Hope’s Door-A Gateway For Victims of Domestic Violence

October is Domestic Violence Awareness Month.  As a nurse, I am required by law, under my nursing license, to report both child and elder abuse, but domestic violence?  Not really on my radar.  I used to view domestic violence as something that went out in the ’80’s, like big hair and heavy metal.  Then I saw a woman getting knocked out in an elevator by her boyfriend, now husband, (Ray Rice), splashed all over the media, and there it was again; front page news, and we didn’t have to wait for October to be aware; domestic violence happens every month, in fact every day; in fact every 9 seconds (http://domesticviolencestatistics.org/domestic-violence-statistics/).

Over the last few years, every October I attend our local Domestic Violence shelter charity event for Hope’s Door; a safe haven for women in one of the wealthiest counties in the United States.  Violence does not discriminate, and it doesn’t take bribes.  It infests all walks of life. There are survivors, some who make it out, and live to tell their tales.  These are the woman whose stories I sit and listen to, and lament over, and they bring me back in time.  Back to 1987 when another famous domestic violence case was splashed all over the headlines, and I’m reminded how very little has changed in all these years.

I was a junior in high school and grossly unaware of the atrocities happening to women and children on a daily basis.  A very famous case of domestic abuse in New York City came to light that year about a six-year-old girl by the name of Lisa Steinberg who had been struck in the head and killed by her adopted father Joel Steinberg.

On November 1, 1987 in a classic 19th century Greenwich Village brownstone, formerly the home of Mark Twain, Lisa received a forceful blow to her head by the hands of Mr. Steinberg.  She fell unconscious, and was placed face down on the bathroom floor and left there unattended for approximately 12 hours.  Her adoptive mother, Hedda Nussbaum, also a victim of Joel Steinberg’s leaded hands, remained in the apartment with her dying child, incapable of calling for help, while Mr. Steinberg stepped out to dinner with friends that night.

On the early morning of November 2, 1987 little Lisa Steinberg stopped breathing as a result of her traumatic brain injury.  At that point, Hedda Nussbaum was given permission by Mr. Steinberg to call 911, but it was too late for Lisa.

When police arrived on the scene, Lisa, unconscious, naked, filthy, and covered in multiple stages of bruising, was handed over to an officer by Mr. Steinberg.  The soles of her feet were so encrusted in layers of black neglect; they required scraping to remove all the grime.  Behind this limp and lifeless child, in an adjacent room, the police officers spotted an infant tethered to a playpen with a rope tied around his waist; he was filthy and saturated in urine.  This was Lisa’s younger adopted brother Mitchell.

(Just a brief note, both children were “adopted” under shady circumstances as Joel Steinberg worked as an attorney in the criminal court system in NYC and did not go through the proper channels of adoption.)

Hedda Nussbaum was quickly vilified by her inability to call for help to save her dying child.  She refused to make any decisions without the consent of her partner, and the public outcry was deafening.

Domestic Violence had made the front page.

But what the public would soon come to find out, was that Hedda Nussbaum was also a victim of domestic violence.  On the same day Lisa was brought to the hospital, Hedda was also examined at Bellevue Hospital and found to have facial cuts and bruises around her eyes and nose, a split lip, several broken ribs, a fractured jaw, a broken nose, and life threatening leg ulcerations.  She was extremely malnourished.  According to her later testimony, it was discovered that Ms. Nussbaum and her children were not allowed to eat without permission from Mr. Steinberg. Ms. Nussbaum was an educated woman.  Liked and admired by her peers, she was described as: kind, intelligent, and quiet.  She was a former editor and writer of children’s’ books for Random House Publishing.   How could a woman of this intelligence allow a man to control her into such a state of immobility?

Charges against Nussbaum were subsequently dropped due to the severe nature of her abuse. She received immediate physical and psychiatric help, and later testified against Joel Steinberg.  In the first ever televised courtroom trial, the American public was given a front row seat into the minds of both victim and abuser.

The doors to domestic violence awareness and public conversation were now wide open.  That same year the National toll-free hotline for victims of domestic violence was established.

Hedda Nussbaum went on to help other victims of Domestic Violence, and began giving lectures about abuse at colleges and shelters.

