Jamaica Gleaner / The high number of trauma cases being seen by medical personnel at the Kingston Public Hospital (KPH) has left many doctors and nurses numb, operating on autopilot just to maintain their sanity.
“Once you work in the emergency rooms there is no way you can leave the same way you came in; you get a little hardened by what you see,” medical officer at the accident and emergency (A&E) department at KPH, Dr Renee Armstrong, told a Gleaner Editors’ Forum at the downtown Kingston-based hospital last Thursday.
“Sometimes you don’t get to face the situation the next day, sometimes it’s half an hour or an hour later. Sometimes three or four patients come in at once, all with critical injuries, so you essentially have to, in some respects, operate on autopilot,” added Armstrong.
No matter how horrific the injuries or the sounds of anguish around them, these medical personnel are not expected to display their emotions because ‘they are doctors and nurses and they are not supposed to react like normal people’.
“So from the first year of medical school we know that we are trained to save lives, to be professional, you’re trained to internalise and not let the outside world see what you’re feeling, but you’re basically trained to be a machine,” shared anaesthesiologist at the KPH, Dr Ayanna Ennis.
“We may go home and cry, but we are taught that this is something you do with yourself, you dust yourself off and you go back the next day and do it again,” said Ennis, as she added that working in the emergency room at KPH alters your life forever.
Coping mechanism hurts families
In the meantime, head of the A&E unit at KPH, Dr Hugh Wong, said while doctors are not necessarily trained to hide their emotions, what happens when they are working in certain areas may be maladaptive, “but it allows us to function”.
But this coping mechanism at work is affecting the families of some medical personnel who are unable to reconnect with their emotional side once off the job.
“You’re a doctor and you go home and (a family member) has a cut which probably just needs a Band-Aid or probably the person just needs some comfort but, unfortunately, because of where we work, and the autopilot where you just work and you don’t have the time to hug and comfort, they will get very annoyed,” said Dr Sophia Henry, who works in A&E at KPH.
“Your friends would even say how come you’re a doctor and you don’t care that I’m having a headache or cramps,” added Henry.
She said to avoid these situations, she informs family and close friends that once they are ill she will recommend and take them to a doctor, but cannot be their doctor because she would be emotionally involved and might make poor decisions.
International research has indicated that medicine is the profession with the highest suicide rate, and Dr Junior Green said he would not be surprised if the profession also features prominently where divorce is concerned.
“It does affect the relationship a lot of times and you will find that medical personnel sometimes have unstable relationships.
“You might not be there for a lot of the special days they have, because you might be working and that sometimes can affect you. You have to keep reminders of the birthdays, anniversaries and special occasions,” said Green.
While he has remained married for 17 years and has three daughters, ages 14, 10 and five, Green admitted to having downplayed injuries to his children at times because of the severity of wounds he sees at work.
“For them, what they are seeing is a cut and they are feeling pain, and what I am seeing is that it is not so bad or I might be so tired I will say, ‘it’s OK, just let your sister put some alcohol on it’,” Green told Gleaner editors and reporters.
That is a concern for Dr Orville Morgan, senior medical officer at the Victoria Jubilee Hospital, who is worried about the lasting effects treating trauma patients daily might be having on doctors and their personal lives.
“There is scientific data that suggest that re-exposure to stress continuously does affect their relationships, does affect them as persons, and does affect them psychologically in the long run,” said Morgan.
“Where they (doctors) might be thinking that they are being objective, sometimes they are actually becoming callous. It is of concern because it has been documented that they have been affected, whether they think so or not,” added Morgan.
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