Speaker 1: Welcome to the Trauma Therapists podcast. My name is Gaming Person.
Speaker 1: I interview incredible people who've dedicated their lives to helping
Speaker 1: those who've been impacted by trauma. A big thank you
Speaker 1: to our sponsors and our guests who are supporting this show.
Speaker 1: So vive for Grade too and one our folks book
Speaker 1: back to the podcast. Very excited to have as my
Speaker 1: guest today, Doctor Jim Jackson. Jim Welcome, Thanks guys.
Speaker 2: It's really good to be with you today and I'm
Speaker 2: excited to talk to you today and to your listeners
Speaker 2: about medical trauma.
Speaker 1: All right. Jim is a clinical psychologist, researcher, and award
Speaker 1: winning author specializing in trauma, PTSD, and the psychological impact
Speaker 1: of critical illness. He serves on the faculty at Vanderbilt
Speaker 1: University Medical Center, where his work focuses on ICU survivors
Speaker 1: and the long term effects of medical trauma. Doctor Jackson
Speaker 1: is the author of Clearance, as well as Reclaiming Your
Speaker 1: Life from Medical Trauma, his latest book offering a practical,
Speaker 1: compassionate roadmap for survivors of serious illness and ICU stays.
Speaker 1: Drawing on clinical experience and patient stories, the book helps
Speaker 1: readers understand post intensive care syndrome process trauma, and we
Speaker 1: build a sense of meaning and identity after medical crises.
Speaker 1: All right, Jim, obviously, just a little bit about you
Speaker 1: share with the listeners where you're from originally and where
Speaker 1: you are currently.
Speaker 2: Yeah, sure, thank you, Yeah, thank you. I'm from southwestern Michigan.
Speaker 2: I don't know how many listeners you have from Michigan,
Speaker 2: but I'm from right outside of Kalamazoo, a little town
Speaker 2: called Portage. And I love Michigan, but when I moved
Speaker 2: to a warmer locale, living there seemed a little bit
Speaker 2: less good. And I now live in a place where
Speaker 2: they don't have six months of winter, and that is
Speaker 2: in Nashville, Tennessee. I've been here for about twenty five years.
Speaker 1: Awesome, all right, so we're going to get into the book.
Speaker 1: I'm really curious how you started out, how you got
Speaker 1: pulled into this field in the first place, and then
Speaker 1: more specifically trauma and the effects of critical illness and
Speaker 1: chronic illness secondarily. But how did it all begin for you.
Speaker 2: It's a really good question, you know. I have Vanderbilt
Speaker 2: undergraduates who are in our lab here at Vanderbilt, and
Speaker 2: often they asked me for career advice, and I wish
Speaker 2: that I could tell them that it's a linear process,
Speaker 2: right like you set out down a straight path and
Speaker 2: you know how it's going to work. In my life,
Speaker 2: that rarely has been how it happens. I came to
Speaker 2: Vanderbilt to do a psychology residency at a place called
Speaker 2: the Vanderbilt VA Consortium. And during those days in two thousand,
Speaker 2: there was a critical care researcher named Wes Elee who
Speaker 2: was just starting a program focused on outcomes and ic
Speaker 2: you survivors, mental health outcomes, and he needed a psychologist
Speaker 2: and I happened to be one, and we had a
Speaker 2: baby on the way, and I needed a job. And
Speaker 2: it was really that simple, you know. I dipped my
Speaker 2: toe in the water. It felt fine, and then I
Speaker 2: jumped into the deep end and began to study specifically
Speaker 2: individuals who had been on a ventilator, on a respirator.
Speaker 2: Often they'd had a condition called sepsis or something called ards.
