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Testimony

Working for the Defense

I’ll be talking quite a bit this week about expert consulting and testimony, so the topic of what it means to be an ethical defense expert is on my mind. But the truth is that lately, I have been thinking a lot about what it means to work for the defense, particularly when you may be interviewing and/or testifying opposite a treating medical-forensic examiner. The reality is that no one really teaches a clinician how to be good defense expert and the ways in which that role differs from being a good prosecution expert. However, there are differences, even as the goal (regardless of who has hired you) continues to be objectivity.

There seems to be a common misperception that in order to be helpful to the defense you must destroy the treating clinician, and this is an unfortunate approach. With very few exceptions, I take the good camper approach to all treating clinicians, even as the defense expert: leave people a little better than when you found them. People are naturally wary of talking with the defense team; it costs you nothing to be collegial even while identifying issues on the part of the exam, the clinician or the documentation. There are a million ways to determine what success looks like in this work, but one sure-fire way to know that you have failed is when the clinicians you come in contact with want to quit the profession after talking with you. And yet, that’s exactly what I have heard on more than one occasion after clinicians have finished interviewing with defense experts. Can you imagine being so caustic that you literally drive someone from the profession?

By the way, the flip side also holds true: in order to be helpful to the prosecution, it is not your job to save the treating clinician. Sometimes exams are done badly; sometimes the documentation is so poor as to be utterly unhelpful. Sometimes people embellish their credentials (true story) and they have to face the music on cross-exam. Experts don’t make these cases. Experts are simply one part of a larger strategy. We educate, we advise. We don’t win or lose trials.

Every interaction with other clinicians is an opportunity for mentoring, even in the courtroom. Anyone who has been doing this work for the years it takes to be a good expert at trial should commit to growing the profession, not tearing it down. It is the very least our patients deserve.

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Have you checked out the FHO store lately? You can find the newest research brief, Applying The Strangulation Research To Expert Testimony In Cases With Adult Victims. Or purchase the complete set of three (Strangulation, Aging Bruises, and Consensual Sex Injury) for a special price.

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Uncategorized

Since Last We Spoke, 9-9-19

I’m off to New Orleans for what is one of my favorite weeks of the year, the IAFN annual conference. I hope to see many FHO readers in person (please stop me and say hi!), plus I am looking forward to two sold-out sessions, and another 2 that should be pretty lively, even if we don’t reach bodies-on-every-surface type numbers for those (c’mon guys. 3-hours of ethics isn’t your jam?). With everything going on in my world right now, I am grateful for this week, which always recharges my batteries. Particularly because it gives me facetime with so many like-minded folks. Can’t wait to see y’all there.

After a really terrific course at Ft. Hood last week, I spent much of the weekend playing catch up. Still, there was time for some surfing–here’s what caught my eye since last we spoke:

Good news! Shaving/waxing your pubic hair doesn’t increase your risk of STIs. We can all breathe a bit easier (thanks, Kim Day for the link)

New ACOG Committee Opinion on Human Trafficking

Words. Mean. Things.

When death shuts down justice, it also shuts down the voices of victims.

The role of nurses when patients decide to end their lives

Don’t want to provide abortions? Don’t go into healthcare.

Related, from NEJM: The Dangerous Threat to Roe v. Wade

Great interview questions, in case that’s a thing you have to do soon

And because this week is the 9/11 anniversary, one of my favorite StoryCorps animations:

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Have you checked out the FHO store lately? You can find the newest research brief, Applying The Strangulation Research To Expert Testimony In Cases With Adult Victims. Or purchase the complete set of three (Strangulation, Aging Bruises, and Consensual Sex Injury) for a special price.

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Articles of Note Child Abuse DV/IPV Elder Abuse/Neglect Sexual Assault Testimony

Articles of Note: September 2019 Edition

It’s time once again for Articles of Note, our monthly romp through the peer-reviewed literature. Nothing free this month, but plenty worth tracking down, so I encourage you to spend some time with the list. It’s particularly fitting that I get a new edition up since I am sandwiching it between two weeks of teaching testimony, this week at Ft. Hood and next week at the annual IAFN conference, where we discuss at length the importance of fidelity to the science.

