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It took "everything she had" for Theresa to run away from, and not toward, her home to seek help from a neighbor after she was badly beaten by her husband.
Hurt and bleeding, Theresa rang a neighbor's doorbell and asked for help, frantic about the children she'd left behind with her husband.
"What I needed most that night, in this order, was reassurance that my children were safe and that my husband had been arrested and would in jail at least overnight," Theresa said. "I wasn't terribly cooperative until I knew the answers to those questions."
On Tuesday, Theresa credited the Indiana paramedics who responded that night five years ago with helping her break free from an abusive relationship.
"That was the first time a health care professional knew that domestic violence was part of my life, a very secret part," said Theresa, identified only by her first name during a news conference at Intermountain Medical Center in Murray.
The center joined with the Utah Department of Health and the Utah Domestic Violence Council to urge health care practitioners to become educated on how to recognize and help abuse victims.
Theresa said the paramedics who cared for her were "professional, nonjudgmental and kind." So, too, medical staff at an urgent care center she later visited for X-rays.
"A safety net for domestic violence victims is critical if they are ever to become survivors," Theresa said. "I had no close friends and my relatives had become estranged. So for me, that safety net came from total strangers. But it was effective."
The first people to treat domestic violence victims have a tremendous opportunity to "shape whether they will leave, whether they will break that cycle of violence and escape their abuse," said Brooke St. John, a South Salt Lake victim advocate.
Kathy Franchek, who teaches pediatrics at the University of Utah's medical school, said all health care providers need to become educated about and incorporate routine screening in their practices.
"We are asking health care professionals across this state to be a voice for those who are suffering silently from domestic abuse," Francheck said.
Emergency departments at Intermountain Medical Center, Alta View Hospital and LDS Hospital have adopted what's known as the "Code-D" protocol to help staff screen for domestic violence, understand legal reporting requirements and be familiar with victim services.
But a 2009 health department survey found 55 percent of Utah emergency department staff believed they were not adequately trained to screen, access and make referrals for victims of domestic violence. The same survey found 76 percent of emergency department staff believed there was little they could do to help victims.
"We hope all the other hospitals will adopt the protocol," said Katie McMinn, the health department's violence prevention specialist.
Ned Searle, director of the Utah Office on Domestic and Sexual Violence, said domestic violence should be considered a potential health problem "for anyone who enters the doors of a medical facility, even if it's not the chief complaint."
Studies have found 44 percent of victims killed nationwide in a domestic-violence related homicide had visited an emergency department within the two years preceding death. With that in mind, the center's trauma center will ask all patients about physical abuse and personal safety as part of a new study to determine the prevalence of domestic violence, said Mary Pugh, a nurse practitioner at Intermountain Medical Center's trauma service.
But Theresa said many victims are unlikely to be truthful or forthcoming. She said she would have lied about her own abuse to her physician.
"It would have been just too terrifying and shameful to admit what was happening in my house."
That makes the work of those on the front lines of domestic violence challenging, she said.
"But this community has a tremendous network of dedicated professional people who make a difference in people's lives every day," she said. "Like the paramedic who helped me, they can save people's lives and not even realize it."
The 'most serious violent crime in Utah'
Ned Searle, director of the Utah Office on Domestic and Sexual Violence, said such abuse is the "fastest growing and most serious violent crime in Utah."
In Utah, one in four women will suffer some form of domestic violence in their lifetime.
In Utah, 225 children, women and men lost their lives in domestic violence related incidents between 2001 and 2009.
National studies have shown more women are injured as a result of being battered by an intimate partner than from motor vehicle crashes and anonymous assaults combined.
National data show that four women die each day in the U.S. as a result of intimate partner violence.
Source: Ned Searle, director, Utah Office on Domestic and Sexual Violence; Mary Pugh, trauma nurse practitioner, Intermountain Medical Center