Some Injuries Too Much Even for Doctors to Handle Alone

A bus carrying elderly Hurricane Rita evacuees caught flame near Dallas in 2005.

"There were a lot of fatalities on the scene, and also some when they came in here," Wilkerson said. After the fire, the hospital called one of the Critical Incident Stress Management programs to bring in trained counselors to talk about what happened.

"It's typically the younger folks [who need help], but when it's really a tough case it sort of cuts across the ages of everyone," Wilkerson said.

Increasingly, medical schools and hospitals are incorporating mental health help and training into their programs.

Brown said many programs did not offer a class to help physicians cope with emotional or mental shock when she attended medical school in the early 1990s.

"I think after I graduated they started this topic called wellness," Brown said of her alma mater, the University of California at Los Angeles.

"Right after I graduated, there was a big push to make doctors more human, including teaching people beside manners," she said.

Dr. Alex Rosenau, a member of the board of directors for the American College of Emergency Physicians, said treating doctors' emotional stress is more than a kind thing to do. Rosenau said it can make a difference in work performance.

"Stress can disturb people's thinking, so that later on, in time, they can have flashbacks or memory problems," said Rosenau, who is also the vice chairman of emergency medicine at Lehigh Valley Health Network in Allentown, Pa.

"At a trauma center like mine, we've seen just about anything," he said. "But, just like soldiers on the battlefield, emergency staff is sometimes exposed to things even beyond what they normally see."

When to Call Professional Help

Rosenau has been present during counseling sessions, called "debriefings" under his charge. He said for a hospital system with 9,500 employees, he typically saw only one or two debriefings in a year -- for instance when a child died on the operating table, or when a nurse saw an industrial accident.

"That person was called to the site of an industrial accident where the worker's hand got caught in a roller," he said. "When she arrived what she had was a patient crushed, lying on the floor already dead."

Hospital administrators that spoke to were more likely to report similar small, unpublicized cases when the Critical Incident Stress Management program was called. However, these same crisis teams can treat bystanders, victims and emergency workers in the case of a larger disaster.

The Critical Incident Stress management program came to the aid of firefighters, emergency workers and families during the aftermath of the 2003 Station Nightclub fire in West Warwick, R.I.

Scenes from the parking lot at the deadly 2003 Station Nightclub fire in West Warwick, R.I.

Started by a stage light show, the fire quickly engulfed the whole nightclub, killing 97 people and leaving many in the small community in grief.

"Most hospitals and medical institutions realized that if there's something big and traumatic, it's important to have a debriefing with all those involved," Brown said.

For her case, she was glad to go along with her staff to the meeting.

"The hospital I'm at, we have all the different specialties, thank God," she said. "I think that's one of the best things that we have in this country is that were able to mobilize resources so quickly and so effectively."

The Associated Press contributed to this story.

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