This Person You Love Will Take Your Life

It is a frigid morning in February on the outskirts of Detroit and Jacquelyn Campbell stands on the vast floor of a lecture room dwarfed by three massive screens behind her. She has flown in from her home in Baltimore just for the morning to teach the hundred or so assembled here about something she created three decades ago called the Danger Assessment. Originally written to help healthcare workers identify potential victims of domestic violence in emergency rooms, the Danger Assessment is probably the single most important tool used in intimate partner assault, treatment, and awareness today. How a victim answers the questions on any given Danger Assessment will determine what comes next: whether a perpetrator is arrested, tried, found guilty, and whether a victim will press charges, be taken to a shelter, walked through the court system. Often it will determine a much starker outcome: whether someone will live or die. The Danger Assessment has changed the course of how we understand and treat intimate partner violence in America and beyond. It has broken through cultural and political barriers, been adapted for use by police, attorneys, judges, advocates, and healthcare workers, among others. It has informed research and policy and saved countless lives.

Campbell is tall and elegant, with a tweed jacket and a black blouse, a thick head of deep auburn curls, and a chunky necklace. Her voice contains a perpetual smile, like a public radio host who has to deliver terrible news to an audience, but still sounds soothing. It’s the kind of voice you’d want if you were being told your mother was gravely ill or your family dog had passed on. She is talking about family violence, about the worst things people can do to each other, but Campbell’s voice has the assurance of a therapist promising that you’re in good hands. In Michigan alone in a single month—January of 2017—eighty-six women and five children were killed, she tells the audience. Many of those victims were known by those in this room.

The attendees gathered in this lecture hall to talk about family violence, everyone from uniformed and plain-clothed police officers to district attorneys and prosecutors, along with domestic violence advocates, mental health counselors, healthcare workers, and shelter volunteers. Campbell’s slideshow lists grim domestic violence statistic after statistic: second leading cause of death for African American women, third leading cause of death for native women, seventh leading cause of death for Caucasian women.

Campbell says twelve hundred abused women are killed every year in the United States.1

That figure does not count children. And it does not count the abusers who kill themselves after killing their partners, murder-suicides we see daily in the newspaper. And it does not count same-sex relationships where one or the other partner might not be “out.” And it does not count other family members, like sisters, aunts, grandmothers, who are often killed alongside the primary victim. And it does not count innocent bystanders: the twenty-six churchgoers in Texas, say, after a son-in-law has gone to a service to target his mother-in-law, or the two spa employees in Wisconsin killed alongside their client by her ex. The list is endless. And it does not count the jurisdictions who do not report their homicides, since homicide reporting is voluntary through the FBI’s Supplemental Homicide Reporting Data. So how many people are killed as a result of domestic violence each year? The bystanders, the other family members, the perpetrators’ suicides? The victims who just can’t take it anymore and kill themselves? The accidents that turn out not to be accidents at all, victims pushed out of cars and from cliffs or driven into trees. Tragedies forever uncategorized.

In this room, Campbell is among the believers, those who understand the underpinnings of how domestic violence operates. Many of them know the statistics intimately, in that they don’t see statistics, they see faces—of women, of men, of children caught up in this seemingly intractable cycle of violence. Campbell tells the story of a twenty-six-year-old woman killed in Maryland recently by her seventeen-year-old boyfriend. In Maryland, homicide is the leading cause of maternal mortality. Same with New York City and Chicago, Campbell says. Foreign armies and international terrorists and drunk drivers don’t have to kill us, because we are very efficient at killing ourselves.

This Maryland couple, the twenty-six-year-old and the seventeen-year-old, also had a two-month-old child, and the woman had three other children by three other men. Her five-year-old watched, screaming, as she was shot and killed. The two other toddlers came running out and so saw their mother dead, too. Three young children, traumatized, and a newborn. One of the toddlers had been abused by her biological father. The mother’s own father had abused her when she was a child. The seventeen-year-old boyfriend’s abuse as a child was so horrific that he’d been removed from his family home for five years. Layers, years, generations of abuse.

When Campbell and others looked into what happened in the aftermath of these four kids, they learned the newborn was being raised by the deceased mother’s parents—including her own abusive father. The other three are all also being raised by abusers. When the seventeen-year-old boyfriend gets out of jail after his twelve-year term for murder, he’ll likely take over raising the newborn, who will be an adolescent by then. And on it goes, the cycle of abuse, laid out right there in a single, complicated family. Campbell says they told Maryland state officials, “We’ll be looking at another case involving these kids [in twenty years] …” The state representatives balked, told Campbell they weren’t interested in what might happen in the future. In how kids who witness abuse perpetuate the cycle as adults. They wanted the immediate answer. What could they do right now? But the future was her point.

