Finding hope in the darkest moments

“Working in the field of trauma has taught me about the importance of ‘hopefulness’ for survivors – even in their darkest moments,” says Dr. Susan McNair, Medical Director of the Regional Sexual Assault and Domestic Violence and Treatment Program (RSADVTP) at St. Joseph’s.

The physician leader has been the Medical Director of the RSADVTP team since starting her career in 1991. Today, this program provides more than 2,000 visits a year – to patients as young as infants.  

For as long as she can remember, McNair wanted to be a doctor. After completing medical school in Toronto, she returned home to London to complete her family medicine residency through Western’s Schulich School of Medicine & Dentistry. She soon joined St.

“St. Joseph’s has been my clinical home throughout my career,” she says.

From its earliest days in the 1990s, the RSADVTP has grown to provide medical, forensic and psychological care and has become one of five provincial paediatric centres offering care to infants, children and youth. Today, as a regional program, it provides care 24/7 to individuals of any gender identity, across the age spectrum, who have experienced sexual assault/sexual abuse and/or domestic violence from Elgin, Huron, Perth, Oxford and London and Middlesex counties.

McNair says the team – including  nurse examiners, physicians, social workers and a program secretary – are at the heart of the interdisciplinary program. And she credits the Program’s Clinical Manager Cassandra Fisher for leadership in bringing patient-related needs to the forefront and for supporting changes.  

It’s that positive and forward thinking that has led to the RSADVTP recently developing new partnerships with Western University, Fanshawe College and Oxford County. All are focused on increasing care and service to survivors. Whether it’s going on-site to university or college or providing increased training to care providers in the region – the team is dedicated to meeting each patient’s needs where they are in the community.

They have also developed partnerships with London Police Services (LPS) that builds capacity for police to come to the Program at St. Joseph’s to take official statements – eliminating the need for survivors to suffer more trauma by navigating their way through police headquarters.

A further agreement with the LPS is centred around support for victims of human trafficking. McNair explains that London is a significant centre for human trafficking and women are regularly taken along the 401 corridor to be trafficked. Now, the RSADVTP is the point of first contact when the human trafficking office division of the police rescues someone. Rather than waiting for care in an emergency room, they are brought directly to the RSADVTP to receive acute forensic and medical care, and to address their many unmet primary care needs.  

The RSADVTP team and their hospital and community based colleagues are also continuing to strengthen their care partnerships, particularly in paediatrics. “I feel more than ever that multiple organizations and agencies are wrapping our arms around patients,” says McNair.

A passionate advocate for primary care, combined with a lack of available primary care practitioners, have required McNair to create informal clinic hours to support trauma survivors in the program– many of whom don’t have a family doctor or have not found success within traditional health care settings. “Trauma survivors require a trauma-informed care setting in which their needs can be recognized, the impact of trauma realized and the response to their suffering provided in a healing and non-retraumatizing manner.”

In addition, as medical director, McNair oversees the development of new protocols for care, plays a major role in the training of new nurse and physician examiners and develops curriculum in this area for undergraduate and postgraduate learners in a number of specialty areas.

She also provides integral outreach teaching for other health care programs including orthopaedics, rehabilitation and dentistry – all areas where evidence of assault may be uncovered.

McNair is equally committed to advancing research in this field, with a particular interest in patterns of body and genital injury, areas in which she provides expert witness at all levels of the court system.  

The dedicated physician is proud of the work the RSADVTP does and the care it provides, but she doesn’t shy away from the realities of our world and the increase in cases the program is seeing annually.

Reflecting on a recent medical school lecture about trauma-informed care, McNair says she spoke about hopefulness and urged her students to be curious about their patients’ lives and reflect on their own biases as they provide care.  

After more than three decades, McNair says she is providing care with more conviction than ever. And it’s hope that drives her.

“Within the confines of the trauma, I regularly tell survivors, that while the event they experienced may impact their life in the long term, it doesn’t have to ruin their life, and the care we provide is aimed at assisting them in getting to a new normal, a place where life again has meaning and joy.  As care providers, we can hold out hope for survivors – for their treatment, recovery and their journey through life.”

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