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We Live Here Rerun: Caring about health in the face of toxic stress

In this rerun of We Live Here, we examine the concept of toxic stress and learn how managing patients who experience it is challenging for doctors and for the patients themselves.Caring for patients in the face of toxic stress.

First a definition.

Toxic Stress: This refers to the impact of bad experiences that happen over and over again on a person's brain architecture and chemistry. Many researchers study the impact toxic stress can have on a child's development. But it can also apply to an adult.

For example, if a single dad needs to go to municipal court to pay a fine, but he doesn't have the money to pay it, that can be stressful. But let's add to that. Not only can he not afford the fine, but he cannot afford child care and he's not allowed to bring his child with him to court. That's even more stress. Then, on top of that, he is supposed to be at his job at the car wash, which pays hourly, but going to court will make him late to work. 

That's toxic stress.

But it also applies to how safe someone feels in their own home or how secure they feel in their job or if they've been exposed repeatedly to violence. 

Someone suffering from toxic stress experiences health and health care much differently than someone who is secure in his or her life.

And for physicians like Dr. Heidi Miller, treating these patients isn't something doctors learn about in medical school. 

"I was taught what normal physiology was and what pathology was. Seven years of learning how to identify a nail that I could then hammer," Miller said. "Over 12 years of maturing as a physician, I've realized that human suffering does not come down to one medical problem with a pill that solves it. The vast majority of my patients are in some capacity suffering from stress in their lives now or in their past."

Our podcast follows Dr. Miller as well as people who experience toxic stress as they cope with the things that create it.

Copyright 2016 St. Louis Public Radio

Shula Neuman is the executive editor at St. Louis Public Radio. She came the station in late 2013 as a subject matter editor, after having worked as an editor for NPR in Washington, D.C. Shula started her journalism career as a general assignment reporter for the Watertown Daily Times and made the switch to radio when she took a job as a reporter/evening newscaster at St. Louis Public Radio. After that, Shula reported on economic development for Cleveland’s public radio station. This is Shula’s second stint with St. Louis Public Radio. She says she just can’t stay away from her hometown because she’s tired of rooting for the Cardinals in absentia. Shula has a master’s degree in journalism from Columbia University; an Executive M.B.A. from Washington University in St. Louis; and a bachelor’s from Reed College in Portland, OR. She claims she has no intention of going back to school again.