The Rose Garden, Chapter 17 – Illness

Emergency Room, Markham Stouffville Hospital, Ontario, Author Raysonho @ Open Grid Scheduler/Grid Engine, (CC0 1.0 Universal Public Domain Dedication)

“…rejoicing in hope, patient in tribulation, continuing steadfastly in prayer…” (Rom. 12: 12).

There may be an abuse-related dimension common to all the major illnesses from which I have suffered over the years, disparate though at first they appear.

The mechanism of this is not fully understood, but is thought to involve somatization, i.e. the expression of psychological or emotional factors as physical symptoms [1].  The pain associated with somatization is a physiologic response to the stress and trauma of abuse, but all too real [2].

Abuse and Autoimmune Disease

Around the age of twelve, I suffered a major attack of hives.  Though I did not know it then, this presaged the chronic urticaria (CU) from which I suffer today.  In effect, the body does not recognize, and so attacks itself.

A growing body of research suggests a link between childhood abuse and the development of autoimmune disease [3].

At the time of the initial hives, I was repeatedly bathed in ice water as I writhed.  Since they had been on the phone to a physician, it was twenty-four hours before my mother or grandmother considered taking me to an emergency room.

Of course, my mother had gone to work with a second degree sunburn.  Her enormous blisters burst while she was on the subway.  My grandmother washed the kitchen floor on her hands and knees the day after she returned home from the hospital, following a hysterectomy.

After years of childhood earaches and tonsillitis, I finally had my tonsils removed at age nineteen.  Following surgery, I awoke from anesthesia to find my father at the foot of the hospital bed.  I cannot convey the joy I felt.  It was entirely unexpected and moved me immensely that he had taken time off from work to see me.

It strikes me as funny to this day that I shared a room with a Jehovah’s Witness and a Black Muslim.  Unable to speak, I lay there between them as my fellow patients held theological arguments at high volume across my bed.

Abuse and Endometriosis

From the time I first began to menstruate, my periods were irregular and accompanied by severe cramps.  Endometriosis was ultimately diagnosed.  Child abuse has, also, been linked to endometriosis [4].

It would not be until my thirties that I obtained any relief.  Before that, each month I would swallow as many aspirin as I could tolerate, then lie prostrate on the bathroom floor, comforted by the cool tile until the pain passed.

Again, no one took me to an emergency room.  I remember the pain ending early one Christmas morning, after I had endured it for some ten days.  Julia Child was on TV at the time, demonstrating how to stuff a turkey.  I have retained a sentimental fondness for her ever since.

The day I took the scholarship exam for college, my period came on suddenly during lunch.  We had completed the morning session and were sitting in the cafeteria.

With the onset of cramps and bleeding, I rushed to the ladies room, but could find no sanitary napkins.  Desperate, I attempted unsuccessfully to insert my first tampon, all the while doubled over in pain.

Wave after wave of cramps rolled over me.  I broke out in a sweat.  For some reason, after forty minutes, the cramps stopped on their own.  I used toilet tissue to craft a make-shift pad, and rejoined the others in time to sit for the afternoon session.

I won a full scholarship, as a consequence.  With no thought to a career, I chose biology as my major out of wonder at the beauty of the world.  Medicine — since I tend to faint at the sight of blood — was never an option.

Years later, I, too, had a hysterectomy.  I had to be taken from my office by stretcher — moaning, but issuing last minute instructions to the staff as I went.

My then Office Manager, a close friend, stayed by my side.  This was no surprise.  We had done the office budget together one weekend, as her infant daughter lay asleep in a carrier on the floor at our feet.

Abuse and Chronic Back Pain

I have had many years of back pain.  A fall may have aggravated the scoliosis from which I suffer.  It, also, produced disc herniation.  But childhood trauma is frequently associated with chronic neck or back pain [5].

At times the pain has been so severe I have wondered if it would kill me.  Ultimately, I had to undergo a spinal fusion at the cervical level, then spend three months strapped into a brace.

