Oppressions

I have refrained from really writing about the "Duke Lacrosse" case here.  I'm not directly involved in the case, I don't know anyone who is directly involved in the case, and there has been so much conflicting information in the media that it is hard to judge for myself.  

When the case was "happening" my source of information was largely the NY Times.  I've heard it discussed, and I know people in that region of the world and from time to time hear their opinions.  (By the way, you North Carolina Voters, I understand that your attorney general is using the Duke case in his re-election ads . . . which if nothing else seems in bad taste and likely to convince victims in your state that the state is unfriendly, uncaring, and not really all that nice to victims.  But, that's just my take.)

Today, we in the office watched via the internet a press conference held sometime within the past week to announce the publication of a book by the young woman in the center of the case.  I was most impressed by a professor from NC A&T University who spoke rather elegantly about the case.  

Her statements were the perfect springboard to a discussion about the intersectionality of oppressions and sexual violence.  This case isn't just about rape.  Or gender.  Or race.  Or privilege.  Or social class.  This case is about ALL OF THOSE things, and probably a few more.  

Would it be too simple to say that perhaps what really went wrong with this case, beyond the obvious, was that it challenged too many of our socially held notions and the system overheated and blew up?

Maybe the long shot of this case will be that we start working towards a meaningful conversation about the many oppressions at play in our society.

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?

A Huge Leap Forward

Much stress around the office.  Lots of outreach/community education with the start of the school year.  Still waiting for a grantor to honor their contract with us.  

But, still a tad bit "work high" from a new development this week.  Years ago, I attended a wonderful workshop at the national conference about a new program to train nurses to gather forensic evidence in sexual violence cases . . . document it . . . and teach them to testify.  It was hugely successful in the communities where it was going on.  

I immediately met with the director of our Emergency Department about this cool new idea.  I had grand plans . . . a room equipped with everything we would need to perform truly excellent forensic examinations, nurses trained and available.  It was going to be cool.  Except that the hospital had plans for expanding and renovating the ED and a forensic examination room wasn't in their plans.

That was years ago.  Since then, I've tried to convince individual nurses to take the training.  But, even the few who did were frustrated by the hospital's lack of cooperation and found higher paying jobs elsewhere.

Until this week.  This week, we had a certified forensic nurse examiner perform an evidence kit . . . and she had a nurse in training with her.  I learned that there are 7 nurses in our ED who have taken the 50 hours of classroom training and are working through their 50 hours of clinicals.  The trainee nurse told me that she is hoping that in a year's time . . . they will have all kits performed by a forensic nurse examiner and possibly our exam room set up.

For those of you not aware of the forensic nurse examiner program . . . the program is open to nurses with several years of ED or women's health nursing experience.  There is extensive classroom training for everything from evidence preservation to being cross examined.  

Most clients won't necessarily realize the difference . . . except that the forensic nurses work harder to build a relationship with the victim . . . to make the evidence gathering process as much of a joint venture as possible.  And, I noticed that the nurse was a lot more patient with examining for internal trauma when usually doctors only notice it if there is blood or it is unmistakable.  

It took years and much patience, but oh my goodness is this a huge leap forward for us.