Category Archives: parenting

18 Saturday Jun 2022

Posted by in Evil, love, narcissism, parenting, PTSD, Rape, residency, Sin

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I got my living room and dining room ready to paint last night. It was a loooooot of painter’s tape. Like, a lot. I was spent by the time I finished. I headed to bed and decided to read a little of my book about Abraham Lincoln and John Brown and then go to sleep. I was soon interrupted, however, by my son telling me the toilet was flooding the bathroom. And it was.

I stood in 2 inches of water while plunging the toilet with one hand and holding up the ball float with the other. Tried to turn the water off but the valve wouldn’t budge. Once the toilet was unclogged my son helped me construct a duct tape sling to hold the ball float up while I researched how to fix it. I got out my single lady fix it guide

and it was fixed in no time. Well, it was a bit of a struggle but pretty quickly anyway.

I also replaced the P trap on my kitchen sink recently. And laid some flooring. In the past couple of years I have dealt with mice and bats, sewage back ups, the moving of numerous heavy objects and setting up of various electronics. And it makes me realize how much I let myself rely on other people to do so many things, basic things. Not just plumbing and heavy lifting. I spent so many years feeling like there were only a few very specific things I was capable in. There was always a dad or a husband to depend on. And that’s what I chose to do.

I don’t know if I’ll ever find my person and have a long term relationship but if I do, it will be very different than it always has been. Because I’m very different than I always have been. I used to want someone to take care of me and someone I could take care of. In a childlike way.

Dependent on each other, chasing and being chased by one another, idealizing and devaluing one another. Anything to avoid stillness, connection, intimacy, vulnerability. It’s not just romantic relationships. It’s with everyone in my life and even with myself.

So many people went mad with the pandemic because they were left alone with themselves. In silence and stillness. And so many of us fear it. Because we fear knowing ourselves. We fear the shame, the weaknesses, the parts we’ve been taught are unlovable. We fear ourselves. Because we are the ones that have kept us from getting that hole inside of us filled. Surely it must be our fault. And who would want to know someone like that? Spend time with someone like that?

Judith Herman says trauma is being abandoned. By everyone who was supposed to protect us, humans and God himself. But who is the one who ultimately failed us? It was us. It was me. I made my choices. I just didn’t know how bad it would get. Didn’t know it would never end.

I have a ritual I complete each time I move. My therapist taught me that when I was fixating on something I should picture taking that thought and putting it in a box and placing that box on a shelf for later. I was fixating on The Ordeal at the time so I took the court transcript and literally put it on a shelf in the hall closet. It worked. Now each time I move I take that box and put it in the hall closet of my new house. And if there is a day I need to take it down for a while, I do. And when I’m done I put it back.

My ex-husband reads this blog and looks for things to use against me. I wish he wouldn’t but such he life. My therapist asked me recently why I keep writing it if it bothers me. There are a lot of facets to that answer. One being that trauma is lonely. If you were in war or a natural disaster, you have other people who went through it with you. But most of us who were raped went through it alone. And sometimes you need to talk to someone who knows what it was like. And that person doesn’t exist. And for me, this blog, I know it reaches other people who’ve been through the same thing. Not a lot, but a few anyway. I feel like someone might be listening who understands. And sometimes, when the box is off the shelf, I really need that.

I do my best to forgive myself for the choices I’ve made because wallowing in guilt does no good and is insincere. It is an indulgence. I sit with myself, but sometimes it’s okay to need someone sitting there with you in the darkness. Not because you can’t be alone but because it would be nice to not be alone for a while.

I hope you are out there sitting with me. I hope you know I’m sitting with you too. He did unspeakable things to me. Maybe someone did to you too. I tried to not write about trauma today. I tried to write about how proud I am of myself for fixing the toilet. But I would be lying if I said the box isn’t down right now. That I didn’t read through his appeals last night, late into the night, long after the toilet was fixed and the water mopped up.

a room of one’s own

04 Saturday Jun 2022

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I told you in the course of this paper that Shakespeare had a sister; but do not look for her in Sir Sidney Lee’s life of the poet. She died young—alas, she never wrote a word. She lies buried where the omnibuses now stop, opposite the Elephant and Castle. Now my belief is that this poet who never wrote a word and was buried at the cross–roads still lives. She lives in you and in me, and in many other women who are not here to–night, for they are washing up the dishes and putting the children to bed. But she lives; for great poets do not die; they are continuing presences; they need only the opportunity to walk among us in the flesh. This opportunity, as I think, it is now coming within your power to give her. For my belief is that if we live another century or so—I am talking of the common life which is the real life and not of the little separate lives which we live as individuals—and have five hundred a year each of us and rooms of our own; if we have the habit of freedom and the courage to write exactly what we think; if we escape a little from the common sitting–room and see human beings not always in their relation to each other but in relation to reality; and the sky. too, and the trees or whatever it may be in themselves; if we look past Milton’s bogey, for no human being should shut out the view; if we face the fact, for it is a fact, that there is no arm to cling to, but that we go alone and that our relation is to the world of reality and not only to the world of men and women, then the opportunity will come and the dead poet who was Shakespeare’s sister will put on the body which she has so often laid down. Drawing her life from the lives of the unknown who were her forerunners, as her brother did before her, she will be born. As for her coming without that preparation, without that effort on our part, without that determination that when she is born again she shall find it possible to live and write her poetry, that we cannot expect, for that would he impossible. But I maintain that she would come if we worked for her, and that so to work, even in poverty and obscurity, is worth while. -A Room of One’s Own, Virginia Woolf

I am no longer sleeping on the left side of the bed.

