By: Kayla Gonzalez, MD
Childhood trauma has been an enduring personal and professional interest of mine. My parents are immigrants from Cuba and did not have support upon arrival to the United States. My father only completed an 8th grade education and suffered from an intense drug addiction. My mother was disabled and struggled with complex medical needs. We often endured food insecurity, poverty and housing insecurity. We frequented food shelters for our meals, and at one point, almost lost our home. During this time, my childhood was also fraught with emotional and physical abuse. These childhood experiences shaped my unique identity and have a continued impact on how I work with my patients.
I began to recognize the impact of these childhood experiences early on in my medical training and career. Upon arriving at Cornell University for my undergraduate studies, I learned for the first time that not everyone faced the same hardships that I faced as a child. I felt equal parts ashamed and angry that I had been exposed to such profound childhood trauma.
Often, I would hide my home life from my classmates. While others were studying and relaxing, fully enjoying the college experience, I needed to work more than 30 hours a week as a peer advisor at my undergraduate resource center to provide income to pay for my family home. While this instilled into me a profound work ethic, I often struggled with a sense of “otherness.” My classmates did not have to worry about paying for their childhood homes or putting food on their families’ tables while balancing the daily responsibilities that come with a rigorous university education. Daily, I felt angry and jealous. I had a difficult time processing these emotions, and finding the meaning in why I had experienced what I did.
Finding those with similar backgrounds to my own was a challenge, and often led me to feel socially isolated and alone. However, when I embarked on a medical mission trip to Guanacaste, Honduras, I found a greater sense of purpose and direction.
One summer during my undergraduate studies, I went on an adventurous, weeklong trip to rural Honduras, along with a physician, a dentist, other undergraduate students, and thousands of dollars in medications and supplies. While there, we provided medical care to 400 families. Many families walked for hours to our rural pop-up clinic because they had no other way to access medical care. My most profound memory that still sticks with me throughout my medical career was meeting a family of four children under the age of 6, who lived next to the clinic. Their house had two connected rooms, two beds, and dirt floors. One of the sons, a 6 year old boy, had been struggling with unrelenting asthma, likely in part because of the home environment. In addition to dirt floors, the family’s oven would blow smoke into the room where he slept. He had no access to treatment for his asthma. His family struggled to have enough food to feed their family and could not access needed medical supplies.
Remarkably, this family was considered wealthy by their neighbors because they had an oven. I could not help but speculate on the health outcomes for this little boy. His experiences felt similar to my own, and his smile touched my soul. In the face of such poverty, he remained happy. His family was immensely grateful for the medications we provided them. This eye opening experience that touched on my own personal trauma provided me with a sense of direction and empowered me toward advocacy. The empathetic lens of my childhood provided me with a sense of duty to help these families.
My work in this area continued when I attended Rutgers New Jersey Medical School. There, I saw many of the patients I cared for had similar childhood experiences to my own. Many struggled with poverty, food insecurity, low educational attainment, and substance use. I saw many families affected by the turmoil of trauma and adversity. Because of my own adverse childhood experiences (ACEs), I was able to recognize that my patients had unmet needs related to their trauma. Many of my patients had medical and psychological problems directly related to the trauma and psychosocial burden of their ACEs. I made it a personal goal to work on meeting this need. I was able to help provide resources to the community in the form of community educational sessions on the impact of childhood trauma, the creation of a community garden to help combat food insecurity, and the addition of a mentoring program for underserved youth. I found my most rewarding experiences working with those struggling with drug addiction and homelessness, as these are issues I connect with personally.
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Now as a pediatric resident, I often counsel my patients and parents on how trauma during childhood can impact their daily lives. Often, I am met with confusion, as most parents do not realize this connection. Many do not realize the impact childhood trauma can have on their emotional and physical health as adults. This led to my interest in incorporating trauma informed care into pediatric practices, with particular emphasis on training resident physicians and faculty on how to screen, identify, and mitigate ACEs and incorporate trauma informed care into their everyday practice.
I experienced childhood trauma in many ways; this trauma shaped who I am as a doctor today. I strive to provide quality trauma informed care to every patient and family I meet. My experiences have turned me into a more mindful and perceptive doctor who is able to provide better care to my patients. For example, I am currently working with the Child Health and Development Institute of Connecticut and the Early Childhood Trauma Collaborative to develop programs that help increase resilience amongst our traumatized youth. I am investigating the impact trauma and toxic stress have on rates of psychogenic non-epileptiform seizures. I am also currently a 2021 Vot-ER Civic Health Fellow developing a project to increase voter registration amongst groups with decreased voter access and literacy. This project will have a direct impact on the community funding and resources that are essential to help heal our traumatized children.
While my career in advocacy is relatively new, I know that I have a unique experience and perspective that will help me to successfully impact the children I serve. My lived experience has made me a more compassionate and understanding physician. It has led me to balance a multitude of advocacy projects while in the midst of residency. I know I will continue to use my unique perspective to relate to and help heal children who have undergone trauma similar to myself. While my childhood trauma was profound and lasting, I find meaning and help processing through my advocacy work every day. The next steps for my career beyond residency will almost certainly include working for a larger, national organization like the American Academy of Pediatrics, where I will continue to use my unique perspective to relate to and help heal children who have undergone trauma similar to my own.
Kayla Gonzalez, MD, is a resident physician at Connecticut Children’s and the UConn School of Medicine.
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Categories: Health Promotion