The wounds inflicted when a chimpanzee attacked 55-year-old Connecticut woman last week were apparently so gruesome that Stamford Hospital announced it was offering counseling services to the doctors, nurses and surgeons who spent seven hours treating the victim.
Charla Nash was flown in critical condition to Cleveland Clinic, in Ohio, where experts in reconstructive surgery are still evaluating the extent of her injuries. Recordings from the 911 call indicated that police on the scene could not tell if Nash was alive or dead, a man or a woman.
Doctors daily shrug off scenes from car crashes, accidents or stabbings that would give a layperson nightmares. But in rare cases, even first responders need help managing a nightmare case.
Medics responding to the attack told The Associated Press that the 200-pound chimpanzee, named Travis, had crushed Nash's hands and ripped off a substantial portion of her scalp, face, jaw and eyes.
"It's really hard to explain what it's like to people who weren't there -- even if it's people in the same field as you," said Dr. Vanessa Brown, an emergency room physician who treated Nash when she arrived at Stamford Hospital.
"Just the pure trauma of it, by far, was one of the worst cases I've ever seen," she said.
Brown said she felt grateful to have so many experts around to help with Nash's case and everybody involved put aside their reactions to help. But even with the first-rate help and the warning call from the ambulance, Brown said this case took its toll later.
"For me, you think if you see and see it, it gets easier," she said. "But it's just hard.It's always hard. It's hard to see somebody that's that sick."
Brown attended one of the initial communal counseling sessions offered to the staff after Nash was stabilized.
Hospital spokesman Scott Orstad said plans are under way to offer counseling to the medical staff who took care of Nash. The Stamford Hospital, where Nash was first treated, is a level 2 trauma center, meaning it employs specialists in plastic surgery and trauma, and the building is equipped to treat extreme cases.
But those who counsel doctors say even a level 1 trauma center sometimes has to call in for extra mental health professionals.
"Trauma centers are designated by level 1, level 2, level 3 -- and level 1 trauma centers take the worst of the worst," said Linda Wilkerson, director of pastoral care for Parkland Health and Hospital System in Dallas.
Because Parkland Hospital is a level 1 center and sees so many severe cases, Wilkerson said the hospital offers 24-hour "pastoral care" or religious counseling to the patients and staff.
"We pretty much make sure that we go by and talk to the staff after every trauma," Wilkerson said. "Particularly if it was a rough case, where they saw something that was horrendous or when they worked really, really hard on somebody who didn't make it."
Rarely, the hospital calls in extra mental health professionals for the staff.
One such incident occurred Sept. 23, 2005, when a bus carrying elderly evacuees from Hurricane Rita caught fire near Dallas. Some of the elderly patients could not walk, and the quick-burning fire -- fueled by the oxygen tanks many of the people on the bus needed -- claimed 23 lives.
Wilkerson said the survivors of the blaze were sent to her hospital, which is the only specialty burn center between San Antonio, Texas, and Oklahoma City.