This child is not afraid of the saxophone because she is growing up with it. The saxophone player is her father. She’s ready to help and be up on stage as well! She’ll have a fabulous jazz foundation and her father didn’t miss a note!
My cousin asks me once, why do doctors say, “This will only hurt a little?’ when they give a shot.
I thought about it. “It’s a matter of scale. Picture this: in room one, I have a woman who thinks her lung cancer is back and it is. In room two I have a mother and daughter crying because the daughter is pregnant and frightened. In room three, I have a well adult who needs a vaccination. Scale their levels of pain.”
Room one is very high, room two is very high, room three barely registers on my pain scale.
I would give out a health department vaccination information booklet by 24 weeks to my pregnant patients, especially the first pregnancy. I previously had given it later, but then I had a woman who refused the child’s vaccines at visit after visit after visit, saying that they were still doing research. The child still had no vaccinations at 9 months.
Remember the woman who refused vaccinations for her children? She had more than four children. They all got whooping cough, pertussis. They whooped for months and were on quarantine. They were not allowed out of the household, any of them, until they were no longer infectious. The mother said she now was for vaccines and got them vaccinated.
I have seen adults with pertussis. Adults do not whoop but they cough. They can cough until they throw up or until they break a rib. For months. It is not fun at all. The adult Tdap stands for tetnus, diptheria, and acellular pertussis. I have never seen a case of diptheria and I don’t want to. It sounds horrible and can kill.
Have I seen a complication of a vaccination? One in 30 years of practice. And I know a person who had a complication, but they were not my patient.
The illnesses cause way more damage and disability than the vaccine. In residency I care for a young man in a group home. He can’t talk and has an odd skull shape. His mother got measles during the pregnancy. Measles is one of the infections that can cause severe birth defects. Get vaccinated before getting pregnant, though half the pregnancies in the US are “unintended”. That usually means “unbirthcontrolled”. I do not really understand that, since the risk of pregnancy in a fertile woman is one in four every time. Twenty five percent seems a pretty high risk to me.
I’ve written about my response to my last Covid-19 vaccination. It’s not a complication. It is an antibody response and it means that my immune system is WORKING, though admittedly it is weird and annoying. I don’t like the muscle dysfunction, but I will get the vaccinations anyhow.
I have a very alternative young woman in for prenatal care once. I give her the vaccination booklet. “Oh, my child is getting every vaccine there is,” she says.
“May I ask why? I was not expecting you to say that.”
“I was in the Peace Corps in Africa. I have seen kids die from every single one of the diseases we vaccinate for. My kid will get ALL the vaccinations.”
When I first think about divorce, I call my sister.
I say, “I am thinking about a divorce.”
She replies, “YOU don’t want to be a single mom.”
I think, well, crap, that is true. Me: “I AM a single mom. It’s just that one of them is FIFTY.”
My sister proceeds to tell me how difficult it is to be a single mother.
I have to self examine my OWN prejudices against single mothers.
Then I wade in, to solo and couples counseling, for a year. My ex fires our couples counselor after a YEAR. He says the counselor is on my side. “We have been talking to him for a year!” I protest.
“I want a new one,” says my then husband.
I find a new one. I am filling out the paperwork. It asks, what is your goal?
That is the moment I decide: I write “Amicable divorce.”
The two years before that moment, I am not sure. I am trying very very hard to see if it can be fixed. But it takes two to tango and my then husband will not tango. Not one step.
We were each attracted to something specific in the other person. My then husband did not want to work at any sort of traditional job. His father would come home angry from work for years. I loved working, always.
I was a terribly serious child, growing up in an alcoholic family, and I have food insecurity. That is, at some deep level, I always worry about whether there will be food. When I meet my then husband he says that his goal is “To have fun every day.”
This slays me. Have fun? And he WAS fun. Biking, jitterbug dancing, he was a tennis and golf pro, he was smart, well read, divorced from a marriage of convenience to a lesbian to cover so she could be a small town librarian. Really? Yes, really. I demanded to see the divorce papers before we got married. My then husband thought I was very very funny and I thought he was too.
When we divorce, people tell me he will never pay child support. He won’t stay in contact with the kids. There are a lot of opinions.
Wrong, wrong, wrong. My ex returns to school, gets a “displaced homemaker scholarship” because he was a househusband (yeah, I said he was smart). He goes to nursing school and gets an RN. “You’ve yammered about medicine at me for fourteen years, I might as well.”
He gave me hell about us living in an “old person’s” town. Then in nursing school he calls. “Hey, I’m doing a rotation. Guess what it is.”
