I abhor violence

I was thinking back to the time when I began working in Singapore. This was when I met a colleague of mine. I admit I was quite sheltered having gone to relatively good schools and I was flabbergasted when my colleague asked me how to use a library. See, I used to return from my breaks with books from Orchard Library to fill my time while waiting for customers. She was curious about my book fetish and confessed to me that she couldn't remember a time when she read a book. She had never been to a library and had actually thought that one needed to pay to borrow the books.

Such was my sheltered background, I assumed everyone went to libraries. I could not think of a single person who went through school without visiting the library. I was curious about her world and got to know her better during the six months I worked with her.

Often during lull periods, she would talk to me about her husband. Her husband who had no job, frequently absconded from national service and often got into fights with gangs. She had many financial problems especially then with her second pregnancy and heavily relied on her parents for financial support. One afternoon, she sheepishly told me that she had only $50 in her bank and that her daughter's life insurance fees were due and she wanted to borrow some money. Earlier that week, her husband had taken money from her to hang out with his friends. I was nineteen years old then. She was twenty.

Later another colleague told me that she used to come to work with bruises on her face and arms as a result of her husband's violence towards her. She told this to me too as if we were talking about the weather. I did not say anything. I did not know how to respond. I could not fathom why anyone would stay with such a man.

I resigned from the job to take on a new job at a law firm and we stopped keeping in touch. I visited her when she had her baby and met her husband for the first time. He was rough-looking, heavily tatooed and he sat on the sofa smoking his cigarrette in his children's presence while his wife busied herself with drinks. I felt like I was in a different world.

We lost touch after that but I realise now her face had never left my memory. You see, she had this angelic face and cute smile that always lit up when she spoke of her daughter. She got excited over the smallest things and often dragged me to look at baby clothing and shoes. She was so simple and innocent at times that one would never think that she was suffering from domestic violence.

If I could go back five years, I know now what I would have said. I would have said to her that it was not allright, that it was wrong that this was happening to her and that there is help for her. Because saying nothing is just as bad as saying it's ok.

Statistics today are showing that men who abuse their partners are more likely to be more educated and have a university degree rather than coming from low socioeconomic backgrounds. Domestic violence affects all classes, cultures and religions. Below is an article we were given today in school as part of learning about violence against women. Just goes to show education can't buy class.

BMJ 2007;334:747 (7 April), doi:10.1136/bmj.39170.639699.59

Keeping it secret
Anonymous

It wasn't until the razor-sharp edge of a broken CD was held to my throat that I realised I was in real trouble. That, and the threat that followed, to rape me with my mobile phone.

This attack had come without warning, with terrifying speed and ferocity. My head was knocked through the plasterboard of the bedroom wall, I was flung, pushed, and dragged to the kitchen, held down, and kicked all over my body. While my head was being knocked repeatedly on the concrete floor with force, I heard myself beg my partner to stop, heard myself say I would be killed. That's when I knew it was a real possibility.

And that was the moment I knew, finally, that our relationship had to be over.

My partner was, and still is, a senior hospital clinician. I had worked as a general practitioner for several years. I had never forgotten the first dazed woman who sat in front of me with bruises, nor my own shocked anger, pity, and disbelief at the reality of domestic violence. There had been many like her since.

Now it was my turn.

I knew that domestic violence is not exclusively an issue of deprivation. But I was pretty sure I didn't have any friends or colleagues in such relationships. Now I wonder.

We teach doctors in training to recognise their needs as people as well as professionals, as patients as well as providers. However, like many doctors, I rarely needed access to health care. That was for patients. Now it was for me.

I sat in the consulting room of a GP years my junior who documented my injuries—the 10 cm bruises on my arms and legs, the finger marks, and the scalp haematoma—with kindness and a non-judgmental compassion that made me cry. She told me my injuries were serious. She told me even doctors end up in bad relationships, because we are human beings. She told me there was no shame in feeling lonely, terrified, and trapped. She told me I should leave.

It can't have been easy for her: she knew my partner and my partner's parents, yet she treated me with impartiality and respect. Doctors like to feel in control: it doesn't come easily to us to ask for help.

It has been both humbling and liberating to experience the kindness of strangers.

I said that this attack came without warning. Of course, it was not the first: an attempt at choking during a disagreement, an unexpected blow struck with a chairback severe enough to break a rib, a beating for making travel arrangements without permission.

You may ask yourself why I stayed. Because I am a doctor, and because my partner was a doctor. Because I know medicine to be a stressful and demanding job. Because my partner had been assaulted at work and had a recent bereavement, and I tried to make a diagnosis: post-traumatic stress disorder, bipolar disorder, unresolved childhood issues, anything that might excuse or explain this hostile stranger. Because I was so familiar with domestic violence in practice. Because I was arrogant enough to think I was indestructible and I could offer help. Because I became tired and bewildered and confused. Because I simply did not want to recognise that I was living with someone who was potentially dangerous to me who just happened to be a doctor. I am strong, though I was often reviled for being weak.

I am brave, though I was often accused of cowardice. It took all my bravery and strength to leave our home and return to my city of origin.

With the support of friends and colleagues I am recovering my personal confidence. I am thankful for the medical community and the sensitive care and understanding I have experienced. I have a responsible job. I know that I am loved and respected. I did not involve the police.

I did report my partner to the regulatory authorities, requesting a health assessment of fitness to practise. That is a hard thing for one doctor to do to another, especially someone you love. Like any patient, I have to trust the system to handle my concerns with wisdom, sensitivity, and justice, and to live with the knowledge I will never receive feedback on the outcome of any investigation.

I have learnt much about myself as a person, a doctor, and a citizen. My life and my practice will be changed by my experience.

Partner violence is an abuse of power. It happens to men and to women, and is perpetrated by men and by women, in different sex and same sex relationships. It ruins lives. It happens to doctors.

If you are a doctor who is a perpetrator of violence, get help. If you are a doctor who is a victim of violence, get help. If you are doctor who knows of such a situation, get help. Someone's life might depend on it.