Child Study Center Grand Rounds 05.18.21

June 08, 2021

Storied: Compassionate Reflection Rounds" Convened by Ashley Clayton, Dr. Amanda Calhoun, and Dr. Andres Martin

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ID: 6692
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00:00Welcome everyone,
00:01we're delighted that you're here.
00:03We had a little bit of a
00:05technical glitch, but here we are.
00:07We have put this together and
00:09are very excited about it.
00:11My Co hosts and really the brains behind
00:14this operation will introduce themselves.
00:16We have 5 speakers.
00:17I will introduce the 1st 2 speakers and
00:19then the other speakers will introduce
00:22themselves and introduce our speaker.
00:24So which is going to get going with it?
00:27And I have the privilege of
00:29introducing our most senior.
00:31Center today and in fact.
00:33The most senior member of our faculty.
00:35To give you an idea what we're going to
00:38do today is that we're going to go in
00:41reverse chronological seniority order.
00:43It's almost like a journey to the seat from,
00:47you know, fully mature,
00:49wonderful all the way to where we start,
00:53and we're going to reverse order.
00:55So Doctor James Comer Jim Comer is
00:58a man who needs no introduction
01:01but just as a reminder,
01:03Jim is our most senior faculty member.
01:06He is.
01:07He has held all all roles imaginable,
01:10including S Dean of admissions as a Dean.
01:14Of multicultural and diversity
01:15affairs at last count,
01:17which is probably wrong by now.
01:19Doctor Comer had 45 honorary degrees
01:21from institutions all over the world.
01:24I could go on and on and on and on.
01:28But rather than going on and on,
01:30Doctor Comer is going to take us
01:33back in time to just a house call.
01:37Doctor Comer take it away.
01:39Thank you for that kind introduction.
01:42Please have the opportunity to
01:45describe something that is very
01:47meaningful and long lasting with me.
01:50Just a house call.
01:52I was 25 years old in the last
01:55week of my internship in my
01:59hometown hospital in East Chicago,
02:01IN and covering patient calls for a
02:05vacationing doctor, probably in June 1961.
02:07Life for me was going very well.
02:11My remarkable wife of one year,
02:13Shirley and I had a wonderful infant son.
02:17My internship had gone very well and
02:19I was on my way to design A states
02:23public health service to a then required
02:26two year military service assignment.
02:29I was planning to return home to
02:31become a general practice doctor.
02:33An ambition I first expressed
02:36when I was three years old.
02:39I was planning it.
02:41Was near twilight.
02:43I received a request to attend a
02:45new mother in a neat working class
02:48neighborhood down the street from where
02:51I played basketball as a teenager.
02:54When no one responded to my Knox,
02:57I opened the door, fumbles around,
02:59found the switch and turned on the lights.
03:03There was a horrendous screeching,
03:06grinding sound as roaches covering the
03:10yellow ceiling and walls fled to the
03:15crevices and cracks seeking safety.
03:18I was stunned, shocked, frightened.
03:22Still processing what was going on.
03:25I looked down and infant twins were
03:28asleep in fruit cartons against
03:30the entry wall a few feet away.
03:34Cherubic.
03:35And apparently undisturbed,
03:36although they were probably
03:39covered by roaches moments before.
03:42Little African American boys who
03:44looked a lot like me and my brother,
03:47not twins, but close a few years before.
03:52One gave a singular involuntary
03:54facial twitch,
03:55which I have since interpreted as
03:58in order to help not just stand
04:03there do something.
04:05I attended the depressed mother
04:07arranged social services,
04:09stumbled to the door up a few steps.
04:13And crumpled onto the sidewalk.
04:16I was in deep psychic pain.
04:20This could not be in my community.
04:24My town in my democracy.
04:29Anne did not know that mother
04:32from the past high school maybe.
04:36And why was their fate so different
04:39from my own?
04:41The incident just a house call,
04:43was a small moment in my life in time.
04:48And just happened once.
04:51But it greatly deepened already deepening
04:56concerns in my mind about poverty.
05:00Marginalization, our nation's racial problem.
05:05It aroused questions that
05:07was slowly but surely.
05:10Change the course of my life.
05:14The do something charged from that win
05:16in the fruit cart and did not go away.
05:19The next year I became a volunteer in a
05:23volunteer helping agency in Washington DC.
05:26Call hospitality house.
05:29It gave temporary shelter to
05:31young mothers and their children.
05:33Who would have otherwise been
05:36homeless because they lossed public
05:38housing apartments as a result of
05:41an infamous man in the House rule
05:44that required their dismissal.
05:46I worked directly with parents and
05:48children to restore law services
05:50from agencies,
05:52schools and other places on
05:54which they were dependent.
05:56I directly observed the way
05:59they were bullied and abused.
06:02These were not simply promiscuous,
06:05bad, irresponsible young people.
06:07Who had not worked hard and had brought
06:11hardship upon themselves as many argued?
06:14Congressman Mendel rivers from South
06:16Carolina and his Deep South colleagues
06:19appeared to take delight in finding every
06:23platform he could to blame them and make
06:26them feel bad for the sins of his fathers.
06:31But these young families were trapped
06:34by a complex American history and
06:38system that I eventually came to
06:41understand as put and held in place
06:44by the force and power of racism.
06:49My concern grew into an effort to
06:52better understand what was going on
06:55and what could be done.
06:57To a commitment to try to
07:00do something more effective,
07:02more effective for myself,
07:03for the children, families, and society.
07:07The need to better understand the
07:09problem led to training in public health.
07:12Adult and child psychiatry.
07:14And learning for my own lives.
07:18Life experience probably
07:19help more than anything else.
07:22The question it raised,
07:24why did my similar background
07:27and capacities lead to different
07:30opportunities for me and others like me?
07:33Often attending the same schools and
07:36how an whether a community or nation.
07:40Could compensate for past and
07:43present in equities?
07:44And probably because the strategy
07:47and to love my family had been
07:50education and school success.
07:52I turned to education and schools.
