Shirah Vollmer MD

The Musings of Dr. Vollmer

Archive for December 18th, 2014

Holiday Humor

Posted by Dr. Vollmer on December 18, 2014

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The Medical Trauma

Posted by Dr. Vollmer on December 18, 2014

 

 

 

Why go to medical school, if all you want to do is talk to people? I used to ask myself that question, and at times, I still do. Yet, periodically I am enormously grateful for my medical education, as is my patients. LuAnne, seventy, comes to mind. Knowing her for many years, I saw a healthy and vibrant woman who ate well, slept well, and exercised regularly. She has friends, a husband, children and grandchildren. Her family of origin is mostly healthy. Her mother is going strong at 95. She has no known risk factors, with a normal blood pressure, normal glucose levels and her thyroid is intact. Suddenly, I get a call from her husband that she has undergone a procedure for a pulmonary embolus. She had trouble breathing, went to the Emergency Room, was admitted and then devices were put in her veins so that the clot did not stop her breathing. Sure, a non-medical person can read Dr. Google and educate himself on the issues, but for me, with my background, I instantly knew what she went through and I could instantly talk to her husband about the details of her medical care. Moreover, having gone through these emergencies with many patients, I could imagine the psychological trauma which might ensue. The new-found vulnerability. The tremendous fear for the future. The immediacy of the present. Cycling through medical emergencies has given me the perspective and the wisdom to know both from a technical point of view about what the next steps are going to be, but also from a psychological point of view about the game-changing experience this will be for LuAnne’s mental interior.

At first, LuAnne was in denial. “I am lucky” she tells me, meaning that she did not die. “Yep” I say, “I see that, in the midst of being unlucky,” I remind her, to suggest that she was struck by lightning, and as with all traumas, there is initial pull for gratitude, sometimes followed by a tremendous sense of victimhood. Over time, LuAnne’s anxiety has sky-rocketed. She is afraid to go far from home, as that is where she feels safe, even though her trauma began at home. The downstream experience of this medical emergency has yet to flow, but together we are prepared for a lot of discussions about what this all means for her. Understanding the pathophysiology helps us a lot. We can work with her known versus her feared limitations. I can comfortably communicate with her other physicians. I can help her understand her new medications and I can help her ask good questions when she sees the doctor. I can also point her towards mindfulness classes to help her cope with her fears. LuAnne appreciates my medical background, so maybe for that alone, it is good I went to medical school.

 

Posted in Psychiatry in Transition, Psychoanalysis, Psychotherapy | 8 Comments »

 
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