patrick halloran: ⁓ hey, welcome to Rescue Lab. ⁓ so today we are with David Di Rigorio from D2 Emergency Management. So he has led special operations at nearly every imaginable level, ⁓ from serving on a weapons of mass destruction civil support team to directing the Massachusetts statewide hazmat and special operations division. If you've ever wondered how states prepare for incidents, we hope never happen. ⁓ this is a conversation for you. So David, ⁓ welcome. Sure. So you you have the distinction of being only the second in-person guest. So that's a high honor. ⁓ I I'm filming. Yes. Usually remote, but we love having people in the studio. ⁓ but you have a very storied biography. Why don't you give us just the the quick thirty thousand foot view of who David D. Gregorio is? Sure. So I spent thirty two years in the army. ⁓ twenty three years of that I was enlisted as a medic. Always wanted to go to PA school. There was always a reason I couldn't get there, and finally went to PA school, became a physician assistant. While I was a medic, I was a d kind of designated to be the medic on the first CST. When the CST civil support teams were first built, ⁓ I was the medic for that team. When did that start to build up? Really fought about in 99 and we were actually commissioned in 2000. But and I cut you off, what was the the impetus for that? Was that behind building out those CSTs? I you know what? I think the the the bombing of the World Trade Center right back ninety n 93, I think was something. And there was chatter about you know, ⁓ different risks and different threats from ⁓ really state actors. Right. We'll we can talk more about the kind of the lone wolf type of things, but it was more about state actors. So that was really the impetus. I literally had a colonel come up to me and put his arm on me and said, You're gonna meet my med. So I went active duty at ⁓ the civil support team is a 22 member full time National Guard team. So I was a medic for about two and a half years, went to PA school, ⁓ came back a couple of years later they said, Hey we want you to be our PA again. So I was the physician assistant on the team. left to do other things in the National Guard, came back as the deputy commander at the first civil support team. ⁓ retiring in two thousand fourteen, ⁓ I even though I was a physician assistant, I decided to kind of go in the hazmat direction. I I had been working with the Massachusetts hazmat teams while I was with the CST. They needed a deputy director because they knew the director was retiring in a couple of years. Became the deputy director and then I was the ⁓ Dec dep deputy director back in two thousand fourteen, director in two thousand sixteen, and retired in two thousand twenty-three when I started D Two. Yeah, and tell us a little bit about D Two. So D Two, I basically I what I saw was a gap between my the medical scene and the hazmat scene. In other words, that communication wasn't the greatest in the world. And ⁓ having both backgrounds, I decided to kind of combine them and ⁓ start my own ⁓ consulting business. So I not to say that I I don't don't train with hazmat teams in in that type of thing, but a lot of my work is with hospitals, healthcare facilities to try to get them up and and I use the word ready. Yeah. And we'll talk more about that, then just prepared. ⁓ so I do a lot of that work. Okay. And how do you find that gap at the level of the hospitals? Yeah, I I've done nearly forty, actually over forty assessments of hospitals, really in the New England area, ⁓ Massachusetts, Connecticut, and Vermont. And some of them are rural hospitals, some of them are large, larger or more kind of ⁓ you know level two, even level one trauma centers. And what we find is this, that everyone has the plans because you're obligated to have plans by joint commission and those type of groups. Right. The issue is this some will have a dedicated emergency manager, sometimes the emergency manager is shared between hospitals, but either way, most of those emergency managers are wearing several hats. So trying to so An emergency manager may get a grant that says, you know, I'm gonna buy this really great equipment. Who keeps the equipment up? Yeah. Who sees what's expiring? Who keeps the batteries, you know, charged? You know, I've gone into different hospitals where, again, great equipment, batteries are still in the box for the Pappers. You know, that type of thing. That, you know, so prepared is having the plans, having the stuff, maybe even having the staff. Ready is does the staff even know that they're on the in the plan? Are they trained to actually do the work that they are said they're going to do in those plants? You know, is the equipment actually maintained? It's really funny you mentioned that just because on the fire side, you know, we've run into, especially as as we start to expand the scope of what the rescue does and the in our tech rescue side, and we talk to other communities, a lot of the times what you find is these construction companies that come in running these huge projects and the fire department is on their response car as the technical response seat in that. That department doesn't even know. That's a and it's that's kind of terrifying in a sense because where are those capabilities at? Yeah, we find it we've especially more in the in the small rural hospitals is they'll name that fire department as their decontamination team. I'm sure. And then during that assessment, we'll call the fire department. And say, Hey, did you know this? The fire department's like we have no idea. You know, so and we we talk a lot about interagency cooperation when we deal with these hospitals. It's more than just knowing the chief's name. Yeah. It's you've got to have those meetings. You've got to talk through. You've got to have them in your planet. You gotta build out the actual infrastructure of the planet. That's right. Gotcha. So we got your background. Did you always know that you wanted to do something in, you know, the emergency response management world? Yeah, I think it first