# California 200



## TacoMEDIC

This call went down on 8/14/10, but i am new here so I figure it's better late than never. 

It made National Headlines, so some of you may have already heard about it. 


I was working with an event safety company for the MDR California 200 Night Race, a race that involves full size race trucks and buggies. The race was set to start at 1930hrs and we were pulling in right as it was getting started. I was hoping to get some sleep because I had just gotten off of a 96 hour shift at my primary job. My partner was all gung-ho and stated that he hoped that something serious would go down so he would get to play. I wish he never said that. 

We show up at the start line to get comms all squared away and MDR officials tell us to wait until they get all the race vehicles off the line. No 5 minutes later we have the same race official come running up to the ambulance (because we have no comms yet) screaming at the top of his lungs that a race truck has just rolled into the crowd at the "rock pile" ( an area of the course that i have known to be pretty dense with spectators from past experience). 

We haul *** toward the incident when I have a buddy call me on my personal phone screaming, "get here quick, man! there are people everywhere!". I asked for a little clarification and dig for some more constructive info so I can start some resources. No luck. 

We get on scene 8 minutes later and just as my buddy stated... bodies everywhere. Absolute chaos. I'd love to rattle off a bunch of specifics, but it was kinda a blur from there. I called Comms Center and asked, "how many helicopters do you have withing a 100 mile radius?". After getting a baffled response, I added, "Send all of them!". 10 airships on the way. 

We had 17 immediates, 24 delayed, and 4 DOA... not sure how many minor. Our nearest Trauma Center is 2-1/2 hours by ground. Nearest ER is 1 hour by ground. Nearest ground resource is 45 mins. No bueno. It doesnt matter how many MCI videos you watch, nothing works when you have 500 spectators yelling at you to help their friends and family and no PD to help with crowd control... Triage triage triage... that's all you can do. 

When additional resources arrived, 2 more pts had deceased. I started delegating pts to responders and relinquished command to the Capt. Then it was treat treat treat, load pts to helicopters and ground ambulances and try to remember what the hell happened for reporting. 

It took a little over 3 hours to get all pts transported. Total death toll was 8 by the end of the night. It was a mess. The media didn't help. And how tough you think you are, CISM is worth it... 

Sorry I couldn't elaborate more. Official report will be coming out in JEMS soon. If you have any other questions, I'll be more than happy to ask. 

-Matt


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## rachelrescue

*wow...*

I'm sure that was a very traumatic experience for you, but it sounds like you handled it very well.  I just got hired on with a company out of Los Angeles that does IFTs but of course I would love to do 911.  What company do you work for?


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## clibb

Props to you for calling for air evac right away. Some people will wait.

In the town I work in we get a lot of mass accidents since the intersections are so hard to control after and accident. You're right, no movie or exercise can prepare you for when :censored::censored::censored::censored: hits the fan.

Good job controlling the accident though!


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## TacoMEDIC

rachelrescue said:


> I'm sure that was a very traumatic experience for you, but it sounds like you handled it very well.  I just got hired on with a company out of Los Angeles that does IFTs but of course I would love to do 911.  What company do you work for?



I work for several companies. 

Baker EMS (Baker and Needles, CA) Very Rural. All 911. -Paramedic

Impulse Ambulance (North Hollywood, CA) IFTs and Events. -Paramedic Coordinator

Symons Event Safety (San Bernardino, CA) Events. Company I was working for on this call. -Paramedic

M.O.R.E. (Mojave Offroad Racing Enthusiasts) Event Safety. - Paramedic


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## rwik123

Sounds crazy. Do you work for a company that was contracted for the race? And were you in a bus? Or your povs?

Good call on the hems.


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## TacoMEDIC

clibb said:


> Props to you for calling for air evac right away. Some people will wait.
> 
> In the town I work in we get a lot of mass accidents since the intersections are so hard to control after and accident. You're right, no movie or exercise can prepare you for when :censored::censored::censored::censored: hits the fan.
> 
> Good job controlling the accident though!



Thanks. I figured the MOI was significant enough that many of the 40+ pts may not live long enough to get to a TC by ground. Blunt traumas have a way of turning for the worse in a hurry. Calling for multiple airships at the time of the initial size-up/ first order for additional resources only seemed logical.


