“I have trauma”
Three words that need to carry the gravity of more than three words can carry. They need to express the inexpressible. They need to be the words that tell the story that can’t be told.
Trauma in healthcare means different things but not usually what these three words must stand for. There are trauma patients that come through the Emergency Room door on stretchers, trauma surgeons standing by. Nurses and doctors who treat these traumas with efficiency and dedication.
“I have trauma.”
But they can’t see it.
They need to know and I can’t say.
How deep it runs.
Where it came from.
What treatment it needs.
They keep asking what’s wrong with me when I need them to know what happened to me.
The types of trauma – too many, too varied.
The understand the trauma of a gunshot wound or violence or natural disaster.
I know they won’t understand my trauma.
There’s no time to explain, but it will affect everything.
There’s no time to read what I try to write when the words don’t exist to tell them out loud.
There’s time for three words.
“I have trauma.”
But they aren’t enough.
I write this two weeks after my latest trip to the emergency room. I write this for the doctors in that hospital and ever hospital I’ve ever entered. I didn’t know how to disclose my trauma to them. I needed them to know. I needed them to know what happened. But beyond those words, I can’t…
Those words aren’t ones they were taught in medical school. They weren’t taught trauma informed care. They weren’t taught to handle disclosures. They weren’t taught how to change their standard procedures to accommodate this person who shows up with a need for care but whose deepest wounds they can’t see.
I want to explain. I’ve written in my notes app on my phone when I can. I have something printed, but it’s too long. And with care teams constantly changing, to have to disclose again and again and again, it can be as excruciating as what brought you there in the first place.
Further, when types of trauma abound, how can those three words explain? There’s abuse as a child, abuse as an adult, rape, gun violence, domestic violence, surviving a natural disaster, watching someone die, watching people be abused, medical trauma, war trauma, emotional and psychological trauma, trauma from serious accidents, generational trauma, trauma that has no category and trauma that fits every category. How to explain the types of trauma I’ve survived? How to explain how you might make it worse or better? There is no time. There aren’t enough words.
There is no understanding of what trauma means to each person individually. Some patients prefer victim. Some prefer survivor. Some identify with both and neither. Those who know trauma also know to prepare as best we can for complicated scenarios, trying to brace ourselves and our minds from being torn asunder once more. The “best” of circumstances will still be too hard. But it’s never the best of circumstances. There’s always more. It’s not in our control. Though it never truly was.
There’s no way out and no way through.
There are these three words, “I have trauma.” And they need to stand for what happened to me. They need to tell the nurses and doctors and staff to slow down. They need to convey that they are hurting me even when they are healing me. They need to communicate what types of trauma and how indelible trauma is to my existence. They need to set in motion trauma informed care practices – formal protocols that don’t yet exist. They need to impart knowledge that is on here but is not there.
Three words that are never enough.
I write on here about trauma informed care and about my experiences because I need the words to be enough one day. I need them to hold the enormity and solemnity carried within those eleven letters. My words here may not reach those who I’ll need to understand, but in the midst of the chaos that is health care, perhaps these words will reach others caring for patients who only have those three words:
“I have trauma.”