June 19, 2008 (or, Tequila!)


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It was raining this morning as I headed out for my run. Ten years ago on this day, though, it was hot and sunny. I know this because I can remember the beads of sweat rolling down the back of my legs as I sat in my green minivan in that long, heavy, black Land’s End skirt I’d bought on clearance a few weeks before. My air conditioner was broken and the van churned out warm air as I sat staring down at my phone.

I’d programmed the phone number for the Pittsburgh field office of the FBI into it a couple months before under the name “Hope.” It was finally time to call. I knew he might kill me. Knew he might kill my two boys. Mies had just turned 4. Max was 2 1/2. I asked God to please protect them but told Him if something happened to them, I knew it just was what it had to be. I had to turn him in. I could never face my babies again if I didn’t. I didn’t want them to live in that kind of world. Abraham, I am feeling you, brother.

I operated purely through adrenaline at that time. Until he was arrested in August. And released on bail to a local podiatrist. And jailed again since he, ya know, had threatened to kill me and my kids and all. And then as I fought to stay in school as my med school slut shamed me and tried to get rid of me. Once the adrenaline stopped flowing continuously later that Fall, the real hell began. PTSD.

I wanted to give up but I somehow got to a place where I told myself, this isn’t it. Someday things will get better. You will watch your babies grow up. You will become a doctor and take care of your patients. You might even get married and have more babies. Maybe a daughter. Maybe. I fought off the hopelessness. I convinced myself there was possibility.

Here I am ten years later. With five beautiful kids (including a sassy-sweet daughter). With a handsome, devoted husband. With a practice of my own, complete with amazing patients I care about more than I knew I could. Healed of my PTSD. Having forgiven Jeremy and even Sylvia, the head of my med school, and all those professors who betrayed me. Training for a semi-impossible obstacle course race with my husband and a trainer, for goodness sake. A trainer. More than I dreamed possible.

I am so grateful to God my babies are alive. That I am alive. That I am a doctor. That I have the husband and kids I do.

I skipped work today and drove through the country to Deer Lakes park to go running. The rain and grey gave way to fluffy white clouds and sunshine in a beautiful blue sky. I held my hand out the sunroof as I drove. I felt the sweat run down my legs from my run as I drove.I sang along to Tequila! like a fool. I’m sure I looked and sounded ridiculous.

I pray the little girls he hurt find the peace I have. I pray he does too.

I am so grateful for today. I am alive, I am free. Thank you God.


Until then, rape culture will thrive


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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.


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.


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.

No Fear in (I) Love (New York)–or, Our Lady of Perpetual Selfies



I got to go to New York this week. I love New York. Well, to visit anyway. Wasn’t so crazy about living there in grad school, but glad I did it. I feel very comfortable getting around the city when I visit now. And it stirs up a lot of happy memories.

I planned my trip carefully. There wasn’t much free time outside the conference I was there for, but I made the most of it. I went straight to Chinatown from Penn Station when my train got in. wonton garden. Go there the next time you’re in New York. Damn good Chinese comfort food.

I bought some Asian pears from a fruit stand on the sidewalk on my way there like I used to when I lived there. I took in the energy of the city. Whether you love New York or hate it, you have to admit it has a life to it that you feel in your cells.

I went to the top of Rockefeller Center before I left. I was the first one in line actually so I stood on top of New York by myself for a moment. I’m not one for views to be honest with you. it drives my poor husband crazy sometimes. He’s big on views. We used to go on hikes and get to the top of a big hill or a small mountain and he’d say, “Look at that view!” He couldn’t believe how underwhelmed I was. Guess I’m not a visual person.

I looked at the city below me and took pictures. Got some panoramic shots for my son Max. He’s a big fan of panoramic pictures. Guess he is a visual person.

I was hoping, quite cliché-ly, that going up there would help give me some perspective on my life.

I’ve been exhausted and overwhelmed lately, Taking in the suffering of addiction and PANDAS patients is draining sometimes. A lot of my patients have been having especially bad weeks lately.

And so has Max.

Sometimes it feels impossible. Like I’m living the Book of Job. I’m sure we all feel that way sometimes. Most of us anyway. Just one difficulty on top of another. Enough already.

It helped to get away from Verona, to spend time with a group of entirely new people, to spend some time alone too. Some calm and stillness.

Standing on top of New York wasn’t especially helpful though. Not my thing. Mountains, buildings, planes. Views don’t do it for me.

