Tag Archives: mental illness

The Expulsion

18 Sunday Sep 2022

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

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Judith Herman

tells us that trauma is abandonment, being abandoned by all the people who were supposed to protect us, even ourselves, even God. to be utterly alone. when we shouldn’t be. when we least expected it. not knowing will we live or will we die, will this black hole we are falling into ever end.

In church

They tell us that Hell is the absence of God. No need for fire and brimstone. There is nothing worse than to be left by God. And so, trauma is Hell

In the Bible

Adam and Eve ate of the Tree of Knowledge and were banished from the Garden of Eden. Never to return. A life of toil and sickness and pain and death. Final. No way to earn their way back to Eden.

Our parents

Are the source of us. The holy Mother and Father of us. And when they unleash a rage that has no borders, we are Alone. we grow up and roam the earth, trying to find our way back to the Garden. But there is no going back

We cannot go back, only through. Onward into the valley of tears. Where God hears us and loves us but cannot save us. Where he gives us the ability to love one another, hear one another, comfort one another, but not to save one another.

Loving and saving are not the same thing. And that which your parents couldn’t give you will never be found in someone else. There is only one person capable of never leaving you, and that’s you.

And you

are enough

christofascism

04 Wednesday May 2022

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

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

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

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

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

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

03 Sunday May 2020

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

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We have now had a fever for 42 days. Off and on. Mine had gone away yesterday and I thought, maybe this is it. Maybe this was a fever that lasted 40 days and 40 nights, that started two days before I stopped being 40 years old. And maybe if that’s true, there is a deeper spiritual meaning to it. So, I researched the number 40.

They say 40 in the Bible essentially means, a really long time. It rained for 40 days and 40 nights when Noah was out on the ark. The Israelites wandered in the desert for 40 years. Moses’s life is divided into three 40 year phases. Jesus was tempted by Satan for 40 days. He stayed with the disciples 40 days before ascending to Heaven where he is seated at the right hand of the Father.

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They also say 40 represents a new beginning. It has to do with it being a factor of 5 and 8, and 4 and 10. I will skip over those details. After 40 days, the flood receded and it was a new world. After 40 years the Hebrews were considered to have paid the price for their disobedience and given a new life in the promised land. After 40 days, the Holy Spirit anointed the disciples and they were reborn. In Judaism, the embryo is considered to be formed at 40 days gestation. And a pregnancy lasts 40 weeks.

It also represents water, baptism, mikvah. There is the great flood. In traditional Judaism a woman goes to the mikvah ritual bath for purification 40 days after having a son, 80 days after a daughter. The mikvah is filled with 40 seah of water.

According to the Jewish Talmud, at 40 years old you gain the gift of understanding. You come to begin to fully understand all you’ve been taught.

I have been feeling exhausted lately, burdened. And feeling like I will forever be wandering in the wilderness, the promised land always just slightly out of reach. Time and again telling myself, you just need to get through this phase and then things will get easier. At what point do I admit to myself it’s a lie, that this is as good as it gets? In other words, I have been hopeless and have lost that sense of possibility I’d been so grateful to regain back in 2015 when my PTSD was healed.

My life is better than a lot of people’s and I know this in my head and I know this in my heart. But their suffering did not seem to alleviate mine. I kept telling myself to get over it, but I just couldn’t.

Perhaps it’s the nature of this fever. You feel good for a day or two or three. Really good. And you’re so grateful. You have energy and joy and you can run and get things done and enjoy life. And you think this is it, I’m better. I can get on with my life. And then it comes back.

Perhaps it’s this quarantine grinding us all down. Or the fact I had three people close to me in my life a year ago and now I have none. And I’m in isolation and can’t replace them. I cannot picture my future because none of us can. We do not know what will happen with the economy, with the pandemic, with the election, with the way things are done and the way we relate to one another. And so, how do we have a sense of possibility? There are infinite possibilities and none at all.

And so I looked to the number 40 for hope. If my fever lasted 40 days then maybe there was a divine reason God had allowed it to go on so long. Maybe God had a plan for me. Maybe beyond 40 years and 40 days and nights I would emerge from the wilderness and finally enter the promised land. Purified and born again.

But here I sit on day 42. Maybe sometimes a fever of unknown origin is just a fever of unknown origin.

I had the energy to play with my daughter today. She couldn’t believe it. We ran shuttle runs and played charades and had a jumping competition. I felt great. For now, I’ll take that and be grateful. We’re not promised a damn thing in this life. If I ever return to good physical health and energy I will be grateful in a way I couldn’t have been before. When we emerge from this quarantine and I can be with my patients in my office again, I will be grateful in a way I couldn’t have been before. And when the second forty years of my life are easier than the first (and they will be. I know this much is true), I will be grateful in a way I couldn’t have before.

