Littleton’s Station 13, geographically separated from the rest of the city’s fire stations by the winding„Platte„River, is located in a quiet, affluent neighborhood. Throughout the department, Station 13 is known for low-call volume, compared to the other seven stations. However, it’s also infamous for the high-profile calls, including the 1999„Columbine„High School shooting, that have taken place in its response area.

On Oct. 29, death came knocking on Station 13’s front door, but luckily none of the crew was there to answer. An elderly male parked his car on the lawn — right in front of the station’s sign just feet away from the day room windows and front service door. He got out, removed a large hand gun from the vehicle and shot himself in the chest with the high-caliber weapon. He apparently survived the first wound to his chest and then shot himself in the head. The second shot left him unconscious and barely breathing in a large pool of blood on the sidewalk. Station 13’s crew was out of the firehouse at the time of the shooting. A series of station tones rang out in their vehicles, and a familiar voice aired an ALS response, “Engine 13 and Medic 13 respond on a possible suicide in front of your station, standby for law enforcement.”

The„county„Sheriff quickly arrived and secured the scene and weapon as Station 13’s crew emergently returned back to their firehouse. The crew found the 70 year-old man, unconscious with agonol respirations at 5/min and a faint pulse around 68/min, with a gun shot wound to the chest and a massive head wound with an entrance and exit. He had already had lost a substantial amount of blood by the time the crew arrived. They quickly established an airway with an endotracheal tube, packaged the patient on a backboard with a collar and loaded him into Medic 13 for an emergent ride to the Level One trauma center just eight miles away. The on scene time was a short four minutes. During transport they removed his clothing and performed a detailed assessment, established an IV with EZ-IO and applied the cardiac monitor. He still had a good pulse ox reading of 90 percent with assisted ventilations but had lost his pulse. CPR was started immediately. The crew knew the chances of his survival were slim with brain matter protruding from the exit wound. Shortly after arriving at the hospital, the man went into cardiac arrest and was declared dead. His life was over. But he had changed the lives of his rescuers, adding another small mark on their souls and lasting memories of that day.

This patient was no stranger to the members of„Littleton’s Station 13. Just five months earlier, he had attempted suicide using carbon monoxide at his home. Station 13’s crew found him in his garage with the car running. He was semi-unconscious, barely breathing and saying he wanted to kill himself. He had written a note, collected his personal papers and provided his insurance papers for whoever would find him. The crew transported him to a local hospital, where he spent time in intensive care and received mental health counseling for his depression. He was released, only to complete his suicide wishes months later on the sidewalk of„Littleton’s Fire Station 13.

What was his motivation to commit this act in front of a public building, where so many school children have come for station tours? Of all places, why here? Did he come to the firehouse looking for the crews who had defeated his earlier suicide attempt? Was this a planned homicide-suicide quickly modified when he discovered Station 13’s crew missing? No one will ever know his motivation even though a suicide note was found in his car. He did not mention why he chose Station 13 for his final moments, only who he was and who should be called after his planned death.

“The reality of this suicide death on our property didn’t set in for me or my crew until long after the call,” Station 13 Capt. Tim Woodward said. “It wasn’t until my family came to visit me later that night that I realized that this tragic event could have happened when they were in the firehouse or when school children were seeing the firehouse. In retrospect, we all feel very lucky we were not in the station when he did this.”

The suicide is not the first of its kind. Earlier this year, a person committed suicide in the parking lot of another fire department in south„Denver while on their cell phone with the dispatch center. In another incident, a 36-year-old female patient with a history of suicide attempts leaped out the back doors of a moving private ambulance driving on a„Denver expressway and jumped to her death. She had removed her cot straps while distracting the attending EMT. Her family is now suing the company for damages.

Two Suicides in One Day

I remember another day this year when I was taking my normal route home, one I had traveled many times over my career as the EMS chief at„Littleton (Colo.) Fire Rescue. The communications specialist’s calm voice crackled over my radio as she dispatched an ALS response, “Engine11 and Medic 11 respond on a possible suicide, standby for law enforcement.”

I was just blocks away and had a truck full of ALS equipment. I pulled into the modest subdivision and waited for law enforcement to stabilize the scene. Within minutes a safety message radioed to all incoming fire units that it was safe to enter. I parked across the street as children gathered to see what all the commotion was about. I could hear the sirens from the approaching fire department apparatus still blocks away as I was motioned toward the garage by a police supervisor. A female police officer was leading a distraught wife away from the home and toward a waiting police car. I remember thinking to myself, “this doesn’t look good.”