We moved this week to a beautiful house in the country with big, old pine trees. Like the ones I grew up playing in. It’s my forever home. It’s home. Finally home.

There is room to spread out in this house. We still spend a lot of time together but when we want to be alone, there are lots of lovely spots to go to. I sit in the screened in porch and watch the deer and the chipmunks and sometimes a fox. And my bedroom has a sitting room that I have made a little cozy gym. I have my own bathroom. For the first time in my life. I take long relaxing baths now. And I spread out in my bed and take up space. The luxury of space.

My heart has felt the words of Virginia Wolf for so many years. A room of one’s own. When I am overwhelmed by all the needs I am asked to meet everyday I find myself saying, can I just have ten minutes to myself, can I just have one inch that is mine alone. And now, now I have an acre. And a room. A screened in porch. A whole big bed. That is full. Of me alone.

I used to be afraid to be alone. It terrified me. I felt like I was falling into a darkness so deep and wide, with no bottom. That I would just fall forever. Afraid of hitting bottom but more afraid of never doing so. Its the fall that is intolerable. It’s a terrible thing to be afraid to be alone. You keep company with wolves because being eaten seems a better fate than being alone.

I used to be afraid to be selfish. To not be omniavailable (yes I just made up a word) to my kids, my attendings, my patients, my family, my friends. But that’s no good. Ten minutes to myself, sometimes hours or days to myself, is a beautiful thing that makes me a better mother doctor friend. And space. Space that is just my own. Whether it be my tree house in Jamaica or the back room of my office in Grove City or my Mini or my queen size bed.

I wish I could give this to my female patients instead of medication. Space to themselves instead of tiny falling down houses with 6 or 7 people on top of each other. Time. Without kids or work or toxic family. But a lot of them would be terrified by it. We are raised to be this way. To stay small and not take up room. To give ourselves away. Inch by inch, moment by moment. Chipping away the boundaries. To be terrified of our own freedom, afraid to declare our time and space and bodies and thoughts and feelings and wants and needs our own.

And words. To claim our words, our voice, our writing, our ideas, our cadence, our beauty.

There was a time in my life I read Allen Ginsburg and Jack Kerouac and dreamed of all the life that lay outside my little town in the country. All I had ahead of me. The life I would live. Of revolution and gorgeous poetry and art and fascinating people slightly mad but mainly genius burning brightly, so bright.

I have lived intensely and now I am ready to be content, back in the country. Back to my own bed in my own room as it was then. Time to myself, to read and savor and enjoy. My kids are the ones heading out into the world. Beyond the pine trees and the covered porch and sometimes a fox. While I spread out in my bed in the quiet of my room and write you these words of my very own. Send them out into the world and hope they land where they’re meant to. Here in a room of my own.

i would be a terrible dance teacher

21 Saturday May 2022

Posted by in empathy, kids, love, parenting, romance

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I’ve done this dance as long as I can remember

(not the foxtrot. We did that in Gym and I was awful)

This dance of give and give and be who they want and not who they don’t and when they step on your toes don’t say a word because they might leave you and dance without someone else, someone who doesn’t complain when they step on their toes. So even if your toes are raw and bleeding and you can barely stand up, you keep dancing, because the only way to win is for the dance to last Forever

But

Inevitably it gets to be too much and you realize how messed up this dance is and so you leave. It’s always better to be the one who leaves. And if you should find yourself in that old familiar black hole, well, you’ll figure that out when it comes

They used to have these dance marathons for charity on sitcoms where the couple who stops dancing last is the winner and they’d dance all day and all night and wacky funny things would happen. But really what happens when you lose if you quit dancing is that you get so damn tired and bitter and hopeless and then that’s all your children know of life

They need to know it is not healthy at all to dance all night and all day no matter what the cause. They need to know the Baker bunion is not inevitable just because every other female in the family has it. And so, you sit and rest. You know now in your bones that there are a lot of ways to win, not just dancing forever. Know that bone that is your bunion has been trying to tell you this all these years but you wouldn’t listen. Maybe you thought you deserved to live that way. Maybe you taught them they deserve to live that way. But not anymore.

I was so afraid she’d disappear and never come back. And she did. Afraid if I said even the littlest thing out of line and I was right.

I was so close to invisible I thought I’d found heaven when I heard those words that day. To be so watched you must do everything right and yet not seen at all. And so I see them dancing the dance. And I hope I show them that the way to win isn’t to never stop. That it’s just a silly show and at the end of the day the best part is getting to rest with your feet up at home with the people that love you. And to choreograph your own life to your own song with an audience of one.

Cha cha cha

christofascism

04 Wednesday May 2022

Posted by in addiction, Catholicism, christianity, Evil, kids, love, outrage, parenting, Politics, PTSD, Rape, Sin

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Nowhere in the Bible does it say life begins at conception. Nowhere in the Bible does it say 10 year old girls ought to carry and birth their father’s baby if he chooses to rape her which fathers sometimes do. To think this is what God would want says an awful lot about a person. And it isn’t good.

