Adverse Childhood Experiences 3: Attachment Disorder

I ought to have an attachment disorder, which now is called “separation anxiety disorder” in the DSM IV, now redefined in the DSM IV-TR and then the DSM V. That is, they keep changing the definition of psychiatric disorders. It’s a bit unnerving, isn’t it? Not only the brain is “plastic” and can be rewired throughout our lives, but the psychiatric diagnosis manual is being updated.

When I went into allopathic medicine, I was under the impression that I needed to learn everything I could and apply it. Spectacularly wrong. I needed to learn everything and then track everything because at least one fourth of what I learned was wrong or was going to change. I just didn’t know WHICH 25% was wrong.

This is why older doctors have a healthy skepticism towards new medicines, new equipment, new ideas. Older doctors are more likely to use old cheap medicines and eschew the new-fangled samples. It’s not just that the pharmaceutical companies only give us samples of the new expensive stuff. It’s also that some of the new expensive stuff is not as good as advertised and has a chance of hurting people. I still would advise my patients to use coumadin (warfarin) if they have a clotting disorder. Yes, you can take the new drugs without doing a monthly blood test — BUT if you bleed, I can’t reverse the new medicines. So I wouldn’t take them: if I need a medicine to keep me from clotting, I want coumadin. I will decide about the new medicines in 5-10 years. Old and cynical, that’s me….

As previously written, I had five “experiences” under age three that left me not trusting adults. However, the adults seemed to love me, even though they kept abandoning me to other adults. At under three, this did not make sense. I could have decided never to trust anyone and presumably would have really gone off into some sociopathic bad place, but I didn’t do that.

The clue to what I did is in my mother’s stories. My sister was born five days before my 3rd birthday. She came home right by my birthday, at Easter.

My mother said, “You asked if you could dress Chris. She was two days old. She was nearly ten pounds and had a triple chin. You wanted to put a lacy dress on her. I decided that you could try and told you to be very gentle.

You put Chris into the newborn baby dress. She was so big that it barely fit and in fact, that was the only time she ever wore it. You had to stuff her arms through the sleeves. She cracked her eyes and looked at you, but she did not object at all. You were gentle.”

That doesn’t seem like much. Next story:

My mother said, “You would meet visitors who came to see Chris at the door. You would say “Come see my baby.” I let you open presents for Chris because she didn’t care. You would show the visitors your sister.”

My baby. That is the key.

I think what happened is this:
1. The adults who took care of me did seem to love me.
2. Even though they loved me, they kept abandoning me, or giving me to other adults. I really really disliked this.
3. I thought that adults were misguided and wrong to give me away. I thought there must be some explanation. I would try to figure it out. Meanwhile, I was going to take care of my sister: she was MY BABY. I was going to show those stupid, loving, confused adults how to take care of a baby and NO ONE was going to give HER away. I could love adults but no way was I going to trust them.

That was my crisis brain wiring by age 3. Adults are loving and untrustworthy. You can love them back but they may abandon you to someone else at any moment. You can’t predict what they will do. They may be even LESS trustworthy if they are loving and you know them, than if it is a stranger.

My mother again, “When I got you back at nine months, you didn’t know me. You wanted to be as independent as possible. You missed your (maternal) grandmother. In the grocery store, you would cry if you saw a white haired woman. We couldn’t comfort you.

I thought that you didn’t like us at all until you ate a cigarette butt and got really sick. You let us take care of you. Then we left you with friends for a night. You were absolutely furious when we got back and I thought that you really did like us….”

Poor young mom, 23 and recovering from tuberculosis and still not strong, with an angry and grieving nine month old who really didn’t want much to do with her and didn’t trust her at all…..

Changes from the DSM IV-TR to the DSM V: http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf

The DSM IV criteria for separation anxiety: http://behavenet.com/node/21498

Theme song: The Devil Makes Three “All Hail”

My weekly demon

I am in blogging 101.Today is the last day and the assignment: to create a recurring feature. A weekly or monthly or repeating feature. I thought, no, no, I don’t want to do that….

