Anyone who lands a seat in medical school in this highly competitive era is, numerically speaking, a rarity. That Stephanie Zobel did that after serving five years in the U.S. Marine Corps, graduating from Ohio State University and then giving birth to twins, now two and a half, puts her in an even more exclusive category. But the second-year DMU osteopathic medical student is truly remarkable – incredibly so – because she accomplished all that after surviving years of adverse childhood experiences (ACEs), the cruel realities for kids that have been scientifically linked to the likelihood of risky health behaviors and disease in adulthood.
Not that Zobel sees it that way. The soft-spoken student radiates calm while being open about her path to DMU. When she was a baby, her biological father was a recent leg amputee who felt he couldn’t provide for her and her brother, Richard – so he didn’t. Their biological mother’s paranoid schizophrenia led to their being adopted by a maternal uncle and aunt – whom Zobel considers “Mom” and “Dad”* and who are referred to as such in this article – when she was nine months old and Richard was two and a half years old. The family lived on five acres in an isolated rural area of southern Illinois.
“We always had food on the table. We had cherry trees, a little vineyard, a strawberry patch and a very large garden that me and my brother would help out with,” she says. “Dad would hunt, too. He had been an orphan in West Virginia and grew up knowing what it was like to be hungry.”
Zobel has positive memories of shelling peas and watching the sunrise with her mother and walking in the woods with her dad. But there were stretches where the plumbing in the trailer they lived in didn’t work, so the two children collected rainwater for bathing, cooking and flushing the toilet.
“When it didn’t rain, we would drive into town for groceries and steal water from the laundromat in recycled milk jugs,” she says.
The forecast calls for pain
Mental illness took a greater toll on the family. Zobel’s biological mother sometimes drove to the family’s home to angrily demand to get her children back. She tried kidnapping Richard and once shot a gun at the trailer.
“I just remember feeling not safe because the trailer was very old and fragile. My brother and I had to hide in the closet,” Zobel recalls. “Dad had guns, so he went out to calm her down and tell her to leave. A protection order was eventually put in place.”
But not “protection” against other crises. The children’s adoptive father was an alcoholic who increasingly had paranoid delusions and was at times violent to his wife. One night, when he was out of the home, she told the children to pack up their things.
“I was so excited because we were finally leaving, but she started crying and said we had to go back. She’d had a difficult childhood and had been completely dependent on him her entire adult life,” Zobel says. “I threatened to call social services many times, but my mother scared me away from it by saying I’d probably be separated from my brother, whom she knew I loved a lot, and molested. So naturally I never called social services.”
The “worst thing,” Zobel says, was her father’s unpredictability. “A lot of events got ruined because of Dad’s temper. The holidays were always bad because they seemed to trigger him,” she says. “After those things happened, I had trouble making friends and having fun like my peers. I was scared of saying something that would set off someone like my Dad. I withdrew into myself.”
Rural + poor = trouble
The violence escalated. The father increasingly believed people were plotting to kill him. One night, he was so threatening to his wife that Zobel was convinced he would kill her.
“After that, I remember crying every night. I asked my mom if I could see a psychiatrist. She couldn’t find one and told me to talk with the one teacher at school I didn’t like,” she says. “That did not help at all.”
It wasn’t until years later, after two tours of Iraq as a U.S. Marine, that she realized that violent evening was the “exact moment” she acquired post-traumatic stress disorder (PTSD). Despite all the adversities of her childhood, though, and the fact she rarely communicates with her adoptive parents now, she doesn’t harbor resentment toward them. She is sympathetic toward them and the harsh realities that shaped their lives.
“We were poor and lived in a rural area, so access to health care was limited; mental health services, even more so,” she reflects. “This meant that my father could not get care, my mother could not get domestic abuse support services and I could not find a psychiatrist who would have diagnosed me with PTSD from having witnessed the domestic violence.”
Zobel moved out of the house after Richard, then 18, got an apartment, and their parents announced they were moving. (Years before, the family had moved out of the trailer.) They said Zobel could come with them, but she had her senior year of high school to complete and had enlisted in the Marine Corps, in part because she “no idea how to apply for college.”
“I’d done junior ROTC in high school and always liked the military. Hollywood played a big role in that,” she says. “But the biggest thing the recruiter sold me on was its feeling of family, of belonging. That really appealed to me.”
