Tough Job, Tougher Women

Sue Rotolo’s eyes are the first thing you’ll notice about her; they are almost impossibly blue, and glow lightly beneath red hair.  Her smile is easy and warm, and she has an enviable air of serenity, whether in the presence of an eight year-old rape victim about to be forensically examined or an aggressive attorney attempting to lock her down on cross examination.It’s a good thing.  That Zen-like calmness serves her well.  In the clinic, her job as a Sexual Assault Nurse Examiner (with the odd acronym SANE) is to treat patients who are victims of sexual violence.  In the courtroom, she testifies as an expert to what she observed and what it might mean legally.  Ask her which job is more difficult and she’ll likely tell you the courtroom; it’s less predictable and more brutal.  It’s at times a tongue in cheek response, but it’s no less true even if a little bit funny.Rape, after all, doesn’t usually happen between 9 and 5 weekdays.  SANEs are torn from their beds, their loved ones and their lives to provide hands-on care to people suffering some of the worst trauma imaginable.  It happens in every combination of off hours, holidays, weather and traffic.  In the crush and tangle of Northern Virginia where I learned from Sue the business of forensic nursing, a trip to Inova Fairfax Hospital can take hours from two towns over in the wrong circumstances.  The patients are at times tragically young or old (Sue’s youngest was about three months). Some are combative, some intoxicated.  Some giggle.  Some beg for relief from any number of things that haunt them, real and imagined.  Sue, and the nurses who work for her, see them all.And nevertheless, it’s us, the lawyers, who create the ultimate crucible for a woman in Sue’s crew who wants to be a SANE.  It’s the contact sport of criminal litigation- often at its most bitter and belligerent in cases of sexual assault- that drives many hopeful forensic nurses out of the business.  Attorneys often treat them, because they’re “just nurses,” with far less than the respect they merit (most doctors, unless they specialize in forensics, are much less valuable on the stand in a rape case than an experienced SANE).  They’re attacked mercilessly for being everything from sorority-like “little sisters” of the police and prosecution to man-hating zealots or glorified candy-stripers.  Every cruel and gender-based stereotype that can be slung at them from the male dominated world of trial law is done so.  The successful ones realize early on that testifying is yet another skill- completely discrete from anything else one does as a nurse- that must be mastered in order to survive.  Sue has one iron rule- no crying on the witness stand.  I worked directly with her nurses for years and never saw it broken, even when I knew I’d have been reduced to sobs had I been where they were.The ones who do survive the process make healing differences in the lives of their patients few will ever match.  Rape has always been difficult to report, but prior to SANE programs (an adjunct of the woman's and victims movements of a generation ago) it was at times tantamount to a re-victimization.  Victims waited for hours, triaged behind whatever nightmares took precedence in the ER they found their way to.  Many physicians were unable or barely willing to conduct the examinations both for treatment and possible evidence collection, and they wanted no part of the legal process. Victims were judged, ignored or even threatened with arrest depending on how they presented.  It was more than wrong, more than something that worsened experiences and deepened the pain. It also killed cases and drove victims underground.  That allowed attackers to escape justice and rape again; most rapists don’t stop at one.The idea of SANE programs is to specially train nurses to treat and examine patients whose chief complaint is sexual assault, and to evaluate the body as a crime scene, collecting potential evidence for investigation and trial.  As an invaluable plus, the exams are conducted in a safe, private and dignified setting where the person at the center of the case can begin to heal, and regroup.  With the help of victim advocates who provide the emotional support and ties to other services they need, the process, when it’s done right, produces a better, stronger witness for us and a sex assault survivor with a fighting chance at looking at life at least similarly to how she did before.It’s still an evolving process, and I’ve been blessed to work with some of the finest women I’ve ever known in the building and sustaining of the programs and their interaction with the legal system.  From Jen Markowitz in Ohio, Eileen Allen in New Jersey, Tara Henry in Alaska, Pat Speck in Tennessee, Jen Pierce-Weeks in New Hampshire, Jacqui Calliari in Wisconsin, Diana Faugno in California, Elise Turner in Mississippi, Linda Ledray in Minnesota, Karen Carroll in New York and dozens of others, I’ve learned more about the relevant anatomy and reproductive health then I ever thought possible, and we’ve broken bread and self-medicated together in more places than I can remember.But it was Sue, with her bright eyes, warm smile and unflappable mien who taught me with plain speech how to drop my blushes, learn the anatomy, pronounce the terms, protect the truth through her testimony, and do my job.What Sue has done literally thousands of times is probably best exemplified by a story she sometimes relates in training regarding an eight year-old girl who had been sexually abused by a family member.  After being examined by Sue in an invasive but tender and careful manner, the child asked her how bad she looked inside now that she had been made bad by what had happened to her.“Honey,” Sue said, “you are perfect inside.  And you’re perfect outside.”That child may forget the lawyers, the judges, the police officers and the numbing, contentious process that played out above her.  She will never forget the abuse.  But God willing, she also won’t forget the blue-eyed lady with the stethoscope; the one who reminded her of the most important thing of all.