Stress You Get Paid For
26 May 2005
It appears there are epidemics and there are epidemics. Few of us will forget the anxiety and economic loss this country suffered during the SARS outbreak. Now reports indicate we face another one. It’s a disease that strikes the brain with profound effects on some and leaves others unscathed.
Recent reports say that thousands of ex-soldiers, some of whom haven’t even been in conflict zones, are receiving disability pensions for Post-Traumatic Stress Disorder (PTSD). Soldiers claim they suffer from anxiety, depression, insomnia and have nightmares when they relive traumatic events. And often they seek refuge in alcohol and drugs.
Since Canada doesn’t have a large army, the fact that 9,000 Canadian veterans are receiving tax-free pensions for psychiatric problems is alarming. Last year the government received 22,600 pension applications with two-thirds getting some compensation.
It’s not pleasant to see comrades die or suffer debilitating injuries. But when recruits join an army they must know it’s no garden party, that "war is hell" and some might get killed. As Harry Truman counselled, "If you can’t stand the heat get out of the kitchen". So young people ought not to join a volunteer army if their psyches can’t stand adversity.
But soldiers are not the only ones that face daily physical and psychological trauma. For instance, doctors who specialize in emergency medicine may not see heads and arms blown off in battle. But day after day they have to contend with ghastly sights, severely burned children, horrendous injuries from car or motorcycle accidents and the psychological trauma of having to tell families that a loved one has died. One would think that this stress disorder epidemic would also strike them.
So I asked the directors of several emergency departments and the Association for Emergency Physicians, "Do you know of any emergency room doctor or nurse who has been diagnosed with Post-traumatic Stress Disorder (PTSD)?" They all replied, "None to my knowledge".
I’m sure genuine cases of PTSD are found in the armed forces. But I find it hard to believe that thousands of psychiatric claims are justified. As one sage remarked, "It’s like setting up a food bank. Suddenly there’s a demand for it."
The problem is it’s hard for doctors to separate genuine PTSD sufferers from the phonies. The fakers are well aware of this medical dilemma. After all, who doesn’t at one time or another experience a little depression, anxiety, insomnia and occasional nightmares. Fortunately, the majority of people with these symptoms just consider them a normal part of living. But they also end up paying the bill for the cheaters.
We can’t lay all the blame for stress disorder on the military. I often see it in my medical practice. One patient was sitting on a chair at a supermarket when it collapsed. She later told me she had convinced a court of law this had caused arthritis in her hips and she was no longer able to have sex. We both knew she had suffered from severe arthritis for years. Yet she was awarded damages and proudly expounded on how she had ripped off the system.
Another patient was involved in a minor rear-end accident and was totally free of any after-effects. That is, until a friend several months later told her about whiplash injuries. Now she has developed neck pain and is involved in litigation.
In North America most rear end collisions occur at speeds from 6 to 12 miles an hour and the total cost is 29 billion. This makes payments to the military look like poor cousins.
But isn’t it odd that demolition drivers face 700 rear-end collisions during their career at speeds up to 45 miles per hour. Resulting neck pain seems to be mild and lasts less than three weeks. And that people in Greece, Germany and Lithuania where there’s
little or no medico-legal compensation, recover quickly.
Researching this column made me realize why I’m a psychological wreck. I’m suffering from all the symptoms of PTSD. Why wouldn’t I have recurring nightmares when my editors insist on a new column every week. Unfortunately I’ve never heard of lifetime tax-free pensions for medical journalists. So it’s back to the drawing board for another week.