The procedure necessitated a bone graft from my right hip.  The night before surgery, the nurse and I laughed together as we wrote on my left side in black marker, “Wrong Hip.”

Groggy from pre-anesthesia medication and fearful that a tube could damage my vocal chords, my last words to the anesthesiologist before surgery were, “Please, be careful.  I’m a lawyer.”  He undoubtedly thought I was issuing a threat.

I did not let my mother (who was seriously ill, herself, at the time) know about my surgery until it was over.

While I recuperated, a long-time friend, arranged to have meals sent to my home.  Another close friend drove me upstate to her summer place.

Abuse and Fibromyalgia

Emotional, physical and/or sexual abuse can trigger fibromyalgia in certain individuals [6].  I am among these.  Fibromyalgia causes an increased sensitivity to pain.

Abuse and Migraines

Child abuse can have neurobiological effects on brain structure and function.  As a result, it may increase the risk of headache disorders [7][8].  I suffered from severe migraines for decades.  Only in recent years have these abated somewhat.  I can still remember my sister softly stroking my hair one night, as I lay exhausted by pain.

Abuse and Anxiety

With uterine cramps, back pain, and migraines, I have seen the inside of countless emergency rooms.  This was when anxiety would rear its head.  What if I could no longer work?  How would I support myself?  What if the pain never stopped?  How would I live, if I could no longer function?

With a history of abuse, anxiety was destined to become an issue [9].

I first experienced crippling anxiety preparing for a chemistry final in college.  I was so sure that I would not be able to understand the material that I could not even open my notebook, until granted an extension.

That act of mercy released the tension.  I pretended to myself the anxiety attack had not taken place, all the while fearful of a recurrence.

The problem resurfaced during my last semester of law school.  I found myself incapable of completing a particular report, and was forced to seek counseling or abandon my studies.  With the help of a gifted and compassionate psychologist, I began untying the knots.

Counseling helped me recognize that my experiences were not outside the human realm.  Therefore, neither was I.

While seeing my psychologist, I learned the significance of fairy tales, and why I had been so hungry for them as a child.  In effect, fairy tales spoke in masked language to me on the very issues of the incest [10].

I did complete the report, and go on to take the bar exam that summer.  I could not, however, bring myself to study until the last two days before the bar.  I sat in on review classes; took notes, but was paralyzed to do more.

While others crammed, I buried myself in a history on the Civil War’s 1864 Battle of the Wilderness.  Somehow, the story of courageous men fighting in impenetrable scrub and rough terrain seemed apt.  Little did I know how closely it would later parallel the events of my professional life.

During the bar exam, itself, I experienced an icy calm.  The results of the exam were not published for several months.  When the letter arrived, I opened it with trembling hands to find I had passed.

In retrospect, I realize the significance of the psychological paralysis I experienced.  The report was the final opportunity for educators to discover I had been a fraud all along.

The bar was more than a licensing exam for me.  It was, in a profound sense, a test of my intelligence.  When I passed, my long-held feeling of inauthenticity was at last dispelled.

I was, by the time of the bar, again living in my parent’s home.  At some point during law school my funds had simply run out.  I was deeply discouraged.  It seemed my only option to drop out of school and work for a time.

My mother and I discussed the topic one night, as we sat on the couch in my tiny apartment.  “Move back in,” she said.  “Grandma loved you kids.  She helped me and Daddy buy the house.  She lived for you.  Ve’re family.  Ve share.  Come back home.”

So I did.  It meant more conflict; was perhaps a mistake.  But it allowed me to complete the accelerated legal program in which I was enrolled.  I will be forever grateful for my mother’s kindness and generosity.

Abuse and Heart Disease

While on trial in 1988, I received word that my mother had collapsed.    Thankfully, the case settled.  I rushed to the Bronx and spent a sleepless night on my mother’s couch, unable to convince her she needed hospitalization.

