Category Archives: christianity

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

03 Tuesday Mar 2020

Posted by in christianity, empathy, Evil, love, medicine, romance, Sin, Uncategorized

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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

IMG_39BE05EDA837-1

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
Dream

Merry Christmas to you, Jeremy, in jail!: A very PTSD Christmas Eve

24 Saturday Dec 2016

Posted by in christianity, Evil, kids, PTSD, Rape

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I love Christmas. I’m a Christmas nut. Perhaps the result of growing up on a Christmas tree farm. I love the music and the movies and the pine cones on the mantle and the gingerbread cookies my four year old insisted using the cowboy hat cookie cutter for. Christmas Eve is a very special day for me. But it’s also one of the 365 days a year I have at least a passing thought about my trauma. It’s the gift that keeps on giving.

One of my favorite Christmas movies is “It’s A Wonderful Life” starring Jimmy Stewart (who is from my hometown, by the way. I used to volunteer at the world famous Jimmy Stewart museum) as George Bailey. There’s a scene in the movie where greedy villain Potter gleefully shouts “Merry Christmas to you, in jail!” at George. (I’m not going into the context here but I’d encourage you to watch it if you’re curious)

So, I have a Christmas Eve tradition that those of you who haven’t known trauma might find a little… odd. Creepy maybe. Depressing perhaps. I like to shout,

Merry Christmas to you, Jeremy, in jail!

Jeremy’s the one who did trauma to me(read about it here if you like). I’m an anomaly in that my rapist actually went to prison. Not many do. It’s a merrier Christmas this year and the next 40 of them for the little girls he was planning to traumatize. So, I don’t see this tradition as odd or creepy or depressing at all.

Christmas is a season of hope. What was the birth of Jesus if not the creation of a whole new hope for us all? Hope that there is something more than this fallen world. And hope, I’ve learned through my PTSD, is the stuff of life. Without it, we’re not dead, but not really alive either (read about it here if you like). My hope was resored when I recovered from PTSD. I like to think sharing my recovery on here could give other survivors in the purgatory of PTSD have some hope too.

I’m a big believer in speaking your truth, in the toxicity of silence. The time I spent singing/screaming in a riot grrl band were some of my most empowered. Maybe it’s the autism in me, but screaming is liberating for me. When the problems of life seem unsolvable, I scream and it helps. For so many years I was told be quiet about what Jeremy did to me. I was told it would ruin my career. I was told it was my fault, that I was a slut and I mustn’t advertise this. I have seen the damage this did to me and so, I don’t just speak my truth in this season of hope. I scream it.

Joy to the world, you fucker.  Joy to you, little girls. There is hope.

2016 was-boop!-a little-boop!- stressful boop boop!

19 Monday Dec 2016

Posted by in autism, christianity, love, special needs

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2016 was a helluva whaddayagonnado kinda year. Bernie rose and then had the election stolen from him by corporate Democrats. Trump won, ushering in an age of all out fascism. Brock Turner got a slap on the wrist for rape. Various police got absolutely nothing for murdering people of color. Aleppo. Standing rock protestors getting limbs ripped off for peacefully protesting. Global warming it is now unavoidably obvious is going to kill us all off pretty soon.

On a more personal front (hey, stick with me here. this post will take a positive turn soon. I swear), my autistic legally blind son got horribly bullied in our school district. My other son’s anxiety reached an all time high and his tics escalated to a whole new dimension. My marriage disintegrated, culminating in separation. I had a post-pregnancy hormonally induced mental health episode. My cousin died from mental health problems. A dear kind friend died from overdose. I found out some other beautiful friends from high school are on heroin (and therefore, will die soon enough. opiates are what they are). I broke off with my family. Is that enough, people? You want more? Oh yeah, our four year old still isn’t potty trained…

But here’s the thing:

Millions of people voted for, donated to, fought for a Jewish democratic socialist who demanded universal health care, maternity leave,  a $15 minimum wage and a kinder approach to Palestine. If you’d told me in 2015 that would happen, I’d have told you that you were nuts. And even though Bernie didn’t win, he’s still out there fighting like hell. And people listen.

For the first time ever, we actually talked about rape and the disgustingly low conviction rates and sentence lengths, as a nation. Some people even said “rape”. Do you realize how huge that is? (Most of the headlines still used euphemistic bullshit and called it “sex” but, hey, it’s movement).

