While I was in Fargo, North Dakota delivering my third TEDx talk (you can watch my other two here and here, I facilitated a community conversation about health care with Dr. Susan Mathison, founder of Catalyst Medical Center, who is also one of the doctors in my Whole Health Medicine Institute training program. The brunch was filled with doctors, nurses, energy healers, chiropractors, and empowered patients, and many of them have beefs against each other. You could feel the tension in the room, but you could also feel the capacity for love, for connection, for a long overdue bridge.
In the middle of the event, I had a massive epiphany (yet another in a week filled with painful but necessary epiphanies that are helping me refine my message and get clear on my role in healing health care.)
Here’s what I realized.
Doctors Are Traumatized
As doctors, we are traumatized by our training, the limitations of the health care system, and the very nature of what it means to be a doctor- to be on the front line of a lot of suffering- death, disease, disability, despair. We’ve had to come to work sick, we’ve skipped our postpartum leave and left our babies, we’ve had bloody scalpels thrown at us by physician professors who curse at us, and we’ve stayed awake to help others in 72 hour shifts. We’ve witnessed the deaths of children, dismemberment, and patients who die when we did everything we could to save them. We’ve gone through a hazing worse than any fraternity and similar to what soldiers experience. Yet people expect soldiers to have PTSD, but not doctors.
Having gone through all this, as doctors, it’s easy to get frustrated with the entitlement of patients and the disrespect of alternative health care providers who dismiss the often life-saving work we do, who don’t appreciate the sacrifices we make in order to do this life-saving work. Doctors feel unappreciated, devalued, and disenfranchised by a fractured system that has robbed them of much of the joy of their work, and that only amplifies the trauma.
Yet, as doctors, we tend to normalize the trauma. Every doctor we know has been through the fire, so we just think it’s an unavoidable part of the job. We think it’s our job to just buck up and keep going, not realizing that by failing to acknowledge the trauma and recover from it, by shutting down and closing our hearts, we are losing the very part of us that makes us good doctors.
Some doctors have done a great deal of difficult personal growth work to heal from the trauma of our profession. But most doctors are blind to the fact that they have experienced profound trauma. Those doctors don’t even realize they may be perpetuating more trauma because of their own unhealed trauma.
Nurses And Other Health Care Providers Are Traumatized
The nurses, nurse practitioners, physician assistants, midwives, and other health care providers who report to doctors are often traumatized by the doctors, who are so exhausted and traumatized and overworked that those who help them care for patients often bear the brunt of their misplaced anger. Psychologists call it “sublimation,” a defense mechanism whereby you suppress a socially inappropriate impulse and replace it with a substitute you deem to be more socially acceptable. (Your boss yells at you, and you’re not allowed to yell back, so you come home and kick the dog.)
But nurses are not dogs paid to get kicked by traumatized doctors who haven’t healed themselves. Nurses and physician extenders are healers in their own right, and when it comes to the art of true healing, they often practice it better than doctors.
Alternative Medicine Practitioners Are Traumatized
The alternative medicine practitioners- the acupuncturists and Reiki masters and homeopaths and chiropractors and naturopaths and energy healers- are traumatized by the disrespect of doctors, who tend to dismiss them as nothing more than quacks whose work is “just the placebo effect”. They practice their art and get results with patients, and then when the patient shares what’s happening at the alternative medicine practitioner’s office with the doctor, the doctor may even go so far as to tell the patient they’re wasting their money or that the treatment they are receiving is dangerous. In doing so, the doctor is disrespecting both the alternative medicine practitioner and the patient, who has chosen to see that healer because something in their intuition told them it might help.
The Patients Are Traumatized
The patients are traumatized by the doctors who don’t listen to them and who disrespect their intuition and the fact that they know their bodies better than doctors do. The patients are traumatized by the doctors who get pissed off if the patient questions a diagnosis or a treatment plan or if they ask for a second opinion. They’re traumatized by the doctor who walks in, makes no eye contact, and then delivers bad news without a lick of compassion or tenderness. They’re traumatized by having their autonomy disrespected when the doctor walks in and starts performing a procedure without fully explaining what is happening. Patients are taught to respect doctors and follow their orders, so it’s hard for them to speak up and ask for what they need, and when they do, they often meet with resistance on the part of the doctor, so they wind up learning helplessness and feeling victimized by the system. It makes it that much harder for the patient to be proactive.
Patients just want to feel loved and nurtured and respected by their doctors, especially when they’re feeling weak and sick and vulnerable. And yet, way too often, they’re getting traumatized instead.
The Trauma Is Systemic
I had a big a-ha in Fargo because I realized that when you gather together doctors, nurses, alternative health care providers, and patients, you have A ROOM FULL OF TRAUMA! Every other book tour event I’ve done has been the same thing. Our health care system is a TRAUMA UNIT. And nobody is saying “The emperor has no clothes!”
Standing up there in front of that room, I suddenly felt the gravity of what I was up against in my quest to heal health care. When Martha Beck helped me lead the first retreat for doctors in the Whole Health Medicine Institute, she told me she had worked with trauma victims across the world, but that the only people she’d ever worked with who were more traumatized than the doctors were Rwanda genocide survivors.
Here’s what you need to understand. Your doctor is traumatized and nobody is helping them, and their trauma is trickling down to the whole system. Many of the doctors have full blown PTSD for which they have not received treatment. I know I did- the nightmares, the flashbacks, the panic attacks, the chronic anxiety. I’ve done a lot of healing work since I left conventional medicine in 2007, but I still get triggered from time to time, especially when I’m with other doctors.
As doctors, it’s our responsibility to first heal ourselves so we can help others heal. And everyone else in the system needs to deal with their own trauma as well, so we can find middle ground and really work together in service to the patient.
How Do We Heal?
We can start by having compassion first for ourselves, and then for the trauma we’ve inflicted upon others. We must have compassion for each other. We are all doing the best we can as limited, imperfect human beings with egos and agendas and physical limitations and exhaustion and biases. But if we can find a way to feel compassion for each other, if we can acknowledge our shared humanity – as healers and patients- we can acknowledge and recognize and heal the trauma so we can do what we’re here to do- help each other heal.
Some have already done this work. In the Whole Health Medicine Institute, one of the three pillars of our program is the “Heal The Healer” pillar, which is aimed at healing the doctor. Others are doing this kind of work too, like Dr. Rachel Naomi Remen, who trains doctors and helps them find meaning in medicine. Much of the healing I’ve done around my own PTSD has been through a group of doctors who meet once a month at Rachel’s house. For the first three years of these gatherings, I cried at every meeting. Others cry too. We heal each other and Rachel loves us through it.
Do You Have Trauma You Need To Heal?
Not everyone has been traumatized by the system. Some have sent me wonderful emails telling me about their awesome doctors. And some forward-thinking integrative medicine doctors (like my friends Rachel Carlton Abrams, Mark Hyman, Aviva Romm, and Frank Lipman work beautifully in conjunction with alternative medicine practitioners. And some nurses work with wonderful doctors.
But I hear these stories less than the stories of trauma…
How has the system affected you? Tell us your stories in the comments.
With hope for healing us all,
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