Tag Archives: feminism

“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.”

23 Tuesday Jan 2018

Posted by in medicine, PTSD, Rape

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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.

pretending to grill in the garden of eden

04 Sunday Dec 2016

Posted by in love, PTSD, Rape, Uncategorized

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I have lost some weight recently. A goodly amount, I think it’s fair to say. Only ten more pounds to go. I weighed 150 pounds nine years ago when my trauma began and by 2013 I was 224 pounds. I ate for a lot of reasons. I’ll tell you about it some time.

Today I am thinking about a picture of me grilling. Well, pretending to grill. It was 2007 and I had left my first husband and was just starting medical school. I was young. So damned young. 28 to be precise. I just knew my soul mate awaited me out there. And I would of course find him on the internet. A single mom going to med school doesn’t have time to go out, so she would of course take advantage of online dating. But, I needed a profile picture. This was before the advent of selfies and not too many of us had a gaggle of carefully angled, flattering pictures of ourselves lying around in our smart phones. I didn’t even have a smart phone. So I asked my mother to take a picture of me.

I wanted to look natural so I said, take a picture of me in the kitchen cooking spaghetti. (Because everyone has a picture of them in full make up smiling as they cook spaghetti. So natural. And maybe I could use it if I ever decided to sell my own brand of jarred spaghetti sauce. Kill two birds with one stone. Bam) Unfortunately, the lighting in the kitchen was bad so we went out on the back patio of my little ranch house in Erie. Unsure of how to keep up the natural theme, I went for the grill. Here, I said, take a picture of me pretending to grill.

And so here I am today, looking at a picture of me with my hair perfectly done, pink lip gloss shining, smiling with my mouth and my eyes (so it wouldn’t look fake. Even though it was). Holding a large grilling spatula in my hand, the cold grill lid opened. No sign of my special needs toddlers to be seen. None of the dark circles I’d soon earn staying up late studying. The flat stare of depression that had occupied my face most of my life, the fear of the abuse I’d lived under, the wide eyes of my mania, absent. I’m beaming with hope in that picture. An endless stream of possibility before me. Faith that I will have a wonderful life. (I did work in the Jimmy Stewart Museum in high school, after all).

I do have a good life now. Nine years later. I have been blessed and I have fought for it. I certainly do not have the life I imagined then, when I was young. How many of us do? I have walked through my darkness these years and come out on the other side.

I am now almost to the weight I am in that picture. And as I have dropped each pound, run each mile, I have thought, this is a victory over my trauma. I have reclaimed my mental health and now I am reclaiming my physical. He can’t take this from me. I am leaving behind my trauma pound by pound. I am escaping a body that is not really mine. Getting back to being myself after so long.

But now I am close to the weight in the picture, to wearing the clothes I wore then, all of which I have saved in anticipation of this day. And I look in the mirror and I have not returned to looking like myself at all. I am not the girl at the grill.

My stomach has gone from that of a 28 year old whose had 2 kids to that of a 37 year old whose had 4 and gained and lost a lot of weight. My face has crow’s feet and laugh lines it didn’t then. And my eyes don’t smile the same. They’ve seen too much to smile so damned naïve. They smile not with happiness, but with the joy that comes from knowing sadness.

I’ll be honest with you, I wish my body looked like it did back then. I’d love to be a good feminist and not feel that way. I know I shouldn’t subconsciously convey such attitudes to my sweet daughter. But, life’s a process, okay? And I wish I was a little firmer, a little perkier. Less stretch marks. Less lines. But I don’t wish my eyes were perkier. I don’t wish these past nine years had been different. Don’t wish I could return to being naïve.

I’ve never believed in regret. It’s never made sense to my logical autistic brain. If you can’t do something over, why would you possibly sit around thinking about what might have been? It is what it is, I often say. Life is what it is.

I have no regrets about choosing the medical school I did. About pursuing the awful man I did. About turning him in as I did. Never have, never will. But I have been continuing to labor under the false idea we get after trauma. The idea that keeps us from moving on, that locks us into PTSD if we believe it enough. The idea that we can make this trauma not matter. That it can become a minor footnote in our life story. That we can go back to being who we were before. Before. Before *it*. You know, that event that doesn’t matter anymore. Even though it’s the yardstick we now measure every accomplishment by. Constantly claiming victory. Telling yourself, living well is the best revenge. Tallying up everything you have that your perpetrators never will. Telling yourself, I’m not like those whiny survivors who blame all their problems on their trauma. I’m different. I have overcome.

