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 HymanAviva 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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  1. This post brought up tears. I am an Rn. You really get it. I too left the traditional hospital setting in 2007 traumatized at age fifty. Wanting to work again in postpartum I moved to California thinking it would be different—we had a union and wouldn’t that make nursing easier? And what about that law that said we could only be assigned five patients? (I had twelve in Indiana). Well, infants were not counted as full patients—we still had eight! Even if babies were 8 weeks early and barely breastfeeding they were considered “half a patient”. I got ill, got high blood pressure, then was reprimanded for absences. After two and a half years of stress I had a sleep disorder from shift work and got fibromyalgia and major depression. I left on disability and recovered my health completely through life coaching and writing a memoir of what lead me to give my power away. LIssa, I love what you are doing and your courage to take this on. I am with you. I now coach women to find the grace in living again. But I have been in fear to coach anyone in healthcare—the nerve is raw—with fear that traditional medicine is so lost it is beyond my reach—that it would only stir my anger or depress me to hear more stories of medically induced trauma. You are touching me and inspiring me. Thank-You.

  2. This post finally explained a lot that I’ve seen and experienced with doctors and could never understand. It explains an email I just got this past week from my primary care PA. I share the insanity I go through, and she chose to share a challenge she’s going through (knowing I practice some alternative energy modalities). At first it really shook me; what was happening to the “doctor/patient” model. But after reading this, I realized just how great her own need is, and I can be that person to stand in the gap for her as well.
    Thank you for bring transparency and clarity to this issue.

  3. I am speaking from a proactive patient’s side……… I will agree that RN, Natural medicine doctors and patients are traumatized, I agree.. but to say that Doctors are?????????? I am sorry I must be living in another planet.. From what I have seen experienced and honestly lived, NOT one doctor I saw or visited, is traumatized. I visited 6 oncologists, (in 2 years) 5 surgeons (2 years) and yes in the past years I visited few regular doctors for general stuff, (I have always done natural medicine and few times had to visit the regular physicians) and I am yet to figure out their trauma.. What I have seen is totally the opposite, it is the nurses or the medical students who tend the patients.. I enjoy this site and admire Lisa’s work for standing up against the current, but to use yet another excuse for doctors.. mm, is just not right. All the doctors I visited and have known whether they see me or not, are 1) well educated, 2) very wealthy 3) could care less if you get better, 4) are in a hurry 5) pass you to the intern, or even better the extra worked nurse who does everything for the doctor 6) see you for no longer than 5-20 min the most. perhaps it will do some service to the truth to re word the article about what doctors are suffering.. one thing is for sure NOT trauma.. not doctors.. I have to say that in my cancer journey – which to me is /was a gift as I began to learn compassion more than anything else, I have learned so much but one thing is that doctors are no different from politicians.. sorry Lisa but this is the state of current affairs in the USA medical system. If we keep making excuses for them such as they do not get the training in nutrition (which by the way is true) they are not to blame, (the insurance forces them, ) bla bla and now they are also traumatized, little to no change will be seen in their behavior.. I know this is tough but one must speak the truth if one is to see change.While having compassion for all beings is one thing, there is such thing as making excuses or not addressing the issue from where it needs to be.. I am not saying they are not human beings, they are, and that is what we all need to remember – they are not God, no creators, but society has given them so much power, and continuing to portraying as this article does, continues to give them power and make excuses.. for them. Please please send me to such a doctor you describe here.. I am in MN and I am yet to see a doctor who will come to see you right after they gave birth or if they are sick… good luck..
    I would say this is correct for the nurses, natural healers, natural doctors, but for MDs? I hope someone can enlighten me on that.. Perhaps I misunderstood the article, but I just can continue being silent when people say doctors are traumatized or excuses are being made for them~ While you are one in a million trying to bridge the gap that exists now between regular doctors and natural doctors and nurses, etc.. I hope you show transparency… and one must be very careful with words, as they are powerful……….very powerful.

