Developing strength from adversity

"I started to get the flashbacks, the bad dreams. I was hyper vigilant, hyper anxious, my anger was on a hair trigger, and as a doctor I identified all this as post-traumatic stress." These are the words of Dr Dan Pronk who served in the SAS and Commandos as a Regimental Medical Officer and fought in over 100 combat missions.

This might be an exceptional circumstance, but unexpected situations regularly occur in medicine and the lessons taken from those involved can help others manage the stresses.

Dr Pronk spoke at Avant’s Q & A series ‘The Quake, The Cave, The Commando’ alongside Dr Richard Harris, anaesthetist and Thailand cave rescuer, and Dr Lydia Johns-Putra, a urologist who was caught up in the 2011 Christchurch earthquake. They shared their experiences and how they learned to manage their emotions afterwards.

Reflection to build a resilient mindset

Dr Johns-Putra was part of a team who rescued a man trapped in a collapsed building. As aftershocks continued, she performed a bilateral leg amputation using only a tradesman hacksaw and pocketknife.

After the event she admitted shutting down and not wanting to talk about it. However, once Dr Johns-Putra knew the man she rescued was okay, with a support network around her, she became comfortable opening up.

“What I've realised is that it's okay. I know I was part of something good, and there was a good outcome, and it's okay to accept it,” she said.

Dr Johns-Putra believes the building blocks of resilience reside in all of us, and by reflecting on the experiences you build, train, and learn more through your resourcefulness.

During the earthquake she said she drew from her mental storehouse of “good things.” Elaborating, she said, “When I'm feeling really bad, and those bad voices are trying to have a go, I can go back to that storehouse and then put them to bed.”

Dr Harris, a cave diver, spoke about his journey after successfully rescuing 13 people who became trapped in a Thailand cave in 2018.

“I found myself in this situation where I could be the right guy for this job," he explains. “It became apparent that when the call went out for a cave diving anaesthetist, there weren’t many of us around.”

His experience in cave diving taught him to prepare for emergency situations. Reflecting on his experience, Dr Harris says, “you can’t intentionally plan for some of these things in life, but you can do as much as possible to prepare yourself.”

“I always felt I was not a resilient person. As a young person, I felt quite anxious, and I think now I’ve gone out of my way to build resilience. I think it can be learned,” Dr Harris said. “I started to build my sense of worth by finding something that I loved. I found that in the ocean and in the bush, and adventuring.”

Similarly, Dr Pronk said, “the more you know yourself, the more you challenge yourself, the more things become less challenging.”

After facing the brutality of combat and not being able to save all of his comrades, it wasn’t until his discharge from military service that the emotional impact of war surfaced.

“On paper in that period everything was fantastic but within a few months of being discharged I started to experience flashbacks and bad dreams,” he said. “As a doctor, I identified all this as post-traumatic stress.”

He realised he hadn’t had the chance to stop and reflect after each mission. So, he reflected on his military experiences and explored the construct of resilience.

“If I could work out what was making us so resilient, then I thought that was my roadmap back to the best version of myself.”

Post-traumatic growth

As the saying goes, it’s not what happens to you that’s important, it’s what you do with it. Each of the speakers have encouraged others to build on their own unique circumstances with a framework for growth in their professional and personal lives.

Post-traumatic growth is taking an experience, changing the frame of reference, and using it as a catalyst to grow and become a better person.

Dr Johns-Putra admits it took time to accept that she had done a good thing and was portrayed as a hero.

“One of the more profound things I’ve learned from it is that I was uncomfortable with the idea of being a hero because things could have gone either way,” she said. “But, it goes back to having your own resourcefulness, to believe in yourself and be kind to yourself.”

Dr Harris was catapulted into the limelight after being awarded joint Australian of the Year 2019, and like Dr Johns-Putra, he initially felt uncomfortable with the fame.

“We were cave divers who got involved in an amazing event but didn’t feel like we had up until that point, done something worthy,” he said.

Embracing the attention, Dr Harris ruminated on what was important to him and realised “my life of adventure could actually offer something to young people.” Using his position, he advocates for sensible risk-taking in young people to improve their resilience and mental health.

For Dr Pronk, he continued to carry the burden and guilt of those he had lost in battle for many years after leaving the army until one day he had an epiphany.

“If I was the one that died, I wouldn’t want the people who tried to save me being miserable. We did lose these handfuls of men, and that’s devastating, but we also saved a few as well.”

“There’s a small percentage that actually become a better version of themselves because of their trauma and that’s post-traumatic growth,” he said. “I consider myself one of those people. I’m a much better version of myself. A much better husband, a much better father, and I feel a much more empathetic doctor.”

Lessons for all doctors

It’s important to believe in yourself and be kind to yourself. Accept that what you’ve done is a good thing, regardless of the outcome. It is possible to build a resilient mindset and, after experiencing a traumatic situation, achieve post-traumatic growth through reflection.

You can watch the full recording of the Sydney event, hosted by Avant’s Chief Medical Officer, Dr Michael Wright.

Resources

Avant recognises the importance of reflecting on your own health and wellbeing while you provide care for others. We have a wealth of resources available on our website.