From the bombing and manhunt in Boston to the fireball at a Texas refinery to the collapse of the Interstate 35W bridge, first responders have plunged into action, running toward danger as others flee.

The police officers, firefighters and paramedics who do so are hailed as heroes, but they don't always feel so valiant. Many are haunted by the sights, sounds and smells of carnage, especially when children are involved. Or they have doubts about whether they performed as well as they could have. Or they're angry that a rescue failed. Or grief-stricken that a person died in their arms.

For Burnsville Patrol Sgt. Richard Flaten, it was a gruesome accident early in his career, when he pulled a woman from a flaming car who died the next day. For Corinne Becker, it was finding a supervisor who had committed suicide when she worked as a young police officer in North Dakota.

Becker, a detective with the Brooklyn Center Police Department, chairs a nonprofit organization that helps first responders in the seven-county metro area deal with their stress. The Metro Critical Incident Stress Management Team is a group of about 60 law enforcement officers, firefighters, paramedics and emergency dispatchers who volunteer to talk with their peers about fatal car crashes, child injuries, burn scenes and other horrific events.

"We don't do therapy, but we set up a safe environment where a first responder can unload what they experienced and how it's affecting them," said Becker. The team responds to about 65 requests a year for debriefings, in which first responders meet within 48 to 72 hours of a critical incident to talk it out.

Some of the most troubling situations, especially for first responders early in their careers, are calls that include children, Becker said. "It's very easy for them to identify with a child who is suffering, or a child who has died, and to see the face of their own child on that victim," she said.

In other cases, a victim may remind them of a parent, close friend or relative, leaving an impression that's hard to shake.

Other particularly disturbing incidents include any time guns are used by or against law enforcement officials, suicides of co-workers, prolonged standoffs or rescues, and calls where responders personally know the victim.

Inside the room

During a debriefing, no one takes notes, Becker said, and only those who were part of the incident can participate. They are essentially structured conversations in which first responders participate and talk about what happened and how they feel about it. Two or three team members get the discussion started, but no one is expected to talk unless they choose to, Becker said. Meetings last about 90 minutes, she said, and include anywhere from a half-dozen to 20 people.

Usually a mental health professional is part of the team, and sometimes a chaplain is brought in, Becker said. Although it's rare, she said, first responders who are having an especially difficult time may receive private advice to seek professional therapy.

"It's incredibly helpful," said Mike Glassberg, a sergeant in the Hopkins Police Department who went through his first debriefing in the 1990s after a colleague's suicide. "You speak among your peers and you realize that your co-workers are going through some of the same feelings."

Glassberg joined the team about three years ago and serves on its board.

"We see all these horrific incidents, and behind the scenes people don't realize that the responders are seeing this first-hand," he said.

A look at chain of events

People who come to the debriefings may arrive "a little ramped up," Glassberg said, or quiet, with muted attitudes. But afterward they are often visibly more relaxed, he said, feeling supported by their peers.

Another benefit of getting together is simply to learn the chain of events about what happened. Emergency workers may blame themselves for something that's not their fault, said Sue Johnston, a clinical social worker who has worked closely with the team since the mid-1990s. That's why dispatchers are often included in debriefings, she said, and why the first order of business is to piece together what happened.

"First responders say they're the ones who show up when somebody else is having the worst day of their life," she said. "They are always around when there's intense suffering. Trying to rescue or recover, that's just what they do."

Debriefings become a "teachable moment" to remind first responders how to deal with stress, Johnston said.

"These are strong and competent people," she said. "We want to keep them healthy and on the job so they can have long careers."

The team also provides training to police and fire departments and other first-responder groups to teach them how to deal with the unexpected, and how to help colleagues immediately after stressful incidents.

"The old philosophy was 'suck it up, deal with it, and push the emotions down,' " said Becker. "We now know that's an unhealthy way of dealing with stress."

Tom Meersman • 612-673-7388