|
Forensic nurse Gail Perkins coordinates SANE, the Sexual Assault Nurse Examiners program, at Mary Washington Hospital. |
Gail Perkins sat calmly on the witness stand, a small figure with short blond hair and glasses, dressed in a black suit and white sweater.
Perkins smiled at defense attorney Brent Jackson, who stood before her ready to begin his cross-examination.
Jackson smiled back, but Perkins was not a friendly witness. Jackson knew that Perkins' testimony might convict his client. If Rodney Braxton was to be found innocent of rape, Jackson would have to explain the evidence that Perkins had found.
Perkins is a nurse at Mary Washington Hospital. She is trained to treat sexual assault victims and has examined more than 100 of them. She examined the victim in the Braxton case hours after the attack happened on June 15, 2001.
Among the many things Perkins did that morning was to inspect the woman's genitals. As part of the exam, she searched for bruising, redness, swelling or small cuts. She used a medical scope to examine the woman internally, and she applied Toluidine Blue dye to reveal tiny lacerations. She found no evidence of trauma.
"Nothing at all?" Jackson asked her.
"That's correct," Perkins replied.
"So you can't tell if there was a rape?" Jackson asked.
"I can't say," Perkins replied.
The exchange, which took place this month in Fredericksburg Circuit Court, illustrates the work done by Perkins and a team of specially trained nurses at the hospital.
The SANE nurses, or sexual assault nurse examiners, treat victims of sexual assault and document the evidence they find. Someone else--often a judge or jury--must decide whether that evidence merits a conviction.
In the Braxton case, Perkins found no evidence of vaginal trauma, but she did find other injuries that corroborated the victim's story. More importantly, she found what she said was "white fluid" inside the woman.
DNA tests revealed that Braxton was literally the only person in the world who could have deposited that semen there. When neither he nor his attorney could satisfactorily explain how it got there, a judge convicted him of rape.
Sexual assault nurseWhen Perkins talks to community groups, she tells them, "You or someone you know has been or will be the victim of sexual assault."
In 2005, at least 37 people, including two men, showed up at the emergency room at Mary Washington Hospital for treatment of sexual assault.
This year the hospital expanded its sexual assault program to treat juveniles as well as adults. So far 23 people have received treatment, including seven children, ages 2 to 9.
The numbers represent the patients seen by SANE nurses. They are but a fraction of those who have been assaulted. Other assault victims do not seek treatment at the hospital, or go to the hospital for medical care but decline evidence-gathering.
In recent years, many U.S. hospitals have concluded that sexual assault is so personal and so invasive that victims must be treated differently from other crime victims.
Perkins, a former ER nurse, remembers a time when a sexual assault victim might wait hours for care. Nurses who may have had no training were handed an evidence kit and told to do the exam. The evidence they gathered was sometimes rejected by a court.
"There has to be a better way," Perkins concluded.
That "better way" has been the SANE program, Perkins said.
For example:
Sexual assault victims are now taken immediately to an exam room and do not stay in the ER lobby.
Victims are not billed for the exam or any treatment they receive in connection with the evidence-gathering.
When a SANE nurse is assigned to a victim, she stays with the victim the entire time the victim is in the hospital. The nurse is not responsible for any other patients.
The SANE program started 30 years ago in hospitals in Minnesota, Texas and Tennessee. It's now found in hundreds of hospitals nationwide, including 22 in Virginia.
SANE nurses train for a year, including both classroom and clinical work. Sometimes, as in the Braxton case, they are asked to testify as expert witnesses.
The program started at Mary Washington about six years ago. It closed for about a year from 2003 to 2004 during a management change.
Local police and prosecutors asked the hospital to reinstate the program. Without a local program, victims of sexual assault had to travel to Richmond or Fairfax for SANE exams. That meant that investigators also had to travel to interview them.
"It caused a lot of problems for our office," said Travis Bird, assistant commonwealth's attorney for Fredericksburg.
After hearing from prosecutors, hospital administrators decided to fund a full-time program.
"To say [to the victim] you've got to go to another hospital to get the necessary legal examination just adds to the trauma," said Fred M. Rankin III, MediCorp's president and chief executive officer.
In 2004, hospital officials asked Perkins to rebuild the SANE program and to serve as its full-time coordinator. The 53-year-old Spotsylvania County resident had been one of the founders of the program in 2000. She has worked as an RN at Mary Washington for 17 years, including time in the emergency room and in the post-anesthesia care unit.
She hired six other nurses from throughout the hospital and began round-the-clock coverage at the end of 2004.
At first she was the only one doing exams. By the end of 2005, the other nurses had completed training and started doing exams.