I hate the saying what doesn’t kill you makes you stronger, even though it’s true. I mean, what a crappy gift: the knowledge now you can make it through something even more awful. But this truth has saved my butt more than once and I put faith in it that my children’s difficulties have done that for them. Because life is hard and the best thing we can do for our kids is prepare them to face whatever it throws at them without falling apart. But what doesn’t kill you also makes you more grateful (if you let it).

I’m grateful for my kids’ fever because at one time their immune systems were so dysregulated, their bodies couldn’t mount a fever response to invading pathogens. I’m grateful every time my 14 year old acts like a jerky teenager because he gets to a live a relatively normal teenage life now instead of being in PANDAS hell. I’m grateful every time I eat a meal without an abusive husband there criticizing what I’m eating or not eating because that was not always the case. I’m grateful to be a doctor, the good and the bad, because it was almost taken from me and I gave literal blood, tears and a piece of my soul (and my cervix) to get through my training. I’m grateful for the sense of possibility because for so many years in PTSD, it wasn’t there as I dwelled in that place between life and death.

So maybe that’s what the promised land really is: gratitude. If we never wandered through the desert for forty years, how could we even know we were in the promised land? Maybe it is not a static place, this promised land. Maybe it can’t be. Maybe it’s an oasis where we replenish ourselves and get a rest before heading out again. We never know how far into the wilderness we will go and for how long, but we know the promised land is always there. Until we reach the end of this life and enter the world without end and find that possibility we have been been seeking once and for all.

Lassoing the Beast

24 Friday Apr 2020

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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America we’ve given you all and that’s not nothing (or Narcissus needs a drink)

11 Wednesday Mar 2020

Posted by in empathy, Evil, love, medicine, narcissism, Uncategorized

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America
I’m addressing you.
Are you going to let your emotional life be run by Time Magazine?
I’m obsessed by Time Magazine.
I read it every week.
Its cover stares at me every time I slink past the corner candystore.
I read it in the basement of the Berkeley Public Library.
It’s always telling me about responsibility. Businessmen are serious. Movie producers are serious. Everybody’s serious but me.
It occurs to me that I am America.
I am talking to myself again.
*
*
*

I have spent a lot of time reading about narcissism lately. I have my reasons I won’t go into here. An unexpected outcome of this research is the realization almost every politician in the Democratic primary is above average on the naricissim spectrum, some just as high as Trump. One in particular. The one who had to drop his bid in 1988 because he was exposed as a pathological liar and plagiarist. The one whose toxic masculinity led him to challenge someone to a fist fight recently. The one who has assured the billionaires “nothing will change.” And a relationship with a narcissist, my dear reader, only ends one of two ways: you wake up and leave or they suck the life out of you. The Democratic electorate has chosen the latter. It is narcissist versus narcissist in 2020 (it has been before, to be fair) . We will all lose no matter which one wins. If Biden wins, we are left with an America still under the conditions that created Trump and we will either get another Trump or …. Trump. Do you really think leaving the White House will make Trump go away? He has created a movement and they will follow him where he leads. The presidency,  my dear reader, may become significantly less relevant. The question is, will the movement Bernie is driving remain intact to counter it?

 

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I think of the people most affected by all this and I cry. My addiction patients in rural Pennsylvania, their children. They don’t even realize just how different much of America is living. And most of America doesn’t realize how they’re living. If they did, I’d like to think things would be different. But narcissists are very good at gaslighting and projecting and lying. Lying especially. Lots of lying. And if you’re a decent, feeling, empathetic human being, it is hard to resist. It is hard for for you to conceive that such a person could exist. Someone with no empathy and no remorse. Entirely self serving with nothing to limit what they’ll do to get it. Try to imagine. It should scare you. Terrify you.

I believe most Americans are decent people trying to get by in the face of a lot of hardship. I see it in my office everyday. Not just my most vulnerable patients, my middle class medical marijuana patients too. The cop with PTSD who had to retire because of it and now has no insurance or income to pay for the therapy he so badly needs. The single mom of an adult son with autism, trying to get services that aren’t there, trapped in her house. Chronic pain patients that were abruptly kicked off their pain meds once doctors started facing consequences for over-prescribing, not offered any help for withdrawal or to manage their pain. And I see the upper middle class patients who benefit from the system but have so much anxiety and depression, the money does them no good. And still they hold onto it tightly, unwilling to see letting some of it go would not only save so many struggling; it would save them too.

