by Tammy Bottner, MD
It was the spring of 1997, and I had a newborn baby. He had arrived ten days after his due date, pronounced healthy, and after four days at Newton Wellesley Hospital his father and I drove him home, me sitting beside him in the backseat because, like every new mother, I was worried he would stop breathing back there and who would know? But I only did that the one time, then I sat up front like a normal person, confident Ari would survive the car ride. I really was not an overly anxious new mother. As a pediatrician I had more experience than most new moms. I could see Ari was a strong and robust baby.
We had just moved into a little carriage house in Newburyport, and had fixed up the smallest bedroom as a nursery. Ari’s room held a light-colored wooden crib and changing table and a pretty lamp his aunt had painted for him, and sported a good-sized window which looked out onto a leafy street. Danny was working as a psychiatrist in a local practice, and I had four months’ leave before I would be starting work in a pediatric practice. We were newly settled in a lovely community. Everything was good.
Yet I was terrified. And I don’t mean just the regular “oh my God I have a newborn what do I do” type of terrified. I had already taken care of hundreds of newborn babies, many of them premature or sick. Feeding and caring for my sturdy little son was not difficult for me. My husband, Danny, was a bit scared in that way, but for me even the waking up at night to feed baby Ari was a cakewalk compared to the stress-filled, sleep-deprived years of my residency.
No, I was terrified because I was caught in a waking dream, that of a parallel universe, one in which I had given birth in a different time and place, in which an unspeakable horror was in store for me and for my child.
My grandparents were Holocaust survivors. My father, too, was a survivor. He had lived through World War Two as a young child in Europe. Despite the thousands of miles and more than fifty years of time separating my family’s traumatic wartime experiences from that of Ari’s birth, I found myself reliving the trauma. It was deeply troubling and very strange.
When I was a young girl, we would sometimes drive up to Montreal to visit my father’s parents, Melly and Genek, whom I called Boma and Saba. The adults would put my sister and me to bed and then stay up talking about “the war.” But of course I was still awake, and listening, and could hear all kinds of scary things. Since I wasn’t supposed to be listening, I never spoke about these late-night reminiscences. But the fear they elicited stayed deep inside me. I can’t even remember any specifics of what I heard now, but I can very clearly recall lying in bed with my heart pounding, experiencing equal parts guilt for not having had to suffer as they had, and horror at what they went through.
Decades later, while I was pregnant with Ari, Danny and I watched the Holocaust movie Schindler’s List. It was awful. Of course, I knew about the horrors of the Holocaust. I had read plenty of books, heard lots of stories, some even first hand. But this movie somehow clarified the degradation, the humiliation, the slavery, and the pointless sadism that the Jews endured under the Nazis. The movie struck a deep cord in me. For days afterward I couldn’t sleep, images of the movie haunting my imagination, a feeling of fear permeating my being so completely that I didn’t know what to do. But slowly I returned to normal, and I thought I had moved past the reaction the movie had caused me.
When Ari was born, however, those feelings came back. Even as I looked around my little house in beautiful Newburyport, part of me was living in Nazi-occupied Europe during World War Two. Profound terror shook me as I gazed at my baby boy lying in his bassinet beside me, and obsessive thoughts went through my mind – what if we were being hunted? What if boots were pounding up the stairs to our room? Where would I hide? What would I do if he cried? What if I had to give him up in order to save his life?
Was it just because of what I had heard as a child that I experienced this terrible distress? Maybe. But perhaps—and I mean this literally—the horror of the Holocaust was actually in my DNA.
Epigenetics is a relatively new scientific field, but a fascinating one. We used to believe that our genes, which we inherit from our parents at conception, formed a permanent and unchanging blueprint of our makeup for our entire lives. In other words, you got what you got, and that was it forever. We now know that it’s a lot more complicated. It seems to be true that genes themselves don’t change, but what is incredible is that there are countless ways that the expression of these genes is changeable. And almost everything we do, eat, or experience in life can change the way our genes are expressed.
So, it is possible that the trauma that my grandparents lived through, and that my father experienced as a child, actually changed their genes, and that these altered genes were passed on to me. If I inherited some of the trauma of the Holocaust in my very genes, maybe that explains my visceral reaction to seeing Schindler’s List and other Holocaust movies, and my overwhelming anxiety when Ari was born.
Think of your genes as a very, very long row of light bulbs. Each bulb represents one gene, and we have millions. Interspersed among these light bulbs are switches. The switches represent points where changes can occur; they can be turned off or on, dimmed or brightened. Those switches are where epigenetics comes in.
Let’s pretend we have two identical twins. And let’s say one of them smokes two packs of cigarettes per day for thirty years and the other twin doesn’t smoke. After thirty years, we look at the two and compare them. Remember, identical twins have the same exact genetic makeup. The smoker appears older than his twin, his skin tone is different, and he is ten pounds thinner than the nonsmoker. Why? Because the effects of the cigarettes caused some of his genes to be turned off, others to be turned on, and these changes resulted in different proteins being made in his body. Proteins are little messengers, and so the smoker’s body received different genetic messages than that of the nonsmoker twin. What is truly fascinating is that, as a result, the smoker’s children will inherit different genetic material than will the nonsmoker’s, even though the twins had identical genetic makeup when they were conceived.
