NFPA Journal

Joe Kovalsky has wrestled with post-traumatic stress disorder (PTSD) and other behavioral health problems for much of his three decades in the fire service. Kovalsky, 48, started as a volunteer when he was a teenager, became a career firefighter in 1995, and since 2003 has been a member of the Danbury (Connecticut) Fire Department, where he is a lieutenant. In 2017, after years of depression, substance abuse, anger management issues, suicidal urges, and failed attempts at outpatient treatment, he completed the in-patient program at the International Association of Fire Fighters’ Center of Excellence for Behavioral Health Treatment & Recovery, which opened last year in Prince George’s County, Maryland. Kovalsky reports that the IAFF program was “the greatest decision I ever made,” and that he’s happy both at work and at home. He lives with his wife and two teenage children in Wappingers Falls, New York.

Kovalsky will present an education session on his personal journey with PTSD at the NFPA Conference & Expo in Las Vegas.

The following is an edited excerpt of an interview with Kovalsky conducted by Scott Sutherland, NFPA Journal executive editor.

I was traumatized before I even got into the fire service. My father was a police officer for the City of Yonkers who suffered from PTSD and was an alcoholic. He got on the force in 1970 and retired in 1992. They recognized his alcoholism as a job-related injury, which completely blew my mind. I didn’t have a good relationship with him. My parents got divorced when I was 12 or 13. It was tough for my mother raising me and my brother. There was a lot of stress.

I volunteered for the local fire department when I was 17. I wanted purpose in my life. I had zero self-esteem, and I felt like the fire service was only thing I could do. I didn’t go to college, didn’t have a degree, had no trade experience—all I’d done was work part-time in a record store. Growing up, I was that kid who spent Saturday nights watching Johnny and Roy on the TV show Emergency. From that point on I always knew I wanted to be a fireman. When I finally joined, I thought, “wow, this is for me.”

Within three months of joining I went out on two calls where there were fatalities and another call involving a serious motorcycle accident. And then I was like, “what am I doing?” One was a 16-year-old who’d been shot in the head with a shotgun. Then I was first on scene where a guy had dropped dead in front of his wife and she’s screaming at me to do something, and I’m 17 years old and I don’t even know what cardio-pulmonary resuscitation is. Then I responded to a motorcycle accident—it was a kid I’d gone to high school with, and he lost his leg in the accident. I had to go retrieve the leg.

After all that, I was like, “I’m done—this ain’t for me.” A senior guy from the firehouse came over to my mom’s place. He brought a six-pack of beer, and we sat there drinking and he said to me, “you have to bury it—you can’t get attached.” So that’s what I did. I buried it all—every call, every bad call, all the stuff in my personal life. Everything.

Around 2007, it was like I couldn’t keep it all buried any longer and Pandora’s box just opened up. I had a lot of rage. There was no rhyme or reason to what would trigger it. It might be that the garbage didn’t get taken out at home, or someone would cut me off in traffic. At work, it might be a busy day or the politics of the job or we’d run a bad call—it would be four or five things, and I’d just snap. I’d yell at somebody, or be aggressive. I’d physically change, where I’m clenching my fists.

The anger would quickly switch to depression. I’d go for days where I wouldn’t get out of bed—I’d have three days off and I wouldn’t leave my room. I had trouble sleeping. I was a rollercoaster of emotions—my coworkers and family didn’t know how to deal with me. My kids would just avoid me.

I’d gone back and forth with substance abuse, drugs and alcohol, for 10 or 15 years before that. I was a binge drinker and I was able to start and stop when I wanted to. I went on and off for years. When I was younger, my cocktail was beer and sleeping pills, because I couldn’t sleep, but I became immune to it. I thought I was able to function like that, at least in my mind.

But I decided in 2007 that it was too much, and I was going to talk to a therapist. I contacted one through another firefighter who was a patient. The therapist specialized in PTSD, substance abuse, anger management, and worked almost exclusively with first responders, police, and military. She diagnosed me as having an acute stress disorder. It was around 2012 that I received a diagnosis of complex PTSD, anxiety, and depression. They often go together, along with substance abuse.

But I was really bad with the treatment. I’d cancel appointments and wouldn’t tell my therapist certain things. I wasn’t good about taking medications. I was just kind of going through the motions. So no surprise that I wasn’t making any progress. I’d been seeing my therapist for less than a year when my father died unexpectedly. There were a lot of unresolved issues and tension between us and I took it really hard. I was binge drinking. I drove home drunk one night and blacked out. My son found me in the morning passed out on the living room floor. It went on like this more or less for 10 years.

Then the suicide stuff started. What got me into trouble was that I stopped drinking last year after binging for two years, so I no longer had the alcohol to dull the pain. It was a physical pain—fatigue, muscle aches, sweating. Rapid heartbeat, upset stomach, headaches. Trouble hearing, trouble seeing, problems concentrating—every day I hurt in some way, on some level. I was a hypochondriac for years. Without the alcohol I became hell-bent on wanting to kill myself. It went from occasional thoughts of suicide to a constant obsession to, “ok, how am I actually going to do this?”

