Friday, June 08, 2007

Doctor Treats The Molested

Phil Jacobs Executive Editor 

(Dr. Baker is a long time member of The Awareness Center's international advisory baord)

Dr. Mesa Leventhal Baker lives a frum life, deeply committed to her faith, her family and her synagogue.

When one is next to this
Upper Park Heights resident, you feel her positive energy. You find yourself with a quicker step and at times a long-lost smile on your face.

Baker. stays "up."

She wouldn’t call it a survival method, but it probably is in a way. Because as medical director of the
Baltimore Child Abuse Center, Dr. Baker. has probably seen more "downers" in one day than any one of us could humanly handle.

She is a forensic pediatrician. Dr.
Baker. sees hundreds of cases of molestation yearly in her practice. And yes, some of them come from homes you and I would call "in our neighborhood."

"You have to be a really upbeat person to do this sort of work," she said while eating lunch on a warm spring Sunday afternoon. Her husband, Dr. Edward Leventhal, is coming in from mowing the grass. He is a urologist practicing in Owings Mills. The two physicians are products of the medical branch of the U.S. Army. They both saw action in
Iraq during Gulf War I.

Mesa is from Baltimore, born at St. Agnes Hospital. Ed is a Sinai baby.

While in the Army, she averaged one case of sexual molestation a week, collecting about 300 cases by the time she left. But then she moved to
Baltimore, and saw more than 700 cases her first year. They’re infants to 18-year-olds, a full third are boys.

"A huge amount of children don’t tell anyone at first," she said. "They wait, mostly until they feel safe; sometimes not till the offender dies. For littler kids, under 6, they are even more likely not to disclose at first. And this really flips the parents out. ‘Why didn’t my child tell me?’ The only way to have a child better prepared to disclose right away is for them to know what kind of touching is wrong in the first place. Once kids are out of diapers and don’t need direct assistance in the bathroom any more, it’s time to let them know that the parts of their body normally covered by a swimsuit are not for other people to touch. If someone does, they should tell Mom or Dad or another trusted adult right away. This isn’t a conversation that should be overly dramatic, nor take very long. Just as I hope you’re telling your kids not to ever get into a car with a stranger or accept anything from a stranger, you tell them this."

Baker. said that child sex offenders operate on a spectrum of behavior. They go from married individuals who prefer a partner of the opposite sex to dedicated pedophiles who are often clever and insightful. They know, she said, "their target audience. The first group are often called perpetrators of convenience. They go after what is handy, be it a stepdaughter or the teenage friends of a daughter.

"It all adds up," she said. "It’s all too convenient."

Dedicated pedophiles wants long-term contact with compliant victims. And they want a perpetuation of convenience. The Internet can make it so handy. "For many, it’s an addiction like other variations, I believe," Dr.

She said also that she believes the Orthodox community to be about "20 years" behind everyone else in the validation and care of victims. Some of her patients, she said, are so in the dark about what’s happened to them, that they don’t even know the proper names for their own genitalia. They, instead, refer to these areas, she said, as "down there." As in, "He touched me down there. If you’re 3 or 4 years old that may make sense, but if you’re 10 or 12, it is sad. Some kids just don’t have the right words to use."

For boys, she added, it’s especially not OK to be a victim because Dr.
Baker. said boys feel there is an added stigma of possible homosexuality.

"In approaching possible sexual abuse from the parents’ point of view, I want them to treat it like a cut on the hand. You wouldn’t ignore it, but you also don’t cry and run around in circles. You’re supposed to apply direct pressure and call for help. The equivalent steps in possible child sexual abuse are to ask open-ended, non-leading questions, then find some way to report. Yes and no type questions are not good. You don’t want to put words into the child’s mouth. One of the best approaches is to repeat exactly what the child has said to you and then ask, ‘Tell me more. Tell me all about that. Tell me what that means to you.’ All in as calm a manner as you can give. Victims will often give you the bare minimum at first. If you’ve heard enough to be reasonably convinced that something has happened to your child, then you call until you get the appropriate professional response."

Baker. emphasized over and over again that child abuse is a crime that must be reported to the authorities. Allegations of child sexual abuse deserve the most experienced professional assessment you can get. It should also be done in a way that does not traumatize a child or put words in his/her mouth. That is why the Baltimore Child Abuse Center was developed as a child-friendly, supportive, neutral location to conduct a non-leading interview by an experienced forensic interviewer. To keep children and their families from having to repeat things over and over, a multi-disciplinary team approach is used.

The team is comprised of the forensic interviewer (a licensed clinical social worker or a psychologist), the detective from the Child Abuse Unit, the Child Protective Services worker and Dr. Baker.

The forensic medical exam is much less intimidating than it sounds. "I’m a board-certified general pediatrician. There is no separate specialty of forensic pediatrician as of yet. However, the board is moving to make a specialty with its own testing and certification possibly in 2008.

"Meanwhile, I have the dubious distinction of having performed more child sexual abuse exams than anyone else in the state." Dr. Baker performs a close-up examination of a victim’s skin, using a special camera, looking for changes or scarring. "The kids love the camera; they’re naturally self-centered anyway and the exam is all about themselves.

"In general I love my job because I know that anything positive you do for kids is not wasted. For my own community, I want them to realize that abuse knows no bounds," she continued. "It has no socio-economic, national, religious or ethnic group it favors."

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