Now, suddenly he's a victim in a patient here in our emergency room.

He's alone and confused and afraid in an alien world of bright lights and unfamiliar sights and sounds will ease his physical pain and treat his physical wounds.

But what about his emotional pain and his emotional wounds?

They can be just as devastating.

Shouldn't that be our concern as well?

I mean, I hear about people getting shot out, how he got shadow just blow it going, went in out the other.

But when it happened to me, when the state is shot, I'm saying I mean, my my whole my you know my whole idea in my mind like I'm gonna die, I'm laying on the street.

I'm about to die.

That's all I kept thinking about.

You know what I mean?

It's Kate filling doctors coming in.

They're asking you.

I mean telling Mr Shanklin, we don't know if we can save your leg.

Mr Sank when we don't know if you're gonna die.

I mean, I don't know that that affection mentally really dies.

Post traumatic stress disorder is the syndrome off really a normal response to abnormal events, and the abnormal events have to have that quality of being searing and intrusive and horrifying and terrifying.

Any of us can have PTSD more or less, but for some people it lasts a long time, and it has other elements as well.

It embarrasses them.

It makes them feel ashamed and weak and guilty that drives them to drink.

It causes panic and depression.

But what we're looking at here is a response that many people have to abnormally intense traumatic events.

Last backs, I mean, a lot decrease of sleep.

I mean, certain certain areas of the city.

Certain heirs of this city on that remind me of what happened.

You know, wake up in cold sweats and I think that, you know, just reap reap repeating over and over in my mind like not still fresh in my mind.

I get scared at first.

When I first got home, my mother might have to goto work.

I didn't want to stay there by myself because I was scared.

I'm thinking, Well, this guy coming to finish me off, honest down.

I'm saying PTSD is three things at once, and the first riel guts of it is that you're haunted by your memory.

It comes back to you.

It can horrify you and terrify you.

It can be a flashback.

It could be a nightmare, and you don't want to remember.

And this part of the triad often causes people to think that going crazy because they're not controlling their mind.

The second part is almost the opposite.

It's not having feelings in general being numb or deliberately or unconsciously avoiding those parts of your life.

That might trigger a reminder.

And the third part is physiological.

The third part is having your threshold for anxiety and fear and arousal being lowered.

So any little thing could make you jumping and it disturbs your sleep.

And you're thinking in your sex life those three parts together or PTSD.

How are you doing tonight?

Pretty good tonight.

Dr.

Eaton is a psychologist specializing in post traumatic therapy.

Dennis Bohannon is one of her patients.

18 months ago, he was the victim of a brutal drive by shooting outside his local grocery store.

He's been back for over 30 operations.

When you went home, that's when you first noticed the PTSD symptoms.

Is that right?

Yes.

What?

Did you notice?

What?

Well, I started having nightmares.

How often were you?

Have it every night, every night.

So you wouldn't get a full night's sleep any night, you know?

And what kind of what would be the the subject of the nightmares?

What would your dream?

I mean, just what happened?

What happened?

Reliving it again and again every time he would go to sleep.

Let's go through each of the elements of the post traumatic stress disorder.

First there is the intrusive recollection.

It means that out of the blue, without any clear warning, you're there again.

And it can have the intensity and the immediacy of a flashback.

That means it is as vivid as it was when you first encountered it.

You may actually hallucinate.

A smell a touch aside, very intense and very disturbing.

It doesn't necessarily have to be a flashback, though.

It can just simply be a memory.

And you would rather not remember when you were home before you came back in for this surgery?

Were you going out of the house at all?

Not very much on the front porch to get the mail if I had to, you know, go out to the car and back in the house.

And this is over a year and 1/2.

Yes.

Now, the second part, it is, uh, six or seven individual possibilities.

But altogether, they're called the negative symptoms.

Not having feeling feeling somewhat alienated from others, finding that just almost automatically.

You stop doing the things that you used to do that we're a source of pleasure because you don't want to risk a reminder.

It's loud sound.

Yeah, Maybe that would sound like a gunshot playing with guns.

Oh, dear.

He'd be playing third heart.

The increased arousal, the anxiety cluster means that your adrenal gland is triggered that much more readily that you are very, very aware of threats and that you're jumpy.

You're nervous coming back.

Some of the patients who come into Detroit receiving are coming in in life and death situations.

They've been shot, stabbed, raped.

They've been scalded.

And of course, this is a trauma for the individual and for everyone who cares about them and loves them.

And the nurse, the doctor, the person who deals with this physical wound is in a unique situation.

toe help that whole family on that individual understand emotional reactions.

In the beginning, what they say may not be totally absorbed, but they can see a little bit about what might occur.

Down the road is part of the healing process, and by doing this they remove the fear and remove the confusion, and they remove the stigma.

But it can be pretty frightening being wheeled in here suddenly finding yourself in this alien world way all know that.

So what can we do to help Just to reach out and connect something we do instinctively can be very important, maybe more than we sometimes realize.

Way my doctor on the trauma therapist, too.

Emergency department.

You were brought in tonight and you had been shot.

That right?

You know you're okay now, do you mind telling me what happened?

Dr.

Eaton's job is to find those trauma cases most at risk and intervene as earliest possible.

