Comments about Luka's patientgreenspun.com : LUSENET : ER Discussions : One Thread |
I read with great interest "the comments on THE VISIT" and several comments were about Luka's patient and his reaction to her. One comment was "she doesn't look like a 7th grader." Haven't you ever met the kids that physically mature faster and think "she looks 18" or "he looks just like a baby"? I certainly have--I'm a OB nurse and I have taken care of 15 year olds that look 25 and 20 year olds that look 12. The other comment was about Luka "just assuming" --wrongly--that it was the father that was abusing her. For those of you not in the health care profession, let me assure you that domestic abuse is a hot topic these days. In the OB field, much is in the literature about taking this opportunity to #1 ASK the questions---most health care professionals are uncomfortable asking if a woman has been hit, slapped, beaten, or verbally abused. In the case of this girl, it was obvious that SOMEONE hurt her and she wasn't talking. Also, as in most cases of child abuse, the first person to look at is the parent or primary care giver. In this case, the father was hovering (as many abusers do) and not wanting to leave her alone (when she might talk about what happened) and there was no mother in sight. I think Luka did the right thing about trying to talk to her alone, reporting the incident to the police (because she was a child). The girl was constantly defending her father without offering any other explanation which was also suspicious of her father being the abuser. I liked that Luka went back to talk to her alone to ask more questions, although his speech about people sometimes being unable to control their anger was so obviously hard for him (as someone else pointed out--he knew how ironic that was for him to say that). And the look of utter disbelief in his eyes when she said her abuser was a boy in her homeroom class, another 7th grader, was amazing. Talk about someone saying more with an expression than with words--kudos to Goran Visnijc!By the way, I just learned in a conference yesterday, that in the state of Texas, domestic abuse cannot be reported unless the woman gives consent, UNLESS the "woman" is 14 years old or under in which case, it is considered child abuse. If she is under 17 and pregnant and the father is more than 3 years older than her, he can be prosecuted for statutory rape. I'm sure that each state is different and laws can change, but you can see where things get very confusing for the care giver: the person abused may not recognize the behavior as abuse--it may be her "norm", the caregiver often only SUSPECTS abuse because the patient's story isn't consistent or doesn't seem to ring true, and the legalities are confusing.
Just some thoughts, sorry about the length of the post.
-- christine (cmniekamp@aol.com), November 18, 2000