Indigenous activists and their allies won. Won. The people who have endured the most, who have had the most stolen from them, who have suffered the most violence, in this nation won.  Did you expect that? I didn’t. They worked and sacrificed and prayed and endured and… won.

Pennsylvania (my home state) legalized medical marijuana despite the ill informed Pennsylvania medical society opposing it. I did not expect this. It’s huge.

My legally blind son with autism started at a new school (not in our district) where he is thriving. He went to an amazing therapeutic summer camp. He’s made more progress at his new school than he’s made in the past few years combined.

My son with anxiety got a great psychiatrist and got comfortable at his school and is doing a ton better. (and he doesn’t make his “boop” tic unless things are really stressful now. Boop!)

My most recent episode combined with other events from this year caused me to truly shift the way I approach my mental health. I’m now committed to doing every single little thing I need to do to keep myself healthy. No matter what. I’m working through issues I thought were un-workable. I’m feeling more optimistic than I have since I was five. About myself, my kids, my marriage.

I worked through my lack of enthusiasm for Catholicism and have started a whole new kind of Catholicism in our home. I’m reconnecting with the mystical.

My son sang beautifully in his school musical. I had one of the happiest days of my life taking my daughter to the Nutcracker. My son with autism can now get his head wet in the pool without melting down (after 8 weeks of twice daily swim classes at his awesome therapeutic summer camp). My baby turned one and still has the chubbiest most delectable thighs you’ve ever seen. He calls me Mama and loves the water like a fish.

I prescribed suboxone to a lot of patients who hopefully will not die from opiates as a result. I started at a new urgent care where I actually have time to talk to my patients. I had a paper on intimate partner violence published in American Family Physician and got invited to speak at some medical education events.

I’m not going to sugar coat things. I’ve got nothing to say to you about Trump or this country’s refusal to face the racist police violence plaguing us. Global warming’s not looking good either. But, as Howard Zinn said, pessimism is illogical. Amazing things you didn’t see coming happen all the time. Look how many in 2016 alone? And, as my old pastor used to say, God is good all the time. All the time, God is good.

Happy holidays, everyone. Here’s to finding out what 2017 holds for us.

That choice is gone (or, This is hell. get walking)

06 Thursday Oct 2016

Posted by in christianity, Evil, kids, love, residency, Sin

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Mental illness kills.

It kills with heroin overdoses and self-inflicted gunshot wounds and anorexia induced cardiomyopathy and obesity induced sleep apnea and girls who take risks they shouldn’t with dangerous boys.

And when it does, there are usually kids left behind. And that is the worst tragedy.

When I was a resident, we would admit patients overnight who had failed at killing themselves with drugs. We needed to make sure they were medically stable before being sent to inpatient psych. The ER  had saved them but we were the ones to run fluids and monitor them and fill out the paperwork once the psychiatric hospital was ready for them.

It was the job of the residents to go see these patients at two in the morning and complete an H&P, a history and physical exam. We would ask the questions we asked all patients: chief complaint, onset, duration, intensity, chronology, exacerbating and remitting factors, associated symptoms. In this case, the chief complaint was not shortness of breath or fever. In this case, the chief complaint was, I wanted to die. So I tried.

Sometimes onset was a long time ago, often it was right beforehand. Intensity was of course always a ten. Sometimes they told you their story freely. Sometimes only the bare minimum. (we would write “history limited by non-cooperative historian)

I remember one patient in particular. She was a mom. She had three kids around the same ages as my three kids at the time.  She told her story of how her boyfriend had hurt her. Hurt her so badly she decided to die. I asked where her kids were when she took the pills. They were home with her. Maybe they’re the ones who found her and called 911. Maybe it was the worst night of their lives after many other bad nights. She didn’t know whether they’d found her or not. She didn’t care. She never asked us where her children were now. Just went on about the boyfriend and how he’d hurt her and how hurt she was. And I tried very hard to have compassion for my patient, but all I could think of was her kids. Of how badly a successful suicide by their mother would have wounded them.

I have never been the type to lack compassion for those so hurt inside they feel killing themselves is the best solution. I have heard good Christians say they will go to hell. I have heard people call them selfish for hurting their families and thought, do you have no grasp of how much pain they must be in?

But by this time, at the age of 34, I’d lived a bit more of life and had a more nuanced view, you could say. I still think its’s awful to say they’d go to hell. But I do not think, when children are involved, we can simply say they were ill, they were in pain, and so it was.

