The Unquiet Trauma Beneath Our Flag

Hidden Struggles Affecting American Lives

As a doctor who has served as New York State health commissioner and CDC deputy director, I would diagnose America as suffering from complex trauma - a body politic that has chronic stress, manifested by the inability to calm nerves or steady the pulse. Though diseases do affect people, it is the nation that is now showing physiological signs of trauma.

When our bodies are exposed to a threat, we respond by releasing adrenaline making us feel the racing heart inside. Even after the danger passes, our brains continue to replay events in a never-ending loop. With time, we find this level of hypervigilence grinding down our immune system and clouding better judgment. The more people exposed to trauma, the more isolated we become from each other. Connectivity turns to survivability, and many ultimately suffer from post-traumatic stress disorder.

It is no different for our country. Each national tragedy is met by a momentary cringe that is eclipsed by the next crisis, which occurs all too soon thereafter. We find our children practicing lockdown drills as frequently as fire drills. Barely making eye contact in elevators, check-out lines or playgrounds, which would boost our oxytocin - a hormone that fights trauma and promotes social bonding - we succumb instead to the dopamine kick of scrolling through a smartphone. This leads to addiction and sends our sympathetic nervous system into overdrive. Instead of reflecting on a situation, we reflexively react just as if exposed to a traumatic situation.

If scientists could measure America’s stress hormone levels, they would be exorbitantly high, reflective of our lives of uncertainty and fear. As a coping mechanism we, as a nation, retreat into our ideological tribes and use digital devices to numb the pain. Trauma survivors similarly try to desensitize themselves from their angst-ridden experiences.

The numbers confirm the diagnosis. Suicide rates have escalated, with 50,000 Americans dying by their own hand in 2023. Not since World War II have we seen such statistics. If that is not concerning enough, the rates for our youngsters have risen by 50% in the past decade. One in two Americans reports a sense of loneliness and three out of four believe our moral values are in decline. These are the vital signs of a nation whose faltering heart is pumping into a bloodstream anemic of empathy. It manifests through trauma to our communities, schools, health systems and even democracy, itself.

The lessons of history show that America has previously experienced such trauma. The Civil War left a nation in shock, and the Great Depression necessitated the New Deal to heal wounds. The turmoil of the 1960s led to reconciliations and reforms and the tragedy of September 11th was healed through dialogue and a shared purpose. To nurse ourselves back to health we must first recognize the pain rather than numbing ourselves to it. After all, anesthesia wears off eventually. In fact, the prescription for national healing is no different than for individual survivors of trauma: safety, connectivity and self-discipline.

From our children to our elderly, we must have schools and community centers that provide a sense of safety. We must listen to conflicting opinions and disagree without succumbing to rage. Just as serotonin calms the anxious brain, compassion calms a fearful nation. Mentorship, volunteering and helping our neighbors are small acts that lay the foundation for national healing. Slogans and quick fixes are not treatments for national trauma. Recuperation begins with humility and patience, with honesty and trust.

As a physician, I have seen patients recover from trauma that once seemed insurmountable. The human body, as well as the American spirit, have remarkable capacity to heal when given a tincture of time and a cup of kindness. But recovery begins only when we slow down and remember that health, be it that of a person or of a people, is not just the absence of disease but by equanimitas: the presence of balance, purpose and calmness of mind.