Firefighter Syndrome

By: Martha Chapman

IT’S FAR MORE THAN “JUST” PTSD

What do a firefighter living on a hobby farm near Toronto, Ont., and a professor of psychology at the University of Hawaii have in common?

They’re both passionately devoted to educating firefighters, city halls, the healthcare system and even insurance companies that what a lot of firefighters experience is not “just” PTSD.

FIREFIGHTER SYNDROME, AS THEY HAVE CALLED IT, CAN INCLUDE AN ARRAY OF SYMPTOMS, AND A PATTERN OF INTER-RELATED MEDICAL, SOCIAL AND PSYCHOLOGICAL INJURIES ACCUMULATED OVER A CAREER IN THE FIRE SERVICE.

According to the two, Canadian Jadie Miller and American Christopher Frueh, a career in the fire service involves regular exposure to chronic stress, lethal risks and short as well as long-term medical, psychological and social strains. They have identified 19 different features of the syndrome which, while yet to be officially recognized, may sound familiar to many CRACKYL readers.

These vary from toxic exposures and disrupted hydration and nutrition to chronic pain and traumatic brain injury (TBI). To that list they have added a host of other problems that can affect personal relationships: marital and family dysfunction, anger, anxiety, hyper-vigilance, depression and difficulties with the work-to home transition.

Substance abuse, including alcohol and drugs (recreational or prescription), can complicate things further. Poor sleep including sleep apnea can exacerbate it all. And yes, PTSD, with its intrusive memories and physiological reactions (racing heart, sweating), is also on the list.

You can find a full lineup of firefighter syndrome symptoms by visiting:

It's no secret that PTSD is already commonly used as an umbrella term to cover a whole range of disturbing symptoms. For generations, soldiers and other combatants have come home from battle struggling with frequent fear, stress and anxiety. Even in the 1700s, an Austrian physician wrote about soldiers stricken with listlessness and torpor – a condition he termed, strangely, “nostalgia”. Such nostalgia was widely noted during the American Civil War, but it was World War I which brought these recurring symptoms—the tremors, nightmares, impaired sight and hearing experienced by soldiers—to the fore. Back then, it was termed “shell shock”. Fast forward to today: according to the Anxiety and Depression Association of America there are some 7.7 million Americans who are suffering from PTSD.

YET MUCH AS AUTHORITIES AND LAYMEN (INCLUDING FIREFIGHTERS’ FRIENDS AND FAMILIES) TEND TO LUMP ALL FIREFIGHTING-RELATED DISORDERS UNDER THE PTSD UMBRELLA, IT’S NOT AS STRAIGHTFORWARD AS THAT.

Just ask Canadian firefighter Jadie Miller. Having survived a childhood of abandonment and abuse, she decided that the fire service, with its credos of service to community and risking a lot to save a lot, would be the perfect career for her – or as she puts it, “Because I am alive in the world of fire.”

But all of a sudden, ten years into her career, during a call at a townhouse fire she decided she “didn’t care”, telling her captain, “Let it burn.” Clearly something had gone wrong. And not only professionally. Miller explains that she lost her ability to

interact and socialize with her family and experienced anger, forgetfulness, and nervousness. “I was in a collapsed state all the time.”

She did a 100-day deep dive trying to figure out what she had been exposed to physically and mentally. Sensors strapped to her body tracked where she went and when. She logged her heart’s activity, her urine, and her glucose.

MOST TELLINGLY, SHE STARTED TO LEARN THAT SHE WASN’T ALONE.

Desperate to find a definition for her ailment, Miller spent four years seeking the healing necessary to rejoin the firefighting community. PTSD, the “one-size-fits-all” diagnosis didn’t fit the bill, so she took her search worldwide.

Which led her to Christopher Frueh, PhD, a researcher of treatments for PTSD. A clinical psychologist and widely-published author, Frueh (whose name is pronounced “free”) spent 15 years as a staff psychologist and director of the PTSD clinic at the Veteran Affairs Medical Center in Charleston, South Carolina and has over 30 years of professional experience working with military veterans and active-duty personnel. Miller decided to reach out to him because she felt he could help her –and her community. As Frueh recalls, “During Covid I got an email from her asking if she could talk to me, and she persuaded me to join her in her passion to help firefighters.”

IT’S A BIT LIKE KIDS LEARNING TO PAINT. THEY’RE TRAINED TO PAINT BETWEEN THE LINES SO THAT EACH COLOR REMAINS DISTINCT AND DOESN’T TOUCH ANY OTHERS. BUT IT MIGHT BE BETTER TO THINK ABOUT PAINTING WITH WATERCOLORS, WHERE COLORS OVERLAP AND BLEND TOGETHER.

Miller says in her usual self-deprecating way, “I’m in awe that he said yes to some farm girl, and here he is in big fancy Hawaii.”

It is an unlikely collaboration: the American academic and researcher with over 200 professional publications under his belt, and the Canadian female firefighter who is the first person in her family to graduate from high school.

BUT TOGETHER THEY REALIZED THAT FIREFIGHTERS CAN EXPERIENCE AN ENORMOUS ARRAY OF SYMPTOMS IN THE COURSE OF THEIR PROFESSION, AND THAT THE MEDICAL WORLD HAS YET TO CONNECT THE DOTS BETWEEN THEM ALL.

It’s a bit like kids learning to paint. They’re trained to paint between the lines so that each color remains distinct and doesn’t touch any others. But it might be better to think about painting with watercolors, where colors overlap and blend together. It’s the same with medical symptoms— but what psychiatrist is likely to ask a firefighter about his testosterone count? Would a GP, busy recording a patient’s blood pressure, ask about work-to-home transition difficulties?

FRUEH AND MILLER DECIDED THAT WHAT WAS NECESSARY WAS A WHOLE SYSTEMS FRAMEWORK, TO BE CALLED “FIREFIGHTER SYNDROME”, DESIGNED TO BETTER UNDERSTAND AND ADDRESS THE COMPLEX NEEDS OF THE PROFESSION.

“It’s time to stop sitting around drinking coffee and bitching about it. It’s time to do something,” says Miller.

In 2018, they co-founded PYROC Technologies Inc., dedicated to changing how society cares for and optimizes the performance of first responders. Its goals include the establishment of clinics (on a franchise model, ideally owned by first responders) to care for the mechanisms of injury that are specific to each type of responder and fill the gaps in the present system.

Among other aims, they plan to help the science community to acknowledge firefighter syndrome and encourage much-needed studies, while ensuring that workplace insurance boards across North America recognize the syndrome and make it a “box you can tick.” And they hope that the IAFF and IAFC will engage PYROC so that everyone can collaborate to educate locals across the nation on behaviors, habits and collective amendments to protect firefighters.

In five years, Miller hopes that PYROC will still be driving change, having helped the science community acknowledge firefighter syndrome.

“WE ALL COME INTO SERVICE WITH WOUNDS AND THIS IS OK. IN FACT, IF WE DO THE HARD WORK OF UNDERSTANDING OUR WOUNDS AND HEALING THEM, THEY TURN INTO AN INCREDIBLE OPPORTUNITY THAT MAKES US STRONGER. SORT OF A SECRET SUPERPOWER.”

And in this challenging profession, who couldn’t use a secret superpower?

If you’d like to learn more about PYROC, VISIT PYROC.COM