    • Evangelina,
      Let me speak only about my experience so I don’t put words in others mouths (though those traumatized doctors tell me their stories every day.) I have had surgeons hand me the suction catheter in the OR and say “Suck me good, Lissa. Suck me hard, Lissa.” I have had bloody HIV infected scalpels thrown at me by MD professors when I got a suture wrong. I was forced to scrub into surgery with an IV, when I was vomiting and wearing a diaper because I had diarrhea. I was verbally abused for 6 years straight, humiliated, shamed, told that I would never amount to anything because I got too emotional when people- babies usually- died.

      I watched people come into ER’s without limbs. I saw pregnant women stabbed in the chest and belly and hemorrhaging. I was the first responder at a bombing once. It was gruesome. If you don’t call that trauma- and every doctor I’ve ever met has been through that- then I don’t know what is.
      I’m not trying to defend ANYONE, including myself. I’m just asking us all to have a little compassion for each other.

      • HI Lisa, I know you are not defending anyone, I get that. That is why I said, words are very powerful and important, and the context of all as well. And yes I agree 100% with you that we are to develop compassion, for all no exceptions :-). I just think that lots of emphasis is put on doctors, the title says it all: “Your Doctor has PTSD”… while I know what you are trying to say, I think that words are powerful……. very much so. If one is asking for compassion for each other , or for everyone why not say that, and then explain the context of the situation of all players involved.. I know you are a doctor and talk from personal experience, we all do, we are all talking from our personal experience, well from what we think is our experience but truly our perception. I know doctors are stressed, specially those in the ER.. yes but we are all experiencing PTSD, of some sort or another.. like you i have seen people stabbed, killed etc.. however there is always context to all of that and the best way is to put the context to it and carefully choose the words. I guess all in all, lots needs to be done to restructure the medical system, again, including the insurance business, the pharma, and also the schools which teach doctors with the hope that doctors go back to what originally they are to do, work with the patient, for the patient and with the patient’s best interests. I do thank you because like I said you are one in a million who has chosen to stand up and speak up, and it takes not only courage to do what you are doing.. I am happy we can agree to disagree. Namaste.

      • You are so right about the compassion that we need to practice with each other, Lisa. But you must know these experiences above are not limited nor unique to the physician experience. Thank you for your transparency. I hope you continue this challenging but worthwhile work!

    • Haven’t read other responses, but just as I would never try to speak to how it feels to have a diagnosis of cancer unless I actually had it, you can’t speak to and generalize to all doctors. Walk a mile. I am sorry you had such bad experiences and hope you find more compassionate providers. Also try to be the last appt of the day, often doctors can feel more relaxed / available if they know there aren’t a ton of patients they are already behind in seeing. I have patients who take a lot of time, and I tell them after the first visit to make their appts for last appt etc so they don’t feel like I am rushing them.

    • Thank you, Evangelina. My thoughts exactly. As a NP w/30plus years in healthcare, I have a hard time buying the pity party. Perhaps for some but the overall medical industry has set themselves up for failure in this department. When you set your self up on an intentional pedestal, build a culture of god-like status and the ultimate result will be failure as is seen perhaps in the lives of these “traumatized” individuals.
      Until the medical industry chooses to put the patient and healing of the patient in true precedence in medical care, the medical system will continue to fail themselves and those who expect god-like performance from them.
      Until we begin to practice the compassionate intelligent care due our professions and our patients, we will not have the outcome that so many of us desire and work each day to achieve in our individual holistic practice.

