Category Archives: Sin

Lassoing the Beast

24 Friday Apr 2020

Posted by in christianity, empathy, Evil, kids, love, marriage, medicine, my awesome husband, narcissism, PTSD, Rape, Sin, Uncategorized

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

golden lasso

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

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

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

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

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

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

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

pemphigus

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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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

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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

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

12 Monday Aug 2019

Posted by in doctors, Evil, kids, medicine, outrage, PTSD, Rape, Sin, Uncategorized

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

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

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

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

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

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

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

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

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

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

Until then, rape culture will thrive

05 Saturday May 2018

Posted by in PTSD, Rape, Sin

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A few things have happened in Pennsylvania recently that we should find encouraging. Bill Cosby was finally found guilty of sexual assault and two friars were charged for protecting a priest who they knew was molesting children. The near complete absence of legal consequences for rapists and those who stand by and do nothing about them is horrifying. That it may slowly be changing is a victory for activists. I felt a swell of hope when they announced the Cosby verdict. I belted out some Kesha on my drive home and cracked open a cider as I told my husband the news.

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But as this tide shift begins, there are certain things that must be said.

I have been seeing patients in my office for medical marijuana certification these past few months since Pennsylvania’s first dispensaries opened. It is amazing work to do. I hear so many heartbreaking stories of patients not only suffering illness but being abandoned by the medical system, struggling to hold onto hope. Their diagnoses range from cancer to pain to ALS to autism to seizures. And PTSD.

As a certifying physician, I am simply assessing if a patient has one of the 17 qualifying diagnoses Pennsylvania has designated to receive a medical marijuana card. As such, patients bring records from their treating physician and I use those records along with a history and physical exam to determine if they do indeed have the condition and are appropriate for medical cannabis therapy. They come to me because their physician either doesn’t believe in cannabis or, more often, recommends it for them but cannot certify them. A physician in Pennsylvania must go through a special process in order to be able to certify for medical marijuana and many physicians are reluctant to do so for a variety of reasons.

When I see a patient for PTSD I ask them about their symptoms, what other treatments they’ve tried, how long they’ve had PTSD and how its changed over time, and what their treatment goals are for medical marijuana. I do not ask them for the details of their trauma. It’s not medically necessary for what I am doing with them and just as I’d never perform an unnecessary pelvic or rectal exam, I am obligated as a physician to avoid being unnecessarily intrusive on a patient. If you’ve lived trauma then you know talking about it can be a more vulnerable and difficult procedure than an internal exam.

Still, patients often tell me their stories. I hope it is because they feel safe with me. I hope it helps them to speak their truth to me. It certainly helps me to hear their stories. It makes me a better physician and a better human being.

For the most part, I just listen. There are rarely words powerful enough to reflect back to them what they have just told me. I know it and they do too. Trauma is a language like no other. Sometimes I say to them, that’s horrible. I can’t imagine. I’m so sorry that happened. Sometimes I just listen and look and they know that they’re heard and that’s what matters.

I say nothing here of anyone’s story. Of any specifics. Anonymous or not. But I will tell you, dear reader, that something has surprised me. After spending all these years learning about trauma, thinking about trauma, writing about trauma, speaking to other rape trauma survivors, I have taken something new from it.

Many of my patients have gotten PTSD from being in prison. I wasn’t expecting that. And it makes me think of Jeremy. There was a time in my trauma healing process where I savored the idea of him being attacked in prison. I’m not proud of it but I do accept it as part of my journey through PTSD to the other side. It is not something I allowed myself to get stuck in. I believed before I ever met Jeremy in the importance of the corporal act of mercy of visiting the imprisoned. I recognized the inhumanity of our criminal justice system. And that wasn’t something I was going to let Jeremy take from me.

th37HGTF0J

I cannot imagine how hard it would have been to let this idea go if I hadn’t been one of the extremely rare few whose attacker actually gets prosecuted, found guilty and imprisoned. I have a safety and a sense of justice that is almost unheard of (even in the case of convicted rapists, it is rare they get the 45 year sentence that Jeremy did. I need not worry about the day he gets out and comes for me. I did not face the indignity of him getting a slap on the wrist sentence). Letting go of anger and the desire for vengeance when justice is denied seems almost impossible.

What I cannot excuse or validate is the similar sentiments expressed by those not involved in a particular perpetrator’s trauma. We have all heard and seen on the interwebs the comments of so many people when someone is found to be a rapist or child sexual predator. They make comments, some purely serious and others sickly comical, about the fact they hope the perpetrator will be raped in prison. An eye for an eye, a rape for a rape.

