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Sources are listed at the bottom of the article (minus linked page)
As most people who are reading this are likely aware, trauma is something that everyone can experience regardless of your background or age. In fact, age only acts as a way for the brain to develop a wider network of information to help process situations, familiar or unfamiliar; it doesn’t prevent any one type of trauma. One type of trauma that is widely under-talked about that is important for everyone to be aware of is Medical Trauma.
But first, a definition of Medical Trauma should be given as most people are likely unaware of what it is. Thankfully the ISTSS describe medical trauma as:
“Medical trauma is defined as a set of psychological and physiological responses to pain, injury, serious illness, medical procedures and frightening treatment experiences.“
-International Society for Traumatic Stress Studies
Accidental and Deliberate cases of Medical Trauma
In the most innocuous of cases of medical trauma the cause of the trauma is disconnected from the intention of the provider. Instead often tied to the environment or nature of the illness. Some examples of more innocuous cases of medical trauma, with the help of the ISTSS, are as listed:
- Sudden diagnosis of a chronic and/or terminal illnesses
- Treatments for said chronic illnesses, especially in cases of invasive treatments (ex. Intubation)
- The environment in cases of extended stays in hospitals, example being an ICU
- Hallucinations caused by delirium
- The shock and loss of control from the diagnosed illness and/or injury
- Compilations during or after treatment
However, medical trauma is not only possible, but has a higher chance of developing in cases where the medical professionals are deliberately not providing the necessary level of care. The cause can range from institutional biases to deliberate neglect or malpractice on the part of the medical professional. Here are some examples both from the ISTSS and from researchers who’ve found significant differences in care:
- Medical Racism, such as that which black people face in regards to pain treatment (Hoffman, 2016)
- Gender biases in research leading to women having less effective treatments (Holdcroft, 2007)
- Sudden changes to plans that are improperly explained, such as a vaginal birth changing to a Cesarean during childbirth.
- Forced treatments that the patient didn’t consent to, especially in cases where alternate treatments are/were available.
- Deliberate malpractice by the medical professional
Do note that these are not the only cases, nor the only groups more at risk of medical trauma. For example, intersex people are almost universally left out of medical research and medical professionals have been and are being trained to treat each race differently such as the Nurse’s book highlights.
The Statistics on Medical Trauma and Personal Idea(s)
While it is important for everyone to know about Medical Trauma for their own mental and physical well-being, it can be especially important for systems. As with the ISTSS’s own estimation on Medical Trauma, around 15-25% of children and adolescents experience persistent traumatic stress, and up to one third of adults can experience it depending on the cause. With such high rates in the general population, the added complexity and disorientation of existing as a system can mean that the usual steps taken to try to prevent medical trauma may not be enough. Especially since different members of the systems might have different needs, which unless a medical professional has been trained to understand and meet, have a high chance of being missed or ignored.
Though only my personal conjecture, the estimation above of medical trauma rates is likely not accounting for people who have previous traumas and/or health issues outside of the one that led to them receiving medical care. The aftereffects of prior trauma in PTSD impacts the psychological ability to process new adverse events easily, but also, research suggests that PTSD additionally has negative affects on the body, specifically in regards to the cardiovascular, gastrointestinal, and musculoskeletal systems (Jankowski 2018). Therefore, systems (and singlets) with PTSD may be at an especially high risk for medical trauma, due to the combination of higher rates of physical health issues that could expose them to potentially traumatic medical events, alongside a decreased facility for “bouncing back” from such events.
Thus, to us, it is highly important for everyone, but especially systems to take steps to educate themselves on warning signs that a medical professional might not be a good fit, particular risks you and your family are at for medical trauma and in what areas, and the like.
And remember, if a medical professional isn’t a good fit, you are absolutely within your right as a patient to request or seek out a doctor which you feel would work better with you.
Footnote: Content Warnings
Specifics of medical abuse, medical racism, and medical sexism.
Sources
Jankowski, Kay. “PTSD and Physical Health.” U.S. Department of Veterans Affairs, U.S. Department of Veterans Affairs, 16 Aug. 2018, http://www.ptsd.va.gov/professional/treat/cooccurring/ptsd_physical_health.asp.
“Medical Trauma.” ISTSS, International Society for Traumatic Stress Studies, istss.org/public-resources/friday-fast-facts/fast-facts-medical-trauma. Accessed 14 Sept. 2023.
Hoffman, Kelly M et al. “Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites.” Proceedings of the National Academy of Sciences of the United States of America vol. 113,16 (2016): 4296-301. doi:10.1073/pnas.1516047113
Holdcroft, Anita. “Gender bias in research: how does it affect evidence based medicine?.” Journal of the Royal Society of Medicine vol. 100,1 (2007): 2-3. doi:10.1177/014107680710000102
Multiple Multitudes 