Category Archives: Adverse Adult Experiences

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Autoimmune disease

Autoimmune Diseases Statistics in US 2026 | Key Facts

After Lou Carreras commented on my write up on autoimmune disease, I thought I would do more research. The article above https://theworlddata.com/autoimmune-diseases-statistics-in-us/ shows an enormous increase in autoimmune disorders in the last twenty years. Also, I can’t tell if they include fibromyalgia, chronic fatigue, long covid and the encephalopathies. The first three can be ANA and ESR negative. To me that means that we have not found a good inflammatory marker for these disorders. It is certainly not that they do not exist.

The data is a bit overwhelming and horrifying. I know too many people with connective tissue disorders and those were very very rare when I was in medical school (1989-1993). Not nearly as rare now and all the people I know are young.

I stand by what I wrote and this reinforces it: as a culture and world we have to back off from the high sympathetic nervous system fight or flight.

And today, Formula One racers are driving around the mall and Washington, DC. So what do I think of that? Imbecilic, toxic, dangerous. Which egotist set that up?

For the Ragtag Daily Prompt: egotist:

https://ragtagcommunity.wordpress.com/

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Level up 

I just leveled up

Level pro

level pro in poetry
or in writing
or in emotional maturity
or maybe

or maybe connection to the Beloved
or my dead sister
or forgiveness

I don't know

all I know
is

I leveled up

______________

For the Ragtag Daily Prompt: egotist.

Written August 21, 2026.

Terry took the photograph. I had to dance very carefully so as not to trip Tom.

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Watching my sister die 

I wrote this today thinking about my sister's write up "Watching my mother die" here: https://everything2.com/title/Watching+my+mother+die
Her write up is the fourth one down.

______________________________

Watching my sister die


I know before she does
but maybe not
maybe she knew
that last year

brave front
while soliciting money
on the internet
as the cancer progresses

she describes new treatments
I forget
how many rounds of chemo
she endured

eight years
from diagnosis 
to death

I stop visiting
for a year
after she bullies 30K more
from our father

and he calls me crying

I give myself permission
to change
to be a physician
more than a sister

because as a sister
my sister is 
cruel

she destroys my reputation
with my mother's family

or maybe they already
don't like me
because I think the family rules
are ludicrous and stupid

and I won't follow them

I suppose each generation
has someone who says
wait
these rules make no sense

why are we following these?

I think she will die
by February 2011
but there is another death
unexpected

the death of my hope
for a sister who loves me
for a sister who treats me well

for a sister who loves me

and I let that hope die
and I rise from the ashes
and I choose not to visit

and she uses this
tells people I won't visit
though I don't say I won't

people sent me checks

I sent them back
with thanks
saying

it is too soon 
to leave my nascent business

my sister
stays in touch 
this year

at last 
in February 2012
she calls me

my oncologist 
referred me to hospice
but I am not going

yes, I know
you are refusing to go

I don't saybut the cancer 
is progressing
and like it or not

you will go

my sister 
applies for a clinical trial
miles away

and at last
her enthralled circle 
refuses

they say
we are so tired
we cannot drive you there

daily

I fly down 
for a long weekend
and the hospice interview

I am excluded
but ask to step in
at the end

I ask the nurse
is this like where I live
that if there is a stroke

or a blood clot
or bleeding 
or whatever horror

hospice will keep 
her comfortable 

but will not treat it?

yes 

says the nurse

my sister stands
pushing away from the table
NO she says

I AM NOT READY

yes, I knew that

you are not going

I don't say
but you will go
willing or no

I fly down a second time
and as I leave
she cries

I am surprised

we have not talked
really

there are so many people
in and out
and I've been portrayed 
as a villian

there is still time

I fly down a third time

she is angry, angry
now in hospice
angry that she is dying

I start to sing a lullaby
and she says NO

I study her
I sing Samuel Hall

To the gallows I must go
I must go 
I must go

To the gallows I must go
with my friends all down below
saying Sam I told you so

damn their eyes
damn their eyes

saying Sam I told you so
damn their eyes

she smiles
a vicious secret smile

she is in renal failure
strange
says 

I have to take a trip

I say yes
you do

I don't know how

You will figure it out

How will I find you?

