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“Professor Evans of the Presbyterian College, Carmarthen, actually saw a sin-eater about the year 1825, who was then living near Llanwenog, Cardiganshire. Abhorred by the superstitious villagers as a thing unclean, the sin-eater cut himself off from all social intercourse with his fellow creatures by reason of the life he had chosen; he lived as a rule in a remote place by himself, and those who chanced to meet him avoided him as they would a leper. This unfortunate was held to be the associate of evil spirits, and given to witchcraft, incantations and unholy practices; only when a death took place did they seek him out, and when his purpose was accomplished they burned the wooden bowl and platter from which he had eaten the food handed across, or placed on the corpse for his consumption.”

I gave a talk on PTSD in women to a room full of doctors today. I talked about incest and oral rape to a room full of doctors today. I started off my talk by telling them the next 45 minutes were going to be unpleasant and uncomfortable because discussing trauma, thinking about trauma, is an innately unpleasant, uncomfortable thing. And for the first five minutes or so they did look uncomfortable. Which made sense. And then they didn’t. They stopped looking uncomfortable and began to look the way they always do during a lecture. Some of them listened attentively and made eye contact. Some of them dozed off.

It went pretty much as lectures do. There were questions and comments afterward. About screening and medication and epidemiology.

I told them something else before the lecture started too. I told them I have PTSD and that I was talking to them about PTSD that day (not hypertension or diabetes or depression or all the hundred other diseases it would have been so easy to talk about) because I wanted to help all the survivors I’ve met along the way.

I have not told many doctors over the years that I have PTSD because the admission of the disease, quite unlike other diseases, is a confession of having lived something. In this case, something horrible and terrifying and evil. I’m not supposed to tell them what happened to me in medical school. Everyone who knows tells me so. We are a society that blames the victim and the medical world is no different. But these people who tell me this, these well meaning people who want to protect me, they don’t know how awful a thing it is to not tell.

What good is it to gain the whole world for the price of your soul? And a medical career, after all, is hardly the whole world.

The thing that keeps me from telling them what happened to me is not fear. I left fear behind the day I turned him in knowing he very well might kill my children, knowing very well bad men like him rarely go to jail for very long. The reason I don’t tell them is that they wouldn’t care, not enough anyway. They do not know evil as those of us who’ve lived it do. They do not have the darkness in them. When evil surfaces, we listen for a moment and tell her we feel so bad for her and tell her she’s so brave. And then we forget. Because anyone who can, will. And the reason we can is because of the sin eaters.

We swallow down the darkness for the rest of the world. It sits in us, contained in us, and you are safe.

It will never change. It is not patriarchy or capitalism or imperialism. It is evil, it is fallen Man.

I stood up there and I taught those doctors about the three stages of recovery from PTSD. I made them feel so good about the whole thing. These women will always have this chronic disease, they’ll never get justice for what happened to them, but they’ll be okay because they’ll break their silence and push through their fear and integrate the trauma experience into the story of their lives. They’ll be redeemed by learning acceptance. Not resignation, acceptance. Cue the music, fade out as the heroine smiles through her tears and heads out to conquer the world with her loving supportive man at her side.

I swallowed down the darkness for them. And there it sits.

I write this now not for those of you who will read this who do not know the darkness. You will never change. You can’t. You will forget this in a few minutes or a day. I write this for the sin eaters. So I might feel a little less alone for a moment before I head back to work, to the land of the those we protect who will never really know.