      • Patrice, I could not agree more!! Well said. and like I keep saying the more I meet people the more their stories sound like mine, (mind you these are patients from all walks of life with all sort of diseases from all over the USA and few others from other places..) and now I am very proactive in every sphere of my life talking to people about how one can take control of one’s health. There are a few doctors who have stood up against the current medical practices dictated by the big pharma and insurance, and those are either in jail or in exile because they wanted to practice compassionately and do what is best for the patient. I think we have way long to go, however, I know for a fact our numbers are growing strong daily and as patients we are demanding not only compassionate care, but human and holistic care, which is what medicine should be about anyway. Namaste

  4. Long time listener….first time comments-haver……first, I adore you Lisa. My story is from the patient perspective of a small child- my son, Henry Tucker. He was dx w ALL Leukemia in 2002….. His primary doc, who is top in his field told us Leukemia was like the flu……I wanted to believe him. The day we were told he needed a life saving bone marrow transplant, after 3 1/2 yrs of “successful” treatment , I felt Dr. Terry Vic move away from our family. He immediately disconnected – I’m not crazy……but, I know that now bc my family and friends fought with feverish abandon to bring pediatric hospice to our state of Indiana. The hospital NEVER really had to tell us he wasn’t going to make it…….I knew. I was a body language major in college. The day they told us Henry would die…and he might live a day…..we wheeled Henry out on the floor……Dr. Vic took one look at us and walked the other way…..Henry was devastated. I, on the other hand, had really bad thoughts. He was our doc for 4 yrs. he loved us – as long as we were a success story. It became evident . At Henry’s service, The Wabash College Chapel was overflowing w nurses, staff and everyone who knew our son. But, not Dr. Vic. In fact, there was not one doctor at that celebration. Later, I discovered through a great nurse (we had so many) that they threatened to fire nurses , saying they were not permitted to leave – nurses walked that day and I made it my committment no other family should be without palliative care and hospice…… has been extremely traumatic to process watching my 6 1/2 yr old let go. The doc who sent us home had just come back from maternity leave with her first child. I gave rith to our second son, George, 5 weeks before Henry passed. I think she felt sorry for me bc when she sent us home she stated, ” they (pointing to docs roaming the floor) would tell you to keep fighting. If he were my child I’d want to take him home”…..Henry was 6 going on 60…. And he was very vocal about “being done”…..he wanted his own bed. He was in an induced coma for 3 weeks ……bc they had no understanding of the medicine he COUlD have been given to make his pain subside and not be sleeping all the time. We fought for those rights too. I am a type a introvert. That was before Henry passed. It has been trauma that has lifted me from e pits of hell. I’d never taken a pill in my life and after 6 mos of not sleeping….they started giving me drugs. I was desperate to sleep. I was fundraising, writing, speaking and looking back…..maybe a bit mad. Lol. Fast forward 2 yrs……..we moved to start a new life. I tired of walking in the grocery store and either being greeted with the pity look or watching friends turn down another isle. Small towns can be socially exhausting……we ended up in the heart of downtown Indianapolis. George started changing immediately. I took him to 3 docs in 9 mos….they told me he was fine, growing and sometimes kids don’t talk much ….. Our Henry didn’t shut up and the docs said I was in grief and trauma…..they overlooked George and offered me more meds. I gained 40 lbs, was a messy mess and isolated myself bc I felt the judgement from others ….. My grief. And, George’s changing behavior. He became non verbal and I wanted to die. When he was dx w autism , we found out the lead count in our backyard was 4 times the toxic limit. Lead is a HUGE problem in our state. They deny it. They pass the buck. Nobody is culpable. Children get branded as trouble makers and they clog the system with mis dx. His lead count was 39 when it was discovered. Devastated, I again started meeting with Congresswomen and men, legislators, doctors and nursijgn staff proposing a mandatory lead test. In the state of Indiana, by age one it is mandatory . NOW, it is mandatory. I live in the now. With the help of one of the cities most amazing cognitive behavioral therapists , I’ve been able to function and get off meds. We were able to get George in another amazing ABA Therapy school where he has attended for 2 1/2 yrs. he has gone from saying 3 words to phrases, sentences and Manding spontaneously. Our legacies are in our children. I feel so passionately about encouraging others, listening and being aware. Empathy is the one way……some don’t take it. So, they may end up with fancy houses and cars – tru dat. But, that’s on them in the end. We all have a part to play. I pray when you make your way here to Indianapolis, you let me help. You and Brene ROCK OVARIES!!!!!!. You both have validated my experiences and given me encouragement – I am forever grateful and appreciative. Xoxoxox