In 1986, on a shoe string budget, Hope’s Door, a haven for victims in Westchester County, New York opened its first 24-hour crisis line; with no shelter to house their victims, they provided local hotel rooms to shelter the wounded and provide a safe place to breath.

In 1989 Hope’s Door was able to open its own shelter and provide temporary housing to victims of domestic violence.  No doubt this was made possible by the Lisa Steinberg/Hedda Nussbaum case which brought to life the notion that domestic violence does not discriminate: race, gender, age, or class.  Rich women and children can be battered just as easily as the poor.  Money can be rationed as effortlessly as food.

After the September 11, 2001 attacks on the United States by the then unknown  group al-Qaeda, American women were introduced to words like the Taliban, Burqua, and Sharia Law.  We learned of the atrocities of our foreign, female, brethren forced to shroud their identities under a shapeless black cloak, kowtow to men, remain uneducated and subservient, and suffer an antiquated death by stoning for the crime of being raped.  How did an entire nation of women become so submissive?

If you don’t know the story of Malala Yousafzai, a fourteen year old Pakistani girl, gunned down by the Taliban, you should!  Her crime?  “Promoting Secularism”, according to the Taliban.  Malala became an activist in 2009 at the age of eleven, writing a journal for the BBC Urdu about living conditions from 2007-2009 under Taliban rule, a time when girls’ schools had been ordered shut.  Malala has championed girl’s rights to an education and has spoken out against female oppression imposed by the extremist laws of the  Taliban.  Her conviction is so compelling at such a young age, it’s no wonder the Taliban fear her.

On October 9, 2012, while traveling home from school. two armed men boarded the van Malala was traveling home in, identified her, and fired their weapons three times.  One bullet entered her skull, and landed precariously close to her spinal cord.  Immediate surgical intervention was performed in Pakistan, then Malala was air lifted to Queen Elizabeth Hospital in Birmingham England for further surgery and long-term recovery, and no doubt for her own security. She survived and went on to write a book about her experiences.

My father was a N.Y.C. policeman.  He wasn’t the preachy type.  But when he had something important to say, it usually came out in the form of one or two cogent sentences.  When the subject of men and violence came up, he said to me, “Jean, if a man hits you once, he’ll hit you again.  Don’t ever let a man hit you once.”

That line has stuck with me my entire life, and no man has ever hit me once.

To the women out there, “Don’t ever let a man hit you once!”

To all the people who make Hope’s Door possible, I want to thank you.

To all the people who man the National Toll free hotline for domestic abuse, and all hotlines across the country I want to thank you.

To Malala Yousafzai: Your indomitable courage is a beacon for all Muslim women that equality is a birthright that no man can steal, beat, or shoot out of you.  I pray for you, and your continued work for girls’ rights.

Domestic Violence awareness is represented by the color purple.  It is believed to have come from the early British and American  Suffragettes, who wore purple ribbons, and carried purple banners while protesting for equal treatment under the law.

Purple is supposed to represent: courage, survival, and honor.

My nine-year old son asked me if the color purple was used to represent the color of the bruises on the women who were beaten.

To all the people who might be suffering verbal or physical violence in your home, please reach out and get the help you need.  You are worth it!

National Toll-free Hotline for Domestic Violence: 1-800-799-SAFE (7233) or 1-800-787-3224

National Sexual Assault Hotline: 1-800-656-HOPE (4673)

Hope’s Door Pleasantville, New York: 888-438-8700

Woman Against Violence Europe (WAVE): 01-5482720

Women’s Aid Federation England: Free 0808 2000 247

Muslim Women’s Help Line Glasgow, England: 0808 801 0301

International Crisis Line for U.S. Women Overseas: 1-866-USWOMEN

Domestic Violence International Resources online: www.vachss.com

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Diagnosing Puberty

picture for puberty post

About a month ago my 7 year old daughter (soon to be 8), came to me one night, with a nervous complaint of a lump behind her right nipple.  With a slight sense of unease, I got up, palpated the spot she was pointing to, and sure enough there was a hard, pea sized nodule lurking under her skin.  Thinking the lump was probably normal breast development, I sent my daughter back to bed with a kiss and an “everything is normal” hug, then immediately jumped on my computer Googling 7 year old girls with breast lumps.