Howard Zinn says you can’t be neutral on a moving train and so I want to hear from my Christian sisters today. I want to hear them screaming for the women who will die, the girls who will die, for the dreams that will die. They asked Jesus the most important commandments and he said love God and love one another. Why is that so fucking hard for so many ChRiStIaNs?

Contraception is next. Do you know I didn’t use contraception for years and I’ve never been a fan and it’s failed me on occasion and I still will give my all to defend our right to it. Do you know the horrors I have seen come of lack of access to effective contraception? Where are you my fellow Christians? With your youth groups and your worship songs and your testimony? Jesus hung with the prostitutes and the lepers. She had two beautiful kids and a hole inside of her so wide and so deep because she’d never been loved and only ever been hurt and that third baby done did her in and now all three of the babies are with someone else and she is in jail detoxing meth psychosis and I miss her so damn much. She chopped wood at 8 months pregnant to try to make enough money to keep the water on. And where were you? At yOuTh GrOuP

I sat in my car and cried for the world we’ve given our kids. I tried. I believed. But here we are. Poor lost children of Eve banished from Eden. But Eden wasn’t enough. Or maybe it was too much. We wanted that apple and who could blame us? How boring a perfect life must be. So huddle together in this Whale with me and let us tell each other tales until the light goes out.

Fuck Ted Bundy

31 Thursday Mar 2022

Posted by in Catholicism, christianity, empathy, Evil, kids, love, marriage, my awesome husband, narcissism, outrage, parenting, PTSD, romance, Sin

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Flesh of my flesh

Bone of my bone

Leave your parents cleave to me 

I am your new home

Home forever

Til death do us part

And if I make you yearn for that end 

Why that’s hardness in your heart

For if you love God

You love marriage, you love me 

And you know when God joins together

You’ll never be free

Free to be who you really are

To follow the fate signed in your stars

No you are mine and I am yours 

Don’t lock your phone 

Don’t lock your doors

We are one in heart and soul 

We are both driven by the hole 

left behind by the barren wombs that birthed us underneath the moon

Mother moon has cried for us while Brigid’s fire inspired us 

To reach for something better than us 

Wait Did I say us? 

I meant me. 

You conjure planks in all our eyes 

But yours are fine 

(It’s a disguise) 

A pleasant reflection outside of you 

Rot and decay is what is true

What god has joined together I will put asunder 

For how can we be one when your trunk is putrid and diseased at its core?

Swoop up the fruit before it hits the floor 

If you can tell a tree by the fruit it bears you’ve done a damn good job of fooling God 

For our children are precious fruit indeed 

Owing little to your bitter seed 

They grow and bloom in spite of you 

Soaring so far past the height of you 

Knowing there is something not right with you

People look at the women that fell in love with Ted Bundy

Stood by Ted Bundy

Accepted a proposal in a courtroom from Ted Bundy

And they think these women are naive or dumb or victims themselves

But has it ever occurred to you that they were there because being in love with Ted Bundy worked for them?

Instead of looking at him as this charming manipulative sociopath fooling these women

Has it occurred to you that she was manipulating him too?

Judas and Ted Bundy and Jeremy Noyes 

Sinners that God so loved he gave his only son 

God and Abraham would sacrifice their sons for the sins of the world

And so do you think yourself holy when you hurt your kids to hurt their mother? To punish her for leaving? For putting asunder what You joined together?

Because it was never about God 

And always about you 

And you, are a jealous and vengeful little demigod 

So easily beat by Brigid and Mother Moon

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

03 Sunday May 2020

Posted by in Catholicism, christianity, doctors, empathy, kids, love, medicine, parenting, PTSD, Rape, residency, Uncategorized

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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.

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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.

the smell of collard greens and sickness: 38 today

24 Friday Mar 2017

Posted by in kids, marriage, my awesome husband, parenting, PTSD, Sin, Uncategorized

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Today was the kind of day you question this whole having-5-kids thing. It’s my birthday and I’ve spent it tending 3 sick kids and taking another one to the psychiatrist. We’re talking wall to wall puke and diarrhea. Kids whining and crying. Wailing and gnashing of teeth. And always, always, the cry from all directions: Mom!

That said, 38 is a good birthday. The sun is shining. My husband surprised me with some beautiful flowers (even more a surprise because I ran into him at the store as he was buying them-he thought it ruined the whole thing but I found it more of a unique thrill). Granted, the 16 month old knocked the flowers and the 2 quarts of water they were in on the floor, but still. Clean up efforts of the spill were difficult secondary to every single rag in the house being in the wash, dirty or currently used as a puke reservoir. But still.

I spent my 28th birthday in the midst of my five month long trauma. So, Hell. I spent my 28th birthday in Hell. The great thing about trauma is that it makes puke and diarrhea look pretty damn good.

I took my sick babies for a walk in the double stroller today around our neighborhood on the river. I ate Thai food and vegan cheese cake with a very nice raspberry sauce, made by my hubs. I drank some wine and even convinced my teetolaller hubs to join me. My kids all made me cards (ten minutes before the party once forced to by the hubs) that were very sweet. My hubs spent the day, when not reducing raspberry sauce or walking our daughter to the dollar store for more pink balloons, working on the medical practice we are opening. The best present ever.

