Sadie (not her real name) was a mother of two in her late 20’s. She experienced severe violence from her husband, who isolated her from friends and family, and beat, choked, and raped her. She had been divorced for two years, when she met with a researcher to tell her story.
Sadie wanted to escape after she became pregnant with her first child. “[I] called my mom up two months pregnant, said ‘I want to go home.’ He said, ‘you’re not going home’… And I didn’t have, I didn’t have anybody… [I was] super isolated… was abused every single day.”
Like many survivors, Sadie was afraid to talk about the violence. She visited the hospital “two or three times with my daughter because my, her dad beat me, my husband at the time. Beat me and sent me to the hospital, with preterm labor.” She added, “And we’d make up this story, where I fell down the stairs and it just started happening. But there’d be physical bruises on me. And they’d see him drunk.”
Sadie said, “I think people did try to talk to me [about violence]. Like nurses.” However, she said the nurses seemed uncaring or uncomfortable … and she was always asked about violence when her husband was still in the room. Only the last time, however, did she encounter a nurse who was different:
“And she was the only nurse that actually took my husband out of the room and said, ‘I need to talk to her.’ All the other ones talked to me in front of him.”
Sadie did not tell the nurse what was happening. “I swore up and down he didn’t hit me. Swore up and down.” However, the caring that the nurse conveyed made an impression on her:
“I believe that the nurse that talked to me had a lot of empathy. And some of the other nurses didn’t. And I didn’t listen to the ones that didn’t. It’s that little seed, you know, that people drop in, into your soul. And it just keeps on building, and it grows a tree eventually.”
Sadie never told anyone about the violence during her first pregnancy. However, during her second pregnancy, she found a doctor she trusted– who became the first person she told. Sadie believed her doctors’ support was key to getting through this difficult time in her life, which included not only leaving her abusive husband but medical complications such as a gallbladder surgery. The word she used to describe their relationship was also one of “empathy”:
“She was, she knew my history—She knew my history, she knew my history with his dad, um, she was just very supportive. I mean, whatever decision I wanted… And from the moment I met her, to even now, she, um, you know. She respects me.”
Sadie described her repeated visits to the hospital in her first pregnancy as a “cry for help” that it seemed like most providers did not want to hear. “It was—it was almost like I wanted, I stayed in the relationship, and I wanted to go into the hospital. Not because I had something to hide, but because I wanted some help.” Years later, she believed that the nurse who screened her for abuse and conveyed such empathy had planted a seed that later convinced her— when she encountered another provider who conveyed empathy– that providers do care and do want to help.
Domestic violence is about power and control. Emotional abuse and isolation are very common tactics used by abusers to control their partners. Abusers work hard to convince their partners that the violence is their fault and that no one cares. Although domestic violence is a common issue with tremendous implications for health, the healthcare system often inadvertently sends the same message… that we don’t care about domestic violence. Healthcare providers are often not well-trained about domestic violence and may avoid asking questions about it.
Sadie’s story conveys just how important a caring provider can be… and how sometimes we don’t even know the impact that we have on a vulnerable patient. Have you seen a patient you thought was abused, but you didn’t know how to ask? Have you felt frustrated and unsure how to help when a patient denied abuse? Have you been asked about violence as a patient?