As a pediatrician working around foster kids all day, my million dollar question is this – How can I end child abuse?  How?  How can I work myself out of a job because there are simply no more kids coming to the shelter?  How can I close down my clinic because there are no more children in foster homes?  How can I create a world where the Department of Human Services can actually serve humans, instead of being shoved into the role of investigators and enforcers?

I think the answer lies in the successes of those who have survived it.  Those adults whose life story is a laundry list of childhood adversity, and yet who have somehow come through the fire to find  hope, freedom, grace, and perspective on what matters in life.  Those adults who grow up to get an education, a job, and a family, and don’t mistreat their own kids.  So what is the secret to their success?  Here’s what they tell us…

I had healthy adult relationships.

I had good counseling/mental health care provided at the time I truly needed it.

I had a mentor.

What else.  Nothing else.  Surely there is something else.  No, that’s it.  Come on – what about placement stability, case worker continuity, not changing schools or docs or counselors.  Those things helped me learn how to form relationships, get mentally healthy, and find a mentor.  Oh.

If I am willing to buy in, to drink the kool-aid and believe what survivors say, then what does my role in all this look like?  Perhaps like this.  Always being genuine and at my best around foster kids.  Opening my home on the holidays to young adults who have challenging childhoods and don’t have a family of their own to hang with.  Being willing to invest time in those whom no one has given the time of day to.  Taking a risk on hiring a new employee whose life experience may far outweigh their work experience.  Not being afraid to address someone’s depression or anxiety and point them in the direction of mental health assistance. 

That’s the million dollar answer.  Only it doesn’t cost a million dollars.  It costs me everything – costs me my life.  Is it worth it?  Every single day. 

What’s your life worth?

(this is the 3rd part of a discussion on the impact of Adverse Childhood Experiences – if you haven’t looked at the first two posts, I recommend starting there)

She was beautiful – petite with shoulder-length auburn hair, blue eyes and a quick smile.  She sat across the desk from me as we discussed work first, then family, and finally life in general.  She was interviewing for a job, but I forgot about that quickly, as I found myself much more interested in her story than in her qualifications.  Childhood was not kind to her – she was one of three kids born to young parents who struggled with poverty and substance abuse.  Her first contact with foster care was at age 3, but after a couple of years she was allowed to reunite with her parents.  Soon they moved to another state – it was easier for her parents than dealing with the close monitoring of child welfare. 

Within another year or two, she was back in foster care, and this time she would never leave.  She saw her parents from time to time – they were never quite “bad” enough to lose their rights to her, but never quite “good” enough to get her back, whatever that means.  It didn’t make a lot of sense to her – she only knew that she missed them.  Twenty-one foster homes later, she graduated from high school, went to college, got married, and was now interviewing for a job.

What?  How did that happen?  Why isn’t she depressed?  Sick?  On drugs?  Who convinced her to go to college?  How did she become part of a normal, loving relationship?

That is the million dollar question.  And tomorrow, I will give you a million dollar answer.  One that you can be a part of.

Yesterday I talked a little about the impact of childhood adversity on adulthood.  Let me tell you a story about that…

So in the late 1980′s, there was a guy who was an internal medicine physician (adult doc) in California.  He ran an employee health clinic, and spent his time trying to get obese people to lose weight and become healthier.  The clinic helped folks learn about nutrition, gave them an exercise regimen, and monitored their progress.  And, they lost weight.  However, what he noticed was that there were some people who were initially successful, but then reverted back to their old habits and regained the weight.

Can you relate to that? 

Well, this doc didn’t like that one bit (you can imagine what Jillian Michaels would have to say about it…), so he sat down with some of these folks over a cup of coffee and let them tell him about their problems.  At first they talked about the role of food in their lives, but eventually the conversation drifted to the things that we humans use to comfort ourselves – food, alcohol, drugs, tobacco, sex, sleep, withdrawal from relationships. 

If we’re honest, we all use those things or others to comfort ourselves.  For me, it’s chocolate.  And caffeine.  And maybe occasionally a margarita.  With lots of tequila. 

The problem is that you can’t really heal an internal problem with an external solution.  And when the internal problems are a gaping, bottomless pit, all the chocolate or caffeine or alcohol in the world won’t help.  And in the meantime, you get fat.  Or sick.  Or addicted.  Or dead.  In fact, in the population that this doc studied, not only were folks obese, they had high rates of heart disease, diabetes and high blood pressure (from overeating),  liver disease (from alcohol), lung disease (from smoking), drug abuse, sexually transmitted disease, unwanted pregnancy/abortion, depression and suicide. 

Not just a little more.  A LOT more.  In fact, they were dead men walking…

Depressed yet? Hang in there – we will get to some hope soon.  Tune in again tomorrow…

One of my favorite reality TV shows is The Biggest Loser.  I enjoy the creative competitions, last-chance workouts, and of course the drama of the weigh-in.  But what fascinates me most might be lost on the majority of viewers.  Every once in a while there will be an occasion when a contestant has a private conversation about their weight issues with one of the trainers.  There are usually tears flowing as the trainer probes the depths of the contestant’s soul, attempting to get at the cause of a lifetime of unhealthy behaviors.  In the middle of all the made-for-TV drama, if you listen closely, you will hear them answer.

My parents divorced.  I was molested.  My mom was a drug addict.  No one cared about me.  I was abandoned. 

Now THAT is reality.  Reality is that some kids have a childhood full of pain and loss.  Reality is that some kinds of adversity screw you up.  Reality is that surviving childhood does not guarantee a clean slate into adulthood.

Want to know more?  Stay tuned for the next episode…