We all learn about intimate partner violence. We learn about the signs to look for in our patients. We ask screening questions at triage. But what happens when the patient is one of us, as healthcare professionals. What happens when we know too much. What happens when we are the one enduring abuse. This post shared anonymously with us is POWERFUL.
The first time it happened, I wore a wrist brace to cover the bruises and blamed it on carpal tunnel from anatomy lab. The second, I blamed on rope burns from my dog’s leash. When my arm and multiple ribs were broken, I crafted a story with a mechanism that I knew matched my injuries. Medical school has taught me the foundations for becoming a doctor. Anatomy, patterns of injury and illness, patient interview skills, and red flags for abuse. These very same learned skills allowed me to become an expert at successfully hiding the thing that tormented me and that I was most ashamed of for over two years.
The first time it happened, I wore a wrist brace to cover the bruises and blamed it on carpal tunnel from anatomy lab. The second, I blamed on rope burns from my dog’s leash. When my arm and multiple ribs were broken, I crafted a story with a mechanism that I knew matched my injuries. Medical school has taught me the foundations for becoming a doctor. Anatomy, patterns of injury and illness, patient interview skills, and red flags for abuse. These very same learned skills allowed me to become an expert at successfully hiding the thing that tormented me and I was most ashamed of for over two years.
During those two years, I spent multiple nights in the emergency department at my home institution. My abuser accompanied me each time and was never asked to leave the room during a physician interview. The triage nurses, who always knew my face and name, selected no on the domestic abuse screening questions without asking. I would basically provide my own HPI to the resident physician and was even quizzed on the type of arm fracture I had by the consulting surgeon. Each time I thought “this time someone will question me,” but it never happened. And why would it? I was medical student everyone knew and I would surely report anything that had happened.
I never thought I would write my story, because to be totally honest, I still carry some amount of shame from it. Today I write my story for three reasons:
I know there are other physicians and students who are hiding their abuse with the same knowledge and techniques that I did. You’re not alone, there is a way out, and your colleagues are here to help you.
I want to encourage physicians to pay more attention to cases of potential abuse, even if the patient is your star medical student, a resident, or attending.
Women who hide their abuse aren’t stupid or weak, they are afraid. The judgement I know happens in the privacy of the glass box has to stop.
As much as we fail to acknowledge it, female physicians and students are not immune to intimate partner violence (IPV). Good studies don’t exist on the prevalence of IPV in the physician community because it’s not something we talk about. I can’t help but believe some of our casual denial of the issue is due to knowledge these women have to expertly hide their own abuse. But why do they hide the abuse when they know they could get help? As a future physician, I’ve always thought I was expected to have my life perfectly together and portray myself as a “strong woman” in order to be successful. Being abused by my male partner didn’t fit that narrative, so the logical choice to me was to hide it. Each woman has their own reason for hiding it, but it always stems in fear. Fear of the unknown, fear of worsening abuse, fear of destroying the outward appearance that took so long to build.
I myself have been guilty of judging women who hide their IPV. It’s so easy to question “Why doesn’t she get help? Why doesn’t she leave?” Now knowing the answers to these questions myself, I realize there is no place for asking these victim blaming questions either directly to the patient or in conversation with your colleagues. What these women need, what I needed, was for someone to provide resources, someone to reassure that being abused doesn’t make you a bad student or a future physician, someone to make the tough call to separate the abuser from the room. I encourage you to be that person to any woman experiencing IPV instead of pulling the “you can help those who won’t help themselves ” card that we love to keep in our pocket. Even it makes you uncomfortable, even if the patient is someone you know..don’t stand there and judge, do something.
Strangely enough, one good thing came out of this pandemic for me. I was finally separated from my abuser for long enough that I had an out. His fear of me bringing home COVID-19 from the hospital and infecting him is what saved me. I don't believe everything happens for a reason, but those two years will forever shape who I am as a future physician and is already impacting the way I treat patients and my colleagues now. Now, without fail, I will ask every single one of my patients about safety in their relationships and not assume it's already been asked. I will screen every single patient I see for domestic abuse, even if the patient is my resident or my old lab partner. I will never again question a woman’s motives for hiding her obvious abuse. I will support my colleagues and recognize that IPV is something that affects women in medicine too. I encourage you to hear my story and do the same.