    • I am so sorry for your loss of your first son and having to find out about lead poisoning w your second. One of my friends has a 3 yo daughter diagnosed w same and let me know about the Mislead documentary and website/ org. Are you involved w this? This is the trailer
      You and your family did not deserve all this and you speak exactly to what Lissa wrote about, I think. Do you have any small suspicion that your doctor for Henry felt like he failed him bc he became terminal w his cancer and couldn’t bear to look at him bc he didn’t want to cry or lose it? I don’t know, I am just wondering; it would be so hard to face all the losses involved w treating kids w pediatric cancers. More funding for research is sorely needed as I am sure you know well pediatric cancers are grossly underfunded. Also have you looked at the MISS foundation ? is expressly for those who have lost a child whether adult or young or before birth. I strongly support it as well!
      I hope George recovers in full and what a service you have done for children in IN by getting mandated lead testing, bless you.

  5. As a patient I have come to the conclusion that I suffer from PTSD. Since 2010 I have been lied to and manipulated by doctor after doctor. This has caused me unnecessary pain and suffering. My stories could fill a book! I am now under the care of a Naturopathic doctor and starting mind/body and energy work to try and heal body and soul. You have to fight for yourself when dealing with allopathic doctors because they are not looking out for you. They just want the money so here take this pill, chemo, radiation, surgery!! Countless people have died a painful death doing what their doctors tell them without questions and research.
    Do doctors have PTSD? maybe, but the patients that trust them and their education deserve more than lies, they deserve honesty and TRUTH and a caring heart.

    • Marilyn~ I so agree with you……….. your story resonates with thousands of people /patients who are finally speaking up, me included.. your story is so sounding and painful, and I hear it with almost every person who comes in contact with the doctors. Please know that I am not against doctors but the way they behave and treat people, and the power society has given them and continues to give them. I personally have suffered more from the medical system treatment than the cancer itself , can you believe it? I keep saying nothing will change unless we address the big pharma which has demands from doctors, (whether one believes it or not) and the insurance and yes they are to make money.. just read this: ( I am sorry but is important to be honest and truthful and have transparency even here):
      this is a true article of a doctor who diagnosed cancer to make money.. this is but one of the thousand of stories.. all I am saying is that there is always context and for so long society has sided with doctors, we now have to paint a whole picture of not just doctors but patients, nurses, pharma, etc.. to understand the whole thing. I agree with LIsa we are all in this together and we ought to be compassionate but remember who is the patient.. please. Blessings.

  6. What a profound insight, Lissa. You are really onto to something with this. I get chills thinking about the ramifications of this revelation. Now we are all even better poised for healing.

  7. So true, so true, I see it as a public cancer patient at my local hospital. And it’s all because of money that I haven’t ventured into the private sector for additional help, apart from seeing a naturopath. I believe in alternative medicine, even though I understand & accept that conventional medicine has its place. I do my own research and put alternative practices into place as much as possible in my circumstances. (I live in Australia). After 2 failed radiation bouts to relieve the pain, (according to these Drs’s, my metastised cancer is incurable & inoperable), I am now in a wheelchair, and very angry as not 1 of them told me there was a risk that this might happen. So now where do I go & what do I do? I can feel their indignance when I go for regular blood checks etc., that I’m just a number to them and not worthy of their time, because I am practicing alternative therapies. I don’t feel supported at all and even though I know all this, it’s very hard to ignore. They dont even offer any further information/support about my paralysis! People get healed every day, by whatever means, so there’s always hope that something might work, yet they don’t even offer that. Yes, that’s what happens in a public system, even in Australia !!

