Editor’s note: The opinions expressed by the author do not necessarily reflect the opinions of the AAMC or its members.
I had just purchased a bagel and iced coffee at Lange’s Little Store and Delicatessen in Chappaqua, New York — my 7 a.m. ritual before heading to work at the Mount Sinai Health System — when I heard a loud boom and felt a hit to my right shoulder. My heart began to race. I saw blood. Someone was shooting at me, and I had to get to safety.
As a physician-scientist and an educator, I had studied post-traumatic stress disorder (PTSD) and people’s response to trauma for decades. My colleague Steven M. Southwick, MD, and I co-authored the book Resilience: The Science of Mastering Life’s Greatest Challenges. And now I was the victim of a life-changing catastrophe. Someone was trying to murder me.
Back inside Lange’s, my only concern was survival. Fifteen pellets penetrated my shoulder, my lung cavity, my diaphragm, and areas around my liver. One pellet landed dangerously close to a critical vessel. I quickly lost half my blood.
I had studied post-traumatic stress disorder and people’s response to trauma for decades. … And now I was the victim of a life-changing catastrophe. Someone was trying to murder me.
Later, I learned that the shooter was a former researcher at Mount Sinai who had been terminated for scientific misconduct. When he shot me in August 2016, I barely knew him, but I had signed off on his dismissal a few years earlier.
Although my story is dramatic, I am certainly not alone in experiencing trauma. One study indicated that nearly 90% of U.S. adults will experience at least one traumatic event during their lives. Such events might be a car accident, sexual assault, cancer diagnosis, or even a natural disaster.
Responses to trauma vary widely. Some people are so haunted that they cannot move forward with their lives — suffering recurrent nightmares or flashbacks, for example — and require professional treatment for PTSD.
Many others will suffer distress for a while after a trauma but then bounce back. They will learn from the experience, incorporate it into their lives, and ultimately grow stronger.
Rebuilding after trauma
For those working to move on from a terrifying experience, there is a road map for resilience — a psychological toolbox — that certainly helped me.
For one, I found concentrating on role models extremely important. I admired many of the people described in our book, including prisoners of war who were tortured for years and later went on to achieve great things. Of course, a role model needn’t be someone dramatically heroic; it can be someone from your daily life who inspires you in some way.
A strong moral purpose also helps, providing a sense that your life offers opportunities for beauty, joy, and contribution. This inner strength sometimes comes from religion, but some people find it in other types of spirituality, such as yoga or meditation. In fact, mindfulness — the practice of staying focused on the present moment — can be quite helpful in resisting the pull of upsetting memories.
In addition, the support of family and friends helped me tremendously. My wife and children were always by my side. And as dean of the Icahn School of Medicine at Mount Sinai and president for academic affairs of the Mount Sinai Health System, I had no choice: my recovery was very public. I discovered that people cared about me and admired my work. Often, that happens in memoriam, but for me, it happened during my recovery, and was so gratifying. For those lacking such broad support, I recommend reaching out for it. Support groups around shared issues are a great resource, for example, providing not just practical advice but emotional connection.
Toward the future
During my five days in intensive care, I consciously set a goal for myself. I knew from my research that setting goals is a key part of physical and emotional healing.
I told my doctor that I was determined to give my annual White Coat speech to our incoming students in September, two weeks away. I always find the ceremony moving, as each student receives a white coat as a symbolic entry into medical school. I became laser-focused on giving that White Coat speech, and this served to motivate me during strenuous physical therapy sessions.
At the same time, the Bruce Springsteen song “Tougher Than the Rest” kept running through my mind. The refrain became my mantra in the ICU. I realized that my training as a physician had prepared me to be tough, and I was determined to share that message with the incoming class.
Being a doctor means coping with loss and disappointment on a daily basis. … [B]ut if you stay the course … ultimately you will emerge further down the road tougher than the rest.
And I succeeded. I was greeted with a standing ovation as I made my way up to the podium to give my speech. It was the first time I had returned to the campus since the attack.
I told the students, “Being a doctor means coping with loss and disappointment on a daily basis. Many of your patients will not get better. Some will die. Too few will be cured.” But, I added, being a doctor can also be incredibly rewarding. “You will face tough times, but if you stay the course, nose to the grindstone, eyes to the stars, ultimately you will emerge further down the road tougher than the rest.”
In the two years since the shooting, I continue to take great pleasure in helping to educate a new generation of doctors and enabling brilliant researchers to make discoveries that improve health. I love my family intensely. I exercise often, and even compete in sea kayaking.
There is a quote from A Farewell to Arms by Ernest Hemingway that summed up my state of mind after my ordeal, when I was so vulnerable yet determined to get back to my life. I shared the quote at the end of my White Coat speech, and it still motivates me today: “The world breaks everyone and afterward many are strongest at the broken places.”