When the doctor has PTSD

PTSD is a normal response to an abnormal situation.

A horrible, terrible, situation.

It affects 76% of mothers who have/had babies in the neonatal intensive care unit.

It affects me.

I’d like to say affected, but it is a scar and like all scars it fades, but never completely goes away. Injuries cause scars. And it is my soul that has been injured.

For me, that is the best way to describe PTSD. A scarred soul.

For many mothers of premature babies, PTSD results from the NICU experience, which in many ways is like a battlefield. But the soldier is your newborn premature baby. And you can’t do much to help.

Many parents live for days, weeks, or sometimes even months not knowing if their baby will survive. And then there is witnessing your baby’s suffering, sleep deprivation, noise, and the foreign environment. It is a constant state of high level stress. Add in the fact that the NICU is an isolating experience, and you have a perfect PTSD storm.

Although my PTSD is not from my NICU experience. I can walk in and out of an NICU without any kind of a trigger. I can feel sadness for the parents and the babies or join in milestone celebrations that only preemie families really understand, such as joining the kilo club or getting the PICC line out.

My PTSD comes from delivering my first baby (I had triplets) by myself in a bathroom. Deep down I knew that pressure I was feeling wasn’t the urge to go to the bathroom. I am an OB/GYN, after all.

That moment of realization as I got out of bed starts the loop of film that, if left unchecked, can play over and over again in my head. I can close my eyes and it is as if I am there. The cool linoleum on my feet. The sound of the bathroom door closing. The frailness of his body in my hands. My screaming.

He was the last baby I delivered. I gave up obstetrics when I went back to work 9 months later. I just couldn’t face delivering a baby in that same room with that bathroom behind my back.

I didn’t realize I had PTSD until I researched the chapter on the mind-body connection for my book, The Preemie Primer. A little ironic. I just thought everyone had high-definition flashbacks of terrible trauma and that avoiding reminders was, well, a good coping skill. My difficulty sleeping, feeling detached, difficulty concentrating, and feeling jumpy, well, I chalked that up to having two premature babies at home who were on oxygen and monitors still essentially critically ill.

There is a lot of mental health stigma in this country, which is stupid. The worst thing I did was bottle it up. I didn’t really have anyone to talk with and I think the prevailing belief was that my additional level of bitchiness was due to the stress of two preemies at home.

For me, not talking about it was agony. I pretended I had twins. I avoided the Mothers of Multiples club because seeing a set triplets was agonizing. I felt I had a dirty little secret. I told people I had twins, but that was a lie. I am the mother of triplets.

As I wrote my book and came to understand the symptoms, it all made so much sense. And of course, I researched prevention and therapy. Experts suggest that talking about the traumatic experience(s) and learning (and practicing) relaxation techniques can help. So I told my boys they had a brother. We celebrate his birthday and talk about him. Not all the time, but it comes up in that lovely, natural way that children approach painful subjects. And now I talk about of myself as the mother of triplets, not twins.

With time the images of my delivery have started to fade. Now it’s like an old program from a television with rabbit ears, not high-definition. And it pops into my head far less often than it did before. Seeing triplets is still hard, but that’s okay. A scar is never as strong as the native tissue, so I should expect some things to be a little hard.

Last week some people in the operating room were commenting on my weight loss and physical transformation. I only see them every 2-3 weeks, so maybe the changes are a little more apparent. They were admiring my abs and one exclaimed, “Damn, and you had twins.”

“Actually,” I replied. “I had triplets.”

And then the silence followed. It always does. Because truly, people don’t know what to say. And you become that mother, the one who lost a baby. And yes, it does color the way some people look at you or think about you. And it’s why I never spoke about it. But silence, I have learned, is bad.

“Yes, I had another son who died at birth. But I only brought it up because if you think getting back in shape after having twins is hard, think about doing it after triplets!”

I smiled, we chatted a bit more, and then I walked away. A little stronger than before I started the conversation.

Scars don’t heal, but they fade.

Talking about it helps.

PTSD is a normal response to an abnormal situation.

That is one of the most important lessons I have learned as the mother of triplets.