All my articles are somewhat autobiographical; this one is even more so.  My hope is that it helps you understand someone in your life, or at least appreciate the trauma certain professionals are exposed to in their line of work. 

Our fascination with psychopaths goes back to the first documented serial killer, H. H. Holmes, and to John Douglas who started the behavioral science unit for the FBI and wrote the best seller, Mindhunter.  He interviewed many serial killers, including Ed Kemper.  Psychopaths fall on a scale from hardened criminal to professional assassin, like Chris Kyle, the Navy Seal featured in the movie, American Sniper, who had over 150 confirmed kills. 

So, what behaviors characterize psychopaths?  Psychopaths exhibit shallow emotional response, superficial charm, callous indifference, manipulativeness, impulsiveness, lack of remorse or guilt and lack of empathy—to name a few.

As terrible as these traits sound, psychopathic tendencies can be put to good use when the training paramedics, police and military personnel.  We can use some sweeping generalizations about psychopaths to learn how some people can embody all the requirements for a psychopath and use them for good versus antisocial behavior.  I used these behaviors to deal with the working conditions that came with being a paramedic attached to a SWAT team.

A Toxic Work Environment

There was nothing in my paramedic or police training to prepare me for what I was going to see; there’s no boot camp for paramedics to ready them mentally and emotionally.  Our trainers just told new recruits that people will die; you can’t save everybody, so you better be one hardcore son of a bitch if you wanted to survive in this business.

The first few years were a nightmare.  I worked complex emergency scenes with multiple casualties, and I had to be jacked in the whole time, adopting psychopathic behaviors to withstand the screams, blood, brain matter and the contorted faces of dying people while I was trying to save their lives.  The visuals were a motherfucker.  Not many people understand this or get it thanks to the desensitization of death by Hollywood.  I never heard any music when people died in my arms, but I still remember their last words.  They were scared, they felt pain and most of them died screaming.  I can’t unsee any of this.

I had to become cold, noncaring, focused and detached, and learn to compartmentalize while preparing to respond to the next emergency call.  Some weeks I would work ninety-six hours straight with small micro-sleep sessions.  I could work on twenty people and within hours forget what they looked like but remember their injuries.  Bullet wound, upper chest.  Broken femur.  Drug overdose.  Heart attack.  I entered an altered state of reality that would make LSD users jealous.  

I questioned my own behavior; I would look at myself in the mirror and say, “What are you becoming?”  I’ve read that even soldiers who were face-to-face with the enemy and delivered a kill shot experienced a short burst of elation quickly followed by remorse.  Many comforted their victims, talked to them and held their hands as they died.  I never wanted to lose my humanity, not for one second.

Psychopath vs. Lifesaver

My only option for self-preservation was to inadvertently cultivate psychopathic behavior.  This behavior is on a continuum: Ted Bundy the serial killer on one end and me on the other, using the same skills to save my life as well as the lives of the patients I worked on.  During an interview, Bundy revealed his talent for choosing victims, even spotting their weaknesses by the way they walked.  A master manipulator, Ted drove a blue VW Bug and wore a cast on his arm while asking for help to draw his prey closer for the attack.

I’d watch my coworkers on emergency scenes closely.  I saw their weaknesses as well.  This ability allowed me to get them help before permanent damage was done.  Some people are just not made to be lifesavers; emergency scenes are too much for them to cope with, and in the days that follow, they can’t shake their thoughts because they’re too empathic.  This can cause sleep disorders and depression.  They incur physiological damage from the very first emergency call and it gets worse with each passing week on the job.

My work transformed me into a person with an undiagnosed mental illness.  While off duty I would have to do intense physical triathlon training—thirteen-mile runs and 100-mile bike rides—to quell the beast rising inside me.  While running, I heard a white noise that fell in sync with each foot strike, each breath.  The best I can describe it is “rest in motion.”  This is where the executive thinking center of my brain, called the prefrontal cortex, went offline, allowing me to just not think about anything—this was as calming as a bump of heroin is to an addict.  My sweat baptized me, washing away all my bad memories.  Hours after my intense workout I was back to reality and then it was time to drink, smoke and have as much sex as possible to get me to the next 24-hour shift of emergency calls.  At the time, I knew this lifestyle was going to kill me.  My thinking was that I’d never make it to 40, so what the fuck, let’s party like it’s 1999.