I am surprised again
the connection is still there
buried deep

You said I can take the dragon home
the one I made in college 
and gave you

You are born in the year of the dragon
you will have wings
find the dragon 

and you will find me

oh, good
she says 
relieved

she speaks of a bad pig

I say maybe it isn't bad
maybe it's done some bad things

she shakes her head

I say shall I take the 
bad pig away?

she still is not satisfied

I guess: do you want me
to keep the bad pig
from hurting anyone else

yes
she smiles
yes

again we are alone

I am Bad she says

You are not bad
I say
You have done some bad things

Very bad

She is crying

I say I love you anyway

and she blooms
like a rose
soft in a dark orange blanket
with matching lip gloss

forgiven
and reconciled

flying home
I name the dragon
Bad Pig

and gird myself
for death

three days later
she dies

and then the fallout
and the aftermath
begins

_____________________

I will attach this to the Ragtag Daily Prompt "escapade", though I think of escapades as fun.
The escapade is the photograph. She and I were dancing before my wedding, in 2007. 
I am the short one and clearly I was teasing her about something. 

Sorrow never dies, quite.

Neither does love.


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Liar, liar

Liar, liar, pants on fire, nose is as long as a telephone wire.

Trigger warning: sexism, child abuse, dating, US culture. Kinda not tame.

The last guy I date, only we don’t date, is a liar.

It is a bit into Covid. He knows I’ve had three pneumonias and he texts. “Are you worried about this?”

“Heck, yeah. Of course.” Then I ask if we can talk on the phone.

We start doing distanced beach walks and talking. Talk, talk, talk. At first he has to lure me out.

“Want to go for a beach walk?”

“I dunno.”

“I made lunch.”

“Oh, then yes!”

He points out that I have food insecurity. He is annoyingly correct. By the end of any meal, I am checking to see if there is food for the next meal. It is automatic and dates to when I was a toddler.

We compared abusive childhoods. Really. Back to toddlers. He finally says, “You win.”

“What?” I am not trying to win.

“Your childhood was more abusive than mine.”

I think various unprintable words.

I start noticing lies. They are stupid lies, as far as I am concerned. They shut me up over time because there really is no reply except, “Uh, why are you lying? I am not believing any of that.”

He says he is really really smart. Ok, fine. He says he can read my mind. I do some attempt at a girlie modest shy face which probably more resembles a grimace. But he is deep in his dream lies and honestly, notices me less and less. When he says he can read my mind, I know he can’t, because he’d be horrified by the swearing and laughter.

He is the smartest one in the room, though, he says modestly, often people don’t realize it. I nod and keep looking for calcedony nodules, aka agates. He’s better at finding them than me. I am automatically competitive, but that’s on an upper level of my mind. At the deeper level I could care less.

I also do not care if he’s trying to impress me with his smarts. My feminist level laughs hysterically and thinks nasty nasty nasty thoughts. But I have a deeper level that can love most people. I keep that stuff hidden and I know he can’t read it. Though I can read him: not his mind, but my inner psychiatrist gets involved and wants to know, why does he lie? And he’s lying to himself, not me. I don’t believe a word, but I am interested. What is the goal, here? Why lie?

He had a perfect marriage. I can’t control my expression on THAT one. Uh, doesn’t exist, hon. Why THAT lie? It starts to sort out. Well, in a way it was perfect. Perfect for him. Not perfect for his wife. She was super super depressed. Guess none of that was his fault. Our absolutely sexist culture. And now I know why he is hanging out with me. I am depressed. But it is situational and temporary. I need to close my clinic and I still have a year on the lease. And I will go work temp doctoring, but it is risky. I may get pneumonia a fourth time and it could kill or disable me. So I cannot take the risk of closing early and paying off the lease as a temp. I have to work the year out and I am really down. He is looking for a depressed woman and I seem to fit the bill. And I am a doctor. Who better for a really smart male to control than a woman who is smart enough to become a doctor (but not as smart as him).

Well, it all blows up after a year. I close my clinic, go work as a temp, and keep walking in to rooms where patients have their masks off. It only takes me five week to get bad Covid, even though I am masked and even though I ask the clinic manager, the nurses, the medical assistants to have people keep their masks on. I am down and this time I need oxygen.

Pneumonia for me comes with tachycardia and the opposite of brain fog. The tachycardia makes me drop ten pounds in the first week and wires my brain like a rocket. I wake up in the morning anxious like that cartoon of the cat attached to the ceiling with all four paws and fur all on end.

He says, “Pneumonia makes your brain go faster.”

I say, “Nope.”

“No? What do you mean?”

I say, “My brain is the same speed as it always is. But when I have this, I can’t hide it.”

