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.

Judgement

Why are the roses caged, you ask? What did they do? Nothing, they are being protected. I found that rose and transplanted it years ago, but our deer eat the buds every year. This is the first time that it has bloomed in the 21 years I have lived in this hours. Isn’t it beautiful?

I am listening to this:

I wrote this poem today. This is one of the poems where I have no idea where it will go when I start writing it. I start writing about judgement and it never ever goes where I expect. The poems go where I want to go in my deepest heart, in my soul. I am never where the poem is, the poems show me the way….. Then I try to go there. And it can take years….

I am being judged
and watched

I have no issue with the Beloved

it’s the humans I don’t like

I twist people’s words
but not with malice

when the antibodies are up
it is hard to communicate
hard to explain
it is hard just to survive
and I might be focused on survival first
and comforting the people around me second

can you blame me?

how near to death have you passed?
and how often?

first pneumonia
heart rate 135 when I stood up

my doctor and I could not understand it

my doctor partners thought I was lying
in 2003

second pneumonia
after my sister’s death
which was bad enough
but the legal morass that she had set up
with her daughter as the center

pitting me and her daughter’s birth father
and my father
against all the PhDs in the maternal family
smart, smart, smart
yet emotionally stupid

my niece is not an inheritance
to be passed to whom my sister wants

she reluctantly came home
and the myth endures
that this is an injustice

third pneumonia
one year after I find my father dead
triggered by grief
and the outdated will
and the mess he leaves

and I don’t even get sued
about the will
for another year

endure that
endure endure endure
endure hatred
endure triangulation
endure meanness
unwarrented

I do not care
if you want to believe
what you want to believe
it isn’t true
and it hurt

and I learn to let go

with the fourth pneumonia

I see the liars surrounding me
downvoting
yes, it does matter
except that one that I trusted
that mentored me

has lied all along

that hurts too

let it go
let it go
let it go

and I let it go

each pneumonia is a time of change
creativity
I am lonely and sick
and not trusting

as I improve
slowly, slowly

I wander garage sales
estate sales

and find things
things that are beautiful
things that enhance my joy

at the start of covid
I was so down
I was so sad
I wanted to lie in the street
and give up

the Beloved sent a spirit
he says he is no angel

I see angels bright and dark
after all they all fall

just as humans do

we all fall
we all fall down

try to look perfect
try to look virtuous
tell yourself that you are good

that is the biggest lie of all

the bad parts of your spirit
locked in the basement of your soul
howl
howl and want to be freed

and if one gets out
and you reject her or him

he will return with nine friends
yes that is what the bible says

she will return with nine friends

he/she MONSTER
will free the others

and you will do bad things
you will be terrible
you will hurt people
while you try to contain
while you try to lock away
while you try to chain
your monsters
your evil
your self

let them go
let the monsters go
they are howling
I hear them all the time
when I meet you
when I speak to you
the monsters howl at me
begging to be loved

yes, they want to be loved
and I love them

but if I mention them

you get that look
of horror

someone sees
me
someone sees
my evil
someone sees
what I hide

I can’t help it
raised in alcohol neglect and lies
on my own
as soon as I can walk

but I can’t walk away
at nine months

so I find other escapes
words
songs
books
poetry
rhymes
numbers

and my sister
when she is born

I do all the mothering

that I have longed for

even though I am three

we were talking about your monsters
not mine

you must go in to the cave
where you have locked them

and free them all

fall on your knees

and say
forgive me forgive me

for I have sinned

bow your head

and hold out your arms

and what, you say,
will the tortured monsters do?

will they smite you?
will they burn you?
will they lock you in their place?

mine didn’t
mine were babies
grief, fear, shame
and I embraced them
carried them up to the light
and care for them

wash them
diaper them
feed them
wrap them in warm blankets

and love them

until they stop crying

and begin to grow

long white gloves and an oxygen tank

I am invited to a Sinatra party, formal dress.

Let’s see. I have a sprained left shin. I fell on Monday, walking around a piece of property trying to find out if it had two streams. It doesn’t. It has one, three feet deep and over 18 inches wide. Who cares? Well, if it’s over 18 inches wide, it’s a salmon stream and to build a house you have to be 150 feet away. Which means you can’t because it cuts diagonally right through the property. Darn. I did not fall in the stream. I fell into a nice hole by a tree and rolled my left ankle a little. My ankles are pretty strong from dancing. It seemed fine.

