Adverse Childhood Experiences 12: welcome to the dark

Welcome to the dark, everyone.

When you think about it, all the children in the world are adding at least one Adverse Childhood Experience score and possibly more, because of Covid-19. Some will add more than one: domestic violence is up with stress, addiction is up, behavioral health problems are up, some parents get sick and die, and then some children are starving.

From the CDC Ace website:

“Overview:Adverse Childhood Experiences (ACEs) are potentially traumatic events that occur in childhood. ACEs can include violence, abuse, and growing
up in a family with mental health or substance use problems. Toxic stress from ACEs can change brain development and affect how the body responds to
stress. ACEs are linked to chronic health problems, mental illness, and substance misuse in adulthood. However, ACEs can be prevented.”

Well, can they be prevented? Could Covid-19 be prevented? I question that one.

I have a slightly different viewpoint. I have an ACE Score of 5 and am not dead and don’t have heart disease. I spent quite a bit of time thinking about ACE scores and that it’s framed as kids’ brains are damaged.

I would argue that this is survival wiring. When I have a patient where I suspect a high ACE score, I bring it up, show them the CDC web site and say that I think of it as “crisis wiring” not “damaged”. I say, “You survived your childhood. Good job! The low ACE score people do not understand us and I may be able to help you let go of some of the automatic survival reactions and fit in with the people who had a nice childhood more easily.”

It doesn’t seem useful to me to say “We have to prevent ACE scores.” Um. Tsunamis, hurricanes, Covid-19, wars… it seems to me that the ACE score wiring is adaptive. If your country is at war and you are a kid and your family sets out to sea to escape, well, you need to survive. If that means you are guarded, untrusting, suspicious and wary of everyone, yeah, ok. You need to survive. One of my high ACE Score veterans said that the military loved him because he could go from zero to 60 in one minute. Yeah, me too. I’ve worked on my temper since I was a child. Now it appears that my initial ACE insult was my mother having tuberculosis, so in the womb. Attacked by antibodies, while the tuberculosis bacillus cannot cross the placenta, luckily for me. And luckily for me she coughed blood at 8 months pregnant and then thought she had lung cancer and was going to die at age 22. Hmmm, think of what those hormones did to my wiring.

So if we can’t prevent all ACE Scores, what do we do? We change the focus. We need to understand crisis wiring, support it and help people to let go of the hair trigger that got them through whatever horrid things they grew up with. 16% of Americans have a score of 4 or more BEFORE Covid-19. We now have a 20 or 25 year cohort that will have higher scores. Let’s not label them doomed or damaged. Let’s talk about it and help people to understand.

I read a definition of misery memoirs today. I don’t scorn them. I don’t like the fake ones. I don’t read them, though I did read Angela’s Ashes. What I thought was amazing about Angela’s Ashes is that for me he captures the child attitude of accepting what is happening: when his sibling is dying and they see a dog get killed and he associates the two. And when he writes about moving and how their father would not carry anything, because it was shameful for a man to do that. He takes it all for granted when he is little because that is what he knows. One book that I know of that makes a really difficult childhood quite amazing is Precious Bane, by Mary Webb. Here is a visible disability that marks her negatively and yet she thrives.

A friend met at a conference is working with traumatic brain injury folks. They were starting a study to measure ACE scores and watch them heal, because they were noticing the high ACE score people seem to recover faster. I can see that: I would just say, another miserable thing and how am I going to work through it. Meanwhile a friend tells me on the phone that it’s “not fair” that her son’s senior year of college is spoiled by Covid-19. I think to myself, uh, yes but he’s not in a war zone nor starving nor hit by a tsunami and everyone is affected by this and he’s been vaccinated. I think he is very lucky. What percentage of the world has gotten vaccinated? He isn’t on a ventilator. Right now, that falls under doing well and also lucky in my book. And maybe that is what the high ACE score people have to teach the low ACE score people: really, things could be a lot worse. No, I don’t trust easily and I am no longer feeling sorry about it. I have had a successful career in spite of my ACE score, I ran a clinic in the way that felt ethical to me, I have friends who stick with me even through PANDAS and my children are doing well. And I am not addicted to anything except I’d get a caffeine headache for a day if I had none.

For the people with the good childhood, the traumatic brain injury could be their first terrible experience. They go through the stages of grief. The high ACE score people do too, but we’ve done it before, we are familiar with it, it’s old territory, yeah ok jungle again, get the machete out and move on. As the world gets through Covid-19, with me still thinking that this winter looks pretty dark, maybe we can all learn about ACE scores and support each other and try to be kind, even to the scary looking veteran.