Greed is an illness. An ugly dark emptiness that cannot be filled and will not stop making you hunger for more. Like any addiction. Are the heads of the pharmaceutical companieds just projecting then? Turning so many into addicts so they can see themselves? And Trump, who will never have enough cheering angry supporters or enough money. He pulls the worst from us, feeding off negative emotions and chaos as narcissists do. Projecting onto America the darkness inside of him.

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I do not mean for this post to sadden you or leave you feeling hopeless. Indeed, that is exactly what a narcissist wants. I want you to see that once you know you’re dealing with a narcissist, you begin your steps towards recovery. Leaving is not easy. They will try to suck you back in. They will love bomb you, bring you flowers and tell you how wonderful you are. But if you stay strong, it gets easier in time. And the best part? The thing narcissists hate most is someone who heals and is happy and strong. Our revenge would be a healthcare system that takes care of us, universal childcare, a Green New Deal, a living wage, an end to mass incarceration. Our revenge would be joy. Like an army of Care Bears shooting out beams of love and kindness and hope from our chests. They would keep trying, but with no one to reflect their image back to them, narcissists wither. Like Narcissist himself, when the reflecting pool they’re so addicted to dries up, so do they. And we, America, will have won.

***

America, by Allen Ginsburg

America I’ve given you all and now I’m nothing.
America two dollars and twentyseven cents January 17, 1956.
I can’t stand my own mind.
America when will we end the human war?
Go fuck yourself with your atom bomb.
I don’t feel good don’t bother me.
I won’t write my poem till I’m in my right mind.
America when will you be angelic?
When will you take off your clothes?
When will you look at yourself through the grave?
When will you be worthy of your million Trotskyites?
America why are your libraries full of tears?
America when will you send your eggs to India?
I’m sick of your insane demands.
When can I go into the supermarket and buy what I need with my good looks?
America after all it is you and I who are perfect not the next world.
Your machinery is too much for me.
You made me want to be a saint.
There must be some other way to settle this argument.
Burroughs is in Tangiers I don’t think he’ll come back it’s sinister.
Are you being sinister or is this some form of practical joke?
I’m trying to come to the point.
I refuse to give up my obsession.
America stop pushing I know what I’m doing.
America the plum blossoms are falling.
I haven’t read the newspapers for months, everyday somebody goes on trial for murder.
America I feel sentimental about the Wobblies.
America I used to be a communist when I was a kid I’m not sorry.
I smoke marijuana every chance I get.
I sit in my house for days on end and stare at the roses in the closet.
When I go to Chinatown I get drunk and never get laid.
My mind is made up there’s going to be trouble.
You should have seen me reading Marx.
My psychoanalyst thinks I’m perfectly right.
I won’t say the Lord’s Prayer.
I have mystical visions and cosmic vibrations.
America I still haven’t told you what you did to Uncle Max after he came over from Russia.
I’m addressing you.
Are you going to let your emotional life be run by Time Magazine?
I’m obsessed by Time Magazine.
I read it every week.
Its cover stares at me every time I slink past the corner candystore.
I read it in the basement of the Berkeley Public Library.
It’s always telling me about responsibility. Businessmen are serious. Movie producers are serious. Everybody’s serious but me.
It occurs to me that I am America.
I am talking to myself again.
Asia is rising against me.
I haven’t got a chinaman’s chance.
I’d better consider my national resources.
My national resources consist of two joints of marijuana millions of genitals an unpublishable private literature that jetplanes 1400 miles an hour and twentyfive-thousand mental institutions.
I say nothing about my prisons nor the millions of underprivileged who live in my flowerpots under the light of five hundred suns.
I have abolished the whorehouses of France, Tangiers is the next to go.
My ambition is to be President despite the fact that I’m a Catholic.
America how can I write a holy litany in your silly mood?
I will continue like Henry Ford my strophes are as individual as his automobiles more so they’re all different sexes.
America I will sell you strophes $2500 apiece $500 down on your old strophe
America free Tom Mooney
America save the Spanish Loyalists
America Sacco & Vanzetti must not die
America I am the Scottsboro boys.
America when I was seven momma took me to Communist Cell meetings they sold us garbanzos a handful per ticket a ticket costs a nickel and the speeches were free everybody was angelic and sentimental about the workers it was all so sincere you have no idea what a good thing the party was in 1835 Scott Nearing was a grand old man a real mensch Mother Bloor the Silk-strikers’ Ewig-Weibliche made me cry I once saw the Yiddish orator Israel Amter plain. Everybody must have been a spy.
America you don’t really want to go to war.
America its them bad Russians.
Them Russians them Russians and them Chinamen. And them Russians.
The Russia wants to eat us alive. The Russia’s power mad. She wants to take our cars from out our garages.
Her wants to grab Chicago. Her needs a Red Reader’s Digest. Her wants our auto plants in Siberia. Him big bureaucracy running our fillingstations.
That no good. Ugh. Him make Indians learn read. Him need big black niggers. Hah. Her make us all work sixteen hours a day. Help.
America this is quite serious.
America this is the impression I get from looking in the television set.
America is this correct?
I’d better get right down to the job.
It’s true I don’t want to join the Army or turn lathes in precision parts factories, I’m nearsighted and psychopathic anyway.
America I’m putting my queer shoulder to the wheel.
Berkeley, January 17, 1956

