Wednesday, April 2, 2003

Children have a friend indeed

Colleagues know Pat Myers deserves a huge thank you for a career of working to prevent child abuse

By John Johnston
The Cincinnati Enquirer

The guest of honor is a small, brown-eyed woman, bald because of chemotherapy. "I'm not a wig or hat person," is what Pat Myers says about that.

On this recent weeknight, her workplace, Cincinnati Children's Hospital Medical Center, is hosting "A Tribute to Pat Myers." The 65-year-old social worker sits on an auditorium stage and listens, along with nearly 200 colleagues, friends and family members, as speakers praise her pioneering work on behalf of abused children.

It's a moving tribute, but anyone who thinks Myers might lose her composure probably doesn't know her very well. This is, after all, a woman who in 30 years of hospital work learned by necessity to hold her emotions in check.

[photo] Pat Myers has been in the vanguard of child-abuse prevention since the 1960s.
(Tony Jones photos)
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She has seen it all: children who have been raped; children who have been victims of chronic sexual abuse; children who have been deliberately scalded; children who have been beaten and bloodied, their bones broken; children who have died from abuse.

"We are saving children here," Dr. Frank Putnam tells the crowd. He is director of Children's Mayerson Center for Safe and Healthy Children, one of the nation's leading hospital-based child-abuse programs, located three floors above the auditorium. "We are making some very difficult things less painful, a little easier, more hopeful for these children. We owe this to Pat Myers."

Found a calling

She didn't set out to be a pioneer. She was, she says, simply in the right place in the early 1970s to address a need.

"Child abuse was around us, no question," she says.

And yet, "It was very difficult to get physicians and other health-care professionals to even consider child abuse as a diagnosis," says Dr. Bob Reece, a nationally recognized expert on child abuse who worked with Myers at Children's Hospital in the early 1970s. "It was such an anathema to their thinking. We're trained to think of parents as loving and supportive."

Myers, though, had dealt with abuse and neglect cases while a social worker for Hamilton County's welfare department in the late 1960s. A few years later she became social work director at the Convalescent Hospital for Children, which eventually merged with Children's Hospital.

That's where, in 1975, Myers and a small group of doctors and social workers established one of the country's first child-abuse teams.

"Pat recognized that this was something that not only required vigilance on her part, it required the teamwork of community professionals and professionals within the hospital to help diagnose the condition and protect kids from further injury," says Dr. Robert Shapiro, medical director of the Mayerson Center.

"She's one of those who led the way," says Dr. Reece, now clinical professor of pediatrics at Tufts University School of Medicine in Boston and author of several books on child abuse. "And Pat did it in the usual Cincinnati way - without too much fanfare or horn blowing."

She had to do a lot of coaxing, though.

Occupation: A licensed independent social worker, she is clinical director of the Social Service Department at Cincinnati Children's Hospital Medical Center; associate director of the hospital's child-abuse team; associate professor, pediatric field service, University of Cincinnati.
Born: Sept. 13, 1937 in Indianapolis.
Residence: Hyde Park.
Family: Her partner for 18 years is Janet Borcherding, a physician in private practice.
Education: Bachelor's in social work from Ohio State University, 1959; master's in social work, Ohio State University, 1971.
Quote: "I'm fortunate to have had such an interesting and varied career at Children's, and to have had the support of my partner, friends, colleagues and family."
"Everyone was afraid of (child abuse)," Myers says. Doctors knew such a diagnosis could lead to confrontations with hostile parents and aggressive lawyers, subpoenas, court appearances.

Measure of bravery

"The docs who were involved initially (on the child-abuse team) were really quite brave," Myers says. And what of the social worker who wouldn't let those doctors ignore the issue? Wasn't she brave, too?

"I guess so," Myers says, her voice flat, unemotional. "I didn't really even think about it at the time. I just felt it was something that needed to be done."

Her hand was strengthened in the 1970s when state child-abuse laws were amended so that people who reported abuse were protected from civil or criminal action. Still, many doctors resisted diagnosing child abuse. One roadblock: few articles on the subject had appeared in medical journals.

Tracking the guilty

In the early 1980s, frustrated by their inability to bring suspected child-abuse cases to justice, Myers and Dr. Elaine Billmire, then medical director of the hospital's child-abuse team, began statistically analyzing records of children under age 1 with head trauma.