And  I got one other very important gift: time to write this.  Luxury living at its finest. I do not know how I could have made it to 38 without writing. It was my escape as an outcast Aspergery tween, was my voice against oppression in high school and beyond, won me scholarships and fellowships that made me feel like maybe I really did belong in academia, inspired lyrics that gave me the drive and the confidence to sing in a punk band in front of hundreds of people despite being completely terrified, got me published in a legit medical journal at a time when I struggled with feeling like I was a *real* doctor. Most importantly, writing got me through the weeks and months directly after Jeremy was arrested. Through the second trauma of my medical school shaming me and trying to ruin my career. And it preserved my memories. A true privilege few trauma survivors have.

This blog helped me recover from my PTSD. It helps me still. The core of PTSD is shame. The only way to battle shame is to speak your truth. More specifically, to have someone hear your truth. And not walk away. It is a small little blog with a small group of followers, and I am grateful for each and every one of you. You are a precious gift to me on this my 38th birthday.

It surprises me how I begin to write these entries with a problem and think to myself “Why are you dwelling on this problem with no solution? Cut the pity party.” And I start to write and by the time I am done, I have found an unexpected solution or a new way of looking at it, or have found a path to accepting it as it is. It makes me wonder if anyone can recover from PTSD without creating something. Trauma is the opposite of creation. It is destruction. It is the Fall in the Garden, the closing of the gate. What is it that Eve suffered for the Fall? Pain in childbirth. Pain in creation. But she did not lose the ability to create new life.

There is a certain pain to my writing now that wasn’t there when I was younger. Before my trauma. Before I had my first little boy and was told he was sick at 6 days old (and on the 7th day God rested. I cried the deepest cry I ever have while God rested. He and I are still hashing that one out). Before. But there is still this gift of the ability to create, as God does. And there is a healing in it. And a connection. Maybe not to God so much, but to other people, other survivors–not just of trauma, but all the sad things we live– to time, tradition, cyclical history. And a connection of ideas, of the points of my life, of the people who’ve passed in and out of it. Maybe, just maybe, if I keep writing, it will all make sense. The connections will be drawn, the pattern will show itself. There will be an answer.

I made a big batch of smoky vegan collard greens today for lunch. I made a lovely kale strawberry smoothie for breakfast. I took my medication. I exercised. The day was still utter chaos. I was still pretty damn grumpy for most of it. But I still ate my greens. I did not resolve my ongoing spiritual struggle over the nature of God (he can’t be all loving and  all powerful, so he mustn’t be all powerful so… where the hell does that leave us?)  But I still ate my greens. I was a highly imperfect mother and wife. But I still ate my greens. I was lonely for a lot of reasons. But I still ate my greens.

And so, the house came to smell of sickness and collard greens on this my 38th birthday. But it was 74 and breezy and so we opened the windows and doors and aired the place out. Took the baby out in the yard barefoot. Walked down to the public dock and watched the water. Hung pink streamers and balloons and had a little party. Watched a cheezy terrorist movie starring Morgan Freeman with my husband with the volume down and made up our own dialogue (lip reading did reveal Mr. Freeman called one of the characters “son” as I predicted he would). Spilled some wine on the couch and laughed about it.

We aired the place out because, as I realized shortly before my 29th birthday, I am not in prison. I am alive and I am free. This is not a cell without windows. The sun is not kept from us. And I am not alone. I am eating my greens and cleaning up the messes as they come. The stuff of life. 38 years alive. Booyah.

The World is Coming to an End

27 Sunday Nov 2016

Posted by in kids, love, marriage, my awesome husband, parenting

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My husband is a filmmaker and he made our wedding video. I am blessed like that. He edited it, picked out the music and even hired an animator to make an animated version of the highlights of our relationship. Impressively, he did this while broke and during a really painful separation I had instigated. #MaritalSaint.

We watch it from time to time and we had been meaning to sit and watch it again for the past few months now. Our daughter Lena loves weddings and kept asking when we would watch it. We finally carved out some time to watch it last week. As Lena sat oohing and ahhing over my pretty dress and the “beauuuutyful flowas,” I found myself crying. Which was odd. You see, I am not a crier. I mainly cry when

  1. flooded with pregnancy hormones
  2. when extremely exhausted or
  3. when extremely depressed and heading into a panic attack. When it feels I am falling into the blackness and my world is coming to an end.

I cried several times during the video despite not wanting to do so in front of my sweet, very empathetic Lena. Unlike my boys, she notices any time I am sad or angry. Sometimes she notices before I do. #HighFunctioningAutism. And unlike the boys, I can never lie my way out of it.

I cried as we watched my father give me away and when my nieces walked down the aisle as little flower girls. My wedding was really the last time I saw my sisters and my nieces. I have since then physically seen them a few times, but it was a hollow, awkward exercise. It only served to remind me of what I’d lost.