It perpetuates the idea that prison is a place where the “regular” prisoners will institute vigil ante justice and give these deserving sexual predators their come-uppance. Not only does it violate morality in its wishes for violent harm of the sexual perpetrators, it presents a narrative of prison where those who’ve committed so called victimless crimes are seen as being free from being targets of violence. Prison is a macho sort of wild west where unsavory elements make up for their crimes by using their lack of obligation to societal norms to take care of the dirty work of making these rapists pay appropriately. They atone for their sins and satisfy out blood lust in one fell swoop.

The reality is that prison brings trauma to every prisoner whether they’re their for drug possession, repeated DUI, writing bad checks or murdering their mother. And the reality is, most prisoners are there for something like drug possession or writing bad checks and end up being punished not with time away from their families, home and work, but with assault, both sexual and non. They live in a constant state of fear and hypervigilance. They suffer violence, witness violence and are forced at times, in order to survive, to perpetuate violence. This is something those of us who’ve experience protracted trauma can identify with. This is trauma. This is hell. And no one deserves it. Not even rapists and men who kill their mothers. And certainly not twenty year olds who made a stupid decision and got caught (I speak not here of rich white twenty year olds who make stupid decisions. They don’t go to prison). Their sentence may only be a few years but the PTSD lasts the rest of their life. It is not moral. It does not benefit society. And it deadens all of our souls as a culture for perpetuating this brutal system.

When you call joyfully for anyone to be raped, whether they themselves are a rapist or not, you are promoting rape culture. You are ensuring little girls will go on being raped. I realize it makes *you* feel better and that’s just great because it’s all about you, but you sacrifice the bodies, minds and souls of little girls and boys and women and men.

No one deserves to be raped. Period. Ever.

We do need justice for survivors in this country. I am glad that Bill Cosby and these friars and Jeremy Noyes will be held accountable and it is vital for ending rape and for providing survivors what they need to heal. Prison as we have it in this country, however, is not the answer. When will we establish a humane justice system that truly serves victims and keeps us safe as a society? Until then, rape culture will thrive.

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.

I have slept in the bed with evil

09 Wednesday Nov 2016

Posted by in autism, Evil, PTSD, Rape, Sin

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I am wearing all black today. I am in mourning. I am not going to make a joke about my goth days in high school. I am not going to compare the title of this post to that awful made-for-TV movie from the nineties starring Tori Spelling, “Mother May I Sleep with Danger.” This is no joke. This is not a nightmare we will wake up from tomorrow, a bipolar fugue we will not remember when it ends and we find ourselves far from home. It may be the 1930s.

I do not use the word evil lightly. A lot of people have referred to Hillary Clinton as evil in this election cycle. I am as big a critic of Bill Clinton’s policy and Hillary’s record on free trade, her foreign policy, and her “super predator” comments as anyone. But she’s hardly evil.

For four months, I slept in the bed of a man who can rightly be called evil. A man who loved raping and torturing little girls above all else, who admired Hitler, who raped me again and again and again and threatened to kill my children. A man who disturbed even the seasoned federal judge and the FBI agent who were involved in his case. He was a medical student on his way to becoming a doctor. Nobody suspected. None of us even knew such evil existed as it all came out, certainly not that our fellow medical student possessed the evil.

Trauma changes you. It changes your relationship with yourself, with your family and friends, with God, with the world itself and every person you encounter day by day. They say the fundamental experience of trauma is the feeling you have been abandoned. By the people you love, by the ones who were supposed to protect you, and by God himself.

My Ordeal changed me in so many ways but one of the worst was the knowledge of just what evil exists in our world. Evil I did not know existed. And I had not lived a sheltered life to that point. I was not naïve. And yet I was. My fear now is that we as a country are being naïve. Despite our very violent history.

We cannot underestimate the possibilities of this new world. We cannot afford to be naïve. I do not know what will happen but I know it could be very, very bad.

A few years ago we were at a festival at a place called City Island in Harrisburg. Our three sons went off on their own while my husband and Princess (still a baby) and I stayed and chatted with some friends. Eventually two of our sons came back, but not the third. Our legally blind, autistic son was not with them. They told us they’d had some kind of fight with him and decided to leave him. They were too young to know not to do this. Too naive.