When I was 28, I had a boyfriend too, just like my patient. He broke my heart too, just like my patient. And I decided to die too, just like my patient. I planned out which pills I would take and when. I’d just had pharmacology before Christmas break had begun and knew which ones would be most effective. It was Christmas. The tree was up. I hadn’t given my kids their presents yet. We were alone in Erie for break. I decided I would drop them off with their dad. He would take them to his parents house for several days for New Years as he did each year. No one was expecting to hear from me. It was time to die.

I was in a depression as deep as any I’d been in many times before. But this time was different. I was 28. I’d been battling depression since I was ten. I always held out hope I would get better one day. Life held so much possibility. But at 28, I thought, here I am again. I can’t keep doing this. I can’t. I sat on my floor crying as my three year old and two year old asked what was wrong and brought me Children’s Tylenol to try to make me better. I hate that I did that to them. I am sorry that I did that to them.

I kept pulling presents from the basement and giving them to them one by one to keep them occupied. I fed them leftovers from the Christmas eve party at my family’s house I’d brought back. I suppose I changed their diapers. I don’t remember.

I planned out how to die and thought, they will go live with my parents and be so much better off without a worthless mother like me. But then it happened.

I entered into rational thought long enough to realize they wouldn’t go live with my parents if I died. They would go live with their dad. And their dad, luckily, was a tremendous asshole at that time. And I thought, I’m really worthless, but he’s even worse. Thank you God he was such an asshole. I couldn’t do that to them.

I remembered when my oldest son Soldier Boy was a baby and I didn’t know if he would live because of a genetic disorder they thought he might have. I remembered sitting in the glider in the nursery wailing a gutteral wail from as deep down as a person can, begging God not to take my baby. Put me through the pains of childbirth for all eternity, I said (I’d just finished a 32 hour natural birth so that’s no small statement). Put me through hell, I said. Just save my beautiful baby.

And he did.

And I thought to myself, I am in so much pain. It hurts so much to live. I am in hell. But now it seems I must do what I told God I would. I must walk through hell for my babies. And so I did. One step at a time.

When you are that depressed, finding the will and the energy just to get out of bed in the morning is excruciating and exhausting. But I did. I got out of bed and I took care of my babies. I went to class and studied. I called a psychiatrist’s office and was told they don’t take Medicaid. That about did me in. But I made myself call another. And I got a psychiatrist appointment for a month from then and a therapy appointment in a few weeks.

I kept breathing. I kept living. Every breath hurt. My heart ached. My muscles ached. My soul was not in my eyes if you bothered to look. Luckily no one looked.

I wanted to check myself into inpatient psych but I knew if I did it could ruin my career and I could get my kids taken from me. I was right. I’m glad I didn’t. But it hurt. It hurt so damn much.

It was in this time, this darkness, this exile, waiting to see a psychiatrist that I entered into the relationship with the man who was my trauma, who was my Ordeal. I was in hell, so I laid with a demon. I suppose.

There in the midst of my Ordeal, I made my way through hell. I chose to live each and every day in every decision I made. When I did not feel like getting out of bed,  I would say to myself, you either live or die. If you stay in bed, you are choosing to die. When I didn’t want to go for a walk to get exercise and fresh air, I would say to myself, you have two choices, life or death. If you do not go on this walk, you are choosing to die. And that is not an option. Your babies need you to live. This is hell. Get walking.

I do not know how it is that a part of me found wellness inside the trauma, the Ordeal. Sometimes I think it’s that a part of me, a version of me, broke off and endured the trauma while the rest of me went on with life as usual. Sometimes I think it was the adrenaline. Sometimes I think it was God. Maybe a little of each.

I know that with my therapist and my psychiatrist I got to a point where I could do a load of laundry without exhausting myself. Where I could study and enjoy neuroanatomy and feel proud of myself for rocking the exam. Where I could play with my kids.

Then came PTSD, but that’s another story for another time.

And so this is what flashed through my mind and heart when I stood there collecting this patient’s onset and chronology. For her chief complaint of choosing to die. This is why I could not lend her more compassion.

When we choose to have children, certain choices go away. Dying is one of them. Even when living is hell.

And to not die is not enough. We must choose to live every day in every choice we make. We must fight for our children. Even when we can’t bring ourselves to fight for us.

