Nadine Burke Harris - The Deepest Well: Healing The Long-Term Effects Of Childhood Adversity

Copyright 2018 by Nadine Burke Harris

ALL RIGHTS RESERVED

For information about permission to reproduce selections from this book, write to or to Permissions, Houghton Mifflin Harcourt Publishing Company, 3 Park Avenue, 19th Floor, New York, New York 10016.

hmhco.com

Library of Congress Cataloging-in-Publication Data is available.

ISBN 978-0-544-82870-4

Cover design by Michaela Sullivan

Cover images Shutterstock

Author photograph Michael Winokur

e ISBN 978-0-544-82872-8
v1.0118

reprinted by permission of Center for Youth Wellness.

To my patients and to the community of Bayview Hunters Point.

Thank you for teaching me more than any university possibly could.

All of the stories in this book are true. Names and identifying details of some individuals have been changed in some circumstances to protect confidentiality. Some vignettes are retold from previous published works.

AT FIVE OCLOCK ON an ordinary Saturday morning, a forty-three-year-old manwell call him Evanwakes up. His wife, Sarah, is breathing softly beside him, curled in her usual position, arm slung over her forehead. Without thinking much about it, Evan tries to roll over and slide out of bed to get to the bathroom, but somethings off.

He cant roll over and it feels like his right arm has gone numb.

Ugh, must have slept on it too long, he thinks, bracing himself for those mean, hot tingles you get when the circulation starts again.

He tries to wiggle his fingers to get the blood flowing, but no dice. The aching pressure in his bladder isnt going to wait, though, so he tries again to get up. Nothing happens.

What the...

His right leg is still exactly where he left it, despite the fact that he tried to move it the same way he has been moving it all his lifewithout thinking.

He tries again. Nope.

Looks like this morning, it doesnt want to cooperate. Its weird, this whole body-not-doing-what-you-want-it-to thing, but the urge to pee feels like a much bigger problem right now.

Hey, baby, can you help me? I gotta pee. Just push me out of bed so I dont do it right here, he says to Sarah, half joking about the last part.

Whats wrong, Evan? says Sarah, lifting her head and squinting at him. Evan?

Her voice rises as she says his name the second time.

He notices shes looking at him with deep concern in her eyes. Her face wears the expression she gets when the boys have fevers or wake up sick in the middle of the night. Which is ridiculous because all he needs is a little push. Its five in the morning, after all. No need for a full-blown conversation.

Honey, I just gotta go pee, he says.

Whats wrong? Evan? Whats wrong?

In an instant, Sarah is up. Shes got the lights on and is peering into Evans face as though she is reading a shocking headline in the Sunday paper.

Its all right, baby. I just need to pee. My leg is asleep. Can you help me real quick? he says.

He figures that maybe if he can put some pressure on his left side, he can shift position and jump-start his circulation. He just needs to get out of the bed.

It is in that moment that he realizes it isnt just the right arm and leg that are numbits his face too.

In fact, its his whole right side.

What is happening to me?

Then Evan feels something warm and wet on his left leg.

He looks down to see his boxers are soaked. Urine is seeping into the bed sheets.

Oh my God! Sarah screams. In that instant, seeing her husband wet the bed, Sarah realizes the gravity of the situation and leaps into action. She jumps out of bed and Evan can hear her running to their teenage sons bedroom. There are a few muffled words that he cant make out through the wall and then shes back. She sits on the bed next to him, holding him and caressing his face.

Youre okay, Sarah says. Its gonna be okay. Her voice is soft and soothing.

Babe, whats going on? Evan asks, looking at his wife. As he gazes up at her, it dawns on him that she cant understand anything hes saying. Hes moving his lips and words are coming out of his mouth, but she doesnt seem to be getting any of it.

Just then, a ridiculous cartoon commercial with a dancing heart bouncing along to a silly song starts playing in his mind.

F stands for face drooping. Bounce. Bounce.

A stands for arm weakness. Bounce. Bounce.

S stands for speech difficulty.

T stands for time to call 911. Learn to identify signs of a stroke. Act FAST!

Holy crap!

Despite the early hour, Evans son Marcus comes briskly to the doorway and hands his mom the phone. As father and son lock eyes, Evan sees a look of alarm and worry that makes his heart clench in his chest. He tries to tell his son it will be okay, but its clear from the boys expression that his attempt at reassurance is only making things worse. Marcuss face contorts with fear, and tears start streaming down his cheeks.

On the phone with the 911 operator, Sarah is clear and forceful.

I need an ambulance right now, right now! My husband is having a stroke. Yes, Im sure! He cant move his entire right side. Half of his face wont move. No, he cant speak. Its totally garbled. His speech doesnt make any sense. Just hurry up. Please send an ambulance right away!

The first responders, a team of paramedics, make it there inside of five minutes. They bang on the door and ring the bell. Sarah runs downstairs and lets them in. Their younger son is still in his bedroom asleep, and shes worried that the noise will wake him, but fortunately, he doesnt stir.

Evan stares up at the crown molding and tries to calm down. He feels himself starting to drift off, getting further away from the current moment. This isnt good.

The next thing he knows, he is on a stretcher being carried down the stairs. As the paramedics negotiate the landing, they pause to shift positions. In that slice of a second, Evan glances up and catches one of the medics watching him with an expression that makes him go cold. Its a look of recognition and pity. It says, Poor guy. Ive seen this before and it aint good.

As they are passing through the doorway, Evan wonders whether he will ever come back to this house. Back to Sarah and his boys. From the way that medic looked at him, Evan thinks the answer might not be yes.

When they get to the emergency room, Sarah is peppered with questions about Evans medical history. She tells them every detail of Evans life she thinks might be relevant. Hes a computer programmer. He goes mountain biking every weekend. He loves playing basketball with his boys. Hes a great dad. Hes happy. At his last checkup the doctor said everything looked great. At one point, she overhears one of the doctors relating Evans case to a colleague over the phone: Forty-three-year-old male, nonsmoker, no risk factors.

But unbeknownst to Sarah, Evan, and even Evans doctors, he did have a risk factor. A mighty big one. In fact, Evan was more than twice as likely to have a stroke as a person without this risk factor. What no one in the ER that day knew was that, for decades, an invisible biological process had been at work, one involving Evans cardiovascular, immune, and endocrine systems. One that might very well have led to the events of this moment. The risk factor and its potential impact never came up in all of the regular checkups Evan had had over the years.

What put Evan at increased risk for waking up with half of his body paralyzed (and for numerous other diseases as well) is not rare. Its something two-thirds of the nations population is exposed to, something so common its hiding in plain sight.