When athletes and car accident victims go to the emergency room after experiencing head injuries, they are routinely screened for traumatic brain injury (TBI) as part of basic medical protocol. However, when domestic violence victims show up at the ER, there is no such protocol for them. As a result, many battered women go home with undiagnosed and untreated brain injuries that can affect them for the rest of their lives.

This is the conclusion of groundbreaking research by AU Associate Professor of Literature and Journalism Rachel Louise Snyder, who published it in a recent New Yorker article titled “No Visible Bruises.” Her findings could radically change how domestic violence victims are treated by first responders, medical personnel, and the US criminal justice system.

Snyder, an investigative journalist and novelist, has been covering domestic violence around the world for 20 years. “No Visible Bruises” follows her 2013 New Yorker article, “A Raised Hand,” which was praised for identifying new ways of preventing domestic violence from escalating into domestic homicide.

Snyder is currently at work on her third related story for the magazine, as well as an investigation of guns and domestic violence for Marie Claire magazine. “Domestic violence has become my de facto beat,” she says, “because once I understood the vast constellation of elements surrounding both the causes and the solutions, I realized not only that it's a problem within our grasp to solve, but that if we begin to address it, it will diminish all kinds of violence.”

Starting with 911

The problem, writes Snyder, begins when first responders are not trained to look for signs of traumatic brain injuries in domestic-violence victims, and they may not ask the right questions. At the same time, victims may be too traumatized or filled with shame to share their stories. They might appear confused or hysterical, writes Snyder: “What researchers have learned from combat soldiers and football players and car-accident victims is only now making its way into the domestic-violence community: that the poor recall, the recanting, the changing details, along with other markers, like anxiety, hyper-vigilance, and headaches, can all be signs of TBI.”

Another challenge is that the injuries may not be easily visible. Snyder writes that 50 percent of domestic-violence victims will be strangled at some point, possibly causing strokes, blood clots, aspiration, brain injury, or death. Yet most strangulation injuries are internal, and only a small percentage of these victims will have visible marks that can be photographed by police.

All of this, writes Snyder, “means that diagnoses are rarely formalized, the assaults and injuries are downplayed, and abusers are prosecuted under lesser charges.”

Rachel Louise Snyder

Snyder currently teaches literary journalism and other related courses in the College’s creative writing MFA program. Her first novel, What We’ve Lost is Nothing (Scribner, 2014), chronicles the 24 hours following a series of burglaries in a Chicago suburb. Her previous book, Fugitive Denim: A Moving Story of People and Pants in the Borderless World of Global Trade (W. W. Norton, 2007), maps the global garment industry across the world.

Snyder also has written about a wide range of subjects closer to home, from missing soldiers to rock stars. She has written for Slate, Salon, the Washington Post, the Chicago Tribune, New Republic, Travel and Leisure, and Glamour, among others. She hosted the nationally syndicated global affairs series Latitudes on public radio, and her stories have aired on This American Life and All Things Considered.

To read more visit “No Visible Bruises” and “A Raised Hand.”