I watched my two nieces in their pretty little dresses walking down the aisle. The older one was 6 1/2 and the younger one 4 1/2. Smiling and sweet. At the reception the younger one danced with abandon and ran around, often times chased by her father trying to get her to do something. She was quick and evaded capture often. As I watched them, I realized they will forever be caught in this age in my mind. They will never age. Forever sweet, spunky little girls.

I saw them for the first time since the wedding (the first time in 5 years, in 60 months, in 1,825 days) this past summer. 11 1/2 and 9 1/2. They were hard to recognize. They looked so much like their mother now. They looked so grown up. They did not talk to me or my boys.

My boys, especially the Axe, had been asking to see them for five years. He never gave up. He couldn’t understand why he wasn’t allowed. I didn’t understand either and couldn’t figure out how to explain it. I told him, my sister is mad at me and doesn’t want to see us. He asked why she was mad and I said, I don’t know. Because I don’t.

Now, they were strangers.

My sister gave her older daughter my name as her middle name. Because I had helped her through her very long, very difficult, downright heroic labor. It meant a lot to me. An overwhelming lot. I wonder now what she tells her when she asks where her name came from, as I often asked my mother when I was a little girl.

I cried because I will always miss them. Because they will forever be little girls in my mind even as they grow. And that is a very sad thing, to never grow up.

I cried too to see my parents. My father giving me away.

“Who gives this woman to be married?”

” I do.”

But they didn’t really give me away. They couldn’t bring themselves to let me go. They couldn’t stand the thought of letting me grow up. I was forever a little girl to them. *Their* little girl. They could let no one take me away. It did not occur to them I was choosing to go away, that no one was taking me. In their mind, I was theirs and now he was taking me to be his. After all, a little girl is not able to make such decisions.

If they’d let me go, I would have. I really did want to marry my husband and have a home of my own. Every time I’d left my home as an adult I always came back. I went away to college but then transferred to the local school and lived with them. Then I met my first husband and moved away with him and got married. But then I divorced him and again lived with them for four years during medical school. Then I met my forever husband and moved away again. If they’d let me go, I would have stayed with him. But they couldn’t and I didn’t. I left him twice. I left him in a sudden, jarring, couldn’t see it coming way. Twice. And each time returned to them. The first time I physically moved back in with them. The second time, only emotionally so.

And a man shall leave his parents and cleave to his wife. No mention of the wife in that one.

My husband would say to me I was too attached to my family and our marriage wasn’t going to work until I grew up and left the nest and learned to put my kids and marriage first. I kept insisting I had and offered up various bits of evidence to support the patently untrue assertion. He was never convinced.

They had made clear while we were dating they didn’t like him. My sisters broke off with me after the wedding. My parents remained and put up a show of liking him. When I left the first time, it was at my family’s urging and we sat discussing their true feelings about him. When he and I attempted to reconcile shortly after the separation I kept it a secret as I knew they’d be upset. I was right. When they found out from reading text messages on my phone, my mother kicked me out. Me and my three kids. Me with nowhere to go. I remember calling my oldest sister crying uncontrollably, panicking, terrified. Terrified because I had nowhere to go but mostly because when this side of my mother came out, I felt that black hole feeling. That I was being sucked into the abyss. The world was ending.

Our mothers are the source of life. They are supposed to be the safe womb we can always return to in times of distress. Mine was not. It was in times of distress she was most likely to turn from a seemingly sweet cookie baking, nurturing mom to an ugliness words cannot describe. A cold hate would flow from her and destroy me. My world spinning around me, closing in on me, suffocating me into non-existence.  I would go from being a sacrificial devoted mother in her eyes to a crazy, unfit mother who put men before her children. She would threaten to give my ex-husband money to get a lawyer and take my kids away. Crazy. Unfit mother. Woman who puts men before her children. These were the things I feared most. These were the demons that haunted me. Was she right? Is that who I truly was? That doubt, that possibility, was an endless source of shame deep within me.

You never really knew when she would turn. I grew up in a minefield. Trying so hard not to set her off. And always failing.

I remember going back to my bedroom, the room I had slept in all my life, that I had returned to once again, and calling my husband. Speaking in hushed tones and sobs about my mother kicking me out. He couldn’t understand what I was saying. I was terrified for my mother to hear me so I spoke quietly and ended the call quickly. He had no idea what had happened.

My mother soon summoned me to the living room with an offer. She would not kick me and my babies out on condition that:

  1. I send my two boys to live with their father as she did not have the energy for them. My daughter could remain and she would watch her while I completed residency and
  2. I was to cut off contact with my husband. Any time we met for visitation with our daughter, I was to be chaperoned by my father. They didn’t want my manipulative evil husband sucking me back in. After all, I was just a little girl and easily tricked.

I agreed, so scared. I cut off all contact with my husband without even explaining why. They soon rescinded the demand I send my boys to live with their father, but not the second. We met for visitation with my father awkwardly standing with us. My husband brought me gifts, sweet gifts. A CD he’d made me. Sweet, thoughtful gifts and cards. My family rolled their eyes and laughed. How could he think gifts would make up for what a horrible person he was?

In time, I began communicating with my husband again and we decided again to reconcile. This time, I knew I couldn’t let them find out as we prepared, finding a house to live in and meeting as often as we could (he was living 3 1/2 hours away). My parents rarely left the house, but in August there was a family reunion they would be at for a few hours. In those few short hours we packed up my belongings, disassembled my boy’s bunkbeds and moved all of it out to the new house, an hour away, where I was completing residency. I left them a note saying goodbye.