Speaker 2: They were the sickest of the sick, and in dealing
Speaker 2: with them, what I noted, again this is almost a
Speaker 2: quarter of a century ago, what I noted was that
Speaker 2: often they had recovered physically very well, but now because
Speaker 2: of the difficulties of being in the ICU, they had
Speaker 2: brand new problems they didn't have before. And often those
Speaker 2: problems were of a cognitive nature, that is, they had
Speaker 2: brain injuries. But very often those problems were of a
Speaker 2: mental health nature. They had symptoms of PTSD, they had
Speaker 2: symptoms of anxiety, They were worried about their health, they
Speaker 2: were bewildered by the brand new chronic illnesses that they
Speaker 2: were now experiencing. And as I began to engage with
Speaker 2: those patients in research studies and later in the clinic,
Speaker 2: as I pulled the thread, the story started to kind
Speaker 2: of unravel, and that was it was a story in
Speaker 2: which medical trauma. I didn't have that term. Then, you know,
Speaker 2: people have since started using it. It was a story
Speaker 2: in which medical trauma played a central role. These were
Speaker 2: not veterans of combat. These were not survivors of other
Speaker 2: things that we think of causing trauma, like sexual assault.
Speaker 2: These were not survivors of auto accidents. They were survivors, though,
Speaker 2: of a different kind of trauma, medical trauma. And even
Speaker 2: as those other conditions left to Mark, I began to
Speaker 2: learn that these life threatening medical conditions left to Mark,
Speaker 2: and as my work at Vanderbilt evolved, I moved from
Speaker 2: working with survivors of critical illness to people with chronic illness,
Speaker 2: to people after complicated surgeries, total populations of all kinds,
Speaker 2: and the same truth held, and that is, medical trauma
Speaker 2: was central to their story. It wasn't the only problem
Speaker 2: that they had for many it wasn't the prime problem,
Speaker 2: but it was a key problem. And I decided that
Speaker 2: someone needed to shine a light on this problem, which
Speaker 2: was really underappreciated.
Speaker 1: All right, let me pause you right there, so we're
Speaker 1: gonna get dive into that. I want to take a
Speaker 1: step back. How the heck did you get into psychology
Speaker 1: in the first place.
Speaker 2: It's great question. I wanted to be a sportscaster. That
Speaker 2: was my passion.
Speaker 1: I could see that with you.
Speaker 2: That was my passion. And I was pretty good, I
Speaker 2: will say I was pretty good on air. But all
Speaker 2: the technical things that editing back in the day, and
Speaker 2: the splicing of film and learning to work a camera,
Speaker 2: that was very intimidating to me. And I wasn't really patient.
Speaker 2: I'm not actually patient now, but I very much wasn't patient.
Speaker 2: I really didn't want to be a sports caster if
Speaker 2: I had to do a lot other than talk, which
Speaker 2: seemed at the time to be my singular gift. So
Speaker 2: I changed majors three or four or five times, graduated
Speaker 2: from college honestly in five years. By the skin of
Speaker 2: my teeth. I wasn't hugely focused in the nineteen eighties,
Speaker 2: but I had taken a psychology class or two and
Speaker 2: I had really enjoyed it, and after running around the
Speaker 2: barn a few times, it felt like helping people might
Speaker 2: really be my calling. So I got into a master's
Speaker 2: program in clinical psychology, a program in Atlanta, Georgia, really
Speaker 2: by the skin of my teeth. And while I was there,
Speaker 2: I met the woman that would become my wife, and
Speaker 2: she has been a great influence on me. She has
Speaker 2: focused me a lot, she has pushed me, she's empowered me,
Speaker 2: and with her belief in me, I quickly realized, I
Speaker 2: think I can do this, and I don't need to
Speaker 2: stop at a master's I think I'm going to get
Speaker 2: a doctorate. And before I knew it, I was in California,
Speaker 2: suing one and that's how it unfolded. I was discouraged
Speaker 2: at various times, as people are, and honestly This is
Speaker 2: a strange story, but a true one. Michelle and I
Speaker 2: were at a Chinese restaurant one day called August Moon,
Speaker 2: and I got a fortune cookie, still have it somewhere,
Speaker 2: and it said the fortune said you will prosper in
Speaker 2: the field of medical research. And I thought, how random
Speaker 2: is that? Right? Like, wow, very different than you'll find
Speaker 2: your true love or you know whatever generic fortune cookie
Speaker 2: say you will prosper in the field of medical research.
Speaker 2: And really candidly, I did take that as a sign,
Speaker 2: and I'm happy to say with humility that I have
Speaker 2: been able to prosper in the field of medical research.
