Why has this upset me so much?

[MyDogIsBetterThanYou]

I am a surgeon and am not usually phased by anything. When I’m at work absolutely nothing gets to me in the moment. I am focused on doing my job, things can go wrong and I just fix them.

Today I was driving on the motorway and saw and heard the most horrific crash I’ve ever seen. It felt like it was in complete slow motion. It was on the opposite carriageway to me so I couldn’t stop safely and help, so I immediately called 999 and told the police dispatcher, there was an awful accident and gave the what 3 words thing as I was on the hard shoulder. At the end of the call I said to her she need ambos and fire and she asked why so I reiterated lorry v 3 cars with traffic trying to drive round the cars that had hit each other.

I got back on my way and the ambulance rang me and asked me more information and I repeated I wasn’t at the scene I was on the opposite carriageway and I suspected 5+ casualties. I think I must have been the first person to call 999 as it quite literally was still happening as I was on the phone.

I got to the restaurant and I realised I felt really shaken by it, I googled it out of interest and the motorway was closed and still is.

I feel so shaken up by it, still even like 8 hours later. I felt so calm on the phone but I was probably not very calm!

I just don’t know who to speak to ? I wish I was able to help more. I just knew immediately it was bad. Has anyone else experience something similar?

Not nearly as serious a sounding accident, but yes to watching it happen and being powerless to stop (watched it in the rear view and had to keep driving and just call 999). The horrible wondering what happened and hoping eveyone was OK (they were probably not). In my case there was a car full of us who saw it so we were able to keep talking it through which I think helped. You did as much as you could at the time. Being the first to call for help is the most useful as it gets ambulances on the scene quickest. What a horrible situation though.

I think playing tetris is meant to be genuinely helpful for processing traumatic events and preventing ptsd down the road - might be worth a try? Any friends you could chat it through with? Sometimes awful things that others have witnessed come out of the woodwork when you start a conversation and you might find some support?

It doesn't matter what job you do, something like that will really upset you. It's because we care that it kind of hurts so much inside.
I hope the accident wasn't fatal for anyone and that you are able to talk about it with someone IRL.

Seeing something like this is really upsetting. Being badly affected is natural Also, in your work life its literally your job to do whatever you can for people, whereas with this you weren't able to do anything except call emergency services. That takes away your control and makes you helpless. I saw a really bad accident once on the other side of the motorway where a lorry jack knifed for no obvious reason and went into other cars before hitting the barrier. For a few moments I couldn't really focus on my.own driving, luckily no accident of my own. I went home and talked to hubby about it and was very thankful I wasnt involved. So I can only suggest talking about it to someone if you can.

That must have been horribly shocking to witness! But the speed you called 999 and the amount of information you gave up front, you could well have saved lives in doing that.
Do you have a counselling service available through your work? An employee assistance programme? It might help you to talk this through with a trained professional.

You're so upset by this because of the feeling of powerlessness OP. Whereas at work you're in control and the outcome is in your hands.

Some just go into auto pilot. But then later on the shock hits you. You did what you could at the time.

Exactly this. It’s the lack of control and also the element of surprise. I hope you and everyone involved are okay.

I'm thinking two things:
being unable to help
and
the fact that you hold so much in and don't let things get to you that seeing this accident brought it all to the surface.
💐

I am so sorry this has shaken you so much, and even though you feel like you couldn't help directly, your quick actions in calling 999, and your observational skills as a surgeon will have given the best chances to those people in the circumstances.

Does your workplace have any team that supports people after the trauma of witnessing an event of this kind? Our trust has a team called something like Trim. If not, I've found the chaplaincy to be amazingly supportive and helpful whatever your faith or beliefs

It sounds like you did everything you could in a situation where you had so little control.

Tetris?? Haha that game would stress me out even more!!

I third this

I think it's a perfectly normal reaction to something so shocking. Can I ask if there's a reason you think being a trained surgeon is relevant to your reaction? Just curious if you know of any research or something we wouldn't know about. I can't see a link, really.

I’d assumed the OP meant that in her job she was used to seeing some pretty shocking things, like perhaps the aftermath of similar accidents. So she was surprised that this had affected her so much.

It’s more that absolutely nothing fazes me at work. I don’t feel anxious when operating, everything is compartmentalised, I’m at work and busy I’m not thinking of anything other than what I’m doing, also I do think about my patients when I’m not at work, but I’m also very capable of switching it off and when I’ve handed over to my colleagues I don’t think about work until I’m back in (or at least I try very hard for it to not impact me out of work).

This has thrown me for a loop, I think it’s about the loss of control? Definitely not normal for me. I think I’ll give the employee help people a ring tomorrow. Thanks for being my sounding board

I agree it's about impotence. You were literally helpless, unable to influence anything about the disaster you saw unfolding. It's even possible your profession made it all the more horrible for you, as you may have some idea of what the humans inside the wreckage would suffer.