All links lead to PubMed abstracts. Happy reading!

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Have you checked out the FHO store lately? You can find the newest research brief, Applying The Strangulation Research To Expert Testimony In Cases With Adult Victims. Or purchase the complete set of three (Strangulation, Aging Bruises, and Consensual Sex Injury) for a special price.

Categories
Child Abuse Sexual Assault

Human Trafficking: Shooting Our Wounded and How to Stop

IPSCAN has its lasted webinar posted for viewing, Human Trafficking: Shooting Our Wounded and How to Stop. From the website:

Human trafficking is modern-day slavery and the human rights issue of our lifetime, affecting the vulnerable, poor, and oppressed around the world. In this FREE webinar, Dr. Celia Williamson, director of the Human Trafficking and Social Justice Institute at the University of Toledo, will give an overview of trafficking in the U.S. and around the world, including the process of trafficking, indicators to identify victims and traffickers, and how to report it. Rather than continuing to “shoot the wounded” with quick fixes or less-than-best practices, Dr. Williamson advocates for meaningful interventions at the individual and system levels. These can interrupt this practice, create collective change, and transform the way we think about trafficking, from a “Rescue and Restore” mission to a matter of Human Rights.

This is definitely a more introductory webinar, so if you have new members of your team (clinical or MDT) who haven’t had much continuing education on issues of trafficking, particularly trafficking of children and teens, this is a decent option. Nothing revolutionary, but solid info.

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Have you checked out the FHO store lately? You can find the newest research brief, Applying The Strangulation Research To Expert Testimony In Cases With Adult Victims. Or purchase the complete set of three (Strangulation, Aging Bruises, and Consensual Sex Injury) for a special price.

Categories
Sexual Assault

Virginity Testing: A Mini Clinical Guide For a Thing That Doesn’t Exist

(Clearly, this week got away from me–apologies for the lack of posts, but you know how it is. I’m heading to Ft. Hood next week. Expect more of the same.)

This post on Reddit’s Relationship Advice forum from a young woman whose fiance wanted her to have her hymen checked before their wedding (by his dad!) has been making its way around my Twitter feed, so I thought it would be a good time to re-up a few resources here. (BTW, here’s her update for all of you wondering.) Of course, virginity testing isn’t an actual thing, but we know that sometimes patients are brought in for that very purpose, so you can consider this a mini clinical guide:

Virginity and Hymen Testing: No Factual, Scientific or Medical Basis (Physicians for Human Rights)

Myths Surrounding Virginity: A Guide for Service Providers (International Rescue Committee)

Virginity Testing: A Systematic Review (Olson & Garcia-Moreno, 2017. Reproductive Health; FULL TEXT)

Eliminating Virginity Testing: An Interagency Statement (World Health Organization)

As always, I encourage you to follow the footnotes in these documents because there is a treasure trove of related readings that are relevant to practice.

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Have you checked out the FHO store lately? You can find the newest research brief, Applying The Strangulation Research To Expert Testimony In Cases With Adult Victims. Or purchase the complete set of three (Strangulation, Aging Bruises, and Consensual Sex Injury) for a special price.

Categories
Sexual Assault Testimony

Going Beyond Rape Kits

I am in Hawaii this week and while I will try and get posts up with some regularity, it will be a long week and the hours here are not my own. So, we’ll see how it goes. In the meantime, I’d like to draw your attention to this excellent article by IAFN CEO, Jennifer Pierce-Weeks, Going Beyond the Breakthrough Means Going Beyond Rape Kits. It beautifully encapsulates why the sexual assault medical-forensic exam is so much more than just collecting samples for a kit. Trying to figure out how to articulate in court why it’s important that patients come in and see us, even if they don’t want evidence collected? Well, Jen just helped you out by putting it down on paper. And she did it in less than a thousand words. Do yourself a favor–read it and then share it with your team.

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Have you checked out the FHO store lately? You can find the newest research brief, Applying The Strangulation Research To Expert Testimony In Cases With Adult Victims. Or purchase the complete set of three (Strangulation, Aging Bruises, and Consensual Sex Injury) for a special price.