Aluminum and gold

21 Thursday Dec 2017

Posted by in medicine, PTSD, Rape

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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

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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.

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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.

The demons they won’t fight

14 Friday Oct 2016

Posted by in empathy, love, Sin

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

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

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

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

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

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

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

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

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

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

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

06 Thursday Oct 2016

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

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Mental illness kills.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

And he did.

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

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

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

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

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

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

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

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

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

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

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

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

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

It is not a choice. That choice is gone.

After 37 years, I did

03 Monday Oct 2016

Posted by in empathy, kids, love

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I feel different today. I feel lighter.
I am 37 years old and have never stood up to my mother. Never spoken back to her. Not once. Not as a child, not as a teenager, not as an adult no matter what she said or did to me. I have never stood up to my sister either. Yesterday, I did. After 37 years, I did.
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I have worked hard to turn the other cheek, to look for the log in my eye and not the splinter in theirs. I have tried to be empathetic and loving and kind. To not meet their aggression with mine, as you cannot dismantle the master’s house with the master’s tools. But there is a difference between being aggressive and being assertive. I gave up the passivity that defined my role in my dysfunctional family.
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It was no great scene. Not emotional or dramatic. I simply told my sister I did not want her dirty money (I don’t. She made it off the backs of the poor) and that someone who’d hurt my children like she did, did not get to dictate the terms of our dispute. And then I told her something true that I’m sure cut her to the bone: that she is just like our mother. Because she is.
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My mother responded by telling me she knew I’d sent “hateful” texts to my sister. I told her the truth. I told her I’d simply told my sister she was just like my mother and my sister apparently considers that hateful. (it’s kind of funny, looking back on it) She said, I suppose I won’t be hearing from you for a while again (referencing the months I’d taken while in therapy a few years ago to work out my wounds from her and what kind of boundaries I needed to establish. During which she was free to see my children whom adore her, but whom she chose not to see). I replied, No, unlike you I don’t write people off for disobeying me. I wouldn’t hurt my children like that.
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I texted her today to assure her she was still invited to the three children’s birthday parties we have coming up and that the children would be sad if she didn’t come. No reply. I’m not surprised but I am sad for my children.
*
The narrative of what happened will go down in the family history book like this: crazy Libby did something irresponsible again (believe it or not, this whole thing was precipitated by a dog I’d bought impulsively. Don’t ask) and responsible Becky came in to save her and the poor innocent dog (my mother was considerably more concerned about the puppy she’d know for 24 hours during our exchange than her grandson she once referred to as her “soulmate”). Libby responded vindictively and cruelly.
*
I’ve no doubt my sister Becky, who had shut my parents out of her life for the past five years along with me and my children, will now return to the fold. And so my dysfunctional family will go on as it always has. But without me. Not by my choice but by theirs. And my children will be the ones to suffer. First their cousins taken away and now the grandparents they adore.
*
I hope this doesn’t happen. I hope a distant awkward peace can be made enough that they can bring themselves to see my children.
*
I spent my childhood trying to be the good one, trying to earn their love and never be bad. Good grades, never talk back, extracurriculars, stuff your emotions down, don’t ask for help even when you’re in so much pain inside. I was never good enough. I tried.
*
And so in my lightness today, I am using my energy to write letters to my children. To let them know I love them and I’m proud of them. To let them know I only push them so they can be their best and achieve their dreams and purpose in life. I admit to them I am imperfect but I’m sorry for my wrongs. That they don’t deserve the frustration I take out on them at times. I remind them they have a perfect mother in heaven who is always there.
*
Flesh of my flesh, bone of my bone, I seek a new people now. For mine are gone away. They were never there; I just couldn’t see it.

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.