I stopped at a French bakery to get my sweetie some sweets and then on to my last stop before catching the train home. Back to reality.

I went to St. Patrick’s. St. Patrick’s is where I found God 15 years ago when I was 23. It wasn’t intentional. I went as a tourist, but from the moment I entered, it hit me. And I’ve never been the same.

I walked in now, 15 years and what feels like a few lifetimes later. I decided to pray by the statue dedicated to the Holy Family. Our family has not had peace for so long. We need peace so desperately in our house. I put my candle offering in and went to light my candle, to carry my prayers up to Heaven long after I’d left the Cathedral and headed home. But a tourist using a selfie stick and her phone to take pictures pushed me out of the way so she could extend her selfie stick over the candle and get a good shot of the statue. Really? Do you get at least a few minutes in Purgatory for that? I of course instantly forgave her and moved over to the candles on the other side and said my prayers and left my offering. I prayed for peace.

I then went to my favorite place in St. Patrick’s, the painting of Our Lady of Guadalupe. An area generally occupied by immigrants from various parts of Latin America. And me. She’s the only vision of Mary ever to appear where Mary is pregnant. So very… motherly.

Mary’s a mom so I know she gets me. So I let it all out. Told her everything while tears streamed down my cheeks and tourists walked by. I asked her for some rather specific answers, not expecting an immediate reply, but Mary’s an awesome mom and got right down to it.

Insight into who I am and how to treat my children and my patients. And insight into what is really at the heart of these things that trouble us all.

I feel renewed. Centered. In terms of my family and my medical practice. I have been living fearfully but there is no fear in love. I have not wanted to take care of myself, to be happy, because it seems selfish to take care of myself when my baby can’t, when so many of my patients and their families can’t.

It’s not a sustainable way to live. And it’s not good for my patients or my kids. I have known this intellectually for a long time. But it was always in my head, an idea unrealized, without form.

In the Catholic Church we are sensual. Protestants have formless ideas, a weekly service with a sermon that nourishes the mind. But Christ was both fully Man and fully God. We are physical creatures in this world. And so we have sacraments and incense and statues. Monks chanting and and holy water and the body and blood of Christ physically within us.

It is this smelling, hearing, tasting, touching, seeing that evokes the presence of God in us. Physical creatures seeking to know something so hard to grasp. I got up from the kneeler and looked at Our Lady one last time. I looked up at the great stone arches high above me. Took in the stained glass images of Christ and the Saints. And I felt so… protected, content, loved. Like I was home. The way a perfect home would be. What home should be. Peaceful and warm. A place you can be completely vulnerable and know you will be safe.

I realize something now. It is not that I’m not a visual person or I don’t like views. It’s that I like to look up instead of looking down. Not to see myself high above the small world below but to see the vastness of it all above and feel how small I really am. Part of something much bigger. Something very good.

No fear in love.

Fish oil and marshmallow foldovers will be served at our Gala banquet


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I had fish oil the other day for the first time in a decade. I’d bought an especially high quality one called OmegaCure for my two littlest ones who can’t swallow pills and was excited when it arrived. It is flavorless according to what I’d heard from my sources and I was hopeful I could get it past them. I made them each a peanut butter and marshmallow foldover and put a glug in between the peanut butter and mini marshmallows. They gobbled it right up. Now, marshamllows are such a treat for them it’s possible I could have put just about anything in there and they’d still have inhaled it. But I was pretty confident it was due to the true flavorlessness of the oil. The next morning I opened the fridge to get some berries out for my morning smoothie and the beautiful glass bottle of golden oil was there shimmering at me. I thought, why not put a tablespoon in my smoothie? And I did. And I drank it. I ran into the laundry room and excitedly told my husband the news.

“I had fish oil!”


“I had fish oil! For the first time since 2008!”


More laundry folding

“Ya know?”

Silence. Folding,

“Since Jeremy. I couldn’t take it because of the trauma…”

“Ok good.”

Clearly not something that broke his usual daily laundry folding routine

For me, it’s a big deal. For me, the question “why not put a tablespoon in my smoothie,” has a lot of answers.

