MSI Press Blog

  They run toward what the rest of us flee—flames, gunfire, wreckage, collapse. First responders carry the weight of our worst days, often without pause, without time to process, and without the support they need to heal. Behind every emergency call is a human being absorbing trauma in real time. Paramedics who cradle the dying. Firefighters who sift through ash and grief. Police officers who witness the aftermath of violence. Dispatchers who hear every scream but see none of the resolution. These aren’t just jobs—they’re acts of endurance, empathy, and exposure. The cost? Elevated rates of PTSD, depression, substance use, and suicide. Chronic stress reshapes the brain, weakens the immune system, and erodes relationships. And yet, many responders are trained to suppress emotion, to “tough it out,” to keep going. But resilience isn’t about silence. It’s about support. About peer networks, trauma-informed leadership, and systems that prioritize mental health as much as physical s...

  A HERO'S SUICIDE   b y Joanna J. Charnas   This following essay was written in 2017 but has not been previously published.   Earlier this week I learned that one of my former patients killed himself. I’m devastated and can’t stop thinking about him. His name was Ryan Larkin.   Ryan was a Navy SEAL. He completed four tours of duty, two in Iraq and two in Afghanistan as a corpsman. Ryan arrived at the inpatient psychiatry ward of the hospital that employs me four weeks prior to discharging from the Navy, and he remained with us for a month.   While he was in our care, I became concerned about Ryan’s treatment. His attending psychiatrist was a skilled and caring provider, but the other players in the larger mental health system seemed mostly fearful of Ryan. Fear is not an optimal state in which to deliver care. My colleagues repeatedly expressed concern about his opioid use and labeled him “drug seeking.” In 2016 the country had a new awareness of the burge...