The truth is, your life was divided the day the trauma began. There was before the trauma and after. And it drives you mad. You just want that damned line erased. You want your life whole again. A beautiful continuous flowing story arc. With twists and turns and dips and peaks, but unbroken. But that fucking chasm, fault, break, schism, crack, gully, canyon, whatever you call it, it’s still there. Won’t budge. It’s not something you can remove. Because it’s not something. It’s the absence of something. You can try and try to fill it, but it’s still there. Go ahead, dump in food, pills, booze, drugs, sex, work, reckless driving, overspending, self injury, reality television, starvation, obsessive relationships, obsessive religion, hours of staring blankly at walls… It’s still there. Fill it til it overflows. It’s still there.  It. Will. Always. Be. There.

The Garden of Eden will not be restored. The fallen world remains.

And that’s okay. Well, it’s not *really* okay. It’s trauma. And trauma’s hell. But… it is what it is. It doesn’t have to be okay. It just is. And you have to learn to accept that it is. Over. And over. And over. You build up a life on the other side of it. You peer down into it and thank God you haven’t fallen into it. That you’re here. Looking back at it as you run, mile by mile.

I swallowed a vitamin yesterday. A really big vitamin. I’ve always been good at swallowing pills. So are my kids. Family skill. (baggy esophagus maybe? we’re not the most coordinated family so it’s certainly not that we have an especially athletic swallowing mechanism). The thing is, Jeremy raped me a lot of ways but the scariest one was the oral rape. Because I thought I would die. He would suffocate me and count to ten slowly and I thought he might just hold me there long enough to kill me and I’d never see my babies again. I felt so utterly powerless. I was so utterly powerless. He would tell me he was training the gag mechanism out of me.

It didn’t work and ever since then, I have had trouble swallowing certain things like big pills. Vitamins in particular I guess since he had me on a vitamin regimen of sorts. It wasn’t something I ever wanted to deal with. I  just took gummy vitamins. But yesterday my husband said, these are really good vitamins, maybe you could try and see. And so I did. I put this rather large vitamin and my probiotic capsule and my two medications in my mouth and took a big gulp of water and threw my head back. And they all went down. Down the hatch.

I felt so victorious. I thought, I wish I could tell someone. I was so happy that he’d now taken one less thing from me. I thought about telling people, though, and how I would need to explain that whole oral-rape-until-you-suffocate thing. And then I remembered the whole orally-raped-until-I-suffocated thing. And I felt so powerless. So utterly powerless. There in my living room, my babies’ toys strewn on the floor, the fireplace I love, the pictures of our wedding and our first communion at the Easter vigil and… I felt so terrified and so sad and… I thought to myself, a really awful thing happened to me. A freaky, awful thing. A thing no one deserves. That happened. It happened to me. And it can’t be undone.

The moment passed quickly. In a matter of seconds it was done and I was back to my life. To my beautiful fireplace and crazy bubalink babies and my devoted husband and I stumbling through Catholicism. And now I was doing all that with the benefit of a wonderful multivitamin.

You tell yourself, you need to stop running *from* the trauma and start running *towards* the good things. And the truth is, I do have runs where I think about the healthy habits I’m giving my kids and going on hikes with my husband, maybe learning tennis or kickboxing. How good it feels to be lighter on my feet, to get around easier, to know I’m probably going to dodge the bullet of diabetes type 2 and keep the arthritis at bay as long as I can. But sometimes I think of how far I’ve come. Sometimes I think of him, of her (the head of my medical school),  of the sickness in their hearts that makes them do the things they do. Of the happiness they tried to deny me.

They did, in a way. They took from me the naïve happiness I had then. They put a fault in my life. Made it into a before and after. But I have made a home on the other side. I am not hanging off the edge. I am not in the darkness of it. My happiness has given way to joy and wisdom and a greater love than I could have known. The fault is there to stay. And that’s okay. Well, it’s not okay. But it is. It is what it is. And after all, it really is a wonderful life.