07:57My mother and father were two year six
08:01years school attendees rural South,
08:05the urban north migrants carriers of a warm,
08:09protective and promotive black
08:12Southern Baptist church culture.
08:14Who supported their five children
08:17through work as a steel mill
08:20laborer and domestic worker,
08:22providing a childhood development
08:25experience that powered us to collectively
08:28achieve 13 college degrees and successful
08:32professional careers and contributions.
08:34Thinking from my lived life.
08:37How school and Hospitality house experiences?
08:43My research question became,
08:45would it be possible to create
08:48conditions in school?
08:50That could support and approximate
08:53the kind of developmental experiences
08:56in school that we received at home.
08:59And use the evidence to provide the
09:03creation of social and education
09:06policy and practices that would
09:09make this widely possible.
09:12The effort is still a work in progress,
09:15but the point here.
09:18Is that it was just a house call?
09:20They've got the ball rolling.
09:22Thank you for this opportunity.
09:28Thank you doctor Comer.
09:31Thank you Doctor Comeron boy.
09:34Where has that rolling ball
09:36lead us to? Thank you.
09:41We are. We move on now.
09:43As I said in developmentally.
09:46Reverse direction.
09:47Anne, we go now to someone.
09:51Post college postgraduate degree
09:53and that is Ashley Clayton.
09:55I have to say that there are many
09:57terrible things about this pandemic.
09:59Many, many, countless terrible things.
10:01But among some of the few Silver
10:04Linings and some of the few good
10:07things is that we have come to
10:09either meet or re meet all sorts
10:12of people all over the world
10:14through this thing called zoom.
10:17Ashley Clayton is someone who I met
10:20through zoom 15 months ago and who
10:23have I only met in person once and I
10:26consider her one of my best friends.
10:29She is also an incredibly gifted.
10:33Poet reader of poetry.
10:36Lover of all things language.
10:40Anne in her incredible language
10:42and her incredible prose,
10:44she has written eloquently beautifully
10:46about her own lived experience with
10:49depression with trauma in therapy,
10:51these pieces have appeared in Health
10:55Affairs in The Lancet in JAMA.
10:58She is extraordinary and she comes
11:00to us recently from Kentucky,
11:02where she hails from could tell us,
11:05may joy be found here too?
11:09Ashley.
11:11Thank you so much for that
11:13very kind introduction.
11:16It's been 60 days, one hour and 10
11:20minutes since my brother spoke.
11:22His final word sit.
11:25I was standing in front of my brother
11:28Adam with my sister-in-law Leah standing
11:30behind him and the three of us struggled
11:33to figure out how to get his rigid body over,
11:37which he no longer seemed to possess
11:40control to sit on the stool in the shower.
11:43The one Hospice delivered a month before.
11:48Set. Adam said. Yeah, Baba,
11:53I replied, you've gotta sit down.
11:57And in what?
11:58Felt like an act of great mercy,
12:00my brother sat down.
12:02I stepped out of the shower,
12:05wilia washed him briefly, got lost in the
12:08thought of how dying is so UN dignifying.
12:12And then my niece caught my eye.
12:15Just as casually as she might tell me,
12:18she named her baby doll, Violet.
12:20She looked at me and said.
12:22Daddy can't walk anymore.
12:25You are right. He can't walk anymore.
12:29I'm gonna go and get an extra towel.
12:32I'll be right back.
12:34My brother and I always joked that my
12:37niece was just like me when I was little.
12:40Always in the mix of things unafraid.
12:44Kind of bossy.
12:46In taking care of others.
12:49The next morning my brother
12:50lost consciousness.
12:51I scooped up my 7 year old nephew
12:54Nolan and my 5 year old niece Savannah
12:57and headed to the craft store.
12:59I'd called Andres earlier that week for
13:02advice on how best to support the kids.
13:05Have them make their data gift.
13:08A memory box.
13:09Write cards.
13:13The three of us decided that
13:14their daddy needed a blanket.
13:16His £94.00 body was perpetually cold.
13:20We picked up supplies in McDonald's
13:22and headed to my parents house.
13:25They decorated brightly colored
13:28fabric with felt stickers with
13:31hearts in rainbows and smiley faces.
13:34Nolan wrote, I love you Daddy.
13:3612 times he counted.
13:40The kids wanted to play doctor and
13:42so we played out numerous doctor
13:45patient scenarios as we talked
13:47about how Daddy was sick and how
13:49scary it was when he had seizures.
13:51How he couldn't walk or talk anymore?
13:55How the brain cancer made
13:57him very angry sometimes?
13:59And how sometimes people don't get better?
14:04And then we played with play DoH,
14:06made a Fort,
14:07painted a Unicorn and a dinosaur,
14:10and found hapiness in an orange popsicle.
14:14Five days later, my dad ran up the
14:17stairs to wake me Ashley. We have to go.
14:21By the time I parked my car,
14:23my parents were already in my brothers
14:26house and my niece ran down to meet me.
14:29Daddy is not breathing, she said.
14:32I ran back to my brother's room where
14:35my parents in Leah stood around his
14:38hospital bed. I looked at my dad.
14:42What happened is he. Breathing.
14:46Glassy eyed my dad looked at me.
14:49He's gone. Do the kids know I asked?
14:56Vienna heard me say he stopped breathing,
14:58but she doesn't know what that means.
15:04And then I watched as my sister in law
15:07collapsed in grief over my brother's body.
15:11Followed by my mom.
15:13Before I too unraveled, I heard myself say.
15:18I'll go tell them. I'd never imagined
15:21I would be the one to do this.
15:24And the Super fun aunt who flies
15:27into Kentucky to spoil them
15:28and take them on adventures.
15:30Who answers the 4th FaceTime call of the day?
15:33Because Vanna wants to tell me
15:36she found a worm under a rock.
15:39But I grabbed the doorknob,
15:41took a deep breath.
15:43And try to remember everything I knew.
15:46Be concrete.
15:48Use simple language.
15:50Answer all of the questions.
15:53Reassure them they did nothing wrong.
15:57It's OK to cry.
