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The President’s Paragraph

Casualties of War

by Angela Self, MD

This piece was originally published in the November/December 2021 issue of the Tarrant County Physician. You can read find the full magazine here.

The church bus let me off in front of the house. It must have been after a Wednesday evening service because it was dark. I started to walk toward the house when I heard “Angela, Angela.” It was my mom quietly calling to me from her car across the street, my little sister and brother in tow. I did not know at that moment that my dad was inside the house wreaking who knows what kind of havoc. My parents had been separated for a couple of years after my mom had all she could take of his drunken rages and unthinkable actions. One time we returned home to this very house in Oak Cliff, Texas, to find all of our windows broken out and a note on the kitchen wall (held there by a large butcher knife). 

Let me back up for a minute. My dad was a brilliant man who had a heart of compassion and was an excellent teacher and patriot – when he was sober. The problem was that we rarely saw him sober in my early years. The thing about kids and their parents is, no matter how messed up a parent is, the trauma of losing them is greater than the pain endured by any disease or affliction they bring with their presence. For several years I would ask my mom if “Daddy” knew where we were and if he had called. I was sure that he just couldn’t find us. This feeling only got worse when we moved out of state. My mom met another man, and I knew he was there to stay when she told me that she was pregnant. That was one of the saddest days I can remember. I did not even know what abortion was at the time, but my mom could not afford to travel to California to get one (the year was 1973). I would not see or hear from my biological dad again until I was 19 years old. 

One thing I knew was that I could not let my new little brother grow up without a dad. The pain of that loss was all I could bear as a child and I could not let another child, my brother, suffer in that way. So I kept quiet in the midst of abuse for years. I knew that I had to because mom would leave, and she would not be able to support us without him. I also knew my little brother would be as devastated as I was when I lost my dad. Yes, my stepdad was also an alcoholic. Both of these men have passed, my dad at 53 years of age and my stepfather at 69. I was at my stepfather’s bedside after the stroke that was likely a result of years of alcohol and tobacco use. He and my mother had divorced years earlier, thank God. I had forgiven everything and kept in touch, hoping he would find the same self-forgiveness and peace that I had found at 19 — you see, he also grew up as a child of abuse. 

My mom was a little checked out (okay, a lot checked out) during the “Vegas years.” Though my stepdad was able to do a lot of construction work to support us, my mom struggled with a different addiction. My mom, who has likely never really been drunk or high, was a gambling addict. What does an abusive stepdad do when he wants the freedom to abuse his step kids? He tells his gambling addict wife to go to the casino and even gives her money for the little adventure. As soon as I was old enough to physically get out of the house, I would run away, stay out all night, miss school. My mom would ask me for years to come why I just spun off the rails at about 15 years old. She was concerned about my behavior and sent me to stay with my aunt in New York one summer and then for a semester in 9th grade. I met a boy there; he was cute. Right after I graduated from high school, I continued staying out all night. Mom told me that if I stayed out all night one more time, I could pack my bags and take them with me. I took Mom up on that offer, probably that day. I bought a bus ticket to New York (at 17) and informed the cute boy that I was coming to stay with him. 

I worked as a dental assistant to help us pay the bills; there weren’t many as we mainly lived with his parents. Sadly, he also struggled with some issues that hit a button with me and led me out of the relationship ten years after I met him. I am grateful for all that I learned from his family; I did not really know what family was supposed to look like until I spent time with his. They were wonderful people who taught me things I had not learned at “home.” Do not misunderstand, my mom loved all of her kids very much, but she was dealing with her own childhood and adult struggles which took the focus off of anything other than keeping us physically safe (which would only happen while we were in her sight). Now I was an adult, out on my own, volunteering with my ambulance corps, working as a surgical dental assistant, going to college – just in a very unhealthy relationship. But what was a healthy relationship? It would be years before I knew, if I actually do know. We will leave my relationship struggles between me and my very capable counselor. Let’s get back to the casualties of war. 

The pain of that loss was all I could bear as a child and I could not let another child, my brother, suffer in that way. So I kept quiet in the midst of abuse for years.

My mom and stepdad moved back to Texas. It’s funny how unsustainable it is when you tell your husband that you’re making the mortgage payment and you’re really putting it in the slot machines. It doesn’t work well with car payments either. They had an opportunity to buy a small home on a pretty lake near Caldwell, Texas. It was the town where we had gone to visit my grandparents when I was a kid. Things were seemingly okay with my mom, stepdad, and youngest sibling, my half-brother. Then things got rocky between my mom and stepdad, and my little brother dealt with the breakup by running with a crowd that was likely not the best. By the time he approached his teen years he had dropped out of high school and had started having kids. I remember his first daughter being born when I was in med school. He and his girlfriend began having problems and drugs entered the picture. At some point one of those drugs was meth. My mom has spent so many years trying to make up for the years lost with her oldest three kids by being a doting mom to her youngest and to his kids. At present my brother still struggles with meth. His oldest daughter, who ran track and got many awards before graduating from Caldwell High School, is now an addict who might not be alive as I write this. I really do not know. I am not allowed to mention my youngest brother to my other family members (except Mom) as we have all lived too many years waiting for that phone call from the police, hospital, or morgue. 

You can take so much and then you just check out due to helplessness in the situation. We have all been casualties of addiction of various sorts, yet we fight on. My sister is a very good nurse and has been the best mom to her college student daughter. My sister does not drink or dabble with any of the substances that wrecked our family. My brother (the clean one) has a sheep farm, is a carpenter, a loving husband and father, and has also kept his house clean from any of the things that wrecked our lives. I am here writing this article, hoping my mom will not be too hurt as she is doing the best she can to try to save the life of her granddaughter this week. Literally, doing whatever she can to get her arrested so that she will not die in a drug house (weighing about 100 pounds, covered in sores, mind almost gone, and threatening to “fix herself” in her own way). Oh, don’t worry about the resources available – my niece has already been visited by the police and MHMR this week. There is nothing they can do. 

The thing about meth is that it does not take its victims all at once; it slowly makes them and everyone in their lives casualties every single day. I wish I could give a hotline or support group info, but the only thing that I can do is pray. And I do, we do, pray. We have all come to terms with what addiction has done to our lives. We have made peace with the actions of others and regret how our own actions have hurt those around us, but we continue on in the midst of a bad dream and find joy in any area that life offers. As you go out today, remember that there is not a specific background that defines a physician, or an individual. Often, we assume that doctors only come from privileged environments, but many of us have a different story. Yet, I am the sum total of what a physician is, and so are you. We are changed, we are impacted, but we are not defined by our pasts. You never know who around you is a fellow casualty of war, doing their very best to enjoy one day at a time. God bless you all – it has been my honor to serve as your president. 

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