We Liked You Better When You Didn’t Talk So Much: Life After PTSD (a.k.a. after your fasciotomy for compartment syndrome of the soul)

24 Friday Apr 2015

Posted by in doctors, empathy, kids, outrage, PTSD, residency

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Compartment Syndrome with Fasciotomy Procedure

It’s been four months since I recovered from my seven year bout of PTSD. (See previous entries of my blog for real time coverage of the recovery process). My coworkers don’t really know I had PTSD (although I did give a talk on PTSD and tell them the reason I was giving it was because I had it, I think they either weren’t paying attention or blocked it out). They just know that all of a sudden a few months ago I stopped being so quiet and agreeable all the time. At first they thought it was great. I’d blossomed. Developed self-confidence, gotten a backbone. They assumed it to be the result of residency training. But as the months have gone on and I’ve become more and more my true self, they’ve started commenting to me they miss the old quiet me.

I’m a little too opinonated, they say. Talk a little too much now. I’m too hard on the interns. I’m angry, they say. Well folks, what I really am is … me. The real me not suffocating under PTSD. The real me not constantly trying to avoid the bad things I think are coming. The real me who isn’t convinced I’m going to get kicked out of the medical profession if I let on to who I am.

I am indeed angry at times. Unapologetically angry. Righteously angry. Old testament angry. Jesus turning over the money changers table angry. Malcolm X I’m-done-begging-for-crumbs angry. No apologies.

I am hard on the interns. Hard on them like my senior residents were hard on me. I thank God my seniors were so hard on me. Guess what? We’re training them to be doctors. We’re not at the brownie jamboree seeing how many friendship bracelets we can collect. They’re here to learn to be excellent doctors: thorough, hard-working, devoted, compassionate physicians who think things through and can communicate and lead. Some interns need more nurturing than others, but even the most fragile (hi, I had freaking PTSD when I was an intern. I was about as fragile as they come) needs to be held to a high standard. We owe it to them and every patient they will ever treat.

I do talk a lot and have a lot of opinions. It’s not that I have a lot of opinions that bothers them though. I haven’t met many doctors who don’t have a lot of opinions they feel you must be dying to hear all about. What bothers them is that my opinions disagree with theirs. I don’t find their sexist jokes funny or even acceptable. I’m really such a drag, I know. But I’m 36 and I have a daughter and I’m done tolerating that crap.  The male residents are assertive while the female ones are called aggressive and told to tone it down for the same behavior. The male residents really hold the line and don’t take shit while the female residents are told to calm down and lighten up when we do the same thing. To hell with that.

It’s possible I’m a little overly zealous with the assertiveness and rightous anger right now as I delight in my recovery, but can you blame me? PTSD is hell. You’re not dead but you’re only technically alive. I’ve got seven years of pent up thoughts, words, feelings, and actions here.

In my defense, it’s not all anger and thunder bolts around me. I have a lot of joy. I’ve made a lot of progress on forgiveness (entry on that to come). I’m just not PTSD Barbie anymore, putting all my energy into pleasing everyone and always agreeing and going along and not complaining and working myself to exhaustion because I’m afraid everything’s going to fall apart at any moment.

My husband and I met when I was in the thick of the PTSD so he’s had a little bit of a switch-a-roo pulled on him. He always wished I’d be more assertive and talk more, but , as the saying goes, be careful what you wish for.

The thing that’s frustrating about all of this for me is that I’ve been given this amazing gift. PTSD was hell. I can’t tell you how much of the past seven years I had spent wishing I could die. Knowing I couldn’t kill myself because of my kids and asking God why he would put me in that position. The blackness inside of you. The expansive emptiness that feels like it will break you apart. The loneliness you feel like you just can’t bear. And there’s no end in sight. There’s no hope. The fear. Every noise makes your heart race. Do you know how many times your pager goes off a year as a resident? Do you know what it’s like to feel terrifed every time it does just because of the sound it makes? To not be able to trust anyone, not even your husband. To not let yourself open your heart to your kids because you’re expecting them to be gone any minute. To go on psych med after psych med after psych med looking for an answer and all they do is make you tired and remind you you’re crazy.

