Why Are We Dying?

It's with a real heavy heart that I continue to review the stream of line-of-duty-death notifications that pass through my computer. My review of the statistics indicates that more than 50 firefighters died during the first six months of 2001. The list that covers the cause of each death seems to be vaguely familiar, like maybe we have seen them all too often. The obvious question, of course, is why?

It is my intention to say a bit about each of the major death areas. I will then suggest a few things that we may wish to consider doing.

Let me start by saying that there seem to be a lot of people dropping over because of heart attacks. This does not surprise me, as I have lived the lifestyle of the brave and cholesterol ridden for many years. The causes of this malady are well known. You eat too much, you smoke too much and you don't exercise at all. And then suddenly you are racing to the scene of a blaze, raising ladders, dragging hose and rescuing victims. Or you might just be standing at the panel of your pumper insuring that your associates have the right amount of water.

What bothers me in looking at the statistics is the number of people who have died during physical exercise activities. We are told that exercise is good and then bam, over you go during a PT period. But think about it. Maybe we need better screening procedures.

For those of you who really know me, the mere thought of Harry Carter talking about good diet and weight control in an article must be cause for snickering. But I've seen the light. And it appears that it was my volunteer fire department's compliance with the New Jersey Respiratory Protection Standard that saved me from myself.

I did not pass the screening to be fit tested for self-contained breathing apparatus (SCBA) duty. I have been classified as an exterior-duty-only firefighter. Age and physical circumstances have caught up with me. My pulmonary specialist has confirmed that I have obstructed lung disease. It is not a very serious case, but when you tell a tuba player that his lungs are not what they should be, you get his attention.

I also knew that my personal physician was dead serious (pun intended) when he said something was not right within my hulking body. My weight and blood pressure were up and my exposure to bronchial infection problems was becoming too frequent. He said I needed to lose 20 to 30 pounds right away. Before I could nod or agree, he added, "… you can lose the other 50 to 60 pounds at your leisure." Pow! He struck me right between the eyes.

In this midst of all of this, I twisted my knee stepping down from a pumper after an alarm-malfunction call. The orthopedic specialist suggested that the pain in my knee was a cry from the heart of my soul telling me to pare down my ponderous frame.

What could I do? I was up the creek without the proverbial paddle. I began what I hope is a long-term journey back from the abyss of physical abuse. I have embarked upon a fitness program. I decided not to actually focus on my weight. I just began to alter my diet. I will not bother you with my style of diet, as each of us must find their way in this sad arena, but something good must be happening. I am wearing shirts that I have not worn in nearly five years. I wore a suit to church that had been gathering dust in my closet for some time.

And just prior to beginning this article, I completed my first session on my brand-new treadmill. It is my plan to walk myself back to fitness, one session at a time. I do not envision an easy journey. (I also gave up my favorite brand of Honduran cigar, at the urging of my pulmonary specialist.)

Having said all of this, let me issue a challenge. If an old-time, big-city lug like me can find my way back to health, what excuse do you younger, healthier types have? How about joining me on a journey to better health? My goal is to be at the college graduation of each of my three children, dance at their weddings, and then live long enough to say that I collected my pension for as long as I worked on the Newark Fire Department. That would require me to live another 23 years. Come to think of that, I want to be on the "Today" show on Friday morning, July 29, 2047, celebrating my 100th birthday. Want to join me? Maybe we can begin to have an impact on heart-related fire deaths one exercise session and one healthy meal at a time.

Let us move on to the area of driving-related deaths. There is no excuse for an accident caused by the fire apparatus operator driving too quickly, running red lights, speeding or doing any of the myriad other dumb things a driver can do. Maybe you cannot totally eliminate those accidents caused by being smacked in an intersection collision by the boob who is more attentive to his cell phone than his driving, but you can be sure that you are not the boob.

