IT’S 2040 AND THINGS are a little different. I’m a grandmother now (but wouldn’t you know it, I still look good). I’m retired, and when I’m not putzing around in my garden, I keep busy chasing the grandkids. They are four, five, and seven, and of course I spoil them rotten, the guilty pleasure of every grandparent since the beginning of time.
Our eldest sons (the twins) are thirty-seven and I’m in love with my daughters-in-law, who both called me directly after their first prenatal appointments to tell me they had an ACE screening as part of their routine prenatal care. Even though it’s standard nowadays, they know how much I still love to hear about doctors following through on the guidelines that CYW helped develop. Our boys just roll their eyes when their wives indulge me as I rattle on with my “back in the day” stories, but I know they are secretly proud each time they fill out the school forms for their kids and see the checked box that certifies each child has received an ACE screening right along with vaccinations and TB tests.
Grayboo, who now insists on being called by his proper name, teaches third grade at a public elementary school. He gives me the ACE scoop from the other side of the desk, telling me how the school incorporates ACE awareness into its teacher training. One of the first things the school makes sure of is that teachers know how to recognize symptoms of toxic stress in their students. Every morning, Gray guides his class in a Quiet Time meditation practice to help his students hit the reset button as they start the day, reinforcing the self-regulation skills they have been working on throughout the year.
Even though I’m retired, I still make time to teach at least one course on ACEs and toxic stress to first-year medical students at Stanford, where Kingston is now part of the class. We start at the beginning of the semester with the biological mechanisms, and by the end we’re discussing the latest interventions for healing a disrupted neuro-endocrine-immune system.
On the public-health side of things, the movement has taken off. Two decades ago, CYW was instrumental in convening a group of advocacy and education organizations led by the American Heart Association, the American Cancer Society, and the American Lung Association and together they created a powerful public-education campaign. It started with a viral video and spun out from there—billboards, posters in doctors’ offices, a Super Bowl ad, and more. Celebrities volunteer to be part of the Faces of ACEs ad campaign, and they share their stories along with the call to action: Know your score and learn how to heal. My sons’ generation is the first to grow into adulthood without the stigma surrounding adversity. These days, having an ACE score isn’t any more shameful than having a peanut allergy. But the campaign did far more than change attitudes; twenty-plus years later, we have seen a 40 percent decline in the number of Americans reporting one or more ACEs, and a 60 percent decline in the number of Americans reporting four or more ACEs. Adverse events still happen to all kinds of people, but they are no longer handed down from generation to generation to generation.
The Resilience Investment Act of 2020, which provided federal dollars for screening, treatment, and research, created a national consortium modeled after the Children’s Oncology Group that is wildly successful. The double-digit decline in health-care spending allows us to reallocate dollars to national priorities in some predictable and some surprising ways. Our increased allocation to early-childhood care and education programs was a no-brainer. The big surprise came when I got a call from the U.S. State Department asking me to help advise on a new program that will work closely with other nations’ governments to deploy widespread ACE screening and early intervention in high-conflict areas. This way, we can inoculate the younger generation so they will not be susceptible to induction into gangs, militias, and insurgencies. The science of toxic stress has become a powerful tool in maintaining global security. And our military also uses the latest treatments to help our troops returning from combat.
Ultimately, I help where I can, but for the most part, there isn’t much for me to do. What started out as a movement has become just how people do things—basic infrastructure, standard of medical practice, common wisdom. So Arno and I spend most of our time just being grandparents. We take the grandkids to the park, we buy them things we know we shouldn’t, and when I come across my grandkids chucking paper airplanes at one another, I grab my tape measure and my stopwatch and laugh when they all roll their eyes and flee before the science lesson begins—all of them, that is, except one.