I’ve begun my clerkship rotation in the intensive care unit this month, where we take care of patients with the most serious of medical problems. Many of our patients are post-operative from the cardiac surgery team, which generally means that they have had their ribcages sawed open and their heart stopped, hooked up to a machine, and restarted again. Caring for these patients, I wonder how they have the courage to face illness and to face death so courageously, to stare down the knife and operating table.
Over the month as I’ve grown to know my patients, my admiration has shifted from their adversity in the hospital to challenges overcome outside of the hospital. Many veterans have miraculous stories of war. But often returning home is the beginning of even more powerful stories. They are stories of creating lives, businesses, and families. But there are also stories of loneliness, addiction, and abuse.
How to interpret these observations? First we cannot underestimate the spatio-temporal reach of war. It has now been 50 years since the Vietnam War, and the ripples of PTSD are still omnipresent, from our vets in the hospital to their now grown children who in some cases were raised in households of abuse. The scale and intensity of the wars in Iraq and Afghanistan have similarly unleashed a tsunami of trauma with which we as a society or medical infrastructure are not equipped to cope over the coming decades.