AFTER THE TRAUMA SPECIALLY TRAINED TEAMS EASE THE WAY FOR RAPE VICTIMS IN THE HOURS, DAYS AND WEEKS FOLLOWING AN ATTACK.

Byline: Evan Henerson Staff Writer

For purposes of building the strongest possible rape case against Lakers guard Kobe Bryant, Bryant's 19-year-old accuser acted correctly: She went to the authorities and received medical testing within hours of the alleged incident. Of equal importance, Bryant was also tested within roughly the same time frame. Meaning the evidence was fresh. Time alone will tell whether the evidence is strong enough to secure a conviction.

In recent years, legal and medical authorities have tried to make the path easier and more convenient for victims of rape and sexual assault by consolidating efforts into a team approach. Even so, rape remains one of the least-reported violent crimes. Whether out of fear, shame or a combination, victims are often reluctant to report an attack. By the time they do, there is less chance of successfully prosecuting the attacker, particularly in cases where the rapist is a stranger.

``Most people who have just been raped feel dirty or disgusting,'' says detective Brian Llewellyn, of the Burbank Police Department's crimes against persons division. ``They want to launder or throw away their clothes and stew on the experience for days or sometimes weeks. Often they'll call up and make the report when all of the physical evidence no longer exists.''

Nicole, a San Fernando Valley woman who did not wish to give her last name, waited a week before going to the police after she was raped in her home. Indecision over whether to report the incident factored into her decision only slightly.

``In retrospect,'' she says, ``I wasn't ready. When something like this happens, your mind kind of loses it and you go into denial,'' she says. ``I'm not one to just go to the police. First of all, you're afraid and you don't know what's going to happen. The police are going to go find the guy and that's the last person you want to see. I needed to go through it all in my mind and make sure my story was solid going in. I thought if I was ambiguous, it wouldn't be as efficient.''

Nicole underwent a complete medical examination and received follow-up counseling from the Valley Trauma Center in Van Nuys. But many rape survivors never seek medical attention or report the crime. Rape remains one of the most underreported crimes with an estimated 39 percent of all rapes and sexual assaults reported in the year 2001, according to data from the Rape, Abuse And Incest National Network. An even smaller percentage are prosecuted.

``Medically, we really hope you would get checked out,'' says Gretchen Lampert, a counselor and clinical supervisor with the Valley Trauma Center, which provides crisis sexual-assault services. ``The center's position is that we encourage you to do what's right for you, whatever you decide that is.''

``Statistically, we know that the true perpetrators have an 80 percent recidivism rate, and we've had serial cases,'' she continues. ``We had one survivor who said, 'I think the reason God sent me here was to stop him from hurting anyone else.' She got out of here, remembered a license plate number, identified him and they caught him. He's locked up for life.''

According to Lampert, the clients she sees experience an emotional gamut from tears to lethargy and fatigue. Often it's the family or friend of a rape survivor who appears to be more in need of counseling and comfort than the survivor herself.

``The (survivors) are generally running on adrenalin once they get here,'' Lampert says. ``A lot of the time you get this sort of stunned look. They'll start to get hungry after they've been here 35 to 40 minutes. Sometimes we get people who are actually in tears. It varies a lot.''

All sexual assault victims are eligible for counseling and follow-up testing for pregnancy and sexually transmitted diseases. However, only a law enforcement agency can authorize the full interview and medical exam that is administered by a specialized facility like Northridge Hospital Medical Center's Sexual Assault Response Team (SART) and Children's Assault Treatment Services (CATS).

Adults can call a hotline and get treatment without alerting the police. If the victim is under 18, the person who takes the information is legally obligated to report the crime.

The creation of SART centers is designed to help police, physicians, nurses and rape crisis workers work together with greater efficiency. Better the ``one stop'' approach, team members say, than to send a rape victim from facility to facility, requiring her to repeat her story multiple times.

Originally part of the hospital's emergency room, Northridge's SART is located in a smaller, more secluded area of the medical center's Van Nuys campus. Team members are alerted when a victim is on the way in so that there will be little or no waiting and no crowded ER bustle to wade through.

By the time the SART team sees a rape victim, she has usually already been interviewed by a police agency, which has authorized - at no expense to the patient - a rape examination. An advocate from the Valley Trauma Center may be present during all phases of the examination.

