When Medicine Does Harm: Medical Trauma

Last year, I fulfilled a bucket-list goal of mine: to present at the American Association of Naturopathic Physicians 2024 Convention. I was one of about twenty chosen out of over 200 proposals to speak to my colleagues and it was such an honor. 

But I would be remiss if I didn’t share some of what I presented since it likely affects more people than we realize. And that is medical trauma.

As a society, we are very familiar with the concept of emotional trauma but it’s been in recent years (less than a decade or two, at most), that the idea of medical trauma has been something that is gaining interest. A lot of research has been on medical trauma for children, but recently we’ve realized this can also effect adults.

As a relatively new concept, there’s not a diagnosis or an agreed upon definition but medical trauma is essentially a trauma that occurs from interacting with the medical system. Medical trauma is complex and can have different factors like the patient, the medical staff, the medical environment, and even the diagnosis or procedure itself. 

The main thing when it comes to medical trauma (or trauma in general), is that if the person feels they experienced medical trauma, then they experienced medical trauma. Medical trauma is a subjective experience and exists on a spectrum. 

For example, a person could go in for a routine procedure like a blood draw, but due to their risk factors (like past history of trauma, poor coping skills, lack of a support system), the procedure itself (perhaps the blood draw had to be attempted several times and caused unanticipated pain), the medical staff (they didn’t seem to care that the patient was distressed and was dismissive about their pain), and the environment (blinding fluorescent lights and white blank walls) they experienced that procedure as a medical trauma. 

On the other hand, we could have an individual who had a heart attack, ended up in the ICU for a week and had to have heart surgery, but due to their lack of risk factors (have a great support system, no previous trauma, robust coping skills), the medical staff (the nurses and doctors were genuinely caring), and the environment (their room had a window and they got to take daily walks in a garden), they did not experience that time in their life as a medical trauma.

I strongly feel that naturopathic doctors specifically can be instrumental in interrupting the cycle of medical trauma. We spend time with patients, we allow them to ask numerous questions, and we care about their mental and emotional health. My hope with my talk at the conference was to start to give naturopathic doctors language and vocabulary around this newer concept so they can better identify it in practice and help patients get the support they need.

As I was putting together my presentation, different patients kept coming to mind and how the stories they shared with me, could be considered medical trauma. That’s why I think it’s equally important that you, the individual that is or will be a patient in our medical system, be aware of this issue. And more importantly, know what can be done to prevent this from occurring or if it has already occurred, identify that this is a factor in your health and know what steps can be done to help heal from the trauma that occurred. 

Be Your Own Advocate

One thing I’m frequently coaching my patients is how to be your own advocate. It can be hard if you’ve been (or are currently) gaslit by medical providers to stand up for yourself. It is common, especially for women, to be told their symptoms are due to stress (aka in your head), aging, or normal. Part of being your own advocate is to trust your body and what you’re experiencing. 

Another important step is asking questions. No matter what the demeanor of your provider, it is your right to ask questions. In fact, in medicine there’s “informed consent” where you’re supposed to be fully informed of the process, benefits, and risks to any medical intervention. But the most important part of informed consent is asking questions so you can make a truly informed decision. If a provider doesn’t like you asking questions, gives you non-answers, or doesn’t answer your questions, that is a red flag. 

In Danielle Ofri’s book, “When We Do Harm”, which looks at medical error in America, some great questions she suggests patients asks their provider include:

-“What makes you think so?”

-“Is there anything else it could be?”

-“Is there anything we can’t afford to miss?”

Other steps you can take to be your own advocate is get a second (or third, or fourth) opinion. It is called the practice of medicine for a reason. Every provider has their own speciality, approach, and way of thinking so getting other opinions about your care is well within your right. Worst case scenario, you can fire your doctor. 

And research shows that women receive better healthcare by having a male (spouse, brother, friend, etc) present during their visit. 

Seek Help

We know that medical trauma causes a host of symptoms including:

-physical limitations from the trauma or procedure

-PTSD, anxiety, or depression

-strain on relationships

-disrupts or delays goals

-nonadherence or avoidance of medical care (including preventative procedures) -hypervigilience around medical issues

-financial strain

-existential crises (why me?)

Research is still in it’s infancy around medical trauma in adults but we know there are some risk factors around medical trauma. Most of them are non-modifiable such as gender, race, past history of trauma, etc. But the most important ones thankfully are, specifically post-trauma life stress and post-trauma social support. 

If you are dealing with the ramifications of having experienced a medical trauma, getting help is a wonderful first step to take. This can be through family and friends, but professional help in the form of counseling is a great option. Some patients are hesitant to pursue counseling due to stigma or having seen a counselor in the past and not having a good experience. I tell my patients that counseling (or seeing any provider really) is like dating. You may have to try a few different people until you find the right person for you. 

And there’s so many different styles of counseling and mental health support now! So sometimes it’s finding the right type that works for you. Different types of mental health support include:

-cognitive behavioral therapy (CBT), especially trauma-focused on mindfulness-based

-eye movement sensitization and reprocessing (EMDR)

-brainspotting

-somatic experiencing

-neurofeedback

-neuro emotional technique (NET)

-mindfulness-based stress reduction (MBSR)

In addition to counseling, we have countless naturopathic tools to help support your nervous system to recover from medical trauma. From using nervine and adaptogenic herbs to help your body calm down and reset or a homeopathic remedy to help you process your feelings around the experience, naturopathic medicine has a lot to offer those that have experienced medical trauma.

As a doctor who takes time with, listens to, and believes my patients, I do not take lightly the trust people place in me when they open up and share their stories. Sadly, I’m rarely surprised by the horrific stories I’ve heard but it pains me each time I hear that the very system that is supposed to help people can sometimes be the worst perpetrators of harm. 

If you have experienced medical trauma, you are not alone and there is help available for you. Identifying that this is a problem is only how we in the medical community can try to prevent it and how you as a patient can heal from it.