16:00I sat on the floor in front
16:02of the couch and looked up at
16:05their innocent adorable faces.
16:07You know how daddy's been really sick?
16:10And you know how we talked about
16:13how sometimes people get very
16:15sick and they don't get better.
16:17Well, it's not anybody's fault.
16:18It's not your fault or my fault,
16:20or the doctor's fault.
16:22But Daddy wasn't getting better
16:25and Daddy was so sick that he died.
16:28Do you know what that means?
16:30No,
16:31they said.
16:33My heart sank and I preceded to
16:36tell them what it meant.
16:38I took them back to my brothers
16:40room to say goodbye and a few
16:43minutes later everyone had left
16:45the room except me and Banna.
16:48Vienna climbed onto her parents bed and
16:51began to jump up and down with gusto.
16:54I'm so full of energy.
16:56I'm so full of energy,
16:57she exclaimed, and then she
16:59jumped straight up into the air,
17:02turned her body horizontal in belly,
17:04flopped onto the bed.
17:06Not like Daddy daddy's dead.
17:09And then she got right back up,
17:12fervently jumping up and down,
17:14professing her energy to the world,
17:16and flopped right back onto the mattress.
17:20I'm dead, just kidding, Daddy's dead.
17:25She got back up and repeated
17:27the cycle a few more times.
17:30I was standing in the small space
17:33between my brother's dead body
17:35on my right and my niece belly
17:37flopping on the bed with my left
17:39and it took me more than a minute
17:42to process what was happening.
17:45And then I burst into laughter,
17:47looked at my brother and said
17:49you can't make this **** up.
17:53My brother would have found this hilarious.
17:56And I imagined him leaning back,
17:59clasping his hands,
18:01laughing his loud calculix laugh,
18:03taking such delight in his daughter,
18:06and the absurdity of the situation.
18:11When my brother's health began
18:14to rapidly decline in January.
18:16I took up a practice of
18:18lighting a candle every night.
18:21Repeating two prayers.
18:24Miss suffering be minimized.
18:27May mercy be abundant?
18:32I struggled with very severe and sometimes
18:35debilitating depression in 15 months
18:37into a global pandemic and after the
18:39death of my only sibling, I feel the
18:43shadows pulling me into dark waters.
18:46But I can't think of my brothers death
18:49without remembering my niece jumping
18:51up and add up and down on her daddy's
18:54bed trying to figure it all out.
18:56How two opposite things can
19:00exist simultaneously?
19:01As she could be overwhelmed by
19:04energy and her daddy had none.
19:07As she could be filled with life and
19:11her daddy had been emptied of it.
19:14And every night I find myself
19:17lighting a candle.
19:18Waiting through the tide pool
19:20with its lapping waves of grief,
19:23trying to internalize the lesson
19:25that life insists on teaching me.
19:28To reconcile what I know in my
19:30head with what I know in my bones.
19:33That limitation enjoy will always
19:37find their way to each other.
19:41So here I am. In this liminal space.
19:45With cracks filled with
19:47mourning and heartache.
19:49Holding tight to the truth.
19:51Belly flopped. By my 5 year old niece.
19:55Repeating now three prayers.
20:01May suffering be minimized?
20:06May mercy be abundant?
20:09In May, joy be found here too.
20:24So now we should have thought
20:27about the ordering of this.
20:30I have the pleasure of introducing
20:33our next speaker, Isaiah Thomas.
20:38Isaiah Thomas is a third year medical
20:41student at Yale School of Medicine.
20:44Originally from Little Town,
20:46mass, Massachusetts,
20:47he studied biology and English
20:49at Columbia University.
20:51His research in medical school has
20:53focused on qualitative media analysis,
20:56including exploring the role of psychiatry
20:59in the 1959 Twilight Zone TV series and
21:02examining knew news media discourse
21:04about climate anxiety in climate.
21:07Action about.
21:08Around among young people,
21:10Isaiah has worked in the medical school
21:13curriculum reform around health,
21:14justice, and LGBTQ health,
21:16and he serves on the leadership
21:19for the US Health,
21:20Justice Collaborative and sits
21:22on the Committee for Diversity,
21:24Inclusion, and Social Justice.
21:26He also participates in the medical
21:29Schools Writers workshop and
21:31writes short stories and poetry.
21:33He will be reading his piece
21:35entitled in Age of Anxiety.
21:42Thank you so much for that intro
21:43and thank you for this opportunity.
21:47On her first day, she told us that her
21:49throat had closed up a few years ago.
21:51She couldn't eat for a month.
21:53Things could just happen to you.
21:55You couldn't trust anything,
21:56not even your own body.
21:58On this admission,
21:59her first time in a psychiatric unit,
22:01her grades were the lowest they've ever been.
22:03She didn't see the point in trying anymore.
22:05She didn't trust the schools anyways,
22:07or the government or society.
22:09Everyone just went about their lives,
22:10never doing anything while
22:12the world burned around us.
22:14As she spoke,
22:15I wrote down paranoia on my notepad.
22:17I paused and added a question mark after it.
22:21She was 15 years old with recent
22:22diagnosis of major depression
22:24and generalized anxiety disorder.
22:25Things have gotten bad in the
22:27past few months.
22:28Among other things,
22:29she worried about the environment about
22:31climate change and the loss of biodiversity
22:34and disasters of our own making.
22:36The idea that this could all
22:37be gone within her lifetime,
22:39she didn't know how to cope.
22:40She had been in therapy and started
22:42an anti depressant and after
22:44week she became activated up.
22:45But in the bad way everything was
22:47hyperreal rather than unreal.
22:48Too much reality to bear,
22:49that's why she came to the hospital.
22:51She was feared.
22:52She feared she would walk in front
22:54of a car or fall down the stairs.
22:56It might just happen of its own accord.
23:00She wore a hat on her first day and
23:02every day after that she told us that
23:04she started wearing it one day when
23:06she became depressed and never stopped.
23:08Her speech was pressured,
23:09yet directed like someone in an emergency,
23:11but her tone carried aside anger
23:14like someone already briefing.
