History Repeats Itself: Two Very Different Close Calls

This month, we see history repeating itself in two very different ways. The first account is of yet another apparatus being struck, but fortunately no fire-rescue personnel were hurt. We hope that all fire departments have adopted clear policies, procedures and guidelines (along with training) to ensure all personnel operating on any roadway are well protected. For sample standard operating procedures (SOPs), go to www.ResponderSafety.com as well as www.FirefighterCloseCalls.com. In the second account, we look at a very personal and unique close call – that is, unique to this column, but not unique to firefighters.

Thanks to Lieutenant Michael O’Brian and Chief Richard Marinucci of the Farmington Hills, MI, Fire Department for their assistance in the first part of this column. We also thank all of the Farmington Hills firefighters and officers who were operating at this close call.

Additionally, to Chief Peter W. Meade, assistant chief fire marshal for Nassau County, NY, Fire & Rescue Services, for sharing his very personal and extremely important close call in the second part of this column. And while we rarely do this, we would like to dedicate this month’s column to his brother, Chief Mike Meade of Great Neck, NY, who succumbed to a heroic battle against cancer a few weeks ago. Mike’s family told me that he was never in pain and he was laughing all the way to the end.

Close Call No. 1: Apparatus Struck
Lieutenant Michael O’Brian’s account:

On Dec. 31, 2005, at 10:47 A.M., Rescue 1, Squad 1 and Car 505 of the Farmington Hills Fire Department were dispatched to an unknown accident on Interstate 275 (northbound), north of Nine Mile Road. The units responded non-emergency since the accident was minor and the emergency medical dispatch reported the run as a non-emergency response. That morning, there had been some light snow that turned into slush on the shoulders of the highway. The travel lanes were mostly wet.

Upon arrival, Rescue 1 found a single car on the right shoulder. The four travel lanes (reduced from five) were moving just below the posted speed limit of 70 mph. The crew placed the vehicle on the shoulder and elected to not block a travel lane as the accident appeared to be off the roadway. The officer of the vehicle turned on the emergency lights and exited the vehicle on the curb side along with two firefighters from the back of the rescue.

The driver of the rescue was exiting the apparatus when he noticed a car in the median losing control. The car began to spin through traffic and appeared to be moving toward the rescue truck. The driver remained in the vehicle as the firefighters on the shoulder stayed in the protected area of the rescue. The vehicle struck the guard rail and slammed into the rear of the rescue.

The vehicle struck the rescue on the driver side of the passenger car with major impingement on the vehicle. The firefighters immediately evaluated the scene and requested additional units to respond emergency to the scene. The two people in the car were unconscious and absent of vital signs. The on-duty battalion chief was the next to arrive and placed his vehicle in a “fend-off†position, protecting the scene with the vehicle and requesting additional transporting units. The rescue appeared to have been moved from the shoulder and five to 10 feet and partially into the first travel lane.

The responding crews performed a rapid extrication and began advanced life support (ALS) procedures. Although the patients temporarily regained vital signs, both succumbed to their injuries.

During the investigation of the accident, the highway was reduced to one lane. This caused a major backup. Approximately two miles from the accident, a driver of a pickup truck who came upon the backup decided to back down the entrance ramp. At the same time, a garbage truck was on the entrance ramp. The garbage truck’s driver quickly realized the traffic was stopped. In order to stop in time, the driver of the garbage truck left the road onto the shoulder. The garbage truck and pickup collided and created a second accident in which the driver of the pickup had to be extricated. This incident occurred in a second city’s jurisdiction.

Lessons Learned

Firefighters followed local policy for roadway operations. They placed their vehicle in an appropriate position to protect themselves at the original accident. Incidents involving roadway accidents must have procedures in place to protect the firefighters and other emergency workers. The need for large apparatus to protect those firefighters is critical. A minimum of two units is required on all accident scenes where rescues or ambulances are loading patients. If this accident would have occurred later or while a patient was being loaded in the rear of the rescue, there might have been firefighter fatalities.

• A second vehicle should always be used to protect the loading and unloading of patients.
• The original dispatch was an everyday run that turned into a not-so-everyday incident.
• These firefighters refused to become complacent and protected themselves.
• Traffic cannot be trusted, regardless of the time of day. This incident occurred in the morning, when most drivers should be alert and aware of conditions.
• The firefighters exited the rescue on the curb side for their protection. The driver of the rescue was alert and noticed a car that was in trouble.

