She Was Fourteen

I was working an evening shift in the express care of the emergency department a few weeks ago.  A fourteen year girl was swept into a room with another child and an adult who could not get off her cell phone.  I was told the chief complaint was "medical clearance".  When I asked where she was being medically cleared to go exactly, the answer was, "I think she's going to a group home".

"Do you know where, or what her medical concerns might be?" 

"No. Not exactly.  I'm not her mom, I'm a wrap around worker from the County". 

No parent, no known medical history, being cleared for an unknown destination.  And we're in express care where patients are supposed to move in and out quickly and relatively easily.  I blew the whistle to call a timeout.  I asked the "adult" to come into the hallway so we could talk a bit more.  She was a wrap around worker who serves as an extension for the city's social workers. She also happened to be an acquaintance of the patient because her daughter was in her class.  As it turns out, the girls is a "prostitute".  She is not cared for by her parents because she has bipolar disorder and they can no longer manage her.  She runs away.  And oh, by the way, the police picked her up four days prior at a hotel.  No one knows why she was there.  When the cops showed up she told them she had not been harmed and had not been sexually assaulted. So they let her go.  Where, you ask?  Nobody knows.  She turned up and now needs to go to a group home...again.

Case manager...STAT!!!

Let me jump to the end of the story.  Because my case manager is a superhero and incredibly well connected in the city, I found out the rest of the story.  We transferred this fourteen year old girl  to a local hospital specialized in sexual assault evaluation.  It turns out (shock and awe) that she was being trafficked for sexual exploitation at that hotel four days prior.  The cops believed a juvenile that she was "just hanging out" at a sketchy hotel because she wanted to.  She does have mental health issues and is a handful.  She is known as a "runner".  Girls who chronically leave group homes, shelters, and hospitals and return to this abusive life.  It turns out that hotel was a hub of drug and human trafficking.  It turns out the cops dropped the ball and the investigation of this girl has blown up into a huge crime ring investigation.

This case has haunted me.  I have a fourteen year old daughter.  It makes me sick to my stomach to think of the atrocities that young girl had endured in her precious fourteen years.  I wonder how we have gotten to a place where cops can see this and walk away.  How many times have I walked away?  Sometimes you just don't see things unless you're looking for them.

The words we use are powerful.  If I had called her a prostitute you might think something different about her.  You might think she just chooses that "work" because it's easy money.  You might think she's a drug addict and just wants to get high.  You might be right.  But when I tell you she has a mental health disease and she is developmentally unable to make a healthy decision for herself you might pause in your judgement.  If I mention that her pimp has threatened that she or her family will be murdered if she doesn't comply with his commands and that he has repeatedly assaulted her you might think about her differently.  

Luke 7:36-50 tells us a story just like this in the life of Jesus.  Jesus is hanging out with the church leaders, the really pretentious ones.  I always think that would have been hard enough.  But then this woman who "lived a sinful life" comes in and starts washing his feet, crying the ugly cry, and pouring perfume all over him.  Awkward.  This prostitute bursts in the room, almost certainly uninvited, and causes a scene.  Jesus explains to the socially acceptable guests that this woman who has much to be forgiven, has shown more love to him than any of these gentlemen.  And he says that her sins are forgiven.

I wish for the thousandth time that I could see people like Jesus does.  Instead of a prostitute he sees a woman who is heartbroken, lonely, used up, and afraid.  And he doesn't flinch when it gets awkward.  May we have the eyes to really see people and really hear their stories.  May we watch our words and be careful of the labels we use.  

Is she a prostitute or is she a victim?  Is there any difference?

An excellent resource to educate healthcare providers about caring for sexually exploited youth: