Anger: a sign of trauma

Many healthcare professionals have encountered patients who appear angry or hostile. This behavior can be unsettling and raise concerns about safety. However, it’s important to consider the root cause of this anger. 

Several years ago, I cared for a patient, Mr. H, who was paralyzed from the waist down. He initially presented as withdrawn and reserved. During rounds one day, Mr. H became unexpectedly angry and irritable, no matter what I did to comfort him. This prompted me to pause and ask, “What happened to you?” 

This question opened a dialogue. Mr. H shared that he’d been shot in the spine during a conflict between rival groups. The shooting, coupled with his paralysis, became his lifelong punishment. He was unable to finish his education or walk again, and the trauma left a deep emotional scar. 

Mr. H’s anger stemmed from a lifetime of hardship. His parents abandoned him, and he lacked a sense of belonging even within his own family. He clung to the hope of a cure, which remained unfulfilled. As a doctor, I inadvertently became a symbol of his unfulfilled dreams. 

This experience taught me a valuable lesson: anger in patients can often be a manifestation of past trauma. Recognizing anger and inquiring about a patient’s life experiences are crucial to providing excellent care. Healing goes beyond simply finding a cure; it requires creating a safe space for patients to address their underlying trauma. 

Furthermore, hospital environment itself can sometimes be re-traumatizing. Healthcare professionals must be aware that anger can be a sign of unresolved trauma with long-lasting effects on well-being. 

By asking “What happened to you?” we can empower patients like Mr. H to share their stories and begin the process of healing from their emotional wounds. 

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.