Backing Battered Women

Shawnee Mission team shields, counsels domestic abuse victims.

The call woke her around 4 in the morning.

 Jennifer Johnson jumped out of bed and threw on her clothes to make the eight-minute drive from her home to the hospital, rushing through its glass double doors in the emergency room to get to a woman, Sarah (not her real name), who was pacing and eager to talk to someone.

 Johnson had met her once before, a few days earlier. During that first visit, her husband had been with her, and she was terrified that anything she said about her condition would get back to him and jeopardize her child’s safety.

 This time was different.

 Sarah had snuck out in the early hours of the morning and was ready to tell Johnson what had really happened. This time there was no excuse, no cover-up for the injuries that Johnson hadtreated a few days before.

 Sarah’s husband had stabbed her.

 This scene may seem more likely the part of a television crime drama than an occurrence at Shawnee Mission Medical Center (SMMC), but a special group of people who work in an exam room with an unmarked door and security peep hole know better.

 Behind that door is SMMC’s Forensic Assessment Consultation and Treatment (FACT) Program, which Johnson helped to develop in 2009. It is now one of the most comprehensive forensicprograms in Kansas City.

 The Program’s team of 14 specially-trained nurses not only treats the physical needs of assault victims but gathers the forensic evidence needed to successfully prosecute these difficult legal cases. In five years, the program has already treated more than 2,300 patients — compelling evidence that sexual and physical assaults are growing at an alarming rate in this area.

 Chances are that we all know someone affected by sexual or physical abuse. Someone in the United States is a victim of sexual assault every two minutes, and one out of every four women will be the victim of an attempted or completed rape before the age of 18.

 The part of our brain intent on shielding us from harsh reality can fool us into believing that these assaults happen to other people in other parts of town. That’s not the case.

 Highly educated professional women with seemingly perfect lives have lain on the exam table at SMMC, finger-shaped bruises from their assailant wrapped like a ghostly chokehold around their necks.

 Because 73 percent of assaults are by someone the victim knows, women arrive at SMMC afraid that their attacker — oftentimes a boyfriend or husband — will show up at the emergency room to intimidate them into not filing a formal report.

 And, those fears are often founded.

 The entire unit, at times, has been put on lockdown to protect victims from suffering further trauma of a more manipulative nature when still reeling from the physical effects of abuse.

 Trained in the subtleties of forensic photography, sexual assault medical examinations and the proper way to prepare police reports, SMMC’s FACT team wears many hats.

 Working as emergency room nurses, forensic examiners and assault counselors, they painstakingly gather often obscure evidence with the help of specialized equipment — all free of charge.  “Most women come in between four to six times before they actually file a police report,” Johnson says.

 Because many of the program’s cases involve what are referred to as “intimate partner” assaults, the decision to initiate formal proceedings is not an easy one for the victim.

 “Sometimes it’s easier for them to stay than to leave,” Johnson explains.

 And no matter how many times a victim walks through the doors, team members never acknowledge that they have seen the patient before, understanding that any legal action is for the victim to take. But when the victim is ready to prosecute, so is the FACT Program with the evidence.

 Johnson recalls one particular patient, a repeat domestic violence victim who had moved multiple times with her husband within the Kansas City area.

 Although she had been seen by the FACT Program many times, the woman never wanted to press charges; she did, however, always agree to forensic photographs. This single decision proved critical when, months later, she was ready to pursue criminal action and her FACT case file provided the evidence needed to charge her husband with battery in multiple jurisdictions.

 The FACT team is as much victim advocate as health care provider, working with area shelters to place victims who can’t safely return home. Sometimes, that means sneaking patients out side doors, admitting them to the hospital until safety measures can be put into place, and carefully orchestrating their moves to keep them undetected.

 Recognizing that following up on a lingering suspicion or asking one additional pointed question may make a difficult situation all the more so, Johnson emphasizes the reason why the team is there and how to fulfill the program’s purpose.

 “I tell our team that they have to choose the harder right than the easier wrong,” she says.

 As for Sarah, the stabbing victim who was tormented for days trying to figure out an escape plan, the FACT Program may have saved her life.

 Johnson worked closely with the police department, which choreographed the safe removal of her child from the home, and her husband was taken into custody.

 Acknowledging that not all of her days are filled with such success stores, Johnson relishes the impact that the FACT Program can make.

 “It only takes one patient to make all the difference,” she observes. “We’re all here because we choose to be, not because we have to.”

Kansas City’s Contribution to Forensics

Most people wouldn’t refer to Kansas City as “forensic rich,” but that’s exactly how Jennifer Johnson describes it. Why? The two largest forensic equipment suppliers for the entire country are located here: Arrowhead Forensics and Lynn Peavey Company. Saint Luke’s Health System also hosts an annual forensics conference for healthcare providers, now in its seventh year.

A Silent Assault

The FACT Program averages one strangulation case per week. Although considered one of the best predictors for subsequent homicide, only 3 to 9 percent of strangulation victims ever seek medical care. Unless specifically asked, victims tend to minimize strangulation on the assault spectrum by failing to mention it during medical intake. Since 2009, the FACT Program has seen over 200 patients who have suffered from strangulation — a startling figure considering it reflects only a small percentage of actual victims.

FACT Program Statistics

Adult women, although the majority of FACT Program patients, are not the only ones. In 2013, the Program saw over 40 victims of sexual or physical assault under the age of 18 and male patients accounted for approximately 25 percent of patients overall. Since 2009, the FACT Program’s database has recorded:

Patients: 2,383

Physical Assault Cases: 1,120

Sexual Assault Exams Performed: 685

Intimate Partner Assault Cases: 467

Incidents of Human Bite Injuries: 77