Release the flying monkeys (or, narcissists never get their groove back)


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Narcissists have an uncanny understanding of others and can always be counted on to find some ally somewhere whom they can convince of the lies that the narcissist believes about themselves

I’ve been listening to the How Stella Got Her Groove Back audiobook at bedtime for a few nights now. Stella is a 42 year old divorcee single mom who goes to Jamaica to get away from her stressful like and ends up meeting a man half her age even though she really wasn’t going there to meet a man. It just so happens I am also a 42 year old divorcee single mom and I am going to Jamaica this summer to get away from my stressful life and I’m really not going there to meet a man. I’m waiting to see how the book ends (literally and figuratively)

Taye Diggs looking okay I guess

Life has been stressful and I’m ready for some beautiful beaches and reggae and guided tours of marijuana farms. I’ve had flying monkeys coming at me from multiple directions. I speak, of course, of the vampire-narc’s flying monkeys. The people in their lives that do their dirty work for them, like they did for the Wicked Witch of the West.

Hmm, well now I’m mixing together vampires and witches and that just isn’t fair to witches. Oh well. Apologies to the witches reading this (and their allies). Now where was I? Yes, I’ve had some different flying monkeys using differing tactics this month. One was the nice kind and the other was the malicious, aggressive kind. Harassing and fairly incoherent texts were received. A slight twinge of feeling betrayed followed by a sadness for my children that this is the world they live in. One where vampires are common and hard to spot sometimes. A world where vampires make more vampires.

I have to say I’ve had many, many monkeys sent after me over the years but they’ve always been the nice kind. They try to lure you back into the orbit of the narcissist with flattery, defending the narcissist, encouraging you to try again, and guilt tripping. Looking back, it’s truly mind blowing the sheer number of monkeys and how unlikely some were (because glamour). I’d be impressed if it weren’t for the fact it is an act of manipulation by the very old undead creatures that they use to feed on humans longer and, therefore, not something to be impressed by. Disturbed yes. Repulsed yes. Impressed no. But the monkeys were always nice then. Having an attack monkey sent after you is something else entirely.

So, I shooed the little flying primate away and blocked it from texting me and told its vampire to keep it on a leash. Which they said they’d do (although see here for why I shouldn’t believe them). The same sorts of things that kill vampires kill flying monkeys too. Not engaging in their imbecilic drama, pointing out reality, being rational. They’re simple creatures. Just annoying at times.

The vampire in question made the right call moving from nice flying monkeys to mean ones. I see the vampire for what they are and no amount of flattery or manipulation or guilt trips or empty promises of a glittering future from a flying monkey will change that. Not anymore. Fool me once shame on you; fool me twice shame on me; fool me daily for nine years, that’s one very big therapy bill. But I am the fool no more.

So, let the very old, tired looking undead creature send their mean monkeys with their angry confusing text messages. I have plenty of sage and selenite to clear the energy after I delete them. And a little reggae and a good book will take my mind off of it nicely.

The first rule of vampire fight club (or, Repent! for the end is near)

A scrub is a guy that thinks he’s fly
And is, also known as a buster
Always talking about what he wants
And just sits on his broke ass, so

-TLC “No Scrubs”

I was watching a nostalgic show recently about movies in the ’90s. Dances With Wolves, Thelma and Louise, Austin Powers, Titanic, Being John Malkovich. So many good movies. And of course, Fight Club.

“The first rule of fight club is you do not talk about fight club. The second rule of fight club is you do not talk about about fight club.” Who could forget that one?

And as I’m watching it, I think, “the first rule of dealing with narcs is to keep in mind they’re pathological liars. The second rule is, keep in mind they’re pathological liars.”

If you’re not a vampire-narc, you don’t lie constantly. All damn day long. You don’t look someone in the eye and just balls out lie. So, it’s hard to keep in mind. Some of their lies are so absurd it’s obvious. But many are not. After all, this vampire-narc may have been lying like this for almost 50 years. Half a century. That’s a long time. Longer than you’ve been alive. Much longer than you’ve been alive.

Ah but I digress. If you’re a normal human being you have to constantly remind yourself. It’s difficult and annoying but it is the one absolutely essential thing to remember when slaying vampires. They will lie to scare you, lie to manipulate you, lie to make themselves look good/fit/smart/successful/a great parent/ a good Christian/a victim/ someone who hasn’t cheated on their partner. Sometimes they lie for no reason at all other than the fact they’re pathological liars and liars gonna lie.

The interesting part is when you catch them lying and confront them. They will use every narc trick in the book to distract you: word salad, projection, what about-isms, insults, false equivalence, triangulation, glittering generalities, flattery, threats and of course, more lies. Internally, they are panicking. You see, the vampire-narc is him or herself a lie. A walking talking lie appearing to be a human being. Recall from my previous posts, the narc is in fact a really old blood sucking undead creature who devotes constant energy to pretending to be human and in perpetual need of the life force of actual humans to survive and keep up the lie. So, when you call them out, it destroys them. Their entire sense of self collapses and they begin being sucked into the black hole of shame that lies deep within them where an actual person should be.

They panic and roll through all the defenses I referred to above. They will begin piling on more lies. And as you make it clear there is no way getting out of this, that they are busted, they move on to defending themselves, making excuses, minimizing, attacking you and, of course, more lies. Always more lies. Someone get out the circa 1870 guy on stilts because some gas lamps are about to get lit.

But when none of that works and you walk away and leave them alone with themselves, they realize there is a stake in their chest. They assume you put it there. In reality, they’re the ones who put it there. But, projection, ya know? Nothing is their fault. Most of all, their destruction. Hopefully them make it to their coffin in time and they can sleep it off and send that memory express delivery to the narcissistic amnesia mail room. If not, it ain’t pretty.

Some would call it karma. Others, the natural consequences of their actions. Vampire-narcs don’t learn from mistakes, so it’s definitely not a painful opportunity for personal growth. Some would say it’s the wrath of God, but Jesus surrounded himself with lepers and prostitutes and liars so I have to assume he has love even for vampires and narcissists. They’ll probably go to hell since they’re not capable of repenting but I don’t think He’s the type to punish them while they’re still undead.

