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The Heartburn I Experienced Should Have Been a Red Flag

On January 1, 2019, Dayville Fire Company nearly lost its fire chief due to a preventable cardiac incident. Below is the story about the events leading up to that day, the conflict, and its impact as told from the perspectives of Fire Chief Kevin Ide (Chief), Rescue Captain Jeffrey Buchbinder (Captain), and Robin Ginese (Chief’s Wife). 
Captain: On January 1, 2019, members of our department were out doing New Year’s Day things with our families. At 2:42 p.m., our pagers alerted us to a medical call at an address you never want to see, your fire chief’s. Not only is Kevin Ide, our chief, he’s also a long-time friend of mine and many others. Although we knew he hadn’t been feeling well lately, we believed, as perhaps he did, that he was indestructible. I, along with most of our members, some of whom came from twenty miles away, left our families immediately to head to the hospital. After assessing the chief, the first-in crew was on the road by 2:57 p.m. Everyone was anxious, we had very little information about what happened or whether the chief’s condition was life-threatening. Within an hour, we learned that though he had been stabilized, he was being transported to a trauma center. We gathered at the station all afternoon, the rumor mill in overdrive. 
Chief’s Wife: Kevin’s biggest downfall is that he says he’s okay even when he’s not. He doesn’t “do” doctors. He hadn’t been feeling well since Thanksgiving 2018, though he self-diagnosed the pain in his chest as indigestion or heartburn. The death by overdose of his best friend at Christmas weighed very heavily on him, which is what he thought contributed to his discomfort.  
On January 1, I was at the elder care facility where I work, and Kevin came to help out. The residents know him as the person who comes to transport those who die, so they were glad to see him there in another capacity. When I mentioned to Kevin that he looked gray, he admitted that his chest hurt, and he went home. When I got home after work, Kevin was on the couch and told me he needed to go to the emergency room. I told him I would take him, but he insisted that I call 911. My first reaction was, “You’d better not die on me!”  
I couldn’t understand why the dispatcher was asking me all these crazy questions, like whether I had a dog. Then the dispatcher heard the tones on Kevin’s pager go off and asked if there was a firefighter in the house. When I said, “Yes, he’s the Dayville fire chief,” he said they’d be right there. Although it seemed like hours, a paramedic was there within minutes. Kevin’s blood pressure was fine, so they thought it was a bad case of indigestion. I got into the ambulance with him and rode, without lights or sirens, to the hospital. Although there were no indicators of heart trouble – his EKG was fine – they gave him nitro in the ambulance just to be safe. Some of Kevin’s crew were at the hospital when we arrived. The deputy chief told me to sit down and that everything would be okay, so I knew it would be. Then I looked into the room where Kevin was being treated. The medical staff called for a crash cart and closed the curtain. So many thoughts were going through my head. Kevin had never been sick the entire time I’d known him.  
While the doctors worked on stabilizing Kevin so he could be transported to a trauma hospital in Worcester, his guys kept telling me he would be okay. Though I felt like a deer in the headlights, I believed them because I trust them; they are my family. I rode in the ambulance with Kevin during the 25-minute drive to UMass hospital with all kinds of thoughts running through my head. The fact that they kept giving him nitro along the way made me think, “That’s not good,” despite what his guys had told me. 
From the moment we arrived at the first hospital through his return home several days later, at least one of Kevin’s crew always was there with him and with me. Two or three of his firefighters stayed with me at the trauma hospital while doctors inserted the stents. After Kevin came home, he got the flu and went back to the hospital. Then I got the flu, and his firefighters took care of me too. There were always firefighters with us. 
Chief:  During Thanksgiving 2018, I wasn’t feeling well. Given the holiday, I decided it must be indigestion and heartburn due to what I’d been eating. Then at Christmas, my best friend died of an overdose; her young son found her body. I spent the next week focused on preparing for my friend’s funeral and worrying about her son, so consumed by my profound grief and anger that I was unable to sleep. Then on January 1, the pain in my chest felt different, and I knew I had to get to the hospital. My wife said she would drive me, but I told her to call 911 because I needed an ambulance. Paramedics arrived within minutes. My blood pressure was fine, as was the EKG, but they gave me nitro on the way to the hospital just in case. 