“I don’t like that idea at all.” Yeah, that is the moment when our relationship is done. By him, not me. For one thing, I am no longer depressed. For another, he is the smartest person in the room. But. My brain might be faster. He says, “I can follow what you say, but you don’t even take a breath when you switch from one topic to another and I can barely keep up.” Yeah, well, sorry. That’s why I bloody well hide it most of the time. Because our culture dislikes smart women A LOT. It’s okay, barely, for a woman to be a physician, but men don’t want to date them. They wouldn’t mind screwing them. My maternal uncle told my mother that he was looking for a wife, “But I don’t want a woman who is smarter than I am.” My mother snarled about my uncle for weeks. Go, mom.

So this guy was a liar. But maybe I was a liar too. I shut up once he started lying and I shut the gates and doors of the vast garden and jungle that is my mind. No entry to people lying to themselves. There is a public garden in my mind that they can visit, but the rest is closed, hidden, contains the entire ocean and the deep trench, and maybe the universe.

And I haven’t dated since. Because I can’t stand that the virginal disney princess girl mythos in our culture feeds the sexist child abusive Epstein and all the men with him. And bloody well don’t say, “But there are some men that aren’t like Epstein.” Yeah? Well then why aren’t they fighting the Epstein crowd to the death with guns and knives. Until all the men are protecting all the children, all the girls and all the boys, and the gay folk and lesbians and trans and different races and yeah, I expect you to model Kwan Yin and protect EVERYONE from being abused. Meanwhile, men can stay the heck away from me. And yes, you can substitute a lot of swears for the word heck.

For the Ragtag Daily Prompt: tame. I think this is not a tame subject.

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What to check before bringing your elder home from the hospital

I get a call from the hospital (this is over a year ago). They say, “Your friend is ready for discharge. What time can you pick her up?”

I reply, “Can she walk?”

“What?”

“She has three steps up into her house. Can she walk, because otherwise I can’t get her into her home.”

“Oh, uh, we will check.”

They call me back. “She can’t walk. She’ll have to stay another day.”

I knew that she couldn’t walk before they called. She could barely walk before the surgery and after anesthesia, surgery and a night in the hospital, her walking was worse. She had been falling 1-5 times at home and the surgeon knew that. He did not take it into account. The staff would have delivered her to my car in a wheelchair and then it would have been my problem.

She was confused by that afternoon, which is not uncommon in older people after anesthesia. She stayed in the hospital for six days and then went to rehab, because she still couldn’t walk safely.

Recently I have a patient, an elder, that I send to the emergency room for possible admission. He is admitted and discharged after two and a half days. Unfortunately he can barely walk and his wife is sick as well. The medicare rules say that he needs 72 hours in the hospital before he qualifies for rehab. We scramble in clinic to get them Home Health services, with a nurse check and physical therapy and occupational therapy, and I ask for Meals on Wheels. It turns out that Meals on Wheels will be able to deliver in two months.

The wife refuses to go to the emergency room. I tell her that if she does get sicker, that they both need to check in. The husband can barely walk and is not safe home alone. If one gets hospitalized, they both need it.

If you have a frail elder, be careful when you are called about discharge. Go look at them yourself, make sure that you see that they can get out of bed, get to the bathroom, walk up and down the hall. Can they eat? Do you have steps into your house or theirs and can they go up the steps? I got away with saying please check that my friend could walk because I am a physician, because I knew she couldn’t and because there was no one else to pick her up. Do NOT ask your elder. They may want nothing more than to go home and they may well exaggerate what they can do or be firmly in denial. You want them to be safe at home, to not fall, to not break a hip and to not be bedridden.

For an already frail elder, even two and a half days in bed contributes to weakness. And being sick makes them weaker. If they are barely walking when they are admitted, it may be worse even after just 2-3 days. I used to write for physical therapy evaluation and exercise when elder patients were admitted, to help them for discharge. Once I got a polite query from physical therapy saying, “This patient is on a ventilator. Do you still want a consult?” I reply, “Yes, please do passive range of motion, thank you!”

Your elder does not have to be doing rumbustious dancing before they go home, but they need to be able to manage stairs, manage the bathroom, manage walking so that they can get stronger. Otherwise a stay in a nursing home or rehabilitation facility may be much safer for everyone.

For the Ragtag Daily Prompt: rumbustious.


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Content

I never do know where a poem is going when I start it. Usually I start in the dark. To my surprise, those poems will end in the light. Apparently the reverse is true too.