Whatever it is, it is a dark spiral. But we mustn’t let pity keep us from calling them out on their lies. They’re very good at playing the victim and seeking attention and pity using more lies. We can’t fall for it. Vampires are dangerous predators with strong powers of glamouring and we must stand up to them in the name of truth and love and life. Vampires make more vampires. We can’t tolerate it.

So, remember, the first rule of dealing with vampire-narcs is to keep in mind they’re pathological liars and the second rule is to keep in mind they’re pathological liars. It is the foundation of defeating the very old undead among us. Without it, they win. If we can keep it in mind and call them out, they will eventually not make it to their coffins in time and will have to face who they really are. And they will realize, they don’t actually exist.

Aqua Tofana, the cunning woman’s divorce

I recently asked a patient how their Mother’s Day had been and they replied, not good. Their mother had found out her partner had been slowly poisoning her. I asked them if this person seemed the poisoning type, any history of violence or mental illness? No, they responded. It was a total shock. And I thought to myself, why would someone poison their spouse instead of just divorcing them? And then I thought about what divorce is like and I wasn’t as stumped.

My friend told me about a prominent pastor who’d slowly poisoned his wife and made it appear as though she had a terrible chronic disease so he could garner attention and sympathy (narcissist much?). Another friend related to me a tale of a man who had poisoned his wife (by slipping it into her prenatal vitamins) right before she got into her car, hoping to make it look like a car accident but the poison kicked in too quickly and he was caught.

And then a friend told me the tale of Aqua Tofana.

olden times drawing of Aqua Tofana bottle

Giulia Tafana lived in 17th century Italy. She made cosmetics and holy oils for women by trade. But, she also helped over 600 women kill their husbands with a poison she made called Aqua Tofana. She succeeded for decades but in 1659 she and her daughter Girolama Spara were put to death for their crimes. Well, by one account anyway. Another has Tofana dying peacefully of old age and her daughter taking over the family business.

Spara operated as a kind of “cunning woman” who sold charms and cures to the gentlewomen and nobility of Rome. These activities would not only have introduced her to potential customers, but would also have given her a shrewd idea of which of her clients were happy in their marriages and which unhappy – not to mention which might be desperate enough to seek drastic remedies, and be able to keep a secret.

The thing to keep in mind is that in 17th century Europe, women had no rights. Your husband could beat and rape you as much as he pleased. Your father could pick your husband for you. Women had very little control over their lives and divorce was not a thing back then. What was a girl to do? Giulia Tofana had the answer.

Aqua Tofana was a unique poison. It was colorless and flavorless and only 4 drops was enough to kill a man (or, as the primmer source goes, “sufficient to destroy a man”). The wife would put the first drop in his food or wine and he would feel a bit off, a bit tired. Then in a a day or two she would slip him the second drop and he’d feel worse. By the third drop, he was vomiting and diarrheaing all over the place (which she probably had to clean up) and calling for the priest. And the final drop did him in.

Administered in wine or tea or some other liquid by the flattering traitress, [it] produced but a scarcely noticeable effect; the husband became a little out of sorts, felt weak and languid, so little indisposed that he would scarcely call in a medical man…. After the second dose of poison, this weakness and languor became more pronounced… The beautiful Medea who expressed so much anxiety for her husband’s indisposition would scarcely be an object of suspicion, and perhaps would prepare her husband’s food, as prescribed by the doctor, with her own fair hands. In this way the third drop would be administered, and would prostrate even the most vigorous man. The doctor would be completely puzzled to see that the apparently simple ailment did not surrender to his drugs, and while he would be still in the dark as to its nature, other doses would be given, until at length death would claim the victim for its own…

To save her fair fame, the wife would demand a post-mortem examination. Result, nothing — except that the woman was able to pose as a slandered innocent, and then it would be remembered that her husband died without either pain, inflammation, fever, or spasms. If, after this, the woman within a year or two formed a now connection, nobody could blame her; for, everything considered, it would be a sore trial for her to continue to bear the name of a man whose relatives had accused her of poisoning him.

She initially disguised it as cosmetics but soon moved to hiding it in holy oil bottles marked Manna of St. Nicholas of Barri. This was appropriate because a priest, Father Girolama, was getting them their supplies. (A crooked priest??? Shocking, I know, but it’s true). It was also appropriate because what gal doesn’t want jolly old St. Nick bringing her some Aqua Tofana? Slip a bottle of that potion under my tree, Santa!

Is there Aqua Tofana in Santa’s sack?

We don’t know if any of this is true, of course. The witch hunts were still going in the 17th century as part of a broad and violent effort to suppress female healers, midwives and artisans and craftspeople. Maria Mies refers to this process as Housewiferization . European women were being removed from the public sphere and confined to the prove sphere of the home. It’s possible the tale of Aqua Tofana is entirely a result of the times. But I think most women would like to think it’s true. Not because we’re homicidal, but because, well, patriarchy sucks. Being powerless sucks. Why shouldn’t those 17th century men have at least been a little afraid their wife might poison them if they treated her like shit?

We don’t have to poison our husbands these days. We can just divorce them. There’s less vomit to clean up. But it doesn’t make nearly as good a story.


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Of Bats and Vampire Slayers


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I was thinking about bats. You see, I’m part of a local group that is creating a community garden. My practice is sponsoring an herb garden (which I plan to name after Gwen ferch Ellis, the first woman killed for being accused of being a witch in Wales. She was, of course, an herbalist and traditional healer. Which was the point of the witch hunts: to get rid of midwives and female healers to make way for the new institution of modern medicine). But I digress! We discussed at the most recent meeting perhaps putting up a bat house since our town has quite a few of them. And so, that’s how I came to be thinking of bats as I drove into work this morning.

A family of vampires heads to their Air BnB

My next thought, naturally, was vampires. This idea that vampires can turn into bats and fly away and then turn back into a vampire. Of note, my vampire likes bats and has a bat box which I will be removing when I move back into the marital home after equitable distribution is complete. Ahhh I digress again! Maybe I need a snack so I can focus better.