Speaker 1: What a great story that is. So all right, you
Speaker 1: talked about the opportunity you had initially. I think when
Speaker 1: you when you were studying, you said you dip your toe,
Speaker 1: and then you said you dove in. What about working
Speaker 1: with these individuals who were experiencing medical trauma? Obviously that
Speaker 1: wasn't the term at the time, But what about those
Speaker 1: individuals or that experience drew you or pulled you.
Speaker 2: Yeah, it's a great question. So in the early days
Speaker 2: of my work two thousand and one, two thousand and
Speaker 2: two and three, we were enrolling patients and studies at Vanderbilt.
Speaker 2: But when we were following them up, and I was really,
Speaker 2: in those days, the only person that followed them up.
Speaker 2: I was following them up in their home. So I
Speaker 2: was driving all over the southeastern United States. I was
Speaker 2: going to Georgia, Mississippi, Kentucky, obviously, Tennessee, occasionally other places,
Speaker 2: all the time, multiple times a week. And as I
Speaker 2: was sitting across the table from these patients, these survivors
Speaker 2: of intensive care, eating cast or rolls at their dinner table,
Speaker 2: you know, sitting on the porch after we'd finished an assessment,
Speaker 2: really getting to know them, I was deeply moved by
Speaker 2: how derailed their lives were after these illnesses they had experienced.
Speaker 2: You know, their lives were turned upside down. They were
Speaker 2: often afraid to go to the er because they were
Speaker 2: worried that they would be sent back to the ICU.
Speaker 2: They were reacting to every single noise that they heard
Speaker 2: because it sounded like a noise in the hospital. You know,
Speaker 2: they were clearly hypervigilant. And as I got to know them,
Speaker 2: many of them quite well, I was touched. I was
Speaker 2: touched by the severity of their problems. I was touched
Speaker 2: by the fact that they didn't feel like they had
Speaker 2: any resources or anywhere to turn. And when that happened,
Speaker 2: I thought, you know, the least I can do is
Speaker 2: not dip my toe in, but jump in the deep
Speaker 2: end of the pool and really figure out how we
Speaker 2: can help those people. And that led to a lot
Speaker 2: of developments. One thing it led to was to the
Speaker 2: creation of a clinic for ICU survivors that I co
Speaker 2: founded with my friend and colleague, doctor Carlo Stephen. It's
Speaker 2: called the ICU Recovery Center at Vanderbilt, and that clinic
Speaker 2: has been going for about thirteen years now, and it's
Speaker 2: been dedicated to ice YOU survivors, and not only them,
Speaker 2: but to people with life threatening illnesses of all kinds
Speaker 2: who have complicated problems cognitive and mental health and physically
Speaker 2: physically driven problems. And people have come to us in
Speaker 2: the clinic really from all over the United States, from
Speaker 2: probably thirty different states, and it's been a privilege to
Speaker 2: try to address these challenges they have. And a recurring
Speaker 2: theme that I hear from them is when I talk
Speaker 2: to my PCP, when I talk to my counselor when
Speaker 2: I talk to my subspecialist about these problems, I'm having.
Speaker 2: They don't know what to do with me. They've never
Speaker 2: heard the term medical trauma. They don't know what post
Speaker 2: intensive care syndrome is, and on and on and on
Speaker 2: it goes, So.
Speaker 1: Me, okay, so clarify this if you can. What the
Speaker 1: hell are we talking about here? So these people go
Speaker 1: into the ICU, what do they When you think ic you,
Speaker 1: When I think ic you, you think a high level
Speaker 1: of care, a high level of amazing care. But a
Speaker 1: percentage of people are experiencing what we're calling medical trouble.
Speaker 1: What are they experiencing?
Speaker 2: It's a great question. Uh, And I should clarify. I mean,
Speaker 2: I agree with you. I work in the ICU a
Speaker 2: day or two a week at Vanderbilt, and at Vanderbilt
Speaker 2: and elsewhere, people get an amazing level of care. And
Speaker 2: yet that experience of being delirious and having episodes that
Speaker 2: are you know, essentially episodes of psychosis where people hear
Speaker 2: things and see things that they think are there but
Speaker 2: are not really there. Right Like, That's a common phenomenon,
Speaker 2: and it's very traumatic being on a ventilange and being
Speaker 2: mindful of the fact that you very well may die.