Take care.

Recipe: Corned Beef

My mother gave my sister and I small notebooks decorated with our names when I was starting high school. She said that we were each going to cook once a week. We were to tell her what we wanted to make. She would give us the recipe and we would put it in our notebook. She would buy the ingredients and we would each cook.

It ended up being every other week so that we alternated, but I still have the notebook. My mother died in 2000 of ovarian cancer. I miss her. The first recipe I chose was corned beef and cabbage.

Katy B.’s fruit torte

Katherine White Burling was my maternal grandmother, and this recipe is attributed to her. I still have the small three ring binder that my mother gave me when I was in high school, explaining that my sister and I had to do some of the cooking. We told her what we wanted to make and she would write the recipe in our book and help us. I wrote this recipe out in the 1970s.

preheat the oven to 350 F

cream: 1 C sugar
1/2 C butter

while the butter is softening enough to cream, cut up fruit: apples, pears, peaches, rhubarb, or use berries…

Add to the creamed butter:
1 C flour
1 tsp baking powder
salt
2 eggs

Spread in in a buttered, floured pan. Cover with chopped fruit: apples, pears, peaches. This one was local plums and blueberries.

Sprinkle with sugar and lemon juice
Dot with butter on top.
Bake for 30-40 minutes, depending on your oven.
Cook until browned a little in the part that rises around the fruit, and when a toothpick comes out clean.

I am submitting this to today’s Ragtag Daily Prompt: Kaleidoscope, because the torte reminds me of a kaleidoscope.

What do you see?

What do you see in this rock?

Caged

I was trying to remember the name of this poem the other day. Then I put up the rose picture and remembered. I wrote this in or before 2009.

Caged


She was raised in captivity
Wild one
With her family
They knew the ways
Of the captors
Obedience

The call
Of the wild
Was too strong for her

She strained at the lead
Ears cocked
Hearing
All
And distant calls
Those who were free

She was beaten
Shunned
Thrown in solitary
They told her the rules
Over and over

She fought
Lacerating her captors
And herself

Her family
Wearied
Turned their heads away

Chained
She mourned
Isolated

They didn’t watch her
Closely
Any more

She chewed off her paw
Free

They didn’t notice
She growled
When they came near

They threw the meat
From a distance

Her cubs circled
Behaved
To all appearances

“When, mother?” they whispered

She mourned
As the leg healed
Her gait became stronger

The cubs and she
Ran at night
While others slept

At last she tried once more
Mourned
Howled
Cried to the sky
Grief
Pain
And the call of the wild

The family cringed
Pressed their ears
To stop the noise

She rose
And broke the chain
On the cage
That held them

Howled

They turned away
Cowering
In the familiar

Now she rises
Turns
Trots from the compound
Cubs behind

She sets a steady pace
A loping gallop

They do not look back

Someday
The family may choose
To free themselves

But not now

She follows the voices
To freedom
And the unknown

elevated eagle

For today’s Ragtag Daily Prompt: elevate.

Walking the beach this past week, we saw this eagle. We thought he or she was pretty happy. Why?

First, there were patches of little fish on the beach.

patches of little fish on the beach: dead fish

We discussed the fish. Did they get chased by a predator and get left by a receding wave? Interesting.

Then we wondered why there were no gulls eating the little fish. No birds eating the little fish at all.

And then we figured out why:

Dead seagull wings and beak and not much else left.

Oh, we thought. Amazing how much the gull looked like a dead angel at first.

And a bit further along the beach, the eagle sat, looking very happy. Mmmm, seagull.

The happy eagle.

Liars and the lying lies they tell

This blog post: hanging from a telephone wire intrigues me.

Why do the liars lie?

I disagree with Ms. Kennedy.

The liars lie for the same reason that addicts lie. They are not lying to you or to me. They are lying to themselves FIRST. They want to believe what they say.

“My marriage is perfect.”

“I love all my children the same.”

“I never make an error.”

“I talk to my mother every Sunday morning because we are so close and love each other so much.”

“I can see right in to your head.”

“I don’t care about anything.”

“I am happy all the time.”