So pleased you're going to call the help people Also, well done for your prompt and efficient action! See, you weren't completely helpless.

Same.. but I don't see the link. As a trained surgeon, you're only dealing with a specific set of circumstances (not downplaying the immense importance, forgive any clumsy wording here) - it's (hopefully) a still body / operating area. And you have a set procedure. It's all very standard. And even if something goes wrong, it's still an expected 'wrong' i.e. within the framework of what you're doing and expect to see, so it would be odd to panic in that situation. Maybe the first time or first few. But once trained and experienced, not as much. Basically, if it's expected, there can't be any surprises.

But a car accident is horrific. It's loud, violent, shocking and by the description given, involved multiple heavy vehicles. The OP wasn't a surgeon in that context, with their surgeon brain / thoughts loaded, they were a driver / normal person without a set of rules and expectations for the new and unique situation.

Plenty of jobs require a cool head and the ability to work under stress so I just wasn't sure why this specific job was relevant.. gore.. could make sense but the OP wasn't close to the accident so wouldn't have seen this up close (sorry if I forgot something) - and that didn't seem to be the issue, more the psychological impact.

Maybe the OP assumed they were a little detached from people and wouldn't be bothered by life / death incidents as much. But the operating theatre (is that what it's called?) is quite controlled.

Potentially operating in a war zone in the field, could desensitise a surgeon to real world accidents? I don't know. I need to sleep!

Ah you replied while I was sorting my sleep-deprived essay. Yes, that sounds right! And more succinctly said than my post.

I think it’s probably because you weren’t in control? I suppose if things go wrong at work, you are still (sort of) in control because you would have already been aware / planned for any risks, problems, complications arising etc.

I’m sorry you witnessed it in real time, sounds like you jumped straight to auto pilot and it only hit you hours later. I think that’s entirely normal.

I hope you’re doing alright now xx

Correct re Tetris. Small amount of evidence that it can lessen the likelihood of recurring intrusive imagery after trauma.

Hugs. What a terrible thing to have witnessed. You did everything you could. I've seen two motorcyclists killed on the road; in one case, I'd just parked to visit a roadside florist and heard it happening right behind me; I was the first person to run to the victim, but all my first aid training went out of my head - except that I recognized the agonal breathing. I remember both incidents in painful detail, as if they were yesterday.

When you're in your operating room, your space, you are in control. You have the power to manage anything that goes wrong. Maybe you also feel you have a duty to everything you possibly can to prevent death? Out on the road, none of us are really in control of anything except our own car. I think that's the difference.

I think it’s because your job helps people in this situation and this time you couldn’t. It’s a reminder of the helplessness we all face. I had a crash recently where someone lost control of their car and spiralled into me and there was nothing I could do. It affected me the same way. Well done for calling. You will have made a big difference there as so many people think someone else will.

I imagine the shock had something to do with it. At work you're prepared, you know to expect to see awful things but you were just driving, then all of a sudden you're witnessing something horrible. You didn't have your guard up.

I don't think you'd have felt better if it was on your carriage way and you were able to stop and help

It’s a very normal trauma response. No one is immune. Even amazing people like yourself who manage such stressful jobs that involve trauma.

At work you will be using your full brain. Your frontal cortex will be involved. At this moment when the accident happened, it was your limbic system/amygdala doing all the work. Pure survival. Your body’s fight flight system kicked in.

A trauma doesn’t have to involve you. Just witnessing it is enough to create post traumatic stress symptoms.

Advice:

1. be compassionate to yourself.
2. look after yourself extra well - eat regularly, stay hydrated, avoid alcohol/drigs. Give your body what it needs to recover best.
3. play Tetris. Seriously. Soon.
4. expect trauma symptoms. That’s normal.
5. mostly the post trauma symptoms (eg flash backs, sleep issues, numbing, avoidance) pass with time but if they linger for a while or feel too much then I recommend EMDR.
6. do things that settle your limbic system - make you feel safe. Blankets. Tea. Disney. Whatever it is that your brain and body associate with safety.

Overall, don’t worry. It’s just your brain and body doing what they are built to do - survive. But our brains aren’t interested in our happiness so if it feels at all stuck or overwhelming then seek help. If you work for the NHS then Employee Wellbeing may well offer EMDR.

At work you are in surgeon mode. It doesn't make you immune to trauma responses generally. Good idea to call your employee assistance line to chat it through and process it properly.

I have a similar job but it’s very different when you can be at the scene taking an active part in helping and being (at least feeling) in control to an extent.

You have greater understanding than most of what that crash could have caused and yet you have no closure at all which is leaving it all to your imagination to fill in the gaps.

It will take much more time to process as you will most likely be left wondering. Talk to people about it an be kind to yourself. You’re allowed to feel like this, it’s a normal human response