  8. Great post, totally agree, can’t imagine how cathartic that talk/ meeting must have been!

  9. This article hit me hard. I feel as though I am completely disoriented in dealing with my doctor and the entire healthcare system. And it’s sad, because I am a veterinarian and I know medicine and healing. I do it every day with small creatures who can’t even speak to me. But when I have a health problem of my own and I walk into my doctor’s office, it’s a total disconnect. She is distracted and aloof and i immediately feel as though I am somehow bothering her. She rushes through our time together. I realize that I “know too much” and probably ask too many questions (are there really too many questions to ask?”) and then I always feel intimidated when she becomes overly authoritative and dismisses my concerns. There have been times when I’ve known more than she has about what’s going on with me – I had to force her to test me for celiac disease after an unnecessary appendectomy and a misdiagnosis of scabies (no skin scrapings) when I actually had dermatitis herpetiformis. But I’m not coming down on her as a bad doctor. She’s a good person and board certified in internal medicine, She’s obviously intelligent and well educated. She just can’t handle the system that controls her. And that results in substandard care – for me. She isn’t my first doctor. I’ve tried several others, and it’s always the same story. At this point, I feel like I should just treat myself and have done with it – but that’s not the answer. I NEED a trusted physician; I NEED someone I can rely on. But where am I going to find that person? I don’t trust her; I don’t trust the system; and I dread the day when I need help for something serious.

    • Beachpoet, I ended up (like many people i know all over the world now) treating my self, and going to natural doctors… it was not the cancer that was stressing me out or making me sicker, it was the doctors, the insurance, the system… I had to become my own advocate; and after all after the poor treatment I received (in so many many levels) I was ever so thankful for the awful way they treated me.. because I became a very proactive person advocating for my life and now for others, I became very compassionate with other patients, the nurses, and yes even those doctors, to the extent i sent them thank you notes, because I felt it was their awful way which woke me up and made me realize I needed to take control of my health and life. I do hope and pray you find a natural doctor, there are many. Please dont give up hope!

  10. I just realized that I poured out my feelings about my own relationship with my doctor and her disconnect with her patients without fully addressing the subject at hand – PTSD in healthcare professionals. Lissa, I think you are identifying a very real and pervasive issue. My sister is an ER nurse, and I’ve watched her over so many years change from a caring, compassionate care giver to an angry, judgmental hospital employee. She rants constantly about her patients; about how undeserving they are of care because they are minorities; about how ungrateful they are because they are difficult; about how it’s all their fault that they are ill because of their lifestyle choices. She has seen and had to deal with horrific things and it has changed her as a person. How could it not? She has inured herself to human suffering in order to survive psychologically. But she isn’t really surviving. Her personal relationships are a mess; she is a mess. At work, she is the epitome of efficiency and much lauded for her expertise, but outside of the hospital she is out of control emotionally. Our family has been confounded over what is going on with her and how we can help her. Thank you for giving us a possible insight into what might be going on here. Maybe we can’t help her, but maybe we can gain some insight into understanding her a bit better.

  11. Amen. Really appreciate this post. The present system traumatizes healthcare workers of all stripes. Thanks for the courage to speak the truth. I am both a cancer patient and a physician. Five surgeries in 11 months. Unusual post op complications. My docs are puzzled. Why a previously healthy person with no sick days in 30 years would have so much “breakdown”. But we docs feel that we must be strong and too often silently bear our traumas deep inside. As a patient I know how much a little compassion means. Something as simple as the medical student who takes more time, a touch, a nurses aide who rescues a cold shower with hot water from the coffee pot. Compassion. Pass it on.

  12. As a CNA for Altzheimer’s patients, clients, etc, I see both sides of the doctor and patient equation! I work in home health, and the couple I care for are constantly bombarded by phone calls, “drop in” visits by nurses. It is so stressful for a patient to come home from the hospital from a behavioral unit. They are exhausted, not accustomed to their meds yet, and needing to SLEEP! I care for a lovely couple; she is dealing with AD, and he is a nervous wreck! I know that home health staff need to evaluate a person once they get home, but my client’s husband is overwhelmed by all the activities. I can’t seem to get through to the RN’s and therapists that she needs rest in the morning. I know they are busy and have lots to do, schedules, etc. I just wish they could come see her in the afternoon when she has rested in the morning and has eaten her lunch. Please, staff, remember that the elderly need tons of rest when they get home from the hospital! I wish there was a 72 hr. rule letting them rest before a stranger who holds their fate in thier hands can call at 9:00 am and announce with full authority that they are coming in 20 minutes…GRRR!