started with medicine. So when I was when I was a kid, I was I played a lot of sports. I was constantly getting hurt. Yeah. ⁓ probably because I wasn't very good in clumsy. But either way, I was constantly getting hurt. Broken bones, stitches, sutures, that type of thing. So I I started watching the docs as they're fixing my arm or or put a tuition. I said, This is cool. I wanna do this. So I knew probably by the age of twelve, thirteen I wanted to get into medicine. And that's why I became a medic in the army. The emergency response stuff probably started with the CST. That really I thought it was the coolest team in the world when I was when I was first on it. And it took a lot of tride in that. And we we went through you know, school after school after school, learning not just C B R N and Weapons of Mass Destruction, but really emergency management. And that's when I think I fell in love with emergency management and and saw that connection between medicine and emergency management. Right. And you know, you've been through a lot of roles in your time. What what do you think taught you the most? Was it being the PA, was it the military officer, the emergency manager? What what was it that you're like, yeah, I I took a lot from that. Yeah, they every role. Yeah. you know, you learn different things. And if you're not learning them, why do it? But so ⁓ every role taught something. I think probably my role as the deputy and then the director of Hazmat and then Spec Ops for Department of Fire Services, I think it probably taught me the most because I was a military guy retiring, now thrust in charge of over 300, once I had Spec Ops, over 300 firemen. And it's a different culture. Firefighting in military is a different culture. ⁓ and they I think initially the team saw me as somewhat of a threat because I'm coming from the CST. CST they're saying, hey, they're gonna take our jobs and that type of thing and I had to convince them that wasn't the case. ⁓ so I think a lot of that and really as we talked a little bit earlier, just managing people. Right. You know, managing people and it's different from the military to the civilian side, obviously. Without a doubt. Yeah, in the military, I can just give it a lot. You know, ⁓ ⁓ I actually am very interested in hazmat. I I I'm a hazmat tech in a sense, but it's something I want to learn more about. When did you realize that it was something that you were passionate about? It's funny. So in the CST, you learn about weapons of mass destruction. You learn about CBRN. Yeah. But Overturn vehicles, that type of thing. Yeah. I had to learn that on the job as the deputy and then as the director because CST we that we're not a hazmat team. We're we're a C burn WMD response team. So ⁓ I think I think the passion began in the CST. I think it really truly grew with the Party of Fire Services. I mean, it's just again, we would go to some of these different calls and it was like, you know, you're you you can't learn about every kind. Yeah, you yeah, so you're literally doing science on the scene. And it's ⁓ it's amazing. Yeah, it's very cool. And yeah, I travel a lot and I talk to people in the hazmat community and they have a lot of respect for the Massachusetts hazmat system. How how did that become sort of the standard? Yeah, what went into that? So it's unique. So we're a state s system. Most if you look around the country, most systems are more dedicated to a CIF or or or an area. We're a state sponsored team. In other words, the the the state ⁓ pays our salaries. Pays, you know. So basically in Massachusetts, there's six hazmat teams, 45 guys per ⁓ team. All six teams are trained in the same way. They're equipped in the same way. That's unique. And I think that's what a lot of people they'll they ask, how did you do that? Well part of it is ha you know one being sponsored by state, having a brand I mean I can never really complain about my budget, even though I would complain when I was on the job. You know, we had a good budget. We weren't really hurting for any piece of equipment. So I think again, that was new. That was new to when I started talking to other states, that concept was new to them as far as states were 16. There's very few of them in the in the country. And as far as budgeting goes, obviously it's hard for, you know, state entities, municipalities to to budget stuff. When it comes to the hazmat sign, how important is that budgeting and do the stakeholders really understand what they are you know, what they're actually funding and why it's important to Yeah, then that's that was part of my job. Part of my job was to give it, you the fire marshal is a hazmat guy. So it's, you know, how do you convince the fire marshal to spend all this money on just in case? And that's what hazmat is. It's just in case. You know, we would spend money on different types of equipment that would expire it. So in two years I'm throwing up hundreds and thousands of dollars of equipment. Well I'm not throwing it, other years of training. But Either way, it's a constant budget. It's a co it's constantly eating up the budget. So I would go into the fire marshal and say, Hey, I'm looking at this new piece of ramen equipment. He'd look at like, Yeah, ramen is news. You know, in other words, yeah. So he you know, it's really explaining why. And you know, just like any other job, I'm fighting for the same dollars as four or five other divisions in Department of Fire Services. So but Again, I have no complaints. I mean, I had a good relationship with the fire marshal who happened to put Peter Ostrovsky at the time. Yeah, John Davins new fire marshal. John was one of my hazmat and jader guys. ⁓ wow, okay. Yeah. So ⁓ but yeah, it's it's really convincing them of what could happen. Right. I I I remember talking to them about fentanyl and the potential of fentanyl being used as a weapon. No so we were responding to fentanyl because ⁓ initially firefighters in Cops were afraid to deal with the fentanyl that they were finding in the streets. Yes. You know, overdose you you get a bunch of white powder in a