To my relief, most of my research pointed me in the direction of early thelarche.   Thelarche is the development of breast tissue, otherwise known as breast buds, and is one of the signals of the onset of puberty.  According to a study in the journal Pediatrics, American girls are maturing earlier.  What was once a normal pubescent age of 10 or 11 is now being seen in 7 and 8 year olds.

However, when these signs and symptoms of puberty occur before the age of 8 in girls and 9 in boys, then precocious puberty could be to blame.  Early puberty has its problems and could lead to shorter growing times, and shorter overall height.  The psycho/social problems with early puberty could lead to poor body image and low self esteem.

Signs of precocious puberty in girls:

Breast growth
First Period
Pubic Hair
Rapid Growth
Acne

Signs of precocious puberty in boys:

Enlarged testicles/penis
Body odor
Deepening voice
Pubic Hair
Rapid Growth
Acne

The following morning I placed a call to my pediatrician, and after explaining to the nurse my daughter’s finding from the night before, I expected her to say, “That’s normal, nothing to worry about.”  Instead she said my daughter was too young for breast development, and needed to come in and see the doctor.  My stomach did a little flip as I made the appointment.  Was I missing something?  Was this normal development, or a new anxiety to keep me from sleeping at night?

My daughters experience got me thinking about my own development, or lack thereof.  I have no memory of breast bud development; I would have been horrified to touch my own growing flesh, let alone go to my mom about it.  When I was growing up girls didn’t do that sort of thing.  I was twelve when my period came, and I remember the shock and embarrassment that brought on.  I was horrified by the painful, hemorrhaging happening between my legs, and there was no way I was going to my mother.  My sister, (through my tears of objection), did it for me.

My daughter is a different breed, thank God.  She is the daughter of a nurse.  I don’t lie, or make up silly names, much to the chagrin of my husband and father.  When my daughter was three, she used to run around my parent’s house singing, “I have a vagina; I have a vagina!!”  My father, not quite understanding her sing song, turned to my smiling mother and asked, “What is she saying?”  To which my mother replied in her best sing song voice, “I have a vagina, I have a vagina!!”

There’s a look that father’s, not men, but father’s give when they hear the word vagina that makes them squirm in their seat, roll their eyes, and huff and puff a little bit as if some sort of taboo has been broken, fearing the word period, or perhaps feminism might slip out next.  This was the look my father gave that day.  It’s no wonder I was afraid to get my period.

So thankfully my daughter is comfortable in her own skin, and so far, not afraid to come to me for help.  But could she be facing puberty at age 7, when I could barely face it at age 12?

The pediatrician examined my daughter later that day, and felt the pebble like nodule of what?  She didn’t know.  “Wait three weeks, if it’s still there then I would like her to see a pediatric endocrinologist.”  Really, I thought?  Was this necessary?

With anxious weekly reminders from my daughter, we got to week three, and the lump was still present, along with what appeared to be soft breast tissue, or as my daughter likes to call it, “the hill.”  After a thorough examination by the endocrinologist, we were still no closer to an answer.   She too agreed that the lump seemed odd, but thought we should run some tests to determine if she was entering puberty.  Since when did the normal transition from child to adult become so complicated?

So what are the tests for puberty?  Here is a list of the most common ones:

  1. Blood work is first collected to test for the hormones of puberty: LH (Luteinizing Hormone), FSH (Follicle Stimulating Hormone) Estrogen Levels, and Thyroid levels, (Testosterone levels in boys).
  2. A bone X-Ray of the wrist is performed to measure the growth plates and determine bone age vs. stated age.
  3. An MRI of the brain may be done to look for any abnormalities.
  4. An ultrasound of the ovaries may be done in girls to rule out a cyst or tumor.

If the tests are positive and early puberty is diagnosed then there are treatment options which include a monthly injection of a hormone that blocks the onset of puberty.  This hormone is given until a more reasonable pubescent age and then discontinued, allowing the body to take its normal course.

This treatment option was discussed with me by the endocrinologist, and I have to say it weighed heavy on my conscience.  Medicate my child to prevent early puberty, or let nature take its course?  I was more than hesitant to have to make that decision.

After blood work and a wrist X-Ray, it was determined that my daughter was not in puberty; a relief on the one hand, but leaving me with the question, “Then what is that pea sized lump in her breast?”

Only an ultrasound will be able answer that question.

