Daily Archives: April 3, 2013

A-Z Challenge; C is for Comfort Food

Comfort Food I would be willing to wager that every single one of us has a comfort food.  At least one food that reminds us of a time or place […]

National Child Abuse Awareness Month: Shaken Baby Syndrome

Prevent Child Abuse ribbonIn my lifetime, I’ve worn many hats, had many experiences, seen many things, both beautiful and ugly.

As a pediatrician, I’m grateful for the thousands of beautiful yummy babies who have passed through my hands: such a blessing, such a privilege.

As a parent, I’m grateful that I have a beautiful grownup son, who as a child provided me both with joy that surpasseth understanding and with countless sleepless nights.  This in turn provided me with the experience that I needed so that I could properly empathize with the parents of a subset of my patients: the ones that would not sleep.

My beautiful, wonderful son.  I have never loved him the less, even though he never slept through the night until he was five years old.  He had a traumatic birth; and literally from birth was afraid to close his eyes and sleep.  He cried all night, and I cried too, from a mixture of sadness for him and exhaustion for me.

Sometimes it would get too much for me, and I would feel the edges of anger creeping in: why don’t you just go to sleep, damn it?  And then I knew it was time to put him down safely in his crib, shut the door, put in earplugs or the Walkman, and go for a walk in the yard, or around the block, do jumping-jacks, dance and sing, whatever was needed to get back in equilibrium so that I would NOT SHAKE THE BABY.

Sometimes it hangs on such a fine thread.  I’ve seen parents, usually young and inexperienced, bring their pale, limp six week old in to the Emergency Department in the middle of the night.  We just found him like this, Doctor.  He was fine when we put him down.  No, he hasn’t been sick.

Physical exam: Pupils fixed and dilated.  Anterior fontanel bulging.  Otherwise negative, except that the patient is dead.

Postmortem findings consistent with Shaken Baby Syndrome.

Shaken Baby Syndrome doesn’t just only come from shaking.  It happens when the baby is shaken and then thrown down on a surface, usually a bed or crib.  What causes death is the combination of the shaking and the sudden deceleration that causes tearing of blood vessels in the tissues surrounding the brain, which usually results in death.

Why do people shake their baby?  I know exactly why.  That is why I used to put my baby somewhere safe and go outside and walk around the block, or whatever I needed to do to keep myself sane and the baby safe.  It is because the incessant crying of a hard-to-console baby can and will grate on anyone’s nerves.  Some babies have piercing, high-pitched cries that go off like sirens.  And if the caregiver lacks the emotional resources necessary to take a deep breath and step away, the thing can happen in the blink of an eye.

In the blink of an eye, things can go from having a healthy yet frustrating baby, to having a dead baby.  All in the blink of an eye.

Who does this happen to?  I saw a pattern.  The perpetrator was almost always male, usually under 30, high school graduate or less, often not the baby’s biological father.  The motivating factor was “wanting the baby to shut up and stop crying.”  The problem: lack of impulse control.  If only he had taken that deep breath, turned around and walked out that door….but he wanted the baby to stop crying.  Now the baby will never cry again.

And what about the mothers?  My heart broke for them.  Her boyfriend killed her baby.  How will she ever live with herself?  And so often I saw a dreadful conflict: the mothers would lie to the investigators, to try to protect the boyfriend.  Some even claimed to have done it themselves!  It was so sad, so tragic.

To be fair, I did see a few cases in new parents who were “white, educated, middle class”.  A very few.  The vast majority were from economically and educationally underprivileged families, across all ethnic groups.  It is a kind of death that discriminates against the uneducated, the young, the disenfranchised, the controlled.

How do we prevent Shaken Baby Syndrome?  Sure, we can put up “Don’t Shake The Baby” posters everywhere.  But that doesn’t do a thing to solve the social problems that underlie the issue.  We can’t solve the problem of young women getting into relationships with impulsive, controlling men–who by the way are quite as likely to shake and shove the mother around–although she, being full grown, is able to absorb more physical shock than a six week old.

To me, Shaken Baby Syndrome is emblematic of the price we are paying for allowing our girls to grow up in a system of intergenerational abuse that starts at home and continues into serial abusive relationships.  The solution is not a quick and easy one.  It really does take a village to save one child.

Wednesday’s Quote

“Bipolar robs you of that which is you. It can take from you the very core of your being and replace it with something that is completely opposite of who and what you truly are. Because my bipolar went untreated for so long, I spent many years looking in the mirror and seeing a person I did not recognize or understand. Not only did bipolar rob me of my sanity, but it robbed me of my ability to see beyond the space it dictated me to look. I no longer could tell reality from fantasy, and I walked in a world no longer my own.”
― Alyssa Reyans, Letters from a Bipolar Mother


I’ve come to a slow realization the last couple of days that I am probably experiencing a bipolar mixed episode. I’m dragging and feeling avoidant, I’m easily irritated, and I want to *ahem* DO ALL THE THINGS! I know that it’s a risky time to live through, but the hypomania is keeping me feeling warm enough that I cannot envision doing anything to harm myself. I have myself well convinced that it’s not that bad, that it’ll be over shortly, that all is fairly peachy and that well, a little fatigue isn’t the end of the world.

