Please Help Us to Help Them: A Request to Family Doctors
For more than 20 years, I have been asking the same question of abused women: Have you told anyone? Have you told even your doctor? Have you ever gone to the doctor with the bruises?
Usually, the answer is “no”. They’re too ashamed to tell anyone and too intimidated to call the police – never mind that there are still police officers out there, I hear, who tell them to go back and be a better wife so they won’t “deserve” the “discipline”. Hard to believe in the year 2003, but true.
How can that be changed? All of us need to be more sensitized. The police are getting sensitivity training, and a male and a female officer answer most domestic assaults. Many cities have special domestic-assault units and special prosecutors assigned to these cases.
But there is something I wish to ask the family practitioners and general practitioners to do, please!
Keep notes. Not just on what women actually report, but on the things you sense given your years of experience and knowledge of the patient. The bruising that has no logical explanation or for which the explanation given is far-fetched. There is only so often that a woman can hit herself in the face opening the cabinet, and most people don’t make it a habit to trip on the stairs. What of the bruising and marks that don’t show when fully dressed? Many abusers don’t hit where it will show – face and hands, etc. – but will mark every other square inch of a woman’s body. She may not answer your questions, but keep notes. One day, she may have had enough, or he’ll cross the line by hitting the children, and then the only proofs she may have are the notes you kept.
I often ask a woman to check with her doctor, but too often, there is nothing in her chart because she said nothing. Often I can’t believe that the physician didn’t know something. Something to take to the police to bolster her current story of abuse, showing that it was not an isolated incident. Something to take to the court to get exclusive possession of the house – in effect, putting the husband out of the house and away from her.
Something. Anything. Even a marginal note on the chart.
Let me tell you a true story. Several years ago, a woman came to me claiming that she had had enough. Enough chronic physical, mental, and emotional abuse and chronic womanizing funded by the family business. Years before, she had turned to the wineglass, topped up repeatedly throughout the day, to forget. She had beaten the bottle two years before, but he held this over her head, saying that she was nothing but a lush and that no one would believe her because of that. So she stayed until one incident – not even physical abuse but emotional abuse – made it too much and she wanted out.
I tried to talk to the other side, but all I heard was that there wasn’t abuse; in her drinking, she had “imagined” the abuse.
But there were notes. Not what she had ever reported – she had hidden everything and “protected” her husband. But her ophthalmologist had made marginal notes to do with the marks around her eyes she had had on at least one occasion. Pages and pages of minute marginal notes to her chart about how the marks were clearly from a fist, not from hitting herself with a door, and that someone, not something, had almost cost this woman her sight.
Those notes saved her self-respect, and suddenly she had something to put under the nose of opposing counsel. Even more, the abuse caused the drinking, making it a result of her life with her abusive husband. Her husband called her a lush and no one listened (not even his own lawyer), and the courts really listened to her. She got her remedies in the courts, all because one doctor, who by then was deceased, protected his patient from the grave.
A few words, but they helped change her life. You can do the same for a patient someday. Please keep notes of what you feel is without explanation and one day a patient will bless you.