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## TacoMEDIC

rwik123 said:


> Sounds crazy. Do you work for a company that was contracted for the race? And were you in a bus? Or your povs?
> 
> Good call on the hems.



I was working for the contracted company. We were on an ALS 4x4 van conversion Ambulance. 

Thanks


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## rachelrescue

TacoMEDIC said:


> I work for several companies.
> 
> Baker EMS (Baker and Needles, CA) Very Rural. All 911. -Paramedic
> 
> Impulse Ambulance (North Hollywood, CA) IFTs and Events. -Paramedic Coordinator
> 
> Symons Event Safety (San Bernardino, CA) Events. Company I was working for on this call. -Paramedic
> 
> M.O.R.E. (Mojave Offroad Racing Enthusiasts) Event Safety. - Paramedic



I have to admit, I'm jealous!  Seems like a whole lot of driving...but you're actually making a difference.


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## TacoMEDIC

rachelrescue said:


> I have to admit, I'm jealous!  Seems like a whole lot of driving...but you're actually making a difference.



My biggest advice is don't ever turn down an opportunity to work anywhere in EMS, especially with the way the market is in So Cal right now. Never quit looking for opportunities to better yourself or your situation. You'll get there. I am a strong believer in good things coming to those who work hard.


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## Tyler Bruns

I don't come on this site often but I just happened to check this forum today...

I was also on the scene with you. I was one of the spectating EMT's there watching the race and was even set to do lap #4 in a 1400 truck. Me and a large group of my race team, including a buddy and myself who are EMT's, went to the rockpile to watch our teams trucks go by. I was only yards away from were the truck ended up in the crowd. We lost 2 team members that night. I'm sure you saw some me and my other team mates there providing aid. We were wearing bright green GFO racing pit shirts.


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## beandip4all

TacoMEDIC said:


> My biggest advice is don't ever turn down an opportunity to work anywhere in EMS, especially with the way the market is in So Cal right now. Never quit looking for opportunities to better yourself or your situation. You'll get there. I am a strong believer in good things coming to those who work hard.



i <3 this quote.  particularly because i teach a job hunting seminar to emt-b students, and it neatly sums up a few key points that i try to drive home to those students.  may i quote you on it?

regardless, thank you for this writeup, Taco!


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## TacoMEDIC

beandip4all said:


> i <3 this quote.  particularly because i teach a job hunting seminar to emt-b students, and it neatly sums up a few key points that i try to drive home to those students.  may i quote you on it?
> 
> regardless, thank you for this writeup, Taco!



Absolutely. And thank you.


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## TacoMEDIC

Tyler Bruns said:


> I don't come on this site often but I just happened to check this forum today...
> 
> I was also on the scene with you. I was one of the spectating EMT's there watching the race and was even set to do lap #4 in a 1400 truck. Me and a large group of my race team, including a buddy and myself who are EMT's, went to the rockpile to watch our teams trucks go by. I was only yards away from were the truck ended up in the crowd. We lost 2 team members that night. I'm sure you saw some me and my other team mates there providing aid. We were wearing bright green GFO racing pit shirts.



I saw your team there. There were several off-duty EMS personnel at the event. It was a great team effort. Thanks for your help.


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## Tyler Bruns

TacoMEDIC said:


> I saw your team there. There were several off-duty EMS personnel at the event. It was a great team effort. Thanks for your help.



I was surprised by the amount of EMS personnel there. I remember multiple EMT's, a couple Medics, and even a Army Combat Medic who was at the race on leave.

Do you know when the JEMS report is supposed to be coming out? Do know know anything about what its going to be about?


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## TacoMEDIC

Tyler Bruns said:


> I was surprised by the amount of EMS personnel there. I remember multiple EMT's, a couple Medics, and even a Army Combat Medic who was at the race on leave.
> 
> Do you know when the JEMS report is supposed to be coming out? Do know know anything about what its going to be about?



I'm not sure when it will be coming out. I was interviewed by a Loma Linda MC ER Doc that was working that night. He is writing the report. It will be about MCIs and rural trauma patients.


