He had beaten and raped her, leaving marks inside and out, some of which would heal. This was his latest piece of work, and I doubt she was his first or will be his last. If it’s true you can know a man by his work, then I know he is an evil bastard whose art is violence and whose canvas is women.

Brutalized mentally and physically, embarrassed and desperate to start crawling away from her collision with horror, she refused to press charges against a man she had never met before that fateful day. In her refusal she had a lot of unhappy company, because many other women who are raped do not press charges either. They bear the oppressive silence of their truth, perhaps as another injury. I bet he knows that, counts on it, and hides behind it.

A man who would do what he had done to her does not just do it to one woman and stop; he knows it, I know it, and she knows it. Rape is about power and he needs to feel that powerful again. Most of us think rape is about sex, and sometimes it is, but an act of intimacy turned into an act of violence is perhaps the ultimate expression of power and control. That is why rape is used in campaigns of terror on civilian populations in wartime, and against women as a particularly brutal form of terror. Put a uniform on this man, give him a gun, and he could be terrorizing Muslim women in Bosnia or African women in Darfur. Women all over the world would recognize the type.

I doubt they would recognize him, however, because I bet he looks like other men, sounds like other men, may have a career like other men, and cannot be picked out of a crowd of guys at the community barbecue. He is anonymous, which is another tragedy in the making, because he is out there waiting for another woman and another opportunity. The world is not full of such anonymous men, but it certainly has its fill of them, putting every woman in jeopardy of meeting one, dating one, or even marrying one.

It is a woman’s unfair burden to consistently be on guard against such men, for it is a woman’s unguarded moments that he seeks; walking alone somewhere in the isolating darkness, missing the signals of his need to be in control in their relationship, drinking a little too much at a party, or being trusting on a first date. In his twisted mind, any behavior that singles a woman out as a target of opportunity means she is “asking” for it, and in this he may find some of his victims to be his miserable “partner”; some women who are raped think the fault was partly theirs, and their guilt is another reason for their silence. He probably knows that too.

He does not know that to his victim I am his shadow when I enter the room to examine her. She flinches at my presence and my touch because both remind her of him. I am another man, and one in a position of power touching her in unwelcome ways. I ask permission, where he did not, I am gentle where he was not, but everything I do recalls him to her and increases her pain. In this way he makes me his unwilling partner too, a fact for which I silently loath him even more as I practice my art, that of healing.

Despite my feelings the physician in me cannot forget somewhere in his past he also may have been a victim, possibly of sexual abuse as a child. That is often the case with men who abuse and victimize women. My thought about his possible past is just sterile, clinical acknowledgement of facts, however, and is devoid of sympathy. It dies of loneliness in my lack of interest in anything about him as a real human being. His free pass to compassion and understanding as a victim ran out when he became a victimizer.

The exam is exhaustive and exhausting, especially for the patient but also for health care providers. Our emotions are drained, because rape abuses everyone it touches. Hours of work are required, the documentation is lengthy, and, in the end, it all feels inadequate because we cannot cure the ill that has just been visited on this woman, and there will be no justice for her or him. She limps home and the perpetrator walks away, but if there is a God in heaven, the victim will recover and that rapist will burn in hell. If I could write a prescription for him to do that, I would.

Erik Steele, D.O., a physician in Bangor, is chief medical officer of Eastern Maine Healthcare Systems and is on the staff of several hospital emergency rooms in the region.