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Typically when I go to a conference I come home feeling energized. I am refreshed and eager to use my new knowlege. Last week I attended a five day course on "The Evaluation and Management of the Pediatric Sexual Assault Patient". During the week I experienced anger, nausea, frustration and bitterness. Emotionally, I am worn out.
I planned to tell you about one video that I watched where a four year old bounced up and down in her seat as she described a past experience with her dad. While we understood that what had happened was awful, she clearly did not, and was telling her story with enthusiam. As the pieces came together in my mind, the gut twisting followed. The story is too graphic for me to convey.
I do want to pass on, however, several 'truths' that I learned last week.
1. Injuries that are indicative of child abuse do not guarantee a conviction. The process to get a conviction relies on a huge amount of teamwork between the police, the CPS, the district attorney and the child. The system favors the alleged perpetrator.
2. A normal exam is normal, Most children have no physical evidence of abuse so their cases rely on evidence other than the physical examination. We depend upon a child being able to go in front of a courtroom full of people (including their abuser) and describe their sexual assault in enough detail to sway a jury who does not want to believe that abuse ever took place because....
3. The abusers are intelligent, good looking and often pillars of the community. The successful pedophile is organized and patient. He does not want to get caught. He will gain the trust of adults around him. He will establish such a strong relationship with the child that the child typcially has feelings for this person years later, sometimes lasting into adulthood. We know them, and they are the last person we would ever suspect.
4. They don't start with the genitals...the process is slow and begins with a kiss. Teaching a child to use their mouth helps them to answer 'no' to the polygraph question "did you ever touch a child". A single statement that defined the depravity.... 'babies like to suck'.
One of the statistics I learned was that for every one adult that learns about child abuse, ten cases of abuse are prevented. Read this and pass it on to your friends. To read more about sexual abuse of children see my past blog and the American Academy of Pediatrics website . Help me stop this. Please.
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