In the meantime I wait and I worry (a little), about what I’m putting my child through, and if I really have anything to worry about at all.

I can’t help but wonder if after all this testing, we’ll come full circle to find out her breast lump was nothing more than premature thelarche, and the premature wanderings down the inevitable path to a diagnosis of puberty.

To Spank Or Not To Spank

Zen-and-the-Art-of-Child-Discipline

Zen-and-the-Art-of-Child-Discipline

A study published in The Journal of Pediatrics stated 3 year olds who were spanked were more likely to become bullies by the age of 5. Researches from Tulane University studied 2500 children and their mothers and determined that those children spanked frequently, were more likely to show aggressive behavior.  In lieu of spankings, researchers have determined we should be giving our children positive reinforcement and praise.

The researchers at the Yale Parenting Ccenter and Child Conduct Clinic, out of Yale University, have been studying behavioral influences on children for the past several decades.  What encourages a child to behave well vs. the motivation for malcontent?  Time honored research has determined that praise, not punishment is the key to well mannered children.

But not just any old praise will do.  When our children complete a task, or do as they‘re told, we as parents must extol them with all the pomp and circumstance of a Dallas Cowboy Cheerleader.  When they bring home an A on their report card, heck, even a B+, we must eulogize them as if they were the second coming of Albert Einstein.

As far as going into raptures every time my kid does something he’s supposed to do, I can see the short term benefits; he feels loved and satisfied that he’s not just doing a good job, but that he’s AWESOME and doing a FABULOUS job.  He can also be secure in the fact that he’s not just smart, but his work is BRILLIANT, it shows INTELLIGENCE beyond belief.

I however, have one problem with the long term effects.  When he’s in his twenties, and has his first big job and his boss comes along and pats him on the back and says, ‘nice work son’, will he be satisfied or suicidal?  Will a smack on the ass once in awhile keep him grounded enough to handle his future or turn him into a serial killer?

Is it really smart to overstuff a child’s ego, then send him out into the real world where private cheerleaders don’t exist?

Reposted courtesy of:   http://www.inthepowderroom.com

Post Mortem Etiquette

NYPD One Police Plaza

NYPD One Police Plaza

Did you ever notice that one of the many stupid things people say when you lose a loved one includes the line, “Oh, I’m so sorry, how old were they?”  Well, since I’ve lost someone close to me, where age was never a factor in determining my level of grief, I have come to both dread and outright hate this question.  But now that it has crawled its way into my consciousness, I have no choice but to confront it head on.

The question alone ‘How old were they?’, implies that based on the answer, the questioner can either have a reaction of utter dismay or a reaction of relief, either way it leaves the person who is actually grieving unnerved.  If I respond with “three months old“: dismay, if I respond “ninety“: relief, (followed by stupid response number two: “well, they lived a long life.”)  Am I supposed to buy that line of crap?  Am I supposed to feel less sad for someone I’ve known my whole life, let’s say my grandparent, vs. someone I’ve known for only three months.

Is my grief mitigated by age?

And then there’s the middle aged dilemma, not quite too young to evoke the shock and awe response, but not too old to get that 2nd line of crap.  In fact, people here aren’t quite sure what to do.  Here’s a suggestion, stop asking the fucking question!

My father died at age sixty-seven.  It was sudden and tragic.  Is my heartache any less?  Of course not.  I didn’t see him as young or old, I only saw him as my dad.

In this I am sure I am not alone.  No one wants to measure their grief in time.  From the new mother who gives birth to a stillborn, or the daughter who loses her ninety-six year old mother, grief is grief.

So to all of those thinking about asking this question next time you are face to face with someone who has just lost a loved one, don’t do it.  Be kind, say your sorry, give and hug and move on.  I know I don’t want to be remembered for how old I was when I died, but rather how I lived.

Don’t you?

Reposted courtesy of http://www.inthepowderroom.com

Mom’s Taking a Sick Day (goddammit!)

The other day I was feeling pretty sick, but as usual was on the schedule to work.  When I announced to my boss’ I was calling out sick; there was a moment of silence, followed by a cackling, belly full of laughter.  “Mom’s can’t call out sick!” responded my three little managers, rolling around on the floor still laughing.  Oh yeah, I thought.  I’d show them.  I was going to have a sick day goddammit!  Even if it killed me.

