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thrive, we had been able to treat the root of it—the stress caused by depression and trauma and an unhealthy family dynamic.
Despite setbacks along the way, the child-parent psychotherapy had been a real success, changing the dynamic that was affecting Nia’s health and strengthening Charlene’s ability to ...
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We found that a focus on the underlying biology of toxic stress and the factors that helped balance the dysregulated pathways—sleep, integrated mental-health services, and healthy relationships—made a big difference for our
from a local company, so each kid who met his or her treatment goal would get a bike.
Parents in Bayview made sure their kids stayed safe by keeping them indoors—which
we made sure that every patient in the program with a high ACE score (which was most of them) also received mental-health treatment with Dr. Clarke.
but we were pleasantly surprised to see how much the kids improved when we added healthy diet and exercise incentives to therapy. I sat down to check in with the moms and grandmas each week, and they reported that when they
changed their children’s diet and their levels of exercise went up, the kids slept better and felt healthier, and in many cases, their behavioral issues and sometimes their grades improved.
We’ve long known that exercise improves cardiovascular health, but the research is piling up in exciting new directions, showing us that moving our bodies builds our brains as well as our muscles.
response and reduce the presence of inflammatory cytokines. You might remember that cytokines are the chemical alarms that fire up your immune system and tell it to fight.
While stress activates the fight-or-flight system (also called the sympathetic nervous system), meditation activates the resting-and-digesting system (also called the parasympathetic nervous system).
Given the profound connection between the stress response and the neurological, hormonal, and immune systems, a calmer, healthier mind seemed like a good place to start reversing the effects of toxic stress.
And I did find it, in an impressive organization called the Mind Body Awareness (MBA) Project. MBA was doing mindfulness work (both meditation and yoga) with kids in juvenile hall and getting some solid results.
(one study that came out later on looked at more than sixty thousand young people in the Florida juvenile justice system and found that 97 percent had experienced at least one ACE category and 52 percent four or more),
Never having been around people who didn’t have his best interests at heart, Gabriel implicitly trusted them.
When he later reenrolled in school, his mindfulness practice became the center that helped him stay connected to his values and integrity.
What motivated Gabriel’s work with incarcerated youth was his realization that if it hadn’t been for his father, for his stable and loving relationship with him, he might not have stopped himself from doing the unthinkable.
he felt a strong desire to help those who didn’t have a person like that in their lives, someone who stops you cold in a moment of truth.
But she wanted to know whether the city could find a way to prevent people from becoming victims of crime in the first place.
shootings. Harris was interested in getting to the root of the problem, preventing rather than simply responding to the downstream
effects once the chain of violence had been set in motion.
Was there something they could have done? Could they find a way to recognize the next high-risk kid when he was sitting in front of them in the ED and help him before it was too late?
A typical story looked like this: A patient first comes in as a nine-month-old baby with a suspicious bruise, and the case is referred to Child Protective Services. The investigation is inconclusive. The next notation in his chart is from his pediatrician and details several missed visits for immunizations. At age four his preschool teacher complains that he won’t sit still, has frequent tantrums, and hits other kids when he gets upset. He is diagnosed with ADHD and put on meds. At age ten, he’s fighting and disruptive in school. This time, he’s diagnosed with oppositional defiant disorder and
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clear example of untreated toxic stress.
Harris and I agreed that we were looking at the same problem, just from different vantage points. I was trying to address kids’ medical problems and she, like Dr. Dowd, was trying to keep kids safe.
The next thing I knew, Tipping Point had raised $4.3 million
It was seed funding and it was enough to bring the Center for Youth Wellness (CYW) into the world. The Bayview clinic, supported in part by the hospital, would keep doing what it did—regular checkups for kids in the community and ACE screening. Once a patient screened positive for ACEs, the CYW clinical team would provide the multidisciplinary services focused on treating toxic stress—mental health, mindfulness, home visits, nutritional counseling, all the stuff our research told us could make a difference.
When folks hear that there is money coming into the community, there is a small contingent that essentially makes its living by trying to get a piece of it. That the community would benefit by having more high-quality services for kids is not what they were interested in. They wanted the money in their pockets.
After paying for the rent and construction, we had almost nothing left, and we still had to pay the staff. Clearly, this group had an entirely wrong idea about how deep our pockets were.
stop the massacre! DR. BURKE WANTS TO EXPERIMENT ON OUR CHILDREN!
Accusations of medical experimentation in African American communities are exceptionally loaded because they are founded on a history of shameful and unethical exploitation of blacks by the medical community.
It burned me up that they would use the trauma that came out of those situations for their own purposes.
posts and articles about why people in the neighborhood shouldn’t trust “that Jamaican.”
“I think we can do better by our kids,” I said, rising to my feet. I could see her eyes narrowing, but before she could say anything I continued. “Sister J, our kids deserve better.” And with that, I shook her hand and walked out.
I was beginning to see that the lack of outside investment in Bayview wasn’t only because nonresidents didn’t care; even the people who did care had to deal with ridiculous obstacles placed in front of them by a few misguided gatekeepers. I could see how easy it would be for anyone trying to do some good in Bayview to give up.
journalist Paul Tough.
he had written an article in The New Yorker about the Bayview clinic and our work around ACEs and toxic stress.
It’s not overstating the situation to say that the article changed everything. By spotlighting the subject, it triggered a ton of interest among colleagues and new supporters and brought our work into the mainstream.
“It’s a rite of passage,” Paul assured me. “You’ll make it through. Consider it a badge of honor.”
It occurred to me that the trauma that is endemic in communities like Bayview isn’t just handed down from parent to child and encoded in the epigenome; it is passed from person to person, becoming embedded in the DNA of the society.
stick to what I already knew: my patients and their parents were overwhelmingly supportive of our plan for CYW.
But that wasn’t always the case.
She became quieter and less interactive, and by seven months, she began losing her milestones and developed an odd habit of dropping her head. Concerned, Mary Lou Doll took her daughter to her pediatrician, who diagnosed Margaret’s “head dropping” as seizures and determined her to be “somewhat retarded.”
He suggested she take the baby to the University of Minnesota, where she
tested and diagnosed with PKU.
body unable to metabolize phenylalanine, an amino acid found in most proteins, including br...
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There is a treatment for PKU, but here’s the kicker—it isn’t a million-dollar-a-dose medicine or some fancy implantable medical device.
The combined heartbreak from his son and his niece made Dr. Robert Guthrie a man on a mission. He knew that if the PKU was caught early enough, the phenylalanine-restricted diet would prevent severe neurological damage.
For years after he developed the test, Guthrie was a vocal advocate of screening all newborns for PKU before they left the hospital.
I was about to give all of them the scoop on what turned out to be my most unexpected patient in months, and I knew that together we could help her.