23:16She said that she had always been a warrior.
23:18She used to worry about her health.
23:19Now she worried about existing.
23:21She worried that she was a narcissist,
23:22that she was making this up.
23:24But we're just on a rock in an infinitely
23:26expanding and uncaring universe.
23:28She said it would be so much
23:29easier and so much less painful
23:31to give in to be subsumed by the
23:33nothingness she spoke frequently of,
23:35escaping into the void to keep
23:37up with the conversation,
23:38I've found myself scrambling
23:39for bits of philosophy,
23:40half remembered from college.
23:41The idea of nihilism came up that
23:44nothing inherently had meaning.
23:45The pessimistic spin on it,
23:47being that nothing mattered,
23:48you optimistic that we get to create our
23:50own meanings and choose what matters to us.
23:52She was less convinced of the 2nd.
23:55I worry that I'm talking about
23:56nihilism would make her a nihilist.
23:58But when I trained to answer
23:59calls at a suicide hotline,
24:01we were taught they're talking about suicide,
24:03doesn't make people suicidal.
24:04But that was ten years ago.
24:06Maybe this was different,
24:07but I figured nihilism was on the table.
24:09She had already told me about the
24:11four noble truths of Buddhism,
24:13about the suffering inherent existence,
24:14and the impermanence of all things.
24:17She said she wasn't religious,
24:18but she believed in an energy that connects
24:20all things she felt connected to the earth.
24:22The woods were one of her few happy places.
24:25Somewhere her mind could be quiet.
24:28She worried that she was too far gone over
24:31the precipice past the point of no return.
24:33Not worth the trouble anymore.
24:35I insisted that she was worth the trouble.
24:37She winced, she had no reason to believe me,
24:40or care what I had to say on the matter.
24:43I should have listened, not challenged.
24:45At the hotline, they told us that
24:47you're not there to give answers.
24:48You're there to assess for risk.
24:50Ask open-ended questions
24:51and validate emotions.
24:52You don't know that things will get better,
24:54but you try to help a call and move
24:56towards the possibility that they might.
24:59I don't know if I'm supposed to give
25:01answers now as a provider in training.
25:03I later asked her about
25:04her plans for the future.
25:05She didn't have any at the moment.
25:07Maybe wander into the woods
25:09and live out her days.
25:10She knew that she didn't
25:11want to go to college.
25:13Do you want to learn about astrology and
25:15cosmology and the nature of existence?
25:17I asked if she considered
25:18studying those things in college.
25:19She was quiet. She hadn't.
25:22No one had ever told her that was an option.
25:25One day we told her that we wanted to try
25:27a medication called a mood stabilizer.
25:29We hoped it would slow
25:31down her runaway thoughts.
25:32She was willing to try it.
25:34We asked if she had any questions.
25:35She asked us what to do about the
25:38crushing weight of existence.
25:39I turned to my supervising doctor.
25:40We both shrugged.
25:41You learn to manage it.
25:43Medication can help when it becomes too
25:45much and you learn to share the weight.
25:48We asked if she had any other questions.
25:50She asked me to print out an
25:51information sheet on the medication.
25:53She asked to not be told what
25:54side effects where.
25:55She feared that she would take them.
25:59The first day after starting the medication,
26:00she said that she had
26:01no thoughts in her head.
26:03Her mind was empty.
26:04We suggested that maybe she was used
26:06to the roar of her racing thoughts.
26:08This new,
26:08quiet felt like the absence of thoughts.
26:10She said it was possible we decided
26:12to wait and see how tomorrow went.
26:14The second day,
26:15she told us that her mind was calm and she
26:17had total clarity about what she must do.
26:19She had to die.
26:21It was the only logical answer.
26:22She said that she was nothing
26:24more than a carbon footprint.
26:25She could be vegan,
26:26but she could never be vegan enough.
26:28She couldn't save the world,
26:29but you could certainly harm it.
26:31She didn't need to exist.
26:32She didn't want to exist.
26:34When I was at the hotline,
26:36we didn't get many explicitly
26:37existential colors.
26:38They didn't train us on how
26:39to navigate a conversation
26:40about humanity's near
26:41inevitable self-destruction.
26:42How could you live with yourself
26:44knowing it was all pointless?
26:45I didn't have a good answer for her.
26:47I didn't have one for myself.
26:50So I was honest, I said we do our
26:52best and we hope for the best,
26:54but it's worth it to try,
26:56even if it means just saving one person,
26:58even if that person is yourself.
27:00That's how I live with myself.
27:02She seemed doubtful.
27:03We decided to wait and see how tomorrow went.
27:06The third day she woke up and no
27:09longer felt that you needed to die.
27:10She said that she had had a revelation
27:13and decided she didn't want to keep
27:15existing like this halfway between
27:16life and death as she put it,
27:18she still felt bad.
27:19She was still depressed,
27:20but she wanted to live.
27:21She wasn't wearing her hat.
27:22She said this was her making
27:24steps towards getting better.
27:25There was work to be done.
27:27She wanted open an animal shelter.
27:28One day she would start by volunteering
27:31at the shelter in her town.
27:33And she wanted to start a
27:34garden to help things grow.
27:36Since the day she came to the unit,
27:38I didn't think her existential
27:40dread was unreasonable.
27:41Having experienced it myself in college,
27:42I sunk into a deep depression.
27:44So slowly I didn't register it at first.
27:47The hotline hand prepared.
27:48We said that either.
27:49I thought that by listening
27:51to other people's struggles,
27:52I would somehow be immune,
27:54able to talk myself out of it,
27:56but I couldn't.
27:57My thought patterns always
27:58circled back to the emptiness
27:59and the pointlessness of it all.
28:01Existing hurt one of the lowest points
28:03in my depression I was assigned in
28:06a philosophy class to read the book.
28:08Meditations by Marcus Aurelius.
28:09The plastic workbooks doses on.
28:11The Stoics viewed all external
28:12defenses beyond one's control.
28:14One only controls one's actions
28:15and reactions to such events.
