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‘You have a pneumothorax’: When the provider becomes the patient

Yes, we are the providers, but we are still human, and we must listen to our bodies and advocate for our health


Thousands of firefighters are injured every year. Burns and inhalations; slips, trips and falls; sprains and strains; crushing and cutting mishaps – you name it, it finds us. What’s more, we are some of the worst patients from the caretaker perspective. First, we refuse any help, even as blood is dripping from our head, or we cough-off the admonition to get checked out for smoke inhalation. When we do go to the hospital, we “know” how we should be treated and rush to judgment on any number of actions.

But let’s set aside the injuries of our business to consider the wellbeing of our people, like when we become the patient due to maladies beyond the job. It’s hard to come by lessons learned-focused reports on these types of “events.”

Taking care of ourselves

We train and train and train some more to take care of Grandma Jones. Providing service is the singular mission focus that drives our actions. As providers, whether we’re in fire or EMS mode, we strive to not only be two steps ahead in our training and planning but also in our provisions for care and implementation of prevention and extinguishment strategies. But are we extending the same planning and action mindset to ourselves?

Our tendency is to take care of everybody else first, meaning we sometimes fail to care for ourselves, ignoring the signs and symptoms our bodies are expressing. It’s easy to dismiss the pains, the few extra pounds, the lumps or the unexplained bruising. After all, WE are the responders, the providers! But in too many cases, we don’t recognize the inherent danger in this approach until it’s too late.

Conversely, sometimes we recognize a problem but find ourselves stuck in one of these mindsets or situations:

  • We can’t get anyone (or the right anyone) to listen to our complaint;
  • We feel shamed or belittled by our peers; or
  • We can’t possibly stop living and working at 150 mph to take care of ourselves – “they can’t do it without me!”

Our pride and/or personal situations can get in the way of doing what’s best for ourselves, and we feel like we don’t have a choice. Unfortunately, we must live or die with the consequences of this mindset. Think about that for just a minute – “live or die with the consequences.” If some factor is legitimately out of your control, then OK. But so many factors ARE within your control. Start there and take action.

I’ve shared before my efforts to take care of myself, one pant size at a time, advocating for myself and working to shed 95 pounds of extra weight. But shortly after publishing that piece – even while in the best physical/mental shape of my life – I was thrown into the greatest battle of my life. Fortunately, I won the battle, but there are some ongoing fights to finish.

“It’s just a cough”

In November 2023, I visited my primary care physician with a mild cough, likely related to a previously diagnosed Barrett’s esophagus disorder. The PCP put me in touch with the gastrointestinal (GI) doc, but the first consultation appointment wasn’t until mid- January. “Call me if it gets worse,” the PCP said.

By January 2024, the cough had worsened somewhat, now producing some clear mucus. I went back to the PCP who assured me not to worry unless it looked infected (dark or colored). I met with the GI doc who scheduled me for a colonoscopy and endoscopy – in mid-March.

A week later, I felt warm, and for three evenings in a row, had a fever of 99.1. I called the PCP back, and he said not to worry about the temperature unless it pushed over 100. My fever returned to normal temperatures, but the cough – and now pain – worsened.

“I can’t breathe”

On Feb. 22, I jumped out of bed at 2:30 a.m. to a sharp pain from my back that took my breath away. I woke my wife, Laura, with the pronouncement that I just couldn’t catch my breath, and she drove me to an emergency room.

As the doctor examined me, he asked the routine questions, including whether I was a smoker. “No, never, however, I was an active firefighter for 30 years.” I heeded this advice from other firefighters – always explain the fire service work, especially important for those of us from the less-cancer-conscious” years of the past.

The ER doc took a CT scan and returned with words no one ever wants to hear. He had found “a mass or a pneumonia, leaning towards a mass” in my lung. Antibiotics were prescribed. A follow-up visit with the pulmonologist would determine the next steps. “Go home and rest” was the directive.

“I’m not sure what you want me to do”

Early the next morning found me again awakened by the lack of breath. We went back to the ER where I met with a rather dismissive doctor who examined me, provided some additional medication and professed, “They did everything yesterday that I would do today – I’m not sure what you want me to do,” to which I replied, “I need to figure out why I am losing my breath.”

We headed home, with an afternoon visit to the pulmonologist scheduled. The pulmonologist examined me, told me to take the medications prescribed and come back the following week for an X-ray.

Other than the cough, I was in the best physical shape of my life. Something was clearly wrong, and I was now beginning to kick myself for not pushing harder when the cough got worse and I had the slight fever. After all, I’m a provider!

“You have a pneumothorax”

Monday, Feb. 26, brought a continuing worsening sense of not being able to breathe. Nobody’s listening – we’ve got to do something else. We decided to go to a different emergency room and hoped to speak with someone who would really listen. As it turns out, the third time would be the charm.

After waiting nearly 90 minutes to be seen, and clearly in distress, I was escorted through the very busy ER to an empty patient cubicle. The doctor was prompt at this point and ordered an X-ray. Within five minutes of returning to my cubicle, the doctor returned and asked, “Did any of the other doctors tell you that you have a pneumothorax?” Incredulous, both Laura and I said “NO!”

