Sunday, February 26, 2012

Child Abuse

It's hard to stop thinking about it. It's heartbreaking. How could we let it happen? How can a teenager live with all this? The news reporting has been full of it.

A 15-year old girl was found walking barefoot and wearing pajamas. A man stopped his car to help her and ended her terrible ordeal. He took her to the police. The girl had escaped from her home after fearing that her stepmother would throw her down the stairs.

The story unfolded, as described in the link above. The girl had been imprisoned and beaten in the basement by her father and stepmother, with no bathroom other than a box, and not allowed to eat, since she was ten years old. Her eighteen-year-old stepbrother had sexually assaulted her since she was ten years old. She ate garbage when she could. She weighed seventy pounds and was said to be starving.

This scenario took place in Madison, not inner city Milwaukee. The people are white, not black or some other race. While they don't live in my neighborhood, in a way they are my neighbors. We are all members of the human condition. The human condition includes providing our children with the basic necessities of life, including a safe and nurturing home. This girl's family failed her.

The girl didn't go to school. She didn't go anywhere. Her biological mother had given up custody because she was married to a sex offender. Her father didn't love her enough to give her a chance to live a normal life. Abandonment and abuse are scars she will carry for a long time.

It calls to mind the story of Jaycee Dugard, who was abducted, imprisoned and sexually abused in California a few years ago. Jaycee Dugard escaped back to her loving family. Both Jaycee Dugard and the Madison girl were not found by the safety net of social workers who came to their homes because they were monitoring someone in the home, Dugard's captor, and the fifteen-year-old girls stepbrother. The system failed both girls.

Jaycee Dugard gave birth to two children fathered by her captor; the Madison girl was so malnourished that police said she had not entered puberty by age fifteen.

Something is terribly wrong with people who are entrusted with children, and yet they become cruel predators. The court system is dealing with the family of the Madison girl, but it can not give back the interrupted life she didn't have. Foster care is likely to be a better alternative than her own family. But what will go on in the heart of a girl who has been so badly violated, as she lives into adulthood? Hillary Clinton once said that it takes a village. This girl will need the whole human village.

Friday, February 17, 2012

Patti Brennan's Cave

This morning I actually got excited about science.  Thanks to Wisconsin Public Television, I watched a program that made a difference. In contrast to the usual banality of television, I saw my friend Patti Brennan in a panel of people representing various science disciplines. Usually I don’t connect with science presentations more difficult than the level of Animal Planet, but here were men and women who were talking about collaboration.

Patti Brenan is a nurse, and more than a nurse. Calling her a nurse is like calling cake straw. She is a teacher of nursing at the University of Wisconsin-Madison and much more. On this day, rebroadcast from December, 2010, she talked about collaboration of medical practitioners and home care. This was exciting to me. If I understood her correctly, she was saying that the trend now is to keep patients in the hospital for shorter time periods and have them recover at home earlier than had formerly been done. Her vision was to create virtual environments that she called caves. The cave would be created after someone in the medical field recorded visually the home environment of the patient, to give a better picture of the home environment’s ability to manage the patient’s needs. She pointed out that homes sometimes are not well adapted to recovery situations. How is the home set up for locating medications; does the home have space for a patient’s elevated leg without tripping someone; is the kitchen arranged well for doing what is needed; do you have to put important equipment on the living room coffee table? And so on.

The cave Patti described would show these things and others that normally would not be in a person’s range of view.  She said something like, suppose I’m here and you’re over there and both are seeing different views. The cave would bring them into one viewing range. This would enable medical people to assist the person in the home with accurate ideas of the person’s recovery environment. It would be virtual collaboration of the patient at home and the appropriate medical person. Wow!

To me this sounded wonderful. I might add that Patti explained all this in a few minutes in a way that a non-professional like me could understand. It seemed like a really good way to enable a recovering person to be at home without feeling cut off from medical assistance, and also a way for the patient to avoid making mistakes due to limitations of the home environment. I really liked Patti’s cave idea. I think she was describing some ongoing research that people in her field are doing in collaboration with some other scientific disciplines, so that something like this could actually happen.

My experience with this situation is limited. After my (now deceased) husband had knee replacement surgery in 2001, one knee at a time, not both the same day, he came home. A nurse came in and showed him and me how to do the recommended exercises. She did some medical checking on him. That was good. But as I remember it, that was about all. We were on our own. The cave would have been helpful and reassuring.

Again, the same husband went on kidney dialysis a couple of years later. He went to the dialysis center several times every week, where the medical people performed the service with what looked to me like a lot of equipment. After several years, he came home and said that the people at the dialysis center suggested that he have his dialysis done at home. Immediately I was terrified of being left alone with this monster machine. I felt huge trepidation at the thought of being the one who would use this device to keep him alive. No details on how to accomplish it came home with the suggestion. In theory, home dialysis sounded like a good idea. In practice, I would have felt better with Patti’s cave if it had existed. I declined the invitation. The cave is an outstanding idea.

The other presenters in the televised panel talked about ways to use science to accomplish collaboration among science professionals.  I was impressed with the anthropologist who talked about how people who work together across discipline lines need to address language issues. They all have their own specialized vocabularies. I saw this as a second major point in the discussion. Medical people sometimes talk to their patients in language that seems obscure and unhelpful. The doctor/nurse professional and the patient create another cross-professional situation. (The profession of the patient is to be an ordinary human being.) What does it mean when the nurse asks if a person had any emesis? I think the common patient response would be, “Huh? Are you asking if I puked?”

Since I am healthy, I don’t experience some of this, but I am impressed that all the panelists in the presentation who represent different approaches to science actually are trying to do things together. I am extremely impressed with Patti’s way of sending her vision directly home to me.

Thanks, Patti. Thanks also to Wisconsin Public Television.