The first time I asked that question and ended up vomiting was in 2012. I was pregnant with my daughter Lena and knew I should be taking fish oil heavy in DHA for brain development. It was even more important for me than a lot of moms because I already had a son with autism and malformation of his brain and optic nerves which meant any baby I carried was at higher risk for having issues and needed the best possible start, including fish oil, folic acid and vitamin D. I managed the vitamins fine but the fish oil did me in. When my husband asked me why I wasn’t taking the fish oil capsules he’d gotten me, I had to admit to myself I wasn’t throwing them up because I was pregnant. It was because of *him*. Jeremy. The Ordeal.

No big story attached to it. Jeremy made me take fish oil capsules daily, amongst his other weirdities. Some people are health nuts. He was a health sociopath.

I’ve attempted fish oil a few times since then and it was always a No Go. Couldn’t bring myself to swallow them. The one time I forced myself to swallow them and keep them down, the resultant fishy burps sent me into a daylong relapsing remitting flashback. From that point on, I decided I was going to concede the battle for fish oil. We lose certain things to trauma. It just is. You have to fight to save the things that really matter but you have to learn to let go of the things you can afford to. Lose the battle, win the war. And all that.

But as I stood peering into my fridge this week, that fish oil looked so lovely. (Like nectar collected by little hummingbirds and their magical fairy friends. I’m not kidding. See for yourself, it’s gorgeous.)And I know my kids need me healthy. And so, I figured, why not? What’s the worse that could happen? A day of fishy burp induced flashbacks again? I’ll live.

No fish burps and no flashbacks. It was a little hard to get myself to drink it, I admit. I’ve never been so afraid of a smoothie. But my two littles were sitting there with me at the table watching and I knew I had to play it cool. So down the hatch it went. And stayed.

2018 is a big year as far as my trauma goes. A decade since the trauma started, since I turned him in, since his arrest, since my school initiated their illegal persecution of me for my decision to turn him in, since I got the school’s suspension overturned, since the PTSD began.

It’s not a sad thing. It’s a triumphant thing, I’ve decided to call it my Gala Year. The resumption of fish oil is just the beginning. There’s going to be a whole calendar full of activities commemorating the events, remembering the heroes and making sure it doesn’t happen again.

I was looking for a race to run today. Now that I’m taking fish oil, by God, I ought to be ready to start running again and eat healthy and all that, right? It’s going to take a good while to get me in shape so I Googled “races november 2018 pittsburgh” to give myself ten months. I happened upon one of those obstacle races which I’ve always had an interest in despite being painfully uncoordinated. And it was a charity run for a group that serves people for autism. Perfect, I thought, I can motivate myself to run by raising money for autism. But then when I looked into it further, it wasn’t in November and wasn’t in Pittsburgh after all (thanks Google). It’s called the Beast on the Bay and it’s on Presque Isle in September. Presque Isle, Erie PA. The city of My Ordeal. The home of Sylvia Ferretti. She who sought to shame me out of being a doctor.

And so, please note on your calendar of Gala Year events, the date of September 8th. I will be completing the Beast to raise money for autism services and for The Exodus Road, a nonprofit group that rescues sex slaves throughout southeast Asia, India, and the US using a network of covert surveillance teams and individuals. (i.e. Jeremy Hunters). It will be my first time returning to Erie since his trial in February of 2011 so I imagine there were will be other Gala events added to the calendar for that weekend. Be sure to stay tuned.

2018 will mostly be comprised of healing my children of PANDAS and building up my practice. Of watching my Auggie learn to speak and sending my Lena to kindergarten. Seeing my Max become an excellent cellist and trying not to ball my eyes out on my Mies’s first day of high school (getting dizzy just typing those words). Fighting for my PANDAS patients’ recovery and learning all I can to defeat the Bear once and for all. But it will be my Gala Year too. Let the festivities begin.

“I’m sorry but I can’t look you in the eye because you remind me of my rapist. Nothing personal. I’m just fairly terrified right now.”


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I went into a patient room at my urgent care day job today to see a patient with chief complaint “sinus symptoms.” A routine visit, I was in and out in 3 minutes flat. It’s a very mechanical process when you’re seeing 50 a patients today, 95% of whom have one of ten diagnoses seen over and over. I walked in, though, and said, “I’m Dr. Spaar. I understand you’ve been having sinus symptoms,” as I always do. And I turned and got some hand sanitizer from the pump om the wall as I always do. And turned around to face the patient as I always do. And I’m sure he said something like, “Yeah it’s just all this pressure right here,” and he probably gestured to his face like patients always do when they present with a sinus infection. But I didn’t hear him.

