The thermodynamics of Ghostbusters

So this is love, mmm 
So this is love 
So this is what makes life divine 
I’m all aglow, mmm 
And now I know (and now I know) 
The key to all heaven is mine My heart has wings, mmm 
And I can fly 
I’ll touch every star in the sky 
So this is the miracle 
That I’ve been dreaming of 
Mmm, mmm 
So this is love

The Third Law of Thermodynamics states that entropy is always increasing. That means the world tends toward chaos and you have to apply energy to the system to straighten it back out. The way my chemistry explained it is this: your house is always getting messy unless you intervene and clean it up.

Chaos runs counter to flow. This is why, for instance, a cluttered and messy room has a negative effect on our mood and a clean and tidy room feels good. It’s why it’s so important to give kids a consistent routine. It’s why part of healing from addiction and mental health problems and abuse involves calming down the drama. It’s why narcissists love causing chaos.

Creativity consists of taking something seemingly chaotic and making sense of it. So, sometimes we induce a little chaos in the creative process. And that’s okay. In the end, we are reducing the level of entropy in the system.

Trauma is chaos and requires a helluva lotta energy to be applied to return the system to balance.

The Judeo-Christian story of Adam and Eve (as well as the similar versions of it we see cross culturally) about the Fall of Man, is about the introduction of chaos into the world. The garden of Eden was perfect. It was in perfect balance, perfect flow, perfect order. The Laws of Thermodynamics were not necessary. Adam and Eve couldn’t even conceive of entropy. Until they ate that damn apple. Boom. Cosmic chaos. Before that, they were in a state of perfect harmony with God, a constant state of being in the flow.

This onset of chaos and disconnection from flow was the Original Sin. And that is what all sin is: separation from the flow due to induction of chaos. It can come both from causing chaos but also from failing to apply the necessary energy to the system or blocking someone else from doing so. It disconnects both the person committing the act and anyone it ends up affecting.

Disconnection from flow is not only the effect of sin, it is also the cause. Entropy is always increasing. It is easy, therefore, for individuals and larger groups to get into a downward spiral of separation from flow. When we speak of an individual hitting rock bottom, it is often the only way to break this spiral and gain the strength to rally and begin to apply the massive energy needed at that point to return order. Luckily, there is also an upward spiral. With each act drawing us closer to the flow we receive greater strength and hunger for flow.

We see this not only in choices people make, such as battling addiction or all the other self destructive things we do as humans. We also see it in medicine when restoring homeostasis to the body. An upward spiral is always my goal in treating patients. Energy must be applied to keep the upward movement going but it gets easier over time unless another strong element of chaos is introduced again (which is of course common).

For instance, a patient with autoimmune disorders commonly develop severe fatigue and pain. This leads to them being less physically active, doing less of the things they love, getting out less, seeing other people less. All of this then contributes to a greater likelihood of relying on unhealthy coping mechanisms, depression, negative thoughts, and disconnection and loneliness, a sense of isolation. They also often have negative, traumatic experiences with the medical community and others. You’ve now got a whole new set of problems. Once you are able to start effectively treating the body and reduce the core symptoms, you can then reverse the spiral and begin to work on the other effects.

This brings us, naturally, to the topic of Ghostbusters. Ghostbusters 2 specifically. Remember that one? In it, negative energy has created a river of pink slime under the city of New York powered by negative emotions. It threatens to ruin New York. The answer? They must get New Yorkers to stop being angry and come together in love. (to accomplish this they animate the Statue of Liberty to walk through the city and everyone holds hands and sings along to the song they’re blasting from loud speakers “Put a Little Love in Your heart. It works).

That’s what we need now. Our country has spun out into such a state of entropy and separation from flow, only a massive amount of energy in the form of love will save us. Not, in the words of Martin Luther King, “a sentimental something that we talk about… not merely an emotional something.” The love that is flow. The oneness that we are all connected by. The all encompassing perfect love so many of us don’t feel we deserve, that so many are afraid of, that so many of us violently reject. The ultimate vulnerability, the ultimate act of bravery for so many us who have fallen away from the flow.

We are all born so completely in touch with the flow. It comes from the womb. From our mother’s womb, from Mother Earth too. The power the earth holds, then, is the ultimate power. And this is why Sir Francis Bacon decided he needed to take her in hand and conquer her. And this is why patriarchy takes women in hand to conquer us. And why imperialists and racists take people of color in hand. So great is their fear of their mother’s love, of their need for it, of the fact they feel they will never have it.

There is a reason we joke about therapy and the phrase “Tell me about your mother.” Violent men almost universally feel, true or not, unloved by their mothers. This is true too on a global, historic scale. They seek to conquer and destroy the womb. The source of life, the source of flow.

Can we accept the love our mother has for us? Can we wrap our arms around one another before it’s too late? Step on the serpent’s head once and for all and come home?

A letter from the flow on the topic of armageddon

There is a fine line between madness and genius, or at least that’s what they say. If you look at history, a fairly large share of artists and thinkers have been thought to have had what we now call Bipolar Disorder. And if you’ve ever been manic, then you know. You are tapped into the oneness of the universe, the spirit, the magic, the flow. And the music and writing or painting you do comes from the flow. It is from you but it is from something bigger too. One reason it can be hard to get patients with Bipolar Disorder to take their medication is that being overmedicated can take away not only the mania, but the access to the flow as well. And that, my friend, is an awful feeling. Like being somewhere between alive and not. Because it is this flow that is at the core of every religion the world has ever seen. At the core of art and philosophy. It is the meaning of life.

Plenty of people who do not suffer mental illness tap into the flow too. But we, as a society, have fewer and fewer people able to. And that is dangerous. It is at the core of what is happening in our country now. And what has been happening in this world since 1492, the advent of the Modern Era. People far from the flow grow bitter and unloving and resentful of those still in touch with it. People far from the flow are not quite alive.

In the flow you see connections. You see that everything and everyone is connected. You see that everything is one. And you see that we are all loved. You see that you love everyone. And that everyone loves you; you are lovable. And that can be terrifying. But when you’re in the flow, in that moment and place, it’s not.

There are people in recent times so clearly in the flow so much. Cornell West, the late Howard Zinn, Martin Luther King, Malcom X (El Haj Malik El Shabbaz), Bernie, AOC, Robert Benigni, Victor Frankl, Audre Lorde, Allen Ginsburg, . I clearly follow social justice a lot more than art or music. If you’ve ever gotten a chance to be around these people so much in the flow, you felt it. I felt it when I met Howard Zinnia’s on my birthday in 2003. An energy coming from him, a calm and a peace that came over you in his presence. A feeling of being loved.

If you yourself have not been in the flow, or not recently, I imagine you would not pick up on it. Or you would, but it would be too much to take and you’d block it out. And block them and what they create out. You might ignore it, you might hate it. I tend to think the most destructive people in our society are the ones that have a sense of the flow moreso than those who are just indifferent. There is a knowing somewhere inside of them that they are being denied the flow. But the only one denying it is they themselves. As I said, it can be terrifying.

If you look at the extraordinary cure rate of guided psychedelic therapy with MDMA for conditions like PTSD and depression, you see it is because psychedelics tap you into the flow. But when you hear about someone who was not with a guide, that’s when you hear horror stories of bad trips. And so when we refer to these past few years as a bad dream, a bad trip, we’re exactly right. Our society is being run by people on a bad trip that never ends and they are projecting that out onto us.

What else explains a group of people perpetuating global warming at full steam when it clearly will mean the end of humanity?

While mental illness like Bipolar Disorder can bring you closer to the flow, other forms of mental illness are a sign of alienation from it. The most obvious being narcissism. If you’ve lived with a narcissist, you know what gaslighting is. If you are living in Trump’s America you know too (whether you know to call it that or not). Gaslighting seeks to throw you into a chaos far from the flow. Narcissists seek to make you feel unlovable. Because they are convince that they are. And if you try to prove to them they are loved and lovable, you will regret it.

PTSD at its core is removal from the flow. Trauma is the experience of having been abandoned but everyone in your life, by God, by yourself, by the universe. It is the ultimate disconnection and sense of being unlovable, and of the world being a place devoid of love. It is a world between life and death. The only way out is to face your ineffaceable trauma memories. And to accept that you aren’t alone. That you are connected and loved. And that is why psychedelics cure PTSD. And that is why people traumatize one another. People far from the flow and resentful and angry about it, seek to punish those in it and to pull them out to be in that same in between chaotic world they reside in. And that is why healing and thriving and being joyful and loving enrages them more than anything. To see you’re back in the flow is something they cannot stand. They cannot get back to the flow and they don’t realize it is only them keeping them from it.

