KIM NASH, SANE TRAINER, CO STATE SANE/SAFE PROJECT: I was brought in a domestic violence patient and a sexual assault. I was getting prepared to do her sexual assault and strangulation exam, and the detective spoke with me in the hallway and he said, “Kim, something changed on the way over here. She will not speak to me, she doesn't want you to do the exam, she's really angry and upset, and I don't know what the problem is.” She was fine with the perpetrator being arrested for domestic violence, and for strangulation, and for sexual assault, but she heard that they were charging him with child abuse because the kids witnessed this crime. Her father went to jail when she was a child for sexually abusing her. She said to me, “Do you know what it's like when your dad goes to jail in a small community and then you're the jailbird's daughter? From the third grade on, I was never invited to sleepovers. I didn't have friends ever again.” She said, “That experience of having an incarcerated parent was worse than the sexual abuse because it changed the rest of my life.” And in that moment, we all went, oh, my gosh, she doesn't want her trauma to become her children's trauma. If we didn't have a detective who was knowledgeable to recognize that something changed, if you didn't have a medical provider who was comfortable enough to ask that question in an appropriate way, how would we ever have known about that? Trauma-informed care can be an example like that, an actual trauma that happened in the past that will impact how this patient responds to the medical personnel or the law enforcement personnel. But we also know that trauma, like generational trauma, all of that does have a biological and a psychological impact on how they may view health facilities, government, investigation agencies. So it's not just what is this one trauma, but what other traumas have they lived and experienced in their life that is going to impact how they are going to respond to the health care that we're offering them?