Gone Fishing

Lessons relearned, thanks to my kids.

Welcome back to the on vacation edition of the frontier psychiatrists…

Being a parent is a whole to do. I have twin- 8-year-olds.

Carlene MacMillan, MD

and I will not have other children, we have a complete set. We started trying to get pregnant immediately after getting married, and it worked, just one month later. My cardiac condition announced itself the same day as the children did, I have Supraventricular tachycardia. That means my heart races from time to time. I have been assured by my cardiologist this is a benign condition, in that it can't kill me. Children are similar. The day I found out I was having twins, I ended up getting 6 L of fluid and in the NYU Langone emergency room within hours of getting the news. No, I'm not just a “drama queen”— gendered-pejorative term if there was one!— there is an actual difference in my heart.

There is another actual difference in my heart. Which is that there are two children, my kids, who changed how my heart works.

I've tended towards stoicism, since childhood. It's really hard to be stoic when you can barely stand up, one of the things that happens when your heartbeats too fast. It's so hard to be a stoic about life when you see kids, your kids, grappling with life, absent the enforced stoicism of having experienced the kind of trauma that I have. I'm a physician, and we are exposed to trauma. Our training does a good-enough job of inoculating against it.

For me, at least, it is the traumas for which I could not have prepared that caused the damage. I have been harassed for years, by somebody who is—at once— hapless and ruthlessly effective. There are days when she posts harassing content about myself, my wife, our business partners, and other treaters, up to 117 times in a two hour period of time.

I wake up every day, and I have to check the Internet, to see what insanity I'll have to answer in the next meeting of a professional society.

“No, I didn’t kill puppies with a garden hose. Thanks for asking.”

The problem is not that everyone believes her, as far as I can understand it. The problem is that everybody worries that somebody else might. Did I really murder a puppy? Did I register to vote twice? Am I a rapist —who, perplexingly, documented this in the medical record, and then called the police on myself in the process of committing the crime?

The answer to all of these things, by the way, under oath, is no. The very frustrating thing as it doesn't matter. My ability to create positive change in the world has been curtailed. This makes me sad. There have been patients who told me of their distress, so I know about it. There are countless others where I don't get to know, who haven't gotten care because of this. I do a lot of charity care. When people come to see me, and they can't afford it, fee reductions are pretty common across psychiatric care. I started getting involved in Insurance advocacy because, despite being able to be paid privately like every other Psychiatrist , I just didn't want to do it if I could avoid it. This brought me face-to-face with a complicated system that is unfair for all involved.

It makes me sad that people who need help, who are vulnerable, stopped getting it because they were worried about claims made by a malicious person. In the battle between clumsy and relentless? Relentless wins. Her attempt to shake down the medical system, a success. Large hospital systems settled, and she remains emboldened.

One of the things that makes it much harder than it might be otherwise is the fact that I have these adorable kids, who deserve a father is who is more joyful. The pervasive inability to experience pleasure—anhedonia—that is a common symptom of PTSD really gets in the way of feeling present when your kids catch a fish.

I feel distanced from people. This can lead to feeling cut off from my kids’ joy. I feel that way about everyone. This is because every day—and this is a close to literal statement—I have someone successfully potholing my on ramp to “present and joyfully.”

Now, to go on a boat and watch my kids enjoy these things which are still intact for them. We need better treatments for trauma—it's about having more of us show up for our lives.