Losing My Crown: Estrangement and Medical Neglect

How toxic families gatekeep medical care

The noise was like the crack! that a giant tree makes before it falls; only it came from inside my head.

I spit the contents of my mouth into my palm: several flakes of granola, one very hard, sugar-shellacked almond, and, split in half, the crown.

It’s a good thing that I not only have health insurance (United Healthcare, have you heard of them?), I have dental insurance, via Husband’s job. Thanks to the domestic partner policy in place at his company, I got onto his health insurance plan before we married.

Prior to that, I had been on my own since I graduated college, getting health care from a mix of community clinics, employee health plans, and crappy small business insurance. Because my parents didn’t get health insurance until I left the house, I wasn’t on theirs.

My father “didn’t believe in” health insurance, because he figured that he was so healthy that it was cheaper to pay out of pocket per incident than pay an insurance company.

The modus operandi, unspoken yet communicated, was for us to avoid having medical needs, and barring that, only going to the doctor if we had to. My childhood medical record virtually halts after I got the mandated childhood vaccinations at about eight or nine.

The supporting familial mythology was that we were healthy and robust, we ate well and had superior immune systems. In fact, when I had colds that caused me to get a sore throat or drippy nose, he looked at me with pity, and would muse, “I guess I just have a stronger immune system.”

Cut to 2020, and my sister Peggy Sue was busy sharing memes backing the idea that the Covid Vaccine was for wimps, and that if they didn’t have “a good immune system,” they should stay at home, so the rest of the ubermensches could unmask in peace.

And yeah, I think that the myth of a “superior immune system” is some Naziesque Eugenic ableist bullshit, if you could not tell. It is the bedtime story that misinformed or willfully ignorant parents tell themselves while their children die in the next room.

The migraines started when I was twelve.

The teachers thought I was lying to get out of PE.

My father looked at me like I was soft, because a headache wasn’t an excuse in his day. He rolled his eyes at my needing to do something as drastic as take a pill or lie down. Every single time one of my headache episodes ended in vomiting, he acted surprised.
Mink, he would exclaim (short for minchia, a Sicilian curse word that he favored, roughly translated into English as cunt or twat. Yeah, so basically he watched me twist and gag out yellow bile and would exclaim the equivalent of Cunts! that girl sure is spewing drama out of her puke-hole.

My mother introduced me to Vanquish, an over-the-counter horse pill on which she relied, even though migraine prescription meds were by that time available.

Sometimes during the episodes I couldn’t keep my eyes open, because the light burned them.

Oftentimes I couldn’t stop throwing up, a race against time and space to get enough hydration into me that wasn’t so much or so little that it would make the vomiting and stomach pain worse, but not so much or so little as to override the hydrating function of water as tiny rejuvenating droplets escaped the upchucking and made their way into my system.

If I had not managed to get a Vanquish in, or later, a finely tuned alchemical mix of coffee, aspirin and ibuprofen, before the nausea started, I was basically fucked and in for about 4-9 hours of vomiting, dry heaving, and feeling like elves were in my skull jabbing their pointy shoes into my ocular nerves.

My parents under reacted to the situation, which made me think it was normal to not go to the doctor, even as the headaches worsened after menarche and then again once I started experimenting with alcohol.

My father, remember, didn’t believe in health insurance.

He also didn’t really believe in medical advice, as was evidenced years into the future by his many, many frustrating interactions with his medical team. The source of frustration was him. He picked and chose what advice to blow off and which to follow.

Instead of doctors, my father trusted a mishmash of sources ranging from his ancestral knowledge as a superstiously-raised Catholic child of Italian immigrants to big, bright grifters like Edgar Cayce, Werner Erhart, pseudoscientific gadget things like “positive ion machines” and later, Fox News (funded by all of those dodgy “medical” ads. He himself was nonchalant about his own pain, injuries, lifestyle problems, and diseases.

I don’t know why. If I had been born in 1929, I would have been over the moon at my birth correlating with the advent of antibiotics. Poppa lived through that, the invention all of the really good vaccines, and huge advantages in medicine that prolonged his life. He got to make the switch from outhouses to flush toilets. But it all seemed like nothing to him, just another thing to take unseriously, just another thing to shrug off.

The medical neglect in my particular toxic family began with medical neglect of himself, borne partly of the times he lived in and partly because of the poverty of his youth.

There was the one time he peed blood for six months before getting looked at. My memorable eighteenth birthday, when he passed out on the toilet from a bleeding ulcer. And the heart attacks, the strokes, the diabetes, the neuropathy, and the spinal things.

Additionally, my mother soldiered through forty eight years of her wild and precious life with undiagnosed bipolar disorder. Because she was bright, she masked it to outsiders; and achieved a rhythm in parenting, working and housekeeping that involved a lot of stopping followed by starting; obsessiveness followed by abandonment and laxity.

Also, she was a woman, and the medical neglect she received was often coming from doctors, as a haunting letter to her doctor proved to me.

My mom was ill and not able to care for herself or me properly on her own, but she got by in her bursts of lucid functionality, as well as with the help of extended family and her older children. She loved me and wanted me to be cared for, but she cut corners all the time.