“Don’t know, what?”
“I LOVE these OLD PEOPLE.” he says. And he DOES. He is wonderful with them. He works in a nursing home for years. He gives scholarships to the medical assistants when they leave for nursing school. He brings coffee to his medical assistants and the other staff. He drives by on his day off because one elderly woman will only take her medicine if he gives it to her. He gets pianos for the nursing homes. He does memory loss concerts, where he tries to engage memory loss folks. We store music as entire songs, or entire albums, so if someone starts a song, they can often go through the whole thing. He can sometimes get someone singing who no longer can string a sentence together. Families love it.
Early in covid he calls me. “I have covid.”
“Sh-t.” I say. “Are you ok?”
“Oh, yeah. Everyone at the facility has it. Two staff didn’t so we sent them home. We are working sick because there isn’t anyone else.”
“Yeah, it’s a little depressing. My memory loss folks can look ok at the start of the shift and are dead by the end.”
A quarter of the patients die. This is before the vaccine. My ex sails through covid, says he doesn’t feel bad, for him it’s just a cold. He says, “I miss some of them.” Yeah, holy crap.
So another hero. And he paid the child support every single month and stayed in touch with his kids in his own odd way. “Mom, he tells me about his golf shots,” says my daughter. I laugh, “Yeah. Well, he loves you.” “I don’t care about golf.” she says. “I know, me either,” I say.
The photograph was taken with my camera by my friend Amelia in 2014, I think. It is me and my ex, seven years after the divorce was final.
I read this to my ex prior to posting. Posted with his approval.
My son and daughter-in-law got married April 30th in Black Diamond, Washington. The young man in the photograph was the youngest in the house I rented. We had my two aunts: 81 and 86 years old, and my uncle, 85 years old. Me, my daughter, my two friends and their son. This young man and I took photographs. He taught me new things about my camera and on the last day ran a slide show from my laptop to the television. He helped all of us folks with technology and we really enjoyed having him there.
And I am delighted to hear that he told his parent that he wished we had one more day, all of us. Eight people in a household from Thursday to Monday and it went very well. Weddings always have some interesting glitches, but after putting off the wedding for two years due to covid, the bride and groom did not seem rattled by anything! My daughter-in-law is truly a delight.
Here is to the next generation, surviving this pandemic, sweeping up the pieces and growing, and thriving anyhow.
The photograph is from left to right, my sister Christine Robbins Ottaway, my (sort of but not blood) cousin Katy, and me. This is a fourth of July. We wanted to DO something. We were at my maternal grandparents’ in Trumansburg, New York. My mother suggested that we dress up and do a presentation. We wore her 1950s prom dresses, held a small parade involving three dogs and a cat who were also in costume, and read the Declaration of Independance and the Preamble to the Constitution to a group of adults in lawn chairs. This was in lieu of fireworks. We had fun but we still missed fireworks.
I am thinking about asking. I could not ask my mother for specific things I wanted as a child. She would get me a different and cheaper alternative. If I was disappointed, I would be guilt tripped or humiliated. I did not ask my father for things either. He would make and break promises, too sick from alcohol or he would have forgotten. I stopped asking because I did not like being disappointed and I did not like being shamed. Once I really really wanted something for Christmas. My sister and I made a quiet deal, showing each other exactly which toy we longed for. Then we each shopped with our mother and insisted on the toy the other wanted. Our mother did try to talk each of us out of the toy. We had arranged it so that we were spending the same amount of money: $20. She thought that was outrageous and that something cheaper would do just as well. We both stood our ground on the other’s behalf and then open the presents on Christmas day with faked surprise and real joy. We did NOT tell our mother.
On an earlier Christmas I sewed my sister a toy stuffed snake. My mother was discouraging, but she let me have cloth and needle and thread. “Why do you want to make her a snake? A snake?” I couldn’t really explain well. We had gone to a county fair and my sister and I both longed for the velvet snakes, six feet long and deep red. The snake I made for my sister was only a foot and a half long and I had flowered fabric, not velvet. I coiled it in a circle and wrapped it. My sister was delighted with it and held it all Christmas morning. My mother just shook her head. “A snake.” she muttered.
The things that I could ask for were books and music. I was the kid that the teacher would hand the scholastic book box to after she handed out one or two books to the other kids. I would order 20 books. My father said I could have as many as I wanted as long as I read them all. The only books I avoided were about television or movies. I loved a non fiction book about WWI Flying Aces. The technology of the airplanes and the problem of bullets ricocheting off the propeller were amazing. I also liked that it talked about the ACEs on both sides: German, English, French, American.