Something about him, something about the look he gave me, reminded me so much of Jeremy. The look in his eyes. My stomach dropped. My body went numb. My heart started racing and things started closing in and going black. I quickly moved away from him to get the otoscope off the wall as he talked. I couldn’t look at him, at his eyes. And I needed a moment to panic without him seeing. I went about examining his ears and sinuses and lungs and asked the questions I was supposed to. I finished as quickly as I could and told him his diagnosis and plan and escaped the room. I did not look him in the eye.

And afterwards I found myself thinking, I wish I could have just said to him, “I’m sorry but I can’t look you in the eye because you remind me of my rapist. Nothing personal. I’m just fairly terrified right now.” It would have made me feel better, I think. And if rape survivors did this, wouldn’t the world be a better place? Why do we carry the burden alone? I think about what he did to me daily and yet there are so many people allowing themselves the comfort of pretending rape and child trafficking are not common. And it will never end as long as so many people remain so comfortable.

And maybe I’m wrong about this patient. Maybe he’s a rape survivor too. But rape is a systematic method of oppressing women and so I speak of women here as survivors and men as perpetrators and those conspiring in silence. Because statistics.

I rarely get triggered these days. It was a small blip in my day. But so many women are not as lucky as I am. They are living in the day in day out hell of PTSD. It is holding them back from who they are supposed to be. Creating a space for mediocre men to take the rightful place of exceptional women in many cases. Very few women in my situation would have graduated medical school, gotten a residency and graduated it as well. How many women have dropped out of college and grad school because of rape? How many have set aside ambitions and settled for a small life? And how many men have benefitted from this?

Perhaps the next time this happens I will tell the patient what I am feeling and why. And perhaps he will complain and I will be reprimanded. But I have learned long ago it is the keeping quiet that destroys your career, not the speaking out. Because it is the keeping quiet that takes your soul. There will always be another way forward even if your school or your job or your family or your husband reject you. Silence will eat you from the inside and take it all away. You will pretend at being alive until you can’t anymore.

And so perhaps next time I will tell the patient what I am feeling and why as I go about examining his sinuses and writing his prescription. Because a life of silence, however small, is not living.

Aluminum and gold


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The CBS national news is featuring a story today that I appeared in as a PANDAS expert. PANDAS is a medical condition affecting kids where their immune system attacks their brain when they get sick and gives them things like tics, OCD, anorexia, rage and cognitive impairment. It’s vital that awareness is raised because so many kids get misdiagnosed and don’t get the treatment they need.

Check it out here


End of PSA. Here’s the deal:

The story is a personal vindication for me. After my trauma, the story-slash-international-sex-scandal hit the AP wire and was featured in national and international news. It was not a flattering story for me. My name isn’t mentioned; I’m called simply, Noyes’s sex slave (should have read RAPE slave. there I fixed it for them). It led to a public shaming that contributed to my chronic PTSD settling for seven long years.

The head of my med school said I’d never be a doctor because of my moral failings. Not only am I a doctor (make that, an expert) but I am using my degree to fight the good fight. Quite the opposite of what she uses hers for.

Forgive them Lord for they know exactly what they do and do it anyway but you are a merciful God. Good way to flex your mercy muscles.

2017 is drawing to a close and here I am again, writing another reflective end of year post. I haven’t written in this blog in quite some time as I have a blog on my medical practice’s website now. This blog is really about trauma (although that’s not what I intended when I started it. Life’s funny that way I suppose). It’s about trauma in general and about one trauma in particular. The trauma Jeremy brought to me that cold snowy winter of 2008.

The trauma started January 2008. I began healing in January 2009. I got the subpoena written out by he himself to testify at his trial January 2011. I had my final healing from PTSD January 2015. And so…. January. January is coming again.


It will be ten years since The Ordeal. An anniversary. What are you supposed to give as a gift for your tenth anniversary? I looked it up and it said tin/aluminum for traditional and diamond jewelry for the modern gift tradition. It’s too bad I skipped our ninth anniversary because that one’s leather (get it? He was into BDSM. Leather. Get it? It’s ok. You can laugh. Or look at me awkwardly. You do you)

So what should I get to commemorate the occasion? A tin man? A Coke can? Perhaps an aluminum foil hat to block aliens from stealing his thoughts?

The thing I have in common with him is that he and I both think about The Ordeal everyday of our lives without fail. No one else does. Not consistently. Not without prompting.

