‘Nothing nice’ about incest

Press, 29 July 1989, Page 17

‘Nothing nice’ about incest

Dr Geoffrey Wyatt, one of the doctors involved in the Cleveland child sexual abuse controversy in Britain, gives an exclusive interview to JANET WATTS, “Observer.”

Dr Geoffrey Wyatt has lived in a self-imposed silence for the last two years. He never replied to the hugE public condemnation of the mutiple diagnoses of sexual abuse that he and Dr Marietta Higgs made in Cleveland children brought to them in Middlesborough General Hospital in early 1987. Now the dust is settling on the report of the But-ler-Sloss inquiry into the Cleveland crisis, and people are thankfully forgetting the whole horrible business. But now Dr Wyatt has broken his silence. He came south to London recently to take part in a televised discussion about Cleveland and child sexual abuse. Around the BBC’s table Dr Wyatt faced (among others) the British Miniser of Health, David Mellor, who has supported the complaints of some Cleveland parents against the doctors whose action precipitated the crisis. And they actually found some common ground. David Mellor deplored the scapegoating of the doctors. Wyatt adds: "If you scapegoat a doctor, there’s no-one left to act on behalf of the child. It also carries the grave risk that it will influence other doctors and make the identification of hitherto unsuspected and undisclosed sexual abuse less likely.” While Dr Higgs made most of the diagnoses of sexual abuse in Cleveland children referred by other agencies, it was Dr Wyatt who made more of the diagnoses of sexual abuse in children in whom it had not been suspected. We met very early in the morning after his meeting with Mellor: he wanted to get back to Middlesborough for his 10 a.m. clinic. He had been up most of that night trying to organise his thoughts into suit-

able interview sentences (writing “Blunt and Pithy” as a reminder at the top of a sheaf of notes). He looked nevertheless, fresh-faced and energetic, spoke with determined thoughtfulness, and forgot to drink his tea. Why has he stayed silent so long? Why is he talking now? He has asked himself the same questions. “YOU try to work out why you’re being quiet: and you find it’s because you feel isolated. “Then you realise that this isolation is also the situation of the abused child, and of the abuser. From what I’ve experienced myself over the last two years, I have come to think that isolation is the most damaging aspect of the whole problem. “I believe that to show concern as a doctor both for abused children and abusing adults is the first

step towards resolving that isolation.” But no-one can pretend it’s easy. For the professionals, as for the adults and children involved in this crime, “There’s nothing painless about working with child sexual abuse. It’s like walking over glass. All sorts of experts in the subject almost go crackers. “Look what happened to Freud: he reported his patients’ experience of abuse, then felt the chill wind of professional isolation: and discovered the Oedipus complex.” Dr Wyatt (who has three children of his own) is still employed as a consultant pediatrician at Middlesborough General Hospital, but he can no longer work on sexual abuse cases. “I can’t diagnose it any more. I’ve been stitched up.

This is not only personally hurtful — “that doesn’t matter” — but also potentially harmful to his patients.

“I am not allowed to diagnose a problem that carries with it a major health danger not only at that time but for the rest of the child’s life.” He hammers home the hard, hard-to-deny yet hard-to-accept facts of this matter: “Child sexual gabuse and child health cannot coexist. We are talking about indecent exposure, buggery, the use of children for pornography, the penetration of children’s orfices by penises and fingers. “There is nothing nice about child sexual abuse —- though speaking of ‘sexual gratification’ makes it sound pleasant — and it is unlikely to be detected and relieved without pain and suffering.

“Child sexual abuse arises out of enormously powerful emotional forces in adults, and it produces enormously powerful emotional reactions in children.

“Until you appreciate the magnitude of those two forces you cannot come to terms with everything else that happens with child sexual abuse, like the actions of doctors and social workers and the splitting up of families.

“You see things in terms of ‘Do we like that doctor?’ or ‘That family has gone through hell’.”

Dr Wyatt and Dr Higgs have now submitted to “The Lancet” a paper on the medical diagnosis of child sexual abuse. Until it achieves publication after a rigorous process of checks and referencing, Dr Wyatt feels unable to discuss the medical data it contains: the pediatricians’ attention to the sign of reflex anal dilation, for instance.

All he (stoutly) said was: “I do not regret the

diagnosis. I would not have expressed a diagnosis of sexual abuse were I not as clear and certain as it is possible for a doctor to be when he holds a medical opinion.”

He noted that the But-ler-Sloss report concluded that reflex anal dilation was “abnormal and suspicious and requires further investigation.” There is a well of silence at the heart of this problem. An abused child lives in silence, and so does an abuser; and Dr Wyatt has known that silence, too. There is another sort of silence, which is the silence that falls on any cheerful human company at the mention of child sexual abuse (or its older name, incest).

It suggests that nobody wants to talk about it, or even perhaps to know about it: let alone to have it diagnosed as present and even omnipresent in our society. Dr Geoffrey Wyatt is only human,, and subject to the temptation (under undoubted duress) to shut up about child sexual abuse for good.

But he won’t. “If a pediatrician can’t speak on behalf of the child, who on earth can?”

“But a doctor can only begin the process of helping the child. Professionals can only do what society will allow them to do.

“The tragedy of Cleveland is that the momentum is now fading, and with it are fading the children, the pediatricians, the social workers. “We may be going backwards to an era where professionals will only respond if a child is obviously and grossly abused. And that is an absolute tragedy.

"I do not criticise the Butler-Sloss report. But there’s a lot left to do. And we must make a start. We must be willing to continue what began in Cleveland in 1987.”