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One painful case after another

Copyright © 2013 Albuquerque Journal

Twin girls, supposedly possessed by evil spirits, were taken to a curandero who sodomized them every week for a summer, saying that would get rid of the spirits. Their mother, unknowing, waited in the next room.

Every day, Dr. Renée Ornelas meets one or two young sexual assault victims with similar horror stories when they come to the child sexual assault clinic she founded almost 20 years ago, Para Los Niños, in Downtown Albuquerque.

But what she hears and sees has not dampened her enthusiasm for a niche area of expertise in the New Mexico medical trenches that’s as unique as it is disturbing.

Dr. Renée Ornelas gives a training session that includes signs of child sexual abuse experts might not know to look for at Big Brothers Big Sisters of Central New Mexico on June 6. (Adolphe Pierre-Louis-Journal)

Dr. Renée Ornelas gives a training session that includes signs of child sexual abuse experts might not know to look for at Big Brothers Big Sisters of Central New Mexico on June 6. (Adolphe Pierre-Louis-Journal)

“I love my job. I feel like I make a difference,” says Ornelas, who knows that talking about her work isn’t for the faint of heart. “It’s a conversation-stopper, pretty much.”

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Ornelas, who turns 57 next month, is one of two board-certified child abuse pediatricians in New Mexico. The only one in the state specializing in child sexual assault, she’s one of 264 in the country certified in this branch of medicine that came into its own in 2009, according to a spokeswoman at the American Board of Pediatrics.

A typical case might go like this: A caregiver calls to make an appointment for a child who has been sexually assaulted. Ornelas reports the abuse to the police or to the Children, Youth and Families Department. Next, she separately meets with the caregiver, and then the child, to get a history. Then, she does a physical exam, without wearing a lab coat so as not to appear intimidating.

“Children have a bad association with white coats,” she said. “I want them to like me.”

That’s for their comfort, not hers. “In this work, you have to be in the thick of it. You have to be centered and present to be able to do it. If not, kids won’t talk to you,” she said. “If you’re distant, it’s all in your aura. Kids see auras.”

The child, nearly always female, gets on the table in the exam room, with a colorful mobile hanging from the ceiling and stirrups covered in Winnie the Pooh fabric. It’s often in these quiet moments that she learns details of what happened, as best as the victim can express it.

During the exam, Ornelas takes images using a culpascope, a $28,000 microscope mounted on a moveable arm that has a pedal-operated camera to record bruising, tearing or abnormalities in the genital area.

“I look at their tiny, baby private parts, like, ‘What were you even thinking?’ It bothers me. It’s disgusting, but I don’t focus on that.”

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Instead, she focuses on reassuring victims of their wellness. Ninety-five percent of the time, examinations don’t show abnormalities, but many of her young patients are emotionally bruised, convinced their bodies and spirits are forever changed, and that other people can tell. They feel shame and guilt, even though perpetrators use treats or kind words to break down their victims’ resistance to abuse, a process called grooming.

“I say, ‘You’re good, you’re great. Your body is going to be fine. Your body is healthy and normal and just like any other kid your age.'”

Her attitude is matter-of-fact about some harrowing details. If the child had been sexually abused in the last 72 hours, she explains, she also takes a sexual assault evidence kit, which takes 20 or 30 minutes, depending on what she finds.

“If somebody bites them, you have to take a swab.”

She stores the rape kit in a room at the clinic from which police can pick up evidence. Once the exam is over, she lets the child select a sticker or toy and goes over her findings with the caregiver.

Sometimes, what she’s exposed to – a mother not believing her child, a teenager who won’t break eye contact with her while recounting an experience – gets to her, but she doesn’t let it show.

“Tears well up, but they go away fast. There’s no room for me and my stuff in this. You can’t be doing this and crying.”

She stays grounded and keeps burnout at bay by hiking, cooking and spending time with her friends, she said during an interview in her office at the Family Advocacy Center, which also houses the offices of other victim services.

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A voice for children

Her resiliency after several decades of such emotionally taxing work is what her colleagues praise her for.

