Nina Gaby

Essays, art, and healthcare


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Trump Has to Go. It’s Scientific.

I have spent six hours this morning in virtual conferencing with experts from The Harvard Psychopharmacology Master Class. I have fourteen hours to go this weekend. Usually the conference is held in the grand ballroom of the Fairmont Copley in Boston but this year I am in striped socks, hoody, a warm hat, lying on my toile fainting couch with no lines for the bathroom and no fancy lunch. I am writing from my own understanding of today’s information, and my decades of experience with these issues, not the interpretation of the presenters. No one mentioned our administration, no politics. Just to be clear on that.

 

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As I followed along on my screen today I correlated much of what I was hearing to the environment of our present world, considering how I can apply this research to examine how we move beyond all this intact. Or can we?

Dr. Charles Nemeroff, researcher, professor and consultant states in his presentation–“Interface of Medical and Psychiatric Disorders”: “Covid 19 is associated with a cytokine storm (cytokine is a category of peptide proteins associated with inflamation). There will be consequences.”As he continues it becomes apparent that he may not just be speaking to the immediate Corona illness, but to the interconnectedness of systems which we can extrapolate far beyond our own bodies. That is why I think of our survival and the Trump administration and its dangerous effect on that survival.

So these are nuggets from the research presented today about mental and physical health. I will simplify so we can make own extrapolations to why these dangerous times are are deeply exaggerated by our present administration, and administration that promotes hate and greed when simple kindness would go far to ameliorate the physiological responses I am about to describe. When action based on fact and not opinion would go far to ameliorate the world’s stress.

I cannot replicate any of the slides without permission so you will just have to take my word for it.

  1. Our mesolimbic reward circuitry is affected by stress. The limbic system is the walnut sized structure right behind our nose. It is considered the seat of emotional memory and houses the little light switch we call the amygdala, a peanut-sized structure which can modulate the experience of traumatic events. The mesolimbic dopamine system is the normal pathway for feeling good, but its circuitry is supremely sensitive to alterations brought on by trauma and stress. Poetic words such as “cascades” and “first and second messengers” and “de-arborization” and “connectomes” explain the transmission of chemicals–among them neurotransmitters and neurohormones– and also explain the new study of epigenetics. Basically “epigenetics” describes when events can actually influence gene expression (not sequencing) that leads to dysfunction of brain cells and their circuitry. This is DNA stuff.
  2. Alterations in circuitry affect neurotransmitters and hormones. Peptides which affect oxytocin and vasopressin (the attachment chemicals) can also be impaired. Receptors for these are present in the amygdala and affect bonding–between parents and children, between adults. Disruption changes this. Mammals lacking these peptides are at risk of
    attachment disorders as the presence in one mammal stimulates the system in another mammal. Think, “milk let down” in new mothers. Think, children in cages.
  3. Both physiological and psychological damage to these systems have long term implications that travel through generations. Through generations.
  4. The research shows inarguable effects on cancer and depression, as well as other psychiatric disorders. This is the schema:
  5. Increased environmental stress and/ or Adverse Childhood Events increase the inflammatory process (increases in cytokines and other stress chemicals) with increased risk of depression/heart disease/cancer.
  6. There is a proven bidirectional relationship between depression and medical illness. Autoimmune illness is also correlated with these events. Social connectedness has been proven to improve outcomes. I might suggest that concerns for one’s medical treatment and how to pay for pre-existing conditions might influence one’s mood state. The research shows an increase in suicide among certain demographics receiving diagnoses of certain illness.
  7. PTSD goes without saying. And this may also have a bi-directional schema. One must have been exposed to the stressor, and we now know there is a scientific basis for both developing or mediating the disorder. Understanding and providing support to the specific populations most deeply affected by violence and trauma would go far in healing the world. Homophobia, misogyny, racism, bullying, antisemitism, xenophobia has no place in the world we need to develop. (I am editorializing a tad here but the statistics don’t lie.)
  8. Most of the conference is about treatment, specifically medications, and other options. A couple items of interest: The odds of developing a psychotic disorder with high dose daily cannabis use is 3-4X greater. Use of cannabis in adolescence and pregnancy-a big NO. CBD has anectdotal therapeutic implications but metananlysis suggests data inadequate to recommend clinical use. I don’t even want to discuss ketamine. And what does this have to do with Trump? I don’t have the research on that, just opinions. But tomorrow’s another day.

 

 

 


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The No-Expiration-Date of Grief

“We chose a sunny Sunday. She was about four or five. We bought bunches of daisies for the graves of our family members and and a big cherry pie for later from the farm stand across the road. As we drove around the park with the saleswoman, looking for the four plots we were planning to pre-buy, I asked the saleswoman to stop the car in the section we were considering. I got out, much as one might do when looking at real estate, and lay down in the grass under the tree at the head of one of the plots.”

Nina Gaby, “On Mentioning that our Daughter Wants to be a Mortician” from What Remains,the many ways we say goodbye (Ed: Sandi Gelles-Cole and Kenneth Salzmann, 2019, Gelles-Cole Literary Enterprises)

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In the periphery of my consciousness is the date, December 6, 2019, and that it’s the anniversary of my father’s death in 1989. Brought even closer to home by my Facebook memory page which pops up with a photo of Mexican candles and my parent’s old Danish Modern mid-century menorah, the one I always hated as a child for it’s lack of traditional design, in which I mention my father’s passing. Ahh, I say to myself as I move on with my morning.

I sit down with a cup of coffee and share some emails with a dear old friend from high school who is trudging through her first holiday season without her husband. This is a phenomenon I know I will be experiencing more and more as I look towards my 70thbirthday. Who will be next has become a daily question. After the emails I visit my favorite literary site, the Brevity blog, to read today’s selection which is all about writing memoir after people have died. Clearly a theme for the day has emerged. Then I post on my Central Vermont Writer page about our upcoming planning meeting next week and use a photo of my father’s old Underwood typewriter in the post. OK. It’s starting to snow and the dog is pestering me to go out and play but my phone is buzzing.

My precious daughter texts from her office and we volley back and forth as I try to provide support for a work related decision she has had to make and the ramifications thereof. It’s snowing harder outside and I start to feel a familiar feeling that I can’t yet place. I am feeling so glad that I am home today and I can be at the other end of these emails and texts. And then of course it hits. Just before my father died, on a snowy winter day, I was a new therapist sitting in my new office, having just realized that the system I was working for–and health care in general–was a sea of shark infested waters, that maybe I had made a huge mistake, and in the midst of a panic attack I called my father. Now retired, infirm, sitting in his recliner watching the snow from his own window, he spent time reassuring me that I was fine. That systems suck. That I was above all the crap that was going on, and then he told me…. “You always have us.” Of course, I didn’t, at least not at the end of the phone line. He had not always been that supportive, but he had mellowed into a wise old man, not much older than I am now, and very much like how I am trying to be for my own daughter. The dog looks on in horror as I sob into the sleeve of my hoodie instead of taking him out for a frolic.

Shortly after that phone call with my father, maybe a week or two, on an equally snowy night, he died suddenly, his generous and crazy heart exploding while he watched Wheel of Fortune and now every year as winter approaches, I get a tic either in my left thumb or my right eye. It’s already been and gone this year so I figured we were pretty much done with the grieving.  Although I know better. Grief has it’s own shape and takes it’s own time. And when it surprises us it’s like we have that person back, even for a moment or two.

Anyway, here’s to all of us who have had losses near and far, old and new. Take your time, be kind to yourselves.

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Some great books on grief and writing about it…….