Fear the Reaper: Using Policy to Combat Cancer in the Fire Service

Yes, there are two paths you can go by, but in the long run
 There’s still time to change the road you’re on.” -
Robert Plant

February 24, 2008 was a typical cold wintery day in the Midwest. The trees were brown and barren with just a few dead leaves clinging to the highest branches. The ground was white with a fresh blanket of snow that had fallen the night before. After clearing the snow, I stood at the front of my driveway located in the heart of the Irish Hills in south-central Michigan and looked toward Lake LeAnn.

My cell phone rang and it took me a couple rings to find it in my ski jacket. After finally digging it out of one of the pockets, I answered: “Hello”. “Scott, Todd passed away today”. I asked “When?” The voice said, “A couple hours ago. Funeral details will be relayed through the union when they become available”. I wept for a few minutes and went back into the house. Diagnosed with glioblastoma multiforme grade four just one-year prior, Fire Fighter Todd Stanaway was gone and the Westland Fire Department was in mourning.

Todd Stanaway started with the Westland Fire Department in the summer of 1995 along with several other probationary fire fighters. At the time, I was a “veteran” of the department having only been brought on board three years prior in 1992. The department was in the middle of a major hiring cycle and there were new guys at every station on every shift.

(Todd Stanaway circa 1998)

At first, Todd was just like all of the other probies; acclimating to a new environment in public safety and getting to know his new co-workers. But, but it was obvious early on that Todd was different from the others in his hiring cohort. Todd smiled quite a bit. He had an affable personality. He often did his own work with great efficiency and then immediately offered to help those he worked with every day. The learning curve was short for Todd and on many occasions his Captain trusted him as much as those who had been in the department for years.

As time went on — five years; ten years — Todd had become a respected leader from the rank of firefighter. He was a member of the Western Wayne County Hazardous Incident Response Team for five years. His kind and generous nature rubbed off on many younger firefighters and is seen still to this day. He was the kind of fire fighter that the Fire Chief and other administrative chiefs all love to have, a true professional.

In January of 2007, Todd went on a particularly gruesome motor vehicle accident. The kind of accident that fire fighters, before PTSD assistance was emphasized, coped with back at the station by talking to each other and making compensating jokes to shed the stress of what they saw. Todd’s partner on the medic unit exclaimed, “Did you see how much blood was running down the street from that accident? It was like the Rouge River (a river nearby).” Todd replied, “What are you talking about?” He had a puzzled look on his face. The Captain and the rest of the crew laughed it off as a sarcastic remark. However, this was a foreshadowing of the horrible truth to be revealed in the coming weeks.

Todd was not the kind of employee that would abuse unscheduled leave time. But his sick time use started to increase. Persistent headaches and loss of memory were cause for concern. Those who worked close with Todd saw his lapse of memory as more than just a passing ailment and convinced Todd to see his physician.

After consulting with several specialists and getting multiple opinions, the gut wrenching worst case scenario was given: glioblastoma multiforme grade four.

(MRI of glioblastoma multiforme)

Glioblastoma is a particularly aggressive form of brain cancer that, in Todd’s case, took the shape of an octopus with tentacles that reached far and deep into the brain. This type of cancer is particularly rare for a 35-year-old male. Most cases of this aggressive disease are in found in people age 45–64.

At the time of Todd’s illness, I was an administrative chief for the department tasked with overseeing training and public education. Upon learning of the diagnosis, the Fire Chief came to my office. He asked me to monitor Todd’s status and keep him updated so that we could offer any assistance needed to the family.

After six months of treatment and surgeries, Todd was hanging in there. He battled this particularly nasty disease with all of his strength and was trying to remain positive; the outlook was less than positive.

In early September of 2007, I called Todd to ask how he was doing. He had been out of the hospital for a couple months and had recovered from a surgery that opened his cranium to remove the tumors deep in his brain. There were parts of the tumor that just could not be reached. Chemical therapy was all that remained. Todd asked me if there was a way to return to some normalcy by working with us in the administrative office. I could tell in his voice that he was not feeling too strong on this particular day. I asked him to come to the administrative office when he felt better and we would talk about it. When briefed on Todd’s request, the Fire Chief supported the idea and asked me to handle the details.

(Todd Stanaway post cancer surgery)

Todd started coming in to the office once or twice a week during the month of September. He would put on his uniform and muster up what was left of his contagious smile to greet us at the administrative building. His days were spent mostly talking about the old times and an occasional visit to the stations when his strength allowed. It was as close to normal as there was for Todd and he smiled more; we all smiled more.

In 2007 my brother-in-law, Ruvell Martin, played for the Green Bay Packers. From 2005–2008, I organized an annual trip to Green Bay to watch the Packers play and become part of an NFL players “posse” for a weekend. A year prior in 2006, I had asked Todd if he would like to come. He said “count me in Scotty!!”

Fast-forward to September 16, 2007 and the trip was only a week away when I asked Todd about his desire to still go to Green Bay. He said “Scotty, if I have the strength I will go! Please don’t count me out yet.” Two days before the trip Todd committed and everyone that attended was excited to have him with us.

