Just the Beginning

When I attempt to explain the "victim experience" to people, I often say that the assault is merely the beginning of the whole "victim experience," not the end.

The attack itself is often the scene of panic or alarm or terror. Lots and lots of women I talk to say that they worried more about being killed than they did about the rape itself. They describe that horrible, pit of your stomach feeling of realizing that you no longer have control over not being raped, you refocus your attention on surviving the attack.

But, after the attack, you have lots of rushing thoughts and conflicting impulses to contend with, immediately. Call the police? How is my family going to respond? Will I be believed? Will I be blamed? Do I blame myself? Oh god, what if I get pregnant or a disease from this? What if he comes back? Why? Why? and again, Why?

We realize that only a small percentage of victims immediately call the police and seek medical treatment. The societal myths about rape and rape victims work against that impulse. It is rare for me to see a victim who absolutely knows they did nothing "wrong." Rare. (I constantly debunk the victim's own acceptance of rape myths.)

When medical treatment is sought, we have the opportunity to both gather evidence and provide appropriate medical interventions. Medication can be given to prevent pregnancy. Medication can be given to prevent many of the sexually transmitted diseases and/or infection resulting from the assault. In recent years, the director of our emergency department and I have discussed the efficacy of offering anti-retrovirals to help prevent HIV.

This is becoming more standard as we advance our response to victims of this violent crime. So, imagine my thoughts when I read in the New York Times that in South Africa, a doctor was fired for a) offering anti-retrovirals to rape victims and b) supporting a local rape crisis center who advocated for the treatment. (Read about it here.) Now, judges have ruled that he was fired improperly. But, it took years for this ruling to happen. How many people who needed his medical care were denied it because of his humane and appropriate actions? How many rape victims shouldered the feelings of shame and guilt and blame because their victimization contributed to his firing? (Which is totally a stretch, but so often victims will blame themselves not just for the assault but the aftermath as well.)

And, how much longer will it be before "those in charge" understand that rape is not the result of the victim's actions . . . but the perpetrators? And how long before, universally, we have a society that rushes to the aid and responds to the needs of the victim rather than make their pain a political football?