Their little girl had once again been stolen.

In time, I unpacked the dysfunction of my family in therapy. I began slowly to set boundaries and view my family and my childhood for what it was. I realized there was no emotional intimacy. I realized I had been raised to trust no one but the family. I realized how afraid I had been all these years of my mother disowning me, as she had other people in her life. I realized my mother and I were enmeshed and yet not close at all. Not in the ways that matter.

I left my husband again this past summer just as suddenly, just as secretly, just as heartbreakingly. We reconciled again. And my parents said they were fine with it, but began to punish me in subtle unspoken ways. But still I kept them in my life.

The breaking point came a few months later with the dog incident I have explained in previous posts. I found after I broke with them, my marriage was suddenly so much better. My opinion of my husband so much better, my love for him unconditional. I was not expecting this. I came to see all the subtle ways they had undermined our marriage while, on the surface, appearing to be supporting it. How incredibly cruel. To me and to my kids. Crazy. An unfit mother. Projection.

I no longer have my family in my life and so I cried as I watched my father giving me away in my pretty white dress. They say in Catholicism that we are not waiting for the world to end when Christ comes. The world ends many times in our lives. When we get divorced, get a bad diagnosis, lose a loved on. It ended for me when I found out my son was sick at 6 days old, when a guy I’d been in love with broke my heart, when my medical school tried to ruin my career for turning in a child molester. The world ends but a new one begins. It prepares us for death, they say. For it is in dying that we are born again.

My world has come to an end once again as it has before. But this time I can see clearly the new world that has been created in its place. My children growing up healthier and happier than I, my marriage finally solid, my body and mind stronger than they’ve ever been, my connection to God growing.

They couldn’t give me away and so now I have left of my own will. I am not a little girl. I have grown up.

food is not love ( or: Hail keystone party mix, full of carbs…)

12 Saturday Nov 2016

Posted by in kids, love, parenting

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I’m working a lot of days this week. 6 out of 7 days. Which when you work 12-13 hour days, is a lot. For me and for my kids and husband. #UrgentCareLife.

I needed to prepare for this by making freezer meals for both this hellish week and then the week after since I’d have no time to make *those* meals as I normally would the week before. Because I’m working 6 out of 7 days this week. Did I mention I’m working 6 out of 7 days this week? It’s kind of awful.

I was making a new recipe for the freezer. One I had never attempted before: chicken cacciatore. As it was simmering, I thought of my childhood, of my grandmother’s house. She used to make chicken cacciatore. She wasn’t Italian; she was a farm wife whose people had come from Scotland and England like the people of Appalachia tended to have done. She always cooked from scratch. Three meals a day. No sandwiches for lunch. It was boiled potatoes and pork chops and sliced tomatoes and fruit and… Something was always cooking, the scents hanging in the house when you walked in the door. She wasn’t much into baking so when we would walk the mile down the road to her house on hot summer days to go swimming in her pool, she would bring us Keebler Soft Batch chocolate chip cookies as a snack. Something we did not get at home. Something we absolutely loved.

I thought back on the chicken cacciatore she made as I watched mine coming along. I felt my heart warming to think mine was turning out as well as hers. And then I thought, my Grandma never seemed to love me. I mean, I’m just being brutally honest here. It sounds awful, but I come from a dysfunctional family where I just had no emotionally intimate connection with anyone. It astounded me when I grew up and found out how other people felt about their grandparents, the close bond they shared. Not so with me and mine. I had just assumed that’s what a grandchild-grandparent relationship was *supposed* to be like. Turns out I was wrong.

So, why was the chicken and peppers boiling away in our cast iron skillet making me feel all soft and gooey?

I thought back on my grandmother’s chicken cacciatore and my mother’s snickerdoodle cookies. The peanut butter bread my mother made for us with raisins that made a smiley mouth and two mini marshmallows for eyes. The trips to McDonalds with my mom when my sisters were at school, just me and her. I told myself that food was her way of showing love. But it wasn’t. It was the desperate attempt of a little girl to believe her mother loved her in a way she definitely did not. Children are completely dependent on their parents for their very lives. They have to believe in them, in their love. And so I found a way.

What I didn’t realize until that moment in the kitchen next to the hot stove with the chicken cacciatore wafting into my pores, is that it wasn’t love at all. It was just food. And for all these 37 years I’ve been alive, I have comforted myself with food because, to me, it is love. Not a symbol of love, not a sign. It is literally love. When you’re upset, you should be able to go to your mother to be comforted. I never could. But I could eat chocolate. I could pour my sadness out to Little Debbie cakes and my anger into Doritos.

If your parents don’t comfort you when you’re young, you never learn to comfort yourself. Not in a healthy way, anyway.

For me, food has been my answer to sadness, worry, uncertainty, joy, anger, boredom, frustration. It’s been my self care and entertainment. It has been my secret, my rebellion, my hiding place, my distraction.