Then I read this blogpost: http://findingmyinnerzen.com/me-mantras/

I like the list. I sent the author a link to my poem “Say yes“. I made this comment:

“I would add one more thing to my list: keep my devils close. Remember the old cartoons with the angel on one shoulder and the devil on the other? I listen to my devil and I acknowledge what she says. She is riotously and evilly funny, with a running commentary on everything. She will also suggest totally evil over the top inappropriate responses to any time I feel hurt, sad, put upon, cut off by another car, you name it. By listening, I don’t project her onto other people and I don’t do what she says….. but sometimes it really adds perspective when someone says something thoughtless or mean and she goes into Samurai mode, shouting in my ear, “Get the sword! Get the sword! Off with their head!” I go from feeling surprised and hurt to internal laughter at how mean and inappropriate my inner demons are…… It is hard to stay angry and react to others when you are sitting there telling your demon that chopping someone’s head off is not socially acceptable and is unreasonable and is nasty and so forth…..”

Ah. There it is, the idea for my weekly post. I will write a weekly post about some internal inappropriate over reaction from my inner devil. And maybe from the angel too. We all have both. Sometimes the angel and the devil get to arguing and they are just over the top and the whole thing is silly. And the thing is, they cheer me up. The devil suggests doing terrible things but it’s usually a reaction to feeling hurt or sad. The angel tries to protect everyone else from that awful devil. And sometimes they just put an arm around each other and watch the beautiful sunrise and shut up for a bit….

The angel says, “Say thank you to everyone, it’s been a wonderful course!”

Thank you, everyone! Teachers, fellow bloggers, angels, devils, random strangers who stumbled on my blog…..

And my devil whispers, “Not weekly. Biweekly. No way weekly….”

Branded

This photo is really my brand. In 2009 my rural county hospital dismissed me as a physician because I argued against the daily 18 patient quota that they said that Congress had set us. I said, “I will go argue with Congress.” I was not sure how I would get to Congress or when.

Meanwhile, in Oregon, a group called the Mad as Hell Doctors was readying to hit the road. Two weeks before the Mad as Hell Doctors hit the road to go across the country to give talks about single payer healthcare and to listen to citizens talk about their healthcare experiences, a friend called me.

The friend had gone to the Mad as Hell Doctors’ first program, a practice run in Sequim. It was well attended because the community had a controversy over the word “Hell”. The friend said, “It’s a bunch of older white males. They need a woman. You’re off from work: you should go.”

I researched them and called a friend who is a very experienced agitator. He said, “Do it.” I called them and my father drove me to the Bremerton ferry. I got off the ferry in downtown Seattle and was picked up on a street corner to join the Mad as Hell Doctors. I had never met any of them. That evening I was part of the program.

I was and am mad as hell and often sad, frustrated, appalled and incensed by the healthcare industry in the United States, that leaves people without care and dying in spite of costing each and every one of us twice as much as any other country in the world. And all of the CIVILIZED countries have single payer. Am I saying that the United States is uncivilized? Yes, frankly, I am. We are a country run on greed by corporations currently and I am fighting it.

The Mad as Hell Doctors traveled California in 2010 and I was there for a week of that trip. In 2011 they toured Oregon. We continue to work locally, at the state level and at the national level for single payer healthcare, medicare for all. I think that it will happen and hopefully during my career.

We ended the first trip at Congress and the White House. I sent a postcard to my former employer saying “See? I said I would go to Congress.” We haven’t won the health care battle yet but we will.

Here is a ten minute program that I did in Sequim, WA in (2012) at the American Awakening event:  Enjoy. If you want to see WHY we are Mad as Hell, watch “Health, Money and Fear” and the other videos at this site. For more information Physicians for a National Health Care Program is excellent and Health-Care Now! is also excellent.

You can make a difference. Do you know anyone who has lost their house, not gotten care soon enough because they didn’t have insurance or were under insured, or has been harmed or died because they were not able to afford or access care? Gotten sick and lost their job and lost their insurance? You, too, should be Mad as Hell and fight to change this.

Many thanks for Blogging 101

The photo is the wrong season, you think. Well, yes, but I like it and I am putting it up as a thank you for the wordpress.com blogging 101 course. It has taught me a lot, I feel much more comfortable maneuvering around the wordpress sites, plus I have gotten to meet some wonderful people virtually! Hope to meet them in “meat-space” some day, or at least some of them.

I always enjoy getting this creche out. The other figures are paper mache and turned up this summer, and I thought they fit. They are much thinner than the three kings, and probably quite poor. I hope that they survived….

