Normal is an illusion. What is normal for the spider is chaos for the fly. - Morticia Addams

So what have I seen? What have I experienced? What happens those nights when I come home and just fall asleep and pretend that what I have seen I haven't.  Those things that shape my practice, my life, my stereotypes, my ability to help others, my compassion.

Know that when you come into the ER that we know a lot of things. I know that you have raped your niece. I know that you have punched your mother in the face more than once. I know that you would rather drink your child support payments than clothe your own children. I know that you were a victim of child abuse. I know that you were sexually abused as a child and you are now abusing your own children. I know that you love him, but is that what love really looks like?  I know about the funny little tattoos you have placed in odd spots on your body.  Yes even the ones on your private bits.  It's my job to notice these things. I take in sensory information to get a picture of who you are and where you come from and how you got to be at my door step. Just because I understand why doesn't mean I feel the actions are right or even remotely okay to condone.

I have seen 8 children come through the doors at different times, all from the same village with less than 200 people. Those children between the ages of 1 and 9; that are all diagnosed with gonorrhea. I will let you, the reader, guess how that all happened.

I have seen the face of a mother who brought in her 4 year old child with tears in her eyes as she says her child is bleeding in their private parts. And knowing that that mother was sexually abused as a small child herself.  To see the pain in her eyes as she feared the worst.

I have seen a woman come in drunk day after day, for weeks on end with new bruises all over her body. Who buzzes her hair because if she didn't the person that "loves her" would rip her hair out anyways.

I have seen the man who has drank himself almost to death on a weekly basis. And you think... Get it together!... I think... my god the human body is amazing! And then you learn the story of how his body can continue to withstand a blood alcohol level of .6 repeatedly.  Yes. 0.6.  The legal limit is 0.08. That is 7.5 times the legal limit.  The persons dad and him were on a snow machine when he was 6 years old.  On another snow machine was his mom and two siblings.  The family was going from one village to another to visit friends.  The mothers snow machine fell through the ice drowning the mom and the other two siblings.  The father, having no coping mechanisms, started to drink heavily. The patient having no other way to bond with his grieving father sat and drank with him. At the age of 6.  Like I said I don't condone these actions, or agree with them.  But I understand them.  I am horrified by them.

I have had to encourage a woman whose own son beat her in the face so badly that she had one of her sinuses and an orbital fractured, to press charges against him.  She looks at me and pleads "Why would he do this to me? My own son!"  and the only words I can say are "You must respect yourself and stand up for yourself, you have to press charges"  and she just cries and cries.  I could never imagine the feeling this woman was experiencing.

I was the person that brought an entire family back after their father/grandfather/brother/friend passed away on Christmas Eve.

How do I cope?  I don't often find myself drowning my sorrows at the bottom of a wine glass... especially on the nights when you see what alcohol can do to a person or a family.  I tend to make crass jokes and flippant comments about these situations to other colleagues who also have had these experiences.  It puts a weird barrier between my reality and the patients reality.  I don't really know how else to explain it. This can make me seem cold and uncompassionate. It is to save myself, my soul, my mind, my sanity. It is a shell that I have to wear. If I didn't I would be destroyed.

I think there is something that all of you reading should watch.  It is something that happened all over the world in the 70's when missionaries were canvassing the world to "humanize" village people. Not just in bush Alaska but in other countries, and throughout the lower 48 as well.  The village of St. Michaels is in the Norton Sound region where Nome is the hub town.  The people in the bush had a HUGE disservice done to them, and it truly has never been rectified.  You want to know how the circle of abuse began? This 28 minute video from Frontline on PBS will give you a pretty good idea.  An entire GENERATION that was ruined, humiliated, dehumanized, and left without any retribution.  I ask that you please take the time to watch this. This is not a feel good story, there is no happy ending.

http://www.pbs.org/wgbh/pages/frontline/the-silence/

Until we meet again lovelies.

Be kind to yourself and to others. You do not know their struggles, and they do not know yours.  In the end we are all just trying to get by as best we can.