Month: November 2015

Hitting Home

My first ever thank-you letter as a doctor came when I was an intern.  It wasn’t for an arm I plastered, or a pneumonia that cleared up with antibiotics, or because I was the pinnacle of kind, wise and caring doctor.  It came from the local police station.

A few weeks into internship, I was doing emergency medicine and freaking out on a daily basis.  I will remember this day forever, if only because there was two patients in the waiting room!  One was a straightforward followup case who just needed checking over, the other came up as ‘alleged assault’.  I’d never come across it in medical school.  We had minimal domestic violence training.  I baulked at the list and went to click on the other, easier patient but the resident on with me beat me to it.  The ‘alleged assault’ patient was mine.

For the next 3 hours (hey, I’d only been an intern for 3 weeks and I’d never been in this situation!) I learned about this woman* who had suffered years of abuse and threats.  She had stayed with this man to protect her children because he’d threatened to kill them if she ever left.  The kids had become teenagers and had convinced her to leave and that they would be okay.  They’d all turned their phones off.  They’d all told their relatives to turn their phones off.  Instead of sitting on their dark secret any longer, they’d involved everyone.  And everyone got on board.

The woman was tiny, and shrunken in her chair.  She couldn’t look at me.  She answered everything in short sentences or single words, her kids prodding her to tell me more.  She was covered in bruises.  I had no idea what I was doing.  I went to my boss whose one piece of advice was “X-ray EVERYTHING” (meaning everywhere that was injured). So I did.  I x-rayed every injury.  I asked her how every single one happened.  I asked her about every time she could remember him being violent.  All the threats.  I dutifully wrote it all down.  I photographed every bruise.

When you’re an intern that doesn’t what they’re doing, it goes one of two ways.  Either you gloss over it and hand it to your boss, or you overthink it, and spend WAY too long going into detail that most of the time isn’t relevant, until your boss comes and fishes you out from the deep.  My boss didn’t in this case, I think because he got it.

The nurses called the police and they showed up.  They came to me and asked me to complete an official statement.  I was mortified.  I’d only been a doctor for 3 weeks and told them so.  They said it didn’t matter, I had the qualification, so I was qualified.  So I told them everything she and her kids had told me.  I printed out all my notes.  All the x-ray reports.  The pictures of the x-rays.  I asked the policewoman how she does her job every day.  She told me that because sometimes, she got to put the bad guys away and that made it worth it.

3 hours later the lady left.  The kids were taking her to a family friends house, hours away, all of their phones still switched off.  A team effort to give this lady an exit into the life she had always deserved.

And I forgot all about it.  I stopped taking hours on my patients.  I saw patients with broken arms and pneumonias and strange surgical problems and women in labour and elderly patients struggling at home and kids with ear infections.

A few months later a letter appeared at work for me.  From the local police station.  In it, on police stationary was “Dear Doctor G, on behalf of local police station, we’d like to thank you for your extensive documentation of Mrs ***’s injuries and histories.  Due to your large contribution to the case, the perpetrator was convicted and received a long jail sentence.  Regards, Constable ***”.

It wasn’t the thankyou letter I’d ever imagined receiving as a doctor.  I always thought it would be some eloquent and flowery prose on what a wonderful impact I’d made on healing and helping Mrs’ So and So from her pneumonia.  And at the time I didn’t know how I felt about it.  Tonight I’m watching the ABC documentary, Hitting Home, with years of experience under my belt, and wondering how that lady is going, and realising the impact of taking someone’s story seriously.

Until the last couple of years, people haven’t taken domestic violence seriously.  They’ve shied away from it, minimised it, pretended it wasn’t that bad.  Distanced themselves, blamed the victim for ‘not leaving’, blamed the victim for ‘provoking’ their partner.  Or failed to recognise that violence isn’t always physical, that abusive and controlling behaviour was somehow normal for ‘that relationship’ where ‘they always fight’.

Women don’t leave these situations because their lives and their kids lives are at risk.  Women get into these relationships with this men because they usually are pretty nice guys to begin with who then begin years of slowly and insidiously escalating their level of control and planned destruction of self-esteem.  The fact that people are still asking why they don’t leave defies belief, especially when they’re not asking why the man is violent.

The biggest thing I’ve learned about domestic violence in the last few years, is that it’s not always physical.  It’s emotional.  It’s financial.  It’s sexual.  It’s stalking.  There’s a very good breakdown of what constitutes abuse here.  And the more we recognise it, recognise that it’s wrong, that as Rosie Batty so rightly put it, recognise that we should be outraged that our fellow humans should be treated with such disrespect, the more awareness that we raise, the harder we can come down on it.  I like to think about the one-punch can kill campaign as an example.  Because of the level of awareness raised about that, the legal system can now argue that given the level of awareness, people who knowingly coward-punch another person now gets much heavier sentences.

We need to achieve this for domestic violence.  We need to talk about it.  And we need to end it.

*This person has been completely de-identified and some details changed to protect her identity.