This chapter explores how the term ‘Chernobyl child’ expanded over time to encompass nearly all children from Belarus and Ukraine, categorized based on their perceived suffering and need for help. This classification, while useful for securing aid, often led to ethical dilemmas about who deserved assistance. Through specific examples, the chapter illustrates how this categorization not only shaped their experiences abroad but also influenced how they and others understood their identities. The chapter also delves into how these trips abroad served as a means for the children to cope with the trauma of the Chernobyl disaster. While these journeys opened their eyes to different cultures, they often involved significant emotional challenges, such as adjusting to unfamiliar environments and confronting the reality of their situation. These experiences, though difficult, played a crucial role in how the children processed their pasts and envisioned their futures. The chapter shows that, despite the challenges, the trips sometimes led to lasting relationships with host families, providing a complex blend of support and difficulty in dealing with their traumatic histories.

The inglorious twelfth Battle of the Isonzo (autumn 1917), came to be an icon of catastrophe in the national awareness. It has remained one of the most persistent memory sites in Italian culture. However, many of the revolutionary myths proved in time to be little more than legend or false reports of war. There was no betrayal, no organized subversive plot, no attempt to ‘do a Russia’, yet Caporetto still has evocative power over the collective memory, outweighing the ‘splendid recovery’ on the Piave. Not only is it the most written about (and debated) battle in the history of unified Italy, it is also the only one whose name has entered common parlance to conjure up moral and material disaster. This more than explains why it was also the culminating experience in the life of Luigi Cadorna. Not only did it end his career, it turned him into a reprobate. He who even days before had been an untouchable idol, was now tarred with the brush of incompetence, even treason, and put through the public disgrace of a court of enquiry vetting his every act of command. Unsurprisingly, Caporetto was a ghost which Cadorna tried to shake off for the rest of his days.

Chapter 6 discusses the representation of memory in trauma narratives. Accounts of victims of childhood trauma are contrasted with the testimony of Holocaust survivors. I argue that that the distinctive qualities of trauma narratives can also be understood as differences in the culturally constructed landscapes of memory that shapes the distance and effort to remember affectively charged and socially defined events. Landscapes of memory draw from implicit models of memory that influence what can be recalled and warranted as accurate. Trauma narratives involve cultural models and metaphors of personal and historical memory. For them to function as personal and collective history, there must be public places for them to be told, acknowledged, and retold. The political recognition of collective identity and history can help create such a place. Individuals’ stories, in turn, can serve as testimony to ground collective history and call for further moral and political response. Understanding the personal, social, and political meanings of trauma in theory and practice requires tracing the systemic loops that link memory, symptom, and response with a landscape of cultural affordances.

Chapter 7 explores some ways in which metaphors trauma shape the experience of the self and temporality through examples from refugees and Holocaust survivors. A key function of narrative is organizing the experience of time. Narratives of the self have consequences for the experience time. The discussion distinguishes two meta-narratives of the self in terms of their implicit root metaphors and associated temporalities: the adamantine self, characterized by endurance, integrity, coherence, autonomy, self-definition, self-determination, and self-control; and the relational self, characterized by flexibility, fluidity, sensitivity to context, multivocality, interdependence, and responsiveness. These models of the self are associated with different ideologies and forms of social life that shape trauma memory and experience. They also influence the ways that trauma experience is narrated through personal and collective stories. This occurs in settings that require an attentive listener. The ethics of storytelling has an essential counterpart in the ethics of listening, which involves particular forms of temporality and ways of participating in a cultural community.

The plays of Sean O’Casey are filled with aches and pains, debilitating diseases, and traumatic wounds. He was himself a disabled writer. Furthermore, his presentation of disease and disability is inseparable from his critique of class, militarism, and masculinist ideology. This chapter shows how O’Casey’s depictions of disability are more nuanced than they may at first appear. He does demonstrate an essentialist tendency to see female resilience as a triumph over the failures of male impairment, yet, in plays such as Juno and the Paycock and The Silver Tassie, O’Casey allows space for contrary readings that speak with relevance to contemporary understandings of disability.

