Can Hospitalization Precipitate Toxic Stress?

During morning rounds, I introduced myself to the parent of a patient with bronchiolitis. As trainees, we are taught the medical management of bronchiolitis and how to set families’ expectations for the course of illness. However, we are not taught how to help families cope with the stress of a hospitalization. As we entered the room to discuss her child’s illness, the mother was on edge. Although her son was due to feed, she firmly requested that we let him sleep. Then she glanced at the textbook in her lap, remarking that her child was finally comfortable. Although she had not slept herself, she needed to catch up with her schoolwork. This interaction prompted our team to consider whether this mother’s stress, the challenge she felt juggling her son’s illness with her own responsibilities, was affecting her son’s clinical course. Could the stress of this hospitalization be toxic to her?...