don't provoke the beast

 So, this happened:

I've been working on a project through a site called "Storyworth." Every week they send a writing prompt and you submit a short piece in response, usually a brief memoir or autobiographical ditty. At the end of the year, you have 52 stories they assemble into a book you can give to your children or grandchildren for Christmas. It includes topics like "What was your favorite candy when you were a child," and "Did you have any pets when you were a child?" Nothing too deep.

Last week I tackled this one: What Is One of Your Earliest Childhood Memories?"

I'd been avoiding the topic because my earliest memories date back to my hospitalization with rheumatic fever when I was three years old. What fun is that? I've written about it before. In fact, I published a brief memoir about the ordeal a couple of years ago. I have analyzed the experience in detail from every perspective over the years. I thought I was at peace with it.

I jotted down a few lines and then I went on-line to search for a couple of pictures. I found an image of The Children's Hospital of Buffalo, where I spent two weeks when I got sick. 

Then I found this:

www.ECMC.edu

This is a photograph from the Acute Scarlet Fever Ward at the hospital, and it made me catch my breath. It is exactly as I remember the ward I was in. Except that it was taken many years before my admission there, that little girl could be me. That was where my bed was in the ward. In the bed next to me was a boy about five years old. Back then the nurses wore stiff white uniforms, and they were proud to wear the official nursing caps they worked so hard to earn. I remember it all, but I did not expect the gut-punch I took when I saw this picture. It brought me to tears, it was so uncannily real to me. 

It made me wonder where that emotion has been hiding all these years, and why I felt it so viscerally when I saw this image.

It turns out we store memories in different ways. Narrative memory is the story we tell about what happened to us. Visceral memory expresses the sensory and emotional experience of the story without using words. It's what we feel, physically and emotionally, when the memory emerges. Fear. Sorrow. Anger. A racing heart. Sweaty palms. Nausea. 

"Trauma comes back as a reaction,

not as a memory."

~Bessel van der Kolk~

It's important for health care providers to understand the difference. I can describe the ward where I was hospitalized in great detail. I can tell you about the other children who were there with me. I remember the toys and books I kept at my bedside. I can tell you the whole story calmly and accurately, as though it were no big deal. In fact, I can narrate my entire medical history without blinking an eye. But there's more to it than that. Apparently, something else is still stored away inside, unwilling to be acknowledged and released. Something that still needs to heal.

When a patient presents with anxiety or depression that doesn't seem to fit the picture, or his symptoms don't respond to treatment, think about unresolved childhood trauma. When he senses a racing heart but his EKG is normal, or his headaches won't go away, go back in time with him. What triggers it? A certain song? The scent of his mother's cologne? The sight of a needle? Or like me, a random photograph he came across on-line? 

Narrative memory may be clear and accurate while visceral memory lurks in the shadows. Without warning, an innocent trigger can release a lifetime of unexpected emotion that can wreak havoc on the body. If you're a healthcare provider and things don't add up, go back. Try again.

"I may look peaceful,

but don't provoke the beast."

~Gautham Balaji~

jan