This is what she told us:

She was sitting out on her patio with her friends and cousins, and everyone was drinking. Socially, not binge drinking — the EtOH level we drew on her later would confirm this. Her husband left to go do…something…and when he returned he was (a) inebriated and (b) upset that she was still spending time with her cousins and friends.

So he started yelling, and she started yelling, and he pushed her, and she got mad and grabbed a shovel, but didn’t want to hit him so she started hitting her car (yes, with the shovel; no, I don’t know WTF). This got him even more angry, and he came at her and shoved her to the ground, and then reached down and punched her on the left side of her face.

She stayed down, knowing that if she stood, he would get even angrier, and she directed her cousins to call the police. They did, and when NNPD arrived they arrested him and called the paramedics to take her to us at the clinic.

This is what is different about the witness report:

He did indeed shove her to the ground, and then punch her in the face.

But after that he kicked her, twice, in the face, with his steel-toed work boot.

She has no memory of this part of the assault.

This is what we can deduce from her injuries:

When he shoved her, her right foot got caught on the ground, and twisted. The force of her fall jerked her right leg medially and her right foot laterally. This caused two things to happen. One, her fibula was stretched like the wishbone of a turkey, and snapped, distally, above the tibiofibular joint, where the bone narrows to make the connection. Two, the pressure on the medial malleolus of the tibia caused it to snap off, entirely, and float, unattached, around in the joint socket.

This is a variation on a distal tib-fib fracture. Both of the bones in her lower leg were broken (and she was in excruciating pain).

When he kicked her in the face, he broke her nasal bone. He also caused the tissues surrounding her left eye to swell severely, around and underneath her conjunctiva, indicating a serious blow.

When we pried open that eyelid, we realized her pupils were uneven. Which indicates a brain injury.

And miscellaneous scattered abrasions from the dirt and sand when she fell.

We paged x-ray in to get a look at the leg, but it was obviously deformed. She lay there holding herself rigid, letting the Toradol work.

“Daria,” I said. She opened her right eye. “I can’t say for sure, but we think he broke your leg.”

She started to cry. Her nose started to run and blood and snot ran down her face and tears and pus leaked from her left eye. Then she grabbed a tissue from me and wiped her face and said, “Call the police. I want that motherfucker arrested. I’ve had enough; I’m going to press charges. I’ve got my kids to think of.”

“Has he done this to you before?”

“Yes. He broke my collar before.” Then a thought occurs to her, and she looks right at me. “Is my daughter, is my little girl OK?”

“I don’t know — she’s not here. Did he hurt her?”

She nods, and speaks, and as she does my blood runs cold. “I think he hit her with a two-by-four.”

The story ends as so many do in my ER, anti-climatically.

We sent her out for a stat CT scan of her head, and whatever the radiologist saw concerned him enough that she was admitted on the spot.

NNPD took report in the ER and went after the husband.

I have no idea what happened to her daughter.

So many things about her stick out in my mind, but for some reason, foremost is this: after we cleaned the blood and mud and sand off of her face and arms and legs, we helped her into a wheelchair so she could go use the bathroom. After, we wheeled her back to the bed, and she absently pulled her hair away from her face and looked up at the doctor, and I realized that she was breathtakingly, stunningly beautiful.

I find myself drawn, wholly, to these women, to these victims of abuse and violence. I want to know what to do to help them best. To support their choices — from the fiercely powerful choice to take control and leave him for good, all the way to the heartbreaking choice to go back to him yet again.

It rattles in my brain, as do thoughts about racism, sexism, control, hate, prejudice, all manner of social ills, and how the cycle perpetuates and magnifies across generations. And what a daunting task it is to try to break it apart.