hotel or in a restaurant. ⁓ I remember going to the calls. So those the early times. Yeah. Yeah. And and every you there was a lot of misnoise. If you touch it, you know, you you you're gonna die. If you were in the same town, you're gonna die, you know, that type of thing. So a lot of the hazmat ⁓ division's job was to go out and teach. To be able to sh tell people, hey, that's really not the case. But convincing the fire marshal that Fentanyl or car fentanyl could be used potentially as a weapon disperse over a crowd. You know, they're looking at me like I'm crazy. And as a matter of fact, ⁓ it was it it was really kind of a new concept until the FBI, I think in 2018, came out and said, Yeah, this was this was the real potential. That's ⁓ it it's just fine you bring that up because I remember one of my very first we had the early lesson on fentanyl. I think we had a call literally that night into the next morning, and it was just like the scene came to a standstill. It was a tiny amount. Exactly. I think we we had no capability to to deal with that. So we could call, you know, whatever neighboring city Zodie over. And now we walk into a scene and look at it and you're ⁓ there's Venom. Yeah. I think time has obviously, you know, watered that down a little bit. But also, yes, the lessons of what actually happens if you come into contact. That's right. ⁓ on the rescue level, the big thing we talk about is building teams and capability. And obviously, you know, tech rescue hasn't had those low frequency, high-risk events. In training, how do you keep teams ready for those events that we as we discuss might not come for years and years and years, but you have to be ready for it. It's it's difficult. I mean i you know because as you just said what if people what's the chances of this happening until it does. And so really I think one of the techniques that I would use is I would, you know, we would do case studies and show when it did happen. That hey, you know, this you know ⁓ East Palestine, Ohio didn't expect that day. But it happened. ⁓ you know, old you know, ⁓ Bhopal India. I mean, things happen. So you show the the events to your team members, but it is difficult because you know, you've got all this equipment, you've got all these scenarios. How do you train on? It's it's you know, they gave me one day a month for each team. How do you train a team with basically twelve drills a year? I I likened it to when I was in the National Guard. And I was full time in the guard most of my career, but my part of my job was training the part-timers. How do you train men and women one week in a month, two weeks in the summer, to go to war? Yeah. It it you know, it's it's that type of thing. So I kind of took that attitude and that the way we used to train the National Guard to train some of the hazmat techs. You know, I I remember going to some drills and they drill on one subject for the whole drill. Yeah. And people be in the back of the room and half of them be snoring and you know, it's just and so one of the things that we instituted kind of was this round robin way of training where rather than doing one type of incident per drill, we do four or five. So now you're splitting the forty-five gaps up into in women up into nine different groups, ⁓ or or five different groups of nine, and they would do round robin. You know, one might be how do you use this piece of equipment? Secondly, is okay. How do you, you know, whatever type of technique that you're thinking about, you would just try to build in as much as you possibly could in that day. ⁓ or keeping engagement. Well, that's the other thing. It's it's it's again, when you have forty-five people just doing one task, 40 of them aren't involved. So that's every training. That's every fire service training training ⁓ for even yeah, military, that's an aside. On the tech rescuer has met side, you know, in a leadership position, how do you make decisions when Sorry, every option carries a risk. Yeah. It's, you know, I think I learned that in the military. I mean, everything you are training for has some risk. And the whole idea is one, if you can mitigate that risk beforehand, and that's in training, try to mitigate as much as you possibly can. And then ⁓ look it, everyone puts that uniform on, whether whether it's military or whether it's firefighter, police, they put that uniform on knowing that they are assuming risk. My job as a leader is to try to lessen that risk as much as possible, knowing that I'm sending my people into a risky environment. ⁓ having the right equipment, having the right training, building confidence in muscle memory into those people. So, and again, this is one of the ways I define ready versus prepared. Ready is when you build muscle memory into s into doing these tasks. So Doing the tasks aren't taking up mental space. Now you actually have that mental space to make decisions, have more situational awareness, instead of worrying about am I putting my boots on correctly. Yeah. Yeah. Yeah. And you've right, you've stirred something in my memory in that. And I'll I'll come back to I think I think it was on the the decision side is you know, I I thought about that as a young officer in the army too, is you know, making the right decision, making the right decision. I think what I eventually came to was just make a decision. Huge. And it was like that was sort of a light ball bummer's like. You're f you're sort of floundering, ⁓ my God, like is this the rain thing is like that the indecision is what will eventually You're absolutely right. So one of the things as part of what I am doing now with some of the hospitals is when we run a drill, yeah. I mean, am I looking at some of the skills and all that? Of course. But really, ⁓ I'm looking at the first eight to ten minutes. In other words, in that first eight minutes, how long did it take you to actually make that first decision? How long did it take you to actually Call for notification. You know, you know, what when was the first protective action actually called in? You know, and when there's that dare