So, what does this ability to go back and forth between being the blood sucking undead and a flying rat translate to in our narcissist analogy? If you’ve ever lived with a narcissist, you know.

When you finally leave a narcissist you find yourself spending a lot of time trying to explain to people who know you both that the narcissist is a very different person behind closed doors than they are when they’re in the outside world. Narcissists can be very charming (recall the glamouring) in order to get what they want. They have spent their entire lives (some for as long as 51 years–almost 52) studying human beings and learning how they should act in any given situation to get what they want. Often times what they want is to be admired. Or pitied (they are the ultimate victims when they want to be). Sometimes they want money. Sometimes they want a job. Sometimes they want to gain your trust in case they need you as a flying monkey later. (A flying monkey is different from a flying rat; we’ll get into that soon enough). In any case, they put tremendous energy into containing who they really are. They remain remarkably lifelike. When someone from their home then tells you, no, they’re actually a really old blood sucking undead creature, you find it hard to believe. You find them hard to believe. And then you remember how the vampire confided in you that his entire family has mental health issues. And you think, poor woman, out of her mind and thinking her wonderful husband is a very old blood sucking undead creature.

And so, when the vampire violates the PFA, you hold onto the warrant she went through hell to get and don’t serve it. And when you hear whisperings around town about it, you say “well it’s a he said, she said so we really can’t know. They’re probably both partially right. Divorces are like that.” Because who wants to believe a vampire lives in their neighborhood anyway? It’s really so much easier to take comfort in the glamouring and try not to think about it.

But as time goes on, the vampire can’t keep the image going. He is too entitled, too arrogant, too self-centered, too mentally ill to not begin to slip up. Rules don’t apply to him and neither do boundaries. So, one day he borrows something from your shed without asking while you’re not home. He knows better than, well, everyone, so he begins to challenge your authority in the local club you’ve been running for years that he just joined. And when you politely attempt to contain him, he pushes and pushes and pushes until his glamour starts to wear off and you realize how cold his hand is and how pale his skin. He does you favors you didn’t want him to do and then becomes upset when you don’t thank him. And you just generally begin to realize he’s full of shit.

And so, he must move on to another neighborhood. Another church. Another job. One where he can glamour again. In a cloud of smoke, he turns into a bat and takes flight in the night. He is the fastest, most beautiful flying rat you’ve ever seen. He eats more mosquitos than any bat. He has better sonar than any bat. And when he finds a new hunting ground, he lands and transforms back into a very old blood sucking undead creature with a large nose and an increasing number of gray hairs. And goes about glamouring again. All the people who rejected him in his old neighborhood fade away and he is happy once again and full of fresh, warm blood.

A woman with a bad haircut looks at the phone of a shirtless man, implying they’re a couple where the man has cheated

Vampires are lustful and very good with women. They cheat. And they think no one knows. But people do. And when the human they pretended to love finds out for a fact the vampire has cheated, she makes sure everyone in the neighborhood knows. And everyone in the church. And so, it’s good that he left before the humiliation began. There, in his new home, he is the image he wants to be. And this time, it will be different. This time, he will settle down and be almost human. For the vampire slayer that ruined him did not follow. He is safe from her here in his new home. and he’ll make sure not to take up with another one.

a prose poem on pandemic and human connection (or, angels knocking)


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My receptionist is back and I had an in office appointment today. Almost all of my appointments have been by phone since March 13, 2020, but even with the rare in office appointment, I would greet the patients and have them go into the room with me. Now, she roomed the patient and then I went in. Before I did, I did the doctor knock. That sort of quick, short littler knock you do as you’re opening the door. You pop your head in first and then walk into the room and give your excited greeting. I came really close to crying. I had no idea how much I missed that knock. That moment where you’re standing outside the door and you pause and prepare yourself mentally for what’s on the other side. Sometimes it’s a brief, happy moment. Sometimes it’s a frantic review of the chart that you really should have done sooner. Sometimes it’s a feeling of exhaustion and dread and “can I really make it through another patient today?” If it weren’t for this pandemic, for this seismic shift in how we do medicine, I would have never appreciated that knock, that moment, that island of time and place that is the outer edge of the intimate relationship between doctor and patient. There is joy in my bones right now. The quiet sound of angels singing. A feeling of home in my heart.

I’m good enough, I’m smart enough, and gosh darn it I’m filled with a black hole of shame


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I was thinking this weekend about the concept of a vampire doing self affirmations like Stuart Smalley on Saturday Night Live. He sits in front of a mirror and tells his reflection “I’m good enough, I’m smart enough and gosh darn it, people like me.” But then it occurred to me, vampires have no reflection.

Now, recall dear reader, I proposed vampires as a good analogy for narcissists (as have others). But if you back to the root of narcissism, the original narcissist, you must learn the story of Narcissus. In Greek mythology, Narcissus falls in love with own reflection, not realizing it is not someone else. He sits by the pool of water staring into his reflection until he either dies of desire or kills himself, depending what version you read. The whole idea of narcissism is that the narcissist has no true self and only exists as a reflection from other people.

So is my analogy doomed? I would argue it is not.

We all have a true self and a false self. Our inner identity and the one we present to the world. I some people there is very little difference. But in some, specifically the narcissist, the difference is so great, the true self essentially disappears over time leaving only the false self. When we look in a mirror, we see ourselves for when we truly are. There are no selfie filters, no distractions. Try just sitting and staring into a mirror for five minutes straight sometime and tell me how it made you feel. It’s hard to do. It’s hard for any of us to sit with who we really are. But for a narcissist, it is impossible. They will cease to exist. Because there is no true self. It died long ago when they became vampires. With no true self there to cast a reflection, the narcissist faces a blank mirror. They can create their false self there through delusions, projection, grandiosity. But they will never have a true reflection.

They feed on their human prey to gain the narcissistic supply they need to maintain this false reflection. The more they get you to dislike your reflection, the true self, the more power they gain. The more they get you to doubt your reflection through gaslighting and the like, the more power they gain. And the more they can take from the young, the younger their reflection remains. Vampires may be okay with being old, but narcissists definitely are not.

