Early Winter Reading

This was the view from our front door as I left for work this morning. Just like that, winter weather has arrived with our first lake-effect snowfall. If the ground were not so warm, several more centimetres of snow would have accumulated. Instead of riding my bike to the hospital, I got exercise by using the stairs all day. (not very inspiring!) With darkness falling late in the afternoon, evenings are long and perfect for some extra reading. Here are two mini-reviews of books I have recently enjoyed.

John Grisham is one of my favourite authors. I have read all his books except his most recent one, The Judge's List, which I have on hold at the library. I have re-read several of his legal thrillers including The Testament and The Street Lawyer. 

Sooley is a very different story from Grisham's usual courtroom dramas. It tells the story of a teenager from South Sudan, who shows a talent for basketball and is invited to a tournament in the United States. Samuel Sooleymon comes from a village with few modern amenities, but he has a close and loving family. Shortly after he arrives in America, his village is attacked by rebel fighters. His family members who survive the brutal attack make their way on a dangerous journey to a refugee camp in Uganda. Sooley is devasted, but cannot go home. He works hard at his basketball skills and makes a college team, where he becomes a star player. His goal is to get enough money to bring his family to America. The ending was unexpected, and not the way I wanted the story to conclude.

Grisham writes a thought-provoking parable of sorts about growing up in a poor, war-torn country compared to being a teenager in an affluent society. There are risks to the physical and emotional well-being of people in both settings. The story goes back and forth between South Sudan and America and the struggles that Sooley and his family experience in both places. I could not put the book down and read it in one long sitting. 

The book, Damaged, took longer to get through because I did a lot of highlighting and reviewing of chapters. The authors, Dr, Robert Maunder and Dr. Jonathan Hunter describe how people who have had significant childhood adverse experiences are at higher risk of developing chronic illness. The story of a patient named Isaac is told as the authors develop their thesis. Adverse childhood experiences, called ACEs, include physical, emotional and sexual abuse, physical and emotional neglect, and household dysfunction. The latter category includes mental illness, incarceration, substance abuse, domestic violence, and divorce. A score of 4 or more ACEs increases the risk of serious physical, social and emotional problems significantly. It is important to recognize that these are risk factors that are not necessarily predictive of a child's future health. It does not measure resilience, or the presence of another supportive adult, such as a teacher, grandparent or caregiver who provides positive childhood experiences.

The authors encourage primary care physicians, health care workers, and even teachers to assess a person's ACE score using the simple ten-question survey. It is difficult to change learned patterns of behaviour that develop as a way to cope with abuse and neglect. Early recognition and compassionate interventions are important. I cannot do psychoanalysis, but I have started assessing my more challenging patients differently, giving them time to share their stories, rather than controlling the narrative myself. At least 20 percent of children experience abuse in their homes in Canada. Every fifth person on my street, among my coworkers and patients, in a church or school, has experienced or is experiencing an adverse event at home. We need to be aware that there are people in our circle of influence who may need a listening ear, and support in getting the help they need to overcome the effects of trauma.