So, the reason why I have finally been able to blab away on the blog I have been meaning to start forever, is that I am currently on a “staycation”. Also known as “catching up with films I cannot see while my children are at home”, “trying to eat something healthy”, and spending the majority of time doing work and catching up on charting “vacation”. Sounds dreamy hey? Not quite the beaches of Mexico, but in my line of work, time off to breathe and reflect on what you’ve seen and heard over the last few months is essential so that burn-out doesn’t become an inevitibility.
It is a sad state to be in when one has to take a vacation from work, to catch up with work, but with the amount of patients I see in a day, and the complexity of problems presented, I spend all of my self alloted charting time, trying to sort out problems…the more horrendous, the more time that they take.
So while perusing blood work, I thought it might be a good time to put on a film that I have been meaning to see for a long time. Not really my kind of film to be honest, but it was a rainy day, I was feeling tired, and there was a lot of lab work to cover, so I knew I would be on the couch for the long hall. And when you have two children (the youngest of whom never sleeps) and no family locally for back up, evenings are a series of trying to survive dinner, and then bedtime and then rushing to get into bed ourselves( to fool ourselves into thinking that we might get some semblance of sleep). So, with heart in hand knowing I might regret seeing something so brutal, but knowing that I would have almost three uninterupted hours, I put on American Sniper.
It was a great film. And I will regret watching it forever.
As a parent, personally, there are a few things that my brain cannot really handle thinking about. The number one on that list would be watching my child suffer. The only thing worse that I could imagine would be watching my child suffer without being able to comfort them in anyway. There are many rather shocking and terrible scenes in this film, but there is one that stands out that relates to what I have just said, in a way that had me almost throwing up in the instant that it was happening on the screen.
Three days later, and I was flipping through the Dailymail on my phone. My usual routine in the morning, while my patient partner entertains and feeds the kids downstairs, is for me to sneak off upstairs. If I am lucky, I will have enough time to read a couple of trashy headliners, celeb gossip. Enough to get me out of the reality of real life for a few minutes. If I am extra lucky, I will have a full poop on my own 🙂
This morning as I perused the headlines looking for cheesy news and celebrity gossip. I couldn’t help but be sucked in by the headlining story talking about two women who were kidnapped and used as sex slaves somewhere within the realms of the horribleness going on in the Middle East. The one spoke of how she gave into demands after her one year old child was beaten in front of her. I did not read the rest. My mind had already finished the story itself. I sat hoping to be swayed by the cheesy gossip to the right of that post. But it was too late, the mental damage had already been done.
If you read the news even just on a weekly basis, there is enough shocking stuff packed into several inches of reading space to leave you devastated for months at a time. Despite, promising myself I will stay away from the negativity that fills the front pages of our papers and always grabs as headline news, I always find myself, on my phone late at night, pre-sleep, drifting back to the realm of the Dailymail wondering how it can all possibly be happening.
The only thing that enables me to fool myself, is thinking that maybe it isn’t all happening. Maybe I read the story wrong, maybe someone wrote down the wrong details, maybe it’s different because it’s happening so far away. Except it’s not.
In a small city, in the Western, developed world, abuse of children is alive and well. It’s easy to watch the news and think “how terrible, I am glad we don’t live like that” and then get on with our own busy lives, too busy to look around and see what is happening down the road, in our own neighbourhoods. We see signs at our local parks, parents who act a little bit too harshly for our own comfort level in the grocery store, but we don’t want to offend, don’t have time to offend, and besides, isn’t someone else supposed to be watching out for it? That is someone’s job right? Hiding in the grocery store isle, waiting to jump out and speak with that parent who’s smacking their kid, when I’m feeling like it would be too intrusive for me to look into it further.
As a graduate I was excited to start up a new practice and get to know a group of people that I could help positivly through knowledge and support into their physical well being. I was not prepared to be a psychiatrist. I was not prepared for the onslaught of grim stories I heard during my first few months of “meet and greet appointments”. I was not prepared to find out that most of my patient’s had had incredibly shitty lives mostly as the result of the experiences they had had as children.
I do not work in a poor city. I do not work in a practice that is comprised only of one socioeconomic group. I did realize that I would have more of a challenge then most physicians in my practice as I had taken on all “orphaned patients” as per an agreement that I had worked out with the area in which I was working. Orphaned meaning “without a physician”. Many had been “dumped” from their last physician (and the one before that and so on), for good reason, many didn’t have the wherewithal to find a new physician after relocating to where my pracitce is. Some were too mentally or physically unwell to get themselves connected and had come to me via the emergency department or social services. But the majority, were run of the mill patients in a city with too many people and too few doctors. Looking at most of them at the outset, I thought that life wound be filled with prevenative care, daily medical issues and a handful of the stuff that challenges your knowledge and really makes you delve into what medical training you have.
I was totally unprepared.
Two months into my 30 minute “meet and greet” appointments, whereby I would meet a new patient, take down their medical and social history and determine “what came next” with regard to their health concerns and mine, I found that I was almost in what I would consider a Postraumatic type of stress reaction.