I passed out when we got to the hospital. Although I could see and hear everything, I was unable to move or speak. The doctor knew there was a problem with my heart, but he couldn’t identify it specifically. When I crashed, he thought I had a heart attack; after stabilizing me, he gave orders for me to be transported to the cath lab at the nearest trauma hospital, which was thirty minutes away. My guys were ready to take me immediately in our local ambulance, but they weren’t allowed to do so because the hospital had a contract with a private ambulance company to do the transport. During the one hour it took for that ambulance to arrive, the staff needed the room for an x-ray, so they wheeled me out into the hallway. I thought I was going to die there. 
During the ride to the trauma hospital, I didn’t see a paramedic or EMT in the back; by that time, I was able to speak, so I called out. A paramedic came into the back and tried to give me nitro but spilled it all over me instead. I thought I was going to die there. When we arrived at the hospital, doctors found a 90% blockage and inserted two stents, which made me feel better immediately. I wanted to go home right away, but they kept me overnight. They told me that the reason my chest felt “different” that morning was that my artery had ruptured. Although the usual tests didn’t show anything was amiss, I was bleeding internally. I was lucky, my blood had clotted at the first hospital, and my body went into survival mode. Also, the rupture was on the left side of the heart instead of on the “widow-maker” right side. 
Captain: We continued to wait at the station in suspense for word about our chief. His job is very stressful, plus the crazy hours and irregular meals are realities of the job for all fire-rescue professionals. I was friends with the chief long before he recruited me as a volunteer at our department, so he and I had very strong personal ties. This was true of many of our members as well; that’s why we recognized the address on our pagers that afternoon. Plus, the familial atmosphere that the chief created at the station caused us all to leave our own families immediately to help him and his family.  
It was late that night when we finally got word through our assistant chief that the fire chief would be okay. He had been stabilized for the moment, and the blockages would be removed shortly. However, things were touch-and-go over the next few days; the insurance company refused to cover the procedure for the blockages. The Chief was worried about being out of work and the damage being done to his body. This situation made all of us very angry — insurance shouldn’t be a struggle in a life or death situation. Finally, he was able to have the procedure, which put him out of service for the next few weeks. 
Chief: The plan was for me to return to the trauma hospital in a couple of weeks for surgery to remove a secondary blockage. However, my insurance company said it would not cover the procedure, even though my doctor said it routinely approves coverage when blockages are over 70%. Mine was 90%. As a result, my doctor recommended that I undergo a stress test to prove to the insurance company that I needed the surgery. He gave me the medication, and I got on the treadmill. Unfortunately, my heart rate wouldn’t go above 100 because of other medications I was on. However, it did cause a heart attack. I thought I was going to die. Instead, I was rushed across the street in an ambulance to another part of the hospital, to undergo the procedure I should have had in the first place. I was awake and able to watch the procedure on a TV monitor. Immediately I felt better than I had in years.  
Wife: Kevin wanted to go back to work a couple of weeks after his procedure. He was concerned that his members would think he wasn’t up to doing his job. Yet I could see that he had lost all of his gas after this experience: the reality that he can die finally had hit him. He also realized that he had to let the younger members take the hose and run to the rescue. They have shown him that he can trust them to do the job. Yet he feels anger and frustration at times because he’s learned his indestructibility was a myth. Sometimes he tells me he’s going out for a ride, and that’s okay with me. I never again want to go through what we did during those weeks, and I support whatever healthy coping mechanisms will help him adjust to his new reality. He’s learning not to stress about the little things. 