28:17Quote Make the best use of words in
28:20your power and take the rest as it happens.
28:23For whatever reason,
28:24I found some comfort in knowing
28:25that 2000 years ago someone else
28:27was trying to manage the crushing
28:28weight of existence to find a
28:30reason to get up in the morning.
28:32Quote at dawn when you have
28:33trouble getting out of bed,
28:35tell yourself I have to go
28:36to work as a human being.
28:38What do I have to complain of if I if
28:40I'm going to do what I was born for,
28:43the things that I was brought
28:45into this world to do?
28:46Or is this what I was created for the
28:48huddle under the blankets and stay warm?
28:51And slowly but surely,
28:52with the help of therapy,
28:53I found myself believing in
28:55some of those words,
28:56eventually getting out of
28:58bed didn't hurt so much.
29:00I wanted to give her a copy of
29:02Meditations before she left the unit.
29:03I thought it might help her
29:04feel a little less alone.
29:06We gave kids age appropriate
29:07books in the pediatric clinic.
29:09I didn't know if Stoicism counted,
29:10but it felt appropriate for the age.
29:12The era in which she was growing up.
29:15And age in which children carry the anxieties
29:18of adults without the agency of adulthood.
29:20But I decided against giving her the book.
29:23Those words wouldn't fix any
29:24of her the world's problems.
29:25I didn't need to give her anymore homework,
29:27and she was likely to believe it
29:29more if she found it on her own.
29:31But I hope she would stumble upon
29:33these words someday, like I did,
29:35and find them to be a small but
29:37steady light in the dark days quote.
29:39Do not act as if you had 10,000
29:42years to live.
29:43Be inescapable is hanging over your
29:45head while you have life in you while
29:47you still can make yourself good.
29:49Thank you.
29:56Excellent job Isaiah, so I'm going
29:59to introduce the next speaker
30:01so when next we will have Georgia
30:03Spurrier who will be reading a
30:05piece called my Perfect Mother.
30:07Georgia is a rising senior at Yale College,
30:11majoring in psychology in the
30:12neuroscience track and hopes to
30:14continue doing research in clinical
30:16work after she graduates as well.
30:19She's also volunteered at
30:20our very own when he won.
30:23Our child inpatient unit and is
30:24currently working on a research
30:26project with Quinnipiac University
30:28about the COVID experience during the
30:30pre clinical years of medical school.
30:32Now here is Georgia with my perfect mother.
30:36Thank
30:37you so much, Amanda.
30:40She had shown me
30:41the purple splotchy bruises he
30:42left on her legs, hips, arms.
30:44It was March and quarantine had just
30:46begun which wreaked havoc on alcoholic
30:48households like ours and around him,
30:50my mom succumbed to her disease that night.
30:52The house was quiet.
30:53My mom was asleep and her
30:55boyfriend wasn't home.
30:56Recent police involvement in one
30:58of their inebriated arguments had
31:00confined him to a nearby hotel.
31:01I tiptoed out of the room I stayed
31:04in to get a glass of water.
31:06At first I didn't notice it,
31:08but something was out of place.
31:09The statue. About the height of my waist.
31:12Made up some dense metal like material.
31:14It typically decorated the fireplace.
31:15I saw it now stood in the middle
31:17of the front entryway,
31:19just inches from the door.
31:20What a bizarre and inconvenient location.
31:22How could we even open the door to get out?
31:24But that was just it.
31:26He couldn't get in if he tried
31:27the door would knock the statue
31:29and the resulting crash would
31:30certainly wake her before he could.
31:32She was just as scared as I was.
31:35For most of high school,
31:36my mom was my best friend.
31:38We like to think we were the
31:39real life Gilmore girls.
31:40She was the stylish fun mom and I
31:42was the mini me with dreams of Yale.
31:44Money got tight my junior year
31:46after another divorce and it
31:47was just her and me again.
31:49After some digging I found us a new
31:51apartment in budget and in the same city
31:53as I still stayed with my dad half the time.
31:55It was quaint but it was perfect.
31:57We had her friend take pictures of us posing
31:59together in our new unfurnished living room.
32:01The day we got the keys we
32:02shared a room a bed too,
32:04but I didn't really mind.
32:05She seemed content,
32:06so I was as well.
32:08My sister had long since moved out and
32:10had complicated relationships with
32:11both of our parents an I was highly
32:13determined not to experience a similar fate,
32:15so I cared for them.
32:17I help my mom budget and spotted
32:18the bills when she couldn't pay,
32:20I kept up with my dad's health, a diabetic.
32:22I reminded him every night to
32:24test his blood sugar before bed.
32:26Most importantly though, I mediated.
32:27I need to discussions between them
32:29so they would never have to speak,
32:30and if they spit nasty words
32:32about each other to me,
32:33I may hang my head and
32:35ask them to please stop,
32:36but better at me than at each other.
32:38I know their anger isn't directed at me,
32:40so it's OK.
32:41My senior year my mom started dating Peter.
32:43I hadn't met him yet,
32:44but he sounded alright like he could
32:46provide for us and make her happy.
32:47After a while she had a date with him
32:49on one of the nights she had custody.
32:51I stayed home and studied while
32:53they went out.
32:53After a few hours, she still wasn't home.
32:56A few more hours I texted no answer.
32:59I called no answer.
33:01I frantically began to Google what
33:03I knew about her date and then
33:04attempt to find his phone number.
33:06I had to find her and see if she was OK.
33:09Finally, after the 4th call she picked up,
33:11though I truly wish she hadn't,
33:13her words were slow slurred
33:14though I knew she was an addict.
33:16I had never seen it.
33:17I had the privilege of her sobriety,
33:19my entire childhood.
33:20My heart dropped,
33:21I begged her to tell me what she took
33:23as she continued with the nothing,
33:25I'm fine narrative that spilled out
33:26of her mouth at a sluggish pace.
33:28Suddenly I couldn't be in our home anymore.
33:30I raced out, sobbing.
33:32Overcome with fear,
33:32it was the incoherence I couldn't handle
33:35and I saw it all too often with my dad.