Mirror mirror on the wall, who’s the fairest of them all? You better hope that mirror repeats the narcissist’s name back to them because if that mirror doesn’t keep up the lie of the false self, there will be poisoned apples in the works. And if your magical hair keeps up the illusion of eternal youth for the narcissist, good luck escaping that tower. It will be tall and filled with lies. The narcissist will never let you go. Unless, of course, you make sure they do.

Dracula may leave a trail of bodies, but in the end, he fades away into the sunlight and the heroine lives happily ever after (and hopefully gets treatment for what I assume would be a really bad case of PTSD). The princess’s plight seems hopeless, but there’s always a happy ending. She lets it go into the unknown and no one knows how far she’ll go and all those other Disney songs. She used to wait around for a prince but she has since figured out princes tend to be narcissists anyway and she’s better off doing it herself.

In the end, Narcissus can’t keep his reflection going. The water dries up. Or maybe the illusion. He dies and turns into a beautiful flower. That, dear reader, is where narcissus flowers come from. Because even from the destruction of narcissists, one can bloom into something beautiful and real. Those flowers are wondrous and gosh darn it, people like them. And they like you too. Just the way you are.

Never let a vampire in (of narcs and garlic, or narlic)

“Somewhere along the line we were taught that charismatic and charming people are somehow valuable or interesting … To me, charisma is like heavy perfume or cologne that someone wears when they don’t take a shower. It’s probably covering up something else.”

Dr. Ramani, clinical psychologist

“Unbeing dead isn’t being alive.”

EE Cummings, poet

“Just to be alive is grand thing.”

Agatha Christie, writer

They say that if you don’t invite a vampire in, they can’t cross your threshold. But what do you do if you’ve already let them in? How do you make a vampire go?

I have bells on my doorknobs and black tourmaline above my doorframes, salt in the corners of all my rooms. And I have a PFA that established my house as a vampire free zone from the beginning. But I am not free of my vampire.

The term glamour first arose in Scotland in the 18th century and initially meant a magical spell. In time it took on its more common usage today, “Exciting or mysterious attractiveness usually associated with striking physical beauty, luxury, or celebrity.” But it is also used as a verb in reference to vampires. It is said a vampire can control a human’s mind and get them to do whatever they want through the act of glamouring.

Vampires glamour you, you submit, they drain you of your blood and leave you for dead. Could there be a better analogy for narcissistic abuse? They are, above all, emotional vampires, constantly on the hunt for their next fix. But like vampires, they’re actually quite weak and vulnerable. Pathetic really. They depend on us for our blood since they are the undead and completely unable to create their own. And something as simple as garlic or sunlight or a good old stake to the heart can do them in.

They were once alive but another vampire made them into one themselves and the humanity in them is long dead. They’re miserable and hate themselves but are incapable of ending their own lives, so they roam the earth in search of prey. Hiding who they are, manipulating, killing, oftentimes making more vampires along the way.

Some people are better at spotting them than others. Some more willingly submit to glamouring. Some go their whole lives being fed on and never figure it out.

So, what do you do if you’ve let them in, and the glamour has worn off? How do you get rid of them? Let us consider our options.

Option 1: Garlic

Garlic is tasty and good for your heart and immune system. You could load up on marinara, roasted garlic, even garlic pills from your local pharmacy. As your body grows stronger and your spirit is lifted by the culinary joy, your vampire will be repelled. Vampires like their prey weak and dependent and miserable. Try hiding some under your bed to ward off unwanted sleep interruptions if his sexual dysfunction is on hold that night.

banish your vampire with heart healthy garlic

Option 2: Stake through the heart

A more dramatic and violent choice when garlic isn’t strong enough. Recommended forms include PFAs, divorce filings, healthy assertive statements, boundaries, truth, calling out lies, ignoring, and recognizing reality.

Option 3: Sunlight

Narc vampires often stay up quite late, restless, unable to quiet their minds and close their eyes to the ever present paranoid dangers of their world. They don’t generally sleep in coffins, but if they do, it is the *nicest* coffin you’ve ever seen. Literal daylight, however, does not weaken or kill them. They live in a different kind of darkness. They spend their time trying to pull the people in their lives into it, to starve out the light in them. The brighter you shine, the harder they try. Your light reminds them of what it means to be human, something they will never be again. They’d possess that light if they could, hold it inside and feel its warmth. But they can’t. They can only put it out. Their skin ever cold. The blood they consume losing all warmth the moment it touches their lips. But if you shine bright enough, if you let all that is good and beautiful and joyful and true come through, it’s too much for them. A solar eclipse that burns out their retinas. They realize they are too weak to put that light out. And they move on. They will try in vain. They don’t like to lose. But they will eventually be forced to seek out a new source to feed on or risk dying in the bright glow of the miracle that is you.

Knowing you are a miracle. Knowing you are amazing and wonderful and whole. That is how you get rid of a vampire. And God and all his Angels won’t be enough to protect him if he tries to make vampires of your little ones. Their blood is sweet but he is weak and dark and will be sent back from whence he came. And you will never ever make the same mistake again. Now you know what a vampire is and that you don’t have to let him in. And when he tries to glamour you, slam that door in his pasty face and get back to making your marinara. Just to be alive is a grand thing.

Everything’s fine (of sock monkeys and crocodile tears)


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My therapist and I realized the other day that although I’ve been in therapy with her off and on since 2014, we’ve never discussed my childhood. “Well,” she said, “I’m sure you’ve discussed it with the other therapists you’ve seen in the past.” “No,” I replied, “I haven’t. Never.” She asked. if I thought we should and I paused and took a deep breath and said, yes. My life has been a series of fires to put out for so long, this is the first time we’ve had time to get into it. She is clearly not a Freudian. And I have clearly been avoiding this. (My mother’s voice ringing loud in my head “someday you’ll grow up and go to therapy and talk about what a terrible mother I was,” making a pit in my stomach big enough to swallow me whole. The guilt. The shame. You don’t talk about the family to anyone outside the family.

