Hide the Children? by Pat Conrad MD

Honestly, I had to look it up.  I had never heard the term “trigger warning” before, but a bunch of weenie medical students – pardon the redundancy – seem to be all twisted up about it, so herewith:

“A statement at the start of a piece of writing, video, etc., alerting the reader or viewer to the fact that it contains potentially distressing material (often used to introduce a description of such content).”

An online publication with the odd, safe-space name “Campus Reform” has a piece detailing how a large portion of med students at Ohio University support the use of “trigger warnings” in medical education.  This includes one creampuff “student who said they should be used before discussing ‘very deep issues that potentially could cause an emotional rise in someone.’”  Is my tone contemptuous?  I certainly mean it to be.

“Conversely, only 29 percent of the students who were surveyed rejected the use of trigger warnings in the classroom entirely, citing concerns that they enable students to avoid difficult topics or inhibit the academic freedom of instructors.”  So less than a third of the students have actually begun adulthood.  Lovely.

Study author Prof. Elizabeth Beverly:  “Research is needed to test the effectiveness of using triggering warnings in the classroom with both subjective (e.g., reflective writing, interviews) and objective measures (e.g., stress, depression, anxiety, empathy, knowledge questionnaires),” she explained, adding that “if future research shows trigger warnings improve knowledge, empathy, and wellbeing, trigger warnings would be a positive addition to the medical students’ curricula.”

Additional research might show that pointless academicians, the sort that get paid for these sorts of studies (and develop MOC guidelines) make me want to drink hard liquor straight, scream uncontrollably, and set random structures on fire.  What sort of trigger warning would have helped with the necessary discomfort of my psych rotations?  Should the chief surgical resident have issued a trigger warning before opening up a peri-rectal abscess that nearly killed everyone in the OR?  There are hygienic horrors from late night pelvic exams that I will spend all my life repressing.

Every single med student and physician encounters patients and clinical scenarios that are horribly uncomfortable.  Rare is the clinician, if he exists at all, that has not had some clinical exchange that recalls for him some moment of his own or family past that he would rather take to the grave.  That’s just the human condition, and we physicians often happen to be jammed into it a little deeper than most.  This topic has nothing to do with reimbursements, lousy government regulations, or why we all hate insurance companies.

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This has to do with the plain fortitude that it takes to face up to the nasty, grisly side of our physical beings, and the perplexing, maddening, sometimes terrifying reactions within and between human beings.  Coddling fearful baby med students won’t help them or the patients.

The study authors speculate, “Trigger warnings may represent teachable moments for professors to offer insight and techniques on how to handle challenging situations in future patient encounters.”  My first ever breast exam was as a third year med student, performed on a pair of hair-covered D-size mounds, attached to a bearded, former female impersonator.  I can’t imagine how a trigger warning would have improved the experience.