Categories
Child Abuse DV/IPV Elder Abuse/Neglect Sexual Assault

Five Lies We Tell Ourselves About Trauma

Jason Kander and his wife Diana published an excellent article over at Crooked Media today, Five Lies We Tell Ourselves About Trauma. It’s 100% relevant to the work we all do because it applies equally to the issue of secondary trauma, which is something we should be discussing far more in our field. It would be a great topic for an upcoming staff meeting–particularly as a way to check in with the team.

There’s a lot that resonates, but one thing in particular:

I made the mistake of trying to rank—and therefore disregard—my own trauma for many years, and that only made things worse. If something happened and you haven’t felt right since, then you should address it. To quote a friend, “Somewhere there’s a vet who was in the first wave at the D-Day invasion telling himself to get over it because he was all the way in the back of the landing craft.” 

Thinking “other people have it worse” doesn’t actually diminish your own trauma, it just diminishes your power to heal, because your brain only knows what you experienced. Whether it’s combat, a serious accident, or an assault, there are many possible sources of trauma. Telling yourself to get over it, or thinking “I shouldn’t let this bother me,” will get you nowhere. 

Read the whole article here.

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Have you checked out the FHO store lately? You can find the newest research brief, Applying The Strangulation Research To Expert Testimony In Cases With Adult Victims. Or purchase the complete set of three (Strangulation, Aging Bruises, and Consensual Sex Injury) for a special price.

Categories
Sexual Assault

STI Update

After testimony, FHO readers like a good STI update best, and that’s what we have today. The National Network of STD Clinical Prevention Training Centers is offering a one-hour webinar providing an update of the info presented at this summer’s National Sexual Health Conference. It’s free and has 1.0 CEU/CME attached, so it’s good for all your board certifications/licensures. The session will be held September 3rd at 12pm MST. I do not know that it will be archived–you would need to contact the site directly to find out. From the site:

This one hour webinar will cover national clinical highlights of the 2019 National Sexual Health Conference originally presented in Chicago, IL, July 10-12, 2019. 

(Sorry–not a whole lot of info to go on, I know.) Register here.

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Have you checked out the FHO store lately? You can find the newest research brief, Applying The Strangulation Research To Expert Testimony In Cases With Adult Victims. Or purchase the complete set of three (Strangulation, Aging Bruises, and Consensual Sex Injury) for a special price.

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Uncategorized

Since Last We Spoke, 8-19-19

I’m home with the girlchild this week for her last few days before she starts college. She’ll move in this weekend and I’m off to Hawaii for work (and as of right now, I’m on the road every week until Halloween, although that could change). Certainly a pretty magical time.

Much of this weekend was consumed with reading one thing: the phenomenal 1619 Project published by the New York Times. If you can’t get past the paywall, you can find a pdf of the whole thing over at the Pulitzer Center where they have created a curriculum for teachers. It is worth every minute of your time, especially if you yourself are a medical/nursing educator. Check out also Random House’s 1619 Book List, which features some great titles, old and new.

The other thing I leave you with if you haven’t yet seen it is this video clip from Anderson Cooper’s interview with Stephen Colbert in which they discuss grief. It is one of the most powerful and lovely exchanges on the subject:

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Have you checked out the FHO store lately? You can find the newest research brief, Applying The Strangulation Research To Expert Testimony In Cases With Adult Victims. Or purchase the complete set of three (Strangulation, Aging Bruises, and Consensual Sex Injury) for a special price.

Categories
Child Abuse

Burns in Pediatric Abuse

An FHO reader sent me a request looking for an educational session focused on burns in child abuse. I got you–the National Children’s Advocacy Center has an archived webinar, Burns in Pediatric Abuse. Dr. Jonathan Thackeray is the featured speaker.

It’s free–you just need a one-time registration to log-in. And FYI, their complete list of medical webinars includes:

All of them are available to view once you’ve registered on the site.

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Have you checked out the FHO store lately? You can find the newest research brief, Applying The Strangulation Research To Expert Testimony In Cases With Adult Victims. Or purchase the complete set of three (Strangulation, Aging Bruises, and Consensual Sex Injury) for a special price.