And I finally escape all that and the people I work with, the physicians I work with, they tell me they like me better the way I was. So, you’ll have to excuse me if I’m unapologetic. If I relish giving them a piece of my mind when it comes to what is right. Silence does not protect us, it fills us with its void until the tensile strength of the matter of us gives out. It’s like compartment syndrome of the soul. You must release the pressure surgically and when you do, sometimes things burst forth and get messy. But it’s the only hope of saving the limb. The real me has come back out and I couldn’t stuff her back in to the old necrotic shell even if I wanted to. And I most definitely do not want to.

What Love Really Means

14 Saturday Feb 2015

Posted by in love, marriage, my awesome husband, PTSD, Rape, romance

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trenchfoot

This week is the 50th anniversary of the assassination of Malcolm X, El Hajj Malik El Shabbaz. I read The Autobiography of Malcolm X when I was 21 and it changed my life. Changed it enough that I named my second born after him. Malcolm X was Godly and brilliant and brave. But the thing I’ve always been most inspired by in him was how much he changed and grew in his life. Why am I writing about this on Valentine’s Day? Because I wanted to write a Valentine for my husband.

He was born in the summer of ’69, a couple weeks after man walked on the moon and a couple weeks before Woodstock. He made his first film at age ten. He was an entrepeneur from the start doing everything from delivering papers, mowing lawns, to selling Grit magazine. He grew up and went away to a small town three hours away in Western Pennsylvania for college. My hometown. I was in elementary school then (I was born in 1979, the year of the collapse of the industrial economy in America. Not quite as cool). He went into computers and had a good job but he left behind the security of it to go to film school, to pursue his calling. He came home and made two independent films and got married and had a son. He found God and set about following Him. When God called him to open a cafe, he did. Crazy as people told him it was. And then he got this email from this girl who’d seen his picture on the interwebs and he decided to write her back. It turned out she’d been raped by a madman in med school and she had two kids who were dealing with mental health challenges of their own. On the day they got married she was $400,000 in debt and had failed to match into a residency and might never be able to make a decent living. He married her anyway. He’s not afraid to take risks. He follows God into the fray.

In the years since then, he has found himself facing the sacrifices of residency and the hell of PTSD. He has driven roughly 35,000 miles going back and forth between residency and our son back home. He has devoted himself to our hooligans. He has been a major factor in the amazing transformation of our son Malcolm. He has washed and scrubbed and shoveled and fixed and cooked and shopped and juiced. Wiped butts and cleaned up vomit and blood. Endured temper tantrums, meltdowns, wiped tears, kissed boo boos. He has listened to my frustrations and guarded the bedroom door from invading children when I needed to sleep.

More than that, he has gotten down in the mud, crawled on his belly, down in the trenches. He has done the real work of marriage, the emotional work. He has faced down his demons and mine. And that is the bravest, hardest, most loving thing there is. He has come with me as I travelled into the heart of my PTSD and faced my spiritual crisis. Been there through the anger and the bitterness and neediness and depression and the one-step-forward-two-steps-back-is-this-ever-going-to-end. He has come to be as outraged as I am about rape. Sometimes I think he’s moreso. When the petition we signed to stop the Bill Cosby performance at Heinz Hall worked, he was more excited than I was.

Dorothy Day, founder of the Catholic Worker movement, said, “I have long since come to believe that people never mean half of what they say, and that it is best to disregard their talk and judge only their actions.” You can keep your long stemmed roses and diamonds. I have real love.

I love you, Poobah. I’m so proud to be your best friend. Forever.

New Year New You! (How Ima Got Her Groove Back)

10 Saturday Jan 2015

Posted by in empathy, kids, love, medicine, my awesome husband, parenting, PTSD, Rape

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I found this idea on Pinterest for keeping a jar where you write down happy/funny things that happen throughout the year and put them in this jar. I believe it advised a big jar (with the assumption being you’ll have lots of good things happening I suppose). You open the jar up at the end of the year and read over all the little happy moments you otherwise might have forgotten. The woman who’d pinned it had written it was a “super cute idea !!!!” and that she was definitely going to try it.

I pitched the idea to Poobah and he liked it (although he didn’t call it super cute or exclaim). So I took the large clear plastic teddy bear shaped animal cracker jar and dumped the animal crackers out into a bag (they’ve been sitting uneaten in the jar for 3 months so why not keep them uneaten in a different container a little longer) and wrote 2015 on the bear’s tummy with a Sharpy.