Speaker 2: It's hugely traumatic. The nature of the critical illness, which
Speaker 2: is often Hey, it's Wednesday, and on Monday I was fine, right, like,
Speaker 2: I was living my best life and I got infection
Speaker 2: and Wednesday I wake up with a tube down my throat.
Speaker 2: I have no idea where I am. I have no
Speaker 2: idea how I got there. Those are the sorts of
Speaker 2: traumatic experiences that people have and they are left to
Speaker 2: try to make sense of what has happened. And that's
Speaker 2: even in the context of the best care. You know,
Speaker 2: there are some situations where we can do the very
Speaker 2: best we can and it's still really hard, and critical
Speaker 2: illness is one of those. Cancer would be another one.
Speaker 2: I think.
Speaker 1: So is this something that has been left out of
Speaker 1: the treatment and care that I see you as delivering.
Speaker 1: Is this kind of not really frontline care? Is it
Speaker 1: just are they just thinking, well, we're just dealing with
Speaker 1: we've got to deal with and I'm sorry, but I
Speaker 1: mean to be blunt like that, but yeah, people are
Speaker 1: going to get traumatized.
Speaker 2: Yeah, I think I think there is a recognition that
Speaker 2: people will get traumatized and that we shouldn't be fine
Speaker 2: with that, right, Like, we emphatically should not be okay
Speaker 2: with that, and that despite our best efforts. There are
Speaker 2: going to be some emotional injuries, and those injuries are
Speaker 2: injuries that I think we can attend to thoughtfully in
Speaker 2: the ICU if we have the resources to do it.
Speaker 2: You know, for instance, when I see people in the ICU,
Speaker 2: I'm trying to set expectations. I'm trying to help them
Speaker 2: brace for what is coming. I'm trying to help them
Speaker 2: manage their anxiety. We're talking to families about more effective
Speaker 2: and less effective ways to provide support. So I think
Speaker 2: all of those things make a difference. Things that you
Speaker 2: might broadly call trauma informed care interventions, those make a difference.
Speaker 2: But it's really hard. You know, the nature of the
Speaker 2: critical illness is hugely hard. And as a consequence of
Speaker 2: it being hugely hard, you know, the science varies a bit,
Speaker 2: but you can find studies, many studies of PTSD, in
Speaker 2: particular in ICU survivors, that would say that it occurs
Speaker 2: in up to one in five people. You know, there's
Speaker 2: some studies that would say it occurs in even many
Speaker 2: more than that. You know, depression and anxiety is common.
Speaker 2: I think you hit on it. You alluded to this
Speaker 2: minute ago, and I think you're quite right. For a
Speaker 2: long time. The paradigm in so much of healthcare has
Speaker 2: been we are trying to help you. Let's talk about oncology.
Speaker 2: We're trying to help you survive your battle with cancer. Right.
Speaker 2: We want you to survive. We want you to survive
Speaker 2: the ICU, and very often there's a well meaning, but
Speaker 2: I think misguided dynamic, which is you survived. That's a
Speaker 2: great outcome. My job is done, yeah, exactly. And often
Speaker 2: in the ICU patients they don't come back and talk
Speaker 2: to the doctors who who treated them because they were
Speaker 2: life flighted from, you know, five hundred miles away. So
Speaker 2: it's easy to imagine, Wow, they left the ICU, they
Speaker 2: were pretty happy. I think they must be fine, right,
Speaker 2: And then when you interact with them, they often say,
Speaker 2: oh my gosh, like if I knew what would have happened,
Speaker 2: if I knew what my new life would be like,
Speaker 2: I'm not sure I would want to have survived. I mean,
Speaker 2: we don't hear them, but we hear it occasionally.
Speaker 1: All right, let me just remind everyone I'm speaking with
Speaker 1: doctor Jim Jackson. He's a clinical psychologist, and we're talking
Speaker 1: about his book, Reclaiming Your Life from Medical Trauma. So
Speaker 1: let's get into this book here, and I want to
Speaker 1: hear some stories. Why did you write this book? First off?