Like not getting me the braces that would have prevented the messed-up bite, the grinding, and the need for veneers, that sometimes crack on almond granola. She basically made it sound like it was cosmetic and elective and insinuated it would be a lot of money. I decided that I didn’t need it and that the best thing to do would be to make her happy and not get braces. I could tell that this was the right answer, though she said it was my choice.

My pop was arrogant, dismissive, and sadistic. He did not want his children to have things too much better than he had. He gaslighted his wives, girlfriends, and children into not needing too much from him, so he could be in control over what care he decided to provide, and make him feel like you owed him for it.

Plus, being sadistic, he got off on seeing us, especially the women, in pain. It suited both how he wanted to see us and himself.

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Self-absorbed, narcissistic types don’t properly attend to their children’s healthcare because it takes time, money, and hours of thinking about someone else’s needs. Add to this the untenable and rage-inducing state of American healthcare, a child of such a parent has to navigate the uncaring system like we all do, except without the benefit of a caring advocate.

The dystopian, death-inducing medical system in the United States—epitomized by health insurance corporations that tie access to care to your ability to work— mirrors the toxic family.

You don’t get to be sick until I say you are sick.

If you aren’t valuable to me, you don’t get care.

You are a snowflake, and possibly genetically inferior to get sick in the first place: if you don’t have a strong enough “immune system” to fight off whatever you have, then you deserve your symptoms.

That is, unless you are making them up, which you probably are, because, let’s face it: you are crazy, and probably on drugs.

In fact, that’s what you’re trying to get, aren’t you?

But also: mental health is for sissies, therapy is fake, fuck your feelings, and let’s just be honest about your drug problem, which you can quit without the benefit of the full run of those fancy rehabilitation programs.

I could go on: I haven’t even skimmed the surface of the broken bones, concussions, and wiping-after-touching-hot-peppers injuries that my siblings brag about, not to mention the sexual assaults and verbal abuse endured. Abuses that I think none of them have processed adequately, though some of them have had therapists at some time. When those siblings don’t have a therapist, they say that therapists are bogus, to get a rise out of me. But when they do have a therapist, they change their tune a bit, and adjust their narrative to say that therapy actually is a great thing, I’m just a bad therapist, and furthermore, I need extensive psychiatric treatment.

Allow me to return to the present; and remind childhood trauma survivors that your trauma symptoms might present themselves as a reluctance to get medical checkups or care (like my dead father, who acted this way until it made him dead. )

As I said earlier, the reason I needed crowns in the first place is in part due to my mom opting out of orthodontia for me, forever messing up my bite, causing me to grind my teeth down, and exacerbating the—you guessed it—migraines.

The reason I texted the dentist’s emergency line, and didn’t wait around in apathy and embarrassment for several days was that I have made conscious choices to not be like my parents.

Even more importantly, I take my child to the doctor at the first sign of symptoms—the times I didn’t act quickly enough were always regrettable and times I should have listened to my gut and gone sooner. I am an adult and have the adult knowledge, resources, and ability to self-advocate.

Children do not have that choice. We are their voices. We are in charge of their health. To neglect a child who is in your care’s medical needs, out of ignorance, sadism, misinformation through cult religions, or eugenic bullshit, is criminal. It is abuse. It is wrong. We must be accountable to them.

The reason I and my daughter received care was because I am the spouse of a person who works at a corporation that is considered important and has contracted with another corporation that is considered important (UHC—have you heard of them? They sure have been in the news a lot) and employees of those two corporations together decided how much access to care the employees of Husband’s corporation—and their families—deserve.

(Apparently, more than Luigi, at this time.)

Our current debate about healthcare, health insurance, and who gets access gets to the core of what is most toxic about American culture and by extension, our families. People are valued for what they do, not who they are. People are not inherently valued unless they can do something for those in control. And even when they do manage to add value to those in control, those same powers-that-be will still deny care, because to deny is to maintain control, insure rank, and reinforce the hierarchy.

Nowhere did this show up more in how my extended (highly religious) family reacted to my becoming a therapist. which is to say, they either pretended that therapy wasn’t real, or that it was real, but that I wasn’t a real therapist. These people would tell me that God is the only psychologist in one breath, but then tell me to “get help” in another. Other therapists could be real. In fact, when my cousin Valerie became one, those same fuckers who ignored my accomplishment absolutely gushed over hers.

Scapegoating is a tricky business. The selected scapegoat must at once be a worthy adversary and a pathetic cautionary tale. Scapegoaters do mental gymnastics to be able to keep the scapegoat in that spot. Raised by scapegoaters, the scapegoat, plagued by dissociation, avoidance and guilt, tends to neglect, gaslight, and second guess herself long after cutting off the people who originated the thoughts.

And in this world, that is dangerous.

None of us are perfect, have perfectly functioning bodies, or can avoid disability and illness. I am no longer the princess of martyrdom and delicate, non-complainy, feminine suffering: my crown is broken. I am a granola-eating human who is lucky to have insurance, and thinks that health care should be a birthright, and not due to luck.

You are worth care. Get the checkup! Fill the prescription. Get current on vaccines. Don’t let religion, the alt-right, or problematic individuals tell you what to do—even if they are only in your head at this point. If you can, donate to free clinics, neighborhood community mental health, and give mutual aid when possible. Have a happy, healthy 2025.