The morning begins with a film, "Care of the Rape Survivor." It demonstrates sensitivity to the psychological needs of the rape victim and step-by-step instructions for careful collection of physical evidence. Jeff Levine, MD, MPH, assistant professor in the department of Community Medicine at RWJMS, then discusses the topic.
Martin Finkel, DO, renowned in the field of child sexual abuse, begins by saying that in only 16 percent of child sexual abuse cases are the perpetrators strangers; 84 percent of the time, children know the offenders. They are parents, stepparents, family members, or trusted friends, neighbors or supervisors.
He tells the students that age-inappropriate statements from kids may signal sexual abuse, since they only know about it by experiencing it. He adds that while examining a suspected abuse victim, don't let on, even for a moment, how horrible the situation is.
Finkel says prevention is the best medicine. "Talk to them about safety," he says. "Ask them how they stay safe in a car or on a bike. Then talk about body safety, including their private parts. Ask them why they're called private parts and who should and should not touch them. As physicians, you can make all the difference in a child's life."
A group of Rutgers students and graduates present a play focusing on acquaintance rape. The scene is a party. A girl is raped by a guy she just met. At the conclusion, the actors stay in character and answer questions. Many are provocative: By going to the guy's room on a first date did the girl send a message? Why did the rapist think the girl was "asking for it?" Was she, in fact, asking for it? If not, what did she want?
Thursday's lunch video, "All Dressed Up and Nowhere to Go," follows heterosexual transvestites who talk about their lifestyles. It demystifies men who wear women's clothing.
Michael, born a female, is much happier since altering his gender.
A panel of people who have either experienced gender dysphoria or are practicing unconventional lifestyles tell their stories. Michael was born a female, but even as a child wanted to be a male. "My friends and I would play house, and I would always be the husband," says the 25-year-old. "I hated my female body and disliked dating guys."
As a female, he tried modeling school, hoping to "learn what didn't come naturally." When that failed, he became extremely depressed and attempted suicide several times. A few years ago, he became a male and is now a much happier Michael.
But he has yet to date. "When do you tell?" he asks. "If you explain on a first date that you were once a woman, she'll leave. If you wait until you know each other better, she'll think you've been deceitful. It's a dilemma."
Lee spent her life as a male, until seven years ago, when she began the process of becoming a woman.
Lee, whose gender was male at birth, always fantasized about being a woman; she was preoccupied with it most of the time. "I felt like two people," she says. "It was so distressing, I don't know how I survived." Lee earned a master's and an EdD from Brown University and worked as a college professor. Married and the father of three, Lee grew a beard and bought a motorcycle to try to calm the inner struggle. It didn't work. "I rode around in a black leather jacket, dreaming about being a woman," she says.
Seven years ago, at age 55, Lee began becoming a female. She is on a lifelong regimen of hormone therapy and now considers herself a female. Eventually she will have surgery. She now feels "together and alive," she says, but there are still problems. It's become next to impossible for her to teach, and she was asked to leave a church-related orchestra. Lee's spouse and family are also having difficulty dealing with the situation, but, she says, things are working out.
Jessica (right) and his friend are both male, heterosexual cross-dressers. "I consider myself completely normal," he says. "I simply enjoy dressing in women's clothes."
A heterosexual, male cross-dresser, who calls himself Jessica, says he considers himself completely normal. "I just enjoy dressing in women's clothes." As a boy, he wondered how ladies could walk in high heels, so he tried on his mother's. It was fun, he says, so he began dressing in her clothes. Before long, it was a hobby. When he found out there were cross-dressers' groups, he was thrilled. "I said, 'Praise the Lord and pass the lipstick.'"
Carl, a physician, was born with ill-defined genitals. He was given testosterone and grew "big and hairy," he says, so he figured he was a male. He married Monica, and they had three children. But Carl felt he was a woman trapped in a man's body; he changed his sex and is now Carla. A former race car driver, Carla says becoming a woman and fitting in society was much more frightening than going 200 miles an hour.
About the same time, Monica came out. She is a lesbian. "I believe we were drawn to each other for the hidden selves we both were," she says. The two are happy, although often shunned. Carla firmly states, "I know it's tough to accept some of these things, but if you can't love your patients for who they are, you have no business being a doctor."
Marjorie, 84, and John, 82, were married in 1940. After 12 years of monogamy, they decided to launch an experiment: an open marriage. They agreed either one could ask to end the arrangement at any time, giving the spouse one year to wind down any "satellite relationships." After 46 years, they still enjoy the same lifestyle. Marjorie's satellite, Jerry, has been with her for some 20 years, although there have been others. Right now, John is not involved in an extramarital relationship. Each meets the other's lovers; sometimes they like the person, sometimes not. "Whatever the case," says Marjorie, "our marriage is enriched by what we each bring back to it."
Journalist and author River Houston travels around the world with her beloved dog, Buddy, to speak on HIV/AIDS.
The personal impact of HIV/AIDS is the topic of the next panel. River Houston, a 37-year-old author and lecturer, has been HIV-positive for 13 years. She begins by relating an ordeal at a clinic, where she waited several hours for the "doctor du jour" to take a bone marrow sample. The procedure was painful, but even worse, she says, was the physician's attitude. "He didn't care one bit what I was feeling, physically or emotionally. I was just another number. It was horrible."
She explains that a good doctor-patient relationship involves a special kind of intimacy. "We need your compassion and love," she says. "This is not an easy disease to live with. A brilliant, loving doctor makes our lives livable."
Houston has written several books and lectures around the world on HIV/AIDS. "Many people ask me if having this disease has been a gift," she says. "If this is a gift, I say, 'Where is the return department?'"
Ed, an HIV-positive social worker, agrees: "I'm with you, River. Where can I give this back?" Since being diagnosed 10 years ago, Ed has taken 200,000 plus pills. It's a hassle, he says, to constantly keep track of the time and remember which pill to take when. But at 47, he feels lucky. "I never thought I'd live this long."
Two physicians who specialize in HIV/AIDS talk about caring for patients. "You can't be separated from AIDS - it's everywhere," says Dan Williams, MD. Half of his New York City practice is AIDS patients. "I was on jury duty recently and a defendant had AIDS. I excused myself. I couldn't do it."
Kathleen Casey, MD, clinical associate professor of medicine at RWJMS, says she loses about 150 patients each year, and about five new ones come to her every week. "The AIDS holocaust is still in existence," she says. "People are forgetting to be diligent about protection." Casey says needle exchange programs are imperative to curbing the disease.