We are all born in touch with the flow. You see it clearly in kids. You see the lack of it so clearly in kids who’ve been badly abused. Even if you can’t describe it, you feel it. So many of us are in the flow less and less and less as we get older. And if we are not loved and nurtured the way we deserve to be, we go so much further away from it. And some of us are aware of it enough to get depressed or addicted or tuned out on social media. And some of us get angry. We know that there must be a meaning to life but it always seems out of reach for us.

When people live in survival mode, they are rarely in the flow. Only in moments of respite, which some get and some just don’t. And if you do get those moments, it may strengthen you or it may make the times of survival unbearable.

Those in power seek to take us from flow by putting us in survival mode though poverty, addiction, rape and sexual violence, racism, war, consumerism, and constant fear. They do all they can to keep us from taking in the things people make in the flow, to keep us from creation and focused on consumption, to divide us from one another with the construct of scarcity and otherness, they do evil in the name of God to keep us from that something higher. They keep us uneducated and afraid and traumatized. And they gaslight us. It’s what narcissists in relationships do and it’s what Trump and all those he is the culmination of do on a much larger scale.

Someone cut off from the flow cannot begin to address their privilege and the systems of oppression that are affecting other people or even themselves. Karen is far from the flow. So terrified to face not only her own racism but all the ways she is oppressed too. Because she is afraid of love, of the vulnerability that comes when you are in the flow. To hide outside, to hide in her own shame and do all she can to create shame in others is what is comfortable to her.

And someone not in the flow cannot begin to admit what we have done to our Mother Earth and accept the love she for us and feel the love we have for her. We cannot bear to admit we need her nurturing, cannot bear to accept that we deserve it and she is offering it. After everything we’ve done to her, her arms are still open wide. There is no choice but to destroy her.

The Modern Era began in 1492 and was driven by imperialism, colonialism, slavery, conquest, genocide. But that is not what started it. And if you look at where it started you realize it is not only those institutions we now are beginning to admit are reprehensible, but the ones we still hold in high esteem, that are at the core of us. I am referring to other institutions created at that time such as modern medicine, science and the university system. And don’t forget democracy, capitalism and Protestantism.

You see, it all started with this idea the people would come to be known as scientists came up with. A group of European men who were clearly not in the flow and very, very pissed off about it. They pulled off the greatest act of narcissism in human history. They said, hey the earth isn’t an organic being. It’s a machine that Man can come to full understand and fully conquer. That simple, seemingly harmless idea, is how we wound up where we are today. That is where Donald Trump was born.

They began deep mining for the first time. Before that, it was taboo because it was essentially penetrating your mother. Who would be okay with that? But now, anything was fair game.

Do you think there were no healers before modern medicine? That people just languished and died. That is what modern medicine would have us believe. In truth, there were healers (largely female) and midwives (all female) who were trusted and valued by their communities. The idea of a man coming in and delivering babies was insane. And they were not cool with that. Just as the rest of the world was colonized through violence and conquest, so too was medicine. They called in the witch hunts and it killed a million European women.

The early, small scale witch hunts in Europe were carried out by the Catholic Church during the Inquisition. That’s probably the extent of what you were taught (just forget about the Salem witch trials for now, that’s a whole other thing. We can go into that in another blog post). The vast majority of the witch hunts occurred a couple hundred years later and it was carried out by the Protestants. Women’s knowledge of healing became denigrated as “old wives tales” and one by one they disappeared or went into hiding.

Protestantism itself took Europeans further from nature and their way of connecting to the flow through traditional beliefs. Catholicism, as my evangelical friends in the Bible Belt growing up liked to point out to me, had retained a lot of the old beliefs at the time and still does to a small extent today. The Celts had simply turned Goddess Brigid into St. Brigid. The underlying idea seen across pre-Modern spirituality of the importance of both female and male energy brought devotion to Mary. The title of Theotokos in Orthodox Christianity, God bearer. The recognition of the power of her womb, of all women’s wombs, of creation, paralleling the mother of all of us, Mother Earth. The recognition of the power of ritual and the elements and senses. The mysteries you accept, knowing you can never truly understand. The transubstantiation of the bread and wine into the literal body and blood. His body up on the crucifix reminding us of our oneness with him. The elite hierarchy of the Church that developed once it was transformed from a communal, radical religious group into the religion of the Holy Roman Empire was never of the flow, but the people took that imposed religion and made it theirs, returned it to what it was in its beginnings. A religion of loving everyone and everything and acknowledging the oneness, even with the Judeo-Christian God himself. A religion where, at the very core, was the idea that God loves all of us no matter what awful things we do. And He wants us to do the same.

But I digress.

Science is the dogma of our times. And Sir Francis Bacon is its messiah. Do you know how Bacon explained the exalted Scientific Method he came up with? Hypothesis, experiment, conclusion. The man made, systematic creation of objective knowledge. He was inspired by his time spent as an inquisitor of witches. He said we must torture the earth as we do a witch to extract her secrets. That, my friends, is the heart of the institution of science. He could not have been further from the flow. Using violence and trauma to try to separate us all from it, to try to destroy it.

The consumption of indigenous bodies, African bodies, female European bodies. Imperialism, slavery, science.

And so we have arrived at the only possible conclusion to this era. We stand at the rpecidpice: either those of us in touch with flow will be able to usher in a new, better era, or the narcissists will succeed and destroy us all. But they won’t destroy the flow. They can’t. They will simply return us all to it and it will manifest in another way.

The flow speaks to us; we speak to ourselves. One thing traditional healers know that modern medicine denies is that illness has a message for us. And that message is always a return to the flow. A signpost to us that we have taken a wrong turn in our choices, whether they be personal or societal. We see today a tremendous surge in autoimmune disorders in both adults and in our kids. On the literal level, it is due to the choices we have made that have altered our immune systems and our very DNA: avoiding germs, no longer living in contact with animals, an unnatural diet, the use of pesticides and a million chemicals, coal power plant emissions, and living stressed and disconnected lives. It is our bodies crying out to save our souls. If only we would listen. Modern medicine fights this idea with every ounce of its being. Healers and patients who know this truth have to fight to make even small progress for its acceptance into mainstream medicine. This denial by modern medicine not only inhibits patients’ ability to heal, it traumatizes them. It drives them to avoid getting care, it drives them from the flow. People with autoimmune disorders and their families go from thriving to surviving. Further and further from the flow.

I have long sought to figure out what the autism epidemic is telling us. I have autism as do my two oldest kids. I have seen the ugliness of autism and the beauty. Those of us who have, oftentimes struggle to explain this to a culture that more and more presents the bogus idea of embracing autism as a form of neurodiversity. We do celebrate our kids with autism (and our selves if we are on the spectrum) and the good we see in it, but we cannot deny the bad: anxiety, obsessions, violent meltdowns, sensory issues, not to mention all the GI, immune and other neuralgic issues found in those with autism, and their higher risk for certain immune conditions and neurodegenerative diseases as we get older. Mainstream medicine, incredibly, has denied the existence of the autism epidemic. They have denied the immune, GI and neurologic causes of it and only are beginning to recognize it now after decades of physicians and parents fighting. What is autism telling us? Sensuality, our senses, are part of how we access the flow. That is why you see the elimination of the sensual aspects of Christian worship by the Protestants. That is why you see sexuality repressed and controlled so much with the advent of the modern era. A core feature of autism is sensory dysregulation. And so it is when you have autism you are at times so much more in the flow the most and at other times so far away it is excruciating. Hour by hour, minute by minute. Social disconnection is another feature. Part of the disconnection is this fluctuation with flow but part of it is the message we are sending ourselves with this disorder. We need to be more connected. And so, we show ourselves the ultimate disconnection. (So too with the coronavirus). We see clearly in autism too what is true of all disease, that it is the interaction of the all the body systems the create it. And that all the things we have changed about our world that cause the dysregulation of the body that manifests this way.

We are crying out. If only we would listen.

The trauma and suffering so many are going through now, have gone through for centuries, is not okay. But Victor Frankl taught us human suffering can be transformed if we can bring meaning to it, choose to bring something good from it. And so, in the end, no matter what happens, the flow will go on, and we with it. I just sure as hell hope that form is a better world with all of us still in it. Just spending a lot more time in the flow in between our time in our bodies with all their senses and sadness and joy. With one another. Alive.