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## firetender

To Everyone Involved;

One of the toughest.

Chaos such as this has no order. It sounds like further harm was minimized and the inevitable dealt with as best possible. There's nothing more that could be asked for except for you to keep talking to each other; you've shared an experience few get to understand. The only ones who can help you (if you're going through very human reactions) is each other. You start with making it real, the human aspect, that is.

Sometimes "I was just doing my job." is a lie.


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## Tyler Bruns

firetender said:


> To Everyone Involved;
> 
> One of the toughest.
> 
> Chaos such as this has no order. It sounds like further harm was minimized and the inevitable dealt with as best possible. There's nothing more that could be asked for except for you to keep talking to each other; you've shared an experience few get to understand. The only ones who can help you (if you're going through very human reactions) is each other. You start with making it real, the human aspect, that is.
> 
> Sometimes "I was just doing my job." is a lie.



This is pretty much what I said to my friends that I worked side by side with that night and, also, to those who witnessed it. So 100% true. Only people that have been through this type of incident understand.



> Sometimes "I was just doing my job." is a lie


To this part, I don't know what made me stay at the accident scene and help while so many were literally running away. The only thing I can think of is that my training just kicked in and I did what I knew had to be done.

Also- Kudo's for TacoMEDIC and his coworkers for arriving on scene, and doing so much in a horrible situation. Words can't describe how relieved I was to see that first ambulance arrive on scene. Even though things were far from over it was a big moral boost.


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## TacoMEDIC

Hey all. I just revisited this thread after more than a year. Here is the report that ended up in JEMS in May, 2011:

Mojave Desert Racing:

On Aug. 14, an off-road rally race was just about to get underway. Starting at 7:30 p.m., the California 200 was a 200-mile, off-road rally race in the Lucerne Valley of the Mojave Desert in Southern California. The start/finish line was located approximately 125 miles from Los Angeles (225 miles from Las Vegas) by ground. The race was scheduled to be four 50-mile loops with a 7.5-hour time limit.

The race was part of the Mojave Desert Racing (MDR) series, an off-road racing body that organizes a series of rally-style, off-road races in Southern California. Although organizationally unrelated to SCORE, the vehicles in the races are similar to those that race in the Baja 1000. This race had around 100 entries.

On-site medical support was provided by Symons Event Safety, a regional provider of medical care for large spectator events ranging from concerts, arena sports and races, including NASCAR. One ALS ambulance, staffed by two paramedics, was positioned at the start/finish line. The nearest community hospital was 34 miles from the starting line, or about 45 minutes by ground, and the nearest trauma centers were 30 minutes away by helicopter.

The Incident:

Unique to these off-road races is the lack of barriers along the course. Although spectator instructions had specified that bystanders should stay beyond 100 feet from the course, there was no effective enforcement, and people were able to come within feet of speeding vehicles.

Approximately 10 minutes after the first vehicle left the starting line, a modified Ford Ranger competing in the race hit a popular rise called “The Rock Pile.”

As it hit, the truck appeared to lose control and drifted to the side so that when it landed askew, it quickly rolled off to the side and into spectators along the barrier-less, off-road course.

The ALS ambulance immediately called for support from nearby ground fire and EMS. The event ambulance arrived on scene about seven minutes after the crash. They found four patients dead on arrival, including one spectator who had been decapitated. They called for 14 medical helicopters and began triaging more than 20 patients.

Paramedics began treating two of the most critically injured patients, who unfortunately died prior to the arrival of any transport units. Off-duty medics watching the race assisted with placing patients on backboards and treating them. This bystander assistance proved to be a help and a hindrance. More patients were able to be treated, but there was no organization. The only ambulance was quickly pillaged of supplies. Ground support arrived about 30 minutes after the initial call.

Helicopters from three states—California, Nevada and Arizona—responded, including a military crew from Fort Irwin. They arrived on scene about 40 minutes after the accident occurred. Ten patients were transported by air to trauma centers. Two of those patients later died from injuries. Other unknown patients self-triaged to hospitals by private vehicle. In total, eight spectators died.