I remember being 10 years old in 4th grade and we had to all cross the road to the YMCA and take swimming lessons. I felt horrible about my body. I thought my thighs were just massive. I couldn’t stand the thought of being seen in a bathing suit. I’d never been made fun of. But the idea was there because of what I heard discussed at home as well as the messages we get in our culture. I began looking for excuses not to participate. I would forget my clothes on purpose. Say I wasn’t feeling well.

There was a vending machine at the Y that we were forbidden to use (this is in the days before there were vending machines in schools). I used to try to be the first one out of the locker room after class so I could quickly deposit my quarters to get a snack size bag of Keystone Party Mix. A compilation of pretzels, cheese covered tortilla chips, barbecue corn chips and cheese doodles. I would hide it away in my bag and save it for later. I would take it back to my bedroom and eat it in secret.

My parents found out I was missing swimming class and sat me down and asked me why. Was someone picking on me? No, I answered honestly. But I knew I couldn’t tell them why I was really skipping class. An unwritten, unspoken rule of the family. Don’t have negative emotions. Don’t expose your vulnerability or they will pounce. Everything. Is. Fine. And so I said what I was supposed to. Made up some unbelievable excuse which they readily believed. Everything. Is. Fine. After all.

My Keystone Party Mix comforted me. My Keystone Party Mix was the secret I kept from them. It was mine and mine alone. A protective wall. The more they know about you, the more they will hurt you. Reveal as little as possible. Protect yourself.

Hail Keystone Party Mix, full of carbs, … protect us, Mother.

That was the beginning of it. This is the end.

I know I deserve more now. I deserve love. And food is not love. I am finally able to eat healthily and be happy. I am able to comfort myself without turning to cake. I can get angry with my husband and not stop off at McDonald’s on my way to work for a Sausage McMuffin. I can make it through a boring, frustrating day at work without noshing on candy all day. I can stop after a handful of chips or a single brownie, because I am not empty and searching. I hope I am giving this to my children too. The ability to sit with the hardships of life, to turn to people who love and support them, to know they’re worth more.

I do cook for my family because I love them. I work urgent care for them and clean for them and kiss boo boos too. But I do not offer food as a substitute for love and compassion, emotional validation and open, safe, discussions. Sometimes our family *isn’t* fine. Sometimes we’re a wreck. No, like, a flaming tire fire kind of wreck. And that’s okay. It’s life. It is what it is. We all have permission to feel whatever it is we’re feeling at that moment. We’re allowed to have boundaries. I hope they like my cooking and the birthday cakes I make them, but I hope that’s the least of what I mean to them. They deserve more.

 

Better Living Through Science

21 Wednesday Jan 2015

Posted by in autism, doctors, empathy, kids, medicine, parenting, Sin, special needs

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I’ll admit I spend a good amount of time on Facebook. I like to see what politcal/social justice type things my friends from college are up to. I like to post pictures of my kids for distant friends to see. Sometimes I’ll take one of those quizzes: Which Golden Girl are you? (I got Rose, in case you’re wondering. I was really hoping for Dorothy but I guess I haven’t matured to her level of sass and pith quite yet). One thing that dominates my feed is posting from my fellow doctors and nurses bashing parents who don’t vaccinate their kids. And yes, I mean bashing. I don’t mean expressing concern for their children. I don’t mean seeking to find ways to turn the tide of increasing numbers of people not vaccinating their kids. I mean, bitching about them and how they’re screwing up herd immunity for the rest of us because they are bad people who ignore science.

I have issues with this.

Ironically, these people of science are not being scientific at all. The whole argument is that these crazed non-vaccinators are ignoring science. They’re irrational. They’re backwards. They’re stupid. They’re ignorant. The problem with this argument is that the accusers here are ignoring the fact that *they* themselves are not being scientific. Let’s look at the facts:

-By and large, non-vaccinating parents are highly educated with average to above average intelligence. That’s what the research shows us. Most of them have read everything their doctors have read and come to the decision that it’s not compelling evidence to them for one reason or another. So, calling them stupid or irrational simply isn’t accurate.

-Most parents who do not initially vaccinate will vaccinate their children within a few years. The vast majority of patients questioning vaccination cite their doctor as their most trusted source of information. But here’s the rub: the research shows that if their doctor comes at them with the attitude most doctors hold, these parents actually become *more* likey to not vaccinate. What has been shown to work, scientifically, is for physicians to engage in respectful, open minded dialogue with them and not engage in scare tactics etc.

We have an obligation as physcians to pediatric patients of these parents and also to the greater community and society. We’re tossing aside evidence based medicine and compromising both with our attitudes towards these parents.

Why? Basically because this topic makes most doctors really really mad. And we allow really really mad to get in the way of our obligation to these kids. We find it emotionally comfortable to get angry and make it into a moral failing in these parents. Some of it is righteous anger in defense of community health. Some of it is control issues. We don’t like it when patients don’t do what we say. We got into medicine to help people and now they’re not letting us help them. Maybe it makes us sad to see them hurting themselves. Maybe it pisses us off they’re messing up our plan.