My relationship with Jeremy has changed over time but I will always have one with him. From Stockholm Syndrome to fear to anger to forgiveness and then back and forth a few times. To compassion. Ok, sarcastic compassion at times, but compassion nonetheless.

My husband is reading a book about domestic violence right now and we ended up having a conversation last night about the importance of being able to confront an abuser and bring them to task.

“Did you ever do that with Jeremy,” he asked me

“No. I sent him to prison for the rest of his life. I really didn’t need to say anything”

“No but did you ever assert yourself with him verbally. In the courtroom maybe? I wasn’t there when you testified.”

“No… no. He was completely out of touch with reality. He said “I forgive you.” to me”

Eric continued on about the importance of this confrontation of the abuser and I interrupted him and shut him down. Just… no. No. This conversation wasn’t happening. I had no energy for it.

His point was that Jeremy needed that in order to come to terms with what he’d done. Bullies will never change if no one stands up to them. My point was that Jeremy is delusional and believes my sister and I orchestrated a grand conspiracy to frame him with the entire FBI backing us. He honest to Jesus Joseph and Mary believes that raping little girls is actually good for them, so… I’m really not seeing this asserting myself thing doing a whole lot. And quite frankly, if sitting staring at prison bars for 45 years doesn’t cause you to do a little soul searching, I’m pretty sure a sassy physician confronting you ain’t gonna do it either.

He continues the discussion of abusers as bullies and you need to stand up to bullies and all that and my mind wanders back to the courtroom. Back to the bedroom. Bitter, grey Erie. That uneasy feeling in my stomach. That fight or flight in my muscle fibers. In my eyes, always darting, scanning for danger. As it laid next to me.

There was a discussion at work today about what each of us would do if we won the lottery. Conversation drifts to the importance of buying land as it’s a limited resource and I find mySelf saying “or gold.” They begin discussing the merits of gold versus silver for price stability and my mind wanders back to the gold shop in Erie.

Jeremy was fixated on buying gold. He thought he could make money buying and selling it. He watched the gold markets obsessively. He never slept. I remember that. He was up all night on his computer. Barely slept. He watched the markets and talked to Alex in New ZeLand and researched evil.

He thought he was amazingly smart. Smart enough to outsmart the police. Smart
enough to make it rich buying and selling little gold bars. (Spoiler alert: he’s not)

At some point in The Ordeal he had me take my money and buy gold. I lived off student loans At the time so the money I was to live off of was dispersed in two
payments: one in August and one in January. He had me lend him this money I had set aside to live off of later in the year so he could buy gold. He would then sell it back and pay me back and keep the interest I suppose. I don’t remember the details. I remember very little about it. I remember driving to the bank near the Moe’s to withdraw the money (Welcome to Moe’s!)

I remember sitting in the Cheesecake Factory with my sisters that spring and mentioning the gold to them. I remember the look on my sister’s face and the way she spoke. She spoke to me the way you’d speak to someone holding a gun in their hand about to shoot. She looked horrified. She spoke calmly and slowly. She told me I needed to sell the gold back and put the money back in my savings account. I told her I would. I was glad she wasn’t angry. I was worried by the way she’d talked. Was I crazy, I wondered. She talked to me like I was crazy.

I remember insisting Jeremy give me the gold back in June. He said, the price of gold has gone down. You should wait and I’ll sell it and you won’t lose money. But I insisted and he complied. I don’t know what excuse I gave him. It worked. That’s all that matters.

I needed to get the money back because I was turning him in. Soon the government would seize his assets. I remember sitting there in the minivan with the broken air conditioning outside the gold shop in Erie. Sweating in my heavy black Land’s End skirt.

I still have that skirt. Still looks good. Damn good quality skirt.

Purple scrubs now, standing in urgent care a few lifetimes later. I walk away from the lottery discussion to work on notes. The memory of the Cheesecake Factory is unsettling. It fills me with shame. What decisions I made at that time of my trauma were mine and which were not? Maybe I would have done something crazy like buying up gold even if I hadn’t been in a situation where he controlled me through force.

If so, do I deserve to feel ashamed? No. I remind myself of this. I take a deep breath and let the shame go. Sort of. Hey, life’s a process. Don’t rush me.

So maybe I should get Jeremy something gold for our anniversary? No. Gold was a mistake. I’ll definitely stick with aluminum this time. Maybe foil for the rabbit ears on the prison TV so he can learn about PANDAS and the good fight.

