“Some ER doctors view the emergency room like a battleground,” he argued.
“In a big city maybe, but not in a small town. Most of our patients are victims of accidents or poor health, not violence.”
The middle-aged man that reminded me some of Jim, nodded. “A common misconception about PTSD is that only people involved in war or experience violence are impacted. The truth is that the cause of it is extreme stress that in essence rewires the brain. An extremely frightening experience, such as being threatened with a gun or knife, can lead to symptoms.”
So, he knew about that. Had my mother told him?
“Or prolonged stress. Emergency room doctors have to contend with the unknown every day. They have to make life and death decisions. One wrong decision, one miscalculation, and a life is lost.”
I felt nauseous as the memory of Ms. Mason came back to me. Somewhere in her case was a bad dec
ision or miscalculation.
“The fact is, from what you describe … the nightmares, the feeling of being on edge, fear, racing heart, all that are symptoms of PTSD. But, regardless of what it’s called, if it’s impacting your ability to sleep and function, it’s a problem. It won’t just go away, even if you’re on vacation.” He looked at me pointedly. “Did you have a nightmare last night?”
“Yes,” I said but didn’t want to admit.
“So being with your folks didn’t make that go away.”
“What will?”
“Do you want it to go away?” he asked.
Was he shitting me? “Why wouldn’t I want it to go away?”
“Some people like to wallow in pain. Or perhaps feel it’s a punishment they deserve.”
The ‘wallow in pain’ made me think of Eli. Punishment though, was that what I wanted? No. What I wanted was to be a man worthy of love and success. Worthy of Mia. Jesus, I missed her. I felt like my heart was torn in a million pieces in my chest. I’d hurt the first time she left me, but this time, it felt worse. Was it because I left?
“Tell me what to do to make it stop, and I’ll do it.”
“Start by keeping a journal, especially around the anxious episodes. For example, when I mentioned issues in an emergency room, I could see that affected you. Write down the trigger and what you’re feeling.”
“How does reliving it help stop it?”
“It faces it head-on. It helps you understand it. And gives you a chance to process it in a way to avoid it in the future or take away its power. Often irrational thoughts or guilt are involved. For example, what about the emergency room comment made you upset?”
I inhaled a breath, not wanting to go back to it. “You said mistakes and miscalculations in life and death situations.”
“Do you think you made a mistake that led to a death?”
I looked down. “I don’t know.”
“Nick.” The therapist's voice was sharp, snapping my head up.
“Be honest. In that moment, what was the thought?”
“That I made a mistake that lead to a death.”
“So why did you say, you didn’t know?”
“Because I’ve gone through it a million times and while I did leave her to attend another patient, at the time I’d done what needed to be done. I’d ordered the tests. I thought I’d be ruling out a heart or lung issue, but …" My heart sped up and a wave of despair overtook me. “Fuck.”
“What are you feeling right now?”
“Like shit.”
“No, in your body. Hot? Cold? Anxious?”