They are innocent. We are not. The body is weak, but the will is strong. Must be. For them. This body, this mind, this pain, is not endless. It will all fall away. Ending it a little sooner is not worth the price of their innocence.

It is not a choice. That choice is gone.

 

 

 

 

 

Of Angels and Devils

22 Thursday Jan 2015

Posted by in christianity, doctors, empathy, Evil, outrage, PTSD, Rape, Sin

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gelfand

From January 2015:

Dr. Steven Gelfand died on January 18th after a brief battle with cancer. He was 66 years old. He was also amazing.

I’m going to tell you about him. And just from reading about it, you’ll be better off for having known what little I can tell you here.

I met Dr. Gelfand July of 2009. He was the attending of my very first clinical rotation as a medical student. The first two years of med school are spent in the classroom and the last two years are spent on rotation. You get to leave the classroom and spend time actually doing medicine.

I’d had PTSD for about a year at this point. My perpetrator, a fellow medical student, had been arrested in August 2008. My trauma officially ended with his arrest I suppose, and then came the PTSD.

After he was arrested, my medical school became upset with me. You see, the FBI released my name (even though they didn’t need to) and implied a lot of things about my personal life, sex life, and mental health in the affidavit they used to arrest the sociopathic child molestor I’d turned in. Some of what they wrote about me was accurate and some of it wasn’t. Two things made very clear by this affidavit were:
1. He was a dangerous sadistic pedophile
2. I had risked my life and the lives of my children to turn him in.

I’d like to think a medical school, an institution charged with shaping the physicians we place our trust in and rely on for our lives and health, would be appreciative of a future doctor risking her life and the lives of her children to stop a fellow future doctor who is a sadistic pedophile from hurting any more women or children. But that’s not how it went.

Quite the opposite.

My school chose to punish me instead. They placed me on probation for having morals below the standards of the community (in reference to the affidavit’s inference that I had engaged in consensual, kinky sex with the perpetrator before The Ordeal began). More than this, they waged psychological warfare on me. They brought in a speaker from the state board of medicine (and an alum of the school) who spoke in front of the entire student body about me, saying I really should leave med school now because I wasn’t fit to be a doctor. Warning them not to be like me. A sexually immoral person. The head of my school told me I would never be a doctor. She said no doctor would take someone like me on for clinical rotations and that even if I somehow managed to become a doctor, I would never have patients because I was so disgusting, they wouldn’t want me touching them.

Such cruel words coming from the head of your medical school, coming to you in an acute post-traumatic state, has such an impact. I didn’t even realize at the time how much I believed her.

I was able to get a lawyer and, after a legal battle, get her off my back (but not before suffering the utter humiliation of being forced to apologize for my behavior to the faculty of my school.) But she had gotten inside of my post-traumatic soul and planted herself there.

Fast forward a year to my first day of clinical rotations. The day she said would never come.

The PTSD had obliterated my self-confidence. Deep inside I was afraid she was right, that I wasn’t going to make it and I should have cut my losses when I had the chance.

I know there is a God because it cannot be chance that I wound up on Dr. Gelfand’s doorstep. By the end of my first day with him he’d shared with me that he had no respect for the head of my school. In fact, he told me, he’d once told her to go f*** herself. He was a Jewish, cursing, bold as all hell, certified angel.

He told me she had once punished a medical student he had rotating with him after he gave the student time off to spend with her mother who was dying of cancer. He responded by sharing his feelings as above.

I ended up telling him what had happened to me. The brave deed I’d done and the evil she’d paid me with. He told me I’d done a courageous thing, the right thing. And he told me not to tell any other doctors like I’d just told him. It could ruin my medical career.

Over the next two years, he became my two special needs sons’ neuropsychiatrist. He was, by far, the best doctor they’ve ever had. He became a mentor for me too. He told me I was going to be a great doctor. And part of me actually believed him somehow.

He was a tough attending. He let you know every single detail you got wrong. But he also let you know when you got something right. And when he did, it really meant something.

He went into medicine for the right reason. He cared about his patients and worked for and advocated for them fiercely. He was good and he knew it, and he earned it.

Dr. Gelfand was right that I shouldn’t tell the other doctors I would be rotating with what she’d done to me. It wasn’t the time for it. She still had the power to end my career. I wasn’t emotionally ready to speak publicly about it yet either.