Speaker 2: Yeah, so I had written a book about long COVID
Speaker 2: about three years ago now, and the feedback I got
Speaker 2: from many people, many patients, was it was helpful. It
Speaker 2: was really empowering. And it occurred to me that these
Speaker 2: medical trauma survivors that I had been dealing with, and
Speaker 2: that many of us in the field are increasingly dealing with,
Speaker 2: that they didn't really have a solid patient facing resource.
Speaker 2: There was a book or two written for clinicians, but
Speaker 2: nothing for patients. And frequently I would get emails and
Speaker 2: other people in the field. I would get emails from
Speaker 2: people who would say, I think what I've got is
Speaker 2: medical trauma, but I don't exactly know, and I need
Speaker 2: a guide, you know, I need a resource. Can you
Speaker 2: help me? And occasionally it would come to Vanderbilt, but
Speaker 2: often that wasn't practical, you know, for whatever reason. And
Speaker 2: I really felt like there were useful things to say
Speaker 2: to these patients and their families and that it would
Speaker 2: be be a loving thing, really, it would be a
Speaker 2: kind thing to develop a guide for them, And that's
Speaker 2: really why I wrote the book Reclaiming Your Life for
Speaker 2: Medical traumas dedicated to patients, as dedicated to patients and
Speaker 2: families who I experience as so resilient and so brave,
Speaker 2: often in the face of really difficult things. And you know,
Speaker 2: I think you mentioned practical in the introduction. The book
Speaker 2: is designed to be very practical. Often in academics, you know,
Speaker 2: I'm in my office here at Vanderbilt. Often in academics
Speaker 2: we talk in abstractions, We talk very esoterically about complicated things,
Speaker 2: and I find that often unhelpful from the point of
Speaker 2: view of patients. So this is intended a lot of
Speaker 2: my analogies have to do with food, so forgive me,
Speaker 2: but this is intend to put the cookies on the
Speaker 2: shelf where people can reach them, right, Like, this is accessible,
Speaker 2: and it's a story in the book. It's a story
Speaker 2: of realism and hope. And would I would hold those
Speaker 2: two things together, Like, reclaiming your life from medical trauma
Speaker 2: is no simple thing, right, as you know from interviewing
Speaker 2: countless people with expertise in trauma and PTSD, reclaiming your
Speaker 2: life is no simple thing, and making progress is indeed possible.
Speaker 2: So trying to hold both of those things together, that
Speaker 2: it's not about rainbows and unicorns. Right, It's not simple,
Speaker 2: and it's satisfying, and you can find a way to
Speaker 2: live a meaningful life even in the midst of difficult things,
Speaker 2: even in the midst of medical trauma. And I think
Speaker 2: that last idea is really a central theme, really one
Speaker 2: of the central themes of my life, as somebody who
Speaker 2: has a chronic illness. That is, in an ideal world,
Speaker 2: we could take a giant eraser and just make every
Speaker 2: symptom go away, right, we just erase it from a whiteboard.
Speaker 2: In the actual world, that's not how it works, and
Speaker 2: we should seek to reduce suffering, absolutely, But if we can't,
Speaker 2: there's still a way to live a meaningful life. That's
Speaker 2: that's the theme of the book.
Speaker 1: Share with us, Jim, if you can an individual who
Speaker 1: maybe stood out to you or inspired you, or maybe
Speaker 1: even solidified this idea of I need to I need
Speaker 1: to do this work.
Speaker 2: Some years ago. I appreciate the question, and I'll change
Speaker 2: the details a bit, as I do in my book
Speaker 2: to preserve confidentiality. But some years ago we had a
Speaker 2: patient at Vanderbilt, and I think about her a lot
Speaker 2: candidly and she had been in in in the Caribbean.
Speaker 2: She'd been in a place out side of the United States.
Speaker 2: She'd become rapidly ill young woman, and had been life
Speaker 2: lighted to Vanderbilt actually from hundreds and maybe thousands of
Speaker 2: miles away, and she had a profoundly severe critical illness,
Speaker 2: and among many other things, it resulted in the amputation
Speaker 2: of most of the toes on one of her feet.
