Physician Practice

PTSD: There is help for patients and providers

Medical Environment Update, July 8, 2021

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by Brian Ward

Our understanding of post-traumatic stress disorder (PTSD) has come a long way since General George Patton was reprimanded for assaulting “shellshocked” soldiers on two separate occasions in 1943. Neither of the hospitalized patients had physical wounds, which enraged Patton to the point he dragged them from their hospital beds, slapped them, kicked them to the ground, and pulled out his sidearm. While attacking Private Charles Kuhl, Patton was reported to have screamed, “Your nerves, hell, you are just a goddamned coward. Shut up that goddamned crying. I won't have these brave men who have been shot at seeing this yellow bastard sitting here crying.”

Interestingly, when Kuhl wrote to his family about the incident, he said, “I think he [Patton] was suffering a little battle fatigue himself.” Kuhl’s observation showed insight about a disorder that wouldn’t be recognized by the American Psychiatric Association until 1980. The Centers for Disease Control and Prevention (CDC) places PTSD symptoms into three broad categories, manifesting differently in each patient:

  • Symptoms of reliving: flashbacks, nightmares, extreme emotional and physical responses to reminders of the initiating event
  • Symptoms of avoidance: detachment, isolation, avoiding any possible reminders of the trauma
  • Symptoms of increased arousal: hypervigilance, irritability, loss of focus, insomnia

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Medical Environment Update.

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