Categories
DV/IPV Sexual Assault

Collaborative Strategies and Tools to Meet the Needs of Survivors of Human Trafficking

Futures Without Violence has a good SART/MDT/CCR* flavored webinar coming up for those of you looking for something for your local teams: Collaborative Strategies to Meet the Needs of Survivors of Human Trafficking. The session will take place on August 22nd at 2pm ET; it will also be archived. From the website:

This webinar will highlight collaborative work undertaken by multi-disciplinary teams across the U.S. to support domestic and sexual violence and human trafficking (DV/SA/HT) survivors.  Presenters will share how their partnerships or task forces were initiated; strategies to enhance client services and case coordination; and tools and training opportunities to build or expand collaborative responses for HT survivors across communities and states.  The webinar will share lessons learned from a community-based DV/SA/HT advocacy program, a law enforcement-led program, and a statewide task force operated by the Attorney General’s Office. It will also feature technical assistance and training resources offered by Futures Without Violence.  Time will be included for audience question/answer and discussion.

After the webinar, participants will be better able to:

  • Define the unique service needs HT victims that differ from domestic violence and sexual assault.
  • Identify community and state-wide strategies to develop new collaborations or expand existing networks to support survivors of HT.
  • Clarify multidisciplinary professional and organizational roles in coordinating services for trafficked survivors.
  • Utilize resources to help build or expand multi-disciplinary teams and task forces to support survivors of HT.

Register here.

*Sexual Assault Response Team/Multidisciplinary Response Team/ Coordinated Community Response because, acronyms 🙂

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Have you checked out the FHO store lately? You can find the newest research brief, Applying The Strangulation Research To Expert Testimony In Cases With Adult Victims. Or purchase the complete set of three (Strangulation, Aging Bruises, and Consensual Sex Injury) for a special price.

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Uncategorized

Since Last We Spoke, 8-12-19

I’m up at Michigan State University for a good part of this week, and happily, I am spending much of it writing with my dear friend Kim Day. This should result in some innovative and creative work since Kim is one of my favorite writing partners. It should also mean some long days, but I’ll try and get posts up regularly. In prepping for my time on-site at MSU, I spent most of the weekend working. But Sasha was at Ft. Bragg, so I was left with lots of time surfing the interwebs. Here’s what caught my eye since last we spoke:

I followed her accounts on Twitter and was treated to such a valuable education about the dying process. Truly nursing in action.

Why mental illness is not responsible for the epidemic of mass shootings

Related. Thank you, AMA.

HOWEVER, in a surprise to none of us in this work, the connection between misogyny and mass shooting

“The vulnerability and targeting of our Native women is undeniable, and we must begin looking for new ways to urgently address this plague of violence and disregard…” This is a must read.

Available now (in some places), gender non-binary IDs

Amnesty International has now issued a travel advisory for the US because of gun violence

Toni Morrison’s life and work has been memorialized in some stunning ways in the past week; find some of my favorites here, here and here.

A Utah nurse is facing negligent homicide charges after the death of an inmate from dehydration

This horrific story of an American woman who went to Uganda and administered medical care to children without any training whatsoever is stomach-churning (and also, the arrogance!)

And finally, an excellent video on how to tell someone they sound like a racist (this is truly the most practical advice on the topic):

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Have you checked out the FHO store lately? You can find the newest research brief, Applying The Strangulation Research To Expert Testimony In Cases With Adult Victims. Or purchase the complete set of three (Strangulation, Aging Bruises, and Consensual Sex Injury) for a special price.

Categories
DV/IPV Elder Abuse/Neglect Sexual Assault

New Clinical Guide: Caring for Transgender, Gender Non-Conforming and Non-Binary Patients in the Forensic Setting

In doing some writing this week for one of my projects I realized I had a decent collection of resources for a much-needed clinical guide: Caring for Transgender, Gender Non-Conforming and Non-Binary Patients in the Forensic Setting. It’s long overdue, and while I know it is not exhaustive, it’s a good starting place for everyone who hasn’t given this enough (or any) attention in their programs. To be clear, most of the guidance is focused more on general care issues than forensic setting-specific issues, which means it would be ideal to take one (or a few) of the resources listed here and have a robust discussion with your team about how to apply the recommendations to your own policies, documentation, and general approaches to patient communication. It’s a great topic for your next staff meeting.

