I

Fight and flight are the typical human reactions to threat, but they’re not the only possibilities. Children in general can’t fight or flee well. Instead, they may learn to freeze. 

Freezing dulls the senses, numbs the body and closes off the mind. The clinical term for the freeze response is dissociation. Dissociative disorders tend to develop when a child is exposed to trauma repeatedly while their brain is developing.

Only in the top 200 meters of the ocean—less than three percent of the ocean as a whole—can photosynthesis occur. Those top 200, like sunlit frosting on a five-layer cake, is the region home to creatures like algae, which are sustained by the sun. Here in the pulse of the waves and the shadow of terns on the surface of the water, the green things drink in the warm light while the blue and gold and pink and orange and silver-flashing things drink in the green and it turns to light again on the patterns of their scales, light on their backs and dark on their bellies to render them invisible.

Hulking blue whales. Circling orcas. Tuna, jellyfish, sea turtles, sharks. Zooplanktons and bivalves and stingray and corals and clams, all breathing or eating, in some way or another, the penetrating rays of the sun. 

The food chain here is constantly in flux, each species hustling to stay alive, but for some of the smallest it is rigid: they drink in the sun, they grow a little, and then they die. At least, most of them do. One or two will live a little longer, look up one day and wonder where all the others went.

Right at the surface there’s a thin layer of space that doesn’t know if it’s sun or water. It has a kind of stillness the waves can’t scatter.

This is the epipelagic zone.

_

The halls are adorned with paper fish and the corners are stamped with street names like “Octopus Ave.” This is the department of Pediatric Neurology and Neurosurgery at Dartmouth Hitchcock Medical Center in Hanover, New Hampshire. 

I am nine years old and this is my first visit.

In the lobby, there’s a sandstorm machine. The sight of toddlers playing with it makes me hesitant to give it a go; once I do, though, I can’t look away. I’m not little anymore, I think, I shouldn’t be so astounded. But I am.

There’s a balcony across the hall that stretches out toward a whole wall of glass and April sunlight is spilling in over us the way it would over a goldfish in a tank. There are children everywhere: children in wheelchairs and neck braces. Children whose stubby legs wobble maybe more than they should. Children who open their mouths to speak and what comes out isn’t a language anyone else seems to know. Children hooked up to beeping machines twice their height. And there are parents in every state, too; some lurking by the railing, unsure how to check in, while others are chatting with the receptionists, who know their first names and their last names and their dogs’ names and everything else because this is more or less where they live. There are nurses drifting in and out of the waiting area, calling names and waving clipboards and handing out paperwork and collecting it again.

And in the middle of it all, right in the full sun, is the sandstorm machine.

The bottom and sides are black and solid, like a standard coffee table, but the top surface is glass and under it gold lights alternate with tiny fans. The whole bottom of the machine is covered in sparkling sand, which drifts in swirling clouds when the wind starts. There’s a steering wheel shrunk proportional to me. When I turn it, the wind shifts, chasing the sand first one way, then another.

I imagine myself into the machine, close my eyes and let the colors dance on the backs of my eyelids, drawing me into the storm.

It’s warm in here, not like the cold tile floor below me. And it’s quiet—no beeping, no shrieking, no speaking. It’s just me and the expanse of sand, my arms outstretched as if to reach from light to light. Just me and all the dust falling.

II

About one in four medically ill children eventually develop symptoms of posttraumatic stress—symptoms like avoidance, detachment, and dissociation. In children who spend time in an intensive care unit, that rate rises to one in three.

Meters 201 through 1,000. This is the home of bioluminescence, for creatures who can’t reach the sun, so they make their own and, unable to be contained, their light spills through their thin skin and reaches out, twisting this way and that through the salty water. The pressure is higher here—300 pounds per square inch—and the temperature lower. There is almost nothing to eat. In the evening squid, jellyfish, snipe eels and shrimp must migrate en masse upward toward the distant light to feed. This is a fantastical realm, rarely interrupted by humans: dragonfishes, sabretooth, cuttlefish, and wolf eels go about their lives aware only of the coming of dusk: morning and afternoon, noon and night are endless befores and afters.

_

In this lobby there are actual fish tanks, so big I would fit inside them. Six of me, probably. They have LEDs somewhere in the glass, so they glow like Broadway stages. My parents have become friends with an Amish couple down the hall whose son has leukemia. I wonder if he’s even seen a fish tank before. I’ve never seen one so impressive.

We follow green arrows to an all-glass elevator that carries us up to the waiting area. Here there are vertical, conical fish tanks that bubble around the clock. 

This is the orthopedic suite at Boston Children’s Hospital, and this is not my first visit.

Later, after the surgery, my parents take me to the garden in a wheelchair. Every swerve and stop requires careful navigation of an IV pole and there’s a nasty hospital smell I can’t get out of my nose. It gets unbearably strong when we enter the elevator. It’s a September evening, the hospital quieting toward that buzz of voices and alarms that passes for silence here, and I am sick of all of it: of the wheelchair, of the IV pole, of the smell, of the elevator, of September.

There’s a glass wall that looks out on the garden, and it’s hazy out there. Dusk. Dad holds the door and Mom rolls me out onto the path. She says something about bug spray, but I’m not listening. I am disappearing, out of myself and into the dark air. I can’t feel the IV in my arm or the stitches wrapping around my body. I can’t feel the place where the lung tube slid out of me last night or the soreness in my throat from the breathing tube. I can’t feel anything at all, only stare up at the building rising on all sides of us, leaning down over us, straining against the weight.