Speaker 2: And she was young. What we know is that medical
Speaker 2: trauma can be particularly challenging for people who are young,
Speaker 2: because if you're ninety years old in the ICU, you
Speaker 2: kind of expect to be sick, right, But if you're
Speaker 2: twenty two years old, it's a different thing. So she'd
Speaker 2: been in the ICU, usually sick, lost most of the
Speaker 2: toes on her foot, and she was a big surfer,
Speaker 2: that was a passion of hers. And she struggled a
Speaker 2: lot with anxiety and depression PTSD as well, believing that
Speaker 2: she could never reclaim her life right, never return to
Speaker 2: a meaningful life. And I worked with her, other people
Speaker 2: worked with her to support her. She was delightful, and
Speaker 2: she transitioned h away from Tennessee and and did what
Speaker 2: she did, and a year or so later, I got
Speaker 2: I got an email from her and it had a
Speaker 2: had a video attachment, and and I really cried when
Speaker 2: I when I opened it. It was a picture of
Speaker 2: her on a surfboard. She was surfing. She's surfing. It
Speaker 2: was so beautiful. And there was a comment in the
Speaker 2: email and it said basically, it said, you know, I'm
Speaker 2: proving that you don't have to just survive after a
Speaker 2: disruption like this, but you can actually thrive. And and
Speaker 2: I love that. And you know, if she was with
Speaker 2: us today, I think she would say that all the
Speaker 2: reconstituting and dealing with a new identity and dealing with
Speaker 2: the trauma was was gigantically hard, and that she had
Speaker 2: found a way to embrace this new life in a
Speaker 2: manner that reflected real beauty. And so I think of her,
Speaker 2: you know, honestly, probably not a month goes by that
Speaker 2: I don't think of her. And in some ways, she's
Speaker 2: one of many patients in writing this book that I
Speaker 2: have really wanted to honor. And her story isn't necessarily typical,
Speaker 2: like not everybody who loses their toes is back on
Speaker 2: a surfboard a year later, But I think her story
Speaker 2: is really potent because it shows what can happen, right,
Speaker 2: what can very hopeful, Yeah, super hopeful.
Speaker 1: So as I'm looking at this and thinking about this,
Speaker 1: we have the ICU where this incredible amount of care
Speaker 1: and depth of care is taking place, and oftentimes or
Speaker 1: even because of that, people are experiencing trauma. It's traumatic.
Speaker 1: Like you said, you give us examples of just the
Speaker 1: fact of being waking up with an imagine that happening,
Speaker 1: waking up with a tube down your throat. But is
Speaker 1: there a point at which the ball is being dropped
Speaker 1: in a sense, are they not providing enough psychological care
Speaker 1: in that moment?
Speaker 2: Yeah, I think that's right. I do think that's true.
Speaker 2: I mean we could we could count on a hand
Speaker 2: or to the excellent psychologists around the United States who
Speaker 2: work in an ic setting. My friend Megan Josey at
Speaker 2: Johns Hopkins, my friend Aaron Hall at Geisinger Medical Center.
Speaker 2: It's shortlist, though, and where mental health professionals are working,
Speaker 2: they're making a huge difference. But it's partly a resource problem.
Speaker 2: I think it's not necessarily a lack of will problem,
Speaker 2: but it's a resource problem. At academic medical centers there
Speaker 2: are often many psychologists around, but there are vast numbers
Speaker 2: of ICUs. The majority of ICUs are not at Vanderbilt
Speaker 2: Medical Center, They're not at Yale, they're not at MGH, right,
Speaker 2: they're not at Columbia. And many of the hospital systems
Speaker 2: that have ICUs don't have a single psychologist on the
Speaker 2: team at all or hardly any So we've got to
Speaker 2: find a way to bridge that gap. But I think
Speaker 2: the other issue is there is still a little bit
Speaker 2: of a lack of awareness, I think, and that is
Speaker 2: a lack of awareness of the magnitude of the problem
Speaker 2: represented in the ICU, And I would I would zoom out,
Speaker 2: and I would say there's a lack of awareness of
Speaker 2: the problem represented in so many populations, right in people
Speaker 2: with autoimmune diseases who were never in the ICU, let's say,
Speaker 2: but who are battling with the very real trauma of
Speaker 2: a chronic illness right in a birthing suite where someone
Speaker 2: has had an emergency C section, right, And that's gigant traumatic,
Speaker 2: And it's very likely with that patient that in the
Speaker 2: hospital someone gently and thoughtfully nurtured them. But when they
Speaker 2: leave and they come back for their follow up, it
Speaker 2: kind of falls off, right, So I think in general,
Speaker 2: we need to do better. We need to do better.