My husband and I split up to cover the island looking for him. And as I looked in booths and the dense woods that framed the island, pushing Princess in the stroller, terror went through my body. My mind went to Jeremy. To the people he talked to on the internet who also loved raping and torturing children. Who sent him images of their horrific acts, recorded in stills and movies. The ones presented at trial that took any remaining innocence from anyone in that courtroom. I cried as I looked. I pictured what might happen to him. Things that are worse and more common than we allow ourselves to believe. I didn’t want to scare Princess, but I could not hold back the tears. My husband found him and I ran up to him, shaking and crying and finding it hard to bring the oxygen into my lungs.

I do not know how so many people at Penn State stood by while little boys were raped and did little or nothing. I will never comprehend that. The coaches, the janitor, Mike McQuery whatever the hell he was. I could have been killed. My children could have been killed. I laid down my body. I laid down my mind. I lost seven years of my life to PTSD. So did my children and husband, lost seven years of me being truly present in our lives. I have no regrets and never have. Not for a second. But I know the men of Penn State are much more common than people like me. And this election confirms it.

Evil can flourish, slowly, insidiously. I see friends who loved Bernie so much now so glad they voted Trump. I can see the mainstream Republicans now falling in line or being eliminated (we’re assured by Trump’s people the are making “a list” of “his enemies”). I can see the inevitable persecution of journalists and violent crackdown on peaceful protests. Hate crimes and sexual assault rates rising (if you don’t believe me, look at what happened in the aftermath of Brexit). Muslims forced to wear badges identifying them (yes, Trump said this).

You think I exaggerate. You think this couldn’t be the 1930s. And I hope you’re right. But I know in my bones you probably aren’t.

God bless and protect the Union.

 

The demons they won’t fight

14 Friday Oct 2016

Posted by in empathy, love, Sin

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When I was fifteen, I met a wonderful, intense, intelligent. creative, amazing, intoxicating group of boys who made me feel so alive. They swore and smoked cigarettes and drank beer and smoked pot out of a Coke can bowl. They were nothing like me. I was a quiet, shy girl who’d never sworn or done anything else good girls aren’t supposed to.

I spent the next three years with them, going on adventures always exciting and sometimes terrifying. They introduced me to William S. Burroughs and Jack Kerouac and E.E. Cummings. To grunge and industrial and Irvine Welsh and surrealist art. We were so intensely alive. In love. All of us.

They also did a lot of drugs during these years. I did not. I started to swear, I’ll admit, but I wasn’t into drugs. I was the permanent designated driver for three years straight. I was into political activism and applying to college and various other positive activities they thought were a waste of time. They started out with just pot and beer. They made fun of stoners and burnouts. Kids who did heroin and crack and too much acid. But by the end of high school, they were the kids doing crack and meth and tripping on shrooms.

One didn’t graduate. Another dropped out of college the third day. Another dropped out a year or two later. They all descended into more and more drugs and alcoholism. I would see the poetry and genius in them every now and then but it became less and less common. I knew they were in there somewhere. Somewhere. Deep inside.

I wanted to help them. Wanted to save them. I tried. They knew they needed to change and they would try every now and then to quit. They would try giving up beer and just drinking liquor. Giving up pot and just drinking. Giving up alcohol and just smoking pot. Giving up cocaine and just taking pills. It never worked.

I felt bad for them. I knew there was a sadness in them so deep and so wide. They were trying to fill it with drugs. I wanted to save them from that darkness. They were capable of so much. I loved them so much. But it wasn’t enough.

I realized one day that they loved drugs more than they loved me. More than they loved each other. Maybe it was the night they let one of their friends die from an overdose rather than dump him at the ER because they were afraid of getting caught and I was the only one who seemed to care. Maybe it was no special day in particular. I looked at them and knew. Knew they loved drugs more and it was time to let them go. As much as I loved them, they didn’t really love me anymore. You can’t save someone who doesn’t want to be saved and all that. It was time to let go.

People criticized me for it. Said I should have helped them more. How could I abandon my poor lost friends like that. And I’ll admit it made me sad at the time. But I never regretted doing it. Never regretted saving myself. Never doubted the fact that they would never change.

A time like this comes to all the relationships we end in life. The day you figure out the person you love, loves something or someone else more than they love you and that’s not all right. You stop asking, do they love me or not? They do, but not enough. They do not love you more than their dysfunction, the demons they won’t fight.

When you let them go and with them your guilt, you are light. You are free. You have fought the good fight and given them your best. And now you are free. For better things.

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.

Better Living Through Science

21 Wednesday Jan 2015

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

≈ 2 Comments

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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.