Back home, 200 miles north, it’s too late in the year for fireflies, but here they dance between the hydrangeas, circle each other over the fading chrysanthemums, and pitch and roll in the arms of the impossible redwood tree, whose roots seem to smother themselves in themselves, brown roots on brown roots on brown roots on brown roots.

It’s fully dark when we turn back toward the door, and I am beyond exhausted. The smell hits me the moment we pass over the threshold and suddenly I feel everything again.

III

Though dissociation may start out as a reflex response to a single abnormal scenario, over time, if the abnormal becomes normal, freezing can become a long-term, involuntary coping mechanism that takes over whenever the memory of past threats are triggered.

Meters 1,001 through 4,000. There are no plants in this region because there isn’t any light at all. Most creatures here don’t have eyes—why would they? The fish that live here have developed slow metabolisms, allowing them to subsist for long periods on almost nothing. But oddly, it’s here that the largest whales feed, sperm whales diving  to hunt for squid, wrangling in the pitch dark with the giants. Their tissue-thick heads protect their brains from the immense pressure of this region—almost 6,000 pounds per square inch. The creatures that live in the deepest extents are adapters, evolutionary accidents too large or too small for the upper levels but oddly suited to the deep. These are scavengers and searchers, such as the heterotrophs that feed on marine snow—the dust and sediment and pieces of dead things that sink through the other layers.

Those whales have seen the morning sun on the surface of the water. They’ve seen the evening rising with the shrimp from the deep. But still, they dive. Some of them rise up to the sun again in the morning. Some of them drift there, belly up. And some of them turn to marine snow—the dust-like sprinkling of what only just was that settles over time from the surface to the bottom of the ocean. Some snow takes weeks to reach the ocean floor.

This is the bathypelagic zone.

_

I have to go to the regular orthopedist now. There aren’t any fish on the walls and the halls don’t have fun names. They don’t have names at all. It’s July and the air-conditioned waiting room is the kind of sanitary cold that makes every inch of my skin feel exposed.

Over the years, I’ve spent dozens of hours like this drifting somewhere calm and apart. That place has shifted over the years, traveled around the globe of my mind, and settled for a time here or there, but the most recent resting place is a bridge I built with my dad and my brother over the creek in our backyard one Saturday in early spring when the sun was shining but snow still swirled in the air.

I build the scene in my head while I wait, tasting it, refining it, whittling it away into perfection.

Now, on the paper-covered table, I retreat there. The woman directing the setup of my arthrogram is asking about my pain, if I’ve ever been injured (“not my hip” I say), if I’m very active (“pretty”), if I’m a runner (I say yes, even though I’ve been mostly walking lately). I look up at the room’s aggressive lights—that blue-tinged kind of white so bright it turns dark in your eyes—and let myself swim in it.

Then, laying on my back on the table, a pillow under my knees, I tell myself that I am standing on the bridge, testing its strength by bouncing on my toes, testing my balance by lifting one foot.

The snow starts as she lays a towel over me and pulls back the hospital gown, baring my right hip. She tells me not to look as she wipes my skin down with alcohol and places a sticky plastic cover over my joint. I say “okay” but in my head I am putting out my hand to catch the snowflakes.

The needle is a long time going in, and then it has to be adjusted. She tells me not to tense up, so I lay down on the bridge, suddenly very weak, and as the needle shifts inside my body the snowflakes settle on me and hide me within the earth.

And as she injects the contrast, slowly, and tests and retests the placement with x-rays, I tell myself I feel none of it. I tell myself I am not a body.

When it’s over I open my eyes slowly and the dark dives back in.

_

The brain is full of paradoxes. The freeze response is a form of imagination—a retreat deep into the body, but away from its pains, somewhere behind the curtains of the brain. This response denies reality, eases memories by rebuffing them, and over time adds to the vortex of trauma by trying to suppress it out of existence.

IV

Imagination in general is a strong predictor of resilience post-trauma. People who can imaginatively renarrate their traumatic experiences can eventually move past them in reality.

Marine snow that settles on the ocean floor doesn’t stay there forever. Driven by wind and the turning of the earth, surges of cold water sweep up from the depths to the surface, from the darkness toward the sun. The cloudiness this causes captures the light. It becomes one with the waves and they go on and on together, the waves and the dust and the light.

This is an upwelling.

_

It’s been years now since I looked into the sandstorm machine. The last time I was at Dartmouth, I didn’t see it. Prouty Garden, where my parents walked that September night, was demolished in 2016 to make more space for beds. I imagine, somewhere, the dust of both is still settling.

Now I stand at the edge of the water, my feet the first to touch this sand, the remnants of snails and clams from four states and two countries washed up here.

The water is alive; the sunlight feeds it. The snow the creatures become feeds it. The freezing waves that toss that snow on the beach and suck sand toward the lake feeds it. Under the gathering clouds I stand perfectly still while the water splashes up around my blueing ankles.

I rock back on my heels, letting them sink, feeling the weight of thousands of tons of atmosphere around me, feeling myself upright against it. I know without a doubt that this is where I will go, the next time I need somewhere other than where my body is for my mind to be. 

But I’m hoping I won’t need to. I’m hoping I can just be where I am. And I’m thankful that for now I am here in the sun by the water.

Two birds are circling over the lighthouse. I could run if I wanted, through the beach break, up the shoals, out the causeway to the island, up the steps to the light. I could stand there above it all and watch the water swirl with the sand forever.

I imagine this is the ocean. I imagine I am on my back on the water, the sun-feeders feeding under me, the whales plunging down down down. I imagine I am coming up with the shrimp and the snipe eels, rising with the evening into myself.

This is Lake Michigan in October, and it is my first visit.