We spend hundreds of thousands of dollars on complex firefighting equipment. We spend hundreds of hours on pump operations, hose relays, aerial operations and a whole host of similar operational subjects. But we don't train our people to drive safely. I have seen people drive as though they are immune from the laws of physics. Whether you are in the right or in the wrong at the time of an accident is of no consequence. Dead is dead and crippled is crippled.

The same holds true for the world of the fire police. These are the people who direct traffic and route cars around our operations during times of emergency. Maybe you do not have dedicated fire police in your area, but there is bound to be someone out there directing traffic for you. The training for these people ranges from pretty good to non-existent.

A number of deaths have occurred involving people who were struck by motor vehicles. One of the most notable was the death last year of Chicago Fire Lieutenant Scott Gillan, who was struck by a car at the scene of a highway emergency.

We need to create an awareness of highway safety issues in our people. We must train them to understand that we constantly need to be on guard against the people around us. Without a serious, conscious training effort, we will continue to read about the people who died when their pumper was struck while passing a red light. There will be more dedicated young people who will be mangled in their personal vehicles while enroute to a fire or emergency medical call. This will not stop of its own accord. We must work to minimize the number of response-related problems.

The training function is another area where we should see zero deaths in the normal course of events. There are standards to govern how we perform live-fire training. There are textbooks to assist us in becoming knowledgeable training personnel. Absent the periodic unforeseen heart attack, the training function should not be a death-dealing arena. I would have to say that these deaths come as a result of complacency, more than anything else. People adopt an attitude that training is not the real thing. Consequently, they fail to pay attention to what they are doing. There will be injuries. Some people are just naturally clumsy. Don't ask me how I know that one, I just do. But a strict adherence to proper training methods and policy will limit the incidence of lost-time training incidents.

Live-fire training is serious business. The fatal training-related incidents of the 1980s led to the formulation of national standards that govern this critical element of our training programs. In the early 1990s, the sheer stupidity of one training incident that severely injured three firefighters was the impetus for the stringent regulations governing live-fire training in New Jersey. Where problems exist, they come about as a result of ignorance. These regulations have been in place for years, yet there are still people calling up the state Division of Fire Safety and pleading ignorance.

Let me now focus on the glory part of our business, the actual firefighting operation. Why are people dying during active firefighting efforts? I realize that the environment wherein we operate is dangerous, and that controls are minimal. But are we ignoring the signs that will keep our people safe? Are firefighters rushing into situations where angels might fear to tread?

During my seminar at the 2000 National TRADE Conference at the National Fire Academy last November, I outlined some thoughts as to why our people are dying in fires. I am of the opinion that there are a number of problems in the training arena that frequently translate into deaths or serious injury on the fireground. These I also shared with the students in my seminar session:

• Training is not a priority consideration in far too many fire departments.
• We are not providing sufficient training for our officers.
• We are not providing enough training for our apparatus operators.
• We are not training on the basics.
• There are too many people in positions of authority who think that they know it all, and are threatened by people in pursuit of knowledge.

We have lost our way. Our focus has been diffused by the wide range of tasks that the fire service has been forced to assume over the past several years. There is only so much time available, so we tend to prioritize our efforts. Since the incidence of fires has been on the downswing, and EMS responses have gone through the roof, priorities have been skewed by the operational realities of our daily lives. While this explains what is happening, it does not excuse the fact that we are leaving the most dangerous and least controlled component of our operational aspect to chance.

My generation combined book knowledge with frequent firefighting episodes. Much of what my associates and I know was learned by rote repetition. In my 1998 text, Firefighting Strategy and Tactics - The Eight Step Method, I devote much of the early chapters to some very simple operational rules, concerns and operational hints. I am of the opinion that it is the simple things, or ignorance of them, that is killing our people.

Let me share a few of my clues for safe fireground operation with you:

1. Human life is your primary concern.
2. BIG FIRE - BIG WATER.
3. Make sure you have an adequate source of water.
4. Never pass a fire.
5. Engine companies must work as a team.
6. Do not shoot water at smoke.
7. Vent high, vent low, vent often.
8. No one goes in alone!