Whew. A totally easy list to come up with and I could go on and on and on…. and so could you. When someone says something like this… I am always (fill in blank) or I never (fill in blank)… stop. Think. They want to believe it. They might like you to believe it too. They might even kind of know that it’s a lie and very convincing one but the best liars have convinced themselves.

I saw it in clinic all the time. Over and over and over.

It’s the glitter that gives it away. When they come in all glittery and sparkly and their eyes shine and they are too beautiful for words and they charm your socks right off…. check your wallet. They are an addict or a manipulator or they WANT SOMETHING FROM YOU. And there are people who just do it automatically. They lie all the time.

Whatever. When someone reminds me of my mother or my sister… or the other extremely well trained enablers on the maternal side of my stupid family…. ooooooo. The person has my full focused attention. Which thing is the lie? What do they want? What are they going to try to get out of me?

When I trained in buprenorphine treatment, the guy (enabler) that I was dating was horrified. “You can’t treat addicts!” he said.

“Why not?” I asked.

“They LIE.”

I laughed. “ALL patients lie. There are studies. They lie about whether they are taking their blood pressure medicine. They lie about how much salt they are eating. They lie about exercising. The first question I ask if someone’s blood pressure is too high, is “Are you taking the medicine?” More than half the time I get a sheepish, “Yeah, well, no, I ran out of it two weeks ago.” “Yeah, well, then I can’t tell if it’s working or not, can I? And you’ll have to redo the stupid labs once you have taken it for two weeks and come back for another check.” “Ok, ok, I get it.” If you lie to your doctor, well, you might get hurt. Tell them about the pills your friend gave you, tell them about the supplements, and that infected toe? Might help if you tell the truth about it. Even though it was when you um inserted well we were just, like he has an infected um. That is important information and changes which antibiotics I use plus now I want to check for chlamydia and gonorrhea and same sex male so we gotter talk about HIV prophylaxis and this is a 15 minute clinic visit? I am now running late and annoyed. You need another visit in 1-2 days or else I gonna hospitalize yo dumb self.

And WHY do people, and especially people in addiction, lie to themselves?

Damage. ACE scores. Adverse Childhood Experience Scores. They wish that they were that close to their mother. They long for a perfect marriage. They were beaten in secret by the perfect father. The famous man, their grandfather, sexually abused them. The list is endless.

And how do we help? The person I just stopped dating told me that his children said to him “My picker’s broke.” Our pickers are not really broken. We are attracted to the people who can teach us.

In the book Passionate Marriage, the author writes about how we are attracted to the people who have what we lack. What we want to learn. What we are afraid of. What we need to learn. I needed to learn how to really look at anyone I date with my full on intuition right away and also that it is seriously Not Nice of me to get curious, activate my inner scientist and stick around. I recognize the projection on me at some point and then the scientist in me is intrigued. Really? The most recent one said that inside me there is a sweet innocent joyous tiny girl.

Well, I thought. No, not really. There certainly is a baby. But it’s a baby honey badger or a baby Iron Bitch Alien Lizard. Don’t care what you call it. But it is about as sweet as a pissed off porcupine or skunk. Polecat. Octopoggles done got us! Squirting ink and sliding into an impossibly small space and escaping from the acquarium over and over until the captors let me go…..

And that was actually the moment I should have spoken up. Calmly. Kindly. “Um, no. I was never a sweet innocent joyous tiny girl. I was bathed in antibodies to tuberculosis in the womb and no doubt alcohol and my parents were newly married and I came out saying, “What is happening now? Some new torture? Augh! Bright lights! Is there food? I am really really hungry. Feed me or I will eat YOU.” And then I lost my mother for nine months so that I would not catch tuberculosis from her and die. I didn’t really understand it. I thought people kept giving me away and that you couldn’t trust those evil adults.

In the end this is all actually necessary, says the Passionate Marriage author. WHAT? WHAT? Well, in a truly loving relationship, both people will withdraw the projection. The projection is the “falling in love” where the person is golden, perfect, your true love. No, they aren’t. But you love that aspect of them that you want/need/can’t do. True love is when you withdraw the projection and you see the real person and you love them.

It isn’t easy. But people do it. Birds do it, squirrels do it, trees do it, even elementary bees do it… let’s do it… let’s fall in love.

Qia and the liars

Qia is in her first year of college, 1200 miles from home. She joins the ski team, hoping to ski. There really aren’t mountains in Wisconsin. They are hills. She doesn’t have a car so she has to get rides to the ski hill. She does get demo skis, because she is on the team. It’s mostly guys, a few women. The guys chug a beer at the top of each run. The runs are ice after the first time down. It is very poorly lit and very cold. Qia is afraid of the ice and the guys and the drinking.