The game was notable. Brett Favre was about to set the all time touchdown record and on September 23, 2007 Favre did just that against the San Diego Chargers. After the game, it was customary for family and friends to join the players in the reception area at Lambeau Stadium. Todd was excited to be in the large open space lined with food and drink for everyone while players came out one-by-one to greet their family.

After fifteen minutes or so of mingling, I noticed that Todd was missing. I quickly asked around if anyone had seen Todd and no one could answer definitively. Another fifteen minutes passed with no sign of Todd. We all asked around and were getting concerned about his well being. Panic turned to relief when Todd emerged with Ruvell from one of the “players only” doors. There was the biggest smile on his face that I’d not seen for nearly nine months.

I asked Todd “where have you been??” Todd then relayed the story. Ruvell had taken him to meet Brett Favre in his private dressing area. Unbeknownst to us, Ruvell had set up a meeting with Brett prior to the game. Favre’s wife was battling her own cancer issues and was sympathetic to Todd’s situation. They talked for a few minutes before CBS walked in to ask for an interview with Brett on his major career milestone. Favre’s response to CBS according to Todd: “You tell CBS I am talking to my friend Todd and I will be there when we are done talking”. As Todd conveyed the story, the hair was standing up on the backs of our necks. This story still brings a tear to my eye to this day. On a personal note, I will always be grateful to Ruvell for his kindness to Todd near the end of this life.

(Todd and Brett — September 23 2007)

The fall of 2007, turned to winter. The holidays came and went. Todd stopped coming for his visits to the administrative office. The cancer was taking its toll.

In the early part of February 2008, I visited Todd at his house. The talk from those who had seen him recently was that his condition worsened and that he was becoming more and more weak… barely able to get up most days. My visit lasted less than 30 minutes and somehow I knew this would be the last time we would see each other.

The funeral for a fallen fire fighter is very unique. The planning stages are complex and ceremonial honors are necessary to coordinate along the processional route. Several municipal fire departments lined the cold, snowy surface streets from the funeral parlor to the cemetery. It was an impressive display of reverence for a fire fighter they had never met. Todd was laid to rest with the honor, dignity, and professionalism he earned in his short 13-year career. Todd left behind a wife and young daughter who miss and love him every single day. We all miss him.

(Todd Stanaway’s funeral February 2008)

Cancer and the fire service have been linked together for decades. The kind of toxic exposures that build up over a career can be devastating to the body. Class A (wood, paper, natural fiber cloth) fires are relatively uncommon as natural materials have been replaced with lighter, cheaper, and toxic synthetic substitutes. As the plastics and adhesives that make up much of our simulated wood products and furniture burn they release dozens of hazardous chemicals. As these chemicals absorb into the skin or permeate clothing the cumulative effect is unknown. For years fire fighters have unknowingly worn these chemicals as a badge of honor.

The toxic particulates, aerosols, and off-gasses produced by combustible synthetics are not going unnoticed by State and Federal legislators. As of 2016, there were 33 states that signed cancer presumption laws to provide support for the families of fire fighters who succumb to certain types of job-related cancers. Unfortunately for the family of Todd Stanaway, Michigan is not a state that participates.

Cancer presumption may seem like a step in the right direction, and don’t get me wrong … it is. However, laws do not bring back the fire fighters who have died in the line of duty. A more effective scenario would be to prevent the fire service related cancers from occurring in the first place. Cancer prevention is a newer emphasis in the fire service and is trending up over the last five years. Prevention measures can be simple and inexpensive or complex and costly. Either way there is work to be done by all 30,000+ fire department in the United States.

Five simple or inexpensive policy changes needed to facilitate more emphasis on cancer prevention in the fires service include:

· Remove duty boots before entering the fire station. Use a second pair of shoes or boots for station use only
· Always wear self-contained breathing apparatus when operating in the hot zone
· Do not take work uniforms or gear home or store in a personal vehicle
· Shower after each exposure and remove soot immediately from the neck, jaw, throat and underarms
· Clean turnout gear immediately after a fire

Five complex or expensive policy changes for fire chiefs to consider:

· Install commercial grade extractors at each fire station to wash turnout gear safely
· Purchase a second set of turnout gear for each fire fighter. This would allow one set to be washed while the other is in service
· Create a wellness program that includes a mandatory NFPA 1582 compliant physical
· Integrate cancer awareness into annual training
· Create a culture of safe work practices in toxic settings

Fire Chiefs are tasked with many responsibilities. But there may be no greater need in the modern fire service than for a Fire Chief to invest in the safety of his/her personnel. Cancer prevention programs can create a heavy impact on shrinking budgets but the alternatives are even less desirable. The data and research published by the National Fire Protection Association (NFPA), International Association of Fire Fighters (IAFF), the National Institute of Standards and Technology (NIST), and other independent agencies point to the severity of cancer related deaths in the fire service. So, there are two paths the fire service can go by but in the long run it must change the road it is on. Todd Stanaway, and all of the other fire fighters who have battled cancer, will be watching.

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