Stabbed on duty: A medic's lessons learned on the long road back
Ben Vernon dug deep to work through years of emotional trauma that surged to the front of his mind after he was attacked
Leaning against a trolley stop railing, unable to take a breath and sensing the blood running down his back, firefighter/paramedic Ben Vernon felt anger begin to boil up inside. He had just been stabbed — a victim in a knife fight he didn't even know he was in — and that anger would grow and worsen for weeks to come.
Vernon and his partner, firefighter/paramedic Alex Wallbrett, were both stabbed by a bystander as they attempted to assess and treat a man with an unknown medical problem in downtown San Diego in late June 2015. "I was in rescue mode, not fight mode," Vernon said, describing the incident.
For weeks afterward, Vernon was maddened and perplexed by the incident because of the perfect and "blessed" trajectory of his career, from aimless college graduate to a highly trained firefighter, paramedic and rescue technician.
Finding his calling
Vernon graduated from the University of California, San Diego in 2001 with absolutely no desire for a career in mathematics, his field of study. After a few years of unsatisfying work in sales, he was looking for more.
The former Division I volleyball player was staying active with various outdoor sports, like rock climbing and scuba diving, when a friend mentioned he was taking an EMT class.
"Donald Chen, a friend from the volleyball team, told me about EMT class," Vernon said. "I signed up for the class the day before it started."
The hook was set, and as the paramedic teaching the class explained what paramedics are able to do, he was reeled into EMS quickly.
When Vernon learned there was another level of training beyond EMT he immediately wanted to become a paramedic.
"Then I saw a guy step out of an ambulance in turnouts and asked, 'What are you?'"
Vernon quickly realized that he could turn his new passion for rescue into a career. The path from math major to firefighter/paramedic was rapid. "Everything went my way. In just three years I went from the first day of EMT school to full-time firefighter/paramedic with San Diego Fire-Rescue."
Once on the job, things continued to align perfectly for Vernon. Soon after completing his first year of probation he replied to a department-wide email to sign up for hazardous materials training and join the hazmat team. Then, shortly after he completed hazmat training, the DHS/FEMA California Task Force 8, which is a federal urban search and rescue team based in San Diego, announced new positions for hazmat technicians.
"In 18 months I went from new hire to a hazmat tech on the USAR team that some guys have tried to join for years,” he said. "In nine years I have just been blessed. Everything lined up for me."
Three years ago Vernon capitalized on his USAR team training and experience to successfully bid into Station 4, which houses the heavy rescue team in downtown San Diego, where he was reunited with firefighter/paramedic Donald Chen.
Station 4, the oldest operating station in San Diego, is a busy downtown station with two heavy rescue-trained crews, but those crews also respond day and night to medical calls from tourists, homeless people, office workers and downtown residents. In fiscal year 2015, Engine 4 responded to 5,974 calls, of which 5,281 were medical.
June 24: Dispatched for an intoxicated man at the trolley stop
On most days the weather in San Diego is just as perfect as Vernon's career path: 72 degrees, mostly sunny and a breeze off the ocean. Responding for an intoxicated person at a trolley station at 4 p.m. on Wednesday is about as routine as it gets for Station 4.
The four-person crew from Engine 4 — a captain, an engineer, Vernon and his partner, Wallbrett — responded to a call for an intoxicated person at a trolley stop. A Rural/Metro ambulance was also dispatched but was at least 15 minutes out. Waiting for an ambulance, a persistent problem in San Diego at a time that has led to fines against Rural/Metro, was not unusual. A month later, American Medical Response's parent company announced its acquisition of Rural/Metro.
The trolley stop was located on a road closed to vehicles, so the crew parked the engine at a cross street and walked to the patient, prepared for a medical call, and, "We talked to Ryan Allen Jones, who was a bystander at the incident," Vernon said of the man who a few minutes later attacked him and Wallbrett. "He told us helpful information about the patient."
Vernon's account of the next few minutes is vivid and gripping. But, because a trial is forthcoming, he is reluctant to detail the specifics for publication.
The afternoon of the incident a witness told NBC 7"(Jones) kept struggling, kept fighting, kept swinging, kicking. And I didn't know he had a weapon, and I seen him hit the fireman."