“This is about the long view of prevention,” she says. How to teach people to raise a child without abusing him, how to create a system that reaches out to children and parents and provides high-level, intensive counseling. Even after the murder of a parent, children often are lucky to have just one mental health counseling appointment.

There is good news, Campbell says, and several in the room laugh, because, really, up until now it’s been pretty grim. Campbell says that states where “we have good domestic violence laws and resources” are states where both men and women, though especially men, are less likely to be killed by their partners. Yes, men. The gender distinction is where they find the causal relationship. The states with fewer men’s deaths, Campbell tells the audience, are the states with good police responses, with good laws of protection, with decent resources for victims. In other words, Campbell says, “Abused women feel less like there’s no way out except to kill him.” In fact, since 1976 rates of men killed by women have dropped by nearly three-quarters.2

What she means is that there are states where abused women don’t have to resort to murdering their abusers to return to freedom. While there are no national statistics, some states collect this data. In New York, for example, two-thirds of incarcerated women in 2005 had been abused beforehand by the person they killed.3 Though in many states today, still, victims are barred from using their long histories of enduring violence at the hands of their partners in their own defense. One woman I spoke with who is incarcerated in North Carolina for first degree murder, Latina Ray, says she endured over a decade of abuse. Her partner beat her so badly that she lost the sight in her right eye entirely, yet her long history of victimization with him was never used in her case.4 Prior to taking his gun and shooting him, she hadn’t so much as had a traffic ticket on her record. In her mugshot, she is a beautiful woman with tawny skin and a mangled eye.

Listening to Campbell, I think back on the question most commonly asked by victims’ families. What could we have done? What could we have seen that we missed?

But it’s not really about the families. They can be made more aware, certainly, and Campbell says victims do sometimes confide in friends or family members. But there’s another group to consider; more than half of all homicide victims were seen by healthcare professionals at some point. It’s up to people like Campbell, in other words. Not just the emergency room, but primary care physicians, OB-GYN docs, and a host of other specialists. These people are often the first or only individuals to interact with a potential homicide victim. I think of the clinic Sally took Michelle to when she thought Rocky had given her a sexually transmitted disease. Though HIPAA law bars them from releasing any information on Michelle, they saw enough to prescribe her antidepressants. What else did they see? What may they have missed? Had the violence in Michelle’s life come up? A young, twenty-three-year-old married mother of two being checked for an STD and presenting herself—however that looked—as in need of antidepressants. Surely that’s enough red flags to probe a little deeper into her life.

Campbell remembers reading the file of one woman who had a cast on her arm at the time of her death, when she was shot through the temple and killed. Not a word about domestic violence appeared in the police report or in the notes from the emergency room where she’d been seen. A cast! Where had it come from? According to the report, no one had even bothered to ask about it. Another woman Campbell met had been shot and paralyzed by her abuser, but then went back to him after her release from the hospital. Campbell asked the woman if she’d been referred to domestic violence services, and she said she had not, but would have liked to have been. She’d returned to her abuser because she said she had no one else to help take care of her. Campbell was so incensed she marched down to the trauma unit where the woman had first been taken and they allegedly told Campbell they didn’t have time to assess for domestic violence. Campbell waved the intake sheet that their unit had filled out on the paralyzed woman and pointed right to where it said shot by husband.

On a short break, attendees check their phones, refill their coffees. I ask one of the police officers how he’s come to be here and he tells me the mayor of their town, Auburn Hills, recently put out a call to address domestic violence more effectively. They’d been getting trainings like this on the Danger Assessment. A week earlier they’d had some training in how to recognize strangulation. Later, Campbell will take a moment during her talk to stop, look up at the two uniformed officers in attendance and say, “Thank you for your role in keeping women safe.”

When her talk is finished, a line forms up the center aisle of people who want to thank her, who want to tell her their stories from the field, of how her work has saved not just “lives” in general, but this specific person or that one. How she helped this woman she’ll never meet, this child who will not grow up motherless after all. If there is such a thing as celebrity status in this world, Campbell has it.

Campbell began her professional career as a school nurse in inner-city Dayton. She knew most of the students in the school, boys and girls, though it was the girls who stayed with her. The girls who wound up pregnant, in her office, talking about their lives. How they lacked choices and agency. How they didn’t seem to believe they had any control over how their lives turned out. In her position, she got to know the social service agencies around the city, and sometimes she’d call this counselor or that and talk about some of the problems the girls had. One young woman, Annie, came to her as a teenager and said she was pregnant and her parents were making her life miserable. Campbell felt a particular closeness to Annie, a spark she seemed to recognize, but didn’t quite know how to help. The teenager father, Tyrone, was also one of the kids Campbell knew, though until the pregnancy she hadn’t known Tyrone and Annie were a couple. “He was charming, delightful,” Campbell said of Tyrone. “Such a lovely guy.” Tyrone wasn’t ready to make a lifelong commitment, of course, and Annie was miserable at home, so she managed to get welfare assistance and move into an apartment on her own. She left school, but stayed in touch with Campbell, letting her know how she was doing. Campbell would sometimes check in with another counselor who knew Annie through an at-risk young mothers program. She prayed Annie could find her way toward a rewarding life.