We learned that she had had a heart attack.  My mother did have a heart murmur.  However, childhood abuse and trauma are associated with a higher than average risk of the coronary heart disease from which she suffered [11].

Though barely able to walk for shortness of breath, my mother was the picture of confidence.  She cheerfully told her doctors, “I don’t vant to know anything.  Just tell my daughters.”

My mother’s long-time family physician and her new surgeon could not, however, agree on a course of action.  The surgeon said to me, “This is God knocking.  It’s up to you whether your mother takes the hint.”

We agonized over the decision, but the triple bypass performed on my mother was successful.  In the Intensive Care Unit after surgery, she looked so small and frail.  Fresh incisions ran the length of her chest and down one leg.  Standing by the bed, I softly sang her the only Hungarian tune I know.

Abuse and Cancer

Several years ago, I decided from some last vestige of vanity to have a mole removed from my back.  It turned out to be a malignant melanoma.

Child abuse is thought even to increase cancer risk [12].

My sister drove down to Philadelphia and sat with me, as I waited for surgery.  No words were necessary between us.  Though no chemotherapy or radiation was required, I was monitored for five years.

Medication Side Effects

Eventually, the migraines grew so frequent and severe that my neurologist was at a loss.  With some trepidation, I started on the drug a respected headache center recommended to reduce migraine frequency.

Since brief earlier experience with this drug had produced depression on my part, I consulted with a psychiatrist as a precaution, this second time around.  He placed me on an anti-depressant, although one with the potential for headaches.

The plan was that the two drugs should offset each other’s side effects.  Instead, they magnified those side effects far beyond anything anticipated.

For months, I wrestled with emotional lability, weeping at the slightest provocation.  I experienced memory and language difficulties, all the while struggling to hold down a job as a contract attorney at a large firm.  Soon my symptoms were out of control.

My migraines increased to daily frequency.  My pain medication began to lose its effectiveness from overuse.  The depression worsened.  I developed “hot flashes” so severe I could do nothing but lie on the couch all day, alternately bathed in sweat and wracked by chills.

In addition, I developed muscle aches, dizziness, nausea, insomnia, and a stabbing pain in my eyes.  I lost hair.  My nails began flaking, and coming off the nail bed.

All this was accompanied by the worst nightmares I have ever experienced.  For weeks I relived the incest every night — both as a defenseless child and an anguished woman, unable to intervene.  It was like being raped, over and over.

My doctors could do nothing.  I was shifted from one anti-depressant to another, to no avail.  I learned on my own that these drugs have withdrawal symptoms as severe as any narcotic.

How I held onto my sanity, I honestly do not know.

In 2006, I decided to stop the drugs altogether.  Though it did not entirely clear, the depression began to lift as soon as I stopped the headache preventative.  The anti-depressants I had been on, it turned out, actually trigger depression in certain individuals.

Every last one of my symptoms was a recognized side effect of medication.  I had an impaired ability to metabolize the drugs prescribed for me.  As a result, toxic doses built up in my system.

Though excellent, none of my physicians had taken into full account the power of these drugs or my sensitivity to them.  My health was permanently damaged, as a consequence.

Amid the avalanche of illness, I somehow managed to complete my first book, a non-fiction work on the place of faith in public life.  Throughout the experience, good friends lent their love and support.

Perhaps health issues had to reach a crisis before I could rebuild anew.

The Abuse Filter

Under the guidance of a biofeedback expert, I began slowly reconnecting with my body.  I had viewed pain through the filter of child abuse, i.e. as something to be resisted with every fiber of my being.

What I learned is that pain is a signal there is something wrong.  In that sense, it is neutral, even beneficial.

Not only did I become alienated from my body as a result of the molestation, I was taught, in effect, to ignore my pain.  The needs of a child who is sexually abused are ignored.  They are secondary to those of the predator, assuming he considers them at all.  Consequently, she learns to ignore them herself.

