This story is deeply personal. It's also harsh, perhaps even brutal. That's because I want you to know exactly what I went through so that, perhaps, you can avoid a similar fate. Forewarned, as the saying goes, is forearmed.
From the beginning of the summer of 2008, I had an annoying, low-grade sore throat. After a few weeks, I realized it was not going to bloom into a cold or the flu. It just lingered. I started to think I may have had tonsillitis as, unlike a lot of my peers, I still have my tonsils. What a pain it would be, I thought, to go through surgery in the summertime. I'd heard that a tonsillectomy is more complicated for adults than for children, so I went to work every day, ignoring the small pain in my throat and hoping it would just go away.
As the weeks passed, I started having trouble swallowing. I often had to try to swallow a mouthful of food several times before it would finally, grudgingly go down. While I thought it was a weird symptom, I continued to assume it had to do with my tonsils. "I'm going to have to see a doctor about this soon," I thought. But the weeks passed and I stayed busy and continued to think I would just go back to normal soon.
Then, one day I tried to take a vitamin pill, but simply couldn't. No matter how I tried to swallow it, or how much water I drank to try to wash it down, the pill would just pop out of my throat and back into my mouth. Frustrated, I finally just threw the pill away. Then, out of curiosity, I stuck my finger down my throat as far as I could without gagging and explored. "Is that extra tissue down there?" Suddenly, I was nervous. I made an appointment to see my regular doctor the very next day.
"Are you a smoker?" asked my doctor after I had described my symptoms to him. I told him that I wasn't, but reminded him that I had been a firefighter for almost 36 years. He examined me as best he could in his office and told me it was probably nothing, but "just in case" he referred me to an ear, nose and throat specialist. I went home and tried to make an appointment that day, but found that just about every otolaryngologist was on vacation. I went down the list of other medical providers I got online from my insurance company until I found a doctor who was in town. I took the first appointment I could get, which was still two weeks out.
Like a dark prophesy, an article came out in the Seattle Post Intelligencer that week, titled "Cancer Takes a Heavy Toll on Seattle Firefighters." It described the disproportionate number (over one-third) of Seattle firefighters hired before 1977 who had contracted some form of cancer. I wondered vaguely if I would add to those statistics.
For me, Day One of my cancer experience will always be the day I was actually diagnosed: Sept. 5, 2008. When the day for my appointment finally arrived, my symptoms had progressed to the point that I had trouble even swallowing liquids. I was sure, by now, that something was seriously wrong and suspected that I may have cancer. Sure enough, when the specialist put a probe up my nose and snaked it down my throat, I heard him say "Oh!" as though he had found a surprise down there. He had.
"You have a mass in your throat," he said after examining me, "It looks malignant. And aggressive." He looked me right in the eye, making sure I understood the gravity of his comments. My wife, Mary Ann, and I sat in stunned silence as he informed us of what needed to be done to complete his diagnosis. As he talked on, my mind took me back to all of those times when I entered burning buildings without breathing protection, and all of the times I worked for hours, unprotected, doing salvage and overhaul in the smoldering remains of fires. Like my peers, I had felt bulletproof in those days. I had always thought that cancer was something that happened to other people, not me. Now, for the first time, I was actually afraid for my life.
The doctor scheduled me for a surgical biopsy and a bevy of tests, including a CAT scan, immediately. On Day Five, when the results came in, I brought Mary Ann along to hear what the doctor had to say. Like me, when the symptoms had begun, she was still convinced it was nothing, but I was now convinced that it was definitely something. "The tumor in your throat covers your epiglottis. It's about the size of a walnut, and seems to be growing quickly. It's definitely malignant."
We listened as the doctor explained his recommended course of treatment. He said we had to get the tumor out as soon as possible, and scheduled surgery within two weeks. We asked about the process. He told us that they would go in and excise the tumor and any other affected tissue they found once inside. I would have to breathe through a stoma at the base of my throat for at least the first few months. There was a chance they could save my vocal cords, he said, but I wouldn't have an epiglottis anymore. Part of my tongue and part of my throat would also have to be removed. I would have to learn to eat and swallow again after further surgery to try to make my throat as normal as possible. I had a good chance at survival, he added, but there were no guarantees. I looked at Mary Ann and she had tears streaming down her face. I tried to get my mind around the fact that my son might not have a father around to help raise him.