[photo] Dr. Connie McAneney (left) hugs Pat Myers.
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Their work, published in the journal Pediatrics, showed clearly that brain injuries caused by abuse looked very different from those caused by accidents, such as a baby falling off a couch. Indeed, they found that abuse is by far the most common cause of the injury that today is known as shaken-baby syndrome.

Dr. Billmire, now in private practice, says the abuse cases she saw sometimes caused her emotions to boil over. But she says that was never the case with Myers.

"I would sit with her at times when she was interviewing abusive parents, trying to get the story. She would be very calm, nodding, always reassuring. But if they tried to pull one over on her, she'd calmly say, `This is what's wrong with the child, and that doesn't explain it.' She'd let them know she knew that was a lot of bull."

Even when Myers felt threatened, she didn't show it. She recalls being in the hospital's Intensive Care Unit where a girl, about 2 years old, lay dying. The girl had been the victim of severe, ongoing abuse.

Her father was a tough character, full of bravado, "one of those guys who makes the hair stand up on the back of your neck," Myers says. He got into her face. "What are you trying to do, tell me I abused my child?"

As usual, she did not back down. The father was convicted of murder.

Those who know Myers say her approach - upfront, straightforward - is always the same, no matter whether she's talking to doctors or nurses or parents. Or children.

She remembers a polite little boy who had gonorrhea of the throat.

"We know something's happened here," she told him, "and I want you to tell me what it was."

"Ma'am, I'm afraid to tell you," he said.

She asked why.

"I'm afraid you might faint," he said.

Myers assured him she would not. Then she listened carefully as the boy told his story.

She tries to forget the most horrifying injuries to children.

Emotional detachment

"The attitude I developed over the years was, if I was going to do this job, and do a good job, I could not become emotionally involved with my patients. Because if I went home every night and cried - which you could do - I wouldn't be doing the kids any good."

In time, the respect and credibility she earned paid dividends. She made alliances with doctors and with community professionals. The child-abuse team grew to include law-enforcement agencies, prosecutors, and representatives of the Hamilton County Department of Job and Family Services. And Myers continued to voice her strong belief that everyone had a responsibility to intervene to stop child abuse, which crosses economic and social lines.

"She just never let go," says Ann Brandner, Children's clinical manager for social services.

Indeed, Myers continued to look for ways to help abused children. It troubled her that those who disclosed sexual abuse typically faced several interviews, each time by a different person in less-than-ideal surroundings, such as busy police stations or crowded emergency rooms.

In the mid-1990s, she and Dr. Shapiro started talking about forming an advocacy center, a one-stop, child-friendly place where abuse can be identified, evidence gathered, and decisions made to prevent it from happening again.

Myers' dream came true in January 2001 when the Mayerson Center for Safe and Healthy Children opened on the hospital's fifth floor. (A $1 million gift from the Manuel D. and Rhoda Mayerson Foundation, as well as other gifts, made it possible.) Investigators from a variety of child-abuse related agencies are housed there. Children need only tell their story once, to a trained specialist. Interviews are recorded, and police and others can unobtrusively observe from another room.

"I think everybody recognizes it's one of the top four or five (child-abuse) programs in the country," Dr. Reece says from Boston.

On average, the center evaluates six to seven suspected child abuse cases each day.

And now Myers, accustomed to taking on difficult issues, has been forced to deal with a personal one. Last September, after she suffered severe neck pain, a biopsy proved malignant. She's battled cancer before: mouth cancer in the mid '70s, a recurrence 10 years later, then breast cancer in August 2001.

`An advanced cancer'

This time she faces "an advanced cancer," the primary source of which is unknown.

No mention is made of that during "A Tribute to Pat Myers," which focuses on the achievements of a woman who never had children of her own, but helped so many.

During the program, the Co-operative Society and Junior Co-operative Society, fund-raising auxiliaries of the hospital, announce a five-year, $400,000 gift to fund the newly created Pat Myers Child Abuse Scholars Fund.

And when Myers makes an announcement - "I'm not retiring" - everyone applauds.

Then, "I've been very anxious all day about being able to say the right things," she says to an auditorium full of people who already know she's been saying and doing the right things for 30 years.


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