Post-traumatic stress disorder (PTSD) is a mental health condition that’s triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.

Many people who go through traumatic events have difficulty adjusting and coping for a while, but they don’t have PTSD — with time and good self-care, they usually get better. But if the symptoms get worse or last for months or even years and interfere with your functioning, you may have PTSD.

Doctors much like all professionals suffer from PTSD. The incidence I believe is far higher than reported and rarely makes it into publics eye, it is there, ever present, lurking to expose its ugly head. I believe this probably a result of training from my era of medical training. We were on call every other night, a perspective on this would be to show up on your job at 5:30 am on a monday morning, working all day, usually no break, lunch or limited dinner, with a total of 50 minutes sleep,until the following morning after daily rounds at 11:00am. The days work would continue until tuesday at 11;59pm, home to sleep several hours and back at work on wednesday morning at 5:30am. This was common in US medical training and accepted as a right to passage. Continuous stress, sleep deprivation and lack of food, that is the formula for enhance interrogation tecniques, AKA “torture”. I am not proud to admit I came from a system of training where my longest period on call was 56 hours. Most patients or experts in the field never really have an appreciation of what it takes to develop the most innovative physicians in the world. This was the model used by many training programs and now is no longer tolerated by the american association of medical colleges.

This begs the question, ” Can human performance really maintain high level of competency on minimum hours of sleep and sustenance?

Hans Selye is one of my favorite scientist and usually is credited as the father of stress research. He performed elegant experiments in animals and humans clearly demonstrating the fight or flight response to physiologic and psychological stress. One of his classic experiments was to call a “pop quiz” on medical students and measuring there levels of Adrenalin. He was able to show that the mere mention of a stressful event and the brain can trigger a physiological response of stress. In todays world we now know this to be true that indeed the brain can trigger severe stress response even when our bodies are calm and resting comfortably. Moreover, this really tells us that the brain can trigger responses that are as powerful as the human body. One really does have to ask the question, can stress cause my heart attack? high blood pressure and even cancer? These concepts have already been studied and have not yet been conclusively demonstrated, but it sure is thought provoking.

The new normal for training doctors in the united states is more humane, 50% less call, doctors in training can only work a maximum of sixty hours per week, but miss half the cases. These new laws complement lessons learned from pilots and even commercial truck drivers, as a result of possible error and safety from our roads and in our skies, it is mandated this professionals have rest to protect public safety. The question now is, if doctors in training have limited work hours, what about once they are done training? No such rules applies for the doctors whom are responsible for your care. Your doctor in charge of your six hour operation on monday, could have been on call since friday at 5pm with as little as 4 hours of sleep. Starting your work week sleep deprived and performing high level functioning activities certainly needs to be vetted by the medical community and ask the fundamental question? Do medical errors have any relationship with sleep deprived medical professionals? Nurses, pharmacist, surgeons, emergency room professionals?

The patients need to be reminded of our Hipocratic oath,

I swear by Apollo, the healer, Asclepius, Hygieia, and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgment, the following Oath and agreement:

To consider dear to me, as my parents, him who taught me this art; to live in common with him and, if necessary, to share my goods with him; To look upon his children as my own brothers, to teach them this art; and that by my teaching, I will impart a knowledge of this art to my own sons, and to my teacher’s sons, and to disciples bound by an indenture and oath according to the medical laws, and no others.

I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.

I will give no deadly medicine to any one if asked, nor suggest any such counsel; and similarly I will not give a woman a pessary to cause an abortion.

But I will preserve the purity of my life and my arts.

I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art.

In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction and especially from the pleasures of love with women or men, be they free or slaves.

All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and will never reveal.

If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all humanity and in all times; but if I swerve from it or violate it, may the reverse be my life.

The most obvious in the oath??

“To do no harm”..

With the affordable health care act, economic forces, physician burnout, what those the future hold for humanity?

check you insurance!!!!!!!!!!