PTSD? No—Not Me

Why PTSD Is Hiding in Plain Sight in Emergency Medicine

PTSD isn’t something we think happens to us.

It’s something we screen for in other people.
Veterans. Sexual-assault survivors. Victims of violence.

In emergency medicine, we call what we see the job.
Not trauma.
Not injury.
Not something that follows us home.

And that’s exactly why we miss it—
even when it’s already there.

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The Numbers We Don’t Talk About

Using validated screening tools, studies across Europe and Canada have found point-prevalence rates of PTSD in emergency physicians and emergency department staff hovering around 15%.

Fifteen.

For context, the lifetime prevalence of PTSD in the general Canadian population is approximately 2.4%.

This isn’t subtle.
It’s a signal flare.

And it shouldn’t surprise us.

Pediatric arrests.
Sexual assaults.
Graphic trauma.
Failed resuscitations.

We are exposed—daily—to scenes that would permanently scar most people.

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Why We Miss It in Ourselves

We don’t call these experiences trauma.
We call them work.

And we’re often terrible at recognizing distress—
in colleagues, and especially in ourselves.

Because we’re physicians.
We’re supposed to be tougher than this.

So instead, we push on.

We drink more than we should.
We isolate.
Our work quality slips.
Complaints appear.
Relationships strain.

Often without realizing what’s happening.
Almost always without asking for help.

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Not Just the “Big” Cases

Sometimes it is a catastrophic event.

I once had to emergently crack open the chest of a young girl who looked exactly like my sister.

Same age.
Same build.
Same face.

There was no time to hesitate. I cut through her chest because that’s what the moment demanded—because that’s what the job required.

She didn’t survive.

Years later, that memory still returns—uninvited.
Not as a story.
As a sensation.

But those cases aren’t the whole explanation.

More often, the injury is cumulative.

Trauma doesn’t arrive alone. It layers itself onto sleep deprivation, shift work, chronic stress, limited social support, and the coping strategies we pretend are harmless.

Sometimes it’s quieter than a resuscitation bay.

A patient who looks like your child.
Reminds you of your partner.
A moment when you realize it could just as easily have been you on the stretcher.

That’s how injury forms—
not all at once, but over time.

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Resilience Is Common—But Not Assured

The most common response to traumatic exposure is resilience or recovery.
Occupational injury is not inevitable.

But prevention requires something medicine has historically avoided:

Acknowledging vulnerability before collapse.

Early recognition.
Peer awareness.
Support that doesn’t feel punitive or performative.

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What Actually Helps

Support has to address the provider, not just the event.

What helps:

• Peer-based, non-intrusive check-ins

• Brief post-incident downtime

• Visible, authentic leadership support

• The option—not obligation—to talk

What doesn’t:

• Forced disclosure

• One-size-fits-all debriefings

• Treating clinicians like liabilities instead of humans

We need to normalize the language of injury, not weakness.

Because if we don’t call this what it is, we’ll keep missing it.

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The Quiet Truth

PTSD isn’t a failure of toughness.
It’s an occupational injury of repeated exposure.

And the most dangerous part isn’t that it exists.

It’s that pretending it doesn’t keeps people working—
until they can’t.