13 years


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I am sitting here reading immunology. Cytokine storm, interleukin-1, natural killer cells. I am doing the thing I have been doing for almost 13 years now. I am trying to fix my babies.

Autism and PANS and Lyme and on and on. Their immune systems have betrayed them. They are attacking their own brains. I must stop the marauding hordes. I must. I’m their mother, after all.

I decided to become a doctor almost 13 years ago. Soldier Boy was a few months old. He’d already had more medical tests and seen more specialists than most of us will see our whole lives. Diagnosis after diagnosis. The idiot doctors couldn’t see he was perfect.

He was perfect. He is perfect. But, he’s not. His body betrays him.

I decided to become a doctor for a lot of reasons. Some noble and some not so much. One of the reasons I became a doctor was because I wanted to fix my son. I wanted to save my perfect baby from the many sicknesses he’d been born with.

I had his little brother while I was studying to apply to medical school. He was different. He was not sick. No tests, no specialists. He never even got a cold or had a fever. Ever.

Then, when he was 3 1/2 he stopped eating and began threatening to kill us and… you can read about it here. He got PANS.

Doctors have been no help. I am now finally a doctor all these years later. Almost 13. And now it is my job to figure things out, to help them, to fix them, to save them.

And so I am sitting up, exhausted, reading through immunology slides trying to understand the autoimmune nature of autism. Trying to understand the things I can do for Lyme triggered PANS that has been going on for eight years.

Innate immune system, cellular immunity, microglial activation, …

As I sit looking at the diagrams of these various immune processes, they are familiar to me. You learn so much in medical school they say it’s like drinking from a fire hydrant. You retain the things you use in whatever specialty you wind up in. But I am finding now the things you haven’t thought of in 10 years come back quickly when you need them.

Ten years ago I sat studying Immunology in my living room in Erie. Its a very clear memory. Sitting in the large overstuffed brown arm chair next to the end table with the touch lamp. The same end table I’d placed our Little People manger scene on at Christmas time. We lost baby Jesus and I replaced him with a Matchbox car because… because little boys. The chair was in front of the big bay window where my boys would climb up excitedly when the garbage truck came by.

I remember so clearly sitting there reading my Immunology book the night before the exam. I was behind on studying and I was excited it was clicking. I think I will do well on this test, I thought.

I was behind on my studying because of The Ordeal. Because of Jeremy. I failed the exam the next day.

Amazingly, the unit after that, Neuroanatomy, I rocked. It was considered the hardest course of first year. I was being actively traumatized by a sociopathic sadist, and I somehow managed to kick some ass. I’d gone from scared to pissed off at that point. I’d decided I was going to find a way to turn him in no matter what. Once I got to that place in my head, focusing on studying wasn’t a problem. I’m very good at compartmentalizing my mind when it’s required

But Immunology, I failed. And so I had to remediate it that summer. Immunology and Pharmacology. He did too. I saw him there. It was in those two weeks of remediation that I turned him in. I passed the remediation exam. And then went and turned him in. I was busy.

For so many years this trauma has been at the center of the story I tell of myself. Not so much to other people but to myself. For years it made me believe I was worthless. And then I entered recovery and I became defined as a survivor. Each step closer to becoming an attending physician was marked with a “screw you Sylvia” (Sylvia being the head of my med school who slut shamed me and tried to kick me out) and a “you’re in jail, Jeremy but look at me”.

I had come to accept this. But now, it isn’t true anymore. It isn’t the biggest part of my story.

Being a doctor was always about my boys. And now it is again. They’re the reason I fought to stay in med school when Sylvia was trying to force me out, heaping degradation on me. They’re the reason I stayed up til 2 in the morning studying organic chem long before I ever met Jeremy Noyes. They’re the reason I have started my own practice now. The thing I have been dreaming of for almost 13 years.

In some respects, it is easier to have rape and torture at the center of your story than to have your sick babies there. What mother wouldn’t rather endure suffering herself than to see her babies suffer? But we are not put on Earth to choose the easy path.

I named this blog I’ll Sleep When I’m Dead when I was in residency working 90 hour weeks, 36 hour shifts. But the truth is, for doctors, the sleepless nights and exhaustion pretty much end when graduation day comes and attending life begins. For autism moms, there is no graduation. There is no finish line. We really will wait our whole lives for a sound sleep.

