Wow! Terrific writing Amy! 👏 When I was training to be a clinical psychologist back in the 1970's, I never heard the word "trauma". As I have come to understand that concept better over the last 15 years, it has transformed my understanding of human beings and their suffering/pain. If one has their own trauma compounded by their professional training, well what would we expect? Exactly what you have written so well about here.
Thanks Baird, I really resisted describing my experience as traumatic for a long, long time. In part, because I felt like the word should be reserved for like war and violence (and maybe it should, but then we need a new word for the less severe traumas), but I think that was also a way of diminishing my own suffering as a way to avoid feeling it too.
I agree that "trauma" can be overused. I'm a fan of precision in word choice too. The notion of cumulative trauma is useful, as is vicarious traumatization which emergency medicine docs like you are at special risk for. Or we can just call it "suffering" which is the truth of it.
I am so glad you wrote this and sadly, it makes perfect sense to me, and mirrors a lot of my own experience. I hope others in healthcare find this and normalizes what they might be experiencing.
Thank you Christine! I suspect traumatic stress in the chaplaincy and social work are probably the highest in the hospital because you are more inclined to go into the depths with people and I tend not to call a chaplain unless it’s going down for real.
“If it was an expected and compensated part of your job, yes”
This is so much of what I see too. We don’t stop because we’re not paid to stop and the to-do list never gets shorter because we need a break. We seek help only once things have gotten so bad that there’s no ignoring it anymore, and even then it’s considered “time off” when the main reason we need the medical time off is because our jobs ask too much from us all the time.
This is true for people doing far less consequential work than medicine. What will it take for us to stop trying to pretend we are machines? To stop thinking of time as something to fill?
Amazing and enlightening post, Amy. I’ve often wondered the types of things you’ve endured as an ER doc. I can’t imagine having to get back on my feet and perform after experiencing what you describe here. Thank you for writing this down. I have nothing but empathy for what you have experienced.
Thank you John. I'm glad it struck a chord. It's hard to put into words, but I am experimenting with different ways. I also think most of us need more connection and support than we get or hang onto things more than we let on or sometimes even realize. I have been thinking a lot about how we can support each other in integrating our pandemic experiences and how we lay it down or carry it together because it was definitely a collective experience.
Wrote a long response to this that disappeared into the belly of Substack’s poor editor. Probably better that way. As a medic in Viet Nam war I saw sensory maiming and death. I was able to leave the service damaged psychically but able to survive. I know that I’m not strong enough to survive what you experience.
And thank you for sharing your poem about stones. I think of stones as story carriers because of their presence over time, so I'm just kind of sitting with how that weaves with your writing.
Thanks for sharing your story Jim. I'm not sure anyone can really do what I do without armoring up so intensely they disconnect from life. I think that's a big motivator for writing about this is to call attention to the fact that even people who are “successful” in the field are really struggling.
Many physicist today are wondering if time is an emergent property. When I ponder this and Einstein’s idea or theory of space/time, I think of time in a different way. Therefore my idea of stones does not have a time dimension.
Thank you Bob, I’m sure that as an environmental regulator you have banged your head against the wall of a few nonsensical systems too. It’s hard to know where to turn next when your burnout leaves you feeling like what you do doesn’t matter. I appreciate the Arrested Development reference too :)
Wow! Terrific writing Amy! 👏 When I was training to be a clinical psychologist back in the 1970's, I never heard the word "trauma". As I have come to understand that concept better over the last 15 years, it has transformed my understanding of human beings and their suffering/pain. If one has their own trauma compounded by their professional training, well what would we expect? Exactly what you have written so well about here.
Thanks Baird, I really resisted describing my experience as traumatic for a long, long time. In part, because I felt like the word should be reserved for like war and violence (and maybe it should, but then we need a new word for the less severe traumas), but I think that was also a way of diminishing my own suffering as a way to avoid feeling it too.
I agree that "trauma" can be overused. I'm a fan of precision in word choice too. The notion of cumulative trauma is useful, as is vicarious traumatization which emergency medicine docs like you are at special risk for. Or we can just call it "suffering" which is the truth of it.
I wonder if the word trauma gained such prominence because we have such a strong desire to avoid suffering, the word and the act.
Good point Amy. I have the same opinion about our use of the cold clinical word "anxiety" instead of fear which is what the feeling is.
I am so glad you wrote this and sadly, it makes perfect sense to me, and mirrors a lot of my own experience. I hope others in healthcare find this and normalizes what they might be experiencing.
Thank you Christine! I suspect traumatic stress in the chaplaincy and social work are probably the highest in the hospital because you are more inclined to go into the depths with people and I tend not to call a chaplain unless it’s going down for real.
Yes, I often joke, no one ever calls us for the good news or the parties!
That's not a joke though :)
True. Although one time I told some nurses that and they did call me when they had cake the next day for someone's birthday! 🥳
“If it was an expected and compensated part of your job, yes”
This is so much of what I see too. We don’t stop because we’re not paid to stop and the to-do list never gets shorter because we need a break. We seek help only once things have gotten so bad that there’s no ignoring it anymore, and even then it’s considered “time off” when the main reason we need the medical time off is because our jobs ask too much from us all the time.
This is true for people doing far less consequential work than medicine. What will it take for us to stop trying to pretend we are machines? To stop thinking of time as something to fill?
This is a beautiful piece, Amy. Thank you!
Amazing and enlightening post, Amy. I’ve often wondered the types of things you’ve endured as an ER doc. I can’t imagine having to get back on my feet and perform after experiencing what you describe here. Thank you for writing this down. I have nothing but empathy for what you have experienced.
Thank you John. I'm glad it struck a chord. It's hard to put into words, but I am experimenting with different ways. I also think most of us need more connection and support than we get or hang onto things more than we let on or sometimes even realize. I have been thinking a lot about how we can support each other in integrating our pandemic experiences and how we lay it down or carry it together because it was definitely a collective experience.
Senseless not sensory above, sorry. Editor will not allow editing until some time has passed.
Wrote a long response to this that disappeared into the belly of Substack’s poor editor. Probably better that way. As a medic in Viet Nam war I saw sensory maiming and death. I was able to leave the service damaged psychically but able to survive. I know that I’m not strong enough to survive what you experience.
Stones
I will not leave the imprint
of my feet
into the stones of time
I will not tilt up
the stone monolith
reaching for the firmament
There will be
No stone burial marker
In the grass of the moment
I will be free
To not exist
Leaving no stones
And thank you for sharing your poem about stones. I think of stones as story carriers because of their presence over time, so I'm just kind of sitting with how that weaves with your writing.
Thanks for sharing your story Jim. I'm not sure anyone can really do what I do without armoring up so intensely they disconnect from life. I think that's a big motivator for writing about this is to call attention to the fact that even people who are “successful” in the field are really struggling.
Many physicist today are wondering if time is an emergent property. When I ponder this and Einstein’s idea or theory of space/time, I think of time in a different way. Therefore my idea of stones does not have a time dimension.
Thank you for replying. It helps alleviate my concern that I’m an interloper for you and your audience
Thank you Bob, I’m sure that as an environmental regulator you have banged your head against the wall of a few nonsensical systems too. It’s hard to know where to turn next when your burnout leaves you feeling like what you do doesn’t matter. I appreciate the Arrested Development reference too :)