The hospital where I was recently treated for a blood clot, showing the facade as it was when I was a four-year old child being treated for burns
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For over a decade I was a family therapist. Before that, an educator. In the past 20 years have dedicated myself to writing curriculum and designing trainings for Lakeside Global Institute primarily around the subject of trauma.
I was honored when Bruce Perry invited me to be a fellow with the Child Trauma Academy several years ago and it has been my privilege to know Dr. Sandra Bloom as both a colleague and a friend. I have read close to 100 books on trauma-related subjects and attended dozens of conferences, presenting at several. I have kept current by reading multiple articles, blogs and other information and perspectives on trauma and its impact, like what I read on ACEs Connection. I believe I have amassed a good understanding of trauma and its impact along with approaches that are effective for managing its symptoms with clarity about what does and does not promote healing.
I also have my own trauma history. As a result of experiencing many personal ACEs, I developed a severe panic disorder when I was 14, eventually became agoraphobic and was housebound for 12 years before finally finding therapy that remediated many of my symptoms (EMDR). Working in a safe and nurturing environment for over 20 years, with an extremely trauma-sensitive boss and kind, caring colleagues has allowed me in recent years a freedom from panic that I never thought would happen. I was impressed that someone with my extreme symptoms could eventually be what I thought was “healed.”
That was until a few weeks ago. The short medical story is that after swelling in my ankle persisted for a few months I finally took steps to see if anything serious was going on other than a heel spur I know I will eventually need surgery to correct. I tried to get answers by going to an urgent care clinic and a podiatrist, who gave me a script to have an ultrasound done. The ultrasound showed I had a blood clot. While I had no pain, when I heard the results of the test I knew I was in serious trouble.
While my head knew I couldn’t avoid going to the ER, every part of me wanted to deny the importance of doing that. I postponed going until I ran out of excuses and it was getting late.
At around 10 o’clock in the evening, a friend drove me to the ER and promised to stay with me. She has taken the trauma courses I have written, has done a great deal of her own trauma research and was well-versed on my history. She has a kind and soothing voice and is a wonderful listener. We sat in the waiting room and talked and joked until I was put into a cubicle. That’s when things rapidly went south for me.
I have a tendency to dissociate very easily and with my new Fit Bit, I often check my heart rate. I’m usually in the mid-50s to low 60s, which is normal for me. When it dips into the low 50s or upper 40s, I realize I have somehow gone down one of my trauma-memory rabbit holes and I take steps to pull myself to a better brain state. Over the years I have had problems managing my blood pressure, often having it spike when in a state of high-anxiety. It’s always lowest when I’m home. I take medication to manage it and have my own cuff so I can check it regularly.
Things were getting pretty tense in the ER cubicle. I was aware of a blood pressure cuff constricting my arm so that the pain was almost unbearable. I couldn’t see the actual numbers because the machine was turned away from me, but my friend could. Even though she was trying to cover her expression of concern (or possibly horror,) I knew something was up.
“So, what’s the number?”
She hesitated. “Well, it’s around 230 over 110.” “That’s not good,” I agreed. I could feel my heart pounding out of my chest and when I caught a glimpse of the screen I saw that number was 100. Meanwhile another doctor was telling me that since the blood clot was “massive ” I would have to stay at least overnight. In my head I heard myself screaming, “I CAN’T DO THAT!!”
I was aware of an IV going in the top of my forearm and then a doctor barking out something about the blood pressure medicine they injected through it. Five minutes later my blood pressure was no better so they injected again. I think they did this three times. I tried to tell them I was having a panic attack and that if they would just let out so I could go home, everything would be fine.
While everyone was very kind and seemed accepting of what I was saying, it didn’t feel like they really understood. I even asked the nurse if she knew about ACEs. She gave me a puzzled look. Sheesh! At one point a nurse opened a small packet with an alcohol swab in it to clean the IV portal. As I got a whiff of the smell, I thought I was going to pass out. I could feel even more panic rising in my chest, a panic similar to the massive panic attacks I had experienced much earlier in my life. I began shaking from head to foot, which according to Peter Levine is a good thing because it releases traumatic energy. Hey Peter, it’s still scary!
I was having the dual experience of being able to think about and even talk about panic, applying information about trauma to myself, and think about my brain and all the neurochemicals I most likely had released while I was simultaneously having my body taken over by all the symptoms of panic that had been a part of my world for so many decades.
Somewhere in one of the conversations with my friend I gained some real clarity about what was happening. “Remember,” I said to her, “I told you that I had third degree burns when I was about four years old?”