But I have been healed of my PTSD after seven long years. I am getting ready to graduate from a wonderful, supportive residency. And I’ve never been one to keep quiet.

It was Martin Luther King day on Monday so we talked to our kids about the civil rights movement. We talked about the turning points like Rosa Parks and how those were just moments that sparked off a movement that ha been building for a long time. My son asked me why those particular events set things in motion and I told him no one could say for sure.

The passing of this amazing man has changed things for me. Something has been brewing within me that would inevitably, eventually come out. I didn’t know when.

The silence ends now.

Jeremy Noyes raped me, tortured me, threatened to kill me and my babies. My medical school punished me for risking all of that to do what is right as a physician and as a person. He is now serving 45 years in federal prison. What my school did was wrong and dangerous. They sent a clear message to that school full of future doctors that turning in a child predator could cost you your career. It was unethical, immoral, and unacceptable.

Your seven years is up, LECOM. Let’s talk.

The surprising mathematics of shame

05 Monday Jan 2015

Posted by in christianity, empathy, kids, love, medicine, parenting, PTSD, Rape

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I came home from working a 24 hour shift and thought, I should relax and watch something funny before I head for my nap. I have a tendency not to follow through on such intentions very well. I tend to wind up watching a documentary about something heavy instead. My therapist Dr. O said my main hobby in life seems to be thinking and that has its benefits and its drawbacks. One of the drawbacks being my insomnia largely caused by my unending pondering. So I knew logically that I really should put on something lighthearted to unwind and then go take my nap, but logic rarely dictates what we do in this world and I am no exception.

In my defense, I did go to the Search area of Netflix and begin to type in “Sex and the City.” I can’t be blamed for Netflix suggesting I might enjoy the TED talks on the topic of sex and love.

The first talk was “eh.” It was about parenting taboos I didn’t exactly find earth shaking. Maybe because I entered parenting via the special needs route. I was doing calculus when the parents giving the talk were still learning to count. Not to say their talk didn’t have value. Sesame Street has a lot of value, for instance. But I digress….

The second talk was different. It was by Brene’ Brown, a PhD in social work, and it was titled “The Power of Vulnerability.” She talked about the most basic human need being connection. She said it was the meaning of life. She talked about the thing that keeps us from it too: shame.

She described shame as the fear of being disconnected. Our fear that if people really knew us, they would reject us.

She said something else too: the less you talk about shame, the more you have.

She said the key to happiness in life was vulnerability. Being willing to sit with uncertainty, taking risks worth taking.

She said that the difference between people who feel loved and connected in this life and those who don’t is whether or not you feel worthy of being loved and connected.

She said we numb vulnerability with food and buying stuff and drinking and medication but when we do, we also numb joy and happiness and make ourselves more and more miserable.

She said more in 15 minutes that is worthwhile than I learned in four years of medical school. My husband says I’m exagerating a bit when I say that. I’m prone to exageration, so I guess I’ll rephrase: what she said launched an epiphany for me that will make me a better doctor and a better person.

You see, PTSD is about disconnection and not being able to be vulnerable and numbing and shame. And shame. I’ve been trying to figure a way out of the disconnection and numbing and avoiding vulnerability piece. It didn’t occur to me that the key could be shame. And it didn’t occur to me there might be a simple mathematical solution:

Talk about the shame –> less shame

I always thought it was the other way around. Maybe that’s why therapy hasn’t done a lot for me over the years. Maybe.

So I’m on a mission to talk about my shame. Every last bit of it. Everyone has it except for psychopaths, so there’s no shame in admitting you feel ashamed.

I had a grrl band when I was in college called Dum(b). Don’t ask about the parentheses. I named the band Dumb because we were a grrl band giving voice to women’s and girls voices (dumb used to mean mute in addition to meaning stupid FYI). I used to be an oral historian trying to give voice to marginalized people (thank you Howard Zinn, God rest his soul). But it’s time to look at myself now.

I need to talk about the things I’ve kept silent so long. The things I have tried to stuff down with food, to forget in the rush of infatuation, have tried to bury under a pile of things bought with credit cards. The things that have kept me from being fully present, that have made me afraid to be vulnerable.

These things that keep you from being alive. The opposite of life.

When I look at my children it is so easy to see that they are extraordinary just as they are. So easy to know in my bones they don’t deserve to feel shame. What I have come to realize is that I need to feel that way about myself.

I have spent the past seven years surviving. Surviving for them, because I had to. But survival isn’t life. It’s a holding pattern. I need to live and not just for them. I need to be fully alive again for me too. Because I deserve to be alive and joyful and self-confident and full of plans and hope and possibility.

Possibilty. It’s been so long since life seemed to hold real possibility.

I went to sleep for a few hours last night during a lull in admissions for the first time in so long. I prayed and thanked God for what the Holy Spirit has revealed to me through a TED talk. And then I stopped thinking and went to sleep. Because I deserve it.

You’re Not a Good Little Girl, You’re a Warrior

28 Friday Nov 2014

Posted by in christianity, Evil, kids, love, marriage, PTSD, Rape

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I watched the first two episodes of a British show recently called “The Bletchley Circle”. It’s about four women who were code breakers for British intelligence during world war two who have now blended into civilian life seven years later. One is a stay-at-home mom, another a housewife, another a waitress, the last a librarian. They reunite when they realize they can stop a serial killer with their code breaking skills. They realize, too, that a piece of them has been suffocating all those years. Their minds, their hearts, their spirits, trapped in an ordinary life they weren’t meant for.

They pursue the killer. When the police aren’t very helpful, they take it upon themselves to go undercover. They visit the gruesome crime scenes before calling the police with the location of the body. They set a trap with one of their own as the bait. In the end, they get their man in a dramatic scene where he gets blown away by one of the ladies as he’s about to kill another one.

So, I like it a lot right up until the last ten seconds. I mean, what’s not to like: feisty, intelligent women banding together and protecting their sisters in a man’s world. Well written scenes subtly addressing the alienation of women in modern society and the problem that has no name. Recognition of how common rape and domestic violence are. Entertaining yet socially relevant. I could relate to them too. They knew trauma. They knew aloneness. They had seen the evil of the world, survived it. It made me feel a little less alone. More optimistic maybe. But then came the ending.

The main character is walking home after nearly being killed by a serial killer who rapes his victims after they’re dead. She went willingly to his house because he said if she didn’t, he would kill her children. If she came, he said, he would spare them. She did what we do for our children. She walked into trauma to save them from the evil. And after she nearly died and was saved and the police came in and she processed it all as well as she could with her three friends who’d gone through it with her, who’d saved her, she went home to her husband and kids. She opens the gate of the little picket fence that surorunds her house. She looks in the window at her husband playing with her kids. She’s going to tell him what happened. She’s going to tell him all of it. He doesn’t even know she was a code breaker during the war. He thinks she was a clerical worker. She’s going to tell him now. About the war, about what she and her friends have really been doing when he thinks they’re off gossiping, about the evil she’s seen and known. More than that, she’s going to tell him about the rush of it all. About how powerful she is. She’s stopped a killer. She’s saved countless women. She’s saved her children. She helped defeat the Nazis.

But then she pauses. She looks at them playing happily, blissfully ignorant of it all. She remembers what one of the other women told her. She can’t tell him, she said. She looks at them and she changes her mind. She does what good little trauma survivors do. She swallows it down and hides it away. It’s not enough to have saved so many lives, she must protect them from the knowledge of evil too. To keep them safe in body and mind and spirit.

That’s when they lost me. That’s when my heart sunk and I felt cheated. And I felt pissed.

I wrote in an earlier entry about sin eaters. About swallowing the evil down and keeping it away from the rest of the world. About how I didn’t want to tell anyone about the evil I’ve known because they couldn’t possibly understand. I wanted to be a good little trauma surivor and hold it inside but I can’t. I wanted to be like those war veterans who refuse to tell their families what happened, who maybe don’t even tell them they fought in the war at all. To be like the woman in London who pretened to be a clerical worker turned stay-at-home mom instead of telling her husband who she really was, a warrior. The pain of trauma, the thrill of saving lives.

I haven’t protected my husband from the evil. I have told him all of it in detail. He came to the perpetrator’s trial and saw the graphic pictures of the brutality and perversion. I have told him what he did and how it felt and how it has haunted me. I have been honest about my existential crisis that has started in recent weeks, seven years after the events that changed my life. That changed his. He didn’t even know me then. He was finding Jesus and doing missionary work and writing scripts and raising his beautiful son. It may be harder for him to hear the unholy thoughts I have had lately than the details of the violation.

