Summary
” I want to go in with as much information as possible. He swallows. “She said it was a family member.” I want to vomit. “How do you think you got pregnant?
Aspler has witnessed every imaginable type of intimate partner, domestic violence and sexual assault scenario in her career.
“Forty-four per cent of women murdered by their intimate partner visited an emergency room within two years of the homicide. This represents an opportunity for doctors to intervene and save lives,” says Aspler. “But we are only detecting about five per cent of intimate partner violence cases in the ER. We are missing 95 per cent of the cases. Most survivors have said that if health-care personnel would have asked — they would have disclosed.”
So what can hospitals do better?
“We need to translate some of our essential services for those seeking refuge from violence. Flag people immediately when they register — similar to what we do with seniors for essential immediate care and operate peer support initiatives like we do for substance abuse, which involves rapid followup clinics, to work to decrease the stigma survivors feel and increase the empathy in the care that they receive.”
Readers can learn more about Aspler’s fight to overcome private violence in her personal life and through advocacy for others in Rise After Silence: An ER Doctor and the Patients Who Healed Her, available now wherever books are sold. The Tyee is giving away three copies as part of this exclusive contest.
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Can’t wait to start reading? Here’s an excerpt to get you started.
“Dr. Aspler, there’s a 13-year-old girl asking if she can be seen by a female doctor.”
I freeze in my steps. The request feels sharp in my chest. I don’t know the reason for her visit, but teenagers rarely exhibit this type of agency. The triage note reads lower abdominal pain, nausea. Abdominal pain is one of the most common reasons for an emergency visit.
Instead of the typical curtained turnstile area, though, Giulia has been placed, along with her mother, in a private monitored room. I’m not sure why the need for the acute room, but then my chief comes over to talk with me before I open the door.
“Anne, the girl told the triage nurse she’s pregnant and her mom doesn’t know.”
“Do we know who the father is?” I want to go in with as much information as possible.
He swallows.
“She said it was a family member.”
I want to vomit.
“How do you think you got pregnant?” I hold my breath, swallow hard, and maintain the same tone of voice as my previous questions.
Giulia pauses, and I fear my delivery has come at the wrong time.
Then she says, “He’s going to kill my mom if I tell anyone.”
It’s the same threat used against my aunt and my dad when they were abused.
As I leave, I hear Mrs. Rossi telling Giulia never to tell anyone about this.
I wish I’d turned around and said something.
I should have said to her: It is not your job to stay silent, Giulia.
My chief meets me in the hall with a Styrofoam cup of hot tea. I take it without a word and go sit in my van, staring at a tree branch for a long time. I sip the tea and study the shape of a solitary birch leaf blowing in the wind. And then, for no reason I can explain, I think of an AA meeting my dad took us to when we were little.
Underneath a single ceiling fan light, a saying bounced around in different variations that day. “We’re only as sick as our secrets” and “The secrets make you sick.”
I didn’t know what that meant then. But the saying pops back into my head as I continue to wrestle with whether to lie to my children and others about my dad and why we had estranged him. I have firmly decided that I will tell them all of the truth as I know it. Because I wonder how many secrets Dad had suppressed in his life. Is that what made him sick?
I worry for Giulia and hope she will find an adequate support system of counsellors, friends, and family. Every time I treat someone for sexual assault, I am saddened that silence and secrecy are the norm. Stay quiet, don’t tell anyone, carry the burden yourself.
I’m so sick of the silence.
The silence makes you sick.
Excerpted with permission from ‘Rise After Silence: An ER Doctor and the Patients Who Healed Her’ by Dr. Anne Aspler.
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Source: The Tyee