I went into medical school to become a different kind of doctor than the ones my son had. Condescending, close minded, clueless. I went undercover. Deep cover. And I unavoidably lost my way. Drank the Kool-Aid because there really is no other way to make it out alive.

But I’m on the other side now and I remember who I was. I am an autism mom who became a doctor. I am an autism mom. I am an autism mom who knows immunology and pharmacology and neuroanatomy. I am an autism mom who gave her soul and body and mind and heart for her medical degree. And I have it. And *that* is the story of me. Jeremy and Sylvia were mere diversions.

I am going to help my children and my patients. I am going to speak out and challenge all they do that is wrong. I am going to sleep very little. Because that’s what autism moms do.

Good night. I have some reading to do. 

the smell of collard greens and sickness: 38 today


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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.

happy valentine’s day


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Those of us who’ve lived trauma have our anniversaries. There are no greeting cards or flowers as a general rule, but you never fail to remember it, year after year. There’s not a daft husband among us, covering his calendar in sticky notes to try not to forget to get his someone special that something special.

The peculiar thing about a trauma anniversary is that you share it with someone horrible. You’re the two people in the world who hold it an anniversary. Thinking of each other but hopefully not sending chocolates or poems. My 11 year old would say that doing so would be “cringy.”

Jeremy’s trial started the week of Valentine’s day 2011. The Ordeal with him began around the same time in 2008. So, it’s our special time of year. Me and Jeremy.

The thought had occurred to me a few months ago that the only two people in the world who think of my trauma everyday. Who will think of it everyday for the rest of our lives. The only two people are me and Jeremy.

I double checked with my husband on this one. He doesn’t think of it everyday. Probably most days but not everyday.

It took some getting used to, this idea that I will most likely continue to think of him and of It everyday for the rest of my life. Me at 87 still thinking of it everyday. Maybe I’m wrong. But that’s not likely.

It’s not that I think of him for very long. Something reminds me of It and the thought flits through my mind and it’s gone. It doesn’t linger. I don’t ruminate on it. It doesn’t ruin my day or activate my sympathetic nervous system. No fight or flight. No pupil dilation or rapid heartbeat or paresthesia. Not anymore.

Valentine’s Day this year for me was filled with sweets from my beloved and my four year old daughter squealing with joy over the Shopkins pens her Secret Admirer got her (hint: it’s me. I’m the Secret Admirer). The rad tech at work made a coconut cake. I got the joy of making my husband smile with the surprise I got him. I also looked up articles on the trial and re-read the chapter in my book on it, lost in the quotes of what was actually said on the stand. Remembering. I’m okay with that. I don’t find it cringy. Maybe you do. Eh.

PTSD is a result of fighting these things. It is allowing the cringiness of sharing Valentine’s Day with your trauma memories to keep you locked in it. How do we find a way to be so brave as to face a thousand little things like that? To let go of how we know things should be, of how we thought they would be.

It’s the same thing I went through with accepting my son’s special needs. It’s the same thing so many of us go through in so many ways throughout life. The only difference with trauma is that it’s a whole fucking lot harder. Terrifying actually.

I saw on the news today that Milo Yiannopoulos gave an interview saying pedophilia (that is, child rape) is okay as long as the kid is 13 or so. And now his career’s hit a slight blip. And I thought of Jeremy and his love of Foucault and his love of Ron Paul. Of Trump’s friend Jeffrey Epstein and the man who protected him and of Trump himself.

Jeremy wasn’t a freak. He was just a working class predator who got caught and couldn’t afford an expensive lawyer, whose parents didn’t have connections. Child predators are literaly running our damn country. And no one really cares.

I wish I could send a Valentine to all the little girls out there suffering under predators like Jeremy (and our President). I wish they could know how wonderfully made they are, how strong they are to go on surviving and how much I admire and love them for that. How wrong it is we leave them there because talking about the epidemic of child rape is cringy. I wish they were opening Shopkins pens and squealing instead of drifting off in their minds to another place as they are hurt.

I share my Valentine’s Day with them too. And it may not be okay, but it is what it is.