As I did so, I thought, why only write down the happy times? Why not the bad times too? It was January first and I was heading to work soon. I wasn’t very cheery.

But it wasn’t just working on a holiday that made me think that. I’d been bogged down in PTSD and working crazy hours and stress and financial problems and family discord. Bogged down for a while.

I felt like there wouldn’t be much to put in the jar.

I said goodbye to my husband and kids and headed to the hospital. Holidays can be slow because people put off going to the hospital on a holiday if they can, but it’s been a particularly busy year for hospital medicine because of all the influenza. I expected I’d be fairly busy and hoped it wouldn’t be any worse than that. I hoped no patients crashed. I hoped for some time to think.

Earlier in the day, Poobah and the kids and I had gathered in the living room around our old school fake Christmas tree (the kind that really do look fake and aren’t “pre-lit” and don’t have green concentrated pine scent aroma sticks discretely hung on a strategically chosen back branch) to continue a tradition my sister Nicci and I had started when I was still in high school. Every New Years we make predictions for the upcoming year and then the following year we read over them and see who got the most right. We also talk about things that happened over the past year that were unexpected.

We’d each made three predictions but I wanted some time before I went and started the admissions to write down a few more and think about the year ahead.

I started writing and this is what came out:
I need to move forward. But these next 6 months are going to be exhausting. I’m not sure what to do. I wish it were a simpler tale. I wish I could figure it out.
Where did it begin? Before I was born? If it did, then what?

We all seek to be an individual with self-esteem
There are those who stand in the way
And so we assert to be ourselves in maladaptive ways
Because of the innate drive towards maturity

Malcolm has something special in him. Malcolm could change the world.
He said he wants to be an astronaut so he can change the world.

Mies has this amazingly unique combination of traits.

They’re extraordinary.

Maybe I am too.

And with those four little words, I got my groove back. I didn’t just get my groove back from before Jeremy Noyes traumatized me seven years ago or before my medical school rubbed salt in the spiritual wound and made it stick. I mean I got my groove back from Way back.

It’s a process, of course, but it is set in motion. It is inevitable. The rate limiting step of the reaction has been overcome and the chemical cascade is in full swing.

I’ve spent most of my precious little free time since then wading through shame and heartache, cleaning out every dark corner of the past 35 years. It’s amazing all the things I’ve been ashamed of over the years. It’s amazing how ashamed I still felt now, decades later, simply writing out the words different people have said to me. I’ve done that sort of thing before, sitting and trying to process bad memories. But the difference this time is that I finally believed that I didn’t deserve any of it. I finally believed I’m extraordinary and so deserving of love and safety and joy, it’s ridiculous.

The words lost their power over me. Those people lost their power over me.

There are things I’ve done in my life I’m ashamed of and I sat with those too. Some of them I reminded myself I had no control over (feeling ashamed I “let” myself be raped, for instance), some I decided are just inevitable mistakes of youth, and some I had to forgive myself for. I regret very little as a general rule, but the things I’ve done that have hurt people, really hurt them, I do regret, and I had to forgive myself and let go of the shame.

Another inevitable piece of it is that I am losing the extra weight I have clung to for many years. It’s time to let it go and so I am. I feel hungry but it doesn’t distress me because it’s what’s supposed to be.

I’ve recovered from political amnesia and am reading feminists and progressives and anarachists again. I’m engaging with people about things that matter. I’m throwing a hundred evolving ideas out to my husband on everything our future holds after we graduate this June.

It’s not that I’m becoming a whole new person. It’s that I’m returning to being myself. I’m doing what we are all made to do: becoming more myself and finding what it is I am supposed to be doing to make the world a better place.

I look at my two year old daughter and see she’s there. She’s got her groove on. She knows what she thinks and wants and feels and she lets you know it. She’s engaged with everything and everyone she comes in contact with. She’s alive. She’s in the flow.

I want to do everything I can to keep her there as much as possible. I want to help all my kids find their flow. And anyone else I can. Because that’s what life is. But I see now, it’s not selfish to enjoy having my own groove on. Quite the opposite. Flow begets flow.