33:37His blood sugar dropping
33:39to an unhealthy level,
33:40his words slowing his eyes unreadable,
33:42giving him glucose tablets
33:43was shaking hands for years.
33:44I made sure that every conversation I had
33:47with either one of them ended in I love you.
33:50Should something happen,
33:50I needed that to be the last thing I said,
33:53but it wasn't this past June.
33:55Very out of character.
33:56My dad did not respond
33:58to my text one afternoon.
33:59He still hasn't an I love you
34:02was not the last thing I said.
34:04I have gotten so upset with them both
34:06in the past for their incoherence that
34:08scared me for their illnesses that hurt me,
34:11but I'm trying so hard to allow it
34:13to strengthen me as a daughter as a
34:15friend and hopefully one day as a clinician.
34:17Another dream of mine is to
34:19one day become a foster parent.
34:20I'd like to have my own kids as well,
34:23but I've wanted to foster since I was 16.
34:25Well,
34:25I'm not entirely sure where this
34:27particular dream stems from.
34:28I often think needing to care for my
34:30parents as a child myself made me
34:32intensely passionate about supporting
34:34other kids and getting to just be kids.
34:36Happy and carefree.
34:36Regardless,
34:37I feel it would be a privilege to
34:39be able to love and care for kids
34:41whose family situations turned
34:42out to be less than perfect.
34:43Soon after my dad's passing,
34:45I couldn't help but think that maybe,
34:47just maybe,
34:47this would make me a better foster parent,
34:49because now I understood just
34:51how painful it is to not have a
34:53parent around to be missing that
34:54part of your heart.
34:56Within the first few
34:57months at Yale, I discovered the
34:59children psychiatric inpatient service,
35:00better known as Winnie one,
35:01through a dance group I had joined on
35:03campus every Thursday we would meet at
35:05the fountain in the atrium of Yale,
35:07New Haven Hospital,
35:08and walk across the street to the unit.
35:10I had some experience working
35:11in child welfare.
35:12Given my interest in high school,
35:13but had no knowledge of psychiatry
35:15or hospitals, let alone how
35:16trauma infiltrated these spaces.
35:17Spending an hour dancing,
35:18the cotton eyed Joe and the Macarena
35:20with the 16 or so kids on this unit.
35:23In any given week became something
35:24I looked forward to greatly,
35:25but it didn't feel like enough.
35:27I didn't really know these
35:29kids or their lives at all,
35:30so I found the name of the director
35:32of the therapeutic groups on the unit
35:34sent an email and within a few weeks
35:37I had my bright red volunteer jacket.
35:39Now four semesters later,
35:40I still spend every Tuesday and
35:42Thursday morning on the unit.
35:43The kid stays range from days to weeks.
35:45They all follow a daily schedule.
35:47School and therapeutic groups and meals,
35:49and quiet time.
35:49They also frequently meet one on one
35:51with their psychiatrist on the unit
35:53and may have meetings with their families.
35:55The unit is comprised of psychiatrists,
35:57psychologists, social workers,
35:58teachers, nurses.
35:59From 9:00 to 10:00 every morning,
36:00all the staff meet and discuss
36:02these child's case, their history,
36:03their safety on the unit,
36:04their plan for discharge,
36:05and next steps in their treatment.
36:07I've been very lucky to be able to
36:09join these meetings and hear these
36:10kids stories I wanted so badly to
36:12understand what they were going through.
36:14I used to spend that hour furiously
36:16taking notes and then go home and dig
36:18up research on anything I didn't understand.
36:20Any acronym or vocabulary that didn't click,
36:22which frankly was most of it
36:23across all the complex thoughts,
36:25feelings and behaviors these kids displayed.
36:26I notice one thing almost all of them had.
36:29Trauma some of their experiences
36:31were downright horrific.
36:31I couldn't help but think that
36:33I'd be struggling too if I were
36:35in their shoes and they're just
36:37kids anywhere from 4 to 14.
36:39They had no control over the hand.
36:41Life dealt them,
36:41though I do recognize it's not just
36:43an unhealthy environment that confers
36:45these kids presentation on the unit.
36:47It was then that I stopped seeing
36:48them as victims as patients in a
36:50hospital and started seeing them
36:52as victims of their environment.
36:53Being born into an unhealthy
36:55situation should not determine
36:56your life course clinically.
36:57This concept now comes naturally
36:59to me personally.
36:59It's taken substantial effort.
37:01It is incredibly challenging to see
37:02someone's struggling with something
37:04perhaps beyond their control.
37:05When you are the one getting hurt.
37:07But my mom was just as scared as I was.
37:10She has an addiction and
37:12an unhealthy relationship.
37:13Brought that to the surface and
37:14he provided for us in a way we
37:16weren't used to a few months
37:18into their relationship we moved
37:19out of that one bedroom apartment
37:21and into his beautiful home on the
37:23water that's hard to walk away from.
37:25I had my own room, my own bathroom too,
37:28but I didn't have my mom anymore.
37:30And at first I was furious.
37:31We fought, we grew distant.
37:33I was confrontational and not
37:34comforting and that got me nowhere.
37:36He got us nowhere.
37:37At some point I must have realized
37:39the irony that I viewed the children
37:41that when he won his victims,
37:42but I viewed my mom as the villain working
37:44with these kids forced me to see my
37:46mom circumstances in a different light.
37:48It allowed me to see her
37:49struggling as having an illness.
37:50Not a no heart.
37:51That night when I saw the heavy metal
37:54statues standing guard at the door,
37:56my thinking began to shift.
37:57I realized how much could be accomplished
37:59by validating and attempting to
38:00understand that what may appear as Mal.
38:02Intent is often a reflection of an
38:04internal battle and circumstances
38:05beyond one's control.
38:06Well,
38:06I certainly can't say I understand her fight.
38:08I can say that I'm trying.
38:10I can say the same of the
38:12children at when he want.
38:13I don't get it,
38:14and I never will.
38:15It is not possible to ever truly know
38:17the depth of someone elses experience,
38:19but I don't want to stop
38:21learning and trying my mom.