I was discussing a law recently with some fellow residents that I read about going into effect recently in a southern state. They were starting to arrest mothers who did illegal drugs while pregnant once the babies were born. Two of us thought it was a terrible law because addiction is a disease and criminalizaing it really wasn’t the answer. Putting a baby’s mother in jail soon after birth is incredibly obviously not good for a baby. Knowing she’ll go to jail if she delivers her addicted baby in the hospital will inevitably lead to some of these mothers delivering their babies at home and not getting proper medical care. They’re certainly going to be more likely to lie to their physicians about what drugs they’ve been doing. The resident in favor of the law was adament that these women must be punished. They’ve harmed their child and they must be punished. The fact that this law was only going to hurt these babies further was not the issue here. Addiction was not a disease, it was a moral failing.

The truth of it is, it is simply easier and more satisfying to write these non-vaccinating parents off as kooks and lost causes. But if you truly believe not vaccinating their children (your patient) puts them at risk, you have a moral obligation to not write them off as a lost cause. You are that child’s advocate. You are a physician practicing evidence based medicine. So act like it.

Parents who are simply questioning vaccinating may or may not know much about it. So, guage how much they know and offer them education in a respectful way. Talk when appropriate and listen when appropriate. Don’t engage in scare tactics. Show them some compassion. This will maximize the chances they will vaccinate today or soon therafter. In case we’re not clear on this: making them sign a release recognizing they’re placing their child’s life at risk by not vaccinating is not productive in this regard.

Some parents are at the point where they are refusing to vaccinate and have probably read up on a lot of what you have to tell them about vaccine safety and efficacy. If you can tell they’re already familiar with the information you have to offer, it’s time for you to sit and listen. Ask them why they don’t want to vaccinate and listen respectfully and compassionately. If they’re open to your responding, then go ahead and respond. If they’re not, then thank them for sharing with you and let them know you truly believe vaccination is the best thing for their child and that you hope the dialogue can be kept open at future visits.

If the above approach chafes your chaps, if it seems just plain wrong, that’s a perfectly valid feeling you’re having; but it certainly isn’t scientific.

Instead of reading self-congratulary after self-congratulatory article on how awful these non-vaccinators are, you’d be better served to read up on why parents make that choice. Better yet, try talking to a few of them. As a mom of a child with autism, I can tell you there are plenty of parents in that community who would be more than willing to talk to you about it. Step back from the moralistc thinking and consider all the psychological and social reasons parents might have to make this socially unpopular choice. What life experiences have they had that have led them down this path?

One thing I try to stress to my interns starting out in residency is that there’s a place for book knowledge but most of what you need to know about being a good doctor comes from experience. Your experience as you go along and learning from the experiences of the doctors teaching you who’ve been at it so much longer than you. If you’ve seen a child suffering from a vaccine preventable disease, you’re most likely eager to share that with your patients. But, you’re better off trying to find out about their experiences affecting this decision. Scientifically speaking.

One common misconception amongst the American public that upsets physicians is the idea that vaccines cause autism. How can so many people believe this stil?! It’s been scientifically disproven! Heck, it’s even been anecdotally disproven in the case of thimerosol. Let’s get rid of the exclamation points and ask that question for real. Why is it that people still believe all vaccines or MMR or vaccines containing thimerosol cause autism? Is it all due to that villain Dr. Wakefiled who published that now discredited study in the Lancet? Has he mesmerized these foolish parents? Or could there be a more logical explanation. Perhaps one explained by medicine?

Let’s set aside the vaccine facts for a minute here and consider some facts that are at the core of every family’s life who has a child on the autism spectrum:

1. Doctors do not know what causes autism
2. They’re pretty sure it’s a genetic predisposition that gets triggered but they don’t know what’s triggering it
3. But they’re pretty sure it must be mulptiple things because they can’t really find any one thing these kids have in common
4. Doctors have no cure for autism
5. Doctors don’t even have a very good treatment for it
6. Most PCP’s don’t know nearly as much about autism as an informed parent. As PCP’s, we’re generalists and it’s not something stressed in med school
7. The rate of autism keeps climbing and the truth of it is, scientifically speaking, we don’t really know why

Can you honestly tell me a parent in this situation would be irrational to question things that are dogma to modern medicine such as vaccines? Modern medicine has failed them. What they need from you is not a lecture or an anecdote of what can happen to unvaccinated kids. Assurance of the rarity of adverse events from vaccines (and yes, there are rare but quite serious effects at times) will not comfort them. They need their trust in medicine restored. And that begins with you, the PCP. I say begins because it is a process that can’t be rushed. You have to sit with them, sit with the uncertainty and anger and helplessness that comes with special needs parenting. You need to show them their child is your patient who you care about. That you see the challenges and the joys of their life. To show them that this isn’t about a battle for control. That you want what’s best for their child. And that you’re open to learning from them. That it really is a dialogue and not a lecture.

Only 1% of parents in Pennsylvania choose not to vaccinate their child, but the lessons we can learn from this issue will make us better doctors in a lot of ways. And better people for that matter.

Listen. Empathize. Validate. Assert. Repeat.

I often tell my kids: it’s okay to get angry. It’s not bad to feel angry. But when we get angry, we have to make good choices of what to do with that anger. I think we could all stand to hear that on a regular basis. So, my fellow physicians: it’s okay to get angry about vaccination. It’s not bad to feel angry. But you need to make good choices.

You’re a physician practicing evidence based medicine. So act like it.