Doing Right vs. Doing Wrong

This is a picture of our dog, Duke.  Duke came to use several years ago as a senior dog with some complex medical issues.  He had a significant history of trauma, with his jaw and ribs broken and a BB bullet still lodged in his groin area from where he had been shot.  Duke was only a few pounds with no teeth and wanted nothing more than to be held and cuddled, constantly.  He was also a very timid and shy little dog at first, cowering if you placed your hand over his head to pet him and even sometimes wetting himself.  That subsided after a while as he learned to trust us and know we would not hurt him.  What never went away was his fear (not hatred) of children, specifically older male children.  We gave Duke as much love, care and security for as long as he remained on this earth.  Had he not encountered a serious of loving, compassionate people along the way who did right, he would have been euthanized.  His life was valuable, for him and for us.

When I think about Duke I think about the lives of so many people I have supported over the years.  People who have significant histories of trauma, for which some providers may not even be fully aware of.  Trauma is real, and can evoke very strong emotional reactions that manifest in what others describe as very challenging "behaviors".  Now, I'm not comparing my dog to the people I support, but I'm using him to draw a parallel.  For Duke, his manifestation took the form of lunging at boys and barking in defense if they walked into a room or looked at him.  However, if he was placed on my son's lap somehow he knew he was safe.  We had to work with Duke and my son.  This took a lot of time and patience, and we could have easily given up on Duke and sent him off somewhere else.   We didn't, we worked.

In my work there are two terms I do not readily accept, or I respectfully challenge people to think through.  The first is, "it happened out of the blue" and the second is, "they are being attention seeking".  Let's first think about "it happened out of the blue".  Nothing happens out of the blue.  There are always reasons for something occurring but you may not know what these reasons are.  A person is involved in a car accident, which seemed to happen "out of the blue" but the real reason was a person ran a red light or they hit a patch of ice.  In the lives of people it becomes a little more complex.  Someone may scream (or bark) "out of the blue" but really they are terrified.  Think about it, screaming does equate a sense of fear and barking does parallel a defense mechanism.  As far as the statement "they are being attention seeking" my response is generally, "why do they need to resort to what you describe as very challenging behaviors in order to get your attention?"  Ordinarily this response is not well received but it is relatively thought provoking.  If someone needs to hit you in order to get your attention then it may mean you missed something.  Maybe it's a fragment in the relationship, maybe it's the meaning or communication behind the hitting (i.e. pain, needing something, etc.) or maybe it's a combination of both.  I have yet to meet a person who listed their goal as purposely tormenting their parents or their staff. 

There are times when spoken words do not match body language or manifestations of how a person will get their needs met.  For example, a person may say their sexual interaction with a housemate or another person was consenting (when placed in a room with that person and asked the question) but in recent months their mood and behavior has changed.  Sometimes this happens so much so that behold, a new behavior goal is suddenly created.  We have to dig a little deeper folks, and do right by people.  This means sometimes making some people, or a lot of people, really mad at us.  It has been my experience that as soon as you have separate conversations, a lot of information starts to come to the surface.  Think about it.  If someone was coercing you into sex would you be honest, in front of them, about what was really happening?   Don't do what's easy, do what's right.  This holds true for then ensuring people are provided a safe place and treated with respect without being subjected to repeated trauma.  Don't think that people are just going to get over things and "move on" living and working as normal.  People have thoughts and feelings.  I encourage you to think about this, if your son or daughter were sexually coerced by another peer at school or in their dorm at college, would you advocate for separation and support or would you say "business as usual" and move on?

In order to do good work we have to make efforts to put ourselves in another person's shoes and attempt to walk a mile.  It's easier said then done.  Do you know where they come from or what they have experienced?  Do you know how they view the world?  Do you know what they need in order to feel safe and secure?  And are you doing what is right to honor a person, and provide a sense of safety and security?  Or are you doing what is easy and not advocating for a person or treating them as just another behavior problem? 