The scene was disturbing as I stared from the garage door. A male in his late 40s or early 50s, a father and a husband, had hung himself from the rafters of the detached garage. His wife found him after she returned home from work. He had successfully taken his own life and was now cold and mottled. His fists, still clinched tightly, showed obvious signs of rigor. There was no hope of resuscitation. The death scene was very silent, and the sounds of his wife crying faintly in the police car could be heard in the background. Crew members from„Littleton’s Engine 11 and Medic 11 joined me. We stood quietly, police and firefighters, not saying a word and just looking at one another. We had all seen that “look” on each other’s faces before. Toys and small bicycles were in the yard, and I wondered who would pick the kids up from daycare today. What would they tell the children happened to their dad, and how would they cope with this tragedy of immeasurable proportions? It was a sad scene not uncommon to public safety officers and first responders. As I went “in service” and drove from the scene, I waived to the children who had gathered near the fire truck. I slowly exited the neighborhood and wondered just how many of these sad suicide stories I had witnessed over the 25 years of my public service career.

Later that same day, on the opposite side of the fire district, another middle-aged man hung himself in his garage. He too was a father and a husband. He too was found by his wife in the garage at the end of her work day. Two middle-aged men — both family men with so much to live for — died that day, leaving families in turmoil and first responders with questions. Was this an eerie coincidence or a sign of the much bigger problem facing the affluent communities in the south„Denver area?

A Larger Problem

Suicide deaths and attempted suicides are a major health problem in„Colorado — affecting people of all age groups. In 1998,„Colorado’s suicide rate was the 12 highest in the nation, and suicide was the ninth-leading cause of death in the state. Today,„Colorado has the sixth-highest suicide rate in the„U.S., and suicide is now the second-leading cause of death among people ages 10 to 34. It’s estimated that 9,600 Coloradans seriously contemplate suicide each year, with the largest number of suicide deaths occurring among men between the ages of 35 and 44. The risk of suicide increases as men grow older and is particularly high among men 75 years and older.

The government recently released figures showing the suicide rate among middle-aged Americans has reached its highest point in the last 25 years. The U.S. Centers for Disease Control (CDC) estimates the suicide rate for people between the ages of 45 and 54 rose by about 20 percent between 1999 and 2004. The CDC figures show that there were 16.6 completed suicides per 100,000 people in that age group, the highest suicide rate recorded by the CDC since 1980. Experts believe suicide is an unrecognized tragedy many communities across the country face. Studies suggest middle-aged men are the least likely to have sought counseling prior to their untimely deaths.

Death and Cake

Paramedic Capt. Monte Fleming is a seasoned veteran of the fire service and dedicated family man. When his daughter graduated sixth grade, he was on duty and attended the ceremony with his crew. The school was in his first in district, and it was the perfect opportunity to make a public appearance with the fire truck. The ceremony was short and well attended by 25 other families of sixth-grade graduates. Following the ceremony was a party with cake, ice cream and fire-truck tours. As the crew members chatted with parents and enjoyed the refreshments, a series of alert tones rang out on their portable radios and a familiar voice aired an ALS response, “Truck 12 and Medic 15 respond on a possible suicide and standby for law enforcement.”

Crew members climbed onto their truck and headed toward the call. The scene was charged with profound emotion. Police officers were consoling a distraught wife and her children. The family had come home to find that the father and husband had shot himself in their basement.

On assessment, the crew found a man in his late 40s cold with rigor. He had sustained a self-inflected gun shot wound to the head from a small caliber handgun that now lay between his legs. Fleming’s crew quickly realized there would be no resuscitation or happy ending to this situation. The crew stood silently with the “look” on their faces. The firemen carefully left the man’s body undisturbed, mindful of the potential crime scene. After emotionally supporting the surviving family, the crew returned to the graduation party and tried to pick up where they had left off. Things had changed for one family in a matter of minutes, and the uncertain future for this family was on the minds of the rescue crew. The raw reality of their jobs in„EMS was apparent to each crew member. In the few short minutes, their joyful celebration turned to sadness, and the graduation cake just didn’t taste quite the same. “Each one of these suicides leaves a small mark on your soul,” Fleming said. “You just can’t help [but] feel sorry for each of these families, and the reality they face.”

Each suicide is unique — from the senior citizen who duct taped a bag over his head to the middle-aged man who put rocks in his pockets and cut a hole in the ice he was standing on at a local reservoir, or the war veteran who dressed in his old military uniform and shot himself in the chest. “Each one leaves a lasting memory,” said Fleming.

What have we learned from fatal events and near misses, and how can we protect our first responders from also becoming causalities of individuals bent on self destruction? What role does EMS have in suicide prevention, and what programs are established to reduce these increasing suicide rates in„Colorado? Read more about the lesson learned from the suicide at Station 13, as well as other information on suicide and suicide prevention, in Part 2 of “Too Close to Home: Suicide at Station 13.”