Maintaining emotional wellness as a trauma surgeon

As a member of the trauma team at one of only two level-I trauma centers in Houston, I see all types of injuries, ranging from non-accidental trauma (violence, suicide, abuse) to accidental trauma (occupational, motor vehicle). No matter the circumstance of the injury, these experiences can be upsetting.

Emotionally, the hardest part about being a trauma surgeon is delivering bad news. Families often arrive to the hospital only knowing that their loved one has been hurt, but still having hope that everything will be OK.

It feels awful to take that hope away, and tell them that their loved one has died before they could even say goodbye. Telling parents that their child has died is particularly heartbreaking for me as a parent.

While it can be difficult to cope with the emotions that I experience at the hospital, I have learned to take my emotional temperature more frequently.

Emotional and physical care

The first thing I want to do after a really emotional day is hug my spouse and my children. I’m aware that tomorrow is not promised, so the time with them feels precious after seeing someone else’s loved one taken from them.

I recognize that seeing tragedy frequently can cause disengagement and burnout, and this is certainly not unique to trauma care. When I feel emotionally injured, I do what is needed to give myself time to heal.

A big part of avoiding disengagement is health maintenance. I exercise frequently. In particular, running always makes me feel better. I also play tennis about once a week and try to play golf with my dad once a month (my golf shots generate lots of laugh therapy).

For me, these activities are crucial to having the physical and emotional reserve to handle the stressors and challenges of work, and managing the emotional hazards of trauma care.

Healthy vs. unhealthy criticism

While redirecting my attention at home comes naturally to me at this point in my career, I have experienced some difficulty letting go at times. As I’ve grown more confident in my clinical skills, I am usually certain that I did everything in my power to help my patients, and I am able to focus on my personal life without guilt.

This was not easy when I was a younger surgeon, and I lay awake at night wondering if I had made the right choices at work. Over time, I have learned to recognize that the outcome is not always in my hands.

There is also comfort in our peer-led case review process. Having colleagues who support one another while trying to improve performance is critical. I am proud to say that I work with a group of people who hold me accountable for the care I provide, but simultaneously show respect and even empathy for the difficulty of our work.

Supporting trainees

As an educator, it is also important to be aware of the impact this work is having on student and resident learners. Particularly with residents, there are often signs (such as sarcasm or a short temper) that suggest they may be out of balance. When I note that a trainee seems out of balance, I try to encourage them. Usually, there is no deficit of passion, but their perspective has changed.

Passion is healthy, but passion without balance can be professionally disastrous. I encourage trainees who are experiencing this to take some space from their work to maintain a healthy perspective. There is no simple formula that fits everyone to ensure their wellbeing. It varies from individual to individual.

So, what have all of these experiences taught me? Seeing tragedy strike people suddenly and without warning has definitely made me a more careful person. I think a lot about safety and security now, and it reminds me frequently that tomorrow is not promised.

-By Dr. Chad Wilson, associate professor of surgery at Baylor College of Medicine and director of trauma at Harris Health System’s Ben Taub Hospital