General Trying to educate the medical profession - let alone the public!

[Sighs]

Dear Director of Nursing,

As discussed by telephone today, my partner X underwent an Endoscopy on Thursday 15 March 2018 performed by Dr L. X is a combat veteran who has been medically retired due to PTSD.

While placing X under sedation, the doctor administering the medication asked him what he did for a living. After X explained that he is a retired infantry soldier, the doctor asked a series of more and more invasive questions until finally asking how X’s PTSD came about. By this stage X was feeling very vulnerable and uncomfortable due to the questions being asked of him and had become physically agitated and was consciously fighting against the sedation. Dr L then arrived and seeing X’s agitation, reassured him, telling him to relax and that he would be taken care of.

While I don’t believe the doctor intended to upset X, I want to point out the inappropriate nature of the interaction. While I appreciate that veterans with PTSD may react badly to sedation, particularly when coming around, I consider that that question ought to be very carefully worded and asked well before any sedation is given. It is NOT appropriate to ask a patient about the nature of the trauma which led to PTSD, especially as they are being sedated. In fact, it could have led to extremely serious consequences. If X had begun to recall the details of his trauma, whilst somewhat disinhibited due to the medication, this could have resulted in a flashback, dissociation or even a decompensation of his mental state. Given that the doctor asking him the questions is not a mental health professional, one wonders how he would have managed the situation.

I couldn’t help wondering if similar questions would be asked of a civilian woman with PTSD, or indeed a civilian male with anxiety or depression. It comes across as morbid curiosity which I consider extremely unprofessional.

It would be a wonderful outcome if the doctor concerned was prepared to telephone X and apologise for causing him distress. Moving forward I suggest that staff and medical professionals be made aware of the need to be mindful of patient’s mental health as well as their physical health.

I appreciate the time you spent with me on the telephone and hope that this communication assists in making ABC Endoscopy a safe environment for those with mental health issues.

:banghead::banghead::banghead::banghead::banghead:

 

[Friday]

Have I mentioned lately how much you kick ass?

 

[shimmerz]

if similar questions would be asked of a civilian woman with PTSD

Yes. All the time. I put it down to morbid curiousity at times but at other times it is actually questioning in case there is a bad reaction so the office/hospital can be prepared.

 

[Sighs]

@shimmerz - I understand questions along the lines of 'I understand that you have PTSD. Has that caused you to have a poor reaction when awakening from sedation? Is there anything we can do or should know to help you in dealing with this medical procedure?" I'm fine with that. But, "So, how did you get PTSD?" or "What caused your PTSD?" or "What happened to you that gave you PTSD?" as the patient is drifting off under sedation? Really?

Surely there are more appropriate times and more sensitive ways to discuss it than that? For example, "I see that you have PTSD. This procedure involves placing a camera into your back passage. Sometimes people who have suffered sexual assaults find that very difficult to deal with. Is there a support person you would like to have with you in recovery?" Asked WELL before injecting medication into the patient's veins. And in no way asking the patient to volunteer ANY information about their own PTSD.

I'm sorry to hear that you are also subjected to insensitive questioning. This is why I write these emails to people. If I can educate just one person that is one less person making life harder than it needs to be for those with PTSD (and their supporters who often bear the brunt of the reaction once the sufferer comes home!)

 

[shimmerz]

I think it is a PTSD thing in general @Sighs. I won't bore you but I have had many, many issues with inappropriate questioning and then a complete dismissal of what I have said. This has caused hospital staff to be abusive verbally and physically in my case. They use the mentally ill label at times to justify what they are doing.

Most people don't get PTSD. They don't want to get it. Also, I think you kind of have to have had experience with the authenticity of the behaviours (and the triggers can be so subtle) to really 'get it'.

You are right, the insensitivity of the doctor was deplorable. Shockingly, that doesn't surprise me and I am very sorry your husband had to go through that.

 

[Sighs]

Maybe it's more of a medical professional thing? My daughter had to undergo major spinal surgery at the age of 13 and I stayed in the hospital with her and had SO many arguments with the staff (both nursing and medical) about her autism. As you mentioned "a complete dismissal" of what I had JUST said to them. And some were so condescending! After all, they are a health professional and I'm just the kid's mother! Yeah - with 13 years experience of managing this particular patient's autism 24/7. So if I tell you xyz is going to cause a massive reaction and you need to do abc to achieve the result maybe, just maybe, I know what I'm talking about!

I despair sometimes of ever lessening the stigma and having more understanding of mental health in the general community when we can't even achieve it within the health professions. Sigh!

 

[shimmerz]

Maybe it's more of a medical professional thing?

Yes. That is what I have come up with. My normal interaction in a hospital zone is about on par with what you have mentioned regarding your daughter. Humanity, more so here in Canada, as I have had experience in both the USA and Canada, is definitely not the priority that I once thought was standard procedure in hospitals.

 

[anon1234]

How dare a complete stranger ask details about what led to the PTSD? Particular when the patient was vulnerable? I have never asked my partner the details of what happened in combat, and learn them as he feels able to tell me. This is awful, seems like grounds for disciplinary action TBH.

 

[Sighs]

@anon1234 - I can't count the number of times I've heard the following conversation:

Stranger: So, what do you do for a living?
Vet: I'm a retired infantry soldier.
Stranger: Oh. [small pause]. So... have you ever killed anybody?
:rolleyes::banghead::sour:

 

[anon1234]

@Sighs I know, exactly. It is awful. People have no idea. I still don't know what exactly happened to my vet, and I'm not willing to ask until he tells me. All I know is that it was a deeply traumatic and upsetting experience.

The worst is when you tell people find out you are dating a vet and they immediately bring up PTSD. I'm fed up of it. It's none of their business.

 

[anon1234]

Typo: meant to say "when you tell people you are dating" - always been bad at proof reading!

 

[anon1234]

@Sighs Literally the first and only time I asked that when I was 6 years old. I asked my grandfather if he had killed anyone in the war. And I remember it very well because it upset him and I didn't know what I'd done, so I got upset too, because I loved him and didn't want to see him unhappy. He was a wonderful man, I regret it to this day, even though I was a child when it happened. My Mom very gently told me that it wasn't a polite question. Later on, he calmly sat me down, and talked to me about his experiences, and how war was a bad thing.

I don't know how an adult could ask that question without having an understanding of the repercussions of their actions.