Back to Basics (January 2016): Dr. James Mooney, M.D.

“Your perspective on life comes from the cage you were held captive in.”                                                                                                         -Shannon L. Alder

 The common notion that there are two sides of a coin can be misleading. In fact, if one includes the rim of the coin, it becomes clear that there are actually three sides. And why does this matter? For me, it is a matter of perspective. If I am going to try to understand perspective, it makes more sense to stand on the rim of the coin. That way, I can see both sides more clearly. While this may be an exercise in semantics for some, it becomes a position of utmost importance when dealing with the trauma of life. Humans excel at naming things. We go from the joy of naming a child to the pain of naming an accused. A hero to one time or culture may be a villain to another. Is either perspective correct or are both correct? I would like to try to answer that with a story about a patient I admitted to the hospital.

 Barb was admitted for shortness of breath secondary to an exacerbation of her heart failure. She was in her 70s and her health was complicated by obesity, high blood pressure, and diabetes. The combination of these problems contributed to her long-standing heart problem. Over the course of her first few days in the hospital, I learned that she was caring for her grandchildren in her home as their parents had been unsuccessful in raising them (as a result of personal struggles with drug abuse). She felt compelled to “protect children.” Her description of her efforts reminded me of the line by Holden Caulfield in J.D. Salinger’s The Catcher in the Rye. Caulfield said, “I have to catch everybody if they start to go over the cliff-I mean if they’re running and they don’t look where they’re going I have to come out from somewhere and catch them. That’s all I do all day. I’d just be the catcher in the rye and all.” Having spent prolonged periods of time together in deep conversation, Barb and I began to develop a mutual trust in each other. As a result, when I asked her why she felt so compelled to protect children, she openly shared that the sexual and emotional abuse she experienced as a child compelled her to become a protector of innocence. She noted that her father was the perpetrator of the abuse. She was especially careful to keep the children away from him while he was alive. She did not want anything like that to happen to children under her watch.

 By society’s standards, her father was a perpetrator, a criminal. So I asked Barb if she and her father ever had the opportunity for reconciliation. She noted that they had not and noted that she was not sure that would have been an option for her. The resentment and pain was deep. Barb, though, was introspective. I asked her about her father. I asked her if she ever thought of him as a young boy. She said she had not. I asked her if she thought it was possible that he was sexually abused as well (while variable, statistics show that 30-40% of sex offenders have themselves been victims of sexual abuse). She thought for a moment then looked at me and said, “I guess I never thought of it that way.” We talked about her father at age 5 as a victim and at age 40 as a monster. If she were the grandmother of him at age 5, she would have provided the same compassionate protection as she was currently providing her own grandchildren. However, her father likely struggled with his own childhood traumas and perpetuated the pain through others. Does our neglect of the issue as a society transition the victim to status as perpetrator? Who is responsible for supporting the emotional health of that 5 year old victim? Is it any wonder that a child goes on to do the very thing done to him by those closest to him? So, in getting back to my original question on perspective, was Barb’s father a victim or a perpetrator? I guess the answer to that question stems from your perspective. Do you feel emotionally healthy enough to “stand on the rim?”

About the author:

Dr. James H. Mooney, M.D. is a Hospitalist physician in central Ohio who explores the connection between a person's emotional and physical health.

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