“The work she does is quite laudable,” says Loretta Cordova de Ortega, chairwoman of the Department of Pediatrics at University of New Mexico Hospital, who has worked with Ornelas since 1991.

“You don’t really find a whole lot of people who dedicate their whole career to it, which is what she’s done.”

Michelle Aldana, director of Forensic Services at All Faiths Children’s Safe House, would agree. Aldana’s facility is one that child sex abuse victims are taken to so that an interview of the assault can be videotaped.

“To find someone committed to working in child sex abuse for the amount of time she has been doing it is unheard of,” Aldana said. “It’s just very difficult to find someone who’s committed to such a difficult area of expertise. I think it’s difficult to deal with trauma on a daily basis in the capacity that she does. We’re able to benefit from that expertise and longevity.”

Adds Dr. Leslie Strickler, the only other child abuse pediatrician in New Mexico, who handles cases involving child physical abuse: “I would describe her as a visionary. She came and saw a void. She created a service that’s high quality and sustainable, which is incredibly difficult to do. She has been a wonderful mentor to me, enhancing my professional development, bringing me up professionally.”

What often happens months, even years after Ornelas’ exam, is that a person accused of sexual assault faces trial, and that’s when Ornelas’ expertise becomes important to law enforcement officials, including Beth Paiz, retired deputy chief for the Albuquerque Police Department.

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Between 2002 and 2008, Paiz worked as a sergeant and lieutenant in the Crimes Against Children unit, closely conferring with detectives and with Ornelas, whose opinions carried a lot of sway. “A lot of times, it meant whether we continued with a case or we didn’t.”

For example, Paiz said, a suspect might deny having had sexual intercourse with the child.

“Dr. Ornelas would come back with ‘This is a five-year-old with herpes.’ The next step would then be to test the suspect for herpes.”

It was often in a very no-nonsense way that she described her medical findings, Paiz said.

“We needed her information, her opinion, what she saw. Her medical expertise was just invaluable to us. It’s one thing for us to relay what a doctor told us, but for her to get on the stand … she is really a phenomenal advocate for these children. When they are not old enough to speak for themselves, she is that voice.”

Overcoming obstacles

Renée Ornelas’ path to doing what she does was cluttered with obstacles. From a poor family whose maternal and paternal grandparents came from Mexico, she’s the oldest of four children raised in East Los Angeles by a single mother who was on welfare until Ornelas was in sixth grade. Without any real guidance, she decided after graduating from high school that she wanted to go to college, but her grandmother had a different idea.

“Mi’ja, you can get a job at JC Penney,” she told her. “Then, we can get a discount.”

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She got scholarships to attend the University of Southern California, where her college adviser was against her becoming a biology major. “Oh, no, honey,” he told her. “It’s too hard.”

She graduated with a biology major anyway and went to medical school at the University of California, Irvine, graduating from there in 1983. When she tried to buy her first car, the salesman wouldn’t give her a loan, saying, “You’re Mexican. You’re probably going to get pregnant and drop out of medical school.”

In medical school, she met her future husband, then an aspiring pediatric ICU doctor – with whom she has since had two daughters and divorced. When he got a job at UNMH, she got a position there as well, as a hospital pediatrician often moonlighting in the emergency room, where she worked with child victims of assault.

It was there that she found that, although a lot of other people shied away from dealing with the child sexual abuse cases in medicine, she didn’t need to.

“It didn’t upset me. I could handle it,” she said. “I picked the thing I thought I could do.”

Seeing the need for a specialized clinic, she lobbied the Legislature to secure a $500,000 annual budget for Para Los Niños in 1994 and has been at it ever since.

Not many have made the same choice. A downside of the job is that the nurse practitioners and physician’s assistants she’s trained tend to leave after a year or two because, while doing nothing but sexual assault exams, their skill set atrophies, she said.

Now, there’s funding for an additional clinic staffer. She’s anticipating a search that will not be fast or easy, but she’ll stick around regardless of whether she gets any new help or not.

“I picked this path a long time ago,” she said. “I’m a very single-minded person. I can do the same thing for years and be totally happy.”

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