But I have been brutally honest about those doubts and thoughts and feelings, about the rage I feel for God right now. About my daydreams of violent revenge on my perpetrator which have resurfaced. About how exhausted I am to be seven years out and feeling like I’m back where I started. This is PTSD, I tell him. Why can’t you just get over it, he asks. Why can’t it be over? This is PTSD, I tell him. It will get better, but it will keep coming back. I could go twenty years and be pretty good and then it could come back all over again. And living with that knowdlege in and of itself is cruel enough. We are married for life and so the PTSD is a life sentence for him too.

It is not right to want to violent revenge, he tells me. God calls us to forgive, he reminds me. I said I’d forgiven the perpetrator. I had prayed for him. I had seen him as a poor banished child of Eve. Like a good girl. But I am not a good girl now because I have come to realize I spent all these years being a good girl because I thought maybe if I was good enough, bad things wouldn’t happen to me. I’ve blamed myself all these years because it gave me a sense of control. I realized, really realized, a few weeks ago that it wasn’t my fault. He alone chose to do the things he did. I had no choice. I could not have been so good he wouldn’t have done what he did. I cannot be so good I am safe. And so, I am not going to concentrate my being into being good. I am going to feel the anger I need to feel, I am going to doubt the goodness and power of God as is inevitable with trauma, I am not going to hide from the reality we live in a patriarchy maintained through brutality of body, mind, spirit.

I bring this to him because he’s my husband. I bring it to him first. But I’m not planning to stop there. This is a series of events set in motion in that cold February of 2008. Set in motion by him. I used to think I had such a choice in how I responded to what he did. I used to think I chose to go back to his apartment over and over again because I had made the choice to save my children and to save that little girl. The only choice I had was my body and mind versus my soul. Something would be lost. There was no good choice. I have no good choice now either. Keep it all inside and go on living the nice external life we’ve built up for ourselves or speak the truth and risk losing that external life. Body or soul. Ignore my fellow survivors, the little girls suffering out there, move on and tell myself finding health and happiness is the best revenge. Or be honest.

He’s my husband and my fate is his. His is mine. And God with us. The three of us. And so the three of us have PTSD. The three of us had the good choices taken from us seven years ago on that cold winter day in that motel room in Appalachia.

I will tell my children what happened one day when they are older. It happened to them too. A piece of their mother stolen never to return. A warrior born. I will tell them of the evil in the world and of the not good choices it leaves us. I will tell them I chose my soul over my body and mind. I will tell them he took something from them too. I will tell them the no good choice between body and mind and your soul is at the very core of this fallen world. Because I cannot protect them from the truth of this world but only do my best to prepare them for it. You see, what those good little trauma survivors in the movies don’t know is that you cannot be a good enough girl to keep bad things from happening.

Stop being good and be the warrior you are.

And as I typed the words, I came to believe them

04 Thursday Sep 2014

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I got triggered the other day for the first time in a little while. I refer here to my PTSD. Something happened at work and I had a flashback to what had happened to me in medical school. When one of my fellow students did unspeakable things. And when those higher ups punished me for it instead of helping me. I have never had this happen at work before but there I was. My heart rate was picking up, my throat beginning to gag, the tears welling up. I quietly slipped away from the lecture. I wanted to call my husband but I knew if I spoke, I would begin to cry and wouldn’t be able to stop. So, I texted him instead:

I had a flashback and had to leave. Feeling sad. Please pray.

He couldn’t read the text right away, busy with taking care of baby Princess and our castle. So, I decided to pray with him anyway. I texted him:

God is good. God is good. I knew He is. Christ before me, Christ behind me, Christ on my left, Christ on my right. Christ in the ear of all who hear me, Christ in the tongue of all who speak of me, Christ in the eye of all who see me. We pray for (the Violent Man)’s soul, for (the unethical Higher Up)’s soul. Poor banished children of Eve. May God have mercy on their souls.

And as I typed the words, I came to believe them. And I became calm.

I cannot say I never get angry with the Violent Man or the unethical Higher Up, but I have forgiven them as much as I can as of now. I pray for them and when I do, I forgive them more and more. I forgive because that’s what God tells us to do. Forgive us our trespasses as we forgive those that trespass against us. God has forgiven me, poor wretched sinner that I am. But it’s also true that forgiving them makes me feel better. Brings healing. Loosens the hold it all has over me.

