Nurse examiners help victims through trauma

Posted: Sunday, April 18, 1999

Lois Troup deals with the "ugly" side of life every day.

A member of the Sexual Assault Nurse Examiners team at Northwest Texas Hospital, she visibly tensed as she talked about a mother and her 9-year-old daughter - her patients - who were raped when a stranger broke into their home.

"He raped her as she lay on top of her mother," Troup said, her voice barely a whisper.

The patients - and what has happened to them - are what the nurses remember for a long time.

"The horror of the crime done to them is almost unbearable," said Michele Gorday, Sexual Assault Nurse Examiners coordinator. "But they find a way to work through it - to deal with what's being done to them.

"You feel their history," Gorday said. "Sometimes you have dreams. There are those times when you close your eyes, and you keep seeing your patient - over and over again."

The patients can be any age, from 3 months old on up.

Adult patients often are the victims of acute sexual trauma that has happened within the last 72 hours.

Most children, however, are victims of long-term abuse that's harder to see because children usually know, or are related to, their abuser.

Gorday said figures show only 1 percent of all sexual assaults are committed by strangers.

"We always educate our children not to talk to strangers," Gorday said. "But we fail to educate them not to let daddy or Uncle Bob or family friends touch them in ways that are not right."

Child sexual abuse crosses all racial, economic and social barriers. That's why SANE was established at Northwest Texas Hospital in 1975. It was the first of its kind in the nation and is used as a model in other cities. The protocol is simple - focus on the patient, even if it takes hours. Unlike rushed emergency room physicians, the sexual assault nurses often spend several hours with their patients.

"Sometimes you get a call at 1:30 a.m., spend four hours with the patient and then have to go into work at 6 a.m.," Gorday said. "Then you come back and do it again, sometimes five days a week."

The team "debriefs" daily by talking to one another about their cases and emotions.

"Sometimes you get angry, extremely angry," Gorday said. "How can a human be so inhumane to another? It baffles you how someone can do this to a child or how they can do this to a 90-year-old. We're very cruel to each other - worse than animals."

Sometimes, nothing relieves the stress. Gorday said job burnout occurs frequently. Nurses stay in the field an average of three years.

Gorday herself took a break after two years on the team.

"I performed an exam on someone that was brutally beaten and raped and left for dead," she said. "The victim had been strangled. That night I went home and when I closed my eyes to go to sleep ... I could feel someone strangling me. I couldn't let go."

Troup said chronic child sexual abuse cases are the hardest to prove, and parents often look to the nurses for answers.

"Those are answers we can't give," she said. "Parents don't want to believe that this is happening. They are afraid of what will happen to their marriage or family. And if it's a neighbor, they are afraid that they didn't do enough. That they should have known."

Christine Vecchi, another member of the SANE team, said knowing she helps the sexual assault patients keeps her going.

"It's difficult when you hear their stories and know that they will have to repeat it again," Vecchi said. "If they don't have parental support or are not believed, it's hard. Children deal with adult problems: 'What's going to happen to my family?' ... 'Is it my fault?' "

Vecchi said she's thought about quitting more times than she can count. "It angers me at times that a child has to be exposed to this, or even has to think about this," Vecchi said. "I get angry with myself that I couldn't do more to stop this before it happened.

"(Abusers) aren't mean people who are easily identified. They are lawyers, doctors and sales clerks. They can be anywhere and work anywhere."


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