Karl Robinson MD

Post-traumatic stress disorder (PTSD) is a severe anxiety disorder that can develop after serious injury with the threat of imminent death. Commonly, the person with PTSD describes re-experiencing horrific images of the traumatic event, nightmares of the event or reactions to situations that remind the person of the event.

It is strongly associated  with soldiers returning from combat in Iraq and Afghanistan. However, any traumatic incident can trigger it. These include exposure to natural disasters such as floods or fires, an assault, domestic abuse, rape, or a motor vehicle accident. Those people who arrive first at an accident–policemen, firemen, ski patrollers and paramedics, known as “first responders,” are prone to develop PTSD.

What follows is an unusual, even atypical, example of PTSD.

A 62 year old retired merchant marine captain, was thrown thirty feet in the air when his motorcycle struck a Mercedes, September 15, 2010. When he hit the car he went unconscious.

He had been on a long road trip and was hurrying–hoping to get home a day early and surprise his wife. “I was trying to make time,” he admitted. “I felt driven to get home early.”

Fortunately for him, he was wearing full motorcycle gear including a Kevlar suit. Kevlar is a synthetic that is five times stronger than steel on an equal weight basis. It likely saved his life. As it was, he fractured seven ribs, and a huge hematoma, a localized swelling filled with blood, formed on his left thigh.  Surgery to drain the hematoma was done in the trauma unit and he was discharged with a Jackson-Pratt drain in the site and an appointment to see a surgeon in his home town.  Approximately ten days later, the site became infected with Staphylococcus aureus. Intravenous antibiotics did not control the infection and he was operated on. The wound was debrided, that is, surgically cleaned, and a tube placed. A pump was connected to the tube to assist drainage. The wound then began to heal.

The day following the surgery his wife visited him and found him sitting on the bed weeping. He told her he was weeping “for all the sadness in the world and all the people who are suffering.”

I spoke to him by phone later that day, October 21st.

“When night comes, fear comes,” he said. “Fear of death. Killing and maiming. Rocks falling on people. Slow death. All the world is full of rocks falling.  There is war. Arrows everywhere–piercing flesh. I think about all the soldiers who died in wars in the past with wounds similar to mine.”

He went on and on, describing scenes of horror. “I’m much better if J (his wife) is in the room,” he said.

He was prescribed homeopathic Phosphorus, a medicine known to help people suffering from fear. One key aspect of Phosphorus is that people who need it are much better having someone, preferably a family member, close by. That night he slept peacefully. He remained better for seven to ten days and then went into an even worse state.

On November 11th we spoke again. “At night, I don’t want to go to bed,” he said. “I can’t be in bed.”

“Why is that?” I wanted to know.

“I don’t know. The feeling is not good. There is a sense of danger. When I’m up it’s a level 3 or 4 but when I lie down it’s a level 8 or 9. I can’t stay in bed. It’s even worse if I close my eyes. With my eyes closed I feel I lose control of the situation. I become afraid. So, I get up and walk around. I’ll nap in a chair but mostly I stay up watching TV until three o’clock. Finally, I’ll sleep for three hours.”

He went on, “When I go to the shower and stand under the water I’m afraid I’ll drown. If I close my eyes in the shower the situation is much worse. If I drink from a bottle, I fear I’ll choke. What would happen if the water stays in your throat and chokes you? I have become afraid of the possibility of dying. As long as my eyes are open and I’m awake I’m okay.”

The thoughts of violence had returned. “I have thoughts of boulders crushing people. I think of people being tortured in the Roman Empire. People being cut and tortured, skeletons lying in graves.”

Recently, someone came from his home town and they talked about the old days but all he could think about were all of his friends now dead.

He spoke of his mother and father. “I wasn’t nice enough to them. The same for fat people. In the past, when I saw fat people, I wondered what was wrong with them. Now I regret that. Now, when I see a three hundred pound person I feel sorry for him. I think how miserable he is with his weight. And there’s nothing he can do. And he knows he’ll be this way for the rest of his life. And I feel sorry for him.”

“Now I am home alone and I feel down. Even when J. is here I see her face and I think one day she will die. She will be a skeleton. When I go to the mall and walk around and see all the people shopping I think, ‘In fifty years they’ll all be dead. They’ll be skeletons.’”

He then spoke of a coldness around his heart. “In bed, with my eyes closed, I feel panic and I feel cold water surrounding my heart. I actually have felt that around my heart has become cold. It is physical. I feel as if my heart is surrounded by coldness. The bad feelings…the bad thoughts…they are usually accompanied by coldness around my heart.”

At this point, he became overwhelmed. He could speak no more and handed the phone to his wife. In the background I heard him crying, but it was not crying, it was a howling. It was chilling to hear it.

Clearly, he was in desperate straits. Years back, he had told me about his seafaring days when he had captained freighters. In fact, he once held me spellbound recounting how he had almost lost a huge 60,000 ton ship in a storm, gale force 12 on the Beaufort scale, (winds 75 to 95 mph and waves above 46 feet). At the time, I asked him if he had been afraid. “Not at all,” was his reply. And here he was now, consumed by terror and tortured by horrible thoughts. Now, it was my time not to be fearful. I considered all he had said and looked for clues to the homeopathic medicine most likely to help him.

Homeopaths listen for the unusual, the strange. I decided the strangest thing was the very real sensation of coldness around his heart. That together with thoughts of death, a tremendous sense of guilt over his past, his restlessness and his fear to go to sleep and an equal fear to be alone, lead me to Arsenicum album. He was mailed the medicine and within hours of taking it his restlessness, his anxiety, his fearful thoughts, all dissipated and ceased.

Later, after he had recovered, we spoke about November 11th.

“I remember you howling,” I said.

“I was howling,” he said. “There was so much pain inside…I couldn’t relieve it with a few tears. I had to shout it out. I couldn’t sit in a chair and cry quietly.”

Captain G’s PTSD was unusual in that he did not, as most do, relive the motorcycle accident. His horrific thoughts, though triggered by the accident, were of a violence stretching back into ancient times. Also, unusual was his tremendous sense of guilt and the awakening in him of intense compassion for the suffering of others. That compassion has remained with him.