Speaker 2: And one of the things I'm hoping that reclaiming your
Speaker 2: life for medical trauma will do. The one of the
Speaker 2: things I'm praying it will do is it will shine
Speaker 2: a light on what I think is a hugely underappreciated
Speaker 2: public health problem, right, and that is that trauma isn't
Speaker 2: just combat, right, Trauma isn't just a motor vehicle accident.
Speaker 2: Trauma is wide ranging medical experiences. And sometimes that trauma
Speaker 2: may be a small tea, right, if we want to
Speaker 2: use that term, and sometimes that trauma might be profound.
Speaker 2: But I think, you know, what I've learned is I
Speaker 2: need to be careful and not assume how signal for
Speaker 2: again to trauma might be, right, because there are some
Speaker 2: things that my patients had been completely derailed by that
Speaker 2: I initially thought were not hugely problematic, right, But they've
Speaker 2: they've rocked their world. Equally, I've had patients who've been
Speaker 2: exposed to extraordinary trauma and seem to be okay. So
Speaker 2: there are all these paradoxes, right, And I think the
Speaker 2: truth is there are people with medical experiences of all
Speaker 2: sorts where those experiences have left to mark, and crucially
Speaker 2: that mark leads to lasting struggles in their day to
Speaker 2: day functioning and in their relationships.
Speaker 1: As we kind of wind down here, Jim, what is
Speaker 1: it that allows you to do this work?
Speaker 2: Yeah? I love the question. I went to see my
Speaker 2: own therapists just a couple of days ago. Actually it
Speaker 2: had been a while since I had connected with her,
Speaker 2: and that was a source of such support. Leaving her office,
Speaker 2: I realized, you know, I maybe need to get back
Speaker 2: a little more regularly right than I have been. That's
Speaker 2: been hugely helpful. I've got a family and friends that
Speaker 2: support me. I'm part of something called the Critical Illness,
Speaker 2: Brain Dysfunction and Survivorship Center. It's a research group that
Speaker 2: is filled with people. We're all pulling in the same direction,
Speaker 2: and we're interested not only in science, but also in
Speaker 2: creating a culture where we support each other. And I
Speaker 2: think the other thing is excuse me, I think the
Speaker 2: other thing is my faith. I talk a lot about
Speaker 2: my faith in the book in a way that I
Speaker 2: think is careful and thoughtful. I never want to impose
Speaker 2: it on anyone else, but for me, it imbues in
Speaker 2: me a sense of purpose, and that sense of purpose
Speaker 2: is what keeps me going right, Like, you can have
Speaker 2: a strong sense of purpose. And if you ignore boundaries
Speaker 2: and you don't attend to your own mental health needs,
Speaker 2: and you ignore warning lights, that sense of purpose is
Speaker 2: only going to get you so far right, Like, you
Speaker 2: need more than a sense of purpose. But if you
Speaker 2: have a sense of purpose, which my faith provides, and
Speaker 2: you build around you supportive structures and support systems, and
Speaker 2: when these yellow lights are blinking, you attend to them,
Speaker 2: I think you can do really hard things. And I'm
Speaker 2: grateful to be able to do this work. Some years
Speaker 2: ago I talked about this in the book, and I'll
Speaker 2: be really quick. I had a car. We'd moved here
Speaker 2: from California. I had a car and the check engine
Speaker 2: light went on one day, and I took a post
Speaker 2: it note. I had some post it notes in my car,
Speaker 2: and I took a post it note, and I covered
Speaker 2: the check engine light up and I just kept driving
Speaker 2: because I was really busy and felt fine, right, I'm
Speaker 2: not seeing the warning light. And one night, about five
Speaker 2: months later, the engine seized up and the car started shaking,
Speaker 2: broke down, and the next day I sold it to
Speaker 2: the scrapyard for fifty dollars, right, I had ignored the
Speaker 2: warning lights. And I think what I've realized is in
Speaker 2: this stressful work caring for people with medical trauma, for
Speaker 2: me and other providers, there are warning lights, right, warning
Speaker 2: lights that your life is out of balance. And when
Speaker 2: your life is out of balance, that's not good for you.