Second Chances

www.shawnmcgillmsw.com

December 5, 2016.  I turn 40 years old.  To some this may seem quite insignificant but for me this is sort of like a rebirth, a second chance at life, and showing even some of the most well known experts that odds can be defeated.

Just three days from now will mark the 10 year anniversary of my mini stroke.  It was through this experience that a Congenital Heart Defect was detected.  I'm not sure how it was missed all those years but I have my suspicions that I will keep to myself.  Regardless, within two years I was undergoing open heart surgery at Cleveland Clinic and the past decade has been marked with countless appointments in two states, surgeries, recoveries, and medications I thought would either kill me or make me permanently glow.

Through it all I think I have persevered quite well.  I try hard not to complain, even when most days I don't feel like getting up or talking to anyone.  I'm tired when I wake up and I'm tired when I go to bed.  I have missed a lot of things and it drives me crazy.  This never seems to get better but there are always peaks and valleys.  While 40 seems like a small number to some, it's pretty significant to other people like me.

One of the first specialists I was sent to see was an "expert" here in Pittsburgh, the city known as the medical mecca.  I underwent all of the necessary medical testing to be told there was nothing he would or could do for me.  While he never said the words "liability", I had a funny suspicion he wouldn't help because I was just that.  Since I was born with a hole in my heart that had gone undetected for more than three decades there were numerous complications.  There was right-side enlargement of the heart, damage to my lungs, and an aneurysm in the aorta.  Being the person (and advocate) that I am, I persisted in asking what I was supposed to do and what the prognosis was.  He indicated that ordinarily people with such a condition do not survive and there was nothing he could do for me.  I walked out of the hospital that day and began researching other hospitals, including those within and outside of the United States. 

As you can imagine, mentally the clock of the Grim Reaper began ticking for me.  When I finally had heart surgery I wasn't at all afraid to die, in fact I was ready.  All these years later I have been and I am still ready to die.  Now, this doesn't mean that I want to, it just means there's a level of preparedness and acceptance for what is.  Cleveland Clinic saved my life but there is permanent damage and there is no cure for Congenital Heart Disease (CHD).  Fortunately, all these years later, I am connected with a wonderful clinic here in Pittsburgh that specializes in the care for adults with CHD (thank you Val).

What many also don't know is I've carried a level of survivor's guilt along the way.  In 1998 my nephew passed away from a Congenital Heart Defect.  This was a crushing blow to our family and something I hope people never have to experience.  There is no level of understanding or explanation for why a child passes away.  For me there has long been no level of understanding or explanation for why I would in turn live but I have come to terms with accepting that I can no longer question why things do or do not happen, especially when they are out of my control.  I think of my nephew (and sister) all the time and I hope that I can honor him through work and education for as long as I am on this earth.  More children die each year from Congenital Heart Defects than pediatric cancer and HIV/AIDS combined.

This past weekend I was graced with a surprise party to celebrate this monumental year.  I took a moment to share my story, to not only talk about the relevance but to also thank those who have walked the journey alongside me.  I recall talking about how some people fight to stay young with each passing year but some of us just fight to grow old.  I'm looking forward to wrinkles and grey hair.  I also talked about how it is vitally important, especially to those who work in the human service field, to always be aware of what they say.  Words can never be retrieved, even a "sorry" cannot help a person move from a position of fear.  Be very careful.

I will spend the day, my 40th birthday, doing what I always do...another day of work.  This is my meaning and purpose, and I believe my reason for being here.  There's still much more to be done and I am honored to be a part of it all.  I will balance the day with my family, clogging my arteries with my favorite food (pizza) and attempting to ice skate without breaking another hip.  Ironically, my cholesterol is great!  In the meantime, my gift to myself and to other warriors is to make a donation to the Adult Congenital Heart Association.  Persevere my friends, and always love and care for yourselves even if others cannot see or understand our invisible disease.