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Have you checked out the FHO store lately? You can find the newest research brief, Applying The Strangulation Research To Expert Testimony In Cases With Adult Victims. Or purchase the complete set of three (Strangulation, Aging Bruises, and Consensual Sex Injury) for a special price.

Categories
Articles of Note Child Abuse DV/IPV Elder Abuse/Neglect Sexual Assault Testimony

Articles of Note: August 2019 Edition

It’s time once again for Articles of Note, our regular romp through the peer-reviewed science. Check it: we have not one, but two scientific papers this month on physicians committing misconduct, so that’s fascinating. We also get a look at how a clinician’s personal history of domestic violence impacts clinical care. Needless to say, there’s some good reading to be done in this edition (as always). Most links go to PubMed abstracts except where otherwise indicated.

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Have you checked out the FHO store lately? You can find the newest research brief, Applying The Strangulation Research To Expert Testimony In Cases With Adult Victims. Or purchase the complete set of three (Strangulation, Aging Bruises, and Consensual Sex Injury) for a special price.

Categories
DV/IPV

LGBTQ+ Intimate Partner Violence In Later Life

Long-time readers of FHO know I don’t generally post educational sessions here that aren’t free, but every now and again I make an exception if it’s a topic that doesn’t come along very often (and also comes with CEs). The American Society on Aging has a webinar coming up on LGBTQ+ Intimate Partner Violence in Later Life. It will be held September 12th at 10am PT. It’s free for ASA members, but $49 for non-members. From the website:

This web seminar will provide an overview of domestic violence and how it presents in the older adult and LGBTQ+ communities, and the dynamics of abuse in the older adult LGBTQ+ community. This web seminar will equip participants with a foundational understanding of trauma, and how the symptoms of trauma present in the LGBTQ+ older adult community across the lifespan from a trauma-informed framework.

Register here.

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Have you checked out the FHO store lately? You can find the newest research brief, Applying The Strangulation Research To Expert Testimony In Cases With Adult Victims. Or purchase the complete set of three (Strangulation, Aging Bruises, and Consensual Sex Injury) for a special price.

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Uncategorized

Since Last We Spoke, El Paso and Dayton Edition

I’m up in Newport, RI doing some work for the Navy this week, and it’s frankly a welcome respite from DC right now. In the wake of the mass shootings in El Paso and Dayton, I have to tell you–I’m tapped out. I’ve donated money to gun control efforts, and I’ve tried to stay offline as much as I can. I just don’t have the bandwidth to digest all the media right now, and if you don’t either, that’s okay. To all the FHO readers in both of those cities, and we have many, please know my thoughts are with you as so many of you were undoubtedly working in area hospitals this weekend. My prayers that you and your loved ones are safe and that maybe–maybe–this is the thing that moves this country to finally take action on guns. Because in this climate of white supremacy and toxic masculinity, this is not a problem that is just going to fix itself.

I’ve got nothing else to offer for today. I’ll be back tomorrow with regular posts. Take care of yourselves, people.

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Have you checked out the FHO store lately? You can find the newest research brief, Applying The Strangulation Research To Expert Testimony In Cases With Adult Victims. Or purchase the complete set of three (Strangulation, Aging Bruises, and Consensual Sex Injury) for a special price.

Categories
Child Abuse Sexual Assault

Child Sexual Abuse, Disclosure, and PTSD: Safer Responses to Disclosure

ISPCAN’s August Journal Club webinar will be Child Sexual Abuse, Disclosure, and PTSD: Safer Responses to Disclosure. The session will be held August 8th at 12pm ET. From the registration page:

This webinar will discuss the relationship between child sexual abuse, disclosure, and post-traumatic stress disorder. Given the importance of safe responses to disclosure of child sexual abuse, this webinar will also discuss VEGA (Violence, Evidence, Guidance, Action), a Canadian public health response to family violence. VEGA includes a handbook for recognizing and responding safely to family violence, as well as scripts and ‘how-to’ videos showing providers examples of how to safely respond to family violence, including child sexual abuse.

You can read the article on which this webinar will focus here (FULL TEXT).

Register for the session here.