The race took place on Bureau of Land Management (BLM) property, and California Highway Patrol and BLM investigations of the accident continues. Further Mojave Desert Races have currently been suspended pending these investigations.

Safety remains the unquestioned focus of MDR and BLM, as evidenced by the event’s 15-year history. MDR has already begun strict enforcement of speed and distance regulations, as well as prominent designation of safety fencing. BLM will grant permits only to events that can adhere to strict criteria, as well as improving pre-event coordination and on-scene presence.

Logistically, having dual paramedic teams or two mixed EMT-B/paramedic units for the event allows for simultaneous triage and treatment, and initiation of the incident command system (ICS) system with resource allocation. Most importantly, this incident underscores the importance of incorporating MCI training into continuing education programs.

Joshua Bobko, MD, EMT-T, is the current EMS fellow at Loma Linda University Medical Center. He responded to this incident.

The complete report is available here:

http://www.jems.com/article/ems-special-operations/ems-providers-care-orv-racers


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## mycrofft

*Any words about the interface between groundlings and helos? Or air traffic control?*


Was there radio between ground and aircraft, and who had it?
 Were there predesignated helo pads or were they improvised?
What do you see doing differently in all aspects to prepare for such an event in the future?
Would the presence of a "hardshell" (preexistent) austere medical facility with electricity and commo been of use? Secured prestaged medical supplies?

We have a big off-road event area near us, Prairie City, which seems very rural but is about ten miles or less from a non-trauma center hospital; those are a winding, two lane ten miles though.


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## Akulahawk

Prairie City seems rural but they're very close to the urban area of the City of Folsom. Mutual Aid from Sac Metro Fire and El Dorado County units is easy. The problem is that ground transport from Prairie City can take a while. Once clear of the twisty roads, transport to the L1 Trauma Center only takes a few minutes. An incident like the one in this thread would quickly overwhelm them. The other two L2 TC's are another 10-15 minutes away. There are lots of other facilities that can handle the overflow that are closer, but they would have to be the lower acuity patients. 

Air resources are actually pretty good. Within 20 minutes (assuming none are busy), 4 helos could be overhead. Within 40 minutes, add another 2 or 3. Within an hour, add in probably another 4 or 5. Throw in the National Guard and CHP Rescue Helos and there could be another 3-4 available, but timetable on that could be longer. 

Fortunately, Prairie City has yet to have an incident of that magnitude. I hope they never do...


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## firetender

*What I'm interested in is YOU!*

How are you doing? What did you learn? What advice do you have for those of us who WILL end up in hellish scenarios like that? Not only on the technical end, but in matters of the heart. Did you ask for and get help? What did that help mean to you? Once it does happen to others on this site, where would you direct them to go, and to whom?

A year later, of course what remains are the logistics. But I'm curious about your adjustment to being center stage in hell.

...and thanks for letting us take another look!


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## mycrofft

*Second that.*

:excl:


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## TacoMEDIC

mycrofft said:


> Was there radio between ground and aircraft, and who had it?
> Were there predesignated helo pads or were they improvised?
> What do you see doing differently in all aspects to prepare for such an event in the future?
> Would the presence of a "hardshell" (preexistent) austere medical facility with electricity and commo been of use? Secured prestaged medical supplies?
> 
> We have a big off-road event area near us, Prairie City, which seems very rural but is about ten miles or less from a non-trauma center hospital; those are a winding, two lane ten miles though.



Yes we had radio contact with the flight crews on a designated helo channel (Calcord)

Unfortunately, we did not have any designated landing zones. It was a huge camping weekend in the desert so, of course, all the nice flat spots (lake beds, etc.) were filled with RVs. We landed air ships in several difficult locations 300-500 yards from the incident. I have worked with several off-road organizations since the incident and all have worked to designate 100'x100' landing zones around race courses. Usually every 7-10 miles. 

It is difficult to prepare for such an incident without bringing MCI trailers to every event. We have worked with organizations to make events safer by designating spectator areas and requiring people to stay back 150' from the course. Also, as I mentioned above, we predesignate landing zones, etc. I also make a habit of notifying local EMS systems of large scale events and obtains availability of resources prior to any incident. In short: plan instead of react.

