Smile for the theodolite.
NPR has a couple of stories this week about ACE scores (Adverse Childhood Experiences) and it's health consequences. What drives me nuts is the resistance to gathering this data.
"There are no randomized controlled trials that show that applying these screening tools to a large population changes any outcomes that a patient cares about," says Young. "Someone's got to show me that it's going to actually make a difference in my patients' lives — and to my knowledge no one has done that."
Well, gee, who should do this? I dunno, maybe if every doctor asked these questions and it went into a study... wait, um. It's so much, "I haven't tried, I don't wanna try, it's toooooo haaaaarrd!" Let's see, no the past can't be changed, but proper referrals to ptsd counseling, other therapies, care for adult children who may be just starting to develop problems, or young children still at home could, oh, I dunno, maybe get help. Too many adults seem to think children are resilient, that abuse and neglect aren't that bad, kids will bounce back. Changing that attitude could have huge health effects. It's like seeing a population with measles, shrugging and saying "I can't stop them getting the disease, they already have it. Why bother? There are no studies to show anything will do any good." Nope, that is up to you to get started, right?
No one knows how much help, what strategies might work, since so many health pros don't even want to touch childhood abuse and neglect. A generation ago, cops would walk away from domestic abuse because it was too dangerous to them, and the (usually) wife would not press charges. Taking the onus of legal charges out of the hands of a dependent victim, understanding some of the mechanism of how that sort of abuse works, made huge differences in many lives. Not that the issue is resolved, but awareness of the gross injustice of violence in one's home, has to be a start.
I'm so grateful for the help I eventually got to transform. But getting it earlier, or even some help when I was still a child, I can only imagine. Instead of just clambering out of that emotional hole, oh, what mountains there were to climb. Without that damage... ah, well.
The next time I visit my gp, he's going to be asked about this. Oh, my, yes. Throwing my pebble into the impending avalanche.
2 comments:
good on you. start an avalanche!
I listened to this piece on the radio. The part that most impressed me was the woman who answered the doctor's questions about her adverse childhood experiences. Then she said answering the questions made the connection for her how her background was involved in her current and future health. She also said that the interview was a dispassionate process, not the tears and re-awakening of trauma that doctors may worry about. Honesty is hard work and so much better than the alternative.
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