in the headlights with the leader, again, there's that gap, and that gap is when errors occur. And then when errors occur, they tend to cascade. One error leads to the next, to the next. Yeah. I think it goes back to the training, but even on the military side, I think that and it's that stress inoculation that will break through that in eventually. That's right. After the after all that that training. But it's building muscle money. Exactly. It is. Exactly. How do you build interagency trust or capability before a disaster? So again, I was lucky enough to be on the civil support team where we our job, we were the new guys in town. So our job was to actually build interagency cooperation with the CST. So I knew a lot of the players in Massachusetts anyway. But really what it comes down to, you know, if you're a if you're a a response agency or a business or a hospital, is to actually have your players in the building. Not just a call every so often, but actu you know, meet with them over coffee. Yeah, I always say, if you want to have a meeting, have food. People will come. You know, invite them for lunch. So, you know, in lit in you know, it doesn't need to be it shouldn't be at the time of the incident. Yes. It should be beforehand where you're actually talking, meeting. You know, and and it's you know, have that person in your phone really on speed dial. And they should know who you are and you should know who they are, what the capabilities, not just the capabilities of what they're going to do for you. Yeah, I I mean, look at we trained for the Fourth of July. We trained for the Boston Marathon. ⁓ you know, large events, first night in Boston. You know, so those type of things, it's a lot of moving parts. You've got to be working with your interagency partners well in advance, which Boston Marathon. But marathon's over in April. Our first meeting, I believe, was in October for the next year. We're training for the following year. So exercises, that type of thing. Yeah. No, it's that's incredibly important. ⁓ and that's why I even on the tech rescue side, it just happened to us. I if a crane goes up in our town or neighboring town, I usually pop over and say, Hey, how you doing? We're the local rescue team. And I happen to pop over one and said, Hey, you know, we'd love to train here. ⁓ it was getting to be winter time. I was like, I'll contact in the spring, like, you know. And the guy was like, Absolutely, that's sure. I was away at a training on a weekend. I get a phone call at eight AM on a Saturday and they're Hey, there's some guy hanging from that crane. And I was like, on his lanyard. And I remember I was like, ⁓ my gosh. And Long story short is they there were some workers on scene that actually saw him, they pulled them up. ⁓ but I got home from the training and I I emailed the site manager. I Hey, you know, I heard everything. I hope hope the guy's okay. And he said, Yeah, I expect to be here for me. He's like, We'll get you over here and start training. Yeah. It's just it's no I think those relationships are very important to building that trust that when you actually your two agencies actually do meet up, there is that shared trust. And I've seen it on the sort of the FEMA side or the state response side. What's amazing to me is, you know, if there's a flood in somewhere in North Carolina. They will call like Vermont Task Force directly because they have that relationship. That's right. And to be like, hey, get on the road. We don't know what's coming, but get on the road. It's like anything else. You you're gonna call for people that you trust. And to build trust has got to be that you know, the that building of the trust, those prior meetings to actually build it. The last thing you want to do is to be calling somebody you don't know and saying, Hey, can you do this? And we got a problem. We a pro it's ⁓ talking hazmat. How has the threat, the landscape of of you know, the hazmat threat changed since your time from the CSD? To the stable. Yeah, I think as I s said, the CST when I was first learning UMD and CBRN, it was really aimed or targeted at state-sponsored events. In other words, you know, ⁓ you know, whether it was a foreign country that was going to launch, you know, an anthrax or something like that. So we did a lot of that. I think it's really in the last probably 10 to 15 years, things have kind of pivoted towards that lone wolf and not necessarily from another country. Right. May have been indoctrinated by somebody from another country. But now look at th there's so much out there, the different ⁓ magazines that are out there online, what they're doing is they're targeting usually kids between fourteen and say twenty-five. You know, they're on their gaming ⁓ systems and as they're talking to them, they're literally indoctrinated. And ⁓ So we're seeing a lot more lone wolf threat. Not to say that the state sponsored threat isn't something that's not considered, but it's really that lone wolf, you know, maybe small cell type of thing, ⁓ in this country. Yeah. I think it's amazing to think Yeah, not so long ago the biggest start was probably a nuclear bomb. From a aggressor state. And now we've come all the way from the spectrum to this one lone person. Yep. It's like It's incredible to think. I still say, and I I've actually done a lot of presenting on this. And I when back in two thousand sixteen, seventeen, when I first started presenting this, I'm talking about fentanyl and carfentyl as a weapon, people thought it was nuts. And and now it is like I said, it's considered a a serious threat. To me, I've studied anthrax, I've studied somen, sarin, ⁓ dirty bombs. They're all threats, but I can't get anthrax, a soma, or sarin in the mail. Yeah. I can literally order a kilo of carfentlin right now from the dark web. And it's not hard to get in the dark web. Don't go into the dark web. But I'm just say I'm just saying you can order it. I can have it on my doorstep in less than a week. That's crazy. And I can disperse that. I did it in ⁓ a mod back in 2018 there's a large exercise in