A doctor discusses traumatology within the medical system

Doctor Addresses Prevalence of Medical Trauma

by Robert Scaer, M.D. on July 17, 2012

As medical director of Boulder, Colorado’s Mapleton Rehab Center for 20 years, I saw hundreds of auto accident victims with PTSD and whiplash. These patients exhibited all of the pain, dizziness, and cognitive impairment associated with those conditions. Many patients suffered for years, only minimally helped by therapy. This left me searching for answers.

In 1996 one of my therapists, Marcus Kurek, gave me an article by local psychologist, Peter Levine. Dr. Levine’s article addressed trauma and PTSD— and also described many of the physical symptoms of my whiplash patients. Upon reading his work on Somatic Experiencing®, I sent several auto accident patients to Dr. Levine. After years of ineffective therapy, many of their emotional symptoms of PTSD and also their physical symptoms related to whiplash disappeared with SE®. I realized that whiplash was a traumatic experience, not merely a physical injury. I also realized that their contact with the medical system had contributed greatly to my patients’ trauma by creating an environment of helplessness.

I myself had experienced many surgeries with ether anesthesia as a child, including loss of an eye at age four. I never realized that those experiences were traumatic and had shaped much of my life. I asked Dr. Levine to show me what he did, in SE, with my patients. My response to his treatment session showed me that I had unwittingly carried a huge trauma burden my whole life. For years I’d had a “nervous tic” in my left eye which disappeared after that session. I came to understand that much of my trauma was produced by the terror of my hospital experiences. In my medical training, my teachers had no concept of medical procedures being potentially traumatizing.

The medical care system is dedicated to healing— so what should we do to prevent it from actually being traumatic? How can we adapt these concepts to children, who are even more susceptible to trauma than adults?

Hospitals are scary places, even for adults. Being loaded into an ambulance with your head strapped to the stretcher can be terrifying. Getting X-rays, scans, and blood tests are isolating, strange, noisy, and sometimes painful experiences. You’re often left alone in rooms filled with strange machinery. The operating room is cold, sterile, and everyone is wearing a mask. Having a mask placed over your face for anesthesia feels like you’re being suffocated— but at least they’ve stopped using ether! Can you imagine how a child responds to these experiences? Everything seems designed to make you helpless. And children, in particular, are uniquely susceptible to helplessness and being traumatized by the medical care system.

Empowerment is the antithesis of helplessness. There are many ways to empower the child. We should ensure the presence of the parent when at all possible, especially in the run-up to surgery. We should explain, step by step, what is happening to the child and why. If the child already is familiar with the events leading up to a procedure, the threat associated with strangeness can be mitigated. Ana do Valle addresses these concepts and more in the video below:

Please view the first video of the new Somatic Experiencing Trauma Institute’s medical trauma series here  (9:55) -

These simple techniques are easy to learn and can be practiced by both parent and child. With the skills mentioned in the video, Emma was able to assert her control of the strange operating room. Through simple acts like asking for everyone’s name, she was able to banish her helplessness. This is a powerful step toward preventing medical trauma.

Best,
Bob

Traumatology expert Robert Scaer, MDAuthor Robert Scaer, M.D. directed the brain injury and chronic pain programs for many of his 20 years as medical director at the Mapleton Rehabilitation Center in Boulder, Colorado. Board certified in neurology, he practiced for 36 years. Now retired from clinical practice, Dr. Scaer continues to write and lecture in the field of traumatology.  His book, The Trauma Spectrum: Hidden Wounds and Human Resiliency, is available here, at the Somatic Experiencing bookstore.

Preventing Medical Trauma workshop
with medical trauma specialist Ana do Valle, OTR, SEP
Saturday, August 18, 2012 in Boulder, CO
CLICK TO REGISTER NOWUpcoming workshops on SE

{ 6 comments… read them below or add one }

stuart cohen phd July 18, 2012 at 7:11 pm

Dr. Scaer,
This was a beautifully done & touching video. And I was moved by your personal statements about your own trauma. My own younger brother also lost an eye at age 3, and I’ll never forget the trauma in our family re the surgeries, the implants & maintenance of them, & his adjustment issues as he grew up.
Thank you for your contributions, & thanks again for your help several years ago when I phoned you about a patient with RSD.
Sincerely, Stu Cohen

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Dori September 29, 2012 at 11:47 pm

Hello, I have a question about PNES and trauma. We have a 21yr old son that has had PNES for about 7 months now with some progress with therapy. Do you think this somatic training could help his situation improve? I will gladly give you more info later if needed.
You can contact me at my email address above.
Thank you

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Geoff December 27, 2012 at 10:22 am

Fascinating article Bob. I had a serious ADR from a misprescribed antibiotic at an ER and can vouch for the helplessness experienced and potential trauma, out of dozens of medical professionals I met at the time, only one had any empathy or interest. The majority were too pressured/busy, ill informed or arrogant. Some I was aware even found the suffering of patients entertaining and this needs to be included in an understanding of the potential traumatising experience of patients too. As well as considering the effects of drug/medication adverse reactions which medical staff have little knowledge of how to deal with. My ADR which is not unusual for the class of antibiotic I was given has caused long term harm to thousands including chronic neuro/spinal pain in my case.

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Kat January 28, 2013 at 7:29 am

Great article. I was a little disappointed that the profession of child life was never mentioned. Child life specialists’ main job is to prevent traumatic experiences for children in the medical setting by preparing, supporting, educating, coaching, and working with medical professionals to prevent and minimize the trauma kids experience during medical events.

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Bob Scaer March 28, 2013 at 2:02 pm

I plead total ignorance – I’ve never heard of child life. Perhaps that’s because it’s been 30 years since I had a medical practice and worked in hospitals with surgical patients. Tell me more about it.

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Deborah Mullins March 26, 2013 at 7:36 pm

Thank you for this …thank you for the awareness..having experienced much childhood medical trauma undiagnosed and unacknowledged for most of my 56 yrs I am heartened and encouraged by these advances. It is just so wonderfully touching

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