Jan Rader – TED Talk TRANSCRIPT
For the past 24 years, I have been a firefighter in Huntington, West Virginia. As firefighters, my team and I are tasked with saving lives and property from such disasters as car wrecks, house fires and also life-threatening medical emergencies.
I am a woman leading a department in a male-dominated profession. And 10 years ago, I decided to increase my medical knowledge and I received a nursing degree. That was because it became clear that the next big threat facing not only my city, but other cities around the country, was not the one-and-done disaster, where you can ride in like the cavalry, as a firefighter, put out the fire and leave, feeling like you have made a difference and everything is OK.
The next big disaster in my city was and is the long, debilitating and lethal disaster known as opioid addiction. We now call this a health epidemic, and we have replaced the name “addiction” with “substance use disorder.”
To give you some perspective of how significant this epidemic has become, in 2017, in my county of 95,000 people, we saw 1,831 overdoses and 183 deaths from overdose. This is the job of my firefighters, as well as other agencies, to respond to that… Excuse me.
So, watching this epidemic unfold for several years, I developed some insight. For this disaster, we need to redefine our job as a first responder. We need to be more than just the cavalry. We need to do more than just save a life. We need to find ways to rebuild that life. And it’s going to take a lot of people to do that. And that is exactly what we are trying to do in Huntington, West Virginia.
Now, let me give you some insight as to what we do. First, this is what happens when somebody overdoses. Imagine you are somebody who is suffering from the brain disorder of addiction. You are fragile. You’re embarrassed, you’re ashamed. And you overdose.
Maybe a friend or a family member calls 911. And then all of a sudden, you are awakened by five or six total strangers in uniform. And they’re rubbing your sternum, and they’re saying, “Wake up, wake up! You overdosed, you could’ve died.” Now, would you not be defensive and angry? Because I know I would be.
And on top of that, those strangers gave you a dose of naloxone, which has sent you into withdrawals, or what is better known as “dope sickness.” Dope sickness makes you feel absolutely horrible. Some say it’s like the flu, times ten. Nausea, vomiting, diarrhea, body aches. So not only did we, as strangers, wake you up, but we also made you feel really sick.
So in turn, you, the patient, are not going to be very kind to us. And you’re going to refuse further medical treatment. OK, well, then that’s going to frustrate the heck out of us, and we’re going to be mad, because you’re ungrateful that we just saved your life. This is not a good dynamic here.
What we are dealing with is a brain disorder that changes your thinking. It convinces you that you don’t have a problem. So, this might have been not only the first time you’ve overdosed, it might have been the third, fourth or fifth time that we, personally, have revived you. This is not a good situation.
Second, first responders do not receive much education on what substance use disorder is. Neither does the medical community. We’re not trained how to deal with those suffering from substance use disorder. I am trained to put out many different types of fires. I am trained to save a life in the moment.
But I am not trained to deal with the intricate interaction between first responders, the health care community, social services and the wider community that is necessary to save a life long-term.
Thirdly, and this hits home. As a first responder, I consider myself the cavalry. We’re knights in shining armor. We want to swoop in, do our job and leave feeling satisfied that we’ve made a difference in somebody’s life. But that just doesn’t happen when we’re dealing with somebody with substance use disorder. We leave feeling frustrated and useless.
We deal with the same people over and over again, with no positive outcome. And you know what? At some point, I realized that it is up to us as first responders and as a community to solve this problem, to find better ways to deal with those that are suffering. So what I did is I started observing more on overdoses. I started talking and listening to my patients. I wanted to know what led them to where they are.
What exactly are they experiencing? What makes their situation worse? What makes their situation better? I began experimenting with my words and paying attention to my own actions and how it affected those of my patients.
The education that I have received and continue to receive on a street level in Huntington has been both eye-opening and life-changing for me. So, in Huntington, West Virginia, we have come together as a community, and we are changing the way that we treat those that suffer from this horrible disease. We have started many programs, and it’s making a difference. I’ll tell you about just a few of those.
Last year, we started a Quick Response Team, QRT for short. The team consists of a paramedic, a police officer, somebody in the recovery community and somebody in the faith community. As a team, they go out and visit people who have overdosed within 72 hours of that resuscitation. They talk. They listen.
They build a rapport with that patient, and they offer them treatment options. Right now, about 30% or up to 30% of those that the Quick Response Team have reached out to have accepted some form of help. And the wonderful thing about this is the first responders who are involved in this team, they actually feel like they can make a difference. Positive change where there wasn’t any.
This year — This year, we opened a free-standing specialty clinic, called PROACT, for those suffering from substance use disorder. It’s a one-stop shop, if you will. A patient comes in, they’re immediately assessed by somebody who’s an addiction specialist. They work with them to provide treatment options based on their own needs, individual needs. This does several things for us. It gives first responders a place to either take or refer our patients who are no longer in a life-threatening situation, that have refused to go to the hospital.
And it also clears up the overwhelmed emergency rooms in hospitals that we have.
The third thing that I want to tell you about is very dear to me and very important to my team. We recently started a first responders self-care program. More and more first responders are experiencing compassion fatigue and PTSD. It is not uncommon for the average firefighter in Huntington to deal with or see up to five young deaths per month. These are their friends, these are their classmates. So this much-needed program will not only recognize their hard work, it’s going to give them a voice.
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