``We let them know what to expect from the whole process, which can take away a lot of the fear,'' says Kathleen Adams, the SART's clinical manager. ``We have to interview them about their medical history and what happened during the assault so we can know what sort of injuries we might see and where to collect biological evidence.

``Some people are very afraid of making a report. We let them know that they can change their minds,'' continues Adams. ``The evidence time window is 72 hours. Even if they were to change their mind later, we could still do an exam.''

The examination typically takes three to four hours, but it's the recounting of the rape itself - to a police detective and to a rape crisis center's nurse examiner - that is often the most difficult part of the examination, according to Adams.

``We do that first,'' she says. ``When we're doing the actual exam, they start to relax a little bit. By then, we're talking about other things than the assault just to make the atmosphere a little more laid back and less intense.''

Nurse examiners will conduct a pelvic exam and take fluid samples from the victim's vagina, mouth and/or rectum depending on the circumstance of the rape. Nurse examiners look for visible bruises, which they will ask permission to photograph. They'll also comb pubic hairs and collect fingernail scrapings.

Patients may get referrals for pregnancy, HIV and sexually transmitted disease testing and counseling.

Once authorities have a suspect in custody, the rape victim will end up recounting the events of the attack again, to the district attorney who will prosecute the case before charges are filed, and again on the witness stand if the case goes to trial. Advocates often stay with the victim through the court process.

A certain relief can come with a successful prosecution, but true ``recovery'' and healing can take much longer.

``My counselor was pretty vague,'' says Nicole. ``She said it would take awhile, which I knew. It really depends on your support system and on how well you deal with things like this.

``My main piece of advice would be to see a counselor, even if you don't report (the rape) or do anything else,'' she added. ``As much as they say you can get through it on your own, I don't think that's possible.''

Evan Henerson, [phone]

evan.henerson(at)dailynews.com

Resources for assault victims

Here is a list of hotlines and phone numbers that sexual-assault victims can call for help and guidance:

Valley Trauma Center 24-Hour hotline: [phone] or [phone]

Rape Treatment Center, Santa Monica Hospital: [phone]

Rosa Parks Sexual Assault Crisis Center: [phone].

Project Sister: [phone] or [phone].

South Bay Rape Crisis Center: [phone].

East Los Angeles Rape and Battering Hotline: [phone].

Long Beach Rape Hotline: [phone].

Los Angeles Commission on Assault Against Women: [phone] or [phone].

What to do in the aftermath

Post-sexual-assault tips from the Valley Trauma Center and the Sexual Assault Response Team at Northridge Hospital Medical Center:

1. Report the attack as soon as possible to facilitate a request for a sexual assault medical examination.

2. Do not bathe, shower or douche.

3. Avoid drinking, eating, smoking, brushing teeth or taking in anything by mouth.

4. If possible, do not urinate or use restroom. If you do, collect the urine in a clean container and take it to the hospital.

5. If clothes have been changed, collect clothes, shoes and other garments worn during the assault and place them in a safe area.

6. If you are menstruating, keep tampon or pad.

7. If a condom was used, keep the condom.

8. If you do shower or wipe yourself with a towel, collect the towel.

9. If the attacker was a stranger, mentally note anything he touched either in your home or your personal property.

10. If you go to an emergency room, the examination should be only visual unless there is a medical necessity.

11. Do not consume any drugs or alcohol after the assault.

12. If you were intoxicated and have no memory of events, save any beverage provided by the possible assailant.

13. Limit conversations with friends or relatives about the assault.

- E.H.

CAPTION(S):

drawing, 3 photos, 2 boxes

Drawing:

(1 -- cover -- color) RAPE

Specialized teams help victims through the trauma that lingers long after the assault has ended

Jorge Irribarren/Staff Artist

Photo:

(1) Kathleen Adams, left, clinical manager for Northridge Hospital Medical Center's Sexual Assault Response Team, and Bonnie Bailer, director of the hospital's Center for Healthier Communities, in a child's exam room.

(2) A sexual-assault evidence kit contains a variety of items that may be used to examine rape victims, depending on the circumstances of the attack.

(3) SART clinical manager Kathleen Adams.

Charlotte Schmid-Maybach/Staff Photographer

Box:

(1) Resources for assault victims (see text)

(2) What to do in the aftermath (see text)