«SI fell down the stairs.” The explanation is always the same, like a script ready to be acted out. Repeated like a refrain, as you do when you want to convince someone and perhaps even a little yourself. There Doctor Luciana Marzella, head of the Hand Traumatology and Microsurgery Service of the IRCCS Galeazzi-Sant’Ambrogio Hospitalhe still remembers the first time he had to deal with a case of domestic violence: «She was a young woman, with a fleeting gaze. Extinguished, like his dream of a happy life. He had unmistakable fractures on his wrists, those of someone who had tried to defend himself from the beatings. In the end, she found the courage to tell: it was her husband. Several times within a few months. She was taken into care by social services and accompanied on a protection path.” Since then, the specialist has heard that phrase repeated often. And it always set off alarm bells in her. He will tell it Friday 8 May, during the meeting open to the public (registration required) “Domestic violence and discrimination: a reality you need to know to fight it”, scheduled at 9:00 am, at the Auditorium of the IRCCS Galeazzi-Sant’Ambrogio Hospital, in Milan.
“Defensive” fractures: what are the most frequent signs
«The most frequent signs of violence are well-defined bruises on the wrists, as if someone had grabbed them forcefully. Or injuries to the little finger, the finger most exposed when you put your hands in front of your face, with your palms facing outwards, to defend yourself. Even the isolated fracture of the ulna must arouse suspicion. “When you raise your forearm to protect yourself from a blow, this more laterally exposed bone can break on its own, without involving the radius, which is the first to absorb the trauma of a fall.”
“It’s my fault, it’s nothing”
But it is not just a traumatological issue, which concerns the type and location of the fracture. It matters above all the way the patient talks. Those who suffer violence tend to do two things: minimize and blame themselves. The specialist must always relate the patient’s statements to the traumatic event: “If there is no correspondence – he explains -, something doesn’t add up”.
Not just adult women
The collective imagination associates domestic violence with couples. But the reality is more complex and concerns every age group. «We also see teenagers with suspicious injuries. Violence comes from the daily environment: brothers, cousins, peers. It is a form that resembles bullying, but occurs within family or very close relationships.” And then there are the elderly. “They are the most invisible and arrive with injuries due to the mistreatment of those who should assist them.”
Invisible wounds
In mind, Dr. Marzella has the fresh memory of a little girl beaten up by her brother blinded by envy of her successes. «He had footprint-shaped bruises on his wrists, clear traces of an attempt to free himself from a violent grip. In the eyes, other signs, even more painful: the invisible ones of those who feel betrayed by their closest loved ones”, he tells us with the firm tone – but full of empathy – of someone who has learned to manage emotions to help others. And he also tells of an elderly woman, confused by senile dementia: «I remember her arms locked in her closed shoulders, almost as if still defending herself. He couldn’t explain himself in words, but his body language said it all.”
Why is it so difficult to ask for help?
Behind the silence there is not only fear. «Psychological dependence matters, but economic dependence weighs even more. Many women, even today, do not have a real possibility of leaving their partner. This is why independence is a form of protection, and awareness of its importance must be cultivated from an early age. Just as – he adds – children must be taught that relationships are not possession and that affection is not measured in control but in respect”.
A social problem
Society has a decisive role. «The conditions must be created so that these principles do not remain just words: guaranteeing equal opportunities and strengthening the protection network against all forms of violence, so that women who feel in danger know they have an escape route».
The key is listening
Sometimes a few extra minutes are enough: «The difference is made by listening. One more question. Create a space of trust. If the suspicion remains, social workers and protection paths are activated, up to the point of reporting.” The first step is to talk, from there the rest builds.
You are not alone
The final message from Dr. Luciana Marzella is simple, but essential: “You don’t have to face everything alone.” And to those who feel like victims of violence, he says: «If it is true that there are people capable of doing harm, there are also those who are ready to offer concrete help, starting with health workers. Trust in those who can help you.”