ABSTRACT
In their surveys of second victims in healthcare, Scott and colleagues (2009) identified three possible pathways that second victims take: dropping out, surviving, or thriving. A number of the cases described in this book have resulted in the protagonists dropping out. The pilot in Chapter 2 who stopped flying after the accident is a good example. Nurse Kimberley Hiatt is too, in a way. First forced out of the profession against her will, she then dropped out of life altogether. It is quite possible that dropping out is related to chronic posttraumatic stress reactions that have not been handled well by the environment surrounding the practitioner. When left alone to deal with their guilt, trauma, and depression, practitioners have nowhere to go with questions about their skills, their knowledge, their competence, or even their normalcy. Total avoidance of any cues associated with the original trauma is perhaps seen as the only possible response. The fear of flying, of administering medication, or of directing jets loaded with people on a radar screen can become so overpowering, both physiologically and psychologically, that dropping out is the only option left.
