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To the Editor: In their discussion of the inner life of physicians, Dr Meier and colleagues¹ propose a medical model to address emotionally sensitive issues that most physicians keep secret. The medical model that I use to understand such issues is that of posttraumatic stress disorder (PTSD), which is defined as a set of typical symptoms that develop after a person sees, is involved in, or hears of an "extreme traumatic stressor."² Although PTSD has been described as a consequence of rape, war, bombings, or other obvious overt traumas,³ it is usually not considered a result of medical training.

I believe that most physicians have PTSD and that the resulting feeling that physicians ignore most is toxic shame. Shame has been defined as the failure to live up to one's own expectations.⁴ I define shame as the healthy sense that one is limited and toxic shame as the belief that . . . [Full Text of this Article]

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