And so, the other day, I took a little green slip of paper next to the empty animal cracker jar and I wrote the first memory of 2015: January 1st Ima got her groove back. (our kids call me Ima. I’ll tell you about it some time)

This is for my husband now: My name is Elizabeth Spaar and 2015 is the year I got my groove back

You will sleep soundly because we don’t

15 Saturday Nov 2014

Posted by in doctors, Evil, Rape, Sin

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

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

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

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

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

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

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

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

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

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

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

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

Only Ivy Leaguers Get Raped Apparently

27 Friday Jun 2014

Posted by in doctors, empathy, medicine, outrage, residency

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I was once raped by an educated man. He knew a lot about sociology, philosophy, and medicine. He was also a misogynist who harbored a secret internal hatred for women which he hid very well from all those around him. It wasn’t any more or less traumatic because he was so educated. It wasn’t any more or less shocking to me because we were both studying to be doctors at the time. It was what all trauma is: Brutal and Terrifying and Life changing. When you know you’re in a position so powerless that you might be killed, education and institutional prestige are of little concern. But in the days and months and years that follow, you cannot be truly healed until you find your voice and tell your story in whatever form it is that your story needs to be told. When our society priveleges the stories of certain survivors over others (what of men, prisoners, spousal rape survivors?) it keeps us from healing as quickly as we should. I am glad the voices of certain surivors from Ivy League schools are being heard to the extent they are (I don’t delude myself into thinking things are great for them), but we cannot ignore the voices of so many others. We have a story to tell too.

There’s been a lot of media coverage of the campus rape epidemic lately. Which is a good thing. There’s been an outcry against George Will’s op-ed piece questioning the validity of a lot of these rapes and talking about the privileges attached to being a rape survivor. Also a good thing. But if you read the majority of these articles, you’d think rape and a lack of appropriate administrative response by universities only occurred at elite schools. It wasn’t until I was about a dozen articles in that I even knew a medical school, WVSOM ( West Virginia School of Osteopathic Medicine), was one of the 55 schools under federal investigation for failing to handle reported rapes appropriately. The only reason it got a mention in the article was the fact it was a lesser known school and I got the impression that the point the writer was making was that it’s a lot more shocking that rape victims get treated badly at an Ivy League school than at one of those lesser known schools.

What’s the logic there? Do people in the Ivy League have higher moral standards than us commoners ? Is the upper class known for its devotion to women’s rights? More importantly, regardless of how surprised you are with the Ivy League’s mistreatment of sexual assualt victims (as opposed to those low brow schools where you just expect people to get raped and then harassed by the administration apparently), does that mean that the voices of the men and women at the other 45 schools don’t deserve to be heard as well? Is it any less an outrage when it happens to someone at a lowly osteopathic med school? It’s a lot of questions and I’m sure you can tell how I would answer them, but I’d really like to hear how these journalists would answer them. I know no one is truly unbiased, but can’t they at least pretend, make some kind of effort to appear to give a damn about the rest of us?

When I mentioned the news about WVSOM to some of my fellow residents, they were genuinely shocked. Not only could they not believe a medical school would treat a student who’d been raped poorly, they honest-to-goodness couldn’t fathom the idea that medical students would rape one another. They really just couldn’t comprehend the idea of one of our kind being a sexual predator. Am I the only one bothered that our culture is promoting these kinds of ideas?

It is shocking someone from the Ivy League would rape. It is shocking someone studying to become a doctor would rape. Okay, then who is it that we expect to rape? Apparently we expect uneducated people to rape. I guess the idea is that education is a humanzing process? But rape is, in essence, a very human act. One of the most human acts really. Rape is about anger and the need to control, something every level of society has demonstrated since civilization began. Is it really so difficult to think that Ivy League men, so used to privelege and control, might not have a need to control Ivy League women too? Do medical school admission commitees really get a feel for how angry an applicant is? Unless they’ve been convicted of a felony or misdemeanor, probably not. (And if you’ve ever been in an OR with an instrument-hurling surgeon, you might question if anger in and of itself is a generally discouraged trait in the world of medicine)

I don’t suppose we’ll ever be as upset with the death of innocent civilians overseas as we will be with the death of innocent civilians in America. Maybe we’ll always mourn more for caucasian, suburban school children shot than we do for african-american inner-city kids killed likewise. But, I hope for better days. And I work for better days. My name is Elizabeth Spaar and I was raped in medical school. Yes, our kind do indeed do that kind of thing. Of course, it was an osteopathic school, so maybe you’re unimpressed.