Trauma is one of the leading global causes of mortality. In spite of more liberal use of CT scans, some patients will still have occult injuries and require a short period of observation and may need treatment of pain, etc. Emergency department observation units (ED OUs) have been used for the short-term management of trauma patients since the 1980s. OUs have proven to be a cost effective and safe alternative to inpatient admission for patients who need short-term management of their injury. OUs were found to decrease length of stay, increase efficiency, and decrease the utilization of resources.

Trauma refers to an event or series of events that overwhelms the capacities of the person. Trauma disrupts all developing systems from brain to self. Trauma is especially devastating in the early years because of the nature of development. Development is cumulative and follows the principle of differentiation. Basic forms are laid down and then refined; therefore, there is a lasting impact of early disruption. Trauma can be especially devasting with regard to meaning making, because the major impact of trauma is to compromise integration. Integration is precisely what meaning making is. When early integration is compromised, gaps in the mind in the form of dissociation will result.

Perioperative cardiac arrest occurs in about 1 in 3,000 anaesthetics. The majority occur in older, frailer patients (1 in 1,200), and in high-risk or emergency surgery. The cause may be the result of underlying medical disease – usually cardiac, secondary to surgery – usually due to haemorrhage or secondary to an anaesthetic cause – usually due to hypoxia and hypercapnia, typically resulting from airway problems.

The Resuscitation Council has issued algorithms to guide management of basic and advanced life support in both adults and children. Advanced life support secures the airway and supports the circulation using drugs with the aim of the return of spontaneous circulation. Two main types of arrhythmia occur in a cardiac arrest:

• Non-shockable: pulseless electrical activity (PEA) – a QRS complex without a palpable pulse and asystole

• Shockable: ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT)

Potentially reversible causes of cardiac arrest should be actively sought and treated. There are special circumstances after 28 weeks of pregnancy which require attention and are described. A traumatic cardiac arrest resuscitation algorithm is discussed.

For all intents and purposes, life was good for Karen: happily married and settled with three children and a nice life. A series of events -- including bereavement; a large, organised fraud involving threats, police involvement and a court case; and the sudden severe ill health of her husband -- sent her down a deep hole. Major depression and anxiety opened boxes that were closed many years ago containing trauma that was never disclosed and everything collapsed. PTSD added to the deep despair and there were numerous episodes of self-harm and suicide attempts. Six years of repeated admissions (mostly involuntary) followed, being treated with medications and four courses of ECT. ECT was instrumental in Karen being well enough to be able to engage with the therapy she needed for long-term recovery. The story is narrated with original diary extracts and poems written at the time of her suffering. Karen now works with the ECT Accreditation scheme, reviewing ECT clinics around the country, and has spoken extensively about her experiences to journalists and at conferences, trying to reduce the stigma that surrounds the treatment. She is also employed in the clinic where she received treatment as a peer support worker

Human trafficking is an international problem that involves involuntary or forced labor. This can occur in a range of settings including sex work, agriculture, manufacturing, and hospitality. Patients may present in the gynecology office with sexually transmitted infections, pregnancy, mental health conditions, poor health or neglect, substance use disorders, and injuries. Providers should be familiar with red flags for trafficking and screen patients appropriately. With a positive screen, the patient’s safety needs to be immediately assessed. Trafficking can be reported to the National Human Trafficking Hotline. Providers should be aware of and follow local laws for reporting. Appropriate care should be provided to the patient based on presenting symptoms, including a history and physical exam, sexually transmitted infection testing, imaging, and mental health screenings as indicated. There are limited data regarding outcome of pregnancies in people who are trafficked. Care should be provided using trauma-informed principles.

Intimate partner violence is common amongst pregnant patients. It is associated with late entry to prenatal care, increased rates of preterm birth, depression, PTSD, and substance use during pregnancy. The USPTF supports screening of reproductive age individuals and ACOG supports the screening of all pregnant people. Screening is recommended at the beginning of pregnancy, during each trimester, and in the postpartum period to ensure those affected can be referred to resources for support. There are many validated screening tools but it is most important that patients are screened in private and they know their responses are confidential. Healthcare workers play an important role in helping to detect intimate partner violence and providing a safe healing environment for patients affected by intimate partner violence.