Soon after this, someone tweeted about writing about your childhood and your parents’ reaction. It was a lighthearted tweet but some jackass replied that if one is going to write something negative about one’s parents, they should discuss it with their parents first as he had had an experience counter to this and was not okay with it. Here’s my response:

He has since deleted his comment as you can see.

I mean what I said and yet, I have held back on discussing certain things here. But I’m reminded of the quote:

So, fuck it.

I was reading my fave Viktor Frankl a couple of weeks ago. There’s a book newly translated to English of some talks he gave in 1946, shortly after leaving the camps. He writes about getting out and choosing to stay in Austria and the experience of having so many people there say, oh we had no idea what was going on in the camps. He calls it a deliberate not knowing and says it’s essential to the success of authoritarian regimes. Ordinary people must deliberately turn away from what is happening so that they don’t have to accept responsibility for it, don’t have the moral imperative to do something about it.

And as I was reading it, I thought of my mother. I thought of how much energy she and my father have put into not knowing for my entire life. You see, my greatest fear has always been that my children will turn out like me. They most definitely got some crap genes from me (nature) so I have to know that I am raising them differently than I was raised (nurture). And so, I have to remember what it was like and all the glaring red flags and cries for help and all that that they purposely ignored. Because I wouldn’t. I wouldn’t ignore my kids’ cries for help and red flags and all that.

I used to make excuses for them. It was the 1980s, it was rural Appalachia, not a place mental health was talked about. We didn’t have health insurance a lot of the time. But it’s just excuses. I had a lot of friends, of all classes and varieties, whose parents got them help (tried to anyway). The truth of it is, she didn’t want to be embarrassed and she didn’t want to be bothered. It’s messy, ya know? I remember writing a story in college about a girl who kills herself by slitting her wrists but makes sure to put newspapers down so it won’t make a mess for her mother to clean up. I had no idea the story was about me. I truly didn’t.

When you cut yourself everyday with razor blades, arms and ankles and shoulders and thighs, it is bloody. It wasn’t a thing back then. They still called it “self mutilation.” A friend of mine turned me and my boyfriend onto it and I loved it. I loved it for a lot of reasons, conscious and subconscious. I tried to hide it but apparently something happened that made it impossible to ignore. So they told me to stop. And she said, “You don’t need to see someone do you? You’re all right aren’t you?” And there was only one acceptable answer. “I’m fine.” Because we were always fine.

But my cuts were a reminder we weren’t actually fine. An intrusion into the beautiful little house where she kept her china dolls, four daughters, four dolls. And so my sisters would say that I needed to stop upsetting mom. And they would check me for cuts. And I would find new places to cut that they weren’t willing to look. And in time it blew over. She honestly probably completely forgot about it pretty quickly. They do that, ya know? People like her. They just dissociate out the bad memories that don’t fit their picture of the perfect little life. Just put the cut up doll in a new long sleeved dress and back in her place and everything’s fine again.

Fine. We’re fine. Everything’s fine.

We came home drunk, came home high, came home tripping balls. And they didn’t notice. I thought I was really good at faking them out. My other friends’ parents kept catching them but not me and my sister. We were so much better than them! Of course, we weren’t. Of course, if my kids came home like that I would know instantly. And have to deal with it. And admit things are not fine. And I would. But not her. Not them.

And if my four year old came to me asking for protection because her older sister was bullying her, I wouldn’t say “Toughen up. Life is hard,” and go about my day. If they locked her in a room with a static-y TV meant to terrify her at age 5 because she’d seen Poltergeist, if she was so scared she literally ripped the door off the hinges trying to escape, I would do something about that shit. For her sake and for theirs. I prefer not to raise any of my kids to be dickheads. But she loved her flying monkeys because they did the work for her.

I have to think about these things to remind myself I am a different mother than she was and that my kids won’t turn out like me. They’re already turning out differently. They don’t pretend everything is fine (not at my house anyway). They get mad and sad and worried and frustrated and bored. And they notice when I’m unhappy and ask me if I’m okay and what’s wrong and they try to cheer me up. These things happen daily, generally multiple times a day. And it occurs to me how many millions of time I have stuffed down sadness and anger and guilt and confusion and shame and just generally not being fine. And how many times I have stuffed down the urge to say, what’s wrong, Mommy? Because no matter what I said or how I acted, I knew things weren’t fine. I just didn’t know how to say it. For decades.

I look at my daughter and think, wow, she’s so perceptive. She spots manipulation or insincerity a mile away and she calls you on it. And it’s taken me a year and a half to realize I was that perceptive too. I just didn’t allow myself to admit it. Because I had to survive. Because children die without adults to take care of them.

I think about that study where they replaced infant monkey’s mothers with these cloth monkey dolls and the monkeys bonded to them, clung to them. Those infants turned out much better than the monkeys without one, or with the ones made of wire instead of cloth. And I wonder, did those monkeys grow up and go out in the world and eventually realize their mothers were just dolls, and not real mothers at all? Did the monkeys marry monkeys or dolls? If you’re used to a doll, I’d imagine marrying a real actual monkey wouldn’t feel right. Until you eventually realized being married to a doll isn’t normal at all, and really not a good idea.


I am 42 years old. And up until a few weeks ago, I would have told you I’m not an emotional person. A lot of statements like this “That movie had me crying and I’m not an emotional person.” “I’m not a crier but when she said that, I ended up bawling.” And so on and so forth. I didn’t think I was an emotional person because that’s what they told me. I remember being at the Pittsburgh International Airport and my mom was either leaving for her prolonged trip abroad or returning from it. I was 16 or 17. And my mom was crying and my sister was crying and so on and so forth. And I wasn’t. And it was, oh what’s wrong with her? Why isn’t she crying? And so when I was diagnosed with Asperger’s at the age of 22, it all made sense as to why she never seemed to express the appropriate emotions. And what it took me all these decades to realize, is that I knew it was all fake. The tears, the words they spoke, the situationally appropriate feelings they acted out. All a performance. A play we put on everyday for ourselves, for the world. I just couldn’t play along. Actual sadness, actual crying, I knew to keep hidden. Like a rabbit crouching down in the field, pressing its soft underbelly to the cool grass, hoping the wolf won’t rip its intestines out. Hoping it will pass by. Never, I mean never, expose your soft underbelly to them. Keep it locked away. Even from yourself.