38:22Is an incredible woman and
38:24the opportunity to love and be
38:26loved by her is something I
38:27wouldn't give up for the world.
38:29She's sober now we talk everyday.
38:31I'm getting my mom back and every
38:33time we speak I'm reminded of just
38:35how perfect she was all along.
38:45Thank you so much George.
38:48A beautiful piece,
38:49an last but certainly not least,
38:52I want to introduce Kiana Marie Combs.
38:57She is a senior I cooperative
38:59Arts and Humanities High School.
39:01She is a phenomenal actress and
39:03is actually involved in a clinical
39:05trial and research study that
39:07I'm doing with Doctor Martin
39:09that's looking at depression and
39:11Black African American girls.
39:13She's also an activist writer,
39:15an artist who was born and
39:17raised in good old New Haven,
39:19and she's attending University of
39:21Hartford next year with the hopes of
39:24studying criminal justice and theater.
39:26Everyone please welcome.
39:27Miss Kiana and she will be
39:29reading COVID-19 and me.
39:31A reflection on mental health in 2020.
39:35Thank you so much. Here's my piece.
39:41Diary excerpt from March 5th, 2020.
39:44Good morning was rather and markable
39:47I neglected to pack a lunch,
39:50which I'm beginning to regret.
39:53Ride to school was full of chatter
39:56on the radio about this spooky new
39:58thing called the coronavirus over 19.
40:01I must admit I've been way too
40:03preoccupied with chronicling my boy
40:05kissing shenanigans to write about
40:07the recent news, so here it is.
40:10Originate Ng in Wuhan, China.
40:12The mothers of a flu like sickness soon
40:15became screams as within three weeks
40:17it snuck through nearly every country,
40:19including America,
40:20and only happened about five days ago when
40:24cases are already doubling with 11 dead.
40:26Although every state bordering
40:28Connecticut has a case,
40:29I don't think I'm too concerned if
40:32it's as close to the flu as they say
40:35then I'm sure it'll blow over fast.
40:38And that, ladies and gentlemen,
40:40is what I think they call foreshadowing.
40:44Who would have known that only a
40:46few sneezes in a couple of adults?
40:49Being believing that being told to
40:50wash their hands was unconstitutional,
40:53and every country in the whole world
40:55will be brought to a standstill.
40:58And furthermore it would bring me
41:00face to face with an issue that I've
41:03never struggled with my mental health.
41:05OK OK,
41:05never struggle,
41:06which is a bit of an exaggeration,
41:09more like never had option two
41:12is more fitting.
41:13Mental health was only for when a
41:15celebrity wanted to explain why they
41:17took such a long leave of absence.
41:19Mental health was four on tick tock and
41:22social media when 15 year old girl wanted
41:25to convince you that it's a balista.
41:27Tell a depressed person to clean their room.
41:30Mental health was for when your
41:32friend Emily got her parents called
41:34in gym class over self harm scars.
41:37Now I'm not stupid or in disbelief
41:39that people darker than a paper lunch
41:42bag can struggle with things up there,
41:45but I can definitively say that
41:47I've never seen anyone in media
41:49who looks like me being up front
41:51about mental illness from 13.
41:53Reason wise to over shadow.
41:55There's no pity for the brown girls.
42:01It's not even like my history
42:03with general hospitals would be
42:05anything that rely on anyhow.
42:06When a mother who was scared of
42:08hospitals and a handful of Miss
42:10Checkup appointments over the years.
42:12Whenever I was afflicted with
42:14a new warning set of symptoms,
42:16good old fashioned prescription of Tylenol,
42:18soup and ginger relish.
42:19What I got an it worked except for
42:22those times where I got deathly
42:24ill and earnestly needed treatment.
42:26But those other times it worked.
42:29My actual visits,
42:30visits to hospitals prior
42:32to COVID want too pretty.
42:34Either whenever I went a lot of the
42:36symptoms I described were overlooked.
42:39My experiences were often often doubted,
42:41and my complaints were often
42:43delivered through a game of
42:45telephone between my parents,
42:47and nurses will always
42:48really eager to change it,
42:50since I'm sorry.
42:53Both of which never quite understood
42:56exactly what I was going through.
42:58This of course led to a lot of trial and
43:01error treatment and re diagnosing my PMS
43:05was initially diagnosed as a stomach bug.
43:08My anxiety induced stomach
43:09pains were initially thought to
43:11just be as liquid acid reflux.
43:14My complaints of constant joint
43:15pain in my whole body yielded
43:18no diagnosis period at all.
43:20Now as you can see this built
43:22up some mistrust in the system
43:25in me misdiagnosed me once.
43:27Shame on you misdiagnosed me twice.
43:30Shame on you again.
43:31Probably misdiagnosed me three times.
43:32You should probably get out
43:34the hospital for you.
43:35Kill somebody.
43:37And yeah, that was.
43:39That's why during quarantine when I started
43:42experiencing things that weren't physical,
43:45therefore harder to prove,
43:48I was at a complete loss of what to do.
43:54Diary entry July 23rd, 2020.
43:59100 of the Heat is getting to me.
44:01Don't call me crazy.
44:02OK wait, I doubt anyone's ever
44:04gonna actually read this.
44:06But if you don't call me crazy,
44:08OK,
44:08but I've begun to legitimately
44:10hallucinate sometimes,
44:10like I'll hear voices when I'm
44:12wearing headphones out here.
44:14Someone that I know that I haven't
44:15seen in a long time Call My Name
44:18with crystal clear accuracy that I'll
44:20repeatedly jump up out of whatever
44:22bit of sleep I was managed to get.
44:26And.
44:26I'll run the go and see if
44:29they were both there.
44:31I've made a habit of not being
44:33able to sleep until three again.
44:35Hearing someone yell for me at 9:00 AM
44:37and impulsively running downstairs to check,
44:38even though I doubt that they
44:40were there in the first place.
44:42I've had no hallucinations today,
44:44but my random heart pain is back.
44:48In this,
44:48insomnia is getting unbearable.