William was just shot in the leg, so he's definitely a candidate.

He may or may not get PTSD, but if he does, knowing the symptoms and the risks and that help is available can make all the difference.

Now, you know when you get home, you'll probably feel very relieved for a while.

But then, sometimes people have been through an experience like you.

Some months later, maybe three or four months later.

May have flashbacks or nightmares are not want to go out of the house and things like that that's called post traumatic stress disorder.

One, 45 people develop it.

So you do want you to give me a call, and I'll give you something that my name and phone number you can call me.

Okay, there is a phrase, the second warned.

It's the wound that often comes when we work with people are insensitive.

Dr.

Sullivan, What's bothering me today, sir?

Pushing and pushing for detail when an individual is confused, it's not.

I can't bring forth that detail or when those details air so highly charged that it's emotionally damaging way never mean to push too hard.

But all of us do it at times, especially when it's really busy.

Getting involved with patients and their families mean sharing their hopes and fears and sometimes their grief emotions that can be hard to handle, so we tend to put up rules way.

Call it coping it's only natural.

Wait, he wasn't a diver.

He was acquired too.

And it was He had a little brother and he was only 13.

E guess he had really been a good kid kind of kid with a paper round, done everything right.

And, uh, somebody just came up to the car and shot him in the head.

Some other kid came in and that morning, just suppose that ghosts.

And they say it's just a matter of time, you know, he wasn't gonna make it to hear a sister is screaming and your mother just kind of sitting there in a daze.

How unfair what you wanted.

Uh, there's nothing that can be said.

All you can do is just be there with them, throw it and, uh, sometimes after that's when I find myself crying on the way.

All have stories like these stories that have affected us stories that we carry with us.

It helps to share these emotions, work them out, especially without co workers.

People who understand who've been through it too, dealing without feelings, confronting them.

It helps us to get on with our work.

Helps us move on to the next patient and their loved ones.

Dr.

Sweeney, our vice chief of emergency medicine, has learned to deal with it.

He's learned how to survive.

He also knows he's vulnerable even down here in the emergency department, where there's less time to get involved, even hear a patient, or their family can get to us sometimes when we least expected I had an individual one time who was a young male who had been involved in a drug deal that went badly and the individual was shot and then brought in.

And this was a really trauma code where there are bells and whistles and you know, Ivy's being slammed in and lots of hooped ally in this room to the screaming, yelling and everything.

And we were unsuccessful.

Magic didn't work, and we were given the history that this individual had been involved in this drug deal so that the sort of defence mechanism run up on the wall, went up way, lost an individual.

But maybe it's not so bad because he was a drug dealer and things were better.

Um, and we left the room and the room was all just a big bloody mess.

Everything, and we walked out.

And I was told by the the lead nurse that there was a relative out there that it was his father.

So I went out there and here was this little man sitting in the in the corner of the room, which which we call the bad news room.

And he was a very well dressed little man of Hispanic gentlemen.

And I sat down in a very, you know, robotic way.

And I said, You know, Mr So and so was this your son and we talked briefly for a little bit.

And then I said, I have some bad news and I said, Your son is dead and it was like a shot went through him, and at the same time, it went through me, and it was just like somebody had taken me and completely thrown me out of it through the world because I connected with him in a way that just kiss soul and being and more or less destroyed it.

And he, in turn, connected with me somehow.

And I was devastated.

I was trashed, no matter how deeply were affected.

It's always harder on the family.

At least we're prepared.

We've done it before, and we're on our home ground.

They are.

The shock of what happened to a loved one can be overwhelming, the sudden realization of the enormity, the finality of what's happened.

And this, too, can cause PTSD.

Sometimes a parent will just sit in the days we're wife will just sit sort of dissociated.

She's out on her own, you know, out, never never land or whatever you wanna call it.

Just sort of there with her husband, who's been shot, May or may not survive, but not really there.

The victim's family is at risk.

A swell, uh, someone has been suddenly ripped out of their role.

It could be a child, and the parent could feel terribly guilty.

That they didn't protect this child could be a wage earner, and everyone in the family can wonder about they're, uh, they're financial security.

It could be the mother of the wife, and I just think about the impact of that.

Yes, every seriously suddenly wounded individual disrupts not just your plans, but disrupts your whole sense of security and meaning in life.

Now, when you come to a place like this that has its own rituals in its own sense of security basis in science and in medicine.

That helps to undo that.

That feeling of strangeness, that feeling of having been just shoot up and spit out by your own community with Ryan, you know, he didn't want to talk about his family.

Family got mad with me because I told him, You are a quadriplegic and he said, No, I don't want to talk about that.

Don't call me that.

Don't you know you're not really calling him a bad name?

Don't call me that.

When he told his mother called him a quadriplegic and she said, Brian told me you called him a quadriplegic.

Nobody's ever called him that before.

I said, That is what he is and you and you and you, all of you need to deal with it and and say it to him.

A lot of rooms don't like to talk about it.

A lot of the patients that would like to elaborate on the entries.

I think there's someone when I hear they still deny, deny out this sense.

Denial is a term in psychiatry, and it means that you don't consciously absorb the full impact of what has occurred.