Tag Archives: Possibility

13 years

03 Wednesday May 2017

Posted by in autism, doctors, kids, love, medicine, PTSD, Rape, special needs, Uncategorized

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

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

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

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

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

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

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

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

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

Innate immune system, cellular immunity, microglial activation, …

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Good night. I have some reading to do. 

Merry Christmas to you, Jeremy, in jail!: A very PTSD Christmas Eve

24 Saturday Dec 2016

Posted by in christianity, Evil, kids, PTSD, Rape

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I love Christmas. I’m a Christmas nut. Perhaps the result of growing up on a Christmas tree farm. I love the music and the movies and the pine cones on the mantle and the gingerbread cookies my four year old insisted using the cowboy hat cookie cutter for. Christmas Eve is a very special day for me. But it’s also one of the 365 days a year I have at least a passing thought about my trauma. It’s the gift that keeps on giving.

One of my favorite Christmas movies is “It’s A Wonderful Life” starring Jimmy Stewart (who is from my hometown, by the way. I used to volunteer at the world famous Jimmy Stewart museum) as George Bailey. There’s a scene in the movie where greedy villain Potter gleefully shouts “Merry Christmas to you, in jail!” at George. (I’m not going into the context here but I’d encourage you to watch it if you’re curious)

So, I have a Christmas Eve tradition that those of you who haven’t known trauma might find a little… odd. Creepy maybe. Depressing perhaps. I like to shout,

Merry Christmas to you, Jeremy, in jail!

Jeremy’s the one who did trauma to me(read about it here if you like). I’m an anomaly in that my rapist actually went to prison. Not many do. It’s a merrier Christmas this year and the next 40 of them for the little girls he was planning to traumatize. So, I don’t see this tradition as odd or creepy or depressing at all.

Christmas is a season of hope. What was the birth of Jesus if not the creation of a whole new hope for us all? Hope that there is something more than this fallen world. And hope, I’ve learned through my PTSD, is the stuff of life. Without it, we’re not dead, but not really alive either (read about it here if you like). My hope was resored when I recovered from PTSD. I like to think sharing my recovery on here could give other survivors in the purgatory of PTSD have some hope too.

I’m a big believer in speaking your truth, in the toxicity of silence. The time I spent singing/screaming in a riot grrl band were some of my most empowered. Maybe it’s the autism in me, but screaming is liberating for me. When the problems of life seem unsolvable, I scream and it helps. For so many years I was told be quiet about what Jeremy did to me. I was told it would ruin my career. I was told it was my fault, that I was a slut and I mustn’t advertise this. I have seen the damage this did to me and so, I don’t just speak my truth in this season of hope. I scream it.

Joy to the world, you fucker.  Joy to you, little girls. There is hope.

2016 was-boop!-a little-boop!- stressful boop boop!

19 Monday Dec 2016

Posted by in autism, christianity, love, special needs

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2016 was a helluva whaddayagonnado kinda year. Bernie rose and then had the election stolen from him by corporate Democrats. Trump won, ushering in an age of all out fascism. Brock Turner got a slap on the wrist for rape. Various police got absolutely nothing for murdering people of color. Aleppo. Standing rock protestors getting limbs ripped off for peacefully protesting. Global warming it is now unavoidably obvious is going to kill us all off pretty soon.

On a more personal front (hey, stick with me here. this post will take a positive turn soon. I swear), my autistic legally blind son got horribly bullied in our school district. My other son’s anxiety reached an all time high and his tics escalated to a whole new dimension. My marriage disintegrated, culminating in separation. I had a post-pregnancy hormonally induced mental health episode. My cousin died from mental health problems. A dear kind friend died from overdose. I found out some other beautiful friends from high school are on heroin (and therefore, will die soon enough. opiates are what they are). I broke off with my family. Is that enough, people? You want more? Oh yeah, our four year old still isn’t potty trained…

But here’s the thing:

Millions of people voted for, donated to, fought for a Jewish democratic socialist who demanded universal health care, maternity leave,  a $15 minimum wage and a kinder approach to Palestine. If you’d told me in 2015 that would happen, I’d have told you that you were nuts. And even though Bernie didn’t win, he’s still out there fighting like hell. And people listen.

