Saturday 17 March 2012

Silence Hides Violence

"33 year old female, chest pain"

NB: This post is about Domestic Abuse, so for anyone who has been a victim or knows someone who has, reading may cause distress and provoke painful memories.

We were trundling back to station towards the end of our shift when we got sent the job. We were only a couple of minutes away so were on scene quickly. The address was given as 'above the shops'. Flats above shops can often be very difficult to access, mainly because the entrance is nowhere near the corresponding shop number. This particular flat was accessed via the rear of the shop from an alley way. After a few minutes of looking we found it, but had walked a considerable distance from where we had left the truck. I went in to see our patient whilst my crew mate went to move the vehicle closer. I was greeted at the door by our patient's husband. He was a polite guy and gave me a very full handover of what had occurred. She suffers with anxiety and had a panic attack, but had some residual chest pain. Which seemed reasonable. I entered the bedroom and Claire was sitting on the bed. It was obvious she had been crying and appeared very timid. Her voice was quiet and shaky. I started asking my usual questions about the chest pain whilst trying to get her to slow her breathing down. She said the same as what I had already been told but wasn't giving me very clear answers about her symptoms or cause of her anxiety. I became aware that before and after everything she said she was looking over my shoulder. Her husband was standing in the door way and it was obvious to me she was holding back. 

A couple of moments later there was a knock on the door. My crew mate had returned. Claire's husband went to let him in and I turned to her and said:

"Do you want me to get you out of here?"

She simply nodded and the expression on her face said it all. She was desperate to get out of the flat. She was terrified. I offered to take her to hospital and her husband was very quick to interject.

"She doesn't want to go to hospital, it was just a panic attack"

"That may be but she still has some chest pain and at the very least we need to do an ECG"

"Then do it here, she doesn't need to go to hospital, she needs to rest. The last crew did the ECG here"

(Lying through my teeth) "I'm afraid we can't do it in here, we have no batteries so it needs to remained plugged into the ambulance"

His tone had changed, it was rather intimidating. He was a big guy and clearly objected to my suggestions and started acting in a very aggressive manner saying she didn't need to go anywhere, and that we were no longer needed.

"Look, she has chest pain, she needs an ECG, and that's what we are going to do. One of the best cures for a panic attack is leaving the environment in which it occurred. In this case, stepping outside for 10 minutes could do her the world of good."

With that, I basically ushered her out of the room and out of the flat. He began acting rather frantically and marched out after us.  We got Claire on board and he tried to push his way on. We managed to close the door on him and lock the truck. My crew mate clambered through to the front and started driving off out of the alley way. Her husband was screaming and shouting, punching the back door. I called for urgent police and we drove off down the road and out of harm's way.

Claire burst into tears. While we waited for police she disclosed years of abuse. She showed me the bruises, strangulation marks & scratches. She had suffered since the day after their wedding 6 years previous. He was controlling, possessive, she had no freedom at all. He used to take her to work and pick her up afterwards but had stopped her working 2 years ago. If she did anything he didn't like he would beat her. If he got drunk, he would beat her. If she answered back he would beat her. She feared for her life but was too scared to walk away. He had threatened to kill her should she leave him. She had no friends and no family in the country and not a single soul knew of her suffering. She wasn't allowed to socialise, she wasn't allowed any money. She was basically his prisoner. She had suffered physical, emotional and sexual abuse on a daily basis for her entire marriage. It was gut wrenching to hear. How can anyone cause so much pain and suffering to another? How can anyone be that cowardly to torment and abuse someone who is so powerless to stop them? How can a man do that to his wife? She had attempted suicide on a number of occasions as it seemed the only way out. Each failed attempt came with it a beating and more threats. As she sat there pouring out everything she had been bottling up, I could see what a relief being able to do so was. She was still terrified but had finally found the strength to put an end to it. Her suffering would end here, although it would be a long journey of psychological recovery ahead. 

