Some patients seem to lodge forever in my memory, prompted into my consciousness by happenstance cues from the outside world. And others -- those who have variously shaped my identity as a doctor -- steadfastly reside in the forefront of my awareness, routinely accompanying my thoughts and influencing my view of the world.
One of those latter patients was a young woman I met 30 years ago in a Chicago hospital's emergency room. That hospital -- Michael Reese -- no longer exists. But one room within it -- the one in which we met -- remains solidly constructed in my memory, the details of the woman's face, the room's furnishings, the floor tile and wall color all painfully clear.
It was a warm Saturday afternoon, the kind of slow summer day that typically lured Chicagoans to the lake or Navy Pier. I'd been up all night as a medical resident in training, my green scrubs wrinkled, caffeine keeping me afloat.
The young woman was to be my last patient of the day. I grabbed her chart from the ER nurse and read its sparse contents on my way to her room. I learned that she was 18 years old and living in the housing projects adjacent to our hospital. The intake nurse had recorded the patient's chief complaint as "SA" -- letters of unknown significance to me.
But their meaning became instantly clear when I entered the young woman's room. Dressed in a pale hospital gown, she sat rigidly on the edge of the gurney, her legs dangling motionless and barely contacting the floor. Her every facial muscle clenched while tears dropped unceremoniously onto her lap. She stared at a bare patch of wall a few feet away and said nothing when I introduced myself.
Evidence of prior commotion surrounded her stillness. Discarded iodine swabs. Crumpled medical supply wrappers on the desk. Blood-tinged towels beneath the gurney. And "the rape examination kit" wide opened.
On this sunny Chicago afternoon this woman was in our ER, being questioned by police and probed by strange doctors. Blood and cervical samples had been taken from her body, checking for sexually-transmitted infections. A "baseline" pregnancy test was being processed.
The woman's stunned angry silence was as diagnostic of trauma as any "kit" could ever be. Closing her chart and deciding to forgo the usual litany of medical questions, I just sat down and said, "I'm sorry." And then I waited, my chest aching, my own anger expanding.
"I was just coming home from the grocery store," she finally said. "They were waiting for me in the stairwell."
She spoke matter-of-factly, as though describing a remote event. And without a hint of self-pity she continued, "I know them, too. They live down the hallway from me and my grandmother."
Over the next few minutes, I'd hear about the milk and bread she saw tumble down the stairs when she was thrown to the ground. How she called out the names of the men raping her, begging them to stop. How she feared telling her grandmother about what had happened because it would upset her too much. How, after her attackers left, she found herself simultaneously wondering whether it was worth reporting her rape to the police, and whether she had enough change to repurchase her grandmother's lost groceries.
Then she turned to look directly at me and said, "Thanks for listening. I don't even know you."
Tears in my eyes, I offered to stay with her until she was medically discharged to her home. During our wait, she described how she had dreamt about becoming a nurse, and the first in her family to graduate from college. And while she had always anticipated racial and financial obstacles in her way, the rape now made her feel decisively helpless about controlling her own future.
What I'd like to report is that my former patient ultimately experienced healing and justice. That she's working as a nurse, pursuing her dream. I'd like to say that she and her grandmother found a way out of the projects, into a safe home from which trips to a supermarket did not risk life-endangerment.
But I don't know. She never showed up in my clinic or phoned my office, though reassuring me she would.
Still, I try to keep my promise to her. When I'd asked how I could help, she replied that listening had been "enough." But she quickly added, "Do whatever you can to stop what happened to me from happening to anyone else."
So, with her voice now accompanying mine, this column recognizes April's designation as "Sexual Assault Awareness Month." We encourage everyone to take a stand against sexual violence and the 207,000 rapes and sexual assaults that occur annually in this country alone.
We insistently claim that sexual assault -- any nonconsensual physical or verbal act against someone's will -- is never OK, no matter whether the assailant is a spouse, a parent, a beloved teacher or clergy member, a boyfriend.
And we remind women -- and men -- who are sexually victimized, that there's someone willing to listen and help.
To speak with an advocate, call:
The National Domestic Violence Hotline at 1'800'799'SAFE (7233) or TTY 1'800'787'3224
The National Sexual Assault Hotline at 1-800-656-HOPE
Kate Scannell is a Bay Area physician and the author, most recently, of the novel "Flood Stage."