Having said that, I -am- trying my best to be mindful; mindfulness is one of the many useful tools in my keeping sane arsenal against bipolar. I’ve burned myself too many times by riding the wave of good, and while I do try to use it to the fullest, I know how easily overdoing it can drag me back down to the worst places. I am doing my best to pay the most attention to the bad, the anxiety, the irritability, the exhaustion, but not to dwell on them. At least, when I can remember; my attention is fragmentary at best right now.

Still, what else can I do but keep on keeping on, and hoping that things even back out again? Not much really, so that is what I shall do.


The post Mixed appeared first on The Scarlet B.

National Child Abuse Awareness Month: Introductory Remarks

Prevent Child Abuse ribbonAs I stand on tiptoe, readying myself to launch into what is going to be a very important yet extremely painful month of campaigning, I have to take a moment to remind myself to breathe deeply; that this is not the first time I will be writing and testifying about these things; and that the pain in my chest and throat that I am feeling right now is not a heart attack: it is PTSD.

As some of you may know, I am an Adult Survivor of Childhood Abuse.  I carry a significant burden of PTSD from that.  It’s possible that my experiences as an abused child made me a better Child Abuse Investigator, when I was in practice as a pediatrician.  It certainly fueled my later career as an Expert Witness for the prosecution in child abuse cases.

In the coming days and weeks I hope to write my first-hand experiences as a pediatrician specializing in Child Abuse.  It will not be pretty.  Some of you might not want to read it.  That’s OK, I understand.

I’m uploading the Prevent Child Abuse ribbon for my sidebar.  I encourage you to swipe it and share it liberally.  Children are our treasures.  They depend on us to protect  them.  They have no one else.

Cycles,cycles, everywhere

In light of my mother telling me to get out last night and me lacking the balls to open myself up to another verbal assault by calling to talk to her, I acted on the assumption she was still pissed off so I did not go to the shop today.

Towards lunch, she called to ask why I didn’t bring Spook by, like nothing was wrong. She told me to get out of her house, for fuck’s sake, and no apology, like it never happened. And I just said I figured she could use a break from my kid (I was in heavy traffic when she called so it was all a little too much for my brain to be coherent and remember last time I said that, she went off of me and told me she didn’t need a break from my kid because she gets along with Spook and I don’t.) A millisecond after I said it, I waited for her to blow up. But she didn’t, she just took her snotty little tone with me and said “Okay, bye.”


This of course all happened in the middle of heavy traffic (panic attack in progress) and at the same time as an abrupt shift in mood to dark “fuck you, i want to die” territory.

And all I could think was, FUCK, I am rapid cycling again.

Then I realized I’m pre-pms-ing, so that cycle’s firing up again too. (I’ll run you over with my menstrual cycle!)

I hate fucking cycles.

Once we were in for the day, things got better. I did some housework, even finally folded some laundry. Not all, but some. I played with the kittens. Put up curtains in Spook’s room. (Is it just me who finds Dora utterly creepy????) Watched more episodes of the UK  version of Being Human.

Got my kid to bed. Was going to relax then R called going on about the busy day he had, almost as if to guilt me for not being there. Talking about how the place falls apart without me to keep him focused, blah blah blah. Translation: he had to answer his own damn phone and deal with his own damn customers and he hates pretty much all of them therefore my presence is needed so he lavishes praise upon me to appeal to my vanity and desire to not flake out again.

But, hey, like I have anything better to do. I’m gonna need new brake pads soon, so when the time comes, he will be in my debt, and I will get a car repair. I have to think like that to keep myself going.

Which was another thing that happened t0day, amidst the petri dish chaos and my mood dip and I just had this sudden thought: why am I doing any of this? It’s all so pointless, there is never enough money, I never do anything right or well enough, my kid prefers my mom to me, and I am mad as a fucking hatter, so why can’t I just die already?

Two hours later the mood shifted and I wasn’t up or down, but I felt totally different.

This cyclothymia.

The bastard love child of bipolar one and bipolar two.

“Less severe”, they call it.

Fuck them.

Now the clock is ticking until I have to slap on the happy face and pretend to give a fuck about  busted electronics. (Unless they’re mine, I don’t care, and I know I am a bad person, I just don’t care.)

Ya know, I have pretty much quit drinking, because the doctor said it was bad and would agitate the mood swings, yada yada.

Yet nothing is really changing, it’s still varying cycles of rapid changing moods in spite of all the meds and me not drinking.



A-Z Challenge; B is for Botox Mental Moment

B is for Botox Continuing on with the A-Z April Blogging challenge, today we are on the letter B.  B stands for Botox, a good idea in theory but I […]