  13. Oh no! I wrote a long post, but it disappeared when I signed in. Anyway, I said that this blog was perfectly timed. I abandoned my medical training because I couldn’t see how it was a healing profession, and now I research and teach women’s health issues. As I’m getting ready to head into another semester and teaching a graduate seminar on women and health, I may just have my students read this blog — too often (from horrific personal experiences as well as my research), I see doctors as the system, as the “bad guys,” forgetting that they’re traumatized. I have moments of compassion, but more often than not my frustration at not getting my needs met as a patient and with the authoritativeness of medicine as a whole keep me from seeing doctors as fully human. I truly applaud those who can heal after the trauma their training and profession has put them through….

  14. You are preaching to the choir on this one. I saw this, lived it with my ex (a neurosurgeon) for 24 years. I felt the same tension, PTSD, irony, craziness, lack of compassion, etc in the room at each medical function I attended.

    I begged my ex to cut down his work load and offered many alternative ways we could live together more simply as a family, as a couple.

    What happens is they get so caught up in it, and have such a god-complex they don’t even see what they are doing and how they are acting.

    His job was definitely one of the biggest triggers for his mental health break down. I know this and tried to help him. What I learned was, he has to save himself. And so far, I’m not seeing him changing his ways. He’s on a downward spiral…

  15. As a therapist of many years experience i am alarmed with the propensity over the past few years to label life events so strongly. By your description virtually all of us have PTSD. By definition if we all have PTSD then none of us does. It is instead a norm or a regular experience of life. Something not to be labeled as unusual. What was at one time considered the ebb and flow of life full of pain and pleasure has now been made to seem otherwise. When was it that we as a population became so fragile? The new DSM V broadens categories in this fashion as well encouraging the use of drugs to treat ‘illness’ that were at one time not considered illnesses at all. I believe that this fragile orientation to life and life experience is interwoven with the victim mentality that is so pervasive in our culture today. We are victims, we are suffering from PTSD. If something happens in our lives that calls upon us to transcend our believed limited capacities, that urges us to reach deeper within, we shirk from it and choose to be labeled with an illness instead.

  16. I couldn’t agree more with you. Med school alone is a traumatizing experience. I spent the entire first 2 years feeling like I was never good enough and that I was moments away from failing. I actually wasn’t, but the environment is so unbelievably toxic that is how everyone feels. I always said I had no idea how psychologically hard it would be. Before I took Step 1 I cried myself to sleep every night for months. The amount of pressure you are under for years at a time is insane. I joke around that I’ve blocked out the first 2 years, but I’m not sure it’s actually a joke. It is still painful to think about that time in my life and I know I have some healing to do from it. Now I’m an ER intern and some of the things I have seen horrifies my friends when I tell them about it. I forget that the things I think are normal most people never see/do in their whole lives. And you can’t forget the psychological toll it takes on you knowing that people’s lives are in your hands. Sadly, none of this is ever acknowledged by the medical community. Thank you for such a beautiful post. Maybe one day doctors will recognize the need to heal themselves.

    • Sending you love and blessings as you complete your training. Be kind to yourself!

  17. Hi Lisa and all souls of healing heart

    I too spent 20years of my life as an emergency RN. I began schooling when my youngest was 2 1/2 a time day care was hard to find. The 5 am wake ups to drop 3 children off at strangers in order to arrive at my clinicals. It was the late 80s a time where there was at least 5 psychiatric facilities bigger then many college campuses. I was assigned the women’s ward, their daily activity was simply living, pacing and smoking in a large filthy day room chain link fencing on each window. I remember the day one woman patient told me she wanted to suck my clitoris….later in our school group discussion gathered in our whites and annoying teacup hats which always fell off we met with our professor to discuss the events of the day. I informed my ex catholic nun teacher of the events of the day…she flushed asked me what I said to which I responded” that is very inappropriate”, our learned response to psyc discussions. I think the trauma began there with much of our time spent pouring over patient charts, each had a different diagnosis for their numerous admissions. We now know such institutions are closed and the walking wounded walked among us.

