Iris Chang, the 36-year-old author of "The Rape of Nanking: The Forgotten Holocaust of World War II," immersed herself a decade ago in the stories of those who had survived the period in 1937 when Japanese soldiers invaded a city in China and slaughtered 300,000 people. More recently, Chang interviewed survivors of the Bataan Death March. After listening to the stories of American survivors in Kentucky, she suffered a breakdown and was hospitalized for three days. She returned home to the Bay Area, where, despite therapy and medication, she committed suicide Nov. 9.

Compassion fatigue. Secondary trauma. Vicarious traumatization. These are the terms used to describe what happens to empathic people like Chang who lose their way home after bearing witness to stories of man's inhumanity to man. After five years of working as a psychiatric nurse consultant on a trauma unit, I began experiencing nightmares, palpitations, shortness of breath and an ever-growing fear for my children's safety. Then, I attended a trauma conference where I heard the term "vicarious traumatization" for the first time. My symptoms became understandable and I knew that a break from my work was necessary.

Trauma professionals talk about exposure to traumatic events in terms of "dose." Recent developments in trauma research allow us to map changes in the brain that occur as a result of trauma. Even secondary exposure, especially the strong dose that Chang accumulated over time, may cause observable changes. Cops, firefighters, therapists, reporters and frontline health-care workers are also at high risk.

Treatments are available. Taking steps to reduce stress before symptoms appear is even better. This includes a supportive work environment, harmony at home, regular exercise, balancing work with pleasurable activities and time spent with friends, especially ones who make you laugh.

Mourners said that Chang was a person who "felt others' pain intensely" and that she "wouldn't take time off." Another said, "For Iris, no problem was unsolvable." Maybe that's what happened. Iris Chang confronted the reality of evil in our world and died trying to do something about it. I imagine how the voices haunted her nights and trespassed into her days; how each story pulled her in deeper; how she made herself bear the unbearable in order to give words to unfathomable feelings; how she absorbed the suffering of others so that we may learn to be better human beings.

The only problem is that we don't want to listen. We don't want to hear. We don't want to believe. Talking about feelings has never been the fashion in this country. We would rather medicate them or drown them in alcohol. We are not taught how to care for the emotional needs of others. We are uncomfortable when someone we know expresses pain or sorrow. We avoid such situations because we fear we will say the wrong thing or become emotionally overwhelmed ourselves. But acknowledgement, care and comfort are what people who bear witness need. Sometimes though, even the cushion of a loving family and devoted friends isn't enough to rescue those who have descended deep into the pain of others.

Iris Chang illuminated the lives of many people, but in the process, she lost the light of life within herself. Like the firefighters at ground zero after the Sept. 11 attacks, she sifted through the remains of tragedy without a break, without concern for her own mental health. We need to nurture people like her who have dedicated their lives to seeking truth and in so doing, risk losing their way home. We must offer them respite from their work, feed them with appreciation, listen to their feelings and drag them away when they get too close to the maw of despair.

Laurie Barkin (barkinbro@sbcglobal.net), a psychiatric clinical nurse specialist, is writing a book about her work with survivors of trauma.

© 2004 San Francisco Chronicle

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