Taking Away Choice — The Wrong Answer to Domestic Violence

By Meg Stone, MPH. Stone is the executive director of IMPACT Boston, an organization that works to prevent violence and abuse by giving people the tools to protect their safety and advocate for healthy relationships and sexual respect in their communities. A long-time domestic violence advocate with a degree in public health, she has, in her own words, “a strong interest in raising awareness of the issues facing women who present to emergency departments with injuries related to abuse. My professional background includes training nurses and first responders in asking about domestic violence and documenting incidents of abuse on medical records.”

This post is longer than our usual, but we thought it was worth running in entirety. The names and identifying details of those mentioned have been changed.

by katietower/via Flickr

In the mid-1990s it was rare in most places for nurses and social workers to call domestic violence organizations when women came to the emergency department with injuries related to abuse. I only remember one call from a hospital social worker in the upstate New York town where I worked as an advocate at the local battered women’s program.

Carolyn, the director of the battered women’s service, called me at home on my day off. Nobody else was available, she said, so could I please please please go. The future of our relationships with hospitals depended on our ability to get there when they needed us. I was excruciatingly dependable, powerless against please please please. My trip to the hospital would be another example of a domestic violence organization held together by people who can’t bring ourselves to say no.

The social worker met me in the waiting room. As she led me through corridors past triage stations and hospital beds I tried not to look at any of the people with tubes in their noses or blood seeping through bandages on their heads. When we got to Helen’s room she was sitting on the bed with her arms tightly crossed. She looked only at the floor. All the information we had about the incident had come from Helen’s brother and his wife Renee, who had walked into the house and interrupted it. 

After close to 15 minutes of Helen not speaking, Renee motioned for me to join her in the hallway.

“It’s hard seeing her like this, it just brings me back, you know?” Renee said. Tears eroded the thick black makeup under her eyes. Renee told me her first husband had abused her. She hadn’t seen him in more than five years, but was still alarmed every time she saw a man with a mustache the same color as his. Renee suspected abuse when Helen came to a July 4th gathering in a turtleneck. She remembered her own years of sweating under long-sleeved shirts to avoid having to make up stories about the bruises on her arms.

“We need to get her away from him as quickly as possible,” Renee said. “I can’t go through this again.”

“It’s great that you care so much about her,” I said, “Do you think they’ll keep her here long enough for you to go back to her place and pack her stuff?”

“My husband will stay and make sure she doesn’t leave.”

I didn’t ask any questions about what Helen wanted.  I was just relieved to hear Renee say, “Thanks, you’ve been so helpful.”

It’s understandable that Renee and I wanted to get Helen away from her abuser as soon as we could, but the way we treated Helen was similar to the way abusers treat their partners: we took away her choice.

If we think of domestic violence as an onslaught of physical assaults perpetrated by someone who is always cruel, it’s easy to wonder why women stay. If domestic violence were that straightforward I doubt it would be the epidemic it is. If you live with abuse long enough, wondering whether the person you love most will inflict bodily harm upon you feels about as normal as wondering if it will rain. Most abusers are kind and attentive sometimes, physically violent other times. Most make threats that are so vivid and plausible that their partners are more afraid of what might happen than what actually does. Sometimes a woman feels safest when she is close. She can read his body, look for clues in how hard he squeezes the toothpaste tube or how loud the door slams when he walks out of a room.

For many women living with abuse, the other choice is poverty, sometimes homelessness. According to the National Center on Family Homelessness, between 50% and 60% of mothers living in homeless shelters are fleeing domestic violence. If I had to decide between abuse and poverty, I don’t know what I’d do. I do know I wouldn’t want anyone making that decision for me, no matter how much they loved me or how dedicated they were to stopping domestic violence.

I could have told Renee that insisting that someone leave doesn’t give back the power the batterer has taken away, that nobody leaves unless she is ready. I could have stayed with her in the hallway and listened to her talk about her own experience of abuse. I could have given Helen the 24-hour hotline number, told her she could call any time; that she didn’t have to want to leave her husband to get support. But helping in those ways didn’t make me feel like I’d accomplished anything. If all I did was write down a phone number or have a conversation, would the social worker think I had helped? Would she call battered women’s service again?

That I lost sight of Helen was not surprising—it was Carolyn’s crisis that moved me, not Helen’s. I would like to believe that if Carolyn called today I would not be as desperate to look like I was taking action. But seven years into a career in public health, I am the director of an abuse prevention organization, and when I hear about women’s struggles and successes I too often think about the point I want to illustrate. At least once a week I package someone’s grief to make it appeal to a donor, a legislator, a medical provider, a school administrator. I’m doing the right thing. People’s stories are often the strongest arguments we have to advance the social and institutional change we need. Still, I try to think of Helen and Renee as often as I can. It reminds me to do my work in a way that doesn’t take away choice.

Editor’s note: the last few (crucial) sentences were accidentally omitted from the version of this post that went live earlier today. This is now the correct version.

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2016-11-21T13:16:11+00:00 August 10th, 2010|Nursing, patient engagement, Patients|1 Comment

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One Comment

  1. C. Heard August 17, 2010 at 2:50 pm

    Moving, disturbing. Drives home the trap of abuse.
    Thank you.

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