    I lived for my education. Days at school and raising children then studying until 3 am to wake at 5-7 am and begin again. I worked part time in an urgent care facility of which most people were from emergency departments. I loved the fast pace and the humor thus knowing my calling.

    I graduated after receiving 100 percent on almost every exam, formed study groups after we lost 50 percent of our first semester class. Not many realize the intensity of knowledge a nurse has to learn in a short period of time. I began my first position in a large University Level One Teaching and research hospital in NY. Beginning in a 7 month critical care internship before I was assigned a preceptor assignment SICU 100 percent vented patients with 80 percent mortality rate. My patients never talked or regained consciousness, if they were able to be weaned off the vent they were moved to another floor. Working 12 hour nights the sounds of electric alarms and cardiac monitors our only sound as each nurse dedicated one on one care…possibly 2 patients to one nurse. Our best friend the poor Surgical resident during 36 hour rotations. We became the teachers, wrote most of the orders during the night for them to sign, as well as correcting gently the mistakes before the patient became the mistake. And for anyone who isn’t aware surgical residency is the longest most grueling…with Surgeons out shining the devil in cruelty, as well as 7 pages of orders on each patient instead of one for in their minds everyone around them complete idiots. One surgeon upon opening a woman he had given experimental treatment for ovarian cancer proceeded to remove her interior organs and throwing them across the OR seeing the black of cancer that had not responded to his treatment.

    Going into major depression in 3 months I snuck down to floor 5 and was immediately hired into the level I trauma unit I had dreamed about. The SICU and critical care training team extremely upset having lost one of their students to the ER. I however was in love …we rotated through a pediatric ER, our regular Er, triage before the use of electric blood pressure cuffs, pulse ox use …our skills honed to use all our senses. Here in the early 90sHIV claimed every life. The patients I most frequently saw and fell in love with, would come in with worsening symptoms, I’d sit at bedside, holding hands laughing in their successes, crying at the fear…for death always won out. I knew when I stopped seeing them weekly, or if a nurse from upstairs informed me….they had lost the fight.

    The trauma room was my favorite it became i adrenaline instinct on what to do….how to run to the Er…not so fun when a neighbor came in after sitting on a car bomb, (undercover officer) his daughter best friends with my daughter. The time a 26 year old came in via chopper we worked on 45 minutes following an MVA…..cracking his chest revealed he had bled out internally, going through the clothing I learned this was my best friends brother I hadn’t seen in 2-3 years, though I talked daily to my friend on the phone, this was not going to be a normal phone call. I would wake up at night doing chest compressions overhead.

    I left nursing the first time after needing 2 back surgeries and 7 years of physical therapy thanks to workers comp delays. I had then returned to work in 3 other emergency rooms…each time having to leave for surgery the last most of my neck fused.

    Every job interview in between I hear I would be bored after working in an emergency room. And I have been looking for 10 years hoping to lighten the physical wear and tear on my body….the love of my patients the love of my job I will never lose. But my body paid the price.

    As well as my heart no longer trusts allopathic medicine… It hasn’t offered a cure for the arthritic changes that began at age 28…

    PTSD most definitely ….heartbroken entirely because an intelligent loving stay at the bedside, be with the family throughout is lost to emergency rooms for the now.

    The last hospitals I worked at not blessed enough to have a separate trauma unit…there was a run of 10 or more people to the room that called for code help….which ran just as quickly when the dr called it as over….I remained with family, called more friends and family a chaplain. Alone…as they were in their grief was I in being the one to remain…when there were no words, but hearts do speak the loudest. I remain that heart.