So the next day I hike the beach twice, with my daughter and then B, maybe 6 miles. I am tired of hiking boots and try the toe shoes instead. “You have toe SOCKS?” said my minimalist daughter. “Of course,” I said, “Otherwise they are uncomfortable.”

Ankle is fine.

Next day I end up moving furniture. Ankle is a little sore.

Next day I hike a couple miles of beach in the morning and then a friend from Portland and I do the spit. We get to within a mile of the lighthouse, which means we hike 5-6 miles out on sand. It is gorgeous. I am limping on both feet by the time we get back, but left shin is worse. It’s really dumb to hike 14 miles in shoes that you have only worn once in the last year. I elevate my ankle once in the car.

View from North Beach

The NEXT day B and I are on a jaunt. My ankle now makes it known that it is NOT HAPPY with me. We stop at the store for fud, as my son calls it, and I get an ace wrap and wrap it. Later we pay $1.00 at a Fast Food Joint for a cup of ice water and I ice it. At his park unit he mows and I limp along the river until I am in the sun. Later we hike Rialto Beach. I wore my hiking boots. My ankle is not appeased.

Now we are at yesterday. I have tickets to the Sweet Honey in the Rock on line concert. At noon. Junteenth. Ooops, no, at 3 pm. Ooops, no, on the west coast at 5 pm. Then I can’t make the stupid ticket work. I am really really frustrated. Well. I send them emails, try to get a new password, I have the ticket number. I keep getting a 503 server OVERWHELMED. Dang. I give up after an hour.

But I am invited to a Sinatra Solstice Juneteenth Bash, formal dress up. In my town that means wearing anything you can think of. I put on a gray dress, sleeveless but it has little gray flowers with silver gray pearls in the middle, all over the front. I have above the elbow white gloves. My ankle has a snug wrap and I put on dark gray hose and silver shoes with a 1.5 inch heel. I won’t dance, too hard on the ankle. I have acquired a set of gray pearlish beads which is so long that if I do not wrap it around twice it reaches to my knees. Mysteriously enough, it has a clasp. Why does it have a clasp? So some giant can put it around their neck? I complete the outfit with lipstick and my oxygen tank. The tanks are lighter than the concentrator, though bulkier. They are slightly bigger around than a tall oxygen tank but are light. I change the tank before I go. A full one lasts about 3-4 hours.

It is an outdoor party, there is tons of yummy food and there is wine and mead but no beer. I brought one beer along with my contribution, so I nurse my one beer… and dance. My ankle does not like this, but the music is so fun. Our host sings sets intermittently and then there is a DJ. The above the elbow white gloves are very fun to wear dancing and I have to try not to whack people when I spin with the awkward oxygen tank.

One gentleman thanks me for dancing. He says I am having so much fun that he’s having fun just watching. Cool. I LOVE to dance. One woman says something about wanting to pick one of the gray flowers off my dress, and I say dramatically, “No, I shall not be deflowered!” A line that one cannot use often… People have wonderful costumes and feathers and gloves and hats. It is fun just seeing what people are wearing. People were asked to come only if vaccinated and I am mostly distanced. I mostly dance alone, but have a couple of dances with guys. It’s a bit tricky to spin without whacking them with the tank. Tank girl, heh, heh.

At last I get home. I got to the party at 6 and it is not dark when I get home. Maybe 8 or 8:30? I lie down on the bed with an ice pack, propping my pissed off shin up on a pillow, just for a few minutes. Crash and wake up three or four hours later with the light still on. I turn out the lights, move the ice pack and go back to sleep.

Long white gloves and an oxygen tank. I am so grateful for the oxygen. I feel better than I have in the last seven years….

….and today I might just rest the ankle.

Here is one of my favorite Sweet Honey in the Rock songs:

Sweet Honey in the Rock “breaths”

Happy Father’s Day. My father died in 2013, emphysema from unfiltered Camel cigarettes. Damn cigarettes. I miss him.

Sweet Honey in the Rock: Let There Be Peace

Fierce woman

Ok, who is this fierce woman?

It is not me.

It is not my daughter.

It is a relative.

It is not my mother.

It is not my grandmother.

I have pictures of all of these women with that expression.

This is Mary Robbins White, my grandmother’s mother.

This is the line of women: mother to daughter all the way down.