You Can Do Anything for 20 Seconds


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“You can do anything for 20 seconds!” That’s what the Peloton instructor said as we climbed up a steep virtual hill in my closet at my blue house in Oakmont at 7:00am on a Friday. And all of a sudden I was back in the gym in Verona. 2018. 6:00am on a Thursday morning, getting in a workout before heading up to my Grove City office for a long day of seeing patients. Staring into my reflection in the glass of the front window the treadmills all faced, telling myself “if you survived six months of Jeremy Noyes, you can run a little longer, girl. You can survive anything.”

Now, careful what you say to yourself. Because the universe is listening and if you say, I can survive anything, sometimes the universe goes ahead and sees if it’s true.

I’ve been through a lot since then and I’ve witnessed a lot since then. And I was right: I did survive. I survived a lot more than 20 seconds and a lot worse than a sprint on a squeaky treadmill at a gym that hadn’t been renovated since 1988 and refused to hire a window washer, resulting in a lot of funky spiders peering in at you from their cozy webs outside the windows. But now I’ve reached a strange place. It’s the place beyond survival. A place where you are not desperately trying to get through to the next day. A place where your solace is not picturing the far off someday. I have reached the land of milk and honey.

I’ll say this for the universe: it handed me the land of milk and honey within the worst moment in modern human history. We are essentially living through the Spanish flu, the Great Depression, the 1960s, Germany c. 1939 and a couple dystopian novels all at once. If you’re middle class, go get some weed and take a deep breath and you’ll be okay. But if you’re one of the 94 million Americans living at or near the poverty line, you may not survive this.

I take care of them and I see it and I watch helpless. I do what I can. But I know that almost no one in my life knows they exist. Not really. They were barely surviving before. Now? I just don’t know. All I know is things need to change. And if it’s ugly, then it had to be ugly. Poverty is violence. Our criminal justice system is violence. Our healthcare system is violence. That white rich couple in St. Louis are merely a more tangible representation, guarding their gated community with their big guns.

But I digress.

Back to the irony.

In the midst of all this, I find myself at a new chapter in my life. A chapter I’ve dreamed of for decades but am not entirely sure how to handle now that it’s here. My life is no longer about survival and getting by and fighting.

Now let me knock on wood. OK here goes.

My kids’ health is not perfect but we are over the worst of it and I spend very little time being their doctor now and almost all of it being their mom instead. My medical practice has finally gotten to a good point where I am not afraid month to month if I will make it or not. Where I don’t have to agree to take any patient who calls up and wants seen that day or that weekend or at 2am standing on my head yodeling. I no longer need to work 90 hours a week. I am, after 16 years of more sacrifice than most, finally one of those doctors who can work 4 or 4 1/2 days a week. I could work more and make more, but I don’t have to and I’m not going to, damn it.

My mental health is strong. I have good people in my life with good boundaries. I have moved past the addiction to the delicious chemicals that flood your brain when you are in a volatile relationship. I have a beautiful home that is all mine. My mysterious autoimmune disease is gone and I am training at full speed and loving it. I am working on a plan to section hike the Appalachian Trail. And it’s actually going to happen. I read novels. I ride my Peleton. I’m building a beautiful patio and getting a tiki hut to go over my hot tub. MY FREAKING HOT TUB. I have arrived.

Now, I fully own my class and race privilege. But it’s not the hot tub that is the thing that matters (but it’s pretty darn sweet). It’s the freedom from toxic relationships with other people and with myself. It’s the ability to say, being a workaholic is unhealthy and unfair to me and my kids. The ability to say I deserve to be happy and free. The ability to hold boundaries. The ability to get overwhelmed and pause and take a breath and figure it out without running into something I will regret, something that keeps me in survival mode longer. The ability to sit in pain and uncertainty. The ability to be present, to be fully and wholly alive, the joy and the pain, the exhilaration and boredom. The ability to see the infinite unknown possibilities and be at peace.

The custody battle that was my last great entanglement with the man I loved is now done. This comes at the same time as my practice’s stabilization. The same time my little ones will now be with their dad longer, freeing up more time for me. I feel light. I feel the possibility, and the possibility is here. It’s now. Finally.

I feel like myself. Fully myself.

Life is a journey and I realize I’m not boarding the Good Ship Lollipop. There will be tough times. There *are* tough times right now. I spend a lot of time feeling the things and thinking the thoughts we all ought to be with the way things are. But it’s different now. And I truly believe my personal life hit its last rock bottom this past spring and it is uphill from here.

PTSD tries to take possibility from you. It places your body in a chronic state of fight or fight. Also knows as survival mode. Possibility is a far off, uncertain, unlikely thing when you are in that place between life and death. When you have PTSD as a result of rape and abuse, it will get reinforced over and over again by our patriarchal, imperialist, violent culture. Every time you go to take a step forward, people will try to shove you back down. They will tell you to stop playing the victim, call you crazy, call you a slut, say you wanted it, question why you didn’t fight back the way they think you should have, say you’re exaggerating, call you vindictive towards the poor innocent man you’re trying to destroy. In short, they will do everything they can to keep you in survival mode.

What they don’t know is that you are a badass warrior. What they don’t know is they’re the ones who will never be truly alive. You will.

I am.

40 Days and 40 Nights (or, what doesn’t kill you also makes you more grateful (if you let it).


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We have now had a fever for 42 days. Off and on. Mine had gone away yesterday and I thought, maybe this is it. Maybe this was a fever that lasted 40 days and 40 nights, that started two days before I stopped being 40 years old. And maybe if that’s true, there is a deeper spiritual meaning to it. So, I researched the number 40.

They say 40 in the Bible essentially means, a really long time. It rained for 40 days and 40 nights when Noah was out on the ark. The Israelites wandered in the desert for 40 years. Moses’s life is divided into three 40 year phases. Jesus was tempted by Satan for 40 days. He stayed with the disciples 40 days before ascending to Heaven where he is seated at the right hand of the Father.


They also say 40 represents a new beginning. It has to do with it being a factor of 5 and 8, and 4 and 10. I will skip over those details. After 40 days, the flood receded and it was a new world. After 40 years the Hebrews were considered to have paid the price for their disobedience and given a new life in the promised land. After 40 days, the Holy Spirit anointed the disciples and they were reborn. In Judaism, the embryo is considered to be formed at 40 days gestation. And a pregnancy lasts 40 weeks.

It also represents water, baptism, mikvah. There is the great flood. In traditional Judaism a woman goes to the mikvah ritual bath for purification 40 days after having a son, 80 days after a daughter. The mikvah is filled with 40 seah of water.

According to the Jewish Talmud, at 40 years old you gain the gift of understanding. You come to begin to fully understand all you’ve been taught.

I have been feeling exhausted lately, burdened. And feeling like I will forever be wandering in the wilderness, the promised land always just slightly out of reach. Time and again telling myself, you just need to get through this phase and then things will get easier. At what point do I admit to myself it’s a lie, that this is as good as it gets? In other words, I have been hopeless and have lost that sense of possibility I’d been so grateful to regain back in 2015 when my PTSD was healed.

My life is better than a lot of people’s and I know this in my head and I know this in my heart. But their suffering did not seem to alleviate mine. I kept telling myself to get over it, but I just couldn’t.

Perhaps it’s the nature of this fever. You feel good for a day or two or three. Really good. And you’re so grateful. You have energy and joy and you can run and get things done and enjoy life. And you think this is it, I’m better. I can get on with my life. And then it comes back.

Perhaps it’s this quarantine grinding us all down. Or the fact I had three people close to me in my life a year ago and now I have none. And I’m in isolation and can’t replace them. I cannot picture my future because none of us can. We do not know what will happen with the economy, with the pandemic, with the election, with the way things are done and the way we relate to one another. And so, how do we have a sense of possibility? There are infinite possibilities and none at all.

And so I looked to the number 40 for hope. If my fever lasted 40 days then maybe there was a divine reason God had allowed it to go on so long. Maybe God had a plan for me. Maybe beyond 40 years and 40 days and nights I would emerge from the wilderness and finally enter the promised land. Purified and born again.

But here I sit on day 42. Maybe sometimes a fever of unknown origin is just a fever of unknown origin.

I had the energy to play with my daughter today. She couldn’t believe it. We ran shuttle runs and played charades and had a jumping competition. I felt great. For now, I’ll take that and be grateful. We’re not promised a damn thing in this life. If I ever return to good physical health and energy I will be grateful in a way I couldn’t have been before. When we emerge from this quarantine and I can be with my patients in my office again, I will be grateful in a way I couldn’t have been before. And when the second forty years of my life are easier than the first (and they will be. I know this much is true), I will be grateful in a way I couldn’t have before.

