The difficult and mundane.

In March 2011, while hovering between the East and West Coasts, I visited a friend in San Francisco and found the latest New Yorker issue on their kitchen table. Flipping through its pages, I happened upon an article about Dr. Nadine Burke’s San Francisco-based pediatric practice, and her astute instinct to make clinical linkages between childhood trauma and health outcomes.

Paul Tough, journalist, interviewed her and wrote an incisive, comprehensive article about Dr. Burke’s Bayview practice and evolving treatment philosophy. In Tough’s article, I also learned about a 1998 longitudinal health study commissioned by Kaiser Permanente and published by Felitti, Anda, et al., with profound implications for childhood and adult health.

This is the ACE Study, with ACE standing for Adverse Childhood Experience. You can read the original Paul Tough article here [PDF]. In 2003, Felitti spoke at a Colorado conference and summarized key findings from the ACE Study. Watching an online video presentation of this talk, I found myself transcribing the following:

The eighth category that we added in the second wave was growing up without both biological parents. One of the things that we discovered in terms of losing a parent is that if one is going to lose a parent incontestably, it is best to lose that parent by death, and worst to lose that parent by abandonment.
—Dr. Vince Felitti, “ACE’s by Vince Felitti“, from the Child Trauma Treatment Network of the Intermountain West, September 2003 Snowbird Conference [TRT: 12:06]

I am buoyed by these linkages, and the work of Drs. Felitti and Burke. What we’re seeing is a recognition of the longitudinal effects of childhood experience, and medical treatment models that are evolving to address emotional, physical, and psychological health. And, as important as recognition and acknowledgment of specificity, we are also seeing healthcare treatment paradigms shifting to that of buttressing resilience, like rebars for concrete in architecture, within the lifespan of people who’ve lived through what is difficult, with what I hope is an arc toward exploring neuroplasticity, healing, and also a greater sense of compassion for each other.

It’s clear to me that the difficult and living through it are not statistical anomalies, but are in fact so incredibly common as to be almost mundane—begging the question why—and simultaneously implicating all of us in what are worldwide public health concerns.

To read more, find the ACE Study paper’s abstract on PubMed. The paper itself appeared in the 1998 edition of the American Journal of Preventive Medicine.



2 thoughts on “The difficult and mundane.

  1. Patrick Clarkin says:

    I really like the idea of resilience, and where you wrote:

    “It’s clear to me that the difficult and living through it are not statistical anomalies, but are in fact so incredibly common as to be almost mundane…”

    Happiness is sometimes/often elusive, but we keep forging ahead for a chance at those brighter times.

    1. soonapak says:

      Yes! Resilience seems like the only thing that makes sense to focus on, besides acknowledgment of the thing itself.

      And, thank you, too, for the spare, poetic example of lichen and its desire to live above all else. You wrote:

      “In Bill Bryson’s words: ‘It is easy to overlook this thought that life just is. As humans we are inclined to feel that life must have a point. We have plans and aspirations and desires. We want to take constant advantage of the intoxicating existence we’ve been endowed with. But what’s life to a lichen? Yet its impulse to exist, to be, is every bit as strong as ours-arguably even stronger. If I were told that I had to spend decades being a furry growth on a rock in the woods, I believe I would lose the will to go on. Lichens don’t. Like virtually all living things, they will suffer any hardship, endure any insult, for a moment’s additional existence. Life, in short, just wants to be. But—and here’s an interesting point—for the most part it doesn’t want to be much.'”

      Comical, touching, and very much alive.

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