While these may seem like simple little hints that everybody already knows, trust me, they are frequently overlooked. It is my opinion that much of our institutional knowledge in the critical area of fireground operations is not being passed on from generation to generation.

Far too many officers assume that everyone knows what they know. What a ridiculous thought. Imagine how much worse off the fire service would be if Deputy Chief Vincent Dunn had adopted that approach to structural collapse. Think of how little we would know if he had chosen to assume that everyone possessed his encyclopedic knowledge of this life-and-death topic. How many more people would have been crushed to death in building collapses if my friend Frank Brannigan had not taken up the banner of building construction problems? It is rare for me to pass a building in New Jersey that has been marked, posted and registered for its truss floors and roofs, and not think of Frank.

We all need to become concerned with learning as much as we can about structural firefighting. We must then become zealous in our sharing of knowledge. Let me offer a few questions to stimulate your thinking processes.

1. As you roll up in front of a burning three-story building, you see smoke coming from all three floors. Where is the fire probably located?
2. As your company is moving an attack hoseline into a burning structure, you feel the flow of air come rushing in behind you. What is about to occur?
3. As your company is moving into the deep, murky depths of a smoky dwelling fire, the temperature of the area suddenly spikes up. What may happen?
4. As you approach the front of a building where there is an obviously heavy smoke condition, you note that the color of the smoke is a deep, dark, mustard color. Is this an important clue?
5. Your sector commander has ordered your company out of the building. You think that you have a shot at darkening down the fire, and think that he is a bit of a scaredy cat anyway, so you ignore him. Is this a smart thing to do?
6. It is the policy of your fire department to attack cellar fires by means of a direct attack down the rear stairs of an involved structure. You do not like this and decide to adopt a policy of your own that says to attack down the front stairs. Is this a dangerous thing to do?
7. You note that there is a heavy body of fire blowing out of the second-floor windows in a suburban home. As your company moves into the first floor and approaches the stairway to the second floor, knowing you have a great shot at the fire, you note a small fire in the living room to the right of the stairway. You do not want to lose your shot at the raging fire on the second floor, so you direct a short burst at the first floor fire and then charge up to where the real fire is. Should you be surprised when you are later cut off and trapped above the first-floor fire?

The list could go on and on. I will leave it to you to find the answers to these questions. And I do not care which text you use to find the answers. Whether it is the Skip Coleman, Alan Brunacini, John Norman or Harry Carter version of Firefighting 101, nothing can happen until you acquire the book and commit the knowledge the inner recesses of your cranial regions. As I have said on more than one occasion, knowledge is good and ignorance is bad; the choice as to which you use is yours alone.

We will probably never achieve a zero-death year in the world of fire suppression. I am not a pessimist; rather, I am a realist. We are dealing with human beings and uncontrolled environments. The interaction between the two is fraught with danger. However, our quest to lower the annual death rate cannot begin until we stop wringing our hands and complaining about fate. We have to stop bragging about how dangerous firefighting is and start acting on the steps that I have identified in this piece.

I call upon you to begin the journey to a safer fire department. Like the famous journey of 10,000 steps, nothing happens until you take the first step. And unless thousands of you begin to take those fateful first steps, we, as the fire service, will be condemned to paying a never-ending, ever-increasing tribute at the National Fallen Firefighters Monument in Emmitsburg, MD. Please try the safe way.

Harry R. Carter, Ph.D., MIFireE, a Firehouse® contributing editor, is a municipal fire protection consultant based in Adelphia, NJ. He is also an associate professor at Mercer County Community College and a past chief and active life member of the Adelphia Fire Company. Dr. Carter retired from the Newark Fire Department in 1999 as a battalion commander. He also served as chief of training and commander of the Hazardous Materials Response Team. Dr. Carter is a Member of the Institution of Fire Engineers of Great Britain (MIFireE). He may be contacted through his website at [email protected].