MDMA in the valley of the shadow of death

Trauma is a spiritual event. Trauma, at its core, is the feeling you have been abandoned. By everyone you know and by God himself. Some religious thinkers say Hell is not a fiery inferno or a place of torture, but simply the absence of God. So, maybe trauma is as close to Hell as we’ll ever come on Earth.
The one truly effective treatment science has come up with for PTSD is a spiritual one. The psychedelic drug MDMA (the active component in the drug known as ecstasy) is administered before therapy sessions. The reason the medicine works is that it reinstates in the patient the sense of connectedness. To humanity, to the world, and, if they believe in such, to God himself.
Religion seeks to answer the question of why we suffer. Some say there is meaning in suffering, that God is allowing us to suffer in his divine wisdom we often can’t begin to understand. Maybe to refine us as he does gold, as the evangelicals like to say. Maybe because we’re sinners. Or our ancestors are sinners. Or because someone kind of dared him into it (i.e. book of Job).
My favorite thinkers in this area are recent Jewish scholars who must reconcile this questions in light of the Holocaust. I cannot help but feel the most depth and authenticity comes from those who have seen the suffering and evil the world is capable of, who have lived it. I’ve also always found in Jewish tradition the highest concentration of spiritually, intellectually alive, grounded and wise clergy. I’m Catholic but I studied in the Jewish community and hold certain views more consistent with theirs.
Rabbi Harold Kushner (who wrote Why Do Bad Things Happen to Good People?) posits that there is no meaning to suffering itself but we can choose to give it meaning afterwards. There is no great divine plan that includes babies dying and little girls raped and tsunamis ripping off arms. There is no meaning in any of that. And God is not the one who does it. He would stop it if he could. But, in Kushner’s view, he is not all powerful. An all loving and all powerful God could never allow such suffering.
When my first son was born and the doctors told us he was sick, I went through a long darkness. I could not understand how God would allow babies to suffer and die (my son didn’t die but infants with his conditions did die up until 50 years ago when doctors figured out the treatment to manage it). I turned to Judaism because I recalled when I’d studied the idea that the word Israel means to wrestle with God.
It’s based off the biblical story of Jacob who wrestles with God through the night and in the morning his name is changed to Israel. The idea is that we can question God and the things he does, but we can never turn our backs on him. We can be angry but we cannot deny him.
I wrestled with God over my baby being sick. Over not knowing what he would be able to do as he got older, what he’d be able to see. I wondered if I’d done something to cause it, spiritually. Was I being punished? But I couldn’t reconcile the idea of a God who would punish an innocent baby for its mother’s sins.
In time I found peace. I developed an idea similar to Kushner’s. God was all loving and he did what he could, but he was limited. He’d chosen to limit himself for reasons I couldn’t completely understand.
I decided to become a doctor. My son’s doctors were very frustrating and I thought there should be at least one doctor in the world who got it. I knew he would need me to make a decent living since he’d have special needs. And I wanted to make him proud, wanted to get my act together and be the kind of mom he deserved. It was time to grow up. More than anything, I wanted something good to come of his medical problems. I wanted something so sad to inspire something good.
His suffering (and, let’s be honest, mine) was meaningless in its existence but I brought what meaning to it I could.
He was three when I started medical school, against all odds (no one thought I would get it. Everyone thought I was crazy to try). He was three and a half when I met Jeremy Noyes. He was four when my medical school tried to kick me out for reporting my rapist. He was four when I fought like hell and won the right to stay.
He was seven when I graduated medical school. He was eleven when I finished my training and became what he called “a real professional doctor.”
I sometimes wonder if I would have fought to stay in medical school as hard as I did if it hadn’t been for him and his suffering. If I would have stayed in school and fought as hard as I did to get a residency and finish it. There was a primal drive there to protect my boys, to finish for them so I could provide.
But there was something more too.
Something spiritual.
Becoming a doctor was the good that was to come from his suffering. If they’d managed to force me out of my medical career, not only would it have allowed Jeremy to have kept me from my calling and my livelihood, it would have done much more than that. It would have taken from me the peace I’d made with God over his being sick. It would have taken the meaning that allowed me to go on, walking in the world with that particular hole in my heart.
And so, I wonder, did one trauma help to save me from another?
I cannot help but think that those of us that have been to Hell on earth must know a thing or two the rest of you don’t. We buy up those corny books about people who say they’ve been to heaven in a near-death experience. Learn from them about love and peace. But, what of those of us who’ve been to hell? (What is trauma if not a near-death experience?) We bring with us a lesson not of mickey mouse cotton candy unicorn sappy love. We don’t return with messages that everything will be all right. We bring something deeper. A message that everything most definitely will not be all right, but if we are there for one another and step out bravely into what love really is, we will go on. And find meaning in anything that comes our way.