Of course a large building stocked with medical supplies and comms would have been a great resource, but it is simply not a possibility due to the scale of events. How could you justify a building on a 40-70 mile course? Where would you put it? Not to mention there are 4-5 courses used every year. 



firetender said:


> How are you doing? What did you learn? What advice do you have for those of us who WILL end up in hellish scenarios like that? Not only on the technical end, but in matters of the heart. Did you ask for and get help? What did that help mean to you? Once it does happen to others on this site, where would you direct them to go, and to whom?
> 
> A year later, of course what remains are the logistics. But I'm curious about your adjustment to being center stage in hell.
> 
> ...and thanks for letting us take another look!



I am doing much better now. I admit, I was pretty messed up immediately after the incident for about 10 days or so. 

I learned that we all have limits. We like to be "heroes" but we can't alway be. How do you treat that many patients? Where do you start? How do you tell a teenaged girl that you can't help her pulseless brother? How do you treat so many acutely injured people spread over 50 yards as a single resource. Remember, they are all trauma patients. We only carry 4 backboards. It was absolutely humbling. 

I would suggest anyone put in that situation remember the basics. TRIAGE! Have concrete information to pass on to additional resources when they arrive. How many, how bad. Know what resources are coming. Know their capabilities. Have a PLAN!

After the incident, I was pretty messed up (like I said above). Mostly because that is a normal human response to such chaos. I did have a unique emotional connection due to my involvement in the sport. I did seek help. I talked to the department counselor as well as attend CISM. I found both to be very helpful. I would suggest that anyone who is unusually stressed or troubled after an incident of any scale seek help. Whether it be in confiding in a coworker, friend, family member, department counselor, or CISM after the incident. Do not wait too long. The longer you wait, the more likely that the incident have lasting effects on you.


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## DrParasite

TacoMEDIC said:


> Unfortunately, we did not have any designated landing zones. It was a huge camping weekend in the desert so, of course, all the nice flat spots (lake beds, etc.) were filled with RVs. We landed air ships in several difficult locations 300-500 yards from the incident. I have worked with several off-road organizations since the incident and all have worked to designate 100'x100' landing zones around race courses. Usually every 7-10 miles.


odds are, even if you did have designated landing zones, I would imagine you would have one, maybe 2 designed LZs.  if you are calling for 10 medevacs, your system will get overwhelmed.  sounds like you (and by you, I mean everyone there) did a great job on the fly making things up as they go.


TacoMEDIC said:


> It is difficult to prepare for such an incident without bringing MCI trailers to every event. We have worked with organizations to make events safer by designating spectator areas and requiring people to stay back 150' from the course. Also, as I mentioned above, we predesignate landing zones, etc. I also make a habit of notifying local EMS systems of large scale events and obtains availability of resources prior to any incident. In short: plan instead of react.


maybe you should bring an MCI trailer to every event?  99% of the time, you won't need them.  bring one guy to drive the trailer, set it up, look pretty, and take it all down at the end of the day.  

it's good PR, and if your system has access to it, and can preplan for it, it can often be accommodated.


TacoMEDIC said:


> Of course a large building stocked with medical supplies and comms would have been a great resource, but it is simply not a possibility due to the scale of events. How could you justify a building on a 40-70 mile course? Where would you put it? Not to mention there are 4-5 courses used every year.


that's where a mobile MCI kit comes in handy.  the NJ EMS Task force has a few of these 





capable of 100 patients and 




for 50 patient incidents


TacoMEDIC said:


> I am doing much better now. I admit, I was pretty messed up immediately after the incident for about 10 days or so.
> 
> I learned that we all have limits. We like to be "heroes" but we can't alway be. How do you treat that many patients? Where do you start? How do you tell a teenaged girl that you can't help her pulseless brother? How do you treat so many acutely injured people spread over 50 yards as a single resource. Remember, they are all trauma patients. We only carry 4 backboards. It was absolutely humbling.


with that many patients, you aren't doing much treating.... those 4 back boards aren't going to do much.