For the first time ever, we actually talked about rape and the disgustingly low conviction rates and sentence lengths, as a nation. Some people even said “rape”. Do you realize how huge that is? (Most of the headlines still used euphemistic bullshit and called it “sex” but, hey, it’s movement).

Indigenous activists and their allies won. Won. The people who have endured the most, who have had the most stolen from them, who have suffered the most violence, in this nation won.  Did you expect that? I didn’t. They worked and sacrificed and prayed and endured and… won.

Pennsylvania (my home state) legalized medical marijuana despite the ill informed Pennsylvania medical society opposing it. I did not expect this. It’s huge.

My legally blind son with autism started at a new school (not in our district) where he is thriving. He went to an amazing therapeutic summer camp. He’s made more progress at his new school than he’s made in the past few years combined.

My son with anxiety got a great psychiatrist and got comfortable at his school and is doing a ton better. (and he doesn’t make his “boop” tic unless things are really stressful now. Boop!)

My most recent episode combined with other events from this year caused me to truly shift the way I approach my mental health. I’m now committed to doing every single little thing I need to do to keep myself healthy. No matter what. I’m working through issues I thought were un-workable. I’m feeling more optimistic than I have since I was five. About myself, my kids, my marriage.

I worked through my lack of enthusiasm for Catholicism and have started a whole new kind of Catholicism in our home. I’m reconnecting with the mystical.

My son sang beautifully in his school musical. I had one of the happiest days of my life taking my daughter to the Nutcracker. My son with autism can now get his head wet in the pool without melting down (after 8 weeks of twice daily swim classes at his awesome therapeutic summer camp). My baby turned one and still has the chubbiest most delectable thighs you’ve ever seen. He calls me Mama and loves the water like a fish.

I prescribed suboxone to a lot of patients who hopefully will not die from opiates as a result. I started at a new urgent care where I actually have time to talk to my patients. I had a paper on intimate partner violence published in American Family Physician and got invited to speak at some medical education events.

I’m not going to sugar coat things. I’ve got nothing to say to you about Trump or this country’s refusal to face the racist police violence plaguing us. Global warming’s not looking good either. But, as Howard Zinn said, pessimism is illogical. Amazing things you didn’t see coming happen all the time. Look how many in 2016 alone? And, as my old pastor used to say, God is good all the time. All the time, God is good.

Happy holidays, everyone. Here’s to finding out what 2017 holds for us.

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.

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

12 Saturday Nov 2016

Posted by in kids, love, parenting

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

Lemons and sugar in the snow

31 Monday Oct 2016

Posted by in marriage, movies, my awesome husband, PTSD, Rape

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My husband and I are trying to get out and meet new people, to try to make some friends. “We’re putting ourselves out there,” I said to him as we discussed it the other night, “so to speak. It’s kind of like dating. We’re trying to find another couple to be besties with so we have to be more social and put some feelers out.” He looked a little annoyed, or maybe mildly disgusted. Sort of like the face you make when your stomach is slightly off and you’re trying to figure out if it’s going to pass or if it’s the beginning of a full on GI issue.

I took the first step for us (just as I did back when we first met) and found a get together for us with other 30-something couples with kids at a nearby pub. It’s other Catholic couples so I figured I could pique my hubs’ interest with it and I was right (this is, in fact, even more complicated than dating as it turns out. It’s like I’m a matchmaker *and* I’m dating. This analogy is getting a little cumbersome). I checked with our babysitter and she was free the night of the cas’ soiree so I entered it onto our family scheduling app and we were all set (It wasn’t actually that simple because nothing in our chaotic life is that simple, but we’ll leave it at that).

A few days later, we were driving home from our Saturday evening marital therapy appointment where we’d spent an hour making a family genogram (don’t ask), and my mind began to wander as my hubs drove the minivan down 376 as Soldier Boy made explosion noises behind me and the Baby tried to decide if he was going to cry or fall asleep. I started thinking about what I would wear when we went out to the pub in a couple weeks. I’ve been losing weight lately and I thought of the clothes I haven’t worn in a while that will now fit. I mentally assembled an outfit from med school and paired it with a pair of boots I recently bought. I pictured my hubs and I alone in my car (not the damn minivan, thank you very much) heading out and what nice compliment he might pay me. And then I thought of what I might say to him.

“Do you remember this outfit? Remember the last time I wore it?”