It turns out, I’m actually really fucking emotional. I cried in front of patients in residency. That is not done. I cry on my way home from a hard shift with my addiction patients. I cry every time my son Max plays piano. I cry at movies, on almost every major holiday, thinking about the future, the past. I’m a crier. It’s taken me my entire life to 1) realize this and 2) let go of the shame around it. You’re not allowed to apologize for crying at my office. Humans are supposed to cry. And if someone feels safe enough to cry with me, I’m honored. Crying, real crying, not performance tears, it’s truly amazing. Every cry is a good cry.

Lena knows the difference between real tears and fake ones. She knows there’s a certain look he gives her that’s meant to make her feel bad for him and manipulate her into acting like she’ll miss him when he goes even though she won’t. And she knows how she’s supposed to act to make people happy. I think she knows she doesn’t need to do that with me. I hope. I’m actively working on it. Working on accepting emotions of all kinds from them and from me. On being honest with them when I’m sad or angry. On letting them know I’m there if they’re sad and that they won’t feel sad forever. Listening. Watching. Noticing. Remembering.

I will never understand how you can see your child’s body bloody and gashed and not want to do everything you can to help her. How you turn away from a four year old asking you for protection. How you tell your daughter she’s a crazy slut and a horrible mother and you’re giving her ex-husband money to get a lawyer and take her kids away. How you mention to her that her uncle googled “Elizabeth Fleming slut” and all kinds of things came up. Show her the tiny little AP wire article in the hometown paper about her turning in the pedophile and mentioning, accurate or not, details about her sex life, and talk about how humiliating it is and remind her how embarrassed her sisters are. And will never understand a man jealous of a ten year old. A man who belittles and degrades his children and his wife, plays them against one another, gaslights and lies. And do you know why?

Because they aren’t real people. They’re just cloth dolls pretending at being human. They’re badly behaved little sock monkeys and I merely, dear reader, relate the facts. Because everything was not fine. And every feeling and word and question and desire and lament and exaltation that I’ve swallowed down, that my children have swallowed down, that so many of us have swallowed down, deserves to come out whatever way we see fit. Y’all sock monkeys can go on deliberately not knowing, just work a little harder at it. The rest of us, we’re gonna be just fine.

M m m my Corona (someone left the cake out in the rain)

One year ago today I woke up to my four year old climbing into bed with me, crying, with a barking cough and feeling like he was a million degrees, telling me his throat hurt. It took a minute for me to realize I felt the same way. By the next day, the whole household, all five of us, had a fever. I’d begun tracking all our temps twice daily on March 13th, when the schools shut down and the seriousness of this virus started really hitting me. On Sunday the 15th my oldest son had a low fever of 100.4 but felt fine. It went away a day later and I chalked it up to a sinus infection. I think he was probably patient zero at our house but it could have been a fluke. We’ll never know. It seems likely we got it before lockdown began. Once it had begun, we followed the rules very strictly (although I did go grocery shopping once and no one was masking back then).

When he came into my room, with his barking, croupy cough, I knew it was COVID. I just knew. COVID, as far as we knew, was still barely in Pittsburgh (we were wrong). It was new enough that new cases were reported on the news. There was one at the Oakmont Sheetz as I recall shortly after we got sick. I remember telling people I thought we had COVID and their skepticism. “I don’t know anyone with COVID,” they’d say, as though they were the Universe. “Well, it’s a pandemic, so someone has to have it. And a lot of us are going to get it by the time it’s done.” To be sick and face invalidation is difficult. It’s hard enough being sicker than you’ve ever felt while having four sick kids while working from your closet while in total isolation without that exacerbating things.

We were lucky enough to live somewhere with grocery delivery but the stores were often out of things and needed to substitute and that didn’t work with my kids. COVID took our appetite and I had to offer them whatever food they were willing to eat that day, which was usually very something very specific.

Our symptoms lasted a week but by day 7 we were feeling good. They were saying that around day 7 is where you either got better or crashed, requiring hospitalization. We remained fever free for 24 hours and I took us out of isolation (the guidelines back then were basically just 24 hours fever free). The best day, though, the fever came back. The other symptoms too. This happened over and over. Sick a week then feeling 100% better for a couple days and then sick again. A month in is when it got worse. We were feeling worse and worse each day. It felt like the virus was eating us from the inside out. All the kids did was sit around on their iPads. All I did was sit around on my phone. We didn’t go outside. Didn’t play. It was harder and harder to force ourselves to eat and drink. I began having episodes where I almost passed out. I told my 15 year old how to do the sternal rub if I passed out and didn’t wake back up right away. I was delirious a lot of the time but didn’t know it. If you’re in total isolation, who is there to tell you you’re not making sense?

It wasn’t possible to get a test in March of 2020. Beyond the fact I couldn’t leave my four year old with severe COVID diarrhea home with his 15 year old brother (no childcare in isolation), they wouldn’t give me on unless I had fever, cough and shortness of breath or a known contact with someone wit COVID. When we were getting worse in April, I went to an urgent care where I used to work and basically used doctor-to-doctor privilege to get one even thought I didn’t qualify. By then it was too late for the test to have been accurate (maybe if I wasn’t delirious I would have realized this? Maybe we didn’t even know that at that point. Who the hell knows). I tested negative but the doc told me he thought it was a false negative given my symptoms.

GOD HELP YOU IF YOU TELL PEOPLE YOU HAVE COVID AND HAVEN’T HAD A POSITIVE TEST. The art of medicine means little these days. People want a test. Few will truly believe you had COVID without it.