I hate the saying what doesn’t kill you makes you stronger, even though it’s true. I mean, what a crappy gift: the knowledge now you can make it through something even more awful. But this truth has saved my butt more than once and I put faith in it that my children’s difficulties have done that for them. Because life is hard and the best thing we can do for our kids is prepare them to face whatever it throws at them without falling apart. But what doesn’t kill you also makes you more grateful (if you let it).

I’m grateful for my kids’ fever because at one time their immune systems were so dysregulated, their bodies couldn’t mount a fever response to invading pathogens. I’m grateful every time my 14 year old acts like a jerky teenager because he gets to a live a relatively normal teenage life now instead of being in PANDAS hell. I’m grateful every time I eat a meal without an abusive husband there criticizing what I’m eating or not eating because that was not always the case. I’m grateful to be a doctor, the good and the bad, because it was almost taken from me and I gave literal blood, tears and a piece of my soul (and my cervix) to get through my training. I’m grateful for the sense of possibility because for so many years in PTSD, it wasn’t there as I dwelled in that place between life and death.

So maybe that’s what the promised land really is: gratitude. If we never wandered through the desert for forty years, how could we even know we were in the promised land? Maybe it is not a static place, this promised land. Maybe it can’t be. Maybe it’s an oasis where we replenish ourselves and get a rest before heading out again. We never know how far into the wilderness we will go and for how long, but we know the promised land is always there. Until we reach the end of this life and enter the world without end and find that possibility we have been been seeking once and for all.

Lassoing the Beast


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I do not think that I have ever seen a case where the sentencing goal of protection of the public figured more predominantly. Anyone who sat through this trial would realize that this defendant is the worst nightmare of every child’s parent. The entirely credible and overwhelming evidence demonstrated that the defendant is a dangerous predatory sadist…
Hon Sean McLaughlin, sentencing of Jeremy Noyes

golden lasso

A package arrived today. A hoody. Oh, how I love a good hoody. Is there anything better? Cozy and comfy and flattering on people of all shapes and sizes. Maybe it’s because I grew up crushing on boys with long hair in hoodies and Vans, but hoodies hold a special place in my heart. Back to present day: the hoody that arrived was blazoned with Beast on the Bay. Because I have decided to run the Beast on the Bay again this year.

Regular readers may recall that in 2018, I ran the Beast as part of my ten year anniversary of my trauma. It inspired me to get into shape and do something that felt impossible. It also happened to be in Erie, where my trauma occurred and is sponsored by my old med school, who made the trauma significantly worse. I was not able to run the race in 2019 because the previous summer, in the best shape of my life, I had suddenly developed a mysterious autoimmune neurologic disorder a week before I was to run a different obstacle course race, the Spartan. Now, within this surreal time of quarantine, I’ve decided to do it again this September (if it’s not cancelled).

I had come to some new revelations on Easter Sunday. Not regarding God or Armageddon or resurrection. Regarding my immune system.


In order for me to explain, let’s rewind to June 2019.

I’d been in training for 14 months and was in peak form. My body fat percentage was its lowest ever. I could run a 9 minute mile. I was pumping out burpees like a champ. I felt amazing. On Sunday, my husband I went to a local Crossfit gym to do a class and practice rope climbing. I’d never climbed a rope in my life. I never even tried in gym class as a kid because I was convinced I couldn’t do it and would just embarrass myself. I knew I needed to climb one for the race coming up the following Saturday so we went and the owners gave me some tips and I did it! I was so damn proud of myself.

The next morning I woke up and felt sick: I was exhausted, my muscles ached and felt weak. It wasn’t the way I felt after a really brutal workout. It was the way I felt when I had the flu. I decided I better give into it and rest as much as possible but I’d been planning on working out leading up until a couple days before the race. I needed to get better quick, though , so I cancelled the workouts. By the time Friday came, I was still exhausted and I knew I needed to cancel the race. I was heartbroken. I’d worked so hard and it meant a lot to me. It was odd I was still feeling just as bad six days in, so on Saturday instead of going to the race, I went to Quest to get some bloodwork drawn.

Over the next few months I saw neurologists and rheumatologists. I had bloodwork, MRIs, EMGs, and EEGs. I began to piece together symptoms I’d been having in the months leading up to my exhaustion. Blistering on my lips I’d assumed were cold sores (they weren’t). Neuropathy in my arms and legs after showering. A tightening of my rib muscles during a run. At one point, my calves swelled and hardened during a run, forcing me to stop. My fine motor skills were off and I was having more of the involuntary muscle movements I’d gotten for years. I was losing my balance more often too.


None of the doctors ever arrived at a diagnosis and I was told to deal with it and be grateful it wasn’t something bad. I wasn’t. How could we know if it would get really bad or not if we didn’t know what it was? I had plenty of patients in the same boat. Vague autoimmune symptoms and slightly off labs but no clear clinical picture of a known disorder. They often found their way to my doorstep looking for help from medical marijuana (Which is smart because it helps both the symptoms and has immune modulating effect which can help longterm outcomes). I was now one of them.

I tried changing to a plant based ketogenic diet but it only seemed to make it worse (and was unpleasant as hell to eat). I tried forcing myself to exercise but it made it worse too. I would have a few days where I felt pretty good, but the symptoms always returned. That is, until November.

In late November, my husband moved out. Our marriage ended. And so did my symptoms. I hadn’t been expecting such a dramatic reaction on the part of my body, but there it was. Fatigue, pain, weakness, skin blistering, muscle jerking, neuropathy. Gone. My toxic marriage had been killing me. My body was sending me one last desperate message before it gave up the fight. And it worked.

What can make you more grateful for the movement of your body than losing it?

There has been a lot going on in my life since then. Divorce, buying a new house and moving in less than two weeks before Christmas, and the in and out of court of a high conflict divorce and custody battle. Finally as February came to a close I felt like things had settled down and I was ready to start working out again and go on a diet to shed the weight I’d gained since June. It went well for a couple weeks and then buh buh buh, quarantine! And it all went to pot. Like it did for all of you.


No more daycare. No more school. Time to homeschool 3 kids and take care of a preschooler. And now you have to take your medical practice and completely restructure it because you can’t do office visits anymore. And no one can help you because it’s a freaking quarantine. And did I mention the high conflict divorce I’m in? Yeah, those don’t improve with quarantine either.

And then we got sick. March 22nd, my four year old and I woke up with a fever, sore throat and cough. Exhausted, body aches, chills, no appetite. Then the other three kids got it. We didn’t qualify for COVID testing so I put us into complete isolation (actually considerably worse than regular quarantine life, believe it or not) and waited for it to pass. But it didn’t. The fever would sometimes for 24 or even 72 hours, but it always came back. We’re now on Day 33. I eventually coerced an urgent care into giving me a test despite not meeting criteria on Day 24 when our fevers went up higher than ever. The test came back negative but they told me false negatives were common and I should consider getting tested again. I consulted with my mentor, the best doctor I know. He said he thought it was COVID and a false negative. I agreed.


If you consider the other things in the differential diagnosis (cancer, rheumatoid arthritis, Epstein Barr virus, CMV, Lyme disease), none of them made as much sense as COVID.

And so, here we sit in isolation. Now, back to the Beast. I was in a lull of symptoms two weeks ago on Easter Sunday. I was sitting watching a local church service on my big screen TV while my kids ate their candy and watched their iPads, and a verse struck me.

A good man brings good things out of the good stored up in his heart, and an evil man brings evil things out of the evil stored up in his heart. For out of the abundance of the heart the mouth speaks.

And I realized my husband had ruined my relationship with God. Because that’s what abusive people do. They isolate you. From friends and family and, sometimes, if they’re really good at it, God. I realized how far from God I’d gotten, and how I couldn’t separate God from my husband and the harm he does. And I realized it was now time to stop. And I said hello to God again.

