With my white coat still on, I put my hands together behind my back and heard the police officer ratchet the handcuffs shut. The last place I’d expect this to happen is in the hospital while taking care of patients. But there I was, getting handcuffed along with my attending while standing in the middle of the psychiatry inpatient unit.
Ashley (name changed) was a female in her early 20s with a sweet face pained by hardships endured since she ran away from home in her teens. When I met her, she had been an inpatient on the psychiatry ward for several weeks, having been brought in by the police, who found her in a ditch covered in feces. She had been essentially mute and catatonic.
She told her care team of the physical, psychological, and sexual violence she suffered under her abuser. She described how he hit her belly when she was pregnant, got her addicted to drugs, and forced her to have sex with other men. More women had been abused, she said. To us, the story signaled these women were being trafficked and coerced into sex services.
With coaxing, she gave her abuser’s name. We decided the next step would be to have her file a police report. We called the hospital security office and asked for an officer who would be appropriate for a case of suspected trafficking. A policeman came and launched into a line of accusatory questioning. He treated her like a perpetrator of not-yet-charged crimes.
Based on her reaction and out of concern for her health, we thought it best she have a chance to tell her story to someone with specific training. We told the officer we would have someone else interview her. In response, he said he didn’t think it would work and left.
He returned with a female officer, intent on completing the interview. As we tried to explain our approach and to communicate to Ashley that she had a choice of whom to talk to, we received two brief warnings not to “interfere with a police investigation.” Then, we were handcuffed and detained for almost an hour.
We became a captive audience to a protracted lecture on knowing our place as doctors in the authority hierarchy. My attending was indignant, explaining our standpoint and why we had done no wrong. I was petrified I would have a police record and be barred from residency. After enough apologies, they released us.
My attending and I submitted a formal complaint along with input from nurses, residents, and other students in attendance.
The medical school and hospital administration supported our perspective. The hospital administrator barred the officers who handcuffed us from taking shifts at our hospital sites.
The trafficking problem is pervasive in Houston, which holds the disturbing position as the city in America with the highest number of reported human trafficking victims. According to The Texas Human Trafficking Prevention Task Force Report to the Texas Legislature 2014, in 2008, 38 percent of all calls to the National Human Trafficking Resource Center came from Texas. The report indicates Texas was the source of 2,236 calls to the hotline in 2013, second to California.
Physicians haven’t optimized their potential role in breaking the cycle of trafficking. A 2005 study titled “Turning Pain Into Power: Trafficking Survivors’ Perspectives on Early Intervention Strategies” notes 28 percent of trafficked victims had been seen by a health care professional during captivity.
A 2015 survey in Pediatrics, “Medical Providers’ Understanding of Sex Trafficking and Their Experience With At-Risk Patients,” indicates 63 percent of respondents said that they’d never received training on trafficking victim identification. The greatest barriers to victim identification were a lack of training in and awareness of trafficking.
At press time, bills related to sex trafficking prevention and education were working through the legislature.
Every encounter with a trafficked patient who isn’t asked appropriate screening questions is a missed opportunity. Building a framework of established relationships between doctors and police will require agreement on shared responsibility. The partnership could be a novel approach toward fighting the problem and a step toward stopping the cycle of human trafficking.
Rachel Solnick is a medical student and can be reached on Twitter @rachel_solnick. This article originally appeared in Texas Medicine.
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