They Called His Concussions Anxiety: A Paramedic’s Story

The following account was shared with us by an anonymous paramedic in Colorado. We’re publishing it because head injuries are one of the most under-recognized occupational health problems in emergency services — and because his story ends somewhere better than it started.

Sixteen years on a box. Three hits to the head that I can name. The first was a rollover — we got T-boned running lights and sirens and I woke up hanging in my belt. The second was a combative overdose patient who put the back of my skull into the action-area cabinet. The third was black ice on a driveway at 0300, feet out, head down. Every time it was the same routine: ER, CT scan, “no bleed, you’re good,” back on shift within the week.

But I wasn’t good. The headaches never really left. Grocery stores made me dizzy — all that visual motion in the aisles. Night driving felt like getting flashbanged. I’d lose words mid-sentence giving radio report, which had never happened in my first ten years. I finally told my doctor everything, and he looked at me and said, “Your CT was clean. This is anxiety. The job you do — anyone would have it.” He wrote me a script for an SSRI and handed me a counseling pamphlet.

It took a new occupational med doc, three years later, doing a five-minute eye-movement screen in her office, to say the sentence nobody else had: “This looks vestibular. This looks like your concussions.”

What Actually Happened Clinically

The single most important fact in this story is one nobody explained to him in three separate ER visits: a clean CT scan does not rule out a concussion. CT exists to find bleeds, fractures, and swelling — the injuries that kill you tonight. Mild traumatic brain injury (mTBI) is a functional injury at the level of networks and cells, and it is essentially invisible on standard imaging. “No bleed” was the right answer to the question the ER was asking. It was never an answer to the question he was living with.

His symptom cluster — dizziness in visually busy environments, light sensitivity, persistent headache, word-finding trouble — is a textbook picture of post-concussive vestibular and oculomotor dysfunction. Dizziness is reported by most patients in the acute phase after concussion, and a meaningful share of people who go untreated develop persistent symptoms. The systems that stabilize your gaze and your balance — the vestibulo-ocular reflex, smooth pursuit, convergence — can stay disrupted long after the injury, and grocery-store aisles and oncoming headlights are exactly the environments that expose it.

And here’s the trap his first doctor fell into: the symptom overlap between mTBI and anxiety or PTSD is enormous. Headaches, sleep disruption, irritability, poor concentration, feeling overwhelmed in stimulating environments — both conditions produce all of it, and researchers have spent years working on how to tell the two apart precisely because clinicians so often can’t on symptoms alone. In a first responder, “anxiety” is always a plausible story. That’s what makes it such a dangerous default.

Why This Keeps Happening

First responders take head injuries at rates most clinicians don’t appreciate. A 2025 University of Exeter survey of 617 frontline police officers found that 38 percent had sustained at least one traumatic brain injury — versus roughly 12 percent in the general population — and of those, 61 percent reported more than one. Officers with multiple TBIs were more than twice as likely to meet criteria for complex PTSD. A recent systematic review and meta-analysis has now put numbers to what many suspected: elevated TBI prevalence isn’t a policing quirk, it’s a first-responder-wide pattern.

EMS may be the least protected corner of it. Medics face two of the highest-risk exposures in public safety — assaults by patients and bystanders, and ambulance crashes — and CDC/NIOSH injury data consistently shows EMS clinicians getting hurt on duty at rates far above the all-worker average. Yet unlike a high-school linebacker, a paramedic has no sideline protocol, no spotter, no graduated return-to-play. The culture runs on “got my bell rung” and back on the truck. Three documented head impacts in one career drew exactly zero follow-up questions from anyone — and by the Exeter numbers, his career is not unusual.

What a Better Workup Looks Like

If you’ve had a head impact and symptoms that persist past a few weeks, the workup you want goes beyond a CT and a screening questionnaire:

1. A vestibular and oculomotor exam. Ask specifically for VOMS screening (Vestibular/Ocular Motor Screening) — it checks smooth pursuit, saccades, near point of convergence, the vestibulo-ocular reflex, and visual motion sensitivity. It takes minutes, and it’s the test that finally cracked this case.
2. Balance and gaze-stability testing. Tools like the Dizziness Handicap Inventory and formal balance assessment establish a baseline you can measure progress against.
3. Vestibular rehabilitation if the exam is positive. This is targeted physical therapy for the balance and gaze systems — commonly around 20 minutes of prescribed daily exercises over four to six weeks — with solid and growing evidence for post-concussive dizziness. Our medic did eight weeks and describes himself as “80 percent back.”
4. Screening for both TBI and PTSD, not one or the other. They co-occur constantly in this population, and treating one while ignoring the other is how people stay sick. If a provider only reaches for one diagnosis without examining you, that’s your cue to push.
5. Documentation, every time. Every head impact goes in an incident report and your own medical record, even when you feel fine by end of shift. Cumulative injury claims live or die on the paper trail — and so does the workup a future doctor decides you deserve.

The Bottom Line

Nothing in this story required exotic medicine. The screen that changed his life takes five minutes and costs nothing. What it required was a clinician willing to take a first responder’s occupational history seriously instead of reaching for the most convenient label — and a patient who kept saying “something is wrong” until someone listened. If your symptoms started after your head got hit, say that sentence out loud in the exam room, and don’t let a clean CT scan close the conversation. You know the difference between who you were and who you are. Make them look.

This account was submitted anonymously. Details have been edited for privacy. This article is for informational purposes only and does not constitute medical advice. BadgeBiohacking (policefire.health) is a comparison and review site. We may earn affiliate commissions from links on this site. Always consult a qualified healthcare provider before starting any treatment.