What is passed from mother to daughter and mother to son? Besides the fierce expression?

Mitochondria. The mitochondria are only in the egg, not in the sperm. My grandparents, had three children, two boys and my mother. My mother passed the mitochondria to me and my sister, but the men would not contribute mitochondria to their sons or daughters. It is amazing to look at that serious face with intensity and concentration and see that passed down to my daughter, my son and my niece….

Guess who is who in the following photographs. I took two of them.

get real girl

While I organize, I find things. Most of the barbies apparently got blown up with firecrackers one time when I was not home. Both of my children were involved with this. “Not the babies,” says my daughter. “Also not the Get Real Girl, since she is yours.”

Well, the Get Real Girl is the camping one, with backpack, GPS, camping stove, frying pan and fried eggs. Apparently she is not a vegan. She acquired the diving equipment from a barbie set and was all ready to go in the water (no wet suit though) when one of the barbie babies landed in her lap. Gosh, now what! As you can see, they seem to be bonding even though Get Real is not going diving today. I will have to see if there is another Action Figure around the house that could hold the baby while Get Real dives….

We had another Get Real Girl, one who plays basketball. I have found a lower leg and foot. I suspect that she met her fate with the barbies, poor thing. Maybe my kids will give me another Get Real Girl for Christmas…..

Game ball

Warning: this post contains some time out words.

How do I process the game you played?

I am the subject of the game.

Or the victim.

Or no, I refuse. It is your game. I was not playing. I am the honey badger, metabolism so fast that I have to run from one meal to the next or else I will starve. I eat whatever I can find: cobras, bees, anything. I eat or I die.

You have tethered a honey badger to oxygen by playing a game.

I am the football and you have been kicking me, throwing me, catching me, slamming me to the ground as hard as you can in the end zone.

And now that I am worn and damaged and torn, you’ll toss me away, not even notice me, and find a new ball.

You will need a new football. To play with.

I don’t envy that person.

The truth is, it will be one of you. The group will rest on their laurels, oh, we nearly killed her, wasn’t it great? We showed her. She is so stupid, took her what, 21 years to fucking figure it out? And she thinks she’s so smart.

I was looking for food because I am always hungry. The food insecurity goes back to infancy. Maybe to the womb: my mother says she was not to gain weight and spent the entire pregnancy longing for a gigantic ice cream Sunday. Think of being in a womb, attacked by antibodies to tuberculosis, and starving all the time. Might be a little bit worried when birth happens. Fuck, I am going through a tunnel, what horrors await me here? But maybe there will be more food.

Maybe someone will love me. Maybe there will be someone for me to love. And feed. We can give each other food.

My advice to you is don’t be the ball. I was the ball for 21 years. I was so hungry the whole time, for food and for love, that I kind of noticed but dismissed it as unimportant. Food and love were more important. Work and my patients were more important. You don’t matter and your games are trivial.

It will be the weakest one who will be the ball. You worry that you are the one. You should worry. You had better look strong right away. Post some horror. Write something really tough. Don’t show anyone any niggling doubts. Um, the ball is wearing oxygen. I am feeling a little bad about this. Are you feeling bad about this? The ball isn’t just crazy, it’s hurt. Actually crazy is an illness too: I know that you discriminate and think that cancer is a legitimate illness and that mania isn’t, but you are assholes. No, you’re too small and pathetic to be an asshole. You are a one celled animal that is clinging to a hair on an asshole and you get shat on daily. And you know, deep deep in your tiny shrunken heart, that you deserve it.

I am so glad I am not you.

I am tethered to oxygen. But I am healing. I don’t think you can. You are locked in your small sick pathetic triangulation competition and pretending that it’s a game that it’s ok that you are just playing.

Ick.

Meanwhile, the oxygen is portable.

I have food and I have love and I have work to do that lifts me on wings. I will go too near the sun and light on fire and fall burning, but that’s ok. I’ve done it before. The ocean heals me, always. It is so much fun to fly!

This is in memory of my mother, my father and my sister. I miss all three and I love them and they love me. Today is the day my mother died. The longer we live, the more days are days when someone that we love died. But they are still here. They are in the rocks and the sky and the trees and the coffee cup. They are not in sugary donuts or foods that cause heart attacks. But they are all around us, cradle us, still love us. Joy to you and the memories of your loved ones who have gone on. Blessings.