As the doctor continued to explain, I reflected back for some reason to one of the worst calls I had ever responded to. It was in Seattle, a hot and sunny summer afternoon in 1975, when a full-response assignment came in with a "go" for the house: Engine 31, Ladder 5 and Aid 31. Responding from other north-end stations were Engines 24 and 39 and from the University District, Battalion 6. The report was that some kids were playing in an abandoned construction shack, and the caller said there was smoke in the area. I was driving Aid 31. We got out of the house much sooner than the big rigs, and when I heard that kids were involved, my foot naturally went to the floor. We got to the location minutes before the next-arriving unit.
My partner, Larry LaBrec, and I drove through the gate of the storage yard and up to the smoking shack, where a hysterical 7-year-old boy kept yelling, "She's inside!" We rushed in to pry the padlocked plywood door open from the top and fell into the thick smoke of a smoldering fire. The kids had crawled under the door, which had been intentionally blocked with heavy timbers to prevent illegal entry, and filled the space with cushions and foam pillows to create a makeshift playhouse. The fire had apparently been ignited by candles the kids had used to light the interior. The smoke was thick, black and obviously toxic. We went in without masks, as we always did in those days. Our protective gear consisted only of our helmets, black canvas turnout coats with green wool liners, one-layer leather gloves and non-treated cotton work uniforms.
Visibility was zero. We found the little girl by searching with our hands through the smoldering pillows and Larry handed her out to me as I crawled out first. She was dead; literally cooked to death, and disfigured beyond recognition. Her face was completely smooth, with no indication of where her mouth, eyes, ears or nose had been. I'd forgotten about the little boy until I heard his shrill screaming behind me. As I turned, I briefly saw the terror on his face at seeing the body of the girl, and then he ran away. We never saw him again. When the other responding units arrived, Larry and I were lying on the ground, coughing and spitting up nasty black soot.
I feel as though we danced with the devil, each of us in turn, when first we set out to become firefighters. In some cases, the devil comes right at you; I've known rookies who were beaten down at one of their first fire calls, burned or crushed. Over the years, I've seen some survive the experience with only scars to show for it, while others were swallowed whole.
We went back to the station afterwards and ate our dinner in silence, as, in those days, there was no such thing as a stress debriefing. Larry and I had our own dance with the devil that day, and the devil had exacted his due from the life of a little girl. I kept my eyes on the devil as we danced; I wasn't burned or injured. Or so I thought. But I didn't think about his poisoned tail. At some point, whether at this fire or another, the point lanced my throat so neatly that I didn't even know I had been wounded. It lay there, dormant, possibly for decades, until the time came when it bloomed like an evil seed.
Larry died of brain cancer in 2007. We will never know which exposure, or series of exposures, got him. Station 31, where we both worked at the time, had an especially high number of firefighter deaths from cancer.
And we danced.
MARIO H. TREVIÑO has 36 years of fire service experience, having risen through the ranks in the Seattle, WA, Fire Department to deputy chief before serving as fire chief in Las Vegas, NV; San Francisco, CA; and Bellevue, WA. He earned a bachelor of public administration degree at Seattle University and a master of public administration degree at the University of Washington's Evans School of Government. Treviño completed a fellowship at Harvard University, Basic Law Enforcement Training at the Washington State Police Training Academy and eight courses at the U.S. Fire Academy in Emmitsburg, MD. He also served as president of the Metropolitan Fire Chiefs, chair of the National Technology Transfer Center Advisory Board, board member of the Fire and Emergency Television Network (FETN) and member of the National Fallen Firefighters Foundation (NFFF) Advisory Board. He resides in Newcastle, WA, with his wife and young son, and is a cancer survivor.