The exhaustion was severe and I had to keep working full time. Some days I would do my phone appointments lying down because I was too tired to hold my arms up. By the end of a workday I was so tired, I didn’t have the cognitive energy to watch a movie. I couldn’t follow the plot line. Sometimes I’d just lie on the couch and stare all evening. The fever and chills came and went and brought an awful malaise with them. My joints hurt (left shoulder in particular), no appetite, nausea, diarrhea, stomach cramps, brain fog, a headache that nothing relieved, trouble balancing, flushing, neuropathic pain, extreme muscle tension, back pain, anxiety, depression, mania, apathy, conjunctivitis, insomnia, sore throats, runny nose, hives, and I developed hypertension. No, really. All of that.

My daughter couldn’t really do any distance learning and I really couldn’t handle everything I was handling and also do all the things I was expected to for my special needs son distance learning. I remember calling my daughter’s teacher crying and telling her to fail if she needed to, because I was doing everything I could just to not have a mental breakdown.

I’d lost my receptionist and I couldn’t exactly hire and train another one from isolation, so I was seeing patients remotely and also answering phones and emails, scheduling patients, sending out registration papers etc.

I was also dealing with my soon-to-be-ex-husband having a mental breakdown of his own and financially supporting him. At one point I had to worry about proving we truly did have a fever and needed to be in isolation to a judge since it was interfering with our ongoing custody battle.

And at one point sewage backed up in our basement. It was all very Job-like.

I’m not one to take these things lying down, though.

No one knew long COVID was a thing, so as our fever dragged on, it was scary. I was talking to all the docs I knew and none of them were seeing a fever like that. I began taking our vitals several times a day and recording it. I logged our symptoms and what we’d done that day, eaten. Anything I could think of to figure it out because we didn’t have time to wait around for someone else to do it. I figured out early on the fever was the key to it. Every other symptom you see in other conditions. But a fever lasting this long? It was unique. The fact it came and went was unique. Th e fact it didn’t respond to Tylenol or NSAIDs was bizarre. The fact it didn’t follow a typical fever pattern (worst at night and better in the morning) didn’t make sense. And there was something else: our fevers were synchronized. I could take 10am vitals and we were all fine. Fifteen minutes later I would start feeling chilled and look at my little guy who was now flushed. I’d check our temps and all five of us now had a fever. When it passed, it passed in all of us. That is not normal.

And then one day, ten weeks in, before I’d been able to figure it out, our symptoms went away. The kids went into a PANDAS flare and I gave them all IVIG. They had severe side effects which leads me to think their immune systems had been thrown really off balance. We went to the ocean for a week. And we seemed to be back to ourselves.

Except we weren’t. Looking back on it now, now that we’re truly doing better, we still had symptoms. My one son was depressed and I assumed it was because life is pretty crappy in lockdown, but once his long COVID was treated, his mood improved right away. I had an incredibly label mood all summer. I remember commenting on it to my friend, saying I was exhausted from actively having to reign myself in from being too high or too low everyday. My youngest had developed idiopathic hives. My oldest and my youngest were having difficulty learning. Their teachers were concerned. Our appetites were still off. I still couldn’t sleep.

On October 5th (also a Sunday. What’s it with Sundays?) our symptoms came back in full force. It was bad enough I took my oldest son and I to get tested to see if we’d been reinfected. We weren’t. But the symptoms wouldn’t go away. This time, I was aware of my cognitive impairment and the exhaustion was harder to deal with. I wasn’t going to let COVID ruin my kids’ lives and I sure as well wasn’t going to let it keep me from working. That was not an option. I’m the breadwinner for four kids. If I don’t work, we’re homeless. So, I decided I was going to figure this out once and for all.

I returned to the fever pattern. By now I’d joined long COVID patient groups online and even a COVID survivor physician group. I found other patients with the same synchronization of symptoms. It appeared in a piece in the New York Times. And two of my patients who I suspected had had COVID in February and now had long COVID also had this synchronization of symptoms. This pattern eventually led me to figuring out that our symptoms were actually mast cell based and I was able to develop a long haul COVID treatment for us that has reduced our symptoms by 90-95%. We still get flares but they’re manageable.

I hope someday we’ll be symptom free but I don’t know if that’s realistic or not. If there’s one thing coronavirus has taught us it’s that we don’t know shit. This little virus shut down the world. It’s killed millions. It’s likely left millions with long COVID too. And we still don’t know how to treat it. Not really.

I was sad today, looking back on it. Those ten weeks were so awful. Its return in October. Not knowing if we’d ever get better. People don’t get how scary it was. Remember March 2020? Remember how scared we all were? We knew nothing about this virus except that it was horrible enough to shut down the entire world. A plague. Like a sci fi movie. My kids don’t have normal immune systems so something as simple as strep or flu can knock them down for years. I couldn’t find any other kids with PANDAS with COVID. It’s a small community. I was talking to every practitioner and parent I could and we were the only ones. We were the guinea pigs. After everything we’d been through and overcome with PANDAS and now this? I was terrified. It was traumatic.

And so, I cried today. But suffering and sickness are inherent to life, so I knew there was no point wallowing. There was a party to set up, after all. We had The 1st Annual Spaar-Chiang-Fleming Corona Roast tonight. We made a corona cake and had balloons and glow in the dark axes and a bubble machine (why not?). And we had a coronavirus shaped piñata that we beat the hell out of (at one point my son was worried I was going to break the baseball bat. Damn, it felt good beating the living hell out of that paper virus). We each wrote down something awful about this past year and then something we wished for this upcoming year. We burnt them to send their ashes up to the fairies and saints. And we burned the piñata. The coronavirus is just a pile of ashes now. Ashes to ashes, dust to dust.

I told my kids I’m proud of how well they’ve handled this awful year of sickness and lockdown. I am. And I told them there really will be better times ahead. One of my kids wish was very simple: to return to school. I don’t know if that will happen this year, but it will happen. As my daughter told me when I was upset the pizza we’d ordered for the party was 2 hours late: it’s okay. It’s not like the cake fell and smashed into the floor. The party of our new life was interrupted last March, but it’s only dreams deferred. The cake is still safe on the counter waiting for us. And it will taste that much more delicious when it’s finally time to eat it.