After Kevin’s heart attack, I initially worried about him 24/7, continuously questioning him about whether he had taken his medication and whether he was okay. I made myself crazy by nagging him, especially when he kept saying he was okay. But I couldn’t shake the images of him when he wasn’t okay when his face was so gray when he was crashing when wires and tubes were coming out of his body – in short, when his life changed. Eventually, I realized that I was Kevin’s wife, not his mother and that I wouldn’t like anyone being a fishwife to me, asking if I’d checked my blood pressure, taken my meds, or made a doctor’s appointment. I wanted to be happy, and this was not the way to do it. Yet I knew that if I didn’t find an outlet for my feelings, they would eat me up like cancer. Fortunately, I have a really good girlfriend who listens to me and allows me to vent, providing the space I need to take care of myself so I can be the wife instead of the mother. The days of turning ant hills into the Grand Canyon are over. 
One bright spot that resulted from this experience is that Kevin discovered how much people – not just his crews – care about him and appreciate him. The residents at my work got him a huge card, and everyone signed it. Phone calls, text messages, and cards came from people everywhere. Because he wasn’t allowed to have salt after his procedure, I made a salt-free turkey for him, and five of the guys from his department came to eat with us. Contrary to his belief that people didn’t like him because as fire chief, he had to make decisions that didn’t please everyone, he learned that they care about him and are proud of him. 
Captain: The fire chief is very strong-willed and doesn’t want to be sick. He was back to work 52 days after his procedure, though there were restrictions placed on him by his doctor. Initially, he was limited to lifting no more than ten pounds, which didn’t make him happy. He has become more proficient about delegating administrative tasks and reducing his hands-on activities, which doesn’t make him happy either. However, he is making positive life changes. We (his crews) are trying not to do anything to kill the fire chief or to put him in harm’s way. 
There are other changes made since the chief’s wake-up call. We all woke up to the fact that if a fire chief who took reasonably good care of himself can have a heart attack, anyone can. Seeing him in the hospital brought that lesson into sharp focus. Our department’s Health and Safety Committee meets more often than it did before. We’re working on ways to reduce the risk of cancer and to change our culture about wearing dirty helmets. We have a family dinner at the station once a week. Perhaps the biggest lesson for me – and all of us – is that some form of catastrophic health event is going to happen to us if we do nothing to safeguard our health and well-being. We must get in front of it rather than waiting until we can’t do anything. We need to look after each other, pay attention to our health, and proactively provide support to others when they need it. We have to have each other’s backs when it comes to our well-being. 
Seeing someone at the top of the organization undergo a cardiac incident is very sobering. The changes needed to avert or mitigate all kinds of health and safety issues come from the top down. The fire chief has encouraged all of us to develop and maintain healthier habits, and that level of caring means the world to us. He’s doing his best to set a good example for us.  
Chief: The heartburn I experienced, even when I wasn’t eating, should have been a red flag for me. Instead, I attributed it to the overwhelming grief I felt at my friend’s untimely death. I check my blood pressure every day. Today on a scale of 1-10, I feel like a 10, 100%. 
Since this incident, we’ve made some changes to the department. Everyone gets a department-paid firefighter physical exam annually, including an EKG, no matter what their role is. We’re all trying to eat better on a regular basis, including me. Our rule now is that if you don’t feel good, you must get yourself checked out. If someone else isn’t feeling well, don’t send that person home, send him/her to the doctor. 
My staff has become hyper-vigilant with patients as well as with each other. They ask more follow-up questions, and they stay with them until they’re sure the patients are okay. Instead of treating people for indigestion or heartburn, for example, they look for a progression that could signal something more serious. Instead of stopping when they find something simple that could be the issue, they look further.  
The looks on their faces when they saw me in the hospital told me that they wouldn’t forget the most important message: none of us are indestructible. I hope none of you put yourselves, your family, or your members through a preventable health emergency like mine. 
“If you don’t feel well, don’t make it your farewell.” 

Make sure to check out the IAFC's Cardiac Awareness Toolkit and watch the promotional video from President Chief Ludwig's initiative. 


About The Authors

Fire Chief Kevin Ide, Dayville Fire Company (Connecticut) 
Rescue Captain Jeffrey Buchbinder, Dayville Fire Company 
Robin Ginese, Chief Ide’s wife 

This article was curated and put together thanks to the efforts of the IAFC VCOS.


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