Life is not static. It is not clean. I have my days of mourning and my days of joy. But I have come out of the whole thing better than might be expected. I have forgiven, I have trusted. Because I have to, really. We’re not owed anything in this life. It’s all a gift. There will be trauma. There will be pain. But there is so much more.

My husband got my text soon after I’d sent it. I texted him I was calmed down but asked that he still pray for me. He replied simply:

Yes Love…

My husband loves me. My babies too. God loves me perfectly. Jesus said that it’s easy to love your friends, but that we’re called to love our enemies as well. I used to think that was for the benefit of the enemies, or maybe just a way to keep us all in line. But I think it’s more than that. God really does love all of us more than we can comprehend, yes even child molesting sociopaths. So, yes, it is for our enemy’s sake he tells us to love one another. But he also knows that in striving to love our enemies, we grow closer to him, closer to being good, closer to all that is good. And so in trauma we find God, we find goodness. Our dark days are a gift as much as our joyful. He really does bring beauty from ashes.

The Unspeakable Beauty of Being Broken

04 Thursday Sep 2014

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I accidentally drove to Cranberry this past weekend. I’d meant to drive 2 hours east to Harrisburg but somehow drove 2 hours west to Cranberry instead. I called my husband Poobah and said, “I have to tell you something but you have to promise not to get mad at me.” Not the words he was hoping to hear I am sure. He agreed to the fairly absurd request (one can’t choose to not have at least an initial angry impulse if that’s what’s stirred in them after all) and I told him where I was. He didn’t get angry but he was certainly confused. How is it I had driven for two hours on the Pennsylvania Turnpike the wrong way? Hadn’t I noticed all the signs for the exits that lead to Pittsburgh? I really didn’t know how to explain it and simply told him I’d done it before and that we would try to make the best time we could over to Harrisburg now.

How it happened is not really so complex or mysterious. I’m not on my way to early onset Alzheimer’s or Lewy body dementia. I didn’t have a psychotic break and lose touch with reality. I was just really stressed out with life in general and then climbed into a Honda Civic with three young kids for a three and a half hour drive.

Still, it scared me. It didn’t seem like something a normal person would do. I’d done it before. I’d probably do it again. And it just isn’t normal. Therefore, I’m not normal.

Now, don’t get me wrong. I’ve never been a big fan of normal. I’ve always wanted to be unique, to be myself exactly as I am. I’ve taught my kids the same thing. Truth is, I love my oddball patients the most. I’ve always been a fan of the underdog.

What was scaring me now was the fear that I’m not just unique or special, that I’m somehow… wrong. There lies in me a fear I think we all have to one extent or another: the fear that I’m a fraud. In me, I suspect, it runs deeper and wider than it does in most.

I feel sometimes that my whole life is a house of cards precariously standing by the grace of so many cards all pushing against one another with just the right amount of force, positioned just so for balance. And at any moment, it might just collapse. It all just might fall apart and I will be left with nothing more than a pile of scattered cards. I could just lose it all, just like that, in an instant. I could lose it all because I am not who we all think I am, me included.

It all feels so fragile to me at times. The thing I have to remind myself is that it is. It is fragile. All of it. Everything any of us thinks we have. Anyone’s house of cards could come crashing down. And yes, maybe it would be my fault if it happened. Maybe I would make a mistake and cause it all to fall.

It’s already fallen. The world. Nothing’s owed us. We’re all broken, all imperfect, all sick. Any one of us could knock it all down on any given day. I tend to think that those of us that know how broken we are, are maybe actually the wise ones. I sat in on a drug rehab group recently and listened to a beautiful group of people trying to get their lives back in order after addiction. They laid themselves bare to one another, talking about the wounds of their past, of those who’d loved them and those who hadn’t, of those they’d hurt and betrayed and deceived along the way. Their cards lie scattered and they knew it and they knew it was their own doing. They knew even if they could begin to build again, it would still be a fragile thing and that it very well might fall into chaos again. I hated to leave the group to return to the real world, full of the superficial interactions that make up the day to day of life. I have felt the fragility of it all since I was a little girl and have found so many either don’t know yet, or wish to ignore it or pretend it away. I suppose for many of us, it’s a necessary lie.

Like the woman at Jesus’s feet, cleaning them with her tears and drying them with her hair, breaking open her alabaster jar to anoint him with perfume, we are all but whores at the feet of the Lord. A pile of cards that will one day be made whole again when we leave this broken world for something so much better.