BY KRISTA RAMSEY
The Cincinnati Enquirer

It is a sad but true fact that women are often given more information about the act of rape than about the police and medical procedures that come after it.

Like so many other things that distance a woman from her own body, it then becomes a dark place that no one speaks about or understands until, following an act of violence, a woman is thrust into it.

Women's advocates say the aftermath of rape is sometimes almost as traumatic as the act itself. The woman is subjected to a series of invasive, uncomfortable and sometimes humiliating procedures that are, nevertheless, crucial to her physical care and to evidence-gathering.

Her fingernails are clipped, her mouth and rectum swabbed, her pubic hairs clipped or plucked to be distinguished from those of the attacker. She is asked personal questions that, a few hours earlier, she would never have dreamed of discussing with a stranger.

At worst, she must repeat her story to a string of questioners - police, social workers, physicians.

At a moment when she feels most vulnerable, she also feels most out of control of her body, given over to a string of medical and police officials as if it is simply the scene of a crime.

Minimizing humiliation

Linda Hutson, a staff nurse in University Hospital's emergency department, has seen hundreds of women go through the aftermath of rape. Two rape victims died in her care.

She has helped perform dozens of rape exams. Over the years, she has worked quietly and valiantly to minimize victims' suffering.

One of rape victims' greatest distresses was the agony of three-hour exams. Mrs. Hutson pushed for expedient care. At University Hospital, exams now take 1 1/2 to 2 hours, and a hospital policy promises that victims will be seen within 15 minutes of being ready to be examined.

She has advocated for more privacy, more information and better continuity of care, all to give women dignity and self-determination in one of the most traumatic moments of their lives.

''We've tried to eliminate what we can that's most miserable for the women,'' Mrs. Hutson says.

Late last month, she found an important new opportunity.

Through her efforts, University Hospital won a $24,000 grant from the Ohio Department of Health to begin a sexual assault nurse examiner program.

Beginning Aug. 1, 10 University nurses will be trained to perform the entire rape exam. (Residents now generally do the pelvic exam.) They will stay with the woman throughout her time at the emergency department.

And they will know precisely how to gather physical evidence of the rape, and later to serve as expert witnesses in court.

Better case in court

These are dramatic and significant steps, both in the care of women and the prosecution of their assailants.

Now, women will no longer have to tell their story over and over to a string of hospital staff members. They will have a carefully trained guiding presence helping them through each step of the exam. And they will know, as Mrs. Hutson says, ''that these nurses have chosen to do this, they want to do it and they know the procedures perfectly.''

All of which makes a better case against their assailants.

''When forensics gets the evidence, they will know it's handled exactly the same way every time, and so will the prosecutor,'' Mrs. Hutson says. ''The evidence will be so carefully collected that it will present the best case so the perpetrator is prosecuted. It will go straight from here, and he will go directly to jail.''

Attorneys will provide courtroom training so the nurses become expert witnesses in trials.

Nothing will minimize the pain and rage women feel over being raped. For too long, however, callous legal and medical treatment added to it.

University Hospital's new nursing program will result in more compassion, consistency and efficiency. It will give women more information, more control and support.

For those thrust into the unjust darkness of rape and assault, it is a small, crucial stream of hope and light.

Krista Ramsey's column appears in The Enquirer on Saturdays. Write her at 312 Elm St., Cincinnati 45202 or fax at 768-8340.

RAMSEY ARCHIVE