s shirt. I said, “They’re dead. They don’t care.” And they said, “Wow, that was kind of rude to say.” But how else do you say it? My wife looked at the person and said, “He works in the medical field. Don’t mind him.” My wife gets it now.

I think that the other aspect of not wanting to get help is not letting your family down. With me, getting help was really hard because I have my kids. Them seeing dad struggle when I’m their super hero, I go out to structure fires and on ambulance calls.

Caroline: No one wants to see their hero with his Kryptonite.

Mike: Exactly. They don’t understand why dad’s upset now or mom’s upset and why maybe they’re not home for a week or two because they’re getting the help they need. They just don’t understand it. To our eyes, we’re letting them down.

Caroline: But on the flip side, we know that’s not really true. I think the mindset that we need to build is this: no matter what industry the kids go into, we want our kids to have the mindset that it’s okay to not be okay. “My dad went through this and he got help. He came back and he was better and he struggled but he kept working at it. I want to be strong like my dad.” Shouldn’t that be their mindset?

We want them to know that if they ever go through something difficult they can get help, they can work through it. It’s a different model of heroism that we haven’t really shined a light on before. I think it’s time that we start saying, “This is the example. I want my kids to know that if they need help, they can get it. So, I’m going to be that example.”

Mike: You’re absolutely correct, however, how do we get to that point? How do we get the information out there for people to realize this? My grandfather did this until he was in his seventies. Even to this day, he talks about calls and we think so highly of him. He never had to seek help. Their motto was, “Suck it up buttercup. This is your job. If you don’t want to see the things that you’re seeing then you shouldn’t have signed up for it.” A lot of first responders still have that motto in their departments. So, how do we get around to “It’s okay to not be okay” and get that information out there?

Caroline: That’s the trick, isn’t it? That’s what we’re doing at FRC and other places like On-Site and more groups that are trying to advocate for first responders and mental health support. We’re trying to get that new mindset out there and smash the stigma. We want people to know that you don’t have to be perfect. There’s definitely first responders out there that see a lot of junk and they are okay. No one knows what’s really going on in their minds but they work through it, they manage it, but many more need help.

I know Keith has mentioned this before, but a lot of times it’s someone who has gone through trauma themselves that decides they want to be the helper, because no one was there for them. They become that helper and when they start to see trauma, they don’t realize that they’ve already been set up so that it’s going to be harder for them to get through those moments. There’s a spectrum I think where some people are okay and some people are not. We need that message to get out there that it’s okay if you’re not okay. It’s okay to step back and get some help. 

Mike: Absolutely. I think that’s one of the things we need to push for. I’ve even tossed around the idea to do a podcast where we talk about the things that we’ve been through. Maybe we’d have people come in and give their stories to show that we’re not these superheroes that can just deal with everything ourselves. It’s okay to ask for help dealing with things. No matter how difficult it is, just do it.

Caroline: Yes, everyone’s human. I love the example that if you broke your leg, you wouldn’t suck it up and set it and cast it yourself. No one would say to do that. You go to the hospital. You get it x-rayed. A medical professional looks at it. Someone casts it. No one asks you to walk on your broken leg. You have crutches. They sign your cast and offer to help carry things.

We all have the same human qualities. We all have emotions and brains and have to process things. Why is mental health ignored? Well, it’s an unseen injury. No one can actually see it, so they try to pretend it doesn’t exist.

Mike: Exactly. You know, for the longest time, I did that. I pretended as though it didn’t exist. It’s very hard to fix an unseen injury. 

Caroline: Yes, it certainly is. You mentioned podcasts where people share their stories and I know there’s a few of them, former first responders, some still current, and they have guests on to talk. I’ll drop those links at the end of this Spotlight.

What are some of the ways that you think we can turn this perspective around to let first responders heal their unseen injuries.

Mike: I think we need more peer-to-peer support. I think we need more of the people who are qualified or trained in peer counseling to step into these places and help them. One ambulance company near me since about January alone had ten first responder deaths due to suicide. So, how can an ambulance company sit by and allow that to happen while knowing that there’s support out there?

I think we need to push the support, push that there’s counselors available to talk to, there’s peers that have gone through what you’re going through. Ending your life for something like this is not what you need to be doing. It’s okay to talk about it. I think as people that have gone through it, we need to be able to go into these places with our heads held high and say, “ Hey, this is what happened to me. This is how I got through this. Come with me. Let’s talk.” That’s the only way, I think, that people are going to start opening up.

Caroline: In all walks of life, I think peer-to-peer is always the best way to get through something because you’re talking to someone who has been through it. You don’t have to explain stuff; they know it. Do you think there’s a difference in accountability between first responder organizations such as fire and police versus groups (with smaller, private companies) like EMS?