Lucky for me I got sick over Christmas break.  My husband was off from work all week which meant I had reinforcements.  So I made my announcement to my husband that I was sick, and needed the day off.  I got the same incredulous look from him that I got from the children, followed by the comment, “Really, you don’t look sick.”  I get this comment a lot.  I have the uncanny ability to look really well when I’m sick.  I’m naturally pale, and when I’m ill and running a low grade temperature, my cheeks take on this pinkish, rosy hue, that makes me look as if I’ve just come from a day at the beach.  The mucous packed sinus’ gives me just that bit of swelling that people pay their plastic surgeon thousands to recreate.  Instead of looking miserable, I look refreshed, so no one takes me seriously.

But I wasn’t going down without a fight, and sternly reinforced my position to my husband that I was indeed sick, and that I was taking the day off to recuperate.  He acquiesced, still suspicious that I was faking it, but smart enough to keep his mouth shut, avoiding unnecessary conflict.  Feeling somewhat vindicated, I dressed in my coziest pajamas, and snuggled myself under my warmest blanket on the couch, in front of the TV, just like my mom used do for me when I was a kid, (the same way I now do for my own children).

As I lay there in full command of the remote control, my three children stared at me in amazement, then fired a barrage of questions:  “Mom, why are you still in your p.j.’s?, Mom, are you sick? Mom, what are you watching?, Mom, can I watch cartoons? Mom, are you going to stay there all day? Mom, are you going to get up to go to the bathroom?  Whose going to feed us? Can we lay there with you?”  I soon realized that as long as I was in sight, I was in mind.  I got up, handed over the remote control, and made my way upstairs to my bed, shutting the door behind me.

Ah, peace and quite until…

‘Knock, knock’,

“Whose there?” I responded.

“Lettuce”

“Lettuce who?”

“Let us in Mom!”

Oh no, they were back; I hadn’t locked the door.  In they came like moths to a flame.  Armed with more questions about what I was doing in bed.  I asked them what their father was doing, and why didn’t they go spend some time with him.  Apparently they weren’t into a Judge Judy Christmas marathon, and wanted to be with me.  And I’m thinking, how is it my husband can spend the day on the couch, uninterrupted, completely healthy, and not helping to keep the children from disturbing their sick mother?  Again, I think he thinks I’m faking it.  And I’m thinking these kids are never going away.  I thought maybe if I could throw up they might get grossed out and leave, but the only person I was grossing out was myself.  What kind of low had I sunk to?

I needed someplace to go.  A reprieve for sick mom’s.  A place where the children couldn’t go, and my husband wouldn’t want to.  But where?  That type of retreat hadn’t been invented yet (but would be going right to the top of my nurse entrepreneur to do list).  I needed help now, and I knew just where to go.

I packed my overnight bag, pulled on my heavy winter coat, kissed my three kids on top of their heads, then said goodbye to my husband.  He looked at me surprised and said, “Where are you going?”  I replied, “To the only place I can get some peace and quiet.“, then walked out the door.

That afternoon, in my cozy p.j’s, snuggled under a warm blanket on the couch, watching T.V. I knew I finally was having that sick day I so deserved.  “More soup honey?”  said my mom as she checked my forehead for a temperature.  “No thanks.” I said.

Then I rolled over and fell fast asleep.

IMG_0067

Reposted courtesy of  http://www.inthepowderroom.com

Happy Belated New Year!

001I know, I know it’s January 18th and I’m a little late for a Happy New Year.  The past couple of weeks have been a whirlwind.  My family and I decided to drive from New York to Florida over the ten-day Christmas/New Year break: me, my husband, our three kids, and the dog.  After a treacherous 12 hour ride (that should have taken 8) over the mountains of Pennsylvania through the middle of a blizzard/ice storm, followed by a slow ride through thick fog, into lonely, dark, back woods, country roads, we made it to our first destination, Virginia.  This was our drop spot for the dog, who was to take her own vacation with my husband’s uncle and his two dogs. ( It’s still a toss up as to who had the better vacation.)

As for the kids, it wouldn’t be a trip to Florida if we didn’t hit some sort of amusement park; amusing for them, nauseating for me.  I happily spent the time with my five-year old, (who was too short for the big coasters), wandering around the Sesame play area of Busch Gardens.  I even managed to stomach the Grover Express, a kiddie roller coaster, that in my opinion, was way too fast and scary for me the little ones.  We spent a great week visiting with family and enjoying the sunshine, when sadly it was time to head home.