There at the ER bedside less than five minutes later, I remember some discussion about a tube and “putting me out,” and blah, blah, snore. I later awoke to the ER doctor and an ICU doctor standing over me, the ER doctor explaining, “The first tube in your right side is in, but it didn’t work. This is the ICU doctor who’s going to insert a smaller tube in your chest. We’ll local this one, it should do the trick.”

The second tube didn’t do the trick either. I was admitted to the hospital – a stay that lasted 33 days. It felt like I went from 150 mph to ZERO with the snap of a finger!

There’s a first for everything


Except for minor procedures and the Barrett’s esophagus issue, I’ve been a very healthy person, never before admitted to a hospital. I knew the providers were professionals, but letting them stick things in me was NOT to my fancy. I will not deny that I was scared.

The cardiovascular surgeon and team visited me, somewhat in disbelief that the tubes did not reinflate my lung. Five days later, I was wheeled into the operating room for an exploratory surgery, as the X-rays couldn’t identify the problem. And remember the original CT scan diagnosis of “a mass or pneumonia, leaning towards mass.”

During the surgery, the doctor removed an entire medical basin worth of infected tissue from my lung. Although the doctor was originally skeptical about whether the surgery was necessary, he told me after, “I am not unhappy that I decided to go in,” as he was able to clean out so much of the infection.

All biopsies came back negative for cancer – a huge relief!

Subsequent procedures, including one additional surgery, determined that an undiagnosed and untreated pneumonia had essentially exploded in the center right lobe, piercing multiple holes through the lung. While procedures continued to fail to inflate the lung, the second surgery resulted in three staples placed in the center lobe, stopping the air leaks but still not allowing the lung to fully inflate.

There was NO expectation that I would need to be in the hospital for as long as I was; however, all known treatments and surgeries were failing to produce results. Taken in its totality, the number of specific symptoms I was experiencing had little to no case volume for doctors to reference or follow. Laura found a study from India that looked at 15,000 lung patients – only one had similar symptoms.

Time to go home

On Thursday, March 28, my last tube was removed, and by Saturday, March 30 – 33 days after my third ER visit – I was home.

Without much definitive direction, we followed what we knew from insurance protocols and the limited information we did receive to set up physical, occupational and nutritional therapy. I had lost 26 pounds since that first cough in November.

We bought a new bed to help me elevate and be comfortable in whatever my new normal would bring. Hunched over and using a cane, I was determined to get out and walk – to eventually be able to at least walk the dog without fear of being knocked down and dragged across the grass by an overly exuberant canine (Hershey). I walked every day, and fulfilled what was necessary with physical therapy.

I have progressed better than most would expect and have returned to the gym six days a week, albeit at significantly lighter weight and with much more care than I normally would have taken. I walk slower, have a dry cough and finally got to the scopes I mentioned early – all clear there!

Be your own advocate

I had great doctors and medical staff when I was in the hospital, but it’s also clear that our healthcare system is broken. (Clearly, many before me have said the same thing; this was just my firsthand view of it impacting my life.) My take? Perhaps because I was “healthy looking,” the doctors didn’t expect anything could be critically wrong with me – and I had no fever. I should have been a stronger advocate for myself in January when my body was telling me things weren’t right.

I feel like we shopped ERs to find the answer we wanted. The reality is that it took the third ER to do the right thing. I could have advocated harder myself at the first or second ER, but I also depended on the ER doctors to know what they were doing. Would it have made a difference? We’ll never know.

I have since talked to one firefighter whose wife had to see three doctors before one listened to her complaint about a lump. Having now been through a mastectomy and surviving the ravages of cancer treatment, she is on the mend but only because she was her own advocate. Another firefighter told me a story of not listening to his body when he had a fall. A subsequent stroke revealed brain cancer. He is currently on the mend.

We are human

We are the providers, but we are all HUMAN too. We MUST listen to what our body is telling us, and we must start taking better care of ourselves. More than one of my doctors has told me that if I had not been in as good shape as I was prior to the event that I likely would not have survived. If that isn’t as sobering to you as it is me, I’m not sure what to tell you.

The pulmonologist told me recently that he has no expectation that I won’t be able to get back to where I was – I’m looking forward to that!

Chief Marc S. Bashoor joined the Lexipol team in 2018, serving as the FireRescue1 and Fire Chief executive editor and a member of the Editorial Advisory Board. With 40 years in emergency services, Chief Bashoor previously served as public safety director in Highlands County, Florida; as chief of the Prince George’s County (Maryland) Fire/EMS Department; and as emergency manager in Mineral County, West Virginia. Chief Bashoor assisted the NFPA with fire service missions in Brazil and China, and has presented at many industry conferences and trade shows. He has contributed to several industry publications. He is a National Pro-board certified Fire Officer IV, Fire Instructor III and Fire Instructor. Connect with Chief Bashoor at on Twitter, Facebook or LinkedIn. Do you have a leadership tip or incident you’d like to discuss? Send the chief an email.