Close Call No. 2: Prostate Cancer
Chief Peter W. Meade’s account:

I have always had a tendency to view the world, and my place in it, through the rosiest of rose-colored glasses. I have been blessed with a wonderful family, great friends, an enviable career in the fire and rescue service and, despite an everlasting weight problem, very good health. I am over 60 and still don’t need eyeglasses (except to read the smallest print). So, you can imagine my surprise when I was told I had prostate cancer.

I became a volunteer firefighter at age 23 when I followed in my older brother Mike’s footsteps and joined the Great Neck, NY, Alert Fire Company after three years in the Marine Corps. Five years later, I was appointed a fire inspector in the Nassau County Fire Marshal’s Office, where I began doing routine fire inspections of commercial and industrial properties. Later, I was asked to step in on the ground floor of a new venture. The county was moving to the adoption of 911 as the universal emergency reporting number and the chief fire marshal was tasked with the development of a fire and rescue communications facility.

I had worked in communications and cryptography in the Marine Corps, so I agreed and undertook a “temporary†assignment that has lasted now for more than 30 years. During that time the Fire and Rescue Communications facility, “Firecom,†has grown to a major operation, processing nearly 70,000 dispatches a year, thousands of requests for other assistance and more than a million telephone calls. During those 30 years, I have been promoted several times and enjoy a prominent position in the fire and rescue service in Nassau County and beyond. I chair two Federal Communications Commission committees, the Region 8 700 and 800 MHz planning committees as well as the New York Metropolitan Area (Public Safety) Communications Coordinating Committee.

My work in fire-rescue services is fascinating. We have had our major incidents in Nassau County (notably the crash of Avianca Flight 052 in January 1990 and the Long Island Rail Road shootings of December 1993) and we were the primary mutual aid provider to New York City for the murders of 9/11. But nothing prepared me for the announcement I heard in June 2005.

It all started with a routine physical examination. Last June, I was told that my prostate specific antigen (PSA) number had risen four-tenths of a point from my normal 3.8 up to 4.2. “It’s probably nothing,†Dr. Williams said, “but I think you should see a urologist just to be sure.†He jotted the name and telephone number of a top-notch urologist on a prescription pad along with the words “elevated PSA, 3.8-4.2, 6 mos.†When I got home, I put the urologist’s name and number aside and went about living my life. Fortunately, I am married to the kind of wife who, when she finds a note with a urologist’s number on it, asks, “When are you going to call? I think you should do it today!â€

I saw the urologist, Dr. Anthony Bruno, a week later. He told me he thought it was probably nothing, but suggested an internal sonogram and biopsies of my prostate gland. The next week, I went to his office for those tests. I had to take an antibiotic as a precaution and the sonogram and biopsy process was quick and easy. There was discomfort, but no pain.

Dr. Bruno said he would see me in about 10 days. I went back and sat in his office. He looked across the desk at me and said, “We found some cancer.†My immediate response was, “Well, what are we going to do about it?†Strangely, I did not experience that “woe is me ... why me? ...end of the world†feeling. I understood what was being said and wanted the reassurance that it was a problem with a solution.

Dr. Bruno described to me the various treatments available – radioactive seed implantation, external beam radiation, cryogenic treatment, hormonal therapies – and then he said, “And, of course, there is a cure as well.â€

My reaction was, “Why are we even discussing this? If there’s a cure, then let’s have at it.†He explained that the cure involved removing the prostate. He told me to talk it over with my wife and he made an appointment to see both of us. In the meantime, I went on-line and searched every website I could find, including that of New York Yankees manager Joe Torre, who had undergone the surgery that I was contemplating. His surgery was successful and he is living a normal life and still managing the Yankees. I read other stories from men who had the same surgery as well as stories from those who had selected alternate treatments. I later learned that many of my friends and neighbors had experienced prostate problems and had dealt with them in different ways.

I called my wife and told her the news. Her immediate thought was that the word “cure†was a good one and that I should follow my first impulse and have my prostate removed. We scheduled my surgery for the first week in September.

Peggy and I met with Dr. Bruno and further discussed the pros and cons of the surgery and we all agreed that I would undergo a radical prostatectomy. Dr. Bruno sent me for abdominal scans to be sure that the cancer was contained within my prostate. Had there been cancer in the surrounding organs, tissues or lymph nodes, the surgery would have been out of the question. He told me that the Gleason Score (a number used to designate the severity of my cancer) was a seven. The scale runs from one to 10 with the higher number being the more severe and aggressive cancers. Post-operative biopsies revealed that my cancer had a Gleason score of eight. It was a particularly nasty cancer.