Massachusetts, five different locations. They put me in charge of the Joublette Stadium location for this exercise. And I did a a release. of car fentanyl over the waiting crowd. Not even the crowd in the city, but waiting crowd to get in. But eight thousand people. One kilo of carfentyl released by drone over the crowd, you're talking nearly five thousand deaths. That's nuts out of eight thousand people. ⁓ so when I when I first did that, I was kind of told to keep that in my pocket for a while. Sure. Yeah, yeah, because there's no answer. Well, so this is eight twenty eighteen. That's what, eight years later? I think there's really no answer. I think the obviously the drone anti drone technology's gotten there, but back then that was Yeah. But the drone the drone was only out for fifteen seconds. Yeah. So Yeah. Yeah. That's that's terrible. Exactly. Yeah, keep that in the back, clock it. local local responders, how should they approach weapons of mass destruction or hazmat preparedness? You know, I think I think responders are taught response in general. So I think, you know, ⁓ To your concentration on training is obvious. But know that you have your expertise around you. And this is where that interagency cooperation comes in ⁓ comes in. As a firefighter, as a as a police officer or EMS, you don't need to know the nitty-gritty of WMDs or CBRN. You have people that know it. Your hazmat teams, your CSTs, they've their job is to know it. That's where getting to know those people, having them on speed dial, really, that's what that comes in. Yeah, I I mean, obviously around here it's a great asset to have short sort of in our back pocket. The push that I saw for our rescue was to get as many hazmat techs as possible just because the recognition of the the first five to twenty minutes when you go on a scene somewhere, the to understand and just to be like, Hey, this is above our level. Sure. Or in obviously not to get yourself killed. That's right. I think that's and that was important to me to be like just that base level capability. We don't need to be doing the field science. There's a few people that can do that. That's right. But it is protecting ourselves and you know protecting the rest of the crew. That's a great point because the whole idea is knowing how to protect ⁓ your people and the public initially. That's yeah. If you've done that, yeah, you've really done your job as a fighting fighter EMS call. We get it. Yep. I I I like the crossword with the military and to the civilian side. Like I said, two obviously dynamic and different environments. But what military lessons do belong in the the fire sharper side? I I think I think this I think, you know, there's a lot of times when it's like, really do we have to do this training? It's but, you it's raining now. ⁓ you know, with the with the line in the army. If it's not raining, it's not training. You know, but you know, it's it's it's doing the things that you really maybe don't want want to do and getting them out of the way to be able to put that in your back pocket in case something happens. I think that's what the military taught me. Now the other thing is leadership. Now how do you convince the people that you're in charge of to do that. Not everybody has the passion that you have or I have in in a certain thing. But they're still doing the job. How do you instill that passion into people at least temporarily to get that training done? Exactly. ⁓ I it's and I think that's why there's a billion podcasts on the same thing. Everyone's I think for even for myself personally, coming from the the military side, it was a very sort of rough transition. Just Going from being in charge of two hundred and fifty people where yes, you say whatever it happens, that's right. And now you enter this I know they call it paramilitary, there's nothing paramilitary. I like that one. I'm I'm glad I'm glad you have the second. Yeah, I it just it's paras I say it's parasump I what it is, I don't know yet. But it was just it was a learning, ⁓ it was a learning street. It is it is it is a learning curve. Yeah. We're working on that too. ⁓ so disaster the disaster medicine side, how has that sort of changed your perspective from what you've seen? So Disaster I I look at. I think I've learned disaster medicine ever since I was in the military. I mean, what you know war is the ultimate disaster. Exactly. So you're you're training for that disaster while you're in the military. ⁓ I was lucky enough about six years ago, actually I did one of my presentations. Somebody had seen that. There were faculty, adjunct faculty with the ⁓ disaster medicine fellowship out of BIBMC, Harvard B. I DMC. And I got a call saying, Hey, can you give that presentation to our fellows. Every year they bring in a group of international doctors. They train them in disaster medicine. So I gave the presentation and afterwards I got called in the their office and saying, hey, how'd you like to be adjunct faculty for the fellowship? Great, because and actually now I'm core core faculty. So which is phenomenal. But either way, that's ri what I when I really learned much more about disaster medicine. You know, here are these mostly physicians, but some nurses and other ⁓ jobs That are spending the year learning disaster medicine. I would I'm able and still able ⁓ to learn from a really good friend of mine who's actually calling, kind of known as the father of disaster medicine. His name is ⁓ Dr. Greg Sigato. Well, Greg is he's my butt. He was just with him the other day. So he he runs the fellowship and I'm learning so much from him as far as disaster medicine. I'm near Seaburn piece, but I learned so much more. ⁓ sure. Like on the technology side, what I find is interesting is we train so much for The rescue or the extrication, but there's still sort of that the gap between the medicine side and the actual rescue side. How important is that? Yeah, is that huge? That's why I started D2. That's why I started D2 EMC, really. One of the things that I that we notice, I say not I, what we notice in hazmat is that oftentimes the