Damaged

November 15, 2021
Childhood trauma is “one of the biggest public health issues of our time, and yet health care systems are ill-equipped to even acknowledge” it, argue psychiatrists Maunder and Hunter in this vivid appeal (after Love, Fear, and Health). At the center of their story is Isaac, a patient whose life exemplifies the connection between childhood adversity and chronic disease. As a child, Isaac was abused and neglected by his parents and sexually abused by a neighbor; since his youth, he has suffered from chronic disease. Readers get an up-close look at Isaac’s therapy sessions, starting with his first at age 45, ostensibly for help coping with the stress of his Crohn’s disease. The authors trace the highs and lows of his healing as he recounts his abuse, and along the way they call for a “care revolution” that supports “strong children instead of trying to fix broken adults,” and advocate for the CARE method of dealing with trauma (which stands for consent, asking, reflection, and engagement) and for medical students receiving better education about trauma. It’s not for the faint of heart—many events from Isaac’s past can be hard to read. But those who persist will find much to consider.