Books I Love: The Deepest Well Dr. Nadine Burke-Harris
Dr. Nadine Burke-Harris discovered something when she started a clinic in an underserved area of San Francisco. Her patients, despite doing all of the right things, medically speaking, didn’t always get better. She realized that they needed more than just inhalers and eczema cream…they needed help dealing with stress. And they were kids.
Dr. Burke-Harris earned her medical degree and then went on to receive a master’s of public health from Harvard before completing a pediatrics residency at Stanford. Her public health perspective told her that this stress her patients were experiencing was not simply at the surface, it went much deeper.
Her hunch was right…there was already good research published…but nobody was talking about it.
The research she came across was about Adverse Childhood Experiences, ACEs for short. ACEs are scored on a scale of 0-10. Having 4 or more ACEs could result in someone being far more likely to experience chronic health issues like diabetes, stroke, and cancer. Moreover, when she looked for ACEs in her patient population, she found them, along with persistent health issues.
Dr. Burke-Harris uses brilliant storytelling to emphasize the depth and breath of the issue of ACEs. She demonstrates how ACEs can change the brain and lead to a dysregulated nervous system. The nervous system becomes toxically stressed, which in turn, leads to disease.
Through her own personal stories as well as those of her patients, the author makes the case that mitigating the impact of ACEs could positively impact national health writ large. If ACEs could be measured for every patient, and, if we could provide the appropriate support and treatment, then this toxic stress wouldn’t have a chance to create chronic health conditions.
I particularly enjoyed this book as a healthcare provider who also worked in public health. During my time working in a federally qualified health center, I saw the same things in my patients that Dr. Burke-Harris did. Similarly, I wondered what tools we even had to begin to help these patients.
And, even though Dr. Burke and I both worked in underserved and poverty-stricken areas, ACEs do not discriminate by zip code. In fact, the original research on ACEs was done in a population of college-educated people with good insurance.
As I delve deeper into my post-retirement life, and have had the time to ponder many things, I realize that much of my own stress, as well as my patient’s, and friend’s, and family member’s stress could be heightened by things that happened when they were very young.
Going beyond the scope of this book and into the arena of something called epigenetics, we are now finding that stress which impacted our ancestors may continue to impact our own genes. My behaviors today are not only shaped by circumstances from my childhood but perhaps by my great-grandfather’s childhood too.
The wonderful news is, that Dr. Burke-Harris found ways to help her patients cope with the toxic stress. Talk therapy for both children and their parents as well as mindfulness practices, could lessen the mental and physical burden of ACEs.
This book is an important one. It is a stark reminder that most humans are walking around, whether aware of it or not, with some level of toxic stress. People make choices out of their stress which can and do lead to health, economic, and relationship issues. This is universal, not limited to any specific strata of socio-economic standing, and its something that we need to acknowledge as a major piece of health and well-being.
I think that ACEs impact not only our health, but our overall decision making. Not to call out the hardcore FI/RE people, but we do often talk about avoiding a “scarcity mindset”.
But…
Scarcity mindset has to come out of somewhere, some experience, that compels a person to want to avoid the pain of scarcity. Stresses of childhood can lead to scarcity mindset in adulthood as well as all of the behaviors that result. After reading about ACEs in The Deepest Well, it is abundantly clear that scarcity mindset isn’t something a person can simply turn off. But it is something that can lessen over time with proper attention.
This is one of those books that I found myself nodding along to the entire time. The information the author presents is as important as ever. I personally believe that conversations about toxic stress and ACEs should be fundamental to healthcare, social policy, and beyond. When the impact of ACEs are lessened, and humans can make stride towards more full and brilliant lives, we all win.