hospitals have no idea what's going on. And you got people that'll self-present, and now all of a sudden they're trying to figure out what am I dealing with. Prime example is the Tokyo Subway attack. Right. So one of the things that we started doing, and ⁓ deputy Gallagher, ⁓ Kevin Gallagher, Donald Brockton, ⁓ is one of the people that kind of got this going, was we started to pilot something called the Toxymedic program. So basically it's paramedic level, hazmat techs. When there's a large event, and this is down in District One, the kind of the southern part of Massachusetts, southeastern part, we would immediately send a hazmat tech paramedic level. To the hospital to be the conduit between what's going on in the field and what's actually what the hospital should be expecting. Now, they're not giving them treatment protocols or anything like that, unless they're asking. But really, it's kind of like, all right, you know, how what kind of type of decon should I set up? What type of PPE should I be using? What type of symptoms might you be seeing? It's just really kind of loading that ED up to to to be ready for what they're gonna see. Is that program still in so I I hope. I I don't know. I know that we started it in in Massachusetts. It's something and we look at there's other states that do a toxic medicine ⁓ or other hazmat teams. I'm hoping that they continued with that because it is what I'm noticing now in my surveying job running D two is it's still a major issue. ⁓ you know, people think, okay, there's an incident, they're gonna be deconned at the scene, and then they're gonna be driven to the hospital. That doesn't happen. It can happen. Yeah. But people aren't going to wait for a decon line to be set up. if they're able to transfer themselves to the hospital themselves. So people are going to self present to those hospitals and hospitals need to be ready. Yeah. And that's what I'm trying to teach hospitals. Yeah. Understood. Where's disaster medicine heading? What do you see in the next, you know, from your friend Nathan? What do you ⁓ yeah what do you see the future of it? Again, I think I think a lot of the the less of the state sponsored, although you see, I mean we've got wars that are going on right now. So what's a concern? But more of the the lone wolf type of things, you know, ⁓ that those people being indoctrinated, you know, a lot of people, you know, whether you agree with the government, don't agree with the government, have issues. So and they and they find ways to express you know their their their issues. I think that's one. The other things are some of more of the I call ⁓ simpler, if you want to call ⁓ that, type of devices, you know, you're seeing a lot more fire as a weapon. People are building ⁓ you know, Molotov cocktails. I think that just happened in New York. Yeah. Some student incendiary bomb and stuff. I forget the buildings. Yep, yes. Exactly. And what they're doing with these Molotov cocktails oftentimes is they're actually putting things like styrofoam or something or waxes inside of them. So when it gets on you, it sticks. Yes. So that's one thing. And that's something, again, that's learned in some of these magazines and online type of thing. The other thing is simple binary devices where you'll take a chemical here, chemical here, you put it in a PVC PVC tubing that has some type of a valve in between. So Safe on this side, safe on this side until they mix. Turn that valve, release it onto a whether it's a subway, whether it's a building, that type of thing. So that the you know, they're teaching. The other thing to really be concerned about, and and and probably should have got to this earlier, is there are really, really dangerous chemicals around us every day. Yeah. You know, carried on the rail system, carried on the roads, you know, that type of a thing, you know. That in itself, if somebody were to target those, is a major incident. You know, it's it's one of those things where I think it's it probably should get more attention from fire departments, hazmat teams. You know, what's in your community? Right. Hazard assessments. Hazard assessments, exactly. You know, ⁓ tier two reports. You know, in Massachusetts, each chemical company or each company is supposed to give a report on what they carry ⁓ if they're carrying a certain amount. It's a requirement, but it's not a stringently required. So You know, it's you know, pushing those type of things, getting to know, you know, what's on your you know, what's on your rail systems, you know, what is traveling through your city, yeah, you know, every every day. Yeah. And it's just it's being alert and aware. How do you how do you think a again, a small department or a department that's not really vested in, you know, chasing asthmat, how can how can an individual affect that in a department? That's that's what we try and crack, like right? Like, how do you build capability in places that don't have the capability or don't, you know, they're not the environment to build the capability. How can one person start that? Yeah, no, I think just what we were talking about, knowing what's in the community. So you know here I am a hazmat tech coming from a different community, coming into your community. If you're telling me because you know that building, hey, we know they have X, Y, and Z in this building, that's going to help me out immensely. You know, so it's it's really the outside teams relying on those people in the community for that information, yeah, it would be huge. I I what's interesting is Summerville has had a proliferation of lab design. And I think a lot of the Metro Boston probably has. And what I try to do when a new lab will come on is just obviously go, well the department will try and go to walk through, ⁓ which is always good. And I've tried to get with their safety managers to be, hey, let's run a drill. Sure. And that's that's always eye opener. A lot of companies are open to it. They are. Yeah. If you if you actually approach a company and say, hey, you know, we want to work with your staff, build safety. We