Someone Else's Nightmare

“Some men hear the word ‘no’ from a woman, and they push harder with a side of violence,” says Dr. Sampsel. 

As a Clinical Forensic Medical Examiner, Dr. Kari Sampsel is the only Canadian physician with a fellowship in Clinical Forensic Sciences. Dr. Kari Sampsel is an Attending Staff Emergency Physician and the Medical Director of the Sexual Assault and Partner Abuse Care Program at The Ottawa Hospital. As the Medical Director of the Sexual Assault and Partner Abuse Care Program, when victims of  sexual violence come into the emergency room, she is in charge of the rape kit, assessments of sexually transmitted disease and pregnancy as well as setting up long-term physical and mental health care for these victims.

She states that statistics show that one out of every three women will be sexually assaulted in their lifetime. Although those who come into the emergency room are overwhelmingly 18- to 24-year-olds, women of all ages are raped, even those in their 80s.  Since 85% of rape victims know the attacker, Dr. Sampsel says that one of the crucial questions to ask is,“Do you feel safe?” and that this should be a screening question for all rapes. 

Interestingly, Dr. Sampsel says that younger woman are more likely to come into the emergency room to prevent disease and pregnancy, but it is women in their forties who are more likely to complete the evidence kit. Older women want justice but younger women may only want physical safety. 

During the ten years Dr. Sampsel has run the unit, she has seen a marked rise in the number of rape victims coming for help. However, she points out that it is only 10-20% of rape victims who seek help immediately. Some rape victims don't come in because stigma and shame keep them from reporting the rape. Interestingly, Dr. Sampsel says that after being raped, many are confused about what happened. This is only in part because of the use of alcohol or drugs. More often it is that trauma makes it difficult to remember. Later, they may get snippets of memory of the event.

A large proportion of rape victims develop recurrent symptoms like headaches and abdomen pain. Dr. Sampsel’s work is also to educate doctors in the emergency room and family doctors’ offices to recognize these symptoms and ask the right questions. 

I asked Dr. Sampsel how we can decrease the incidence of rape. She hones in on education. On three fronts.

The first thing we need to do to reduce the incidence of rape begins with our children. Young people should be educated in the need for consent on all levels. You don't have to give a hug unless you consent. If you are uncomfortable, you should walk away and adults should support this rather than be embarrassed.

In the emergency rooms and doctors’ offices: there needs to be an education campaign by those in the field, clarifying what to do with rape victims who seek help immediately and also those who come in later. Protocols for treatment need to be in place and these have to be adequately funded to mean anything.

On a societal level, Dr. Sampsel would like to see a public campaign, perhaps like the one that educates people on the signs of stroke. One piece of this would obviously be about consent and how it needs to be given in every circumstance of physical contact. This might seem extreme to some; however, if I rephrased it and said that every person entering your home needs consent and an invitation, it seems like common sense, does it not?

The other piece of this is what Dr. Sampsel calls a social contract: what is done privately between people should be up to the standards of what is allowed in polite and civil society, where we all adhere to the basic principle that how we treat others is how we would like to be treated. This has the perfect makings of a public campaign. 

With one in three women being assaulted, this looks like a healthcare epidemic to me. It rivals the chance of getting cancer or having a stroke. So, perhaps the same steps to reduce the problem are in order. The steps outlined - prevention, identification and public awareness - seem long overdue.


One final and haunting statement from Dr. Sampsel: “People need to realize that their flirtations may be the makings of someone else’s nightmare.”