No, hearing that child screaming in the patient care room is not “normal.” My best friend’s son was throwing a tantrum the other night while we were having dinner. He did not want the Chinese food I had picked up, even though I got him the good stuff (sweet and sour chicken). He cried for a while on the couch until his father couldn’t take it anymore. He brought the child upstairs to his room to let some of his frustration out. All he did was cry more. His father eventually brought him back downstairs and gave him to my friend to hold while the rest of us ate dinner. His father, clearly distraught by the situation, finally calmed when their son fell asleep in my best friend’s arms. The weird thing was that this whole situation didn’t faze my best friend or me. Because we are pediatricians, we listen to crying children all day. We even joked about how when kids scream in our office their parents get so upset, and we have to calm them all down like this is our normal everyday life. Unfazed by crying, screaming children? This is not “normal.” The relentless pain, fear, and illness we witness as physicians have rewired our brains. These traumatic experiences our patients are suffering have become commonplace for us. Our fight or flight instinct has been on overdrive since the day we started medical school and saw our first patient. We have worn down this instinct so much that only high-impact distress causes us any worry. Our brains are unable to compute a screaming child as a danger. As something we should worry about. Our brains have to experience more extreme distress to compute that we are in danger. This constant low-frequency amygdala activation has led us to decreased awareness of our own body’s response to stress. We move from patient to patient without thinking that what we see every day is not “normal.” Ultimately, we may never stop to consider this until we burn out. We burn out due to severe circumstances that are beyond what a typical person would quit for because we are unaware of those initial warning signs. We allow ourselves to experience these traumas because it is our job, and we make efforts to find comfort in these situations without awareness of what is happening subconsciously. This must stop. Too many physicians are burning out and/or developing moral injury, many losing their lives to living in this constant state of stress. We need change. It is time for us to rewire our brains to understand that what we witness every day is not normal. It is time that we center ourselves before moving on to the next patient. It is time that we take care of ourselves immediately when our amygdala is activated instead of pushing through. Next time you hear that child screaming and afraid of seeing the doctor, take a deep breath, notice how your body feels, and notice the areas you have tension. Become aware of the areas that feel tense, the headache that is nagging at you, and the stomachache that is starting to build. Allow yourself a moment to focus on yourself, not the next patient. Take a drink of cold water, go to the bathroom, and maybe take a lap around the room. Physically relax those tensed muscles. This will allow you to start the journey of healing. Instead of just pushing yourself deeper until the bottle of unprocessed emotions causes an explosion, notice each moment. The more that we are aware of what we are experiencing, the easier it is each time to ground yourself and process before moving on. This is not easy and requires practice, but we can do hard things. We graduated from medical school and residency! We spend so much time healing other people. It is time we heal ourselves too. Source
