While @Donna Jackson Nakazawa is usually too busy writing books, training, and research to blog, she does share gems, nuggets, and information every once in a while on Twitter or Facebook which demand to be turned into blogs. With her permission to post, here's a recent, consolidated Tweet thread version of her writing. It's in response to another thread by Jennifer Brea (which can be found here) where she details about what we can expect from her upcoming book, The Angel and the Assassin. Please note, this title was mentioned by @Former Member in yesterday's testimony before the first ever Congressional Oversight Committee hearing on childhood trauma (which really is worth the several hours watching time).
A thread by DonnaJacksonNakazawa
...@jenbrea you touch on so much re the patient doctor relationship especially in the context of the female experience, and how crucial it is that we better explore the brain-immune link, in this thread. Thank you for this.
Jennifer Brea ✔@jenbreaDoctors who follow me:
I’d love to write a small note to the doctors who diagnosed me with conversion disorder, told me I was too young to be sick, that I wasn’t really sick, that I didn’t need a wheelchair, that I would never end up bedbound,
... I offer a narrative of the latest science emerging from top labs around the world which unveil the biological link between body and mind. What I've reported on offers us (I think, and I hope readers will come to understand this too when they hold the book in their hands! startling new insight into every story of human suffering. Especially for women and girls, who face depression, Alzheimer’s and autoimmunity at much higher rates than men.
@jenbrea few thoughts:
- As you point out after you exercised a voice of power through TedTalk, film, etc. you received a different level of care/attention. Physicians offered you what I think of as "healing presence" investigating the unseen while making you feel known, seen.
- I have a perspective on this as a science journo with rare autoimmune disorders (I also care for a loved one w rare disorder). Because I am so fortunate to have a national platform, the care I/we receive is not always the same as the care others receive. It should be the norm.
- This exploration into the brain-immune link is the most important science of this century. Full stop.
- That was why I spent 2 years writing/ researching my next book, The Angel and the Assassin: The Tiny Brain Cell that Changed the Course of Medicine (Jan 2020).
- Ton to say here about our health care system, the difficulty in finding a physician who will be a skilled detective while also --by training, experience, or both -- offer healing presence.
- I call searching for this kind of healer-physician playing THE DOCTOR LOTTERY, for a deep dive on that see my piece for The Washington Post on why winning that lottery can mean life or death for the patient, or certainly has been in my family
- I also think your journey
@jenbrea says a lot about patient self-advocacy. Especially for women. Not shutting up, not stopping. - This kind of astonishing healing journey often means (especially if you are a woman with a rare or confusing Nightingale disorder, something drs. can't figure out through differential diagnosis because they can't see it via blood tests/ scans) being a DETECTIVE OF SELF.
- It shouldn't require that. But it does! I think
@JenBrea your story is the greatest example of that that I've ever seen. And it's in this murky area of brain-immune science. Which makes it all the more maddening.
It means being what I think of a the General Contractor of your own health. Until physicians listen. Until you find the right team. It shouldn't require that. But it does. Much more to say on this. But just wanted to add these thoughts. Thanks for sharing your thread. Powerful.
The Angel and the Assassin: The Tiny Brain Cell that Changed the Course of Medicine (January 2020, Random House/Ballantine) is ALL ABOUT THIS. In telling the story of this tiny cell, the power of which science overlooked for so long...
... I offer a narrative of the latest science emerging from top labs around the world which unveil the biological link between body and mind.
What I've reported on offers us (I think, and I hope readers will come to understand this too when they hold the book in their hands! startling new insight into every story of human suffering.
Especially for women and girls, who face depression, Alzheimer’s and autoimmunity at much higher rates than men
ACEs/trauma shift the architecture of the female immune system in both body and brain in unique ways thanks to estrogen and the female stress response via glucocorticoids (stress hormones) which means we launch a more robust immune response to pathogens and social threats. This can be good in the short term especially in terms of protecting a fetus if pregnant, but causes more wear and tear on the body and brain's immune systems over the longterm, altering the female immune response in unique ways. This make #depression, #autoimmunity, rare "nightingale" #brainimmune
disorders, #Alzheimers more prevalent in women.
It can also alter #NeuralNetworks in the hippocampus, PFC, amygdala, default mode network, which matters in terms of how our innate sense of self-worth develops. This affects us as adults, how kind we are to ourselves, how worthy we feel. The self-loathing or self-doubt that is all too common amongst those with #AE or #Trauma histories (prior to becoming #traumainformed) can sabotage our ability to engage in self-advocacy and self care.
All of these #NeuralNetworks share ONE COMMON "LIGHTSWITCH" in the brain. Microglia ARE the Angel and the Assassin of #NeuralNetworks, and therefore of brain health. #Microglia are affected by the same stressors, pathogens, infections that alter the physical immune system.
For more on this see Random House's announcement of my next book, The Angel and the Assassin: The Tiny Brain Cell that Changed the Course of History (or to preorder!! see; ) you can also get a sneak peek of early praise coming in (bit.ly/2XBc7uc) (amzn.to/2Y3Amkd)
Okay this thread is getting much longer than I thought, wow. (Twitter is hard, I'm
a #Longform writer!) Bottom line: w/ these neural and bioimmune changes it is harder to respond in assertive ways in traumatizing situations that echo earlier #trauma#ACEs.
That makes it harder to stand up in medical settings if one is being dismissed, disbelieved, diminished (and female patients are more likely to be dismissed than male patients). (See my piece in WaPo on how the patient doctor encounter affects outcomes!) (wapo.st/2XZupV9)
That dismissal and doubt echoes the original trauma of the diminishment that comes with experiencing #ACEs and of being female in our society #MeToo. That said, our needed #HealthCareRevolution for a more healing patient-doctor encounter includes all patients, male, female, child, elderly, ACE history, no ACE history.
I've interviewed many male patients who've also suffered in our health care system due to dismissive drs. Last tweet in this thread, whew): For female patients w #ACEs all this (which is true for all pts.) is amplified many times. Re-envisioning the pt-dr encounter in general and w/ these #traumainformed
nuances needs to central to med school training.
Some changes are happening. One last thing: I am engaged in doing that training now (for instance, The Angel and the Assassin and Childhood Disrupted are part of a med school program at Columbia Medical School ... I teach at many medical/practitioner conferences. Trying to make a change, one word at a time. That's it. My #ThursdayThoughts.
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