Violence and trauma part of every shift for Wis. medic
For a Milwaukee medic it is important to leave his stress at the station and not bring home the violence he sees on the job
By Sarah Hauer
Milwaukee Journal Sentinel
MILWAUKEE — When Lt. Jamaal Perry returns home after finishing a 24-hour shift at 8 a.m. as a Milwaukee Fire Department paramedic, he usually gets the same question:
"Did you have a bad night?" his wife, Dana Perry, asks.
Most mornings, he says simply, "It was all right."
Perry tries to leave his work at the firehouse, to not let the violence he sees on the job come home with him. This is what he saw on one April shift:
Shortly after 2 p.m. on April 12, he and his partner were dispatched for a call of a child struck by a vehicle in the 4600 block of N. 48th St.
While riding to the scene, an update came over the radio: Shots fired, multiple victims. Perry started to feel anxious. He started to mentally size up the possibilities and prepare himself for what he may see.
Two engine companies were already on the scene.
Getting out of the ambulance, Perry looked to his right. Lying in the street was a middle-aged man. A few firefighters were administering CPR. To his left, Perry saw other firefighters caring for a teenager lying in the grass.
"Where's the kid?" he thought.
As part of the first medical unit on the scene, Perry needed to quickly assess the victims.
The man receiving CPR had a gunshot wound and no pulse. Perry instructed the firefighters to continue CPR. His partner started an IV.
The teenager on the grass was still breathing, and the firefighters were bandaging his torso where he had been shot.
A firefighter directed Perry to the child who was struck by the car.
The toddler had been covered with a blanket. Perry lifted the blanket. He saw the extent of the traumatic injuries and agreed nothing could be done.
A second medical unit arrived. Perry directed them to the teen — the most viable patient. The unit needed to get him to the hospital.
Perry returned to the man. He still didn't have a pulse. Perry can't load a patient into his ambulance without a heartbeat. They ran an EKG to check for electrical activity in the man's heart. He was gone.
Within the five minutes he had been on scene, maybe 10 police squad cars had arrived. It was chaotic.
Perry could just hear crying and yelling.
After 10 years as a paramedic and 17 years with the department, Perry has gone on a lot of bad calls.
A few years ago, when he first transferred to MED Unit 4, calls like this one were few and far between, Perry said. Now he responds to a call about a stabbing, shooting or some other act of violence at least once or twice a week.
He remembers the first bad call he went on, shortly after he became a paramedic.
Someone had called 911 for an infant who wasn't breathing. Perry arrived at the house and saw the infant lying on the kitchen table. The child didn't have a pulse. The mother said the child was 2 years old. Perry said it looked as if the child starved to death. There was nothing he could do.
"It is the worst thing I've ever seen, hands down," he said.
Perry said calls with children are even harder to deal with since his 4-year-old daughter, Chloe, was born
One night years ago, when he worked at Engine 36, the firehouse at N. 27th St. and W. Capitol Drive, he responded to five fatal shootings.
"I don't want to relive some of the terrible things I've seen," Perry said.
Even nonviolent calls hold risk. Overnight Sunday, the department responded to a call for a person who had trouble breathing. While firefighters transferred the patient into the ambulance, one firefighter was shot. The firefighter was treated for a graze wound to the side of his head and released from the hospital.
But Perry said it's worth it — he loves what he does.
Perry grew up in the city and joined the department after graduating from Riverside University High School, following in the footsteps of his father. After seven years as a firefighter, he decided to become a paramedic.
"I've seen this city go from bad to worse to better," Perry said. "It's all over the place. This is where I live and I'm here to take care of people."
He said his training takes over on the scene. He sees tasks to be completed, victims to care for.
"You really don't have time to form some form of emotional attachment at that time because there's a job to be done," he said.
He said he tries to wipe the slate clean each time he returns to the firehouse.
"You can't take baggage from a previous run on your next run," he said.
Perry is one of more than 400 paramedics for the Milwaukee Fire Department. In 2013, Milwaukee paramedics responded to 1,050 calls for shooting and stabbings.
Jason Mims, the department's health and safety officer, said the aim is to address the trauma on emergency workers even before they leave the scene of a call.
Before leaving, firefighters and paramedics hold demobilizations to share what happened.
A few days after a critical incident, such as a child's death, another intervention, a diffusing, takes place. People who were on the scene will describe what they saw. Instead of just sharing how they feel, they are challenged to quantify their emotions.
If a call was particularly traumatic, a deeper session, known as a debriefing, may start as soon as they return to the station house.
Mims estimated the department conducts 30 diffusings and five debriefings a year.
The department has stepped up efforts over the last four years to make sure people are handling the stress of the job. The department also started a peer support team in 2010, which now has more than 30 members.
"We're not counselors," Mims said. "We're there as an ear."
On that April day, Perry talked with police at the scene and found out what had happened.
Archie Brown Jr., 40, had hit 2-year-old Damani Terry with his vehicle as the toddler ran into the street. A man who police would later identify as Damani's uncle, Ricky Chiles, 27, shot Brown. The toddler's brother, 15-year-old Rasheed R. Chiles, was wounded in the gunfire.
Chiles was taken to Children's Hospital of Wisconsin but didn't survive surgery.
While he stayed on the scene to write his report, Perry cared for two more people who began to experience chest pain. Perry treated them, and wrote up another report.
Perry was the last paramedic to leave the scene.
"After the fact, you start thinking about little things that you saw because now everything is slowing down and you have time to think about everything that happened," he said.
On his way back to the station, Perry started to see it all again — how bad the injury was, the mother grieving, the loss of a toddler, family members crying in the street.
It had been a tough week for Perry. Nearly every time he returned home from work, a call from his previous shift was on the news.
He arrived back at the firehouse on W. Mill Road and received a call for critical incident stress debriefing.
"Is it optional?" he asked.
Perry doesn't really like talking about what happens on the job.
"I don't want to relive it again," he said. "I don't want to hear what everybody else saw. I went through all that. I was there."
He knew the debriefing session would start like so many others:
"Lieutenant Perry, what did you see?"
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