When everyone runs from an emergency, first responders have to run toward the danger. That's why Nebraska's Health Department has a special team to help emergency workers through the stress of the job.
When Ron and Tim Larson were found dead in their Wahoo home in January, the victims of carbon monoxide poisoning, some of the first emergency workers to arrive were also friends with the father and son.
"Your heart breaks, because you know what it's going to do to the community, to your family and friends," said Wahoo Fire Chief Corey Wagner.
In a town such as Wahoo, the emotions of the first responders are complicated even more because often times the person in need of help is someone they know.
"As soon as the page goes out, I think of where that could be," said Wahoo firefighter Michelle Libal. "I'm born and raised here forever. I know almost everybody here."
Libal knew the Larsens, too. So did firefighter and emergency medical technician Jim Nelson.
"It was a hard place to be," Nelson said. "It's a horrifying picture, because the mom's there, and all you can hear is her screaming because her husband and son had the poisoning. It's hard to get that scream out of your head."
Wahoo EMTs said they lean on each other for support, and try to keep in mind the days they get to save lives. Still, bad days can haunt them.
"The day things like this stop bothering you is the day you need to quit," said Bob Chvatal, another Wahoo firefighter.
In other emergencies, victims are strangers. That doesn't protect the responders from feeling extreme emotions.
"It's another human being, and you're trying to help the best you can," said Nebraska State Patrol Sgt. Dan Klimek. "Later, then you start thinking about it."
Klimek took his first ride in an ambulance three months ago as Leona Martinez was fighting for her life after she was critically hurt in a crash on Interstate 80.
"She had some pretty horrific injuries. She was talking, trying to communicate," Martinez said.
Klimek said he held Martinez's broken hands to comfort and calm her, but days later, Martinez died. It's a memory with which Klimek said he has to live.
"You get to a point in your career where there's no rhyme or reason why things happen. You stop asking why something happened. There's something bigger than me that decides those things. I don't get to decide who lives and who dies," Klimek said.
After the crash, Klimek sought help from Nebraska's Critical Incident Stress Management Team. CISM is a group of trained professionals and peers who help first responders cope.
"Deal with it, talk about it, ventilate it and put it back in perspective," said clinical psychologist Dr. Jack Wineman.
Wineman has been a volunteer with the CISM team for more than 20 years.
"Individuals sometimes wonder, 'Am I going crazy? Is there something really wrong with me?' Part of helping people through this is to say, 'There isn't anything wrong with you. You're having a reaction, the same as you'd bruise if someone punched you in the arm hard enough,'" Wineman said.
Papillion Fire Chief Bill Bowes still remembers a crash from 1991.
"I remember so many things about it like it was yesterday. The end result was a 3-year-old girl was killed and she was out on the ground when we arrived," Bowes said.
Alexis Anderson died that day. The CISM team helped Bowes work through his feelings.
"The feelings I had as a result of that call really confused me. I had a very hard time with it," Bowes said.
Now Bowes is a peer support counselor with CISM, trying to help his peers through similarly trying times.
Nebraska's Health and Human Services System said the CISM team also helps dispatchers, EMTs and hospital workers. Therapists said a first responder may need professional help if he or she starts showing symptoms of sleeplessness, irritability or withdrawal.
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