Journalist Donna Jackson Nakazawa often found herself lying on the stair landing of her house, resting to regain enough strength to climb upstairs. For years, Nakazawa had been plagued by illnesses: Guillain-Barré syndrome that left her temporarily paralyzed (twice), thyroiditis, nerve damage, severe eczema, dangerously low red and white blood cell counts, and more. Then Nagazawa got lucky. She was referred to Anastasia Rowland-Seymour, a Johns Hopkins internist and assistant professor of internal medicine at the School of Medicine. Rowland-Seymour asked a question no doctor had asked Nakazawa: Had she suffered unusual emotional or physical trauma as a child?
Such trauma, termed adverse childhood experiences, or ACE, includes emotional or physical neglect or abuse; contact sexual abuse; living with someone who was mentally ill, incarcerated, or abused alcohol and/or drugs; living with a mother who was treated violently; and losing a biological parent. Studies published in journals like Circulation and Archives of Internal Medicine correlate ACE with higher adult incidences of heart disease, fibromyalgia, lupus and other autoimmune diseases, alcoholism, cancer, and suicide. How childhood trauma impacts adults' health on a cellular level is still unknown; for now, what researchers have is the correlation and the realization of how children's immature immune systems can be vulnerable to damage that will affect them as adults.
Once she has established the particulars of an ACE patient's illness, Rowland-Seymour treats the physical symptoms through standard medical protocols, but she also recommends therapies such as meditation, yoga, and acupuncture. These therapies ease the ongoing stress that triggers excess cortisol and other inflammatory hormones that keep the immune system malfunctioning. Rowland-Seymour relies on lab tests and patients' own accounts to determine which therapies seem to be working best.
Her biggest challenge, she says, is "taking the time required to set up the relationship so it's comfortable for patients to delve into their experiences and see they have some ability to change. A patient feels safe, feels heard, so [then] he can look closely at those experiences."
Nakazawa's answer to Rowland-Seymour's profound question was yes: Her father had unexpectedly died after surgery when she was 12. The loss devastated her mother and fractured her family. As detailed in her book, The Last Best Cure: My Quest to Awaken the Healing Parts of My Brain and Get Back My Body, My Joy, and My Life (Hudson Street Press, 2013), under Rowland-Seymour's care Nakazawa embarked on a yearlong effort to regain the health that tragedy had taken from her. Improvement was gradual, but after a year, tests showed her stress biomarkers significantly lowered and her red and white blood cell counts in the normal range for the first time in a decade. And she had regained vitality—she no longer needed the stair landing for rest.