Firefighting, rescue and emergency medical service are all about taking command of an incident and resolving it. But that control and confidence can shatter in seconds at the sound of a few words: heart attack, cancer or suicide. Just ask Mike Dubron, a paramedic with the air operations unit of the Los Angeles County Fire Department. He was 39 years old when he was diagnosed with stage-four colorectal cancer. There is no stage five. Dubron was told he had a life expectancy of one to three years.

“It's the feeling of living your life and being in control,” said Dubron. “And then cancer — being such a devastating word and disease — you learn in about two seconds you are not in control.”

During his nine months of cancer treatment, Dubron founded the Firefighter Cancer Support Network. Six years later, Dubron celebrates the anniversary of his diagnosis. The organization and its Web site, www.firefightercancersupport.org, have grown exponentially, as cancer becomes more prevalent among responders. The Web site offers support for emergency responders, their families and co-workers, as well as a wealth of information and updates about various cancer treatments and services.

Like any potentially fatal disease, cancer is hard to understand until it hits home. “It's like you're driving a car with the check-engine light on and the car might break down at any moment,” Dubron said. “My friend Tommy, however, told me everybody is driving their car with the check-engine light on; it takes cancer to see it.”

In the past 10 years, the fire and emergency services have become proactive in their approach to firefighter health, particularly with heart and stress-related diseases. Actions have included not only improvements in personal protective equipment and increased rehabilitation and rehydration efforts during an incident, but also preventive medical testing and the availability of fitness equipment.

The International Association of Fire Fighters and International Association of Fire Chiefs both support and endorse preventative action for physical and mental health. The National Volunteer Fire Council aggressively raises awareness of healthy hearts with cholesterol screenings at trade shows. Together with the U.S. Fire Administration, the NVFC also released a new “Health and Wellness Guide for Volunteer Fire and Rescue Services.”

According to the USFA's 2008 firefighter fatality report, 50 of the 114 line-of-duty deaths (43.8%) were heart attacks or strokes, down from 54 of the 118 (46%) in 2007. Hopefully, this is a trend that will prove preventative measures are helping with responder heart attacks.

For several years, FIRE CHIEF's February issue has been its health and safety issue, with articles on traditionally taboo topics. Several years ago, Portia Rawles wrote an article about her research on firefighter suicides. Other articles included a fire chief's experience with prostate cancer and a 41-year-old captain's battle with testicular cancer. These writers wrote honestly about their physical and emotional challenges to better educate and encourage readers to have annual exams and early detection.

This month we feature a story by Pat Kenny, who writes about dealing with his 23-year-old son's suicide and the effect on his role as a fire chief. While a physical injury is visible, emotional and psychological trauma can be more debilitating and just as real as a heart attack or cancer.

The diagnosis of cardiovascular disease, cancer or any other illness is devastating, and the obvious first reaction is learning how to stay alive.

Dubron stressed the importance of early screenings. “The thing I feared most was leaving my wife and children behind,” he said. “If you can't do it for yourself, do it for your wife and children. Treat [them] to a present that no money could buy.”

The emergency services will continue to face new health risks as new chemicals and products are introduced. Take care of yourself and live to enjoy your retirement.

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