I realized something else that night as I stayed up late journaling about all my newfound epiphanies. I was ready to get in shape and lose weight again. But I needed something to focus on, a race. I thought of the Beast. But when I thought of it, my stomach dropped. I realized the thought of running it alone, without my husband, scared me. That I felt like his ghost would be haunting me the entire time. And most things that scare you, are the things most worth doing. And then it occurred to me. The timing of the onset of my autoimmune issues. I’ve always noted the cruel irony of it beginning right as I was to run an obstacle course race even harder than the Beast, that I’d trained for for so long. Right at my physical peak. My husband was going to run the Spartan with me just like he’d run the Beast with me. He jumped on the Beast wagontrain late in the game. He said he didn’t think I’d actually train and go through with it so he waited. Like it was such a big freaking honor to have him run it. He took something that was mine and made it his. He was jealous. And he was going to take the Spartan from me too. He had spent years complaining I was fat and had a flat butt but when I got in shape, he was so damn jealous, he did everything he could to undermine me. And he couldn’t let me have the Beast, my moment. I didn’t finish high in the Beast, mind you. I couldn’t do about a third of the obstacles. But I finished. And I was so damn proud. He acted proud too: proud of us, proud of his wife, of himself. His wife, not me. His possession that reflects on him. That was what he showed the world. A few weeks after we finished it, I put a “I Beat the Beast” bumper sticker on my car and he looked at it and said “You didn’t beat the beast. You didn’t finish all the obstacles.” And that, ladies and gentlemen, is what he shows his family. For out the abundance of the heart the mouth speaks. I stood up to him and told him I had finished and tried all the obstacles and that was a big accomplishment for me. He gave me a shitty look and walked off.


He took the Beast from me and my body wasn’t going to let him take the Spartan. Maybe that’s why it shut down. Maybe my heart called up my immune system and said, if he does it to her one more time I’m going to break. And my immune system said, ok, time for the Hail Mary. We will throw the switch and shut the whole plant down and give her some time to sit and think. And if she won’t walk away, we’ll leave her there sitting. And if she does, she’ll run it for her. And my heart blew my immune system a kiss and my immune system blushed. Maybe. Maybe it was a gift from my body.

So, I signed up for the Beast. And ordered a hoody. And the next day fruits and vegetable and water became a thing again at our house. Planning and cooking dinners because a nightly thing. And working out resumed for me and my kids too. Life was good. I was triumphant!

But then life happened. Our fever has taken up residence and work and homeschooling are getting harder instead of easier. Yada yada yada. I’m back down for the count. But I’m not cancelling the Beast. I am running it, come hell or high water or fever or economic collapse. Even if it takes me ten hours, I’m running it.

I cried a good bit during the Beast the last time I ran it. Cried for what Jeremy did to me, for what my school did to me, for what their mom having PTSD took from my kids, for all the other survivors I know who will never see justice like I did. I imagine I will cry this time too, for a whole other set of reasons.

My high conflict divorce has been nastier than ever this past week. We may soon go before the judge via teleconference (ya know, quarantine) and I am scared my husband will convince the judge he’s the guy out there bragging about his wife running the Beast, instead of who he really is, the guy denigrating his wife when she dared to be proud of herself. But this is not my first rodeo, dear reader. I have sat in court with a man who accused me of lies before and I have spoken the truth and justice prevailed. I will lasso the Beast again this time. And I will put on my hoody and take a run and thank my heart for being so damn good to me.


America we’ve given you all and that’s not nothing (or Narcissus needs a drink)


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I’m addressing you.
Are you going to let your emotional life be run by Time Magazine?
I’m obsessed by Time Magazine.
I read it every week.
Its cover stares at me every time I slink past the corner candystore.
I read it in the basement of the Berkeley Public Library.
It’s always telling me about responsibility. Businessmen are serious. Movie producers are serious. Everybody’s serious but me.
It occurs to me that I am America.
I am talking to myself again.

I have spent a lot of time reading about narcissism lately. I have my reasons I won’t go into here. An unexpected outcome of this research is the realization almost every politician in the Democratic primary is above average on the naricissim spectrum, some just as high as Trump. One in particular. The one who had to drop his bid in 1988 because he was exposed as a pathological liar and plagiarist. The one whose toxic masculinity led him to challenge someone to a fist fight recently. The one who has assured the billionaires “nothing will change.” And a relationship with a narcissist, my dear reader, only ends one of two ways: you wake up and leave or they suck the life out of you. The Democratic electorate has chosen the latter. It is narcissist versus narcissist in 2020 (it has been before, to be fair) . We will all lose no matter which one wins. If Biden wins, we are left with an America still under the conditions that created Trump and we will either get another Trump or …. Trump. Do you really think leaving the White House will make Trump go away? He has created a movement and they will follow him where he leads. The presidency,  my dear reader, may become significantly less relevant. The question is, will the movement Bernie is driving remain intact to counter it?



I think of the people most affected by all this and I cry. My addiction patients in rural Pennsylvania, their children. They don’t even realize just how different much of America is living. And most of America doesn’t realize how they’re living. If they did, I’d like to think things would be different. But narcissists are very good at gaslighting and projecting and lying. Lying especially. Lots of lying. And if you’re a decent, feeling, empathetic human being, it is hard to resist. It is hard for for you to conceive that such a person could exist. Someone with no empathy and no remorse. Entirely self serving with nothing to limit what they’ll do to get it. Try to imagine. It should scare you. Terrify you.

I believe most Americans are decent people trying to get by in the face of a lot of hardship. I see it in my office everyday. Not just my most vulnerable patients, my middle class medical marijuana patients too. The cop with PTSD who had to retire because of it and now has no insurance or income to pay for the therapy he so badly needs. The single mom of an adult son with autism, trying to get services that aren’t there, trapped in her house. Chronic pain patients that were abruptly kicked off their pain meds once doctors started facing consequences for over-prescribing, not offered any help for withdrawal or to manage their pain. And I see the upper middle class patients who benefit from the system but have so much anxiety and depression, the money does them no good. And still they hold onto it tightly, unwilling to see letting some of it go would not only save so many struggling; it would save them too.

Greed is an illness. An ugly dark emptiness that cannot be filled and will not stop making you hunger for more. Like any addiction. Are the heads of the pharmaceutical companieds just projecting then? Turning so many into addicts so they can see themselves? And Trump, who will never have enough cheering angry supporters or enough money. He pulls the worst from us, feeding off negative emotions and chaos as narcissists do. Projecting onto America the darkness inside of him.


I do not mean for this post to sadden you or leave you feeling hopeless. Indeed, that is exactly what a narcissist wants. I want you to see that once you know you’re dealing with a narcissist, you begin your steps towards recovery. Leaving is not easy. They will try to suck you back in. They will love bomb you, bring you flowers and tell you how wonderful you are. But if you stay strong, it gets easier in time. And the best part? The thing narcissists hate most is someone who heals and is happy and strong. Our revenge would be a healthcare system that takes care of us, universal childcare, a Green New Deal, a living wage, an end to mass incarceration. Our revenge would be joy. Like an army of Care Bears shooting out beams of love and kindness and hope from our chests. They would keep trying, but with no one to reflect their image back to them, narcissists wither. Like Narcissist himself, when the reflecting pool they’re so addicted to dries up, so do they. And we, America, will have won.