I had a plan to kill myself. One day I was just going to leave, ditch my cell phone so no one could track me, drive way out into the woods of Pennsylvania, ditch my car, walk for miles and miles into the woods, dig a hole, lay down in it, and shoot myself. The idea was I’d just be missing—I honestly thought no one would find me, and that my family wouldn’t be traumatized by the knowledge that I’d killed myself. Of course, for your family and friends, either way the trauma is unimaginable. But I was in a place where I just didn’t care. I just wanted the pain to stop.

But I didn’t own a gun. I was very impulsive, and if I’d had the means to kill myself in the way I’d envisioned, I would have. If I’d had a gun, there’s no way I’d be sitting here now talking to you.

I was with it enough to recognize that I needed in-patient care. I checked out a couple of local programs, but they didn’t specialize in first responders—I knew a civilian program wouldn’t work. I’d heard of the IAFF Center of Excellence, which had opened in March. I talked to my therapist about it, and she said, “This might be the place for you.” I made the phone call, and 48 hours later I was there. It was May 19 of last year. It was the greatest decision I ever made.

Within five minutes of walking in the door at the IAFF center, I had people coming up to me saying, “What’s up, brother?” and give me a hug. It was like, “You need anything, brother? We’re here for you, brother. Let me get your bags, brother.” Within 24 hours we were telling each other our stories. We all have the same story, pretty much, and that was comforting—I didn’t have to explain everything over and over and over again.

They take you out of your life—I had to surrender my cellphone, I had to get permission for Internet access. I wasn’t distracted by all that other stuff and it allowed me to concentrate on me. I had phone privileges, and I called my wife and kids every night.

There’s a lot of thought put into making you feel at home in a firefighter environment. They call the dormitories station houses, and they’re set up just like firehouses—the common areas and kitchens are just like in a firehouse, and the sleeping areas are like the bunkroom in a firehouse. There’s a gym and walking trails. Meals are served at a giant table in the cafeteria, and we all sat together just like in a firehouse.

The approach is group therapy, every day. It’s focused on special meetings for PTSD. We learned about complicated grief, where you get stuck in the middle of the grieving process and it just never ends, you can’t let it go, and it just ends up fueling the depression or the PTSD. About halfway through the 45-day program, I started to physically feel better—the headaches and aches and pains started to dissipate. I started eating better and losing weight. I slept better. I started to think it could actually work—not like the outpatient treatment, which didn’t work and made me think I was just going to die angry and bitter, either by my own hand or from substance abuse.

Some of it was very hard. When I first went into the program, I asked my family to send me a letter telling me how my PTSD had affected them. It was heartbreaking to read that my kids were afraid to talk to me, that my wife was questioning if she wanted to stay married to me. It made me think how it impacted my side work as a fire and EMT instructor—I had to leave teaching because things would bother me so much that I’d become aggressive, which of course created a very unhealthy atmosphere.

I’m a completely different person now than I was a year ago. When I got home, I was scared and nervous waiting for that first trigger to fire, wondering what my reaction would be. But my reactions where good. I handled them fine. The anger, the drinking, the sleeping—all fine. I’m seeing my therapist every two weeks.

It took me a good four months to adjust back into my life. I struggled with depression when I got back and I couldn’t shake it. I tried a couple of new treatments, including one called transcranial magnetic stimulation, and the depression disappeared. My family definitely sees a change. My kids are happier being around me, my wife is happy. They see I’m just happier, back to being funny. It’s awesome. Not having to fight the depression allowed me to return to work and love the job and let me be a great employee for the city.

A few guys from our department have asked me what the IAFF center was like, but no one’s come to me and said, “hey, I need help.” But a lot of people from outside my department have approached me and said they needed help and have asked me what I thought they should try. It’s not easy—there’s still a huge stigma attached to these kinds of problems in the fire service, and guys just don’t want to talk about it, like it somehow makes you weak. I didn’t tell anybody when I was getting outpatient treatment. Now, though, everyone knows that if they need to talk, they can come to me. I go out to the Fire Department Instructor’s Conference every year and play drums in the pipe band, and after I came back from the IAFC center and was open about where I’d been and what I’d done, I had friends from the pipe band calling me and texting me and saying, “hey, you inspired me to go get help.” I keep in touch with people I met in the IAFF program, and some are struggling more than others. The vast majority are doing great.

I think behavioral problems are pretty widespread in the fire service. It’s a huge issue. We’re losing more firefighters and EMTs each year to suicide than to line-of-duty deaths. I’ve done a presentation on PTSD at our state association conference, and I’ve talked to four or five other departments about it. I’ve testified at the state capital in Hartford, where the legislature is trying to pass a bill that would provide benefits and coverage for police and fire personnel with PTSD.

More people are talking about these issues and the stigma is starting to break down. But it’s still there. I see guys look at me and I can tell they’re thinking, “yeah, this is all just a scam, you’re just trying to pension out”—no way. When I went to the IAFF center, the goal was to get better and come back to work. I have no idea what I would’ve done if they’d said to me, “Joe, you can’t go back to work.” This is where I want to be. This is what I want to do.

JOE KOVALSKY can be reached at jtf429@yahoo.com. Top Photograph: Bob Handelman