Jones is facing two counts of attempted murder and several other charges for the attack, which was captured on multiple surveillance and body-worn cameras.
Ben Vernon (right) and Alex Wallbrett (left) minutes after being stabbed.
Vernon and Walbrett calmly approached Jones and tried to engage him verbally before Jones charged at Vernon, swinging a knife into his back and side. "Talking people down is what we do all the time, especially when a friend or bystander starts telling us to run the call," Vernon said.
Wallbrett was stabbed when he came to Vernon's aid. The captain and engineer, along with several trolley security officers, forced Jones to the ground and disarmed him. In the melee, Wallbrett was blinded by pepper spray.
'Cover Now! Two firefighters have been stabbed!'
"It happened so quick," Vernon said. "I remember moving back towards a railing for the trolley stop, unable to take full breath and hearing the captain radio, 'Cover Now! Two firefighters have been stabbed.'"
It took Vernon and Wallbrett a moment to realize that the 'Cover Now' — a distress call to summon all available cops — was for them. "We had this surreal conversation about what just happened, and I was gripping the railing thinking, 'This is my lifeline — I have to hold it to keep standing up.'"
Vernon stayed in rescue mode, realizing that he had at least a pneuomothorax, and Wallbrett was losing a significant amount of blood. "I remember thinking, 'I am f---ed!' and looking down the street at the engine," Vernon said. "We left the trauma bag in the engine — we walked to a medical call — which looked so far away.
"I just wanted to help myself and my partner."
And for this dedicated first responder, not being able to help may have been the worst part of the experience.
Look for the helpers
Heavy Rescue 4, the other company from Station 4, responded to the Cover Now and rushed to the scene. Chen, Vernon's longtime friend and the one who told him about becoming an EMT, was on Heavy Rescue 4 that day and the first to arrive.
"Thank God," Vernon said of seeing Chen. "We had been together every step of the way. I am so grateful that of all the possible rescuers in San Diego, it was him."
A Rural/Metro ambulance finally arrived. Whether it was the originally dispatched ambulance or a nearby crew responding to the Cover Now, Vernon does not know.
"The ambulance arrives and the paramedic, Dennis Smith, is the man that hired me for my first job as an EMT," Vernon said. "All guys I know are here to help us. No probies. No interns. No students."
Chen and Smith got Vernon into the ambulance where, despite life-threatening injuries, he stayed in rescue mode, questioning Chen and Smith about his vital signs.
"Alex went in the second ambulance. One of my regrets is that we didn't go to the same hospital," Vernon said.
The rescuers become the patients
Unbeknownst to Vernon, fire department companies from throughout the city rushed to Scripps Mercy Hospital. "When the doors of the ambulance open, all of my firefighters were there," Vernon said, his voice trailing off as he was overcome with emotion remembering the tunnel of blue between the rig and the trauma room.
The medics rushed Vernon into a trauma room. "They stripped me naked, butt naked," Vernon said. "This is when the pain really started, and I still could not get a full breath."
An MRI confirmed that Vernon had a hemopneumothorax and emergent placement of a chest tube was needed. Even with pain medication and local anesthesia, the pain of placing the tube was excruciating. "I was being held down on the exam table and arched my back, screaming when that tube went in between my ribs."
Vernon caught a glimpse of his blood shooting out the tube and into the suction container and felt the first bit of relief. "I was finally able to take a full breath, and the pain meds started to kick in."
With the chest tube inserted Vernon was rolled on to his side. "The first person I see is Chief Javier Mainar," Vernon said. "He asked me, 'Who can I call?’"
Vernon had never considered that as a firefighter/paramedic the chief might need to call his fiancée, Lisa, or his parents. "I realized then that I should have prepared them for this call, and later Lisa told me she had thought many times about getting a call like this. I want other firefighters to prepare their loved ones for the possibility of getting a call from the chief — or worse a visit — from the chaplain."
Two days later, after just 48 hours in the hospital for Vernon and 24 for Wallbrett, they met with the media and described their injuries — a punctured lung and broken rib for Vernon and a deep, complex shoulder wound for Wallbret — and their desire to get back to work.