America, by Allen Ginsburg

America I’ve given you all and now I’m nothing.
America two dollars and twentyseven cents January 17, 1956.
I can’t stand my own mind.
America when will we end the human war?
Go fuck yourself with your atom bomb.
I don’t feel good don’t bother me.
I won’t write my poem till I’m in my right mind.
America when will you be angelic?
When will you take off your clothes?
When will you look at yourself through the grave?
When will you be worthy of your million Trotskyites?
America why are your libraries full of tears?
America when will you send your eggs to India?
I’m sick of your insane demands.
When can I go into the supermarket and buy what I need with my good looks?
America after all it is you and I who are perfect not the next world.
Your machinery is too much for me.
You made me want to be a saint.
There must be some other way to settle this argument.
Burroughs is in Tangiers I don’t think he’ll come back it’s sinister.
Are you being sinister or is this some form of practical joke?
I’m trying to come to the point.
I refuse to give up my obsession.
America stop pushing I know what I’m doing.
America the plum blossoms are falling.
I haven’t read the newspapers for months, everyday somebody goes on trial for murder.
America I feel sentimental about the Wobblies.
America I used to be a communist when I was a kid I’m not sorry.
I smoke marijuana every chance I get.
I sit in my house for days on end and stare at the roses in the closet.
When I go to Chinatown I get drunk and never get laid.
My mind is made up there’s going to be trouble.
You should have seen me reading Marx.
My psychoanalyst thinks I’m perfectly right.
I won’t say the Lord’s Prayer.
I have mystical visions and cosmic vibrations.
America I still haven’t told you what you did to Uncle Max after he came over from Russia.
I’m addressing you.
Are you going to let your emotional life be run by Time Magazine?
I’m obsessed by Time Magazine.
I read it every week.
Its cover stares at me every time I slink past the corner candystore.
I read it in the basement of the Berkeley Public Library.
It’s always telling me about responsibility. Businessmen are serious. Movie producers are serious. Everybody’s serious but me.
It occurs to me that I am America.
I am talking to myself again.
Asia is rising against me.
I haven’t got a chinaman’s chance.
I’d better consider my national resources.
My national resources consist of two joints of marijuana millions of genitals an unpublishable private literature that jetplanes 1400 miles an hour and twentyfive-thousand mental institutions.
I say nothing about my prisons nor the millions of underprivileged who live in my flowerpots under the light of five hundred suns.
I have abolished the whorehouses of France, Tangiers is the next to go.
My ambition is to be President despite the fact that I’m a Catholic.
America how can I write a holy litany in your silly mood?
I will continue like Henry Ford my strophes are as individual as his automobiles more so they’re all different sexes.
America I will sell you strophes $2500 apiece $500 down on your old strophe
America free Tom Mooney
America save the Spanish Loyalists
America Sacco & Vanzetti must not die
America I am the Scottsboro boys.
America when I was seven momma took me to Communist Cell meetings they sold us garbanzos a handful per ticket a ticket costs a nickel and the speeches were free everybody was angelic and sentimental about the workers it was all so sincere you have no idea what a good thing the party was in 1835 Scott Nearing was a grand old man a real mensch Mother Bloor the Silk-strikers’ Ewig-Weibliche made me cry I once saw the Yiddish orator Israel Amter plain. Everybody must have been a spy.
America you don’t really want to go to war.
America its them bad Russians.
Them Russians them Russians and them Chinamen. And them Russians.
The Russia wants to eat us alive. The Russia’s power mad. She wants to take our cars from out our garages.
Her wants to grab Chicago. Her needs a Red Reader’s Digest. Her wants our auto plants in Siberia. Him big bureaucracy running our fillingstations.
That no good. Ugh. Him make Indians learn read. Him need big black niggers. Hah. Her make us all work sixteen hours a day. Help.
America this is quite serious.
America this is the impression I get from looking in the television set.
America is this correct?
I’d better get right down to the job.
It’s true I don’t want to join the Army or turn lathes in precision parts factories, I’m nearsighted and psychopathic anyway.
America I’m putting my queer shoulder to the wheel.
Berkeley, January 17, 1956

That’s me in the corner, that’s me in the spotlight (or, the fault in our star)


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losing my religion:  southern term for losing one’s temper, “flying off the handle,” going insane  etc. Note that the R.E.M. song of this title has nothing to do with religion, despite the common misinterpretation of the phrase.

Oh, life is bigger
It’s bigger
Than you and you are not me
The lengths that I will go to
The distance in your eyes
Oh no, I’ve said too much
I set it up


I don’t remember which one became my patient first. I think it was Him. But it could have been Her. He was initially more memorable. He liked to show me pictures. Of his woodworking and antiques he’d restored. Of his boys. Of the squirrels they’d killed that year. I asked him not to show me the squirrels but he did anyway. She was quiet. Told me about the jewelry she made and the things she grew in her garden and foraged for in the forest. I do remember the day I realized they were a couple. That he was the he she talked about and she was the she he talked about. The “Ohhhhh” moment. The “oh wait, she’s *that* She and he’s *that* He!” It happens a lot in my rural practice. Six degrees of separation is not a thing in rural northwest Pennsylvania. It’s more like two.
They started coming to their appointments together eventually. They would tell me about their garden and their yard and the retaining wall they were battling to put up. And they would tell me about things addiction patients in rural northwest Pennsylvania tell you about. Meth and heroin and jail and stealing from the people you love and five year old kids calling 911 when their mom overdoses. They’d both been clean a long time, but everyone had relatives and friends still lost in it. They were no exception.
They gave me things. A piece of amethyst they’d hunted and extracted themselves. A small glass vase with a flower from her garden. She gave me gardening tips, foraging tips, taught me some herbalism.
They were always late. Always. That was a given. And that was okay. As long as they came. Sometimes they mixed up their days and we’d get a call a couple days later and fit them in the schedule for another day. I always held my breath until they called. Because you never know. You never really know if something didn’t happen and if they’re really all right.
And so it happened that they came in a week or so after their appointment in early February. I wasn’t at my office in northwest PA so they came to my office in Verona. Sam got to meet them for the first time. They got to see my other office, which is fairy tale themed. I knew she’d like it.
She wasn’t herself that day, though. She was sad. So damn sad. He had to talk for her for most of the appointment because she couldn’t stop crying. She’d been depressed. But it was more than that. She’d been having pain in her side a while now and it was getting worse. She’d gone to the ER and they’d drawn blood work which came back with an abnormality but when they tried to get an IV in so they could run some imaging tests, the nurse couldn’t get it. They kept poking her over and over and she ended up leaving the ER.
I asked her some questions to see if I thought she needed to go to the ER right now (it had been a couple days since leaving the ER and she hadn’t gone back yet). Based on her answers I told her I didn’t think it was an emergency but she needed to go back and get the test done. I said maybe she could try going to a different ER where the nurses were better. We talked about her depression and I started her on an antidepressant and told her to email me in a couple weeks to let me know if it seemed to be helping at all so we could work on the dosing.
I had a crystal sitting there. Malachite. A pretty dark green stone. I’d been feeling for a couple of days I was supposed to do something with it. An odd feeling kind of hard to describe. Like, restlessness. But with a stone. And before she left I took it and said, here, I want you to have this. And she told me she had something for me too. It was a necklace she’d made but she’d felt timid about giving it to me. But when I gave her the crystal, she said, she felt okay to give me the necklace.
He said, (or maybe she said?) that it was fitting because it had a star on it and pointed to my walls. The room we were in has a Sleeping Beauty theme and is covered in stars. (It is based off something I wrote about kids with PANDAS battling the disorder and emerging from it, like sleeping beauties waking up). I took it and told her I loved it. And I did. When I went to put it on, the chain broke, so I put it in my pocket. My back jeans pocket. And we walked out together and said our goodbyes. And Sam said they were sweet and I said I was worried about her. And I was.
Somewhere between there and my kitchen, I lost it. The necklace, that is. I realized it later that night and told myself, it’s here somewhere. It’s not gone. It hasn’t fallen off planet Earth. You’ll find it (this is the same thing I say to my children when they are panicking over something they’ve lost. I find it is helpful to give myself the same talks I give them pretty often). I looked a couple places I thought it must be (the cubby over my coat hook by the front door, the back pocket of those jeans I’d since thrown in the hamper) but it wasn’t. Over the next few days I looked a few other places and it wasn’t there either. I tried to remain calm.
Then a week later I found it. I was trying to dig a quarter out of my left coat pocket for a cashier, in line ahead of a grumpy resentful old man in the Giant Eagle “12 Items or Fewer” lane and I pulled it out instead. I was relieved. He didn’t care. At all.
I went to coffee with a friend that morning (please note: this is a rare occurrence) and stopped in at the crystal shop across the street (please note: this is not a rare occurrence). It had been quite a while since I’d received that amethyst. A lot had changed. And I now frequented the local crystal shop (thus, the malachite). I was browsing on this particular day and saw a necklace with a stone in it that looked like the one my patient had given me. I excitedly drew the necklace from my left pocket and held it up side by side to the other and they were an exact match. I told the women in the shop the story of the necklace and asked what the crystal was. They told me and I asked if I could take the little card that had the name of it and its meaning and they said yes. And they said how sweet it was my patient had made me a necklace. And I said, yes she’s very sweet.
The next day I was answering the phone (Sam was out of town and I was like a dad on a laundry detergent commercial, drowning in ineptness with a lost look on my face, trying to perform basic office functions). I was relieved when a familiar voice spoke back to me. It was him. And then it happened. One of those moments. One of those moments that create a Before and After in your life. He told me she had cancer. One of the really bad ones. There’s no such thing as a good cancer. But there are such things as really bad ones. That’s what she had. I stopped breathing for a few seconds. Parastalsis slowed. I got goosebumps (the medical term for that is piloerection. It’s the same thing that makes a porcupine’s quills stand up when it sees a predator. It’s supposed to make us look bigger and scarier, in theory. It does not, in practice). In my head I thought, “Fuuuuuuuuccccckkkkk.” I did not say this to him. I asked how she was. I asked him a series of questions trying to get more medical type details. I tried to get him to say something that would make me realize he’d gotten it wrong and it wasn’t actually cancer. It didn’t work. He said she was resting but I should call her later. I said I would. Even though I was scared to. Because there’s nothing really great you can say. Because you’re a doctor and you’re supposed to fix people and this is not something you can fix.
Her palliative care doctor called a little while later while I was on the other line with someone considering making a medical marijuana appointment for anxiety. They had a hundred questions and, in the end, said they’d call back once they decided what to do. I listened to his voicemail and frantically wrote down his number and called him right back. He was nice. God help me, he was a genuinely nice, caring doctor. If you knew doctors like I know doctors, the way they actually talk when there aren’t patients around, you’d know how rare a thing that is. He hadn’t seen her yet (the appointment was for the next day) but he wanted to touch base with me since I prescribe her a controlled substance and his role was pain management (also prescribed substances).
When I talked to her that night (well, to her voicemail), I let her know the pain doc was good people and would take good care of her. And he did. We have texted and talked since then, each step along the way, She and I. He and I. And even the palliative doc and I. There is more to it than this, various details you might not expect. But the heart of it is this: a really beautiful human being is sick with something she likely won’t survive. She is in a lot of pain. And the man who loves her is doing an amazing job supporting her through it. He is an unlikely romantic hero. Not a sappy, trite one. A genuine romantic hero. And she is a warrior. Strong and smart and intuitive and kind and creative and honest. And she is so damn young. Too damn young for this shit.
And so it was that I came to wear a star necklace everyday (I ordered a new chain for it the day he called with the news. I kept it in my pocket until the chain arrived). And so it was that I came to wear that necklace the night I ran into a good Christian I know.
The Good Christian looked at it in horror. Genuine fear in his eyes. And he said, “Have you lost Jesus?” He was distressed. I looked at him and said, “What?” And he pointed to my necklace and said it was a witch’s necklace, a Wiccan necklace. I said, it’s a star. A patient made it for me. That doesn’t mean I’ve lost Jesus. He looked… freaked the hell out.
And I thought of the word the palliative care doctor had used when he told me about her CT scan. Innumerable mets. Meaning, the cancer had spread to so many spots, the radiologist gave up counting. I remember when he told me that I wondered, at what point do they stop counting? 10, 20, 100? Maybe that particular radiologist was lazy and she really only has 3. But that’s not likely. When he used that word, innumerable, the hope I’d held out faded away. And I began to focus on how we could all support her in finding peace and being comfortable and doing the things with her last months she’d like to do. Because, lets be honest, doctors very rarely actually fix patients anyway. So maybe this very nice palliative care doctor and I could help her with these things. Hopefully I could be of use.
I thought of that word, innumerable. And I thought of the cancer growing inside her. And about how brave she is. And how sweet her he is. And I looked at this Good Christian and saw something in him. A different kind of cancer. One with innumerable mets to the soul. Dark and sticky. Inoperable. Incurable.
And I thought, this patient knows more about Jesus than you ever will. Because Jesus is love. And she is full of love. And she has brought joy and love to so many people. And she will keep doing that. Despite it all. She will keep inspiring other people to love. And she knows that I love her. And she lets me love her. And loves me back.
And that, dear reader, is not something the Good Christian is capable of. Not something he even understands. And that is why a necklace can inspire a look of dread and disgust in him. A star. An innocent little star.
I told my kids a bedtime story tonight. The boy in the story was looking up at the night sky when a shooting star appeared. My daughter got so excited and was urgently shouting “make a wish quick! Before it’s gone!” She was nervous the boy in the story would miss it. Because everyone knows if you make a wish on a shooting star, it comes true. Because that is what stars are for. To wish upon, to make our dreams come true as we sleep beneath their lovely glow. They’re magical. And shooting stars? They’re actually little burning meteors,  magical, glowing rocks. Kind of like amethyst or malachite.
If taking comfort in that means I’ve lost Jesus, dear reader, then consider me lost. Because not every sleeping beauty wakes back up at the end of the story. Sometimes her true love kisses her goodnight one last time. And releases her to shine down on us and remind us of who we are, innumerable stars in an endless universe connected to one another always.