Content

At the moment I am feeling content
deeply content
with monsters

At the moment I don’t need more
then this
me
a few friends
and all the monsters

I can’t fix the monsters
healer, right
the people come
over and over
and won’t admit
their monsters

the monsters sit on the floor
of the exam room
clinging to the person
chained to the person
the monsters wail and cry
while the person
ignores them

It has taken me all these years
to let go of anger
fury
rage
that almost no one
admits to monsters
or tries to heal them

Except the addicts, drunks, crazies
they see them too
many try to destroy their vision
with alcohol or drugs
or persist on telling others
about the monsters
until they are drugged

Yesterday I look on line
for local music
not bluegrass
thinking that I would like
to find a place with grown ups
quiet

I think, how silly I am
to look for grown ups in a bar
and then I try to think
of where to find some grown ups
and I think THERE AREN’T ANY GROWN UPS
it’s all just children
who’ve grown big

I do not like drama
there are no movies
that I want to see

I like clinic
where I try to help a little
sometimes a lot
sometimes a person might remove
one knife
one chain
one arrow
from their traumatized
terrified
bleeding
monster

And really
that is why I am here
and that is all that I can do

__________________________

For the Ragtag Daily Prompt: journey.

Meanwhile, rat joy: https://www.bbc.com/future/article/20241128-i-taught-rats-to-drive-a-car-and-it-may-help-us-lead-happier-lives.

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More bizarre than Sasquatch

Sol Duc and I went for our walk together yesterday. This is a yard across the street, with the grass all pressed down where someone slept recently. Local deer or Sasquatch?

Meanwhile, I think the nearer we get to the election, the more bizarre I find our culture. I don’t suppose Make America Great Again has anything to do with modeling courtesy, kindness, setting a good example, lifting others up. It’s more like the drama of a “reality” show, where all the boring bits of life are edited out and it’s all drama and people getting frustrated with each other and confrontation. And speaking of discourtesies, the other party sent me a text and email, “Earth to Katherine”, wanting more money. I am offended, deleted and blocked that one. What IS this? Are we so addicted to action movies, “reality” shows, drama, violence and video games that our politics imitates them? When will people grow up?

I hardly watch movies or television series any more because honestly, no one on any of them is any more mature than Elmer Fudd. At least Bugs Bunny is funny. And the things “based on a true story”. Right, let’s add some more dramatic moments and more conflict.

I think I would enjoy Sasquatch more.

Thank goodness for my cat.

For the Ragtag Daily Prompt: bizarre.

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Authenticity and masks

The Ragtag Daily Prompt today is identity. Yesterday I went to work an hour early so I could attend the Friday morning Continuing Medical Education. It was about adult ADHD and the positives and negatives.

I do not have a diagnosis of ADHD. I have one friend who insists that I have it, but I don’t much care. However, the speaker started talking about masks and authenticity. She said that we are told to be authentic at work, but that people with ADHD often find that their authentic self is not welcomed and they learn to mask.

I asked, doesn’t everyone mask somewhat at work? She said, “Good point, and yes, people do.” It got me thinking about identity and masks. I pretty much clammed up in Kindergarten because I was too much of an outlier and culturally wrong. We did not have a television and television was pretty much what the other children talked about. I knew songs and poems but these did not interest my peers. I was interested in science, too, but that was also not popular. I think I was a geek before it was named and as soon as I learned to read, I became a bookworm. I am not sure if having a television would have made any difference, either.

Fast forward to after high school. I went to Denmark as an exchange student my senior year and then needed to make up credits to graduate. Another high school student was in my Community College classes. After a bit, she said, “I thought you were shy in high school.” I said, “No, I just didn’t talk.”

Currently I am more authentic in the room with patients than with the rest of the staff. Corporations are very weird hierarchical places. My authentic self always questions authority but I am trying not to do it all the time. At least, not out loud. The patients seem to be fine with it. I had a very difficult conversation with an elderly couple this week about memory and planning, now, before they can’t. I got hugs at the end of the visit even though we’d gone into frightening and difficult territory. They did very well. Yesterday was my last day at that clinic and next week I am in another one. Even after just four months in this clinic, I will miss many of the patients and hope they do well.

Yesterday I really did Urgent Care. My schedule only had a few people and then six more sick ones were added on. We had to call an ambulance for one, the first time I’ve had to do that here.

What is authenticity and what is our identity? Is the work mask less real than the self in our minds?

I took the photograph at a small hot springs resort. A friend that I’ve known since high school and I met there. I love the bookworm rabbit. I think she represents the happy bookworm part of me. I read about 7 novels a month, haunting the library here. Maybe I will get to know some more people over the next 6 months.