Domestic abuse is far too common. I see it on a number of different levels at work, be it emotional, physical, economical or sexual abuse. It is horrible to see and often very challenging to deal with. That said, the emotions I feel when seeing the consequences of it, pale in significance when I think about what the victim has suffered. So often the abuse is painfully obvious but denied by the victim through love or a continuing sense of loyalty. This particular job was some time ago. It was one of the first instances of abuse I had seen and it wasn't until I decided to write about this topic that I found out exactly how common it is and what effects it has, not only on the victims, but also on the NHS too: 
  • Domestic violence accounts for between 16% and one quarter of all recorded violent crime. 
  • One incident is reported to the police every minute. 
  • In any one year there are 13 million separate incidents of physical violence or threats of violence against women from partners or former partners. 
  • Women are much more likely than men to be the victim of multiple incidents of abuse, and of sexual violence.
  • 54% of UK rapes are committed by a woman’s current or former partner. 
  • On average 2 women a week are killed by a male partner or former partner: this constitutes around one-third of all female homicide victims. 
  • The cost of treating physical health of victims of domestic violence, (including hospital, GP, ambulance, prescriptions) is £1.2 billion, 3% of the total NHS budget. 
  • Between 50% and 60% of female mental health service users have experienced domestic violence, and up to 20% will be experiencing current abuse.
  • Domestic violence and other abuse is the most prevalent cause of depression and other mental health difficulties in women.
  • Domestic violence commonly results in self-harm and attempted suicide: one-third of women attending emergency departments for self-harm were domestic violence survivors; abused women are five times more likely to attempt suicide; and one third of all female suicide attempts can be attributed to current or past experience of domestic violence.

The statistics alone speak volumes but seeing it first-hand makes me extremely angry. Any kind of bullying is disgusting and seeing someone so gripped by fear emotes all sorts of feelings. Sadly, it is prevalent in all walks of life, across all age groups, and can take a number of different forms including emotional, verbal and physical abuse. As the world develops so does bullying and with the ever growing world of social media it is becoming more and more prevalent; be it subtle digs and intimidation online or physical violence in person, the lasting effect on the victims are the same and domestic abuse is merely bullying within an intimate relationship. It is picking on someone and making their life a misery for personal satisfaction. Intimidating someone to the point where they put up with it, through fear of repercussions, is what these thugs rely on. I don't know the outcome of his arrest, but the police were confident that he wouldn't get away with it. What also concerns me is the reliance these women (and men) have on the NHS, especially that of the already under resourced mental health services. I shudder to think what effect the inevitable NHS Bill and subsequent privatisation will have on the accessibility and affordability to these services. Only time will tell. There was an interesting article in the Guardian regarding the impact the government cuts will have on the help that is available to victims (click to view). The suffering of many will not stop though. It will continue behind closed doors and will continue to go unreported, often until it is too late. That is the tragic reality of the world we live in. All I can do, and all anyone can do, is encourage victims to come forward as and when we become aware of it.

If you, or anyone you know, is suffering or has suffered domestic violence or abuse please please please contact the 24 National Domestic Violence Helpline either by phone or on line.


0808 2000 247

1 comment:

  1. Any post that highlights the prevalence and nature of domestic abuse is important, but reading your account is particularly interesting, you don't hear so often from the people that attend to and handle these situations, and I can imagine it is often very difficult to get the truth from within the very closed and controlled circle the abuser builds up around the reality. Thankfully this woman was clearly ready to talk and found someone she could trust and feel safe with to do so, that is an accomplishment in itself, and as you say the threats put ahead with the NHS Bill is worrying, getting access to much needed services is under threat, already domestic refuges are having to turn away hundreds of women PER DAY because of funding cuts and the economic downturn, a good article on this is here http://www.guardian.co.uk/society/2012/jan/31/domestic-violence-victims-risk-cuts, yet these very conditions serve as a catalyst to violence in the first place (amongst others)
    I was impressed you discussed how it occurs within all walks of life, all ages, all sexes, and all social groups, it isn't a choice, or a weakness, and it isn't all about violence, but is a complex development of control, bullying, belittling and slow but sure removal of confidence to the point where victims often doubt they are actually in an abusive relationship they are so enveloped in it. It has lasting effects even if you're lucky enough to escape relatively "unharmed". Definitely discussing it, sharing experiences and putting the support and encouragement out there on all levels serves to help one step at a time x Thank you

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