Speaker 2: But also it's not good for your patients. So I
Speaker 2: try to be better at checking those warning lights and
Speaker 2: not covering them up with posted notes anymore, because that
Speaker 2: doesn't actually serve anyone very well.
Speaker 1: Then, all right, So as we kind of wind down here,
Speaker 1: who's the book for?
Speaker 2: The book is for the many, many patients in their
Speaker 2: families who are in the throes of medical trauma. As
Speaker 2: I travel around the country, as I ride in the
Speaker 2: back of a lift, as I sit next to somebody
Speaker 2: on the airline. When I broached the topic of medical
Speaker 2: trauma when I talk about the book, this is a
Speaker 2: broadly resonant theme with people, right, Like, people say, Hey,
Speaker 2: I was in the ICU, or you know, my mom
Speaker 2: has really struggled after that miscarriage, or you know, whatever
Speaker 2: it might be. When my dad developed dementia, that was
Speaker 2: really hard on me, right, So people relate to the
Speaker 2: idea that medical difficulties they leave a mark. So the
Speaker 2: book is for those people and is practical and accessible.
Speaker 2: I think the book is also for clinicians who want
Speaker 2: to quickly get a useful lay of the land and
Speaker 2: who are open to the idea of learning about a message.
Speaker 2: That message is man. You know, they're a huge range
Speaker 2: of problems that we know how to solve, right, like
Speaker 2: people know how to treat PTSD, right like people know
Speaker 2: how to treat anxiety and depression. And that's the part
Speaker 2: that I try to emphasize that we can address these issues,
Speaker 2: but we can't address them if you don't look for them.
Speaker 2: So the book is for providers who are interested in
Speaker 2: learning something that they might not be aware of about
Speaker 2: medical trauma.
Speaker 1: Awesome. How do people learn more about you and the book?
Speaker 2: Yeah, So they can order the book of course on Amazon.
Speaker 2: It's in any major bookstore as of as of April
Speaker 2: twenty eighth. They can come to our website www dot
Speaker 2: icudelirium dot org. They can find me on substack. They
Speaker 2: can find me on x although I'm not there very
Speaker 2: much anymore. So the website I seeudelirium dot org. They
Speaker 2: can find me at Vanderbilt. Again, they can buy the book.
Speaker 2: If they need support, you know, they can be referred
Speaker 2: to the ICU Recovery Center. You know, I'm very accessible.
Speaker 2: If I get a thousand emails on the heels of
Speaker 2: this podcast, might take me a while to respond, but
Speaker 2: my commitment is to respond to all of them because
Speaker 2: I think, honestly, as healthcare providers, it's the least that
Speaker 2: we can do. I mean, this is a privilege, honestly,
Speaker 2: and it can be hard, but this is a privilege
Speaker 2: caring for people with these significant needs, and I am
Speaker 2: I'm hopeful that as a result of this podcast and
Speaker 2: many others, that people will reach out and that we
Speaker 2: will be able to connect them with the resources they need.
Speaker 2: Because a guy, when they get connected to the resources
Speaker 2: they need, not surprisingly they get better.
Speaker 1: We'll have all those linked up here at the show
Speaker 1: notes page at the Trauma Therapist podcast dot com. Jim
Speaker 1: sure love to have you back. Thank you so much
Speaker 1: for being here and the work you're doing. It's inspiring.
Speaker 2: Yeah, my pleasures. Thanks for your kindness.
Speaker 1: Thank you, all right, all right, take care