So as we go through life, our experiences—stress, happiness, trauma, diet, medications, illnesses, sun exposure, radiation, toxins, exercise patterns—almost everything—affect our genetic expression. On a cellular level, this happens because methyl groups bind to certain areas of the gene (the switches), turning it off or on. And the genes can be further affected by histones, the spools around which the DNA is wound. Histones may wind the DNA either tighter or looser, which changes the way the gene is expressed. We can think of histones as the dimmer switches, which can change how brightly a particular light bulb is glowing.
In other words, our environment changes the way our genes are expressed. The old nature versus nurture, or genetics versus environment, question is too simplistic. What we do, how we live, what happens to us, changes how our genes affect us.
And it gets even more interesting now that we know that the differently expressed genes can be passed on to the next generation. The fact that certain lightbulbs have been dimmed or turned on or turned off, results in those modified genes being passed on to the offspring in their slightly altered state.
This is really mind-blowing. What my grandparents experienced in their lives changed their genes. These altered genes were passed on to their child, my father. He, in turn, went through further trauma, food deprivation, and social isolation, further affecting the on/off switches and dimmers, further altering the expression of his genes. And these methylated or altered genes were then passed on to me. So, even though I was born in a time of peace and plenty, nonetheless, some of that baggage is literally imprinted in my DNA. And very likely I have passed it on to my own children.
It’s not all bad news. The good news is that positive experiences, a healthy diet, exercise, even being in love, can also change our genes—for the better. So even if one inherits a lot of “bad” baggage, what one does in one’s own life can modify the effects to some extent. And these positively affected genes are also transmitted to the next generation.
Most people are exposed to a mixture of some good and some bad experiences in their lives. But some people—like the Jews who lived in Europe during World War Two—experienced unprecedented and extreme levels of stress and anxiety. Five years of fear, of hunger, of sensory deprivation, of losing loved ones, of homelessness—five years where each day’s survival was an endeavor, five years when stress hormones were sky-high, as they had to be in order to survive—exacted a serious toll on the people, like my family members, who experienced this trauma. And the cumulative effect of this prolonged trauma no doubt created some very significant genetic modifications.
Psychologists and sociologists have studied children of survivors, and found that they exhibit certain behaviors, have more anxiety, than their controls. This finding could be the result of living with traumatized parents (environment). But further studies show that most children of survivors actually have altered cortisone levels (stress hormones), regardless of how they were parented. We can now understand these findings not just as a result of these children having grown up with a parent who had experienced trauma, and having “learned” certain behaviors that resulted from this trauma, but at a genetic level.
So, science seems to support quite strongly the hypothesis that I, a child and grandchild of Holocaust survivors, inherited altered genes that affect my cortisone levels, and predispose me to anxiety. Could this predisposition have affected me when my son was born? The time after giving birth is a particularly vulnerable one for most women, so it makes sense that I was affected then. What we don’t know is whether there is some kind of collective unconscious memory that is embedded in my DNA, leading me to “remember” the trauma my grandmother Melly was experiencing when her son, my father, was born.
There is still much that science has to figure out. Why do some survivors and their children do well, while others suffer from PTSD or other psychological or physical ill effects? There is no easy answer at this point. Studies show that whether one’s mother or father underwent trauma, as well as what age they were, affects the progeny’s outcomes. And if one looks at grandparents’ experiences, it matters whether it is a paternal or maternal grandparent. Strangely, for example, if one’s maternal grandmother was severely underfed as a child, one is more likely to develop diabetes but, conversely, if one’s paternal grandfather was underfed, the opposite is true. And if one’s father was underfed as a child, one is relatively protected from heart disease, but if one’s mother was underfed, one is more likely to develop heart disease. The science behind epigenetics and its effect on resilience and health is still in its infancy. But the mere fact that we now understand that life experiences can have an effect on future generations’ health is a major step forward in our understanding of how genetics and environment interact in determining our health outcomes.
Excerpted by permission from Among the Reeds: The True Story of How a Family Survived the Holocaust, © 2017, by Tammy Bottner, MD.
Tammy Bottner, MD, is a physician who treats children and adolescents in a small city north of Boston. She completed medical school at the University of Massachusetts and trained for her pediatric residency at Maine Medical Center in Portland, Maine. She has been practicing pediatrics since 1992, and is a graduate of the Fellowship in Integrative Medicine at the University of Arizona School of Medicine. The proud mother of two children, Tammy is a graduate of the first iteration of Wholebeing Institute’s Certificate in Positive Psychology and the author of “Among the Reeds: The True Story of How a Family Survived the Holocaust.”