The Ripple Effect of Trauma in Medical Practice and How to Dampen the Wave

Abstract

There is no doubt that practicing medicine today predisposes physicians to a tsunami of mental and emotional health issues. Certainly, there are predictable causes of stress that come from deep concern for the well-being of patients and there are added demands of time constraints, complex charting, burdensome bureaucratic tasks and more. Additional events that can precipitate traumatic stress reactions in even the most seasoned clinicians include medical errors, patient deaths, and increasingly, rude or violent reactions by patients or their families. Simply witnessing a cardiac arrest in the emergency room can be distressing for some. More covert trauma might come from leadership demands or organizational requirements that restrict one from providing the quality of care they believe in. This form of trauma leads to moral injury—the sense that one is violating their moral code. For female physicians and those from minority groups, micro-aggressions and subtle or overt signs of disrespect can wound and contribute to an ongoing cycle of trauma. The aftermath of such experiences may include grief, psychological, emotional, physical, or spiritual distress, rumination over the event or flashbacks. However, one’s response to trauma can be purposeful and allow for personal growth. Not everyone is traumatized to the same degree by a given event, but we all experience suffering. Over time droplet- sized traumatic events and other stressors add up, leading to the familiar symptoms of burnout—exhaustion, cynicism, a loss of sense of self and feelings of ineffectiveness or lack of accomplishment. However, one’s response to trauma can be purposeful and allow for personal growth. This growth is as much about how we manage suffering as how we help others walk through it.