For the first time, Zobel had leaders, a sense of purpose and no worries about “keeping everyone safe” as she had to at home. She taught herself to make friends. She discovered she loved being physically active – “I got out a lot of aggression” – and that she was capable of much more than she previously believed.
“I felt valued in the Marine Corps. They trust you with a lot of responsibility at an early rank,” she says.
She also worked to hone conflict resolution skills. “I recognized that was a big problem for my family,” she says. “I read book after book on the topic.”
Zobel met her husband, Fred, in the Marine Corps. After they completed their service, they married and moved to Ohio, where she became a psychology major at Ohio State University. “I wanted to find out what makes people tick,” she says. “My whole goal was to go to medical school.”
When she was unsuccessful in being admitted, she and Fred decided the timing was right for parenthood. It wasn’t a light decision. “There was so much mental illness in my family, and some in my husband’s, too. That combination of genes did not bode well for my kids,” she says.
Countering that concern was the couple’s relationship. “Fred and I are amazing at conflict resolution – amazing,” she says. “We just talk to each other without being nasty or yelling or taking little digs at each other.”
That was a saving grace during the first year after their twins, Freddy and Jo, were born. “By the time we got one down and settled, the other was crying. They were preemies so struggled to latch,” she recalls. “That first year was terrible.”
Zobel has a huge capacity for hanging tough, however. She was accepted at DMU and went from being a stay-at-home mom to being a full-time medical student with another saving grace – having a stay-at-home husband.
“Fred does it all – taking care of the kids, the laundry, groceries, shopping,” she says.
Zobel was accepted at three medical schools after her next set of applications. “The first time I applied, I didn’t do a good job of selling myself. The second time around, I parsed out everything I did in the Marine Corps,” she says. “I chose DMU because of the interview process. The people were nice and were interested in me. I touched on aspects of my childhood, but not in a ‘woe is me’ kind of way.”
Zobel shared her story this spring during DMU’s inaugural Human Library event, in which individuals who have experienced some form of being different served as “books” to be “checked out” for one-on-one conversations.
“When I’ve shared my story, people may get something out of it that helps them,” she says. “Growing up, a lot of the time I felt so isolated, but this stuff does happen, and I know other people have had similar experiences. It’s truly wonderful to hear that my story is resonating with people.”
Realities and resilience
Stephanie Zobel’s childhood was shaped in part by some grim realities that directly affect the health and wellness of millions of Americans: poverty, lack of access to physical and mental health care and the potential lifelong negative impact of adverse childhood experiences.
According to the Agency for Healthcare Research and Quality, in 2017 poor people – defined as at or below 100 percent of the Federal Poverty Level (FPL) – experienced worse access to care on 18 of 20 access measures compared with people at 400 percent or more of FPL.
Where a person lives influences his or her health. Compared with their urban counterparts, residents of rural counties are older, poorer, sicker and more likely to be overweight or obese. The National Center for Health Statistics of the Centers for Disease Control and Prevention (CDC) reports that rural residents also have higher rates of injury, smoking, uninsurance, suicide and opioid misuse.
The CDC-Kaiser Permanente Adverse Childhood Experiences (ACEs) Study, originally conducted from 1995 to 1997, looked at seven ACEs categories: psychological, physical or sexual abuse; violence against the mother; or living with household members who were substance abusers, mentally ill or suicidal, or ever imprisoned. The number of categories of ACEs was then compared to measures of adult risk behavior, health status, and disease.
The study found that persons who had experienced four or more categories of ACEs, compared to those who had experienced none, had four- to 12-fold increased health risks for alcoholism, drug abuse, depression and suicide attempt. The study also linked higher numbers of ACEs to an increased presence of adult diseases including ischemic heart disease and cancer.
Despite all these strikes against her, Zobel managed to survive and thrive thanks in part to her resilience. According to the American Psychological Association, resilience isn’t a trait that people either have or don’t have; rather, it’s a process of adapting well in the face of adversity, trauma, tragedy or threats. Ways to build resilience include making positive connections with other people, moving toward one’s goals and taking care of oneself.
*DMU Magazine is not using these family members’ names to respect Zobel’s wishes and their privacy.