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Have you checked out the FHO store lately? You can find the newest research brief, Applying The Strangulation Research To Expert Testimony In Cases With Adult Victims. Or purchase the complete set of three (Strangulation, Aging Bruises, and Consensual Sex Injury) for a special price.

Categories
Sexual Assault

A Campus-Wide Response to Sexual Misconduct: Best Practices

The Forensic Center of Excellence is hosting a webinar, A Campus-Wide Response to Sexual Misconduct: Best Practices. The session will be held August 7th at 1pm ET. I want to caveat this post by saying that I am *extremely* leary of almost anything claiming to be a best practice because it’s an almost meaningless phrase that people often declare of their own work without much evidence to support it (this isn’t specific to this webinar or this presenter, but much of what is presented in the forensic healthcare and -adjacent space). That being said, there are some interesting topics here, and it’s probably worth the 90 minutes. From the website:

This webinar highlights the dynamics of campus sexual assault that may be specific to, or heightened in the context of, a college or university setting. Additionally, the presenter discusses best practices in three areas of response to sexual misconduct on campus – encouraging reporting and use of supportive resources; resolution practices (including investigative/adjudicatory processes, adaptable resolution processes, and coordination with law enforcement); and interim and post-resolution measures. The webinar integrates information about the legal framework within which institutions must operate (e.g., Title IX, VAWA, Clery, case law, state laws, etc) with the nuances of supporting students and creating a safe and respectful campus climate.

Register here.

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Have you checked out the FHO store lately? You can find the newest research brief, Applying The Strangulation Research To Expert Testimony In Cases With Adult Victims. Or purchase the complete set of three (Strangulation, Aging Bruises, and Consensual Sex Injury) for a special price.

Categories
Child Abuse Sexual Assault

It Really is “Normal to be Normal” in Child Sexual Abuse

SAFEta has a webinar coming up on a popular topic, It Really is “Normal to be Normal” in Child Sexual Abuse. Dr. Karen Farst will be the speaker. The session will be held September 26th at 2pm ET. Like all their webinars, it will be archived. From the registration page:

The majority of children who have been sexually abused do not have residual findings of physical injury on the medical examination. Case based scenarios will be used to discuss how the anatomy of pre and post pubertal children and the dynamics of child sexual abuse (including disclosure dynamics) play into this fact. Key literature references will be provided and summarized for use in court preparation on “normal” cases.

Register here.

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Have you checked out the FHO store lately? You can find the newest research brief, Applying The Strangulation Research To Expert Testimony In Cases With Adult Victims. Or purchase the complete set of three (Strangulation, Aging Bruises, and Consensual Sex Injury) for a special price.

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Uncategorized

Since Last We Spoke, 7-29-19

Greetings to you all on this busy Monday morning. Back in the office for the week, and then it’s off to Newport, RI next weekend to teach one of my favorite courses of the year for the Navy and Marine Corps. Not every place I travel is particularly delightful, but this one is not a hardship, particularly in August. Plus, I am lucky enough to be teaching with my crew, so, you know…

A very happiest of birthdays to the girlchild who turned 18 this past week. Hard to believe we are less than a month away from launching this kid into college, and honestly, it’s a super exciting time around here. Especially with her being pretty close to home (2 hours by train, not that we have mapped it out).

It was relatively low key around here this weekend, with both Sasha and I having been on the road on opposite sides of the country last week. We managed to play tourist in our own city a bit yesterday, which was lovely. And there was still time to surf–here’s what caught my eye since last we spoke:

This is such a great, uplifting story: car mechanic to MD at 47

These reports will never stop coming

A powerful OpEd by 148 patriots

Neurosexism

AAP’s new statement on the health impact of racism

Sex and strangulation

There is an epidemic of suicides among seniors

She was assaulted by a State Senator–now she’s running for Congress

This 1st person essay about abortion is really timely

Start your week off right with the incredibly joyful Lizzo’s Tiny Desk Concert (NSFW if your workplace has issues with language 🙂 )

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Have you checked out the FHO store lately? You can find the newest research brief, Applying The Strangulation Research To Expert Testimony In Cases With Adult Victims. Or purchase the complete set of three (Strangulation, Aging Bruises, and Consensual Sex Injury) for a special price.