"At the hospital a social worker visited with me and told me two things," Vernon said. "You and your partner are bonded together. There will be a lot of emotions, and if those emotions go on for more than a few months, that is not normal and you should get help. But I felt fine at that press conference."
Vernon's physical wounds healed quickly. He was discharged with antibiotics and pain medications. For the first week he was doing OK, running the call over and over in his head during the day, but he slept at night, not realizing that the pain medication was suppressing the emotions he had bottled up by staying in rescue mode.
"The pain meds and antibiotics were starting to upset my stomach, so I talked to the doc and decided I could stop," Vernon said. "So I did — stopped cold turkey."
On his first night off the meds Vernon had the worst extreme and vivid nightmare of his life. He was reliving the attack, in exquisite sensory detail, and battling the assailant in the fight he didn't get to have that sunny afternoon.
"I woke up drenched with sweat," Vernon said. "The nightmare was so intense — my heart was racing, I was breathing fast — there was no way I could go back to sleep. I just sat in the dark and tried to calm down."
The nightmare repeated the next night and the night after that. During the day, increasingly sleep deprived, Vernon was becoming anxious, jumpy and angry.
When the physician removed the stitches, he told Vernon he was physically ready and cleared him to return to work. But Vernon recognized he wasn't ready to return to work and didn't want to start taking pain or sleeping pills or drinking alcohol. "I needed to see a psychologist," he said.
Using a list of worker's compensation approved-psychologists, Vernon scheduled his first appointment. He described being "excited to get better," but the appointment was nothing like he expected.
"After telling me he (the doctor) saw the news about the incident, he says 'I have never worked with firemen,'" Vernon said. "I hadn't slept for two days, I felt helpless, and this guy doesn't know or understand us. I was screwed."
But with the nightmares continuing, he made more trips to see the psychologist. "My goal was no longer going back to work. It was just to sleep."
Vernon was bottoming out in a dark place and knew things were bleakest when the psychologist's best and only advice for him was "to lay off the caffeine."
Three weeks after the incident Vernon was scared and running out of hope.
Peer support offers a turning point toward healing
Many emergency responders share Vernon's frustration with mental health clinicians who don't understand cops, firefighters, EMTs or paramedics. Although well-meaning they don't understand the job, stress, culture or dark humor.
A co-worker, formerly a police officer, had told Vernon many years earlier about a traumatic incident from his first career. "I went to him and asked for help," Vernon said. "He told me to go see the police psychologist."
The San Diego Police Department has a contract with the Focus Psychological Services group for any cop to seek out and receive anonymous counseling, fully paid by the department.
"I instantly felt a connection with Dr. (Mark) Foreman," Vernon said of his first meeting with Foreman, a retired police officer, who became a therapist after a 28-year police career.
Foreman knew he wanted to be a psychologist in 1975 but delayed that interest to be a cop. Two years after retiring from the police department, Foreman completed a graduate school program, earning a doctorate in psychology. Now, as a psychological assistant, Foreman works under the license of a supervisor and provides mental health services to police officers and their families.
As a therapist Foreman notes that first responders react or respond to incidents differently, but also have some similarities. "Traumas and experiences are similar to a point but not exactly the same," Foreman said.
He thinks his patients find his experience as a cop helpful because they don't have to educate him on what it is like to be a cop. "They can start talking immediately about a traumatic incident," Foreman said.
Foreman's street experience was invaluable to Vernon. "He gets it. He looks like us. He talks like us. He understands us," Vernon said.
First responders need helpers who understand us
Psychologists, just like physicians and even firefighters, have specialties. Vernon had become a hazmat and rescue expert during his career, and now he needed a psychologist with expertise working with emergency responders rather than an expert in the care of children, addicts or victims of car accidents.
Post-traumatic stress disorder can be the result of a single traumatic event, which is generally the way a civilian might be injured. PTSD can also be the result of cumulative events that happen to a cop, firefighter or paramedic over a number of years or an entire career.
Foreman says post-traumatic stress disorder might be understood better if it were called post-traumatic stress injury. "PTSD is recoverable," he said. "It doesn't have to be career ending or debilitating. A broken bone or hernia is a treatable injury that heals from the inside out with treatment. You can recover and heal — from the inside — when you have a post-traumatic stress injury."