Oh, life is bigger
It’s bigger
Than you and you are not me
The lengths that I will go to
The distance in your eyes
Oh no, I’ve said too much
I set it up
That’s me in the corner
That’s me in the spotlight
Losing my religion
Trying to keep up with you
And I don’t know if I can do it
Oh no, I’ve said too much
I haven’t said enough
I thought that I heard you laughing
I thought that I heard you sing
I think I thought I saw you try
Every whisper
Of every waking hour
I’m choosing my confessions
Trying to keep an eye on you
Like a hurt lost and blinded fool, fool
Oh no, I’ve said too much
I set it up
Consider this
Consider this
The hint of the century
Consider this
The slip that brought me
To my knees failed
What if all these fantasies
Come flailing around
Now I’ve said too much
I thought that I heard you laughing
I thought that I heard you sing
I think I thought I saw you try
But that was just a dream
That was just a dream
That’s me in the corner
That’s me in the spotlight
Losing my religion
Trying to keep up with you
And I don’t know if I can do it
Oh no, I’ve said too much
I haven’t said enough
I thought that I heard you laughing
I thought that I heard you sing
I think I thought I saw you try
But that was just a dream
Try, cry
Why try?
That was just a dream, just a dream, just a dream

Good Friends Are Hard to Find (or, My Brother from Another Mother) (or, Tacos Fall Apart Sometimes and We Still Love Them)


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It’s the Kalenda of March today. You may have heard of the Ides of March (especially if you took Latin at Indiana Senior High like I did) but probably not the Kalends of March. It is the first day of the month. It comes from the same roots as the word calendar (thank you, Latin class. You rock) and was part of the newly formed Roman calendar which was no longer lunar like all those before it (see, for instance, the Hebrew calendar which leads to holidays falling on different days each year). The lunar year is made up of equal months that follow the waxing and waning moon. The Roman calendar had to make up the idea of a Leap Year to reconcile its imperfection.

And so here we are on the Kalends of March, the day after February 29th. That pesky day that tries to make up for the illogic of the Roman calendar. The moon and it’s cycles have always been linked to the Divine Feminine and Nature, so it is no surprise the Romans wanted it squashed. 

March is my birthday month. I will be 41 on the 24th, a few days after the spring solstice. My 40th year has been intense, to say the least.

Some good, some bad, most of it both. 

With me through all the ups and downs have been a few people I managed to stay close to despite the relative isolation I found myself in in recent years. One is a wonderful fellow PANDAS mom, one a good friend from college who was with me through the Jeremy ordeal, and one is my friend and coworker, Sam (he says I can tell you his name. I always get consent, dear reader).

Sam came to my practice at the suggestion of my husband. He recruited him. And for that I am eternally grateful. Sam is warm and sunny and kind and just fills you with positive energy from the second you meet him, whether by person or over the phone as many of our patients do. I cannot tell you how many patients pause in their appointments and say, I have to tell you Sam is wonderful. I say, oh I know! And they look at me very seriously and say, No, I mean it. Truly wonderful, (as though I’m not convinced) I was so nervous when I called here and he made me feel so comfortable and so much better. Never let that one go! I’ve even had patients try to hire him away from me (no joke). They send him chocolate covered strawberries and give him birthday gifts. When I told our grove city patients, who have only talked to Sam on the phone since he doesn’t come up to the grove city office with me, that he was coming up in March, it was like I’d told them a celebrity was coming. The excitement was palpable and real. 

Sam was with me through a lot this year and always there however I needed him to be. He never tried to tell me what to do as I tortured over some big decisions. He listened. He heard me and allowed me to talk it out to figure out the answers I already knew deep inside. He laughed with me. He sat with me as I cried. We drank champagne sometimes; other times we talked about how damn unfair some of our patients lives are and how we wish we could do more. 


More than once he has run something badly needed to my house at 10 at night (not sure what my neighbors thought he was putting in my mailbox but I can assure you it was all perfectly legal). More than once he has either run my son Mies to school when he missed his van, run my office with me completely unavailable tied up in court, run inconvenient errands for me or ordered me rose water pistachio ice cream (vegan if course) when I really really needed it (and run it over to my house of course. The man runs). 

Sometimes we bitch about men together, even though Sam is a man. Sometimes he lets me bitch about women to him, even though I am myself in fact a woman. I know there’s nothing I can say to Sam that will make him judge me or love me any less. (Well maybe there’s something but it would have to be pretty extreme). 

Sam has reminded me I am a good person. That there are parts of myself I’ve pushed down so many years that deserved to rise back to the surface. That it’s okay to be a contradiction. That it’s okay to not be okay. Because everything is going to be okay. And it is. 