Fraud in Medicine: Pain cream fraud

I got a call at home saying that there is a new topical pain medicine for chronic pain. I pressed the number to talk to the agent. I talked to Shawn. He said he was with “Health Advisors”. He asked if I have had chronic pain for long.
I said “Oh, yes.”
He said, “Can I get your name and number to have one of our associates call you?”
I said, “Can I get your number so that I can call you back? My daughter needs me.”
Shawn: “I will have to call you back.”
Me: “I am not giving you any information. Does your company have a number I can call you back?”
Shawn: “I will have to call you back.”
Me: “No way am I giving you any information.” Hang up.

The phone call started by saying that I could get this great pain cream, my insurance would cover it and I don’t even need a prescription…. I just have to give them some information. Right. How much do we want to bet that there is a little fee to cover shipping and handling and they need my credit card or bank information? DON’T FALL FOR THIS SCAM!

I looked on line for “Health Advisors”. I did find an insurance company. Nothing obvious about a pain medicine cream. I looked for pain medicine creams and found:

http://prescriptionpainreliefcream.com/health-care-professionals/

Live chat representative
My Pain Cream MD Live Chat
Chatting with Ben
Ben: Hello, thanks for contacting My Pain Cream MD. My name is Ben, may I have your name?
Visitor: Are you connected with Health Advisors? I just got a call about a chronic pain cream that my insurance would cover.
Visitor: They wouldn’t give me a number to call, so I thought it might be a scam.
Visitor: What are the active ingredients in your cream?
Ben: One of our representatives can discuss this in greater detail. Before we proceed, may I have your name, phone number and email to better assist you?
Visitor: No, I don’t think so. You have not answered my question. Why would I give you any information?
Visitor: Pass me on to the representative. Or if you require that information first, then I will sign off.
Ben: I am an internet agent representing the company for visitors to their website. I would be happy to pass your contact information on to a representatives who can answer more specific questions and assist you further. Would you like to speak with someone in the office?
Visitor: Are we talking live chat or are you requesting my number? Last chance … live chat and you can’t have my name.
Ben: Unfortunately, that feature is not available. I’m not a representative and am not able to answer your questions. May I have someone from our office contact you? They can assist further.
Visitor: Tell your company to go jump. Information in exchange for email and name and all? Over my dead body. Scammers.

And looking for “Health Advisors” I found:

http://www.futureworldcorp.com/board

Well, how nice. “Mr. Robert Carr for the past forty years has enjoyed tremendous success in law and pharmacy.” Um. This is an attorney, folks. “Rob designed and built the original concept specialty compounding pharmacy, United Prescriptions Services in 2002.”  Lovely. How reassuring. Don’t you just want to use a compounded medicine? Comes with free fungus…….

And my family practice medical advice?

TAKE AS FEW PILLS AS POSSIBLE.

EAT FOOD

EXERCISE

QUIT SMOKING, REDUCE ALL ADDICTIVE SUBSTANCES AS MUCH AS POSSIBLE

DO THINGS YOU ENJOY

VALUE GOOD FRIENDS AND GOOD FAMILY

Don’t fall for the “neutraceutical” crap. Hello, it’s food that has been extracted in a lab into pill form. What in the heck is natural about that? I have never seen a pill grow on a tree, though the way things are going….. if they grow a pill on a tree, I personally won’t take it. And you shouldn’t either.

The picture is because these scams, trying to get to people with chronic pain, make me so HOT!

Linking social media

OOO, today’s assignment for Blogging 101: Plug in to social networks.
I am not ready to attach fully to Facebook, honestly.
I also lurk on Sermo, which is a supposedly “secure” site for physicians, though why anyone would imagine anything on the internet is secure… dunno. I have found advertising aimed at companies that want to reach doctors, saying advertise on Sermo. So I am a bit careful of what I do there. They offer prizes for doing surveys, but I figure that that information goes right to the pharmaceutical companies. I don’t participate in the surveys….I’ve written on everything2 since 2005, well, really didn’t do much until 2007, but anyhow….
Got a Facebook page, go to Linked in occasionally, and have email…. AUGH!! I don’t want to be too wired. Reminds me of when we got our pagers in medical school, third year. We were thrilled. That wore off pretty darn quickly on call. Also, I date back to voice pagers, then numerical pagers and now people can text…. change change change….

I will think about the Facebook connection, but I am not ready yet. Also, my teenage daughter says I share too much on Facebook anyhow. Particularly dance videos. I LOVE TO DANCE. Couples dancing since, well, since I was a 17 year old exchange student to Denmark…. and that’s another story.

Sunrise! A new day! More change!