I sometimes see men and women who come to the emergency department and tell me about their PTSD, caused by service in Iraq or Afghanistan.   I believe some of them; others I doubt, since their PTSD seems directly connected to a desire for Percocet, Lortab, MS-Contin or other prescriptions for back pain.  Sadly, the VA system does not lend itself to inquiry by outside physicians, so in many instances I am treating them in an information vacuum.

However, as I contemplate their allegations of PTSD, I wonder how many physicians and nurses from emergency departments have the disorder.  I’m no psychiatrist, but it just seems probable that the years of cummulative stress, the years of sleeplessness and snap decisions, the untold shifts filled with unpredictable chaos, pain, threats, death and anxiety would add up to significant emotional turmoil for providers who work in that environment.

It is appropriate that we are attentive to the needs of those who serve in combat zones.  And yet, they may spend only spend one or two years there.  Granted, that can be terrible enough.

But we must begin to pay attention to the emotional toll of work in America’s trauma centers and emergency departments.  The pay may be better than combat pay, but the fear, the uncertainty, the gut-wrenching pain of watching loss and grief, the struggle to make life-altering decisions, are all as real as those of any battle ever fought.

We may be different kinds of veterans, draped in scrubs not camo, but our struggles, and our pain, also have consequences.

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