So it is not just female friendship I am reveling in now. The Divine Masculine and Divine Feminine are in us all. We must embrace both. Sam does that beautifully. He is a fabulous moon, orbiting with me. I no longer orbit any person. But I make my way through space , through the cycles, pulling the tide in and out, with some wonderful fellow celestial bodies. You can keep your Leap Day. We will take the solstice and the mother moon (and some champagne lunches from time to time).

Love Written on the Hands That Hung the Stars

There were scars before my scars
Love written on the hands that hung the stars



I have a routine for my medical marijuana appointments. A bit of a script. My receptionist-slash-friend I’m sure gets sick of hearing a muffled version of it through the door a dozen times a day. I was back in the office today for the first time in two weeks and I fell right back into it. It concludes with a brief education on the different forms of marijuana offered at the dispensary (… the third form is a tincture. It’s a liquid form that sprays or drops into your mouth under your tongue and absorbs in through the inside lining of your mouth. It takes fifteen minutes to kick in and lasts about 3-4 hours. It’s a discrete form to use if you’re in a situation where you wouldn’t want to be vaping and it’s easy to get small, tightly controlled doses…). There are visual aids. I am very attached to them. As I was going through them today I noticed with embarrassment that my nails are covered in sloppy, chipped pink nail polish. I tried to kind of fold in the top of my finger at the knuckle but it looked awkward so I told myself patients really aren’t focused on nail cosmetics in such a moment and I moved on.

I let my daughter paint my nails New Year’s Eve after I finished painting hers. I offered to paint hers to help her calm down. I don’t remember what she was upset about but painting her nails did the trick. Letting her paint mine took her from okay to happy. She’s in a flare of her autoimmune condition right now, so it was a gift to see her smile.

I’m in a time of transition right now and life is not easy. Transition isn’t supposed to be easy. I’m kind of sick of recurrent transitions at this point to be honest with you, but it is what it is.

I find myself in a situation I have never been in in the forty years I’ve been alive: I am not living with anyone who is constantly gaslighting me. Stop and consider that. I am not walking on eggshells and neither are my kids. Which means I’m not walking on eggshells to keep the gaslighter happy but I’m also not walking on eggshells trying to protect my kids from the gaslighter. There’s no eggs, folks. Just hardwood and recently installed shag carpeting that is really quite nice and soft. We all walk around the house, run even, and there isn’t a yolk in sight. No little bits of shell sticking to the side of the bowl or hiding in our scrambled eggs. Nada.

We are light. We are safe. Even when we are tired and stressed and hangry, we are free. Free to feel whatever it is we’re feeling and talk about it and draw about it and write about it. Safe in knowing we can lose our temper and then feel bad and apologize and we will forgive each other and talk about it and things will be okay. We will still love each other. We can be vulnerable. We can say what it is we want and know we won’t be shamed for it. (We might not get it, but we won’t be judged for wanting it and asking for it). We can try out different looks and hobbies and foods and goals and dreams and then change our minds and no one gets upset. We have privacy and boundaries.

I have never had this and neither have my kids and that’s incredibly fucked up. Period. I literally didn’t realize it was possible to live this way. For forty years. It’s like being trapped in a one woman cult. At least in a cult you have someone with you.

The center of our family is no longer a gaslighter that we must keep balanced. We are the center of our family, all of us. Each of us gets to be our own person.

I need to tell you the difference this has made.

Our immune systems function better. Our anxiety has plummeted. The picky eaters are much less picky. The anger levels are down. We sleep better. All four of the kids have noticeably matured. Things flow like they’ve never flowed.

We have people back in our lives we couldn’t have before. Good people. We are not an isolated cult anymore.

I’ve found myself listening to the same music I did ten years ago, during the time I met my most recent gaslighter. During our courtship. Songs about being broken. Songs about love saving you. About struggling ultimately making you better. It reminds me of who I was then. I was sad and struggling to hold myself together enough to graduate medical school. Surviving. Two sons with a horrible disorder no one was diagnosing or treating correctly. Me with my own severe PTSD no one was diagnosing or treating correctly. Living with my original gaslighter, the source of me. Wanting so badly to get away but so afraid to at the same time. So ashamed of myself. Wanting redemption so badly. To be saved in some many ways. Into the lion’s den she went. A decade she survived.

And I have emerged, my children in tow. Blinking back the bright sun.

I’m glad my kids didn’t have to wait forty years for this. I’m glad I did this. It was hard. It is hard. But most things worth doing are.

That’s one of those things I always tell my kids.  And it is not a script.

The cut is deep, but never deep enough for me
It doesn’t hurt enough to make me forget
One moment of relief is never long enough
To keep the voices in my head
From stealing my peace
Oh, control
It’s time, time to let you go
Perfection has a price
But I cannot afford to live that life
It always ends the same; a fight I never win
Oh, control
It’s time, time to let you go
I’m letting go of the illusion
I’m letting go of the confusion
I can’t carry it another step
I close my eyes and take a breath
I’m letting go, letting go
There were scars before my scars
Love written on the hands that hung the stars
Hope living in the blood that was spilled for me
Oh, control
It’s time, time to let you go
It’s time, time to let you go

Epstein is not a freak and neither are you who stay silent


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Jeffrey Epstein, the billionaire pedophile, died in a presumed suicide a few days ago. I cannot get over how similar his plans were to Jeremy Noyes’s, my perp from med school who now sits in federal prison in Arizona.


I am not just referring to their love of raping children. Jeremy often spoke of having a private island or farm where he would propagate his colony of child sex slaves and work towards creating the perfect race through the use of bought DNA. So did Epstein. In fact, Epstein spent millions seeking the advice of Harvard scientists , hosting a conference on his private island at one point.

Jeremy spoke frequently to others like him online. There was a whole community. I told myself they were lying, that it was all just a sick fantasy world. But, clearly, it was not.

I am a doctor who treats patients for PTSD. They tell me about the powerful men who’ve taken their childhood. They have no reason to lie to me. They don’t speak about it publicly. Oftentimes I’m the only person they’ve told.

Jeffrey Epstein is not an isolated case. He is not a freak. His crimes do not die with him.

There were so many people who knew what Epstein was doing and they did nothing. Made zero effort to save these girls. I cannot comprehend it. I can’t. I risked my life, my children’s live,s my career, everything. I risked everything to try to save one little girl. How is it that children matter so little that we would allow this go on? I didn’t understand it with Sandusky and I certainly don’t here.

It is not a conspiracy theory to not believe Epstein killed himself. In fact, to accept the story that this was suicide is a choice to talk yourself out of obvious reality. Men like Epstein don’t kill themselves. I know. I knew a man like him very well. Epstein’s case clearly held the potential to expose just how widespread the culture of child trafficking is. The media can try to shame me into not saying this publicly all they want. If their lame attempts work on you,you’re part of the problem too. Real shame comes if you have lived as a child sex slave. Shame you will never completely heal from. Boohoo to you, dear reader, if speaking out on this could be embarrassing for you. What would the neighbors think? The real question is, what are the neighbors up to themselves? This isn’t rare.

The choice to turn in a man like Jeffrey Epstein, like Bill Cosby, like Jerry Sandusky, like Jeremy Noyes, is difficult to follow through on but really quite simple to decide on. It is not a morally ambiguous situation. You will never find such a clear ethical quandary: try to stop a child rapist or not. You will not lie on your death bed at the end of your life and say, my only regret is that I turned that predator in. Unfortunately, it doesn’t seem very many of these people are likely to lie there and regret the fact they didn’t. And that truth makes it ever more difficult for survivors to heal. The truth that they’ve done nothing wrong is easy to see, but accepting it and moving on is the most difficult thing anyone will ever have to do.

I still feel some level of shame when I look at this. I still remember how I was made to feel by my medical school, the medical community as a whole, my family and complete strangers talking about me online. I spent years believing I was a crazy slut and bad mother. I wasn’t even consciously aware of it, but it drove everything I did. Like the trauma itself, the afermath almost cost me my medical career. It almost cost me my life. It stole a lot of things from my children.

Speaking truth is the only antidote to shame so I will tell my story over and over, to anyone willing to listen. I will tell you the heroic parts and the horrific parts and the parts that might make you not like me. To remind myself I did nothing to be ashamed of. They did. And to remind all my fellow survivors out there they’ve done nothing to be ashamed of. They are goddamned heroes and all the many people who failed to protect them are the ones who ought to be ashamed. And that, dear reader, might include you.