44:50The most awful symptom which has
44:52just happened was I was listening
44:54something commonly with my
44:56headphones when I suddenly became
44:58overwhelmed by my senses and felt
45:00sick to my stomach and knocked my
45:03headphones off and shut my laptop,
45:05grabbing a Pepto Bismol tablet
45:07and stumbled downstairs,
45:08recover suddenly overtaking
45:10what emotion and wanting to cry.
45:13On the less melodramatic side of things,
45:15I haven't painted in months.
45:17Yeah,
45:17months like I haven't even looked at pencil,
45:20although in order to paint you
45:22probably have to get out of bed,
45:24which I honestly haven't been doing lately.
45:27I have been big sleeping an
45:29I'm gonna be honest with you.
45:31I have no idea what to do or
45:35where to go from here.
45:37And, well, I really didn't know what to do.
45:41I still don't,
45:42so let's go over my options at the
45:45time one doctors were busy trying
45:47not to dive from what people my
45:50age nicknamed Miss Corona Lashay
45:52and trying to end up and me.
45:56So that was a lost cause.
45:58To ask my family for help.
46:00Sure,
46:01I'll do that after I mop up
46:03an entire ocean vacuum,
46:05a beach cut along with safety
46:07scissors and eat an entire Jean jacket
46:10without water for good measure.
46:12Three, someone suggested I talk to the
46:17school counselor, know for therapy.
46:23I've been through it before
46:24when I was younger and social
46:26workers assigned once in me.
46:28And the lady they gave me,
46:31and the subsequent three other ladies,
46:33all with this really uncomfortably similar.
46:36And but that they all didn't
46:38understand a single thing.
46:40I went through and then even try.
46:42They offered nothing but cold,
46:44analytical criticism.
46:45I don't know about you,
46:47but I'd rather not go into depth
46:49telling a lady who looks like Judge
46:51Judy about childhood trauma and
46:53the stigma in black communities.
46:55So yeah. That left me with my friends.
47:00And that went about as well as you think
47:03that couple of inner city untrained
47:05schoolchildren acting as therapist would go.
47:08Not well, so there I was completely alone.
47:11Where do you try and when every
47:15option is an option for you.
47:18Diary exam November 27th 2020.
47:22I've been doing a lot
47:24of introspection lately,
47:25like signal sitting around,
47:27staring at walls and stuff super
47:29hard and reflecting on everything.
47:30I think it's helping slowly,
47:32pulling myself up by the bootstraps
47:34like a depressed Pilgrim or something.
47:36I wonder what the press people
47:38did in that time anyway.
47:40Like they they go and pray or something?
47:43Or did they sit around like damn,
47:45I wish Prozac was invented already.
47:47OK, I digress,
47:48but what I'm trying to say is that
47:51I'm trying to take things slowly.
47:54I wish that this organization that
47:56caters heavily towards health and
47:58Wellness in black women and what
48:00everything that's going on nowadays.
48:02God knows we need it.
48:04But anyways,
48:05I'm reaching out and seeing
48:06if they could hook me up with
48:08someone or something like that.
48:10My fault room might not.
48:11Will see.
48:13And while it didn't bother
48:15going on half a year since then,
48:17I'm doing better.
48:18I still have lost touch with
48:20some things I once loved it down.
48:22Sometimes I still find myself too
48:24tired to get out of bed for half a day.
48:27Sometimes I still double thank my
48:29eating habits, but I'm getting better.
48:31The moral of the story is I held strong.
48:35I was one of the lucky ones.
48:37I shouldn't have been pushed by my family,
48:40friends and societal norms and
48:42especially by the health care system.
48:44To take remedying depression
48:46into my own hands.
48:48What I was fortunate enough to work
48:50through was the exact thing that claimed
48:53the life of Giovanni Giovanni Smith,
48:55a 15 year old who took,
48:57took her life last year in
48:59attempt to cope with isolation,
49:00something that had she had the
49:03outlets to reach out for help would
49:06have hopefully been prevented.
49:07And so I did.
49:09I dedicate this story in presentation
49:11to her into the thousands who look
49:13like me and not who have struggled
49:15with the past year in prior because
49:17they had no one else to turn to.
49:20Help is always possible somewhere out there.
49:24Thank you.
49:34Ashley Clayton. Can you put a cherry
49:36on top of that extraordinary Sunday?
49:40I mean, I don't.
49:41I don't know how anyone goes after what
49:45was such an incredible in hilarious.
49:48Talk wow, I'm so impressed and delighted.
49:52I'm just pure delight but everyone I just
49:56wanted to thank you so much for coming.
50:00This really came from I think part of.
50:05An experience we've all shared,
50:07which is COVID-19 in our lives looking
50:11very different than they did before.
50:14And really, being confronted with
50:16very big things but also thinking
50:19a lot about the small things that
50:22we've missed that impact us more
50:25than we might have noticed before.
50:28I, I'm always if you know me,
50:31I carry around journals filled with
50:34other people's words and two quotes
50:37that I love one by Simone Weil,
50:40which is attention is the rarest
50:43in purest form of generosity.
50:46And then in conversation years
50:48later with Mary Oliver,
50:49who responded not technically but in my head.
50:54Attention without feeling is merely a report.
51:00And so if you had the pleasure of
51:03attending some rounds in internal
51:06medicine a few months ago,
51:08you would have heard.
51:12At Grady,
51:13Doctor Who was a famous doctor,
51:15Kimberly Manning on Twitter and Amanda
51:18and I an Andres were going back and
51:21forth about her stories about these
51:23very small moments of learning from
51:26patients in interacting with people,
51:29and that was really what sparked
51:31this grand rounds.
51:32And so we hope you enjoyed it.
51:36We hope to make this an annual
51:39event and with love for you all to.
51:42Email us your storied 2022.
51:47Anne and just you know, want to say again,
51:51thank you so much for coming.
51:53Thank you Andrea San Amanda
51:55for coordinating this with me.
51:56Thank you to all of our amazing speakers.
52:01And that is.
52:02That is the clothes.