Invisible scars: Recognizing and treating medical trauma

"Some of our patients have said, 'Well, sure, I'm alive, but if I knew I would have these problems—cognitive impairment and PTSD, anxiety and depression, no job, limited ability to work—I actually wish I never would have made it out of the ICU.'" That quote from psychologist James C. Jackson captures why medical trauma matters: survival is not the same as recovery. Jackson, who directs behavioral health at Vanderbilt's ICU Recovery Center, estimates that between 10 and 22 percent of ICU survivors develop PTSD—rates comparable to those seen in combat veterans. But the problem extends far beyond intensive care, and it often goes unrecognized by both patients and providers.

What medical trauma is—and isn't

Jackson defines medical trauma as "the emotional and physical and even the cognitive distress that is born out of difficult medical experiences and also difficult medical encounters." The causes range from the obvious—a ventilator stay, a cancer journey, an emergency C-section, a surgery that went wrong—to the more subtle: the "drip, drip, drip" of a chronic illness that derails your life, or the experience of being dismissed or gaslit by a healthcare provider again and again.