Then, one day in 1979, Annie’s counselor called Campbell, said she had some news. Annie had been stabbed more than a dozen times by Tyrone. Campbell was horrified, distraught. She did what everyone does in the immediate aftermath of such a thing: tried to figure out what she had missed, how she might have intervened to stop it, what had gone so terribly wrong. She went to the funeral and tried to hold herself together. Then later, when she reflected on it, she remembered seeing Annie with a black eye several times, remembered her speaking in generalities, dancing around the edges of the topic by saying things like, “We’re not getting along.” Or “We’re having trouble.” Annie didn’t have the words, and Campbell didn’t know the language of violence yet. Annie had spoken, but Campbell hadn’t gotten it. It felt like a gut punch. She thought listening and just being there were the things she could offer Annie. “If I had been smart enough to ask …” she says. Smart enough to ask the follow-up questions, to press a little harder, to not be afraid to pry.

And so the entirety of her professional life has been learning what to ask.

Campbell had always been interested in public health but had no larger career goal beyond a vague tugging. The feeling that nursing was fine, but she could do more. She wanted to do more. She’d followed her then-husband’s career to Dayton, to Detroit, to Rochester. Interested in public health, she began a master’s degree program at Wayne State University. Campbell’s thesis committee tasked her with the fuzzy directive to go “into a community and prevent something.” She pictured some kind of campaign, like getting people to wear seatbelts.

Their directive would change the course of her life.

There was very little literature on domestic violence homicide when Campbell began her graduate work. She thought of her nursing days, those young women who spoke about their futures with such resignation, and she decided maybe she’d look into the leading causes of death for young African American women. “I envisioned myself teaching them how to do breast exams,” she said. Instead, she was shocked to find the leading cause of death for young African American women was homicide. Murder? How could young Black women be dying in such numbers from murder?5

Campbell had stayed in touch with a number of her former inner-city students in Dayton, so she chose as her “community” these now twenty-something African American women. The place you start in public health, she told me in her office at Johns Hopkins School of Nursing, is the mortality tables. Outside her office, graduate students camped out to meet with her next to filing cabinets called the “Violence Drawers.” She remembered trying to explain to her thesis committee how homicides offered little clinical data, so they told her to create it herself. For her master’s, and later her PhD from the University of Rochester, she pored through police homicide files in Dayton and Detroit and Rochester, and at the same time interviewed abused women in multiple cities. She began to see patterns emerging, patterns that today may seem obvious, but that no one had measured.

Suddenly, Campbell could quantify what had been largely theory until then: that the single biggest risk for domestic homicide, for example, is the prior incidence of domestic violence. (Her initial research from Dayton’s police files showed that 50% of domestic homicide victims had been visited by the police for domestic abuse at least once previously.) Levels of dangerousness operated on a specific timeline. Dangerousness spiked when a victim attempted to leave an abuser, and it stayed very high for three months, then dipped only slightly for the next nine months. After a year, the dangerousness dropped off precipitously. So maybe Rocky Mosure didn’t need to be held forever; he just needed to be held long enough. Just as Michelle needed time to get her life together so she could provide for herself and her kids, Rocky needed time to understand that his life could go on without her. It seemed to Campbell that something that appeared random, like it happened in a snap, could actually be quantified and cataloged. At least half the women Campbell interviewed were unaware of the severity of their situations—a fact she says remains true today.

And even for those who do know, or have a sense, like Michelle Monson Mosure, it’s an absolute leap of cognition to imagine that this person you love, or once loved, this person you made a child with, this person you made a commitment to and vice versa, this person who shares every big and small detail of your life, would actually, truly take that life from you. Love is what makes domestic violence different from any other crime. That the people involved have said to each other and to the world, You are the most important person to me. And then, in an instant, for that relationship to become lethal? It requires us to mentally, intellectually, and emotionally hurdle beyond what we can imagine. “That trauma of knowing someone you love is willing to take your last breath?” asks Gael Strack, a leading domestic violence advocate in San Diego. “How do you live with that?”

