NEW HAVEN, CT, UNITED STATES – As I return to Yale University for another year of summer teaching, I have continued to explore the intersection of medicine, ethics, and the human consequences of conflict. Having written about communities affected by displacement, historical trauma, and war I was particularly interested in speaking with Dr. Benjamin Tolchin of Yale School of Medicine.

Dr. Tolchin’s research focuses on functional and non-epileptic seizures, epilepsy care, and clinical medical ethics, areas where neurology and ethics often intersect in important ways. From a Middle Eastern perspective, his work is especially relevant. Populations exposed to war, terrorism, displacement, and chronic stress frequently experience higher rates of trauma-related neurological and psychiatric conditions. Yet functional neurological disorders remain widely misunderstood by patients, families, and even physicians. Patients may present with seizure-like episodes but have no epilepsy, often leading to years of misdiagnosis and inappropriate treatment. At the same time, mental health conditions continue to carry considerable stigma in many Arab and Jewish communities, making diagnosis and treatment even more challenging.

Our discussion explored the neurological consequences of chronic trauma, the ethics of medical decision-making during humanitarian crises, and the importance of building healthcare systems capable of responding not only to disease, but also to the psychological and moral burdens that conflict leaves behind.

Your work has focused extensively on functional seizures and other neurological conditions that can be influenced by psychological stress and trauma. What should healthcare professionals and the public understand about the relationship between trauma, chronic stress, and seizure-like disorders?

There is very clear evidence from both animal models and human epidemiological studies that chronic trauma and stress affect the hypothalamic-pituitary-adrenal axis, leading to prolonged elevations in cortisol and dysregulation of the body’s stress response. That has significant consequences for cardiovascular health, the immune system, and mental health, including higher rates of depression,........

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