  18. Great post Lissa and so true. All doctors/nurses/healthcare providers are traumatized by their training and/or when they get out in practice. I work as an executive coach exclusively with burned out physicians and I know the trauma is universal and built into the way we train doctors and then deliver care. I even have to refer about 25% of my physician clients for EMDR because they are actively having minor flashbacks causing them to suffer.

    And I want you to know that the Trauma is not the biggest problem.

    The big problem in my mind is two fold

    1) We know the practice of medicine is traumatic … people suffer and die, no one gets out of here alive. Doctors are human and sometimes make mistakes … and even if they don’t, their patients are all going to die. AND we do nothing to anticipate, prepare for or teach doctors how to deal with this loss/grief/trauma when it happens.

    2) The doctor who has a bad outcome is further traumatized by our programming to deny our humanity and our inability to talk to anybody about what happened and our feelings about the event. The doctor who has a bad outcome is treated as if they have a contagious disease, rather than supported through an event that we know everyone must pass through at some point.

    Here is my story of a bad outcome and what happened next that made it all worse:

    You are spot on with this post. You and I and the others who have a vision and some influence on this issue are now charged with changing this “normal” to a new way of anticipating, planning for, teaching about and mitigating for the trauma when it happens. When there is a bad outcome or a patient dies, or a mistake or a conflict .. it does not have to take the doctor down permanently. We can create a culture of support and caring.

    My two cents,

    Dike Drummond MD
    117 Ways to Prevent Physician Burnout in the MATRIX report here

    • Dear Dike,
      You’re So right. Funny you wrote this now. I’m literally, right this moment, in the midst of writing a post titled “Medicine, I Forgive You.”
      Spot on with everything you said. So glad to know you’re on the team that will help heal our broken system.

      Love and gratitude

      • I have found narrative medicine a real catharsis for me and my clients. Especially when a doctor can write down that story they have never told … and then read it out loud and have it witnessed by peers who care and listen well. And you work with Rachel Naomi Remen directly … how cool is that.

        Let’s connect, link up arms and keep pushin’, prodding, motivating, connecting with like minded people in the system and figure a way to create healthy, balanced, happy docs who give their gifts through the practice of medicine with out being torn down in the process.

        The physics is simple …

        You can’t give what you aint got

        The only foundation for lasting, high quality, patient centered care

        => is to put the doctor and their needs first

        When we unconsciously learn to put the doctor’s (our own) needs last … it is only a matter of time before they burn out and either quit — or lose all compassion and empathy and soldier on. The walking wounded are everywhere and it just does NOT have to be this way.

        That’s two more cents for ya

        Dike Drummond MD

  19. I’m the opposite… I feel like nurses abuse patients and don’t listen to patients. People are so quick to defend nurses and frame them as the victim that there is strong bias against anyone has conflict with them. It leave victims of abuse from nurses silenced in the shadows. I was traumatized by the abuse of nurses. They think they know everything and they’re better than anyone who works in the hospital when patient care is actually a team effort. It’s strange that they bestow themselves the position of patient advocate (although no one really asked) yet when a patient has a grievance against an unethical nurse their tone change. They will get angrier at you and give you a harder time if you as a patient advocate for yourself against a nurse even if it’s not the dramatic. Because what they perceive as an unappreciative patient is a actually a patient trying to advocate for their own health. I really wish one day…. Just ONE day patients, residents, doctors, and everybody else in the health care system can discuss about abuse from nurses without retaliation from them. Just one day…

  20. Hi Lissa,

    Thank you for your post. It was very insightful. Just wanted to correct a minor error – the psychological defense mechanism you are describing is known as “displacement, ” and is one of the family of defense mechanisms known as “immature.” Sublimation is one of the few “mature” mechanisms and is different from what you described.

    Take care,

  21. I am in tears. I am so thrilled and scared. It is scaring, brutal…it is what I have been through, how I got wounded and hadn’t dare reopening the chapter to have another look. I read your book Mind Over Medicine. I bought another copy for a man I love, who has also been severely traumatized in medicine. We may not eventually be able to be together, due to different reasons. However I hope this book helps him heal. He is so special to me.


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