And I was taught by life experience not to nurture myself.  Even my grandmother played an inadvertent role in this.  Not that she in any way participated in the abuse by my father.  Had she known, I am certain she would immediately have intervened to stop it.

However, my grandmother’s attitude toward herself sent a clear message.  Since in a real sense I identified more so with her than with my mother, that message went, like the poison arrow in a fairy tale, straight to my heart.

Evaluated solely on the basis of accomplishment and the desire to succeed, I was the classic “type A” personality.  I thrived on stress, with my body paying the price.  I have since reassessed that approach.

Whatever the future may hold for me, I know my life is in God’s hands.

—

[1]  Frontiers, “Families with Violence Exposure and Intergenerational Transmission of Somatization” by Jennifer Glaus, Dominik Moser, and Sandra Serpa, 2/22/22, https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2022.820652/full.

[2]  National Institutes of Health, National Library of Medicine, National Center for Biotechnology Information, “Cumulative Childhood Stress and Autoimmune Diseases in Adults” by Shanta Dube PhD, et al, 2/2/09, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3318917/.

[3]  Science Direct, Child Abuse and Neglect, Vol. 122, “Childhood trauma, dissociation, alexithymia, and anger in people with autoimmune disorders:  A mediation model” by Maria-Magalena Macarenco, Christian Opariuc-Dan, and Catalin Nedelcea, December 2021,      https://www.sciencedirect.com/science/article/abs/pii/S0145213421003914#:~:text=According%20to%20many%20researchers%2C%20exposure,%2C%20diabetes%20(Boscarino%2C%202004).

[4]  Fred Hutch Cancer Center, “Endometriosis linked to childhood abuse” by Diane Mapes, 7//17/18, https://www.fredhutch.org/en/news/center-news/2018/07/endometriosis-linked-to-childhood-abuse.html.

[5]  Forbes, “Childhood Trauma Linked to 45% Greater Risk of Chronic Pain in Adulthood” by Anuradha Varanasi, 12/26/23, https://www.forbes.com/sites/anuradhavaranasi/2023/12/26/childhood-trauma-linked-to-45-greater-risk-of-chronic-pain-in-adulthood/.

[6]  Archives of Rheumatology, Vol. 36, “Effects of childhood trauma on disease severity in patients with fibromyalgia:  The mediating role of psychological resilience” by Ozlem Kizilkurt, et al, December 2021, https://www.archivesofrheumatology.org/full-text/1237.

[7]  Gizmodo, “Childhood Trauma Might Raise Risk of Headaches in Adulthood” by Ed Cara, 10/25/23, https://gizmodo.com/childhood-trauma-abuse-headaches-adults-1850959519.

[8]  Harvard TH Chan School of Public Health, “Traumatic events in childhood may increase risk of headache disorders” by Catherine Kreatsoulas, 10/27/23, https://www.hsph.harvard.edu/news/hsph-in-the-news/trauma-in-childhood-may-increase-risk-of-adult-headache-disorders/.

[9]  National Institutes of Health, National Library of Medicine, National Center for Biotechnology Information, “The Unholy Trinity:  Childhood Trauma, Adult Anxiety, and Long-Term Pain” by Natalia Kascakova, et al, January 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7013389/.

[10]  Bettelheim, Bruno, The Uses of Enchantment:  The Meaning and Importance of Fairy Tales, New York, Random House, Vintage Books Edition, 1989, Copyright © 1975, 1976 Bruno Bettelheim.

[11]  American Journal of Preventive Medicine, “Association between Childhood Maltreatment and Risk of Adult Coronary Heart Disease:  A Systematic Review and Meta-Analysis” by Yinxian Chen, et al, 3/4/23, https://www.ajpmonline.org/article/S0749-3797(23)00118-6/abstract.

[12]  Purdue University, “Study:  Children abused by parents face increased cancer risk” by Amy Patterson Neubert, 7/17/12, https://www.purdue.edu/newsroom/research/2012/120717FerraroChildren.html.

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ISBN: 978-1-60247-890-9

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