we did a number as it has met a team, we did a number of drills in big chemical companies. Yeah. Which again, we learn about the company, they learn about our capabilities. It's it's a win-win. Yeah, and what I found was interesting is obviously it's it's beneficial for and beneficial for them, but there's usually something inside that company that they can use to satisfy whatever safety feel like, hey, we have this new app that tracks everybody who's checked into the building. Yep. So now, you know, this emergency is declared, we can send out an app saying, Has everyone left the building? And they're like, hey, so and so it was last seen in the bathroom. They're not checked out. But it's one thing having the app. It's another thing actually using it real. And that was it. To see if it actually works and see how effective it is. That again, I keep on going. Compared this is having the app. Everything using it, using it and seeing if it works. That's readiness. Yes. ⁓ you know, people don't even realize, you know, we've got you know, th we've got small nuclear nuclear reactors. Yeah. With within towns. I mean you're t there's one in Boston, there's one in Lowell. I you know, I mean I'll that's not classifying the brands. But you know, know that. Know what's in your town. Yeah. Yeah. Yeah. And how to respond to that. How do yeah. ⁓ on the D two side, you know, when did you when did you launch it? ⁓ back three years and a half years ago, two thousand twenty three. And through that and through the work you've done with the hospitals and hazmat, what are there s any trends that you see that sort of stick out to you? In the hospital specifically, ⁓ the one the biggest gap. So we look at we look at ⁓ five different areas, but the biggest gap that we see is training. If especially if you're talking specifically C BRN, very few hospitals have actually done a C BRN through. But we don't look just at C BRN, we look at surge and we look at all those different things. It's it's it's training. Secondly, it's actually having a dedicated DMT. In other words, you know, again, the plan says this is What's going to happen in the response? Well, who? Yeah. You know, ⁓ it could be the additional duty, the dreaded military additional duty that someone gets. It that's exactly what it always is. And you know, no I mean, very like I said, you might have a dedicated emergency manager. That's the only one dedicated to emergency management. Everybody else has other jobs. You know, the the one thing that we try to teach again in the hospitals is it doesn't have to be and it shouldn't be all clinical people on your emergency management team. In other words, if I'm setting up a decon line. I can have my facilities people, I can have some of my admin people, I can have some of my security people setting up DCON or so or doing whatever you know, these these other tasks. ⁓ I only need one to two clinical people on that decon. Right. You know, and I see a lot of hospitals, their their PM team, emergency management team, is mostly clinical people. It's like you're wasting your clinical and where do those clean people go in the back end? That's exactly if you could improve preparedness nationwide, where would you begin? As I said, it's building that muscle memory and the tasks that need to be completed. You know, a lot of people get intimidated by exercises, whether it's a tabletop or functional or a full-scale exercise, because it takes a lot of planning. One of the things that we do in D2 is we try to teach what we call micro trainings. You know, whereas, you know, today we're going to sit here at lunch, our change a shift, and the only thing we're going to do is we're going to put on our pepper. You know, and Get that out of you know, and so now I've got people that are comfortable with doing that. Next time we're gonna set up, just set up, not even run, just set up the decline. That's an amendment stuff. It it is, but I mean, trying to instill that as part of a larger exercise is more daunting. So, you know, just I say it taking that, you know, that that forty five minutes to an hour. to actually do those micro trainings. And you know, if a hospital wants that, we'll work with them and actually create a 12 month calendar as far as or even 18 month calendar as far as how do you get on in these different tasks to build in the skills to that as I said before, now if these people are comfortable with those skills, now their minds are free to actually do some decision making. Yeah, it makes sense. Rapid fire questions for you. Sure. And we laughed about this earlier, but the most underrated hazmat skill. Yeah. Most underrated hazmat skill. So underrated is the simple papers. You know, pH paper, F paper, K paper, you know, those different things where I'll tell you what on it on a decon line or even walking into a building, if I've got a piece of pH paper, a piece of dry and a piece of wet pH paper, I walk in, I'm gonna tell if I'm an acidic environment, a basic environment, or I don't have so much to worry about. You know, it's sit the it's really getting back to the basics. The the the the you know the you know, cool whiz bang, you know, this technology. And believe me, we had it all. Well, and so that runs into the most overrated piece of equipment. Yeah. I think so I don't I I wouldn't call I wouldn't call anything so overrated. I'd say over dependent. You know, ⁓ so, you know, we you know, we had things like GCMS, gas mass spectrometer. We had high pressure mass spec. We had ramen. You know, we you know ⁓ I mean you name it, we had the technology. People got so dependent on what that machine said versus what does this say? And you know, it's i I I I again coming from the medical background, I liken this to the it being a ⁓ physician physician or a clinician in general. Somebody comes up to my E D, the lab tests, x rays, MRI, C T, they're all important. But I still have to make that clinical decision based on my clinical skills. Right. It's the same. Hazmat you were taught hazmat for a reason. If why teach hazmat if I can just rely on the machines? That's