On My Mind: Intimate Partner Violence

By Alyson K. Myers, M.D.
Associate Chair of Diversity, Equity, and Inclusion
Department of Medicine, Montefiore Einstein
Associate Professor, Montefiore Einstein

October and November mark the celebration and awareness of groups, as well as diseases. In October we acknowledge to contributions of persons who identify as Hispanic/Latino as well as those who are Filipino-American, Italian-American, or who have disabilities. October also marks awareness of attention deficit disorder, spina bifida, sudden infant death syndrome, Down syndrome, Rett syndrome, depression and mental health, breast cancer, and LGBTQ+ history. In November, there is Indigenous Peoples Month and Transgender Remembrance Month. We also acknowledge several diseases including diabetes, epilepsy, stomach cancer, pancreatic cancer, and healthy skin. Of all of these, domestic violence, or the transgender month of remembrance are the hardest to commentate. In the past, I worked with a medical assistant who lost her niece due to trans violence. Her aggressor was a romantic partner who was sentenced to 37 years for strangling her but for many their murders go unsolved.

Alyson Myers, M.D.

Alyson Myers, M.D.

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Other cases of intimate partner violence may not turn out deadly but can still cause serious emotional and psychological abuse to the person who is on the receiving end. I will refrain from using the word victim as it has a negative connotation. As health care providers we can experience taking care of patients who are currently, or in the past, suffered under psychological, emotional, and/or physical abuse; 1 in 3 women and 1 in 4 men are victims of intimate partner violence. It can be our loved ones, our friends, our colleagues, our neighbors, or even ourselves.

A classic example was a woman for whom I care who I will call *Lisa. Lisa was a 20-something year-old referred to me for care for her congenital adrenal hyperplasia (CAH). Her PCP had been nudging her for months to see a specialist as understandably he did not feel comfortable managing her steroid replacement. Lisa was a recent transplant from the West Coast and like many young adults with a childhood disease she was used to having her parents’ help. Now she was new to the area and navigating the health care system on her own. Little did I know that managing her hydrocortisone and Florinef would be the easier part of her treatment plan.

Lisa was working in retail and living with her girlfriend who was 10 years her senior. During a follow-up visit, I inquired about their relationship and Lisa seemed quite timid to discuss it. She made minimal eye contact and seemed quite nervous. I asked her if she felt safe with her partner, and she tried to shrug it off, but her body language said it all. She disclosed to me that her co-worker told her that she needed to leave her partner, but Lisa couldn't. She was alone out here in New York, and all of her family was back in California or her family’s native land. Her family would love for her to come home but she feared that her partner would prevent her from leaving. We talked about her coming up with a plan to leave when she was ready. She noted that she had begun stashing items in her work locker or leaving them with the co-worker, but she still did not feel like she could leave her partner.

I feared for Lisa’s safety as I had known women like Lisa who had unfortunately lost their lives at the hands of intimate partner violence. We were able to come to the agreement that she would speak with a domestic violence counselor. Before she left the visit, I called Safe Horizon so that she could be aware of resources for her situation. They provided her with information and told her what she can do when she is ready to leave.

I relayed the information to her PCP who was angry at himself for missing this. I reassured him that anyone could have missed this, as people who are in these situations often live in fear. I know that it had taken Lisa a lot of courage to tell me. I was glad that she felt that this space was safe for her, and she trusted me enough to speak with one of the Safe Horizon counselors. I was also glad that she could entrust her co-worker and was already starting to hide some of her things. Of course, I wished that she would have left her partner that day but I knew that she would have to do that when she was ready.

When we reflect upon our time in medical school or residency, how often were we trained on how to recognize or manage intimate partner violence? When I think about what I know about intimate partner violence, it has been through seeing friends or loved ones endure verbal, emotional, or physical abuse. As much as we would like them to leave, we have to be patient and be ready to help them when they are ready to leave. We can help them by providing resources to help them get to safety, including:

*The patient’s name was changed to protect her identity.

Posted on: Monday, October 30, 2023