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I was waiting as the paramedics arrived and handed over an “approximately 20-year-old female, unknown identity, found unresponsive in street with head injury”. 

I start work on auto-pilot; A-B-C-D-E, her airway, breathing and circulation stable,  I move on, she is unconscious but safe, her large pupils reacting to the light I use when I open her eyes, her hands moving towards the painful stimuli and she groans when I do this. This is my routine; a pattern of examinations and tests I do on the multiple similar patients I see nearly every weekend late shift. 

As we start to cut her clothes off something changes from the normal; I notice bruising to her upper arms, subtle scratches and redness at the base of her neck, and lastly, large bruises shaped as fingerprints on her inner thighs. I know what we find next, why her leggings aren’t straight and why her underwear isn’t pulled up correctly, and I turn and walk away. 

I feel my pulse quicken, my pupils dilate so my vision is blurred and my hands become sweaty. I stand outside the curtain to steady my breathing and I attempt to use my normal tone of voice to tell the nurse I will be back in a moment once I have requested a scan to check there is no brain injury.

Every single part of me wants to run away, to get out of the hospital and keep moving, to scream and only stop to vomit before I run as fast as I can. But I can’t, there is no one else, this is my job – my responsibility. I feel a vulnerability I try to keep buried deep. I think to myself,  “I don’t want to do this anymore,” but what I am really afraid of is that people will know, will see my shame and  pity me and make adjustments. I don’t want my colleagues and friends to see the word ‘victim’ printed on my face, one that I try so hard to mask every day. I realise that I believe I should only be seen as strong, infallible and undamaged by my patients and colleagues. I believe to be anything else, to be human, would be to let people down.  

I often wonder how I can reduce the shame and guilt I feel to be able to talk about this as part of my life story. It has been many years since I was changed, since I was damaged. I knew at a young age the world could be a violent and cruel place. I spent the rest of my early teenage years acting with reckless abandonment, the worst had already happened, the pain was so deep I felt untouchable from anymore. I learned a lot during this time, but mostly that everyone needs human connection, however hurt and damaged you are. It was around this time I decided on a vocation where I could listen to people and care for them.

I continue to look after my patient that day, I hold her hand as she wakes up and I sit with her hours later and explain what I have found with a police liaison officer. She cries and tells the police she just wants to go home; she won’t get any forensics taken and she won’t make a statement. She won’t let us call her friends or family.  I try to convince her, I know she will probably regret this in her future, but I also know she feels scared and vulnerable and I can’t add to that by putting more pressure on her. I manage to convince her to stay to have her wounds assessed by the gynaecology team and thankfully they do not need formal closure. I prescribe her emergency contraception, give her information of where to seek help and guidance on what to do next and where to be tested for STDs. I watch as she walks off into the world on her own; a different person than the young woman who went out the previous evening.

I cry on my way home, the kind of crying where you can’t breathe and your body shakes and you wonder if it will ever stop. Nearing the end of my journey I stop outside the house where it happened all those years ago.  I pull my car over and I realise that I don’t know who I am crying for, and this is the first time I have felt anything but shame, guilt and fear over what happened to me. I finally grasp some understanding that I was just a child and just like my patient,  blameless for what had happened to me. This feels like a defining moment  and I feel a tiny bit of the shame I have carried for so very long, lifting. 

A few years have passed since I looked after this patient. I often think of her and I hope she did return to the police and seek justice for what happened to her that day. I don’t, however, think any less of her if she didn’t. Reflecting on looking after this patient allowed me to see my story in a different light, to see myself not only as a victim but someone who has been successful in the face of adversity. I understand that my vulnerabilities make me human, give me empathy and probably make me a better clinician. I have to acknowledge that whilst I wish this had never happened, it has formed part of who I am, allowed me to be comfortable in the presence of pain and suffering and ultimately may even be part of what bought me into this vocation.  I may not have sought help, but I will be the one waiting for those who do. 

Sometimes, perhaps in looking after others, we can recognise our own narrative reflected back at us. In seeing that story from another perspective, we can find the compassion we need to show ourselves. In helping others we can maybe heal a tiny part of us too.