In exploring how to best handle these cases, we learned about prosecutors in San Diego who consulted with emergency-room doctors. They learned how dangerous it is when hands lock around a person’s neck, that this cuts off the blood supply to and from the brain.
Often, no outward marks are left.
In 1999, we brought a prosecutor and a physician from San Diego here — they trained more than 150 local professionals, including 911 operators, first responders, law enforcement officers, emergency physicians and nurses, prosecutors and victim advocates. They taught us about the dangers of strangulation and how to identify and prosecute it.
I’d always thought that choking someone was about cutting off the air supply, the ability to breathe. It certainly can be but, more importantly, the pressure of hands around someone’s neck closes the arteries carrying blood and oxygen to the brain and also shuts down the veins that return blood from the brain.
Such pressure for only 10 to 15 seconds can render the victim unconscious; continued pressure for less than five minutes will kill the person. To me, learning this was like a light bulb going on over my head, and it made an immediate difference in how I looked at “choking” cases.
I’d also thought that, if there were no marks, there was no injury.
I was wrong. The medical expert taught us that this kind of assault does not necessarily leave marks and that the lack of marks is not indicative of whether there was internal damage or risk of death.
Victims themselves often do not realize the seriousness of what has been done to them. But the symptoms they described to us were directly related to being strangled, to the deprivation of oxygen and internal bruising.
In addition to these physical injuries, there is often emotional harm from the attack and belief that they were about to be killed.
Choking, or more accurately, strangulation is very common in domestic violence incidents. It is also greatly overlooked and minimized because of the lack of training in its significance.
New York’s recently enacted law treats strangulation, defined as “criminal obstruction of breathing or blood circulation,” as a crime separate from assault. It recognizes that choking someone is potentially lethal conduct.
Because the absence of visible injuries led us to believe that this type of attack was not serious, it is eye-opening to learn differently. But this is new only in the sense that police and prosecutors, judges and juries are learning what is fundamental knowledge for medical professionals.
The structure of the neck is not new; the location of arteries and their oxygen-carrying function is not new.
What is new is bringing to court an understanding of human anatomy and “connecting the dots” between violent acts and their effects.
Penny Clute has been an attorney since 1973. She was the Clinton County district attorney from 1989 through 2001, then Plattsburgh City Court judge until she retired in January 2012.