The answer is not our honeymoon or our first date or anything other such romantic thing. The answer is actually that I bought this outfit at the Millcreek Mall in February of 2011 while we were in Erie for the trial of Jeremy Noyes. The man who put me through my Ordeal.

I did not think of this moment, of telling him this, with sadness or anger. I actually thought of it with a slight small on my face.

Jeremy’s trial started on February 14th. It was my hubs Eric and my first Valentine’s Day as a couple. We spent the week up in cold snowy Erie. Jeremy had fired his attorney and chosen to represent himself. He subpoenaed me to testify. I’m not sure which is worse: having to be questioned by your rapist in federal court, or all the time before it that you spend imagining what it will be like. We spent the whole week in Erie, waiting for it to be my turn to testify. Eric was allowed to sit in on the trial but I was not since it could affect my testimony when I was called to the stand later on.

I only packed one suit but I thought I might need a second if my testimony took more than one day. So, as Eric sat taking in images and words at that trial no person would ever want to, evil hard to imagine, I went to the mall. I bought more than I needed, more than I should have. I bought a really, really pretty top. A flowy translucent top with corals and browns and turquoisie blues in a muted floral design like the impressionists, Manet and Monet and all that. It was so pretty. The trial was so ugly. So I bought it even though I was broke. I’m not sorry I did.

We stayed at a nice hotel that the government said they would reimburse us for. We went down to the nice restaurant in the nice hotel one night. I don’t remember which night. The night before I testified? The night after? The night in between? (I was right, it was two days of testimony so I really *did* need that second suit. Not everything else, but, the suit yes)

I don’t remember which night it was but I remember getting ready to go downstairs and making him laugh. I remember sitting there in that nice restaurant in that nice hotel in that pretty flowy top eating a lovely meal with my lovely fiancé. I remember he ordered us dessert and we shared it with two forks and it tasted better than I thought food could. I remember laughing. I remember his eyes. His mouth when the corners turned up. We were still there. In Erie. At a horrible stomach turning trial of a sociopath child predator. We were still there, but for a night, it was a little less. A little less there. There, but better.

And so, almost six years later, when I sat in the mocha colored minivan, a wedding and two kids and a hell of a lot else later, I thought of wearing that top again with the corners of my mouth turned up. It didn’t make me think of my trauma or sitting in that courtroom as Jeremy said the worst things imaginable to me. It made me think of that night. Of that respite, of the soft lighting and the attentive waiter and the clean linen table cloth on the little round table we sat at together. It made me think of all the years and all the hell he’s stood by me through. Of this most unusual life we’ve had together. Of the sweetness that comes with the bitters.

We had watched a documentary about a Holocaust survivor the night before. Made by a man Eric had made films with in another life. And the survivor in the movie told a story of starvation, of being moved from camp to camp. And on one train ride they all looked so malnourished these village women threw food onto the train, whatever they had with them from the market. And so, they had things like flour and sugar and lemons. And at one stop, a man got snow off the ground and brought it on and they made lemon ice with the lemons and sugar. The survivor in the movie said how much he loved lemon ice for the rest of his life. How could that be, I’d asked my husband. Eric had made a lot of films with survivors and he said, yes, he’d heard that many times before. He said, the lemon ice was the first thing he’d eaten after starving for so long, why wouldn’t he love it now? I said, “I guess if I was more like him I could take fish oil capsules.” But I can’t.

Jeremy made me take fish oil capsules. I can’t take them now. I can’t even take vitamins. The body remembers. The esophagus remembers. Remembers the other things he forced down my throat, remembers not breathing, not knowing if he would ever let me breathe again. Eric says I should try to overcome my aversion to fish oil and I say, No. I have overcome a fuck of a lot in the past eight years. I’m just gonna take fish oil as a loss. I’m gonna pass on conquering that one.

But sitting in that mocha minivan, I see the fish oil capsules are not my lemon ice. The flowy top is my lemon ice. I see now how he could love lemon ice. The joy and the beauty and the bodily memory of quite a different kind.

Life is not simple. Is not, yes or no. Good or evil. Would that Eric and I hadn’t spent our first Valentine’s Day together in gray snowy Erie at the trial of a madman. But there was beauty there too. There were lemons and sugar in that snow too. There too.

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.
*
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.
*
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.
*
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.
*
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.

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.