Our ride home was far less eventful.  We picked up our pooch, and made it back to New York where we were greeted by a blanket of snow and a frosting of ice.  Gotta love the winter!

We weren’t home a week, when two of my three kids came down with strep throat, and I have been playing nurse maid ever since.  It’s been sleepless nights, and countless doses of medicine; just in time to prepare me for my return to the night shift.  Yes, the night shift.  I’m going back to work in the ICU part-time on the night shift (it’s all that’s available for now).  I’m also going back to school.  So 2013 is going to be a very busy year for me.

On that note, I plan on reposting a few of my articles, (with permission of course), that I had written for a website known as In The Powder Roomhttp://inthepowderroom.com I need a bit of time to catch up on the new posts I want to write, and I have a feeling I’m going to be a bit busy with school, work, family, and life in general.  So until I’m able to juggle it all, and figure it out, that’s my plan and I’m sticking to it.

I hope everyone who reads this had a great holiday season, is not too devastated by the flu, and has a wonderful 2013 to look forward to.

Happy New Year!!

Suicide…Nurses Who Take Their Own Lives

photo by Jean James

photo by Jean James

What drives a nurse to commit suicide?  In most cases the answer is simple; she or he has made a mistake, and usually that mistake has cost someone else their life or limb.  So why then did Jacintha Saldanha, the nurse responsible for transferring a hoax phone call to the Duchess of Cambridge’s nurse take her own life?  I’m not sure the answer is so simple here.

Jacintha Saldanha violated the British Department of Health‘s confidentiality code of disclosing information with appropriate care when she passed on an unconfirmed phone call made by two Australian D.J.’s posing as Queen Elizabeth and Prince Charles of England.  The D.J.’s, who were looking to solicit private information about the Duchess of Cambridge, decided to play a prank by placing a phony phone call to King Edward VII Hospital.  While impersonating the Queen of England and the Prince of Wales, they were easily able to deceive Nurse Saldanha into transferring them to Kate Middleton’s primary nurse, who then went on to divulge extremely sensitive medical information about the Duchess’ hyperemesis gravidarum while live on the radio.

Like all nurses who realize they made a mistake, I have no doubt Jacintha was filled with shame and embarrassment for the public spectacle that ensued after that phone call.  But was it worth taking her life?  Is any mistake worth taking your life?

The medical profession has one of the highest suicide rates.  The pressure to ‘Do no harm’ sits heavy on the shoulders of all who take that oath.  But what comes after ‘if harm is done’?  How do we counsel the person who may have made the mistake?  I know in America the answer is always the same, “You better get yourself a good lawyer!”  Then you’re dropped off at the edge of a steep cliff and left to fend for yourself.  Nurse Saldanha must have been dangling  precariously off the edge of that cliff.

According to news reports she did not share her mistake with her husband or two children.  I can only imagine the torture she put herself through.  You see, as a nurse, you don’t need to kill someone, or maim them, to feel you have done harm.  I’m guessing Nurse Saldanha felt betraying the Duchess’ privacy was harm enough.  Nurses are their own worst enemies  first.  What punitive damages come later could never possibly equate.

When a nurse or medical professional makes a mistake, immediate counseling and crisis intervention should be provided.  Nurses should not have to bury themselves in grief, fear, and shame.  No one wants to make a mistake.  Nurses work hard, are given heavy assignments, work long hours, are understaffed, expected to stay late, skip lunch, and rarely make it to the bathroom, all for the sake of caring for their patients.  We cater to abusive family members at times, abusive medical staff at times, abusive administrators at times and even abusive patients, and all the while we are expected to keep a smile on our face, and behave like ‘good girls’.

My heart breaks for Nurse Saldanha and her family.  Though I don’t know her professionally or personally, the reports I have read shed light on the kind of exemplary nurse, wife, mother and human being she was.  I’m saddened that her mistake and the insurmountable pressure that followed led her to take her own life.

Prime Minister David Cameron was quoted as saying, “There will be many lessons that need to be learned.”  This is true, but the one main lesson that needs to be learned is what drives a nurse to commit suicide, and how can we prevent this from ever happening again?