SAN DIEGO — "You walk in the door at 8 a.m. and the phone's already ringing. It's a police officer and it can be from anywhere in San Diego County. He wants a child evaluated, he's asking for a physical exam, he's asking for an interview.
"And you say, 'Well, when do you need it?' And he says, 'We need it today.' It doesn't matter what the day's like, whether we have two cases or 10 cases, we still have to fit them in."
Geri Beattie pauses for a quick breath. A nurse, Beattie's speaking style is energetic, precise, professional--an odd contrast to her sweat shirt and slacks.
The casual clothes serve a specific purpose, however. So do the kites painted on the walls. And the stuffed bears cluttering every spare corner of the Center for Child Protection. All are intended to alleviate the anxiety of children--children who come there for examinations that will reveal if they have been sexually abused.
For the Record
Los Angeles Times Friday February 12, 1988 San Diego County Edition Part 1 Page 2 Column 6 Metro Desk 2 inches; 38 words Type of Material: Correction
A story in Thursday's View section incorrectly stated that 1,447 cases of child abuse were reported in San Diego County last year. That actually is the number of cases requiring treatment in 1987 by physicians at the Center for Child Protection at Children's Hospital.
Second in Country
Children's Hospital opened the Center for Child Protection in July, 1985. It became only the second child-abuse clinic in the country-- after the Kempe Center for the Prevention of Child Abuse in Denver--to combine counseling and research to combat child abuse.
The center is a symbol of the long-simmering interests of Dr. David Chadwick, who served as chief of staff at Children's Hospital for 17 years before leaving that position to found the center almost three years ago.
A slender, 61-year-old pediatrician with curling, iron-gray hair, Chadwick saw his first case of child abuse at Children's Hospital in Los Angeles in 1960. Recognized as perhaps the leading local authority on the problem, Chadwick helped draft a model child-abuse reporting law adopted in all 50 states.
Over the past two decades, the number of sexual and physical abuse cases reported in San Diego County grew phenomenally, jumping from 298 in 1980 to 1,442 in 1985. Although the figures have stabilized over the past three years--there were 1,447 cases in 1987--Chadwick says there has been a disturbing increase in severe physical abuse, which he defines as "fractures and up."
"A couple years ago we were seeing 50 or 60 (severe cases) a year. We were up around 200 in 1987," he says. "We've had more deaths, too. Five or six deaths a year was about average for 1980-85. In '87, the number was 17."
Part of the tremendous increase is probably due to Children's being designated as the county trauma center for children. But Chadwick says the jump in serious cases also results from the increased stress felt by parents and the decay of extended family relationships, factors that he says contribute not only to physical abuse, but to a general erosion of the quality of child care.
"Child abuse is just the edge of unacceptable forms of child care," Chadwick said. "I think if you look at less serious things--latchkey kids left alone, kids in marginal child-care situations, unlicensed child care, inadequate child care--you see a big increase in that too. Child abuse is where we define it as something we just don't tolerate."
Although he would never justify their actions, Chadwick speaks compassionately about the kind of people who are likely to injure or neglect their children.
"We're looking at people whose lives are pretty bad," he says. "(Often), they were abused themselves. They've got to sort of reestablish their own childhoods. They've got to go back and learn how (to be good parents), through some positive experiences of their own."
The center's fight against abuse is a fierce one. Here is a glimpse of the battle:
It's 8:30 in the center's two-story building adjacent to Children's Hospital, and the first of five sexual abuse exams that take place on a typical weekday is getting under way. Cases can range from the mild--an infant with a genital rash, where no evidence of abuse can be found--to the severe, like the teen-age girl who recently reported that her mother's boyfriend had molested her since she was 2 years old.
In a fictional but typical case (the center would not discuss actual cases for legal reasons), 6-year-old Pam has been brought in after the mother of a playmate heard her saying, "My daddy touches my peepee," and called the county child-abuse hot line.
Pam and her mother are greeted by Linda Tarke, a licensed clinical social worker, who interviews Pam in a small, cozy room equipped with toys. It looks like any child's playroom, but care is taken to ensure that the dolls are anatomically correct, and a doll house is there to help Pam identify where an incident occurred. A one-way window allows videotaping and observation of the interview by a police officer.
Building a Rapport