What do you say to the rape victim, what can you tell her that might help her begin the process of healing? After 30 years in the emergency room, this is my best attempt.
The Rape Exam
I don’t know if people think of rape when they think of the emergency room, but that’s where the rape victims are taken first. Not just to address any injuries, but to perform a forensic rape exam, to collect evidence.
It’s a really bad situation for everyone. The exam is, in many ways, a repeat of the assault. A woman – or sometimes a man, or a boy – must submit to much the same depersonalization, and objectification, and penetration, that they just suffered through. I can’t imagine how the victim feels. I know I feel like crap.
And for a few years, I was on staff at the largest teaching hospital, and the busiest emergency room, in this quarter of the state. We saw most of the rape victims. So in addition to worrying about the suffering of the patient, the ER doc has to put a busy ER on hold, and take 45 minutes or more to do a proper exam and specimen collection. I got more than my share. For what sparse positives can be found in such a lousy situation, some of the Rape Crisis workers requested that I do the exam. I was hardly ideal, but I think they recognized that I was trying not to let my stress and discomfort show, and to treat the victims with patience and as much dignity as the situation allowed.
After years of doing these exams, I realized something. Almost none of the victims had any physical injuries. Except for one particularly depressing case, a prostitute who had been beaten by her pimp with a garden hose, the victims I saw rarely had so much as a bruise or a scratch.
Their injuries were psychological. That’s not saying the injuries weren’t real; they were all too real, and as debilitating as any other infection or cancer. Many of the victims would never completely heal. And each of them would spend years trying to accept what was intellectually obvious to her, and to everyone, from the outset: it wasn’t her fault, there is nothing wrong about her, she isn’t damaged goods.
But the victim will, nevertheless, accept the assertion of the rapist. She will feel that she is inferior, she will feel insignificant, even disposable. Only after years of effort and healing can she even begin to crawl out of that hole.
Searching for Words
After three decades of these exams, I was recently confronted by a rape situation where there was nothing for me to do but despair. It was a young teenager, a good student from a good family, who unfortunately lived in a poor neighborhood. The rape had taken place a week before, she had been afraid to tell her mother because of course, the victim blames herself. But there was nothing for me to do medically. I had never realized that the rape exam, as bad as it was, at least gave me something to do. It allowed me to contribute a mote of value to a very bad situation.
So I tried to think of something that I could say, that might allow her to begin healing. After I stood there awkwardly for several moments, while the young lady and her mother waited quietly for the ‘wise‘ doctor to speak, this was the best I could do:
Some people will tell you that everything happens for a reason. I don’t believe that. Things only happen for a reason if you choose a reason, if you design a reason. If there is any growth or value to come out of this, you will have to create it.
Right now, your attacker has decided what you are and who you are, and your worth as a human being. When you can take what happened to you and create sense of it, you will deny him his power, and you can then reclaim your own power, and your dignity, for yourself.
Make, or Break
I don’t know if it was the right thing to say. I also don’t know where it came from. Do muses exist? Perhaps a muse is the result of long-term subconscious rumination. It’s possible it wasn’t even a muse. Recently I came across a quote in my files that I had forgotten from Jean Paul Sartre, “Freedom is what you do with what’s been done to you.” Maybe I just remembered that, and restated it.
Anyway, some months later her mother saw me and relayed that she was telling her daughter, “Remember what the doctor told you: this will make you or break you.” It’s not exactly what I said, but it’s close enough, and if that interpretation helps the young lady, that’s great.
Since then, I have realized that perhaps this approach can help others who are struggling. From time to time in the ER we see young men from a local juvenile facility. Before continuing, I have to say that I have been very impressed by the counselors who bring the kids in; by and large, these guys are really committed to the young men, and work hard to help them. And some of the counselors speak from experience, having struggled with rebellious behavior and/or illegality when they were young. It’s one of our worthwhile tax expenditures that often gets missed in complaints about government waste.
Anyway, sometimes these young men have typical teenage injuries and illness. But some of them we see are there because they are deeply resentful and angry, even suicidal: they are away from their homes, they are in a strictly controlled environment, they think they will never get out of the facility, and even though the counselors monitor them as best they can, there is still bullying and fighting. When I think it appropriate, I give some these young men a version of the same talk I gave the young lady.
Because maybe it’s advice that we can all use. Rape is an extreme, something that should never happen to anyone.1)But happens all too often. There are some estimates that 1 out of 3 women, and 1 out of 7 men, were sexually abused as children. But it’s also a metaphor for what we all face in much smaller ways. We will all be violated, beaten down and humiliated, often by other people, but sometimes just by circumstances. When that happens, we all have a strong drive to climb into a hole and accept degradation and victimization. So we have the same choice: either adversity carries important meaning for us, or it is meaningless. It’s up to us.
So I hope I helped the young lady, and the other people with whom I have shared this insight, but I can’t be sure. Perhaps it will help you; it has certainly helped me. When I’m struggling and out of energy (like I am presently, probably the reason I picked this for today’s blog post), I try to remember what I told the young lady. It doesn’t always make me feel better, but it generally gets me up and moving again.
Which, I suppose, is the first step in simply living.
Photograph courtesy of Frédéric Poirot on Flickr.
Footnotes [ + ]
|1.||↑||But happens all too often. There are some estimates that 1 out of 3 women, and 1 out of 7 men, were sexually abused as children.|