At NCB, a Sexual Assault Program Others Seek to Replicate
By Jordan Moss
Jan Propper remembers the night a woman came into the emergency room at North Central Bronx Hospital (NCB) with a black eye. She was hostile, uncooperative and she wouldn't let Propper touch her.
But then Propper, a physician's assistant, asked the woman a simple question that changed everything: "Were you sexually assaulted?" She said she had been.
"Then the whole system got activated," Propper said.
That system is the Sexual Assault Treatment Program, the only one of its kind in the borough. The 24-hour-a-day program, launched two and a half years ago, couples state-of-the-art medical treatment and evidence gathering with advocacy and counseling. It is so well respected that the Bronx district attorney's office regularly relies on the expertise of North Central staff in prosecuting sexual assault cases, even ones involving patient at another Bronx hospital.
NCB staffers hope the program, with its trained team of five attending doctors, physicians' assistants, and social workers will be designated a Center of Excellence under the state's new Sexual Assault Reform Act so that a victim anywhere in the borough will have a better chance of being directed to NCB or other hospitals that develop effective programs. Now, whether or not a victim ends up at NCB is only a matter of luck.
If a patient does enter the NCB emergency room, she is assigned medical personnel - trained as sexual assault examiners - who are cleared of all other responsibilities until the patient's medical needs are met.
The director of the counseling program, Sara Rosenthal, is also notified immediately, even if she is off duty. And one of the program's many volunteer advocates, who receive 40 hours of training and can be at the hospital within 30 minutes of being called, will counsel the patient and stay by her side as long as necessary.
(It is important to note that men can also be victims of sexual assault and many have been treated at NCB.)
"We go in and we explain what the physician is going to do," said Lucy Colon, who began volunteering in the program after she read about the opportunity in the Norwood News two years ago. "It's easier for them to hear it from us."
Colon said she has come in contact with "really distraught [or] violent patients who I've been able to have calm down and be responsive," and often ends up getting a hug in gratitude.
An examination procedure that can seem frightening to someone who has just been victimized is designed to be as private and minimally intrusive as possible.
When a victim was observed making a call from the nurse's station, NCB had a phone installed in the examining room used for assault victims to ensure privacy. In the same vein, a new examining room being constructed will include a shower and there are double curtains on the windows of the special room. If a patient's clothing is needed for evidence or has been damaged, she is given a new sweatsuit to wear home.
Because sexual assault victims could not control what happened to them, the program at NCB does its best to empower patients, Rosenthal said.
At any time, a patient can refuse any part of the examination, and the evidence collected by the examiner for use in a criminal case against an attacker is only released to authorities with a woman's consent. Otherwise, it is sealed up, locked away and kept by the hospital for at least three months in case the victim changes her mind.
Though the first priority is the patient's health, safety and sense of security, NCB also excels in gathering the forensic evidence that could put a rapist in jail.
Because most patients don't have visible injuries, sensitive photographic equipment is essential to record proof of rape.
For instance, NCB has a colposcope, a high-powered forensic camera, which can take photos inside a woman's vagina, and a high definition Polaroid that shows scratches and bruises on skin that would be undetectable with a normal camera. Examining a patient with the naked eye can identify evidence of rape only 15 to 20 percent of the time, compared to 80 percent with the colposcope, according to Dr. Kevin Brown, director of NCB's Emergency Department.
Staff expertise in using this equipment has proven invaluable to Bronx prosecutors.
Elisa Koenderman, the assistant district attorney in charge of sexual assault cases in the Bronx, says her unit regularly relies on the expertise and testimony of NCB doctors in cases all over the borough.
"It's important to have people trained in evidence collection and in medical and legal sexual assault issues so we can make the most of what evidence there might be in a court of law," Koenderman said. "They can testify about what their findings are, or even their lack of findings, and explain their significance to a jury. I can't tell you how important that is."
The fact that NCB, one of 11 hospitals in the city's public hospital system, has an institutional commitment to this issue and that staff often testify in cases of patients treated elsewhere, means that an examiner can spend an 8-hour work day away from his or her regular hospital duties. But NCB picks up the tab.
"It's part of our public responsibility," Brown said.
The director of the medical team, Dr. Bridget Alexander, became an expert on sexual assault after coming to NCB. A former professional photographer, whose expertise behind the lens is now particularly useful documenting assault, Alexander is now regularly called on to speak at conferences and share the hospital's successes with others who want to replicate the program.
Another critical component of the program is that NCB is committed to providing counseling for victims of sexual assault whether or not they've been treated medically at the hospital. Rosenthal, her staff, and the advocates she supervises, work hand-in-hand with the Emergency Room team. But patients assaulted or abused months or even decades earlier come to NCB for treatment, too. Rosenthal said she's seen "everything from 'I was raped five hours ago,' to 'I was abused 50 years ago.'"
Insurance is not necessary for the program. Patients can receive up to 12 weeks of counseling and those needing more attention are referred elsewhere for additional services.
Those working in all aspects of NCB's Sexual Assault Treatment Program say the work can be emotionally draining, but the rewards seem to outweigh all of that.
Take, for example, the hostile woman Propper encountered. "She was calm, a whole transformation took place," recalled Rosenthal, who also worked with the woman. "She said, 'You guys saved my life.'"
Alexander agrees. Time and time again, she said she sees "someone who was totally a victim and walked out with tools to be a survivor."
For more information on counseling services at NCB's Sexual Assault Treatment Program, or to learn how to become a volunteer advocate, call Sara Rosenthal at 519-5722 or 519-3100.
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