Spring was never waiting for us, girl
It ran one step ahead
As we followed in the dance
Between the parted pages and were pressed
In love’s hot, fevered iron
Like a striped pair of pants

MacArthur’s Park is melting in the dark
All the sweet, green icing flowing down
Someone left the cake out in the rain
I don’t think that I can take it
‘Cause it took so long to bake it
And I’ll never have that recipe again
Oh no!

I recall the yellow cotton dress
Foaming like a wave
On the ground around your knees
The birds, like tender babies in your hands
And the old men playing checkers by the trees

MacArthur Park is melting in the dark
All the sweet, green icing flowing down
Someone left the cake out in the rain
I don’t think that I can take it
‘Cause it took so long to bake it
And I’ll never have that recipe again
Oh no!

There will be another song for me
For I will sing it
There will be another dream for me
Someone will bring it
I will drink the wine while it is warm
And never let you catch me looking at the sun
And after all the loves of my life
After all the loves of my life
You’ll still be the one

I will take my life into my hands and I will use it
I will win the worship in their eyes and I will lose it
I will have the things that I desire
And my passion flow like rivers through the sky
And after all the loves of my life
Oh, after all the loves of my life
I’ll be thinking of you
And wondering why

MacArthur’s Park is melting in the dark
All the sweet, green icing flowing down
Someone left the cake out in the rain
I don’t think that I can take it
‘Cause it took so long to bake it
And I’ll never have that recipe again
Oh no!

Oh no
Oh no!

The Moment That Defines Us (In other words, I pulled an Abraham)

The United States Senate chose to acquit Donald Trump today. Everyone in that room knew that Trump was guilty. On top of that, they were the target of his crime. He tried to kill them. His followers still want to kill them. Many of them were afraid for their lives and their families if they voted to convict. We’ve heard nothing from Pence in all of this even though the traitors constructed a gallows from which to hang him. He’s hiding out, they say, because he’s afraid of more MAGA terrorists hurting him and his family.

Hmm, now where I have heard this before? Maybe I’m thinking of everyone from the janitor on up to head foot ball coach and local God, Joe Paterno, at Penn State that did nothing about serial child rapist Jerry Sandusky because they were afraid they’d lose their jobs. Or maybe the dozens upon dozens upon dozens of people who knew exactly what Jeffrey Epstein was doing and did nothing because they were afraid.

Feeling you might be killed is trauma. Being put in a situation where you can either choose to do the right thing and possibly die or do the wrong thing and live is the hardest thing you will ever have to decide. But it’s not difficult. There’s nothing complicated about stopping a child rapist or convicting an ex-President who committed treason and is clearly planning to try it again. There are no murky shades of gray.

To be placed in this position is a tremendous gift. That moment defines you. Everything before and everything after in your life accumulates to far less than the weight this moment carries in deciding if you are a good person or not. Other people have to go their whole lives plugging away at doing the right things day in and out, and always wondering in the back of their minds if they’re a good person. Those of us placed in the hard position outlined above get a beautifully dramatic and swift moment that cements our place in the moral universe.

I had such a moment and faced the very real fear of my beautiful babies, two and four at the time, and I being killed. I chose the right thing. We weren’t killed, but it almost destroyed me. I went through hell for years afterwards but I never doubted I was a good person and that I’d made the right choice. Even if it hadn’t worked out and he had killed me, I would have known I made the right choice. As the Spanish revolutionary Dolores Ibarruri said, it’s better to die on your feet than live on your knees.

But but but they’re afraid for their families too! Ahhh. Sounds noble to want to protect your family, after all. Even people who are giving and understanding and kind, committed to religion and democracy and equality and all the other good things, falter when you bring their family into it. They justify their choosing what they know is wrong by saying they were protecting their family. Who could argue with that? Me I guess. Clearly I didn’t choose this path. We come to the story of Abraham then.

God tells Abraham to sacrifice his son Isaac. Abraham obeys but God spares Isaac at the last moment. And God is well pleased with Abraham. I have atheist friends who point to this story as proof the Judeo-Christian God is, well, bad. What kind of loving God would do such a thing? And why should we consider Abraham a good person if he was willing to kill his own son? In truth, there are people who think I’m a bad mother and a bad person to have put my own children’s lives at risk to stop a man from hurting other children. And, in truth, I know this to be true because some people in my life said this to me. It sounds like something you write a three page paper about in your first year philosophy class. The safety of your family versus the greater good for humanity. Or like that train. The one that will hit ten people if you do nothing and will only hit one person if you flip the switch. Do you flip the switch and actively kill someone, or do nothing and passively allow ten people to die? What is the moral thing to do (or not do)?

The moment I called to turn him in, I prayed. I sat in my green mini van on a hot June day. The air conditioner was broken and my vents were blowing warm air in my face as I sat there sweating in a long, black heavy skirt from Land’s End. I sat and I prayed and said, “God please don’t let my babies die and please don’t let me die because they need me. If we die, then I guess that was your will because I know I’m doing the right thing.” In other words, I pulled an Abraham.

Plenty of Atheists make this choice as well, for the record. It isn’t about trusting God specifically. It’s about loving your fellow human beings and everything else in the universe, in the collective oneness. It’s about putting that love above fear. It’s as simple as that. There is no fear in love. It’s not easy, but it’s simple.

What people who take the easy way out don’t understand is that it isn’t the easy choice at all. It’s easy for one moment and hard for the rest of your life. You spend the rest of your life trying to make it sound difficult but it was really very simple. If it was difficult, then there was more than one right choice. If it was difficult, you did the best anyone would have in the same situation. If it was difficult, you really had no other choice, realistically speaking. After all, you’re only human. It’s not fair for anyone to judge you.

Viktor Frankl, Holocaust survivor and neuropsychiatrist-philosopher, wrote that “life is never made unbearable by circumstances, but only by lack of meaning and purpose.” Forty-three senators chose to sell their souls today. It was a simple choice that cannot be bent and turned to look difficult. I would assume a lot of them are sociopaths without a conscience, but even sociopaths are human and have a knowing deep within them that they have done wrong. They’ve chosen the easy way and it will be with them always.