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Straight, No Chaser: The Initial Response to Sexual Assault

By Jeffrey Sterling, MD November 19, 2018

sexual-assault
There are few more tragic human interactions than a sexual assault.  The physical and mental issues are both challenging and dangerous.  Unfortunately, the response during the initial period of grief and shock often leads to circumstances that complicate matters even more.  The purpose of today’s blog is only to provide you with information and tips to ensure that those initial actions don’t compromise a victim’s chance to get physically better and appropriately evaluated in a way that allows evidence to be collected.  To that end, I welcome to Straight, No Chaser as a guest collaborator Dorothy Kozakowski, Vice-President of the Illinois Chapter of the International Association of Forensic Nurses, a specialist in substance abuse, sexual assault and domestic violence detection. She also heads Forensic Sane Services, providing care in Chicago and throughout Illinois (www.forensicsaneservices.com).
Sexual assault survivors are most often in shock immediately after the event and tend not to consider themselves as victims of a crime.  Feelings of guilt, shame and physical injuries may cloud one’s judgement and lead to inappropriate actions.  There are often additional factors in play.  The victim may still be in danger or captive.  The victim may have lost consciousness or may be under the influence of various illicit substances.
Assuming that the victim is able to overcome these obstacles, and the anxiety and fear associated with publicly alleging an assault has occurred, there still are multiple challenges to overcome (It is important to point out the power of the phrase ‘alleged assault’.  If the act isn’t proven, the consequences of an unproven accusation often lead to even more problems for the victim, and the fear of such may be so powerful that it inhibits the victim from reporting the event.).
For the purpose of this post, we simply want to advise you on initial steps to take to both protect yourself and secure the chain of evidence, thus giving any future prosecution the best possible chance to catch the perpetrator.

  • Remove yourself from the situation ASAP.  Sexual assault is an act of violence, and you should consider yourself to be in danger.
  • Go immediately to the emergency room, local rape crisis center, or other designated facility suitable for an evidentiary examination to collect physical evidence.  If not immediately, certainly within 72 hours.
  • Go as you are. Do not engage in activities that may destroy important evidence that can be used to identify the perpetrator, such as urinating, defecating, vomiting, douching, removing/inserting a tampon, wiping/cleaning genital area, bathing, showering, gargling, brushing teeth, smoking, eating, drinking, chewing gum, changing clothes, or taking medications.

Post-script: The authors have been involved in sexual assault work for years.  Sterling Initiatives is proud to have implemented the first Sexual Assault Nurse Examiner program in the state of Connecticut and to have made similar initial pioneering efforts at major trauma centers in Texas and Wisconsin.
The trauma of sexual assault is only made worse by perpetrators getting away with the act, which unfortunately occurs in 15 of 16 cases, largely because reporting doesn’t occur and/or evidence is destroyed. Please consider the information provided should you or a loved one ever find yourself in harm’s way in this manner.  We welcome any questions or comments you may have.
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0 thoughts on “Straight, No Chaser: The Initial Response to Sexual Assault

    1. Hi, Darla. I would guess over 1000 patients. Back in the various county hospitals, it was not uncommon to see several patients a day. Even so, it is so unfortunate how under reported these episodes are. Thank you for your question, and thank you for following Straight, No Chaser.

  1. So many women don’t report rape because they know that they will be victimized twice. Once by the perpetrator, then by the system that is in place to seek justice, but only works to make them feel as though it is their fault. 🙁

    1. Hi, Stephanie. Although what you say has been often shown to be the case, respectfully that is somewhat of a defeatist attitude. Patients need to be empowered to have the best opportunity to bring the perpetrators of this violence to justice. Services that use SANE programs and are otherwise committed to patients’ rights, offer the best opportunity for treatment and justice and should be taken advantage of. The only thing that is certain is that suffering in silence guarantees no conviction. Thank you for your comment, and thank you for following Straight, No Chaser.

  2. As you noted, for so many survivors, it takes a huge amount of courage to not only acknowledge the victimization to themselves but then to also seek help and report to law enforcement. Thank goodness there are sensitive professionals willing and available to assist! You are an invaluable part of the transformation from “victim” to “survivor.”

    1. Hi, Dee. Very well stated. I really hope those in need don’t believe they can’t receive help or pursue prosecution. That mentality would only empower those inclined to perpetrate additional violence. Thanks for following Straight, No Chaser.

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