On the morning of Sept. 1, I entered Winthrop University Hospital for the surgery. I had been exercising regularly and had been dieting to prepare myself for the operation. Dr. Bruno had said that I would have a better recovery and that the surgery would go much better if I lost weight. I had lost about 30 pounds (and have managed to keep most of it off) and felt ready for the surgery.

I was operated on for about four hours under general anesthesia with a morphine epidural for pain control. I was out of bed the next morning sporting a five-inch incision. I was walking less than 24 hours after the surgery and remained hospitalized for three days, walking out under my own power. My recovery took five weeks. For the first three weeks, I was catheterized while my urethra healed. The urethra (the tube through which urine passes before you get rid of it) runs through the prostate and has to be cut and reattached to the bladder during the surgery. It takes a while to heal and there is a risk of infection. Of course, I got the infection and experienced something called a urethral stricture. The little surgery that is necessary to reopen the urethra is not pleasant, but suffice it to say that now, after four months, I am cancer-free and am functioning at nearly pre-surgical levels.

My strong advice is for all men over 40 to be tested at least annually for prostate problems. The tests are simple: a blood test for PSA (especially the first one to establish a baseline) and a “finger wave,†a physical examination of the prostate conducted through the rectum. It is very, very mildly uncomfortable and takes only a moment. It can save your life.

This year, nearly 180,000 American men will be told they have prostate cancer. Many more will have some form of prostate problem, but remain unaware of it. The statistics show that deaths from prostate-related cancers are on the decline over the past seven years. There is no doubt in my mind that early discovery and early intervention are major contributing factors in that decline.

The reasons why you should be checked for prostate problems are compelling. The excuses why you can’t or won’t go for the checkup are simple to come up with: “I’m too young†… “I feel fine†… “It won’t happen to me†… “It’s going to hurt†or the one I heard and really loved, â€I’m afraid to go for the testing. What if they find something wrong?

I offer you this: if you have doubts, if you think you may have a prostate problem (difficult, painful, frequent or sporadically problematic urination), just shoot me an e-mail at [email protected] and I’ll be happy to discuss my experience. If you have been diagnosed with prostate cancer and are trying to decide which solution to take, I will be happy to tell you about the decision I made and how it has affected me. If you have had prostate surgery and are experiencing recovery problems and you simply want to talk to someone about it, just write to me.

These comments are based on Chief Goldfeder’s observations and communications with the writers and others regarding these close calls:

While we have reported close calls on highways in the past, it is vital to continue reporting timely events so that we are constantly reminded of dangers we face on the roadways. Without question, the photos on page 32 are a grim reminder of how dangerous roadway operations can be.

Does your fire department have a roadway-safety policy? Is it enforced? How many more reminders do we need? Protect your firefighters on all roadways by developing procedures, training on those procedures and working with the local police to ensure that everyone understands how it is going to work-and why it is going to be done that way. The International Association of Chiefs of Police (IACP) Highway Safety Committee, through a cooperative agreement with the National Highway Traffic Safety Administration (NHTSA), has developed “Your Vest Won’t Stop This Bullet,†a program to protect police officers on roadways. Ask your local police to get the program and they will then understand what you are concerned about.

Cancer affects thousands of firefighters annually. In many cases, the disease is job related due to exposure. In some case, exposure is avoidable, by wearing and using all of our personal protective equipment (PPE), and in some cases it is not avoidable, for a variety of reasons. Chief Pete Meade experienced a close call of a different kind than we regularly write about in this column, but no less important, and we thank him for sharing such a personal story. We urge all of our readers to go to: www.prostatecancerfoundation.org for further information on this disease that affects one in six men.

In Los Angeles, firefighters and their families have created the Firefighter Cancer Support Network. Their mission is to give fire department members and their families an opportunity to receive assistance in dealing with cancer. As one focused group, they offer comfort, strength and hope through their own experiences in dealing with the devastating effects of cancer. If you are interested in contacting them, their website is www.FirefighterCancerSupport.org. Kudos to the L.A. folks for such a wonderful and benevolent project.

A final word: While so many cancers and other diseases cannot be avoided, many can – especially in our roles as firefighters. Cancer is a major issue to firefighters. One sure way to avoid exposure is to protect yourself by wearing your protective equipment, having no exposed skin when operating at “working†incidents and by doing all you can to not breathe “bad†air. A good rule of thumb is that if you would not allow a little child to breathe “that†air, then you should not breathe it. It is 2006 and we still see firefighters operating in hazardous environments without self-contained breathing apparatus (SCBA). Enough. If you do it, stop it. Officers, if you see it, stop it. We can save a whole bunch of firefighters’ lives by just wearing the equipment that has been issued to us.