Day after day of meeting new patients, I was briefed on what they thought were the important aspects of their medical history. Since many had not been seen for years by a general practitioner, many had a lot to say. And a lot of the stories were similar, involing a lot of abuse in their youngest years.
I heard stories from adults about being beaten as children- by their parents, by their step parents, by after school carers. Stories about having to pick the implement by which they were beaten (this was a surprisingly common theme). Stories of rape and molestation over and over again. Each was presented to me by a uniquely individual person, and it never seemed to shock me, despite the common themes, how fresh and uniquely individual, each story seemed.
One mom told me how when she had children, that the police were not expected, nor did not want to be involved in domestic abuse. Coming from a small town and having no transport or money, she had no where to go when her partner’s abuse escalted. And no one seemed to notice or take action, when her four year old missed her first day of school, and the month after, after being beaten so badly she was bed bound for weeks. I had a man disclose that after his mother died, his father started drinking alot and lost his job. Being too proud to ask for handouts, and being too drunkenly angry to notice or care, he would beat his children mercilessly when they complained about having to eat squirrel, ground hog, or whatever animal had happened to be killed by a passing car on the country road off of which they lived. They spent the winter freezing without heat, and lived in a world at school where they were antagonized and made fun of for what they wore and how dirty they were.
The stories went on ad nauseam. Out of 1100 new patients I met in that first year, a good 70% of of them had shocking stories of which abuse figured as a main player. It became so common that I was shocked when a family and social history was brief and there was no mention of anything horrendous and abuse related having taken place. Some, told their stories as if they were an inevitable part of their childhood story, something which they assumed most children had been exposed to, a right of passage that they had proudly, though barely survived. Others didn’t fair so well. My patient who ate squirrels for example, is now a fully grown man terrified of his anger and resentment, riddled at night by a feeling of unease and concerned about his own ability to parent. He is so disabled by his experience, that he lives off of income support and is unable to hold down any job and frozen from experiencing any sort of positive, meaningful relationship. And he has had a lot of professional help.
In a world where we find it easy to see how wrong everything is going everywhere else, it is amazing how easy we find it not to fix what is going on here. Not to acknowledge when someone we know is being mistreated, not giving more of our income to worthy charities that support children and families having a hard time. Not wanting to create parents that know how to both discipline and support their children in a loving and kind and respectful way. Possibly because we too have had experiences of our own that make it difficult to know how to be that parent, how to lay down rules and be there for our children without screaming and hitting. How to get through rough and stressful times without doing really bad things.
I certainly don’t have the answers. I still remember my father’s parenting style, raging when angry, making us fearful to do anything that wasn’t in line with what was expected of us. I remember being spanked twice, and the feeling still that both were unjust; being so embarassed that a flat hand had gone across my bare bottom, and taking months to recover from the hard feelings associated with it. As an adult with kids, I can appreciate how it happens; you are warn down, stressed about money, pushed just that little too much, and the wrong thing takes very little time to do and relieves so much built up pressure. I have been close to that edge before, and I know how it feels to almost be there and do something that you will regret.
But people do it everyday. For a thousand different reasons. And we wonder why we have adults with extreme anxiety and depression, unable to work, unable to contribute to society, some passing on the same behaviours to their own offspring. Children who are unable to function, who are overdiagnosed with other conditions, when no one has time to look into or help change what is causing the behaviour at home. And these are normal people. The people with these stories are the people who sell you realestate, work as researchers in University, Minister in churches.
Looking back I can see me as a younger child and know that as an adult, we all survive a certain type of parenting structure, good or bad. I don’t associate my adult self and my close relationship with my father with that man who was often loudly shouting or who dared to embarass me gravely by smacking my bare bottom. Most of the time.
But part of me does. The part that feels anxiety, has nightmares at night, and who feels like crying when she hears similiar stories or sees the outcome of patients of parents who were many stages worse then my average, unpatient, father.
Listening to one of my 89 year old patients who teared up when asking “why would my mom leave me with relatives without leaving the newspapers for me to cover their bedding with?”,explaining how she used to wet the bed often as a child and that her mom would often cover her bedding with newspapers to absorb the urine. She was then left to stay with relatives for a few days, the lady of the house, who beat her mercilessly for wetting her bed, though there was nothing she could do about it. She was then sent home, where she was beaten by her father for embarassing the family. She described the rest of her childhood as loving, but that memory was the one that stuck with her day after day even after 89 years, and left her weeping in my office for a part of her childhood that was lost during that traumatic time.
The news would have you believe it’s a terrilbe world, my experience would support more of the same, and I wonder how our world of abused children will ever come through their experiences and be able to choose to live differently, to parent differently. I know that it is not all grim, absolutely I know that. But sometimes, after a long and bad day filled with the outcome of patient’s “memories”, it is hard to escape how bleak some parts of people’s lives are.
So I am thankful for small moments on the couch, watching movies I can’t handle, as I know I will try, for at least tonight, to be a kinder and more gentle parent while trying to raise children who will feel well supported and who then themselves might be able to offer that support to someone else who needs it along the way.
Mr Know Body 