TacoMEDIC said:


> I would suggest anyone put in that situation remember the basics. TRIAGE! Have concrete information to pass on to additional resources when they arrive. How many, how bad. Know what resources are coming. Know their capabilities. Have a PLAN!


having a written plan, even if it will never be used, is essential for any major event.  it will help you when all hell breaks loose, even if nothing else than gives you something to follow.





TacoMEDIC said:


> After the incident, I was pretty messed up (like I said above). Mostly because that is a normal human response to such chaos. I did have a unique emotional connection due to my involvement in the sport. I did seek help. I talked to the department counselor as well as attend CISM. I found both to be very helpful. I would suggest that anyone who is unusually stressed or troubled after an incident of any scale seek help. Whether it be in confiding in a coworker, friend, family member, department counselor, or CISM after the incident. Do not wait too long. The longer you wait, the more likely that the incident have lasting effects on you.


glad to hear you are feeling better.  i know they can be chaotic and take a toll on you.

I know the ems coordinator for one of the drag racing courses in NJ.  he has plan in place, and every time he has a major event (like when NASCAR or other things on that level where the ticket sales increase 10 fold) they staff extra ambulances, extra ALS units, and an MCRU, SOV 




or some other Task Force truck just incase something happens.  We have the warp tour, every year in NJ, and we have units assigned with EMSTF resources to assist with the planned for 100+ patients.

Some people consider all those trucks a waste of tax payer and grant money.  And it is.  but when you need it, it's great to have them just a phone call away.  and even better if they are standing by at an incident just ready to go.


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## TacoMEDIC

DrParasite,

I think part of the problem is/was that we do not consider a "local" off-road race a large scale event (<10,000 attendees). Maybe we should. 

My company covers very large events as well. We cover 100,000+ person raves, NASCAR (100,000+ for a weekend), Coachella and Stagecoach Music Festivals (100,000+ for 2 weeks), The Baja 1000 (hundreds of thousands of people over 1100+ miles), etc. In all these examples, we deploy MCI capable resources to include Task Vehicles, on site Emergency Rooms with several trauma Docs, RNs and Paramedics, Helicopters, EMS command centers, etc.


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## firetender

TacoMEDIC said:


> I am doing much better now. I admit, I was pretty messed up immediately after the incident for about 10 days or so.
> 
> I learned that we all have limits. We like to be "heroes" but we can't alway be. How do you treat that many patients? Where do you start? How do you tell a teenaged girl that you can't help her pulseless brother? How do you treat so many acutely injured people spread over 50 yards as a single resource. Remember, they are all trauma patients. We only carry 4 backboards. It was absolutely humbling.
> 
> After the incident, I was pretty messed up (like I said above). Mostly because that is a normal human response to such chaos. I did have a unique emotional connection due to my involvement in the sport. I did seek help. I talked to the department counselor as well as attend CISM. I found both to be very helpful. I would suggest that anyone who is unusually stressed or troubled after an incident of any scale seek help. Whether it be in confiding in a coworker, friend, family member, department counselor, or CISM after the incident. Do not wait too long. The longer you wait, the more likely that the incident have lasting effects on you.


 
I'm really happy to hear you sought and got help and are doing better with it all. Let's face it, you got a tour through hell. The help you got, as potent as it was, is still a Band-Aid because such stuff has echoes. My prayer is that along the way you found at least one person with whom you have permission to "work through" the trauma without being judged. 

Sometimes it takes talking about it again and again until it becomes real to you. You experienced a series of relentless moments where you likely have yet to see your way clear. All this is nothing to be feared, and the fact that it still may take you a while to integrate the experience is no reflection on your ability to serve. In fact, going through the process of what amounts to a recovery will strengthen you.

But maybe more important is that you will then become a resource for others who were assaulted in similar ways by the work. The name of the game is to get another tool in your bag of tricks that you can use to help others. This time, though, it's about your peers.

Why else would you have gone through the experience if not to use it to benefit others?

I call it "turning sh*t into d*amonds" and that's how you heal! (I claim copyright on the phrase as written from around 2005, so I don't think I can get nailed on trying to beat the censors, but we'll see!)

Does it make sense for me to say "Thank You for going through this for all of us."? I hope you come to understand why.


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