what's presenting you the information. If it's even presenting it correctly. Right. So in other words, is that ⁓ is what that machine saying is that does it make sense here? And that's really, I think, probably when I say the most overrated, is dependent on the higher level technologies, because there's a ton of them out there and being less dependent on my own. Hazmat or clinical skills. ⁓ it was one of the hardest lessons you ever learned, whether it was leadership or what was something that that stuck with you. We kind of touched on this before is you know, here we are. We we yeah, we're talking about them and we're and we're getting all kind of jazz us about this. Not everyone is. Not everyone's as passionate as you or me about half or about whatever. I mean, you know, maybe their passion is, you know, horse riding. Whatever. So again, this is the definition of leadership. Leadership is getting those convincing those who may not want to follow to follow and that's it's it's you know that there are that's a it's an art and it's a science. And and you know you'll read all kinds of leadership books, but I'll tell you what, you gotta build your own way of doing that. And I think part of it is is letting you people know that you've got the backs, letting you people know that, you know, you're not you're not gonna throw them under the bus. You know, as you build up the trust, people will run through a wall for you. But that takes time to build. Yeah. Exactly. And I that's one of the hardest things to build, especially when there is kickback, I think. And there's always, there's always going to be those people that, you know, and I it's a really good point. One expect that. Yes. Don't be in other words, if you've got somebody that's kind of going against the grain, don't don't be surprised by that first. Secondly, don't let it go unaddressed. Bring that person in. Have a discussion with them. Not to say you need to agree with them. Have that discussion with them. If there's time. Yeah. If there's time. I you know what it sort of is interesting too is talking to people all around. It's like obviously there's so many high-end elite, tr ⁓ trained units out there. You still find those people in those units. Of course. And that's to me, that's incredible. It's human nature. Yeah, with so so there's a I used to have this sign on my desk where it's, you know, ten percent of your people are gonna cost ninety percent of your products. And that is s I have never found a more true statement. It is Absolutely. I thought you I thought you were gonna say ten percent of people are gonna do ninety percent of the work, which I also think is true. But then there's the flip-up side of it. Yeah, yeah. Yeah. That's closing question. Yeah, you've served at all these various levels. What separates organizations that simply respond to emergencies from those that are truly resilient and ready to respond before that event even happens? ⁓ again, and this i this I'm going around wherever I I'll be heard talking about that preparedness versus readiness. And I think what separates is that concentration on small teams training to build into larger team training. And and it's it's building up that builds confidence in your people. It really it's again you know, everyone has to have plans. And plans I'm not saying plans aren't a good thing, but you gotta practice those plans. There's a saying better the planning than the plan. Yeah. And it's you know it's the talking about it. Yeah. It's the experience of planning where you're getting that knowledge where you're getting that experience. You know, and then the plan is done fine. The plan is great. But it's actually the planning process that you need to get people involved in. Yeah. You guys just ran a large scale event out at We did. What's the ⁓ what's the plan for next year you guys? Yeah. So ⁓ I think I can put this out. So if not we'll go back. No, no. So I think so we did active sh vehicle ramming, then active shooter event at Polar Park. That was back in June. The disaster medicine fellowship that I'm involved in, the capstone project for those fellows is to do a tabletop and then a full scale exercise. So last year was Polar Park. This year it's going to be at six flags. ⁓ that's awesome. Which and ⁓ we're still working out all of the details. We had our first meeting about a month ago. And ⁓ yeah, so we had about four hundred people, maybe a little bit over four hundred people. I can't tell you how many agencies involved, and it'll be bigger this year. Well, you know, hopefully the rest of you live can come out and document it. And I'd we'd love to have you. That'd be awesome to check out. Well hey, I appreciate your time. No, I thank you so much for having. No, I th ⁓ I like to say at the end of these, I feel like we solved all the world's problems. Yes. Until we step out that door. Yeah. Okay. Let's talk a little longer. Yep. That's we'll just do another tape. But this isn't the end. We'll we'll see for sure. We actually have some interesting news that we're we're working on. ⁓ Me you. Me You and I. Yes, yes, yes, yes. Yes. And that will ⁓ that will come out later, but I appreciate you stopping by. Appreciate it. Thank Yeah. Thanks for listening to the Rescue Lab. If you found value in today's conversation and want to help strengthen the rescue community, Consider supporting the New England Rescue Collaborative Foundation. Every donation helps fund technical rescue scholarships, training opportunities, and educational incentives that prepare rescuers before the next call comes in. You can learn more or make a tax-deductible donation at NE Rescue Collaborative. And one last favor, if you enjoy the Rescue Lab, the best way to help us grow is by leaving a five-star review on your favorite podcast platform. It helps more rescuers discover these conversations and keeps us bringing you stories and lessons from some of the world's best rescue professionals. Until next time, keep learning, keep training, and remember, no one else is coming, it's up to us. I'm PJ Halloran and this is the Rescue Lab.