The gap between lifesaver and psychopath got closer every year I was on the job.  The patients soon were not people.  Their injuries were visually isolated, their screams did not register.  I was a cold-fusion robot while on the scene and days after.  I became an efficient life-saving machine and got awards for it.  Members of my squad would retch and vomit during calls while my pulse rate never elevated.  The emergency scene became my home.  The adrenaline blast was as addicting as any drug.  While off duty, to avoid drinking, I would call in to the shift captain to see if I could come in and work.  Alcohol suppressed my true drug, adrenaline, which I combined with nicotine and caffeine.  The synergy of all three created an advanced nootropic that flipped a switch in my prefrontal cortex, followed by the extreme focus of a sniper.  I was jacked in for 23 hours of a 24-hour shift and relished every second.

Are You Close to a Psychopath?

The curse of my existence was that I was really good at saving lives, maybe one of the best.  I tried to leave and start other jobs so I could have a “normal” life, but the dopamine bursts from the highly frenetic, mind-altering pace of responding to emergency calls pulled me back with the gravitational force of Jupiter.

I had the ability to pass myself off as normal for short intervals, maybe three to four hours max.  I would smile, laugh, shake hands and engage in conversations.  I always drove my car to whatever the occasion just in case I needed to get the hell out.  I became a social chameleon adjusting to the environment.  People always underestimated me…which gave me the edge.  I was the nerd, the lifesaver, the teacher, the lover of mankind.  Inside this disguise beat a psychopathic Heart of Darkness, my only way to exist with the traumatic scenes that would run on a constant loop in my brain, 24/7.  Today when war vets, cops and EMS personnel come to Scala Precision Health for help, their first request is, “Russ, help me shut my brain off!”

My brain chemistry was not dialed in to be a regular citizen so how could I expect normal people to understand me?  I knew my family and the women in my life loved me.  I knew they cared, and I knew because of my short fuse they walked on eggshells while in my presence.  Now how’s that for a good time?  My best friends and lovers ended up being people with similar traumatic experiences and deep scars.  It was like we had a code. 

One of my girlfriends could read my facial expressions and say, “Let’s go baby, let’s get out of here.”  God knows how much I appreciated this woman. She got me because she had her own traumas, and I understood her as well.  There was a large age gap between us, and I didn’t give a shit; she was an old soul.  She could drift into multiple personalities given the situation and had a remarkable ability to read people.  This skill set evolved from early childhood trauma.  We had to dance around each other on many occasions to sustain mutual love and respect.  She was my love, my partner and my kid all wrapped into one.  I’ve dated many women in my life; this one was made for me, and the mold was broken.

The Physiology of a Psychopathic Superhero

When a person must deal with physical, mental or emotional stress, the constant state of fight or flight elevates adrenaline and cortisol, which lowers the feel-good neurotransmitters serotonin and dopamine.  Sex, alcohol, gambling, exercise—all elevate dopamine levels.  What saved me was getting a grip on this behavior early.  Changing my tribe from emergency workers (who self-medicated with alcohol) to endurance athletes saved my life.

There’s a big difference in the way humans process a traumatic event versus a non-traumatic event.  When people remember an ordinary event, it has a beginning, middle and ending.  It’s a story, like a wedding or the birth of a child.  A traumatic event is like an explosion of all your senses, be it child abuse or a person dying in your arms.  The FMRI brain scans of people who experienced severe trauma show distinct changes in the brain.  Without going into a lot of detail, these changes caused the person to lose the story of the traumatic event.  There is no beginning, middle or ending, there is just fragments of the traumatic event.  When this happens, they have no idea where these thoughts come from. The triggers can be anything from the screeching of car tires to a loud noise.  Once, I was in a coffee shop and heard a baby screaming.  BANG!  I started to relive the emotions, sensations, images, smells and sounds from when a baby died in my arms 15 years ago.  It all came back in a flash, starting with goose bumps and ending with tears in my eyes.  I was totally aware but confused when this happened to me. 

So, if you’re wondering why your psychopathic loved one isolates themself and deals with people and life in short intervals, there you go.  Make sense?  I hope that this article helps everyone understand traumatic event survivors—and thrivers—that we depend upon in the military, police, fire and medical professions.

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