Back decades ago when a child had croup, the treatment was for that child to stay in bed with the vaporizer close by. I had a bad episode of croup that night but in the morning was feeling absolutely fine. My mother insisted I stay in bed. There was no TV or radio to distract me, so I kept calling out to her to come sit with me. My mother was a big fan of daily corporal punishment, sometimes multiple times in a day. "Just spankings," she would say, proud that she didn’t hit me with objects.
My mother had placed the vaporizer that contained several cups of boiling water in it on a table next to my bed. She had run the cord under the bed to the wall on the other side. I was playing with paper dolls when one fell on the floor. I clearly remember wanting to call her to pick it up for me but realized that would mean I would get spanked. Instead I reached down to retrieve it, slipped off the bed, fell on the cord and all the boiling water poured over my side and back.
I don’t remember it hurting. I’ve learned since that third degree burns really don’t hurt. I was taken to the ER at the very hospital I was in for my blood clot. Sure, it looked very different but in my head I knew I was in the same place as I had been decades before. I had never been taken to an ER since that time as a child.
In those days hospitals reeked of ether. I suspected that the whiff of alcohol combined with my awareness of being in the ER were triggers to my brain, retrieving that memory of the smell of ether. Even just driving up to the hospital with its very old red brick austere appearance in the front may have brought back memories. It’s hard to say exactly which memories were being evoked but my sense is that it was a lethal combination that put my body into overdrive as the familiar sensations of panic swept through me.
I was admitted overnight, getting to a room sometime around 2:30. To some degree the panic had gone down but was still hovering and as I had learned throughout my adolescence and for many decades afterwards, it could go either way; staying kind of neutral or suddenly escalating to off the charts as terror would take over.
Needless to say I didn’t sleep very well, feeling my heart pounding and noting that it never got below 95. They got my blood pressure down a few points through whatever meds they were giving me, and they did manage to care for the blood clot. Somehow that’s almost insignificant to me as I processed the power of dormant body memories to resurface and send me into a place of panic and terror.
I was finally released at around 7 o’clock that night. My boss picked me up and took me home. He too has a clinical background and is very trauma-knowledgeable and also knows my history, so I feel very safe with him. It made me smile as we got away from the hospital to note that my heart rate had already dropped down to the low 70s about five minutes into the drive. Once home I checked my blood pressure and finally it was close to normal.
In the days that followed I have had a few mental images of being a child in the hospital those many decades ago. I can recall a room filled with people, some crying, and a nurse escorting us into another room, saying we were not to wait because the doctor had called ahead of time. I knew this was a place called an ER because that’s what my mother told me it was. I remember being put in a wheel chair and a woman sitting across from me at a desk writing as my mother shared what had happened. At some point either she or the nurse in the room – my memory gets fuzzy about that – picked up a pair of scissors and peered over at me saying, “Should I cut the skin off now?”
Even as I type this I can feel a vague sense of panic wash over me, reminiscent of the terror I felt when I thought that someone was about to cut me. I can hear the voice of someone in the room saying, “No, we won’t do that now,” and remember the deep sense of relief that flooded over me.
As I tell the story, I am overwhelmed by my own awareness of and humility about the power of trauma to remain in the body, as van der Kolk says in The Body Keeps the Score.
I was quite touched when two of my colleagues on the CTIPP board [Campaign for Trauma Informed Policy and Practice] asked me to write up my story to possibly share on ACEs Connection. If the story of my experience and how it connects to childhood trauma is at all illuminating, I am happy to share because I think we all need to have a deep humility about the power trauma has to continue to haunt someone with severe trauma experiences decades later, even when we feel “healed.” I don’t think I’ll go back to having constant panic like I once did because I do think I have experienced some degree of healing.
The words healed and healing are important to differentiate. I believe I am continuing to heal but I am not healed and I doubt if I will ever be. I think that’s the nature of some traumas. It will be interesting for me to see what happens the next time I get a whiff of alcohol.
A side note: This may give you a sense of the caring boss I have been describing: when I told him that these two colleagues had invited me to write a blog about my experience of going to the ER, he cocked his head and looked at me very thoughtfully. “It’s all right with me if you write it but I want you to stop immediately if as you are doing it you have any symptoms at all. Do you understand?” I feel so very blessed to be surrounded by so many people who understand and appreciate the power of trauma and who, through caring and compassionate responses when trauma symptoms erupt are models for how we need to treat each other, especially those of us with trauma-histories.
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