I keep reading bits about despair and about how a generation of children is being “ruined” by the pandemic.
Not so, I say. There is hope. We need to support each other to survive and then to thrive.
This generation WILL have a higher than average ACE score. If the Adverse Childhood Experience scale is from zero to eight, children in this time period will have at least one higher point than average and many will have three or four or more. Loss of a parent, a sibling, beloved grandparents during covid. Increases in domestic violence, child abuse and addiction. These are all part of the ACE score.
What does this do to children? They have survival brain wiring. They will do their best to survive what is happening. A friend and I both have high ACE scores, 5 or more, and we are both oppositional defiant. We showed this in different ways. He grew up in the same community. He escaped from home and knew all the neighbors. He walked to the local church and attended at age 3 or 4. He has lived in this community all his life.
His oppositional defiance showed up at home, where he consistently refused to obey. And in school, where he confounded and disobeyed teachers and passed anyhow.
My family moved every 1-5 years. I hated moving. I wouldn’t talk to kids in a new school for a year. It was very difficult. So my oppositional defiance was very very internal. I hid in books and in my head. In 6th grade I got in trouble for hiding novels inside the school book I’d already read. I also would just not listen and my respect for the teacher got even lower when she would be angry that I knew the answer to the question once she’d repeated it. I wasn’t listening because I was bored. She was the first teacher that I thought, well, she is not very bright. The next year they stuck me in the honors class and I stopped being bored, though I still questioned practically every opinion every teacher had. I wanted evidence and I did not believe it just because the teacher said it.
I am not saying that oppositional defiance is in every high ACE score. I don’t know that. Why oppositional defiance? Imagine you are a small child and you are beaten. There isn’t rhyme or reason. You can’t predict when the adult will be out of control. Why would you behave “well” if it makes no difference? You might as well do what you want, because nothing you do will change the adult. Or imagine you are a small child who is with one person, passed to another, then to another. You may not exactly trust adults after two or three repetitions. And you want to survive.
There is an increase in addictions, behavioral health diagnoses, and chronic illness in adults with a high ACE score. A researcher when I first heard a lecture about it said, “We think perhaps that addiction is a form of self medication.” I thought, oh, my gosh, how are we ever going to treat THIS? Well, we have to figure that out now, and we’ve had 30 years to work on it.
I was very comfortable with the oppositional defiant patients in clinic. I got very good at not arguing with them and not taking their behavior personally. They might show up all spiky and hostile and I might be a little spiky and gruff back: sometimes that was enough. I think the high ACE score people often recognize each other at some level, though not always a conscious one. With some people I might bring up ACE scores and ask about their childhood. Sometimes they wanted to discuss it. Sometimes they didn’t. Either was ok.
One thing we should NOT do is insist that everyone be “nice”. We had a temporary doctor who told us her story. Her family escaped Southeast Asia in a boat. They had run out of water and were going to die when they were found by pirates. The pirates gave them water. They made it to land and were in a refugee camp for eight years or so. She eventually made it to the US. She was deemed too “undiplomatic” for our rural hospital. I wondered if people would have said that if they knew her history and what she had been through. It’s not exactly a Leave it to Beaver childhood, is it? When she was telling us about nearly dying of thirst in the boat, my daughter left her chair and climbed on my lap. She was under ten and understood that this was a true and very frightening story.
We can support this generation of children. This has been and is still being Adverse Experiences for adults as well. Family deaths, job loss, failure of jobs to support people, inflation. Remember the 1920s, after World War I and the last pandemic, of influenza. “On October 28, 1919, Congress passed the National Prohibition Act, also known as the Volstead Act, which provided enabling legislation to implement the 18th Amendment.” (wikipedia). There were forces trying to legislate behavior, as there are now. The result in 1920s of making alcohol illegal was speakeasies, illegal alcohol, and violence. Some people acted wild after WWI and the influenza pandemic and some people tried to lock down control, by controlling other peoples’ behavior. It did not work then and it will not work now. The wildness is out of control grief, I think, grief dysfunctional and drinking and shooting and doing anything and everything, legal or not. We remember how the 1920s ended too. Let us not repeat that. Let us mourn and grieve and support each other and support each other’s decisions and autonomy.
Refugees welcome - Flüchtlinge willkommen I am teaching German to refugees. Ich unterrichte geflüchtete Menschen in der deutschen Sprache. I am writing this blog in English and German because my friends speak English and German. Ich schreibe auf Deutsch und Englisch, weil meine Freunde Deutsch und Englisch sprechen.