At Christmas she goes home, to Virginia. She really wants ski pants, she tells her mother. She is cold. She is still skiing in spite of the drinking and the scary guys and the ice. They yell at her to go faster but she goes the speed where she will not die. It doesn’t matter anyhow. She goes to a formal race and they have three foot tall trophies for the boys and nothing, not even a ribbon, for the women.

At home, her father is laughing. He is giggling, silly. He doesn’t make any sense. He gives Qia the creeps. Her mother sails along like nothing is wrong. Qia’s little sister has gone from the extroverted life of the party to locked down so hard that her eyes are stones. Fungk, thinks Qia.

Her father loses his down jacket, leaving it somewhere. Then he borrows her mothers and loses it too. Qia’s sister has out grown hers. On Christmas morning there are two down jackets and a pair of ski pants.

The ski pants are two sizes too small. Her father laughs. The down jackets are the ugliest colors, cheaply made, junk. Qia watches her mother and sister try to smile.

Qia leaves the ski pants and returns to Wisconsin. She gets a spider bite. It spreads. She goes to the doctor. He gives a laugh of relief and says it is shingles. He has to explain what shingles is. “It either means you are very run down or have severe stress.” Qia laughs. Worst Christmas of her life so far.

She realizes the problem. Her father has been abducted by fairies and a changeling put in his place. She reads everything she can find about changelings. Adult changelings are rare but not unknown. She pulls out every stop on top of her heavy schedule to learn about how to fight fairies. She can’t afford to hire a fighter. She finds an iron sword at a second hand shop. She hangs around the gyms and watches the fairy fighters fight. She goes home and practices every move. She collects herbs.

She sets things up before spring break. She arrives home and asks her mother and sister to go with her to a specialist in changelings and fighting fairies. Qia is sad but confident. Her mother and sister both cry after watching the movie about the behavior of changelings. Qia asks her mother and sister to help her.

They both refuse.

Qia can’t understand it. But she has studied and read the books. She will do it alone.

She meets with her father. She tells him how awful and frightening Christmas was. She tells him how ashamed and scared she was. She reads him a letter that her sister wrote to her, emotionless, about having to watch him when he is curled in a fetal ball at the top of the stairs. Her mother asked her sister to watch him, so he wouldn’t hurt himself. Her sister says that she wanted to go out with her friends. Her sister is in tenth grade.

Her father doesn’t say a word.

Qia begs him to tell her the key. The word that will open the portal. She shows him the sword and lists all of her herbs and describes her training. She tells him that after she defeats the fairies he will go home and her real father will be returned. She says that she knows he isn’t happy here, with mortals.

He doesn’t say a word to her for the rest of spring break. Her mother and sister do not say a word about it either. Her father drinks more heavily. Qia returns to college.

Qia refuses to come home for the summer. She stays in Wisconsin. She does not want to be around any of them.

Her sister is three years younger. Qia wishes that she could scoop her up and take her to Wisconsin. Qia frets and is in pain. Qia’s second year starts and her sister is in eleventh grade.

Qia’s mother calls. Qia’s sister is on her way. 3000 miles away. “At the last minute, C invited her to live with them in Seattle.” says Qia’s mother. “C was leaving the next day. Your sister decided and went with her. It’s a relief because your sister was getting A’s on tests but refusing to turn in homework, so overall she was getting D’s. ” Qia is relieved. C and S have a son named after her father. He is younger than her sister. Qia also has a cousin 6 years older who lived with C and S and still lives in Seattle. Qia wishes her little sister the best.

Years later, after her mother has died, Qia asks her father about it. By now her father is back and the changeling is gone. I was angry, says her father. But your sister was getting into lots of trouble. Really bad trouble. What could I do, locked in fairyland. He does not go into what Qia’s sister was doing.

And after her father dies, Qia finds a letter. The letter is from C to her mother. It is talking about her sister going to live with C and S. My mother lied to me, thinks Qia. I am not surprised. I wonder why she lied to me. Qia thinks it is probably because her mother set it up with C and did not tell her sister. Qia thinks that her mother lied to her sister. Qia thinks how much that would have hurt her sister: that her mother chose the changeling over her. Her sister would have been terribly hurt and angry.

