Physicians can reduce the incidence of domestic violence

Abstract

E ach day I have to force myself to read the newspapers. 1 have developed a glaze in my eyes as I read the headlines and find myself still unable to determine who, in Bosnia, are the good guys and who are the bad guys. I skim over the reports of drive-by killings and barely notice that inner-city youths are dying at astounding rates. Even as I watched the footage of the Oklahoma City bombing, my initial shock was muted by repetition. I have nearly lost my capacity to be stunned by violence. Numbed as I am to the global abstractions of violence, I found myself reluctantly involved in the O.J. Simpson trial. So much about this screamed “WARNING” to me: the 911 calls, the fact that in spite of his past record of abuse he was kept on as the national spokesperson for Hertz and at national sporting events, the fact that for a while the trial turned on what kind of woman Nicole Brown was! In the past several years I have learned a lot about this issue. I am somewhat embarrassed by my prior ignorance. But this issue has helped me reidentify with some of the basic reasons that prompted me to pursue medicine as a career in the first place: to identify with patients--each special for her own unique particularity, each hoping that her doctor will care for her as an individual and not just as another case of PID, CIN, or whatever. I can do very little about gang violence in my own country and still less about ethnic cleansing in far-off places. I can, however, as a physician, do a great deal about the domestic violence that takes place in appalling form around me daily. I can turn the spotlight of my professional eye on the dark shadows of this issue. I can illuminate and help to remove the shame these women feel, I can pass on my strength when they are indecisive, and I can assure them of their right to freedom from fear and embarrassment. I can do more: I can help to educate my peers, I can talk to the right people and affect what happens at the local and state level. I can be a role model in my hospital and in my office. I can raise my children to pass on to their children that we are all responsible for addressing this issue. My patients and yours should expect that we are as knowledgeable about this as we are about cervical cancer-that we understand the paradigm of diagnosis, treatment, and appropriate referral. It is my hope that this edition of Women’s Health Issues will provide the reader a glimpse of the scope of this problem. I hope that this edition will give each of you a sense of your own ability to effect change and will enable you to draw that line in the sand that says, “This far, but no further. I will be my patient’s advocate and will always remember this issue as I evaluate each patient.” c 1995 bv The Jacobs Institute of Women’; Health 1049.3867’95&Y .X 1049.38h7(9j)00Ojl-X