The cumulative traumatic stress becomes a problem for emergency responders when it is disruptive to relationships, work and general mental stability. "Cumulative stress eventually leaks out," Foreman said. "You are OK until you are not OK."
Signs of PTSD include intrusive memories, sleep disruption, avoidance of friends and family, withdrawal and interference with daily living. PTSD also manifests with major behavioral changes — on and off duty — as the brain leaks out the emotions that have been suppressed.
"Cops typically deny having a traumatic incident or incidents," Foreman said. "So I ask them to tell me about the significant calls. Then they go to the calls where things went horribly wrong."
EMDR treatment for PTSD
Foreman uses the Eye Movement Desensitization and Reprocessing (EMDR) treatment modality with some of his patients. EMDR, initially developed in the 1980s, provides the patient with bilateral stimulation — finger movements or other stimulation — as a memory is discussed.
"EMDR allows the patient to process information in their mind and body without a lot of talking," Foreman said when describing the treatment. "The patient is fully awake while the back-and-forth stimulates and activates the brain."
The intent of EMDR is to help the brain desensitize a memory from emotions and sensations. "The memory will go where it needs to go, settling it down by attaching appropriate emotions, thoughts and sense," Foreman said. "EMDR is not magical. Some people really love it, and others won't engage with it."
EMDR, Foreman believes, is effective and helpful. The efficacy studies have focused mostly on use of EMDR for a single trauma rather than cumulative trauma, like most first responders have experienced. Vernon describes the EMDR sessions as a technique that puts the logic and emotion of a traumatic incident into balance.
"During the sessions I hold paddles in each of my hands that vibrate like a cellphone in an alternating pattern as I describe the incident," Vernon said. "The process mellows me out, bringing me back to even."
PTSD, like tissue wounds and broken bones, is curable
"I want people to know that PTSD is curable," Vernon said. Through his sessions with Foreman and using EMDR, Vernon has been able to let go of the emotional baggage he has been carrying from the June 2015 stabbing incident. He finds the process so useful that he has been working through a list of all the bothersome calls from his career.
"I feel better emotionally today than when I started my career," Vernon said. "EMDR works for me."
When firefighters and medics are injured on the job — a tissue wound or a bone injury — there are treatment and rehab processes in place to help them quickly return to work. A similar process for mental health injury or illness is lacking in EMS. "We need to care for brain injuries the same way we care for orthopedic injuries," Vernon said.
When Vernon was injured, he felt alone. "In 126 years no firefighter in San Diego had been attacked and stabbed like this," Vernon said. "We were the first."
In the weeks after the incident, he began hearing from medics across the United States and Canada who had been attacked and stabbed. "I heard from a medic in LA and read about the EMTs stabbed in Detroit," Vernon said. "I wasn't alone."
Getting back to normal
Four months after the incident, Vernon transitioned from light duty back to regular duty. Although he didn't feel 100 percent back to normal, he needed to get back to work for the steady income and overtime opportunities.
In November, back on the job for more than a month, Vernon was still seeing Foreman weekly and expects just one more recovery hurdle: "I want another conflict or attack," he said. "Knowing that I will be able to keep my cool and use my training to chemically sedate or apply soft restraints to the patient will let me know I am 100 percent back."
Arriving at this point has been excruciatingly difficult. Vernon has replayed the call awake, in his nightmares, in therapy and on duty with his colleagues. "We didn't even realize it was a fight. We had four firefighters and three transit cops in broad daylight," Vernon said.
Ben Vernon (left) and Alex Walbrett (right) at the Real Heroes breakfast given in their honor. (Photo courtesy
of Ben Vernon)
'Lay off the caffeine'
Part of getting back to normal for any emergency responder who has been through a traumatic incident is being able to joke about the incident and its aftermath.
"Alex and I want people to know that there are psychologists that can help us and that PTSD is curable," Vernon said, "but we also both heard — and have had other medics and cops tell us they got the same advice — to lay off the caffeine."
As a firefighter, paramedic and rescue and hazmat technician, Vernon is hard-wired to solve problems and think creatively. But now he has a new stock answer for any time he is puzzling out the solution to a problem: "I'll say to Alex as we try to figure something out, 'We better lay off the caffeine.'"
Then they have a laugh and get back to work.