Unit 8Section 4 Exercise 15Abuse & Neglect Physicians: Management Issues

Clinical correlate #7 Intimate partner violence
Abuse and neglect

As the song below indicates, identifying abuse can be difficult, and even once it’s identified, it still elicits ambivalence in the support system, of whom the physician or health practitioner is an essential member. Experience the song and then link to the scenario which sheds further light on the uncertainties the physician faces when she or he suspects abuse.

Jason Michael Carroll – “Alyssa Lies"

My little girl met a new friend,
just the other day,
on the playground at school
between the tires and the swings

But she came home with tear-filled eyes,
and she said to me "Daddy, Alyssa lies"

Well I just brushed it off at first,
cause I didn't know how much my little girl had been hurt
or the things she had seen.
I wasn't ready when I said "You can tell me"

and she said...

Alyssa lies to the classroom,
Alyssa lies everyday at school,
Alyssa lies to the teachers
as she tries to cover every bruise

My little girl laid her head down that night to go to sleep.
As I stepped out the room, I heard her say a prayer so soft and sweet
"God bless my mom and my dad
and my new friend, Alyssa
I know she needs you bad"

Because Alyssa lies to the classroom,
Alyssa lies everyday at school,
Alyssa lies to the teachers
as she tries to cover every bruise

I had the worst night of sleep in years
as I tried to think of a way to calm her fears
I knew exactly what I had to do
but when we got to school on Monday I heard the news

My little girl asked me why everybody looked so sad.
The lump in my throat grew bigger
with every question that she asked.
Until I felt the tears run down my face
and I told her that Alyssa wouldn't be at school today

Cause she doesn't lie in the classroom
she doesn't lie anymore at school
Alyssa lies with Jesus
because there's nothin' anyone would do.

Tears filled my eyes, when my little girl asked me why
Alyssa lies.
Oh Daddy Tell Me Why
Alyssa lies

An now link to the following scenario, in which the physician describes witnessing a disturbing episode. It looks like child abuse, but is it?

Study Questions

1. In the first verse of the song, it becomes quite apparent that the daughter quickly picks up on the fact that her friend is being abused – whereas adults like her father seem to initially “brush it off”. As physicians, what does this song teach us about the gravity of a child’s claim of abuse?

2. In the case of a child such as Alyssa, a sense of fear and helplessness often holds them back from reporting abuse by their parents. Adults, likewise, often have an underlying fear of reporting claims of child abuse. Where does this fear arise form in each case? Compare or contrast.