Mike: I do. I can speak to this as a chief. We were a huge revolving door. A lot of it has to do with leadership. And a lot of it has to do with the mentality that “it’s not going to happen to me. I’m never going to have that call that’s going to put me down or that gets me upset at three o’clock in the morning.” Then, when it happens, you think this isn’t what you signed up for.

A perfect example of that is a story of two brand new EMTs on a BLS truck who went to a cardiac arrest. These two EMTs were so new the ink was still wet. They should not have been put together; they should have had someone experienced with them. They did save the guy, luckily, but one of the EMTs went home right after the call and has never set foot back into an ambulance since, and even said, “This isn’t what I signed up for.”

Caroline: So definitely there’s a lack of education. Do you think there’s a difference in accountability for companies themselves when it comes to EMS versus, say, fire or police? EMS seems to be in and out, shorter-termed employment compared to other first responder groups. Maybe you have a different perspective with that?

Mike: No, you’re absolutely correct. With EMS, it’s not as much of a brotherhood as it is with the fire service or as a police officer. With private EMS companies, you are constantly watching your back, maybe even your partner.

Caroline: So, it can feel like a pretty hostile environment to begin with which is not a healthy start.

Mike: Exactly.

Caroline: So, many of the higher-ups, not necessarily the chiefs and supervisors, but definitely the decision-makers, are not going to invest as much in their people if they don’t feel they’re going to stay long.

Mike: Yes, and it’s a shame. When I was an EMS chief, I had an open door policy. My cell phone was on twenty-four/seven. The way I looked at it is: I don’t care who you are, you could’ve just come on the job, if you need someone to talk to, call me, email me, send smoke signals. I don’t care so long as you feel you have gotten what you need out of the conversation. I think a lot of places don’t do that. They feel you are here and then leave if you don’t like what you do. They’re too busy for you.

I see that a lot in the private companies. They get too big for themselves. They can’t deal with their employees. When I was a chief, I had three people when I took over the unit. By the time I was done, I had fifty personnel, an assistant, a chief, a lieutenant, and a secretary. And the reason why is because I gave them what they needed. Just because I’m a chief doesn’t mean I don’t go out and sweep the bay or check the trucks. It’s a title; it doesn’t mean that I’m not obligated to do those things. I think a lot of companies fail their employees by not doing that.

Caroline: We could do a whole topic on how first responders are treated by their employers. I just wanted to come around that point of EMS and staff investment. But really many first responders have this notion of concern of showing weakness. “Maybe they’ll think I’m unfit for the job or that I can’t do this. I’ll get treated differently.”

I think it’s fantastic that you put that to rest with your open door policy. You built this report with all the people you had working with you. With you, not under you, but with you. And you’re right. As the person at the top of the chain, it’s your job to take care of those under you. If you have to sweep the bay, you have to sweep the bay. And guess who’s filling in the shift when somebody doesn’t come in? It’s the guy at the top. 

Mike: My biggest thing is if you feel like the call is too much for you and you need someone to step in, it’s okay to tap out and not be okay with the call. Get what you need. We can’t help others if we’re not around to help them. 

Caroline: You giving permission for your staff to be able to tap out is like a golden ticket. It might actually encourage some to self-check more. “If I have to, I can tap out. Mike said it’s okay.” That might give the encouragement they need. And if they need to tap out, they tap out. That’s better for their mental health. They’re going to last a lot longer on the team if they can longer in themselves. That’s beautiful.

Mike: As a chief, my phone was always on for anyone that needed to talk. I won’t say I understand because I wasn’t there, I don’t know what happened. I understand the job, but I don’t understand your feelings because I wasn’t there. And I think that’s something people need to hear, that when you ask for help, it’s okay that someone doesn’t understand. They’re just there to make you feel better.

Caroline: Wonderful. Mike, I know you’re almost finished with your coaching certification. Thank you so much for doing this Spotlight! You’re going to be a great help to a lot of people.

Mike: Thanks. Happy to do it.

Caroline: Folks! Those peer-to-peer podcasts I mentioned are out there and here’s a few. I know there’s lots more. Keep seeking help when you need it. FRC is here to help as well. Remember, it’s okay to not be okay, but it’s not okay to unpack and live there. You can and deserve to feel better. Let’s work on that together!

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  • Keith HanksFRC’s own Keith Hanks keeps it raw and honest as he puts out his heart and what’s going on with PTSD and mental health
  • The Elsa Kurt Show – Elsa supports LEO families and promotes mental health for all first responders