Breaking the ice (on medical trauma)

Medical traumatic stress refers to a set of psychological and physiological responses to pain, injury, serious illness, medical procedures and invasive or frightening treatment experiences.

The air smelled clean. Like the memory had attempted to be scrubbed from the walls. The smell of cleaners and disinfectants stung my nose. I remember thinking everything looked so clean. The bed was made, things were picked up off the floor, the counter had been tidied. It was so contrary to the way we’d left it, in panic and chaos, and it reminded me of returning to the scene of a crime after it was all over. The blood had been washed away, all incriminating evidence had been removed but in the eyes of the person who had witnessed the tragedy the location would never be the same again.

 I could still see the blood splattered walls. To anyone else walking in that front door they would have seen a clean house but to me everything spoke of what happened that night.

I walked into the bathroom and it was like I was walking back in time. I remember thinking if I just got to the bathroom everything would be ok. I remember the black spots dancing across my vision, the splitting headache that came seconds before I threw up, barely making it to the sink, not awake enough to hold back my hair and only moments later thinking to move it out of the way but by then it was already too late, vomit coloring the ends.

He came before I could even say anything, my body wracked by this vomiting so hard it shook my shoulders and popped things out of place in my shoulders, down my spine, along my rib cage. I remember being afraid but I had no way of saying I was afraid. Being afraid was not an option because if I wasn’t in control no one would have any idea what to do. The whole time, on the way to the hospital, as we sat in the waiting room for what felt like hours but was in reality probably only a few minutes, as I waited for them to put in the IV that would deliver the life saving treatment, I kept thinking “Someone help me.” I was trying to be ok but it felt like I was falling apart on this cellular level. And even when they did start responding, when help was given, I knew I had been referring to something deeper, something they couldn’t touch with the fluids running through my veins. I so desperately wanted someone to trust when it became evident that I could no longer trust my own body. But there was no one to trust, no one who knew what was going on and what needed to be done and how fast to act. There was just me, and the world narrowed into this small, solitary thing. Every once in a while I would hear something and it would pull me from my head but for the most part I stayed in this alone space in my mind. I felt so deeply afraid but felt I had no way of communicating that to anyone. I wanted to return to a place of orientation, where I had some degree of trust in myself and my body. But that too had been stripped from me in a way no one else could understand. And I think that’s why it was so isolating. It was just me and the trauma, and no room to breathe.

 

Many factors may affect a person’s vulnerability to medical trauma such as a pre-existing mental health diagnosis, perceptions about the quality of care, level of trust in one’s medical team, and factors related to treatment (e.g. the length of a hospital stay and types of medications used). Hall says another important factor is the sensitivity of medical staff. “When care is not patient-centered, empathic, and sensitive to patient’s emotional health, patients can suffer as a result. The sensitivity of a professional’s communication plays a central role in how people experience traumatic medical events and how they cope with the decontextualization and disempowerment of being patients.”

I’ve had this theory for a long time now about how being a patient causes trauma. No one ever talked about it, and for so long I just thought it was this idea in my head. When I was younger, I remember experiencing these feelings of acute trauma but feeling as though I couldn’t express them. Whether that feeling was self-imposed or communicated by others I’m not sure, though I suspect some of both, I grew up and into this idea that one doesn’t talk about medical trauma. The first time I heard the word it felt like ice being broken for me. This was a thing, something other people felt too. I wasn’t alone. The trauma that happened inside my head, inside my body, wasn’t just this thing that made me crazy but it was real and it was trauma and it was recognized by science as being this traumatic thing. Growing up I received the message that my medical treatments were just something to be endured. You smiled and were polite and didn’t argue because this was just the way things had to be. Even in the media the patient with a severe illness or injury is looked upon as this beacon of hope and strength. It’s something I’ve heard countless times, the saying “You are so strong.”

And all of these things, at least in the way I received them in my mind at the time, left me no room to feel angry or sad or betrayed by my body or afraid. And I was all of those things, but I felt like they had to be pushed aside in order for me to continue being this beacon of hope and inspiration, to be able to be polite in situations I didn’t want to be in and to endure painful tests that made me want to scream. So I stopped being angry and I stopped feeling this deep betrayal by my body and eventually I just stopped feeling.

“We can also miss the presence of medical trauma,” Hall says, “because many patients likely suffer the effects in silence. We are socialized to endure medical treatment and often we expect both ourselves and others, especially adults, to ‘just deal with’ the emotional effects of care on the psyche. We ask, ‘How is your pain?’ or ‘Any side effects of the medications?’ rather than inquiring about fear, sadness, worry, and the myriad emotions people face as a consequence of their medical event or illness.”

Lately I’ve been doing some deep body soul work. It begins with acknowledging the trauma that has resided in my body all of these years. I wonder if that isn’t why this time, this hospital stay, this trauma I felt more while it was happening than any of the others. Because I am no longer silencing the voice of my trauma, it gives me room to feel it as it happens.
Triggers are an opportunity for healing. Instead of shutting down when the memories come, when I am discussing personal details of my body and my medical history when I’d much rather drop the whole thing and stay silent and “safe”, when these painful procedures and treatments bring up feelings in me that feel more comfortable to avoid and are things I don’t know what to do with, I’m using them as an opportunity to breathe into this new space and invite growth to happen, for air to move into this place that was once stagnant. I’m being gentle with myself, because I know that’s the only way I’ll get through this without making myself smaller. And I know I’ve spent too long making myself smaller, avoiding, pretending, hiding in the shadows. I want to roar, to bloom, to move beyond trauma and into healing. And that starts with acknowledging this simple truth.

 I am afraid.

 

italicized quotes from socialworktoday.com on medical trauma