The Trauma of Medicine
Trauma: we see it every day in the ED. MVCs, GSWs, stabbings, falls, motorcycles, assaults. How we handle trauma in the medical setting is systemic, it’s algorithmic. We do a primary survey, then a secondary survey; methodically assessing, evaluating, diagnosing, and treating. We look for trauma that can’t be seen with the naked eye: Ultrasound, X-rays, CTs. We recognize the trauma, physical as well as other forms inflicted on our patients. Yet we rarely recognize the trauma inflicted on ourselves. The trauma inflicted by medicine.
The trauma I am talking about can’t be seen with the naked eye. No ultrasound, X-ray, or CT scan can uncover the emotional trauma we are burdened with. The trauma of having a 16 year old patient with a GSW to the head that dies on the operating table with your neurosurgery colleague. The trauma of coding a patient for what feels like hours, only to have them never regain a pulse. The trauma of a 40 year old patient with a self-inflicted stab wound to the abdomen, an apparent suicide attempt. The trauma of the young toddler with shaken baby syndrome who will never regain full functionality. We see trauma every day, and it, in and of itself is traumatizing.
Yet we are never fully taught how to cope with it. Sure we are told “don’t get to attached” and “death is the only guarantee in life,” but are those really coping mechanisms? To further compound the problem we are desensitized in medical school. On the first day you begin dissecting a human body. It seems morbid initially. However by the end of the semester you are discussing how hungry you are, and putting together lunch plans… over a dissected body, a human body. The desensitization continues into 2nd year because God knows pathologists love to compare things to food. We have port wine stains, nutmeg liver, berry aneurysms, maple syrup urine, and the list goes on. Before we know it we are on the wards, witness to these daily traumas, but so desensitized that we don’t even have normal human responses to the situations we face.
It is no secret that suicide and depression are prevalent in the medical community. It is my belief that these daily traumas play some role. We have a front row seat to some of the worst parts of peoples’ lives. I would be remiss if I did not acknowledge that some level of detachment is necessary to do the job. However I often see it taken to unhealthy extremes, where empathy is devoid. Being detached yet showing empathy, it’s a tough balance. We walk a thin line. This balance however does not mean that coping and acknowledging these experiences is not necessary. It is our responsibility to set time aside when appropriate to reflect on these situations. We must give ourselves time to experience the full breadth of the emotions we have been suppressing. And if necessary seek PROFESSIONAL help. Studying medicine, practicing medicine…all of it is a gift. We get to go to work and save lives! But let’s face it, if it were easy, everyone would do it.