Reality hurts, reality heals: Lessons from when doctors kill
Image by Getty Images via Daylife
When Maj. Nidal Hasan picked up his guns on November 5th and started firing, his victims included more than the 13 killed and 31 injured by the bullets he sprayed around; the entire community was his victim.
When doctors kill they do more than take innocent life, more than sour the lives of family and friends. They also undermine everyone’s trust that doctors will honor their oath to above all else do no harm. And when the killer is a psychiatrist the fragile trust people need to overcome stigma and seek help for often invisible problems gets further eroded.
Such is the current situation at Ft. Hood reeling from Maj. Nidal Hasan’s murderous rampage. According to the chief of the medical staff at the Carl Darnall Medical Center at Fort Hood in the current issue of Psychiatric News:
“The medical-care piece was easy,” said Col. Kimberly Kesling, M.C. “Helping people with their initial coping mechanisms and then getting them ongoing, long-term care is a bigger challenge.”
via Army Wastes No Time Helping Fort Hood Community Heal — Psychiatric News.
Children are a central part of the challenge:
Stephen Cozza, M.D., a professor of psychiatry at USUHS and associate director of its Center for the Study of Traumatic Stress, spoke initially with the local school superintendent to discuss how to integrate counseling services in the schools, then held a teleconference with 50 area principals.
“This event happened in a community where children were already under the ongoing stress of deployments and separation over the last eight years,” said Cozza, a former Army child psychiatrist who specializes in mental health issues of the children of military personnel.
“We wanted to help parents and teachers help kids understand what was happening and make sure that when they were talking with children that they could identify and rectify any distorted thinking by the children,” he said in an interview.
via Army Wastes No Time Helping Fort Hood Community Heal — Psychiatric News.
But what was the message he conveyed, what could he say to all the those educators that would help them help those in their charge? How do you reassure a community of children now that they know the people who are supposed to help them also include some who will hurt them? According to Dr. Cozza:
“We have to recognize, not minimize, that this [situation involves] someone who was supposed to help people, but we also have to remind children that this was an extremely rare event and that far more people who were there to help them and whom they can trust”
via Army Wastes No Time Helping Fort Hood Community Heal — Psychiatric News.
In other words, when dealing with kids suffering from the pain the world inflicts avoid empty platitudes. Hollow reassurance has no place; recognizing reality does. You can’t just wish away what happened with a warm smile and a pat on the head–a lesson the Catholic Church is having a hard time learning in priest-abuse cases. Instead, recognize what happened and remind victims that the world has love as well as hate, remind victims that many more people want to help than want to cause harm.
Healing from bad realities sometimes requires really good ones.
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Dear Dr. Essig,
Thank you once again for your trenchant comments. I appreciate the parallel you draw between strained and broken trust for doctors and priests. This may be particularly true for mental health providers, in some regards, whose domain arguably overlaps with religious leaders. Freud pointed out in his early technical papers that aspects of the physician’s authority stem from transferences originally felt toward the priestly professions, though this was before he spoke directly about transference.
One observation I’d like to highlight pertains to the different ways of dealing with painful emotions which are described in relation to trauma. One trend emphasizes diminishing uncomfortable emotions, and many effective therapies work on this principle. Another trend engages people in the potentially more difficult prospect of learning to live with, tolerate, regulate, and perhaps learn and grow from, adversity. Which is appropriate for whom, under what conditions, and when, is a complicated and important question.
Best wishes this holiday season,
Grant H. Brenner
Thanks for stopping by here and sharing some of your expertise (full disclosure: Grant is a valued psychoanalytic colleague with a special expertise in disaster mental health). Both of the approaches you mention–soothe the pain and learn how to live with what cannot be changed–take reality as it is. If we don’t start there, even as difficult as it can be to acknowledge how awful the world can be, we’re sunk.
Hope to hear lots more from you!
In response to another comment. See in context »DOCTORS KILL EVERYDAY, THEY KILL AND NOW CALL FOR THE MERCY KILLING AMENDMENT… i hate this concept of choosing to die, euthanasia, come on!
http://www.twitter.com/writtenviews has a word on mercy killing.