The nurses have other jobs in the hospital. Faith Shortal is a nursing supervisor; Katharyn Poplin-McGhee works in the department of education; Barbie Huff works in the intensive-care unit; and Shannon Brooks and Toni Davis are ER nurses. Tanya Lyte is an ER nurse at Fauquier Hospital.
All are paid to be on call and to respond to the emergency room when an assault victim arrives. That happens about once a week, on average. The latest call came Sunday, May 21, about 3 a.m., when a Stafford County woman showed up in the ER and reported that she had been raped.
In some ways, the SANE nurses are like television's "CSI" investigators, Perkins said.
"They would go to a crime scene. Our crime scene is our patient," she said.
Stranger rapeIn the Braxton case, the "crime scene" was a 28-year-old city resident who had gone alone to a 7-Eleven on Lafayette Boulevard to buy cigarettes and beer.
The woman testified in Fredericksburg Circuit Court this month that the rape occurred as she walked home along the railroad tracks near the store at about 11:30 on a Thursday night.
She said a man ran up from behind and tackled her. The man got on top of her, pulled down her pants and raped her, she said. She struggled the entire time, and he threatened her.
She told Perkins later at the hospital that the man said: "If you don't stop screaming, I'll stab you. I'll kill you."
The woman testified that she didn't know the man and didn't get a good look at him. He pressed his shoulder across her face during the attack.
The woman ran home, and her husband called police. The Fredericksburg Rescue Squad took her to the emergency room at Mary Washington.
Perkins met the woman about two hours later in one of the exam rooms. Perkins realized immediately that the case was unusual.
More than 90 percent of sexual assault victims accuse someone they know, often a boyfriend, husband or acquaintance. This case was the exception: a stranger attacking from the darkness.
Also, victims usually have no visible injuries. This woman had abrasions on both knees and a bruise on her thigh.
Perkins recorded the woman's medical history, then marched through dozens of questions that would help her in the search for evidence:
Where did he touch you?
Did he use his fingers?
Did he use a lubricant?
Have you brushed your teeth?
Have you changed clothes?
Did he bind you or blindfold you?
When was the last time you had intercourse?
Perkins said later in her report that the woman "tolerated the procedure well," though the woman cried as she answered some of the questions.
Perkins checked the woman for injuries and spotted two bruises on her knees, apparently from when the man tackled her from behind.
She found no injuries in the genital area, but that did not surprise her. Many rape victims have no vaginal injuries.
When Perkins used the Woods lamp, a handheld ultraviolet light, she spotted semen on the woman's inner thigh. She found fluid inside the woman, apparently semen, and took a sample for lab testing. She also took blood and urine samples.
A state Division of Science laboratory in Richmond tested the blood and urine for drugs, pregnancy and venereal diseases. Perkins collected the victim's clothing, sealed it in a bag and gave it to city Detective John Lippincott, who had been assigned to the case. Perkins also took seven photos of the victim's injuries.
Perkins will often give a rape victim two Ovral tablets, the "morning-after pill," to prevent pregnancy. But this woman was using birth control and told Perkins that she was not worried about getting pregnant.
But the woman was worried about getting a sexually transmitted disease from her attacker, so Perkins gave her two types of antibiotics, Rocephin and Zithromax.
The state lab identified the victim's DNA in her blood sample, then compared it with the DNA on one of the vaginal swabs that Perkins had made.
Their conclusion: The swabs contained two different DNAs, one from the victim and the other from a male, apparently the attacker.
The lab compared the attacker's DNA with other DNA in the Virginia DNA Data Bank but got no hits.
"Future searches will be conducted on a periodic basis," the lab report said.
That is exactly what happened.
More than four years later, in August 2005, lab workers ran another search of the DNA Data Bank, and this time they made a match. The DNA collected by Perkins matched the DNA of a convicted felon, Rodney Braxton of Fredericksburg.
Years after the 2001 rape, Braxton was convicted of cocaine distribution and assault on a police officer. He was serving time in a Henrico County jail, where he was required to give a DNA sample. The sample had been entered in the state's database.
After the lab made the match, a Fredericksburg detective visited Braxton in jail and obtained a new DNA sample. The new sample also matched the one Perkins had obtained.
Braxton was charged with the rape. He was tried and convicted last month. He will be sentenced in July.
The guilty verdict came long after Perkins had left the courtroom. Later she said that the case illustrated how a trained person can provide care for a sexual assault victim and gather useful evidence for law enforcement.
"Justice is served," she said.
To reach JIM HALL:
Email: jhall@freelancestar.com