But so many are dead, what does it matter? Qia’s mother is dead. Her father is dead. Her sister is dead. C’s son is longest dead. S is dead. Even the changeling is dead. Friends in fairyland let Qia know. Actually, Qia and C are the only ones left living.

C did not lie to Qia or her sister directly. She let Qia’s mother do the lying.

Qia does not talk to C again.

Qia is tired of liars.

______________________________________________________________________________________________________________________________

This is not a story about fairies. It is about alcohol or any addiction. We must support families, because the whole family becomes ill. Triangulation, lies, competition, enabling. In my maternal family, the enablers die before the enablees. I have chosen to leave the system and I refuse to be either an enabler or enablee. If you are in that sort of system, you may find that the family resists you leaving and tries to draw you back in to it. When you do finally succeed in leaving, there will be a strong reaction. When the pirahnas run out of food, they eat each other. Stand back and don’t get drawn back in. The newest victim will need to make their own decision to stay or leave.

Thoughts on Ramadan

I have been thinking about Ramadan.

Those religions. Judaism, where you don’t eat pork or shellfish. We do know the reasons: trichanosis and food poisoning. And possibly that paralytic shellfish disease: that would be bad, right? People die fast. So pork and shellfish are forbidden.

But Ramadan. I have thought about it for a long time. I think I will do it next year, the diet part. Because I think I have been doing it: in 2012 and 2014 and now. I change my diet to help kill whatever bacteria I have. I go ketotic and the bacteria that require sugar or glucose or fructose can’t grow. It kills them. Quite effectively, since I was sent home after 24 hours of hospital observation when I had strep A pneumonia and sepsis in 2012, after drinking only 4 liters of fluid and putting out ten liters of urine. This is not a good thing. If it goes on, my circulation would collapse, which happens to be the defining symptom of sepsis. Since I did not want my circulation to collapse, I drank 6 liters of water when I got home. With electrolytes and MgS04 because I had a very low potassium and magnesium when I hit the ER. The hosptialist just said that I was bananas in her discharge summary, but she failed to explain the potassium and magnesium and she didn’t even LOOK at the nurses record of the oral intake and urine output. This is not my standard of care. I think one should ALWAYS look at the test results. The usual urine output is up to 2 liters. Ten liters should have stopped her dead in her tracks. Unfortunately I think she had me labeled. Bananas or not, a crazy person can ALSO get pneumonia and sepsis. Really.

She did give me a penicillin shot. Unfortunately it was the dose for strep throat. Not very much penicillin. After I failed to improve from the antibiotics for a couple of days, I thought OH. THERE ARE TONS MORE BACTERIA WHEN IT IS A SYSTEMIC INFECTION. INADEQUATE ANTIBIOTICS. I pulled my sanford guide. For strep A sepsis you are supposed to treat with:

penicillin G 5 million units iv every 6 hours

and clindamycin 3 million units iv every 6 hours. At least, that was the treatment in 2012.

Damn, I thought. Bit hard to do that at home on my own, isn’t it? Now what?

So I called a local pharmacy. I ordered penicillin V 500mg one four times a day and clindamycin 300mg four times a day and then I hunkered down and ate NO CARBOHYDRATES for two weeks.

Penicillin tablets are horse pills and bitter. Yet the first one I put in my mouth, it tasted delicious. Super weird. But my body must have been saying THANK YOU THANK PENICILLIN and released a crazy high dose of dopamine in my brain.

After two weeks I hoped the damn strep would be dead. I took myself out to dinner, feeling like shit, and ordered food. It tasted like heaven, but…..sepsis symptoms once my blood sugar went up. Third spacing fluid. It feels like sand running out of an hourglass as the fluid leaves your arteries and veins. It also causes an instant and terrifying panic attack as your body tries to tell you YOU ARE ABOUT TO DIE GET FLUID HELP HELP HELP.

Which is why sepsis can get misdiagnosed as a panic attack or mania or what the fungk ever. It is by miles one of the most terrifying things I have ever been through.

Survived it. At home. While my fellow docs in my small town whispered about how I was bipolar. A physician’s assistant told me that the internist told her at a party that I am bipolar. Ok, I cried again. He sucks. How the hell does he know? He’s not my doctor.

Another woman doctor said, “I heard about you in a meeting. After all we aren’t really friends.” I didn’t say much. Afterwards I stared at the phone. I thought we were friends. Guess not. And ok, speaking of HIPAA, what the fungk did they say about me in a hospital meeting? Fungk them. Over and over and over, please. Spank them with a HIPAA paddle.

Next I read about strep A sepsis. Gosh, once you get it you are more likely to get it again. Damn. Power of suggestion. I got it again one year to the day from when I found my father dead in his house. Stress, you see. He’d left an out of date will, my sister was dead of cancer, it was written when I was nineteen. I knew what my father wanted. He’d said that I was the only person he know who could handle my sister, so I was the person he wanted to watch over her daughter. But the damn will didn’t SAY that.

So I did what any sensible human would do. I took the stupid will to an attorney and did what he said. So then the interfering family sued the executor (me) on my niece’s behalf. Stupid interfering mean and actually not very bright family. After three rounds, I said give it to her.

Half the estate? said my attorney.

Yes.

But… how do you feel about that?

It’s good for me. I will be done with her and that part of the family. It’s not what my father wanted but my niece clearly doesn’t want me to watch over her. Ok, fine. Give her the money. Never mind that her mother extracted at least 1/3 of the estate before my father died and made him cry. I was pretty pissed at my sister for making our father cry. That is when my father and I started comparing notes on what my sister was doing. It was grim. Anyhow, let the dead lie. Sometimes they do when they are alive, too.

It’s not good for the niece. Handing her that stack of money is thoroughly dangerous. And she’s over 18, so, well. It is on my cousins’ heads, whatever happens.

Long silence. My attorney says: you are a really nice person.

Well? I said. Have you known any cases like this.

Yes, he said reluctantly. A 19 year old. He got half a million dollars. He was dead in five years.

Mmmm hmmm. I said. Well, I wish her the best.

Anyhow, second round of strep A sepsis/pneumonia. And third round of pneumonia. With the hospital physicians for the most part still insisting that I was a liar. I mostly handled it at home though I confess that when I started bleeding from my gums, I got scared and went in. The kale water, vitamin K source, kicked in and it stopped by the time I got there. The ER doctor said that he wouldn’t believe me unless the disseminated intravascular coagulopathy labs were high. They were only a little high, but he broke his word, told me I was nuts and sent me home. He also told me I was dehydrated, which was comic because I’d asked the nurses for a “hat” and urinated 4 liters while I was in the emergency room. I was keeping track. I WOULD have been dehydrated except that I was drinking fluid when he was not looking. My daughter brought in a water bottle and quietly went to fill it. I didn’t trust that moron ER doctor to take care of me if my blood pressure tanked. Stupid man.

Home again home again.

This time they don’t believe me again. This time I think it’s funny. Also I caught it early enough so that I don’t have sepsis, praise to (your deity of choice)! I have been here for 21 years, doing medicine in this town. I was one of the two doctors who took the lead in the opioid overuse crisis. The hospital didn’t break down and train its doctors until 8 years after I started. You’d think they might say, wait, she has weird ideas….. but you know, sometimes they are really GOOD weird ideas.

Back to Ramadan. I think spending a month being ketotic and only drinking water during the day has a purpose. I think that it kills bacteria that require sugar, and also yeast and fungi, and possibly some viruses, too. What is the mechanism for the virus killing? Well, the cells slow their metabolism in ketosis, because the lizard brain thinks that the person is starving. Some systems get shut down, like chronic pain. Acute pain is still on line because WE HAVE TO FIND FOOD. In ketosis, the body burns fat and protein to make just enough glucose to keep the brain alive, and the side product is ketones. If it is the body’s store of fat and protein, well, that is starving, right? The lizard brain can’t tell if it’s an outside source. FIND FOOD so vision is sharper, hearing is more acute. Fast twitch muscles burn too many calories, so they are decreased. The slow twitch are ON so that we can go for miles and miles if need, cross continents… and where did I learn all this? Not from medical school or residency. There was a brilliant article in the Atlantic Monthly, about fasting for over a month to lose weight. He wrote about the history of fasting and fear of it and about… ketosis. Thank you, Atlantic Monthly, your article helped save my life when my doctors would not listen and sent me home to die.

Maybe viruses can’t get into the cell as easily when the cells slow their metabolism. Or, better hypothesis, the cells are slower so they don’t make viruses very well. They are slow. They ought to ride the short bus.

Ramadan 2022 starts April 1, 2022 and ends May 1, 2022.

I think I will start three days early, on March 29. Because I want to end early. Because… something big is happening at the end of that April in 2022.

Blessings.