For the Ragtag Daily Prompt: identity.

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Love gently

Honey is older, nearly thirty years since that first feeling of being bitten by ants. She is back in corporate medicine, as a temp. Temporary, short term, maybe that will work better.

It is a joy to go in a room and be alone with a person and their monsters. Theirs and hers. Sometimes the younger ones haven’t experienced it, they are terrified if one of their monsters becomes a little bit visible, they hate seeing them. Honey tries to be gentle. If they only want to talk about the sore shoulder and not the stress and violence, well, she leaves the door open a crack. Sometimes the monsters cry.

Older people may be stiff to start with, but when they realize their monsters are seen, acknowledged, this isn’t another robot doctor in to say increase your diabetes medicine, lower your diabetes medicine, tell them a plan without ever connecting, the older ones lean back, sigh, and relax. The monsters play on the floor, Honey’s monsters playing with theirs, happy, engaged.

The hard part is the clinic staff. Honey is with them daily. The medical assistants are young. They kick their monsters aside as they walk down the hall. It is terribly hard and heartbreaking to work at her desk, with the medical assistants’ monsters cowering under their desks, kicked, abused, silent tears and holding bruises. Honey’s monsters mind. They climb into her lap and hide their faces in her shirt, under her jacket, peer over her shoulder. They don’t understand! Why can’t she be nice to THESE monsters?

Honey whispers to her monsters when the medical assistants are rooming patients. “I am so sorry, loves. If I acknowledge these, the monsters of the women working, I become a demon. It is very hard to share an office, no wonder I worked in a clinic alone for eleven years.” Honey has been through that. It is still inconceivable that some people don’t see the monsters at all. Is it learned blindness? Or just not developed unless someone had to learn it? Unless someone grows up in terror and seeing the monsters is the only way to survive.

Honey thinks some people learn to see them as adults, at least their own monsters. Hard enough to do that, without seeing the monsters clinging to other people.

Honey is tired of her monsters crying in sympathy with the staff’s monsters. She thinks maybe there are small crumbs that she can leave for these demons. Little gifts. Her monsters can creep under the desk when she is the only one in the room and leave something. A flower. A dust bunny. A crumb of a crisp. A small rock. A little gift to let them know they are seen and loved. A poem. A prayer. Just a tiny bit of love.

_____________________________

For the Ragtag Daily Prompt: crisp.

The photograph is me all dressed up for the 1940s ball.

______________________________

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Free agent

The Agency contacted me yesterday.

“Yes?” I say.

“Are you free?” Dispatch always sounds so disinterested.

“Yes, I’m free.” I try not to sound annoyed. I am too good at my job. I’ve given up on dating. This frees me up for the Agency.

“Room two.”

Room two has a woman who looks frozen. I introduce myself, a stranger, her previous person left.

“Are you sleeping?”

“No. Well, I fall asleep but then I wake up. Nightmares and my heart beats so fast. Then I can’t go back to sleep.”

“Did something happen?”

Her face tightens all over. She wants to tell me but not let the emotions out. “A scam!” Now the dam is cracking and falling apart. The story comes out bit by bit. “They opened an account in my name! Took out a loan! I am so scared. And ashamed. We could lose the house.” Not many tears. She won’t let them.

“Ok, I think this is a PTSD reaction. The not sleeping is really common. Can you talk to your husband?”

“I’ve snapped at him! We never fight! Forty two years!”

The monsters are visible now. Clinging to her, but some are coming to cling to me. Fear, shame, grief, anxiety, fatigue. They aren’t really that big, because she has been a careful person, a wise person. But this has cracked her open because she never expected it.

“Have you contacted the authorities?” We talk about what she has done, the practical bits. She has already made wise moves. It’s the feelings that are upsetting her.

We pick something for sleep, a low dose, not one of the newer addictive ones. An antidepressant that will hopefully make her sleepy. Close follow up is even more important, to be sure that she is starting to comfort the monsters. Many of the monsters are crying for her. I think they will be ok.

She is more comfortable before she leaves. She brought the feelings out and I was not horrified and I did not shame her. They weren’t so bad after all, when she brought them out in the light of day. It’s when they are fighting to be felt and heard that they feel so dark and dangerous and frightening.

I leave the room. She will be back in a week, sooner if she needs to. One of her monsters smiles at me tremulously as it clings to her. I smile back and nod. I think they will be ok.

For the Ragtag Daily Prompt: agency.

I write this and then start humming. Yes, this is the right song.