The Primary Care Confessions of Traumatized Patients

drawing of patient in waiting room

Illustration by Hana Cisarova. All rights reserved.

In this month’s Reflections essay, “The Traumatized Patient,” family nurse practitioner Margaret Adams delves with sympathy into what she calls the “primary care confessions” of a challenging subset of patients. Writes Adams:

I’ve come to recognize patients like you—sometimes by your disturbingly long and detailed allergy lists, but more often by the frequency with which you come in for the same constellation of symptoms: fatigue, headaches, dizziness, general malaise. Something happened to you— maybe years ago, maybe recently—and it left its mark on you in irredeemable ways, . . .

While symptoms often do have underlying physiological causes, Adams is likewise attuned to the emotional subtext behind certain seemingly fruitless patient encounters. And with many specific examples, she makes the case here that the life of trauma plays itself out over time in the body and mind.

She also describes the emotional effect that caring for patients who bear invisible but persistent scars of old traumas can have on her. Though on the surface the patients’ complaints may be minor, during some encounters she experiences disorientation, an elevated heart rate, a certain slippage of the ordinary ground of reality.

Is there anything redeeming, any source of “grace” in this story? Yes, she writes, and it has to do with these primary care confessions: the patients keep coming back, and she keeps listening. Maybe that’s enough.

Reflections essays are free access. To explore the rest of AJN‘s October issue, click here.



Senior editor/social media strategy, American Journal of Nursing, and editor of AJN Off the Charts.

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