Over the years, Campbell eventually identified twenty-two high risk factors that, when put together in an almost endless series of combinations, portended a potential homicide. Some of the risk factors were broad: substance abuse, gun ownership, extreme jealousy. Others were more specific: threats to kill, strangulation, and forced sex. Isolation from friends and family, a child from a different biological parent in the home, an abuser’s threat of suicide or violence during pregnancy, and stalking all added lethality. Access to a gun, drug or alcohol abuse, and controlling daily activities are among the risk factors, as are threats to children, destruction of property, and a victim’s attempt to leave anytime within the prior year. The sole economic factor Campbell identified was chronic unemployment. Many of these latter indicators don’t cause violence, she is quick to point out, but they can make a volatile situation deadly. It’s not the presence of a single factor that matters; it’s the particular combination of factors, each of which carries a different weighted measurement. She had women fill out a timeline of incidents, a kind of catalog of abuse, so that they would be able to see for themselves if there was escalation. (Campbell says many people do the Danger Assessment without the timeline, which misses crucial information about escalation and keeps victims from really being empowered with the knowledge that comes from being able to see their own situations as a collective whole. Indeed, I have seen multiple Danger Assessments done across the entire country, from police to advocates, and I rarely saw anyone do a timeline.)

Strangulation is one of those danger signs that Campbell pointed out in her early research, but it turns out that it is a much more significant marker than, say, a punch or a kick. Sixty percent of domestic violence victims are strangled6 at some point during the course of an abusive relationship—often repeatedly, over years—and the overwhelming majority of strangulation perpetrators are men (99%).7 Those strangled to the point of losing consciousness are at their highest risk of dying in the first twenty-four to forty-eight hours after the incident from strokes, blood clots, or aspiration (choking on their own vomit). Such incidents can cause brain injury—mild or traumatic—not only by cutting off oxygen to the brain, but because they are often accompanied by blunt force trauma to the head. Still, domestic violence victims are not routinely screened for strangulation or brain injury in emergency rooms, and the victims themselves, who tend to have poor recall of the incident, are often not even aware that they’ve lost consciousness. This means that diagnoses are rarely formalized, the assaults and injuries are downplayed and abusers are prosecuted under lesser charges.8

Gael Strack, chief executive officer of the Training Institute on Strangulation Prevention, is one of the most prominent voices in the domestic violence community today when it comes to strangulation and its attendant issues. In 1995, she was the assistant district attorney for the city of San Diego when two teenage girls were killed “on her watch,” as she puts it. In the weeks before one of the girls’ deaths—she was stabbed in front of her girlfriends—she had been strangled and the police summoned. But when they showed up, she recanted and no charges were filed. The other girl was strangled and set on fire. Both girls had sought domestic violence services and had made safety plans. Strack believed San Diego was at the forefront of aggressive domestic violence intervention. They even had a dedicated domestic violence council and court. “We had specializations everywhere,” Strack says.

Strack and Casey Gwinn, the cofounder of the Training Institute and her boss at the time, felt responsible for the girls’ deaths in some way. Like so many others in the field, they asked themselves what they’d missed. So often a community has a high-profile homicide—such as a Michelle Monson Mosure, or two teenage girls—and it’s the event that finally spurs change. Funds are suddenly found. Trainings and implementation of new programs emerge. Dunne or Strack or Campbell get a call for help.

Strack went back and studied the case files of three hundred nonfatal domestic violence strangulation cases.9 Strangulation turned out to dramatically increase the chances of domestic violence homicide. But only 15% of the victims in the study turned out to have injuries visible enough to photograph for the police reports. As a result, the officers often downplayed the incidents, listing injuries like “redness, cuts, scratches or abrasions to the neck.”10 And emergency rooms tended to discharge victims without CT scans and MRIs. What Strack and the domestic violence community believe today is that most strangulation injuries are internal and that the very act of strangulation often turns out to be the penultimate abuse by a perpetrator before a homicide.11 “Statistically we know now that once the hands are on the neck, the very next step is homicide,” says Sylvia Vella, a clinician and a detective with the San Diego Police Department in the domestic violence unit at the San Diego Family Justice Center. “They don’t go backwards.”12

There are researchers who take issue with this.13 Whatever the research and data, human behavior is unpredictable, even sometimes inexplicable, and numbers are not an infallible solution. There are offenders who kill without any history of strangulation, just as there are those who strangle but never kill.

In many of Strack’s three hundred strangulation cases, she also saw that the victims had urinated or defecated—an act she chalked up to their fear. She spoke to an emergency room physician named George McClane who offered her a very different view. Urination and defecation are physical functions, like sweating and digestion, that happen below our level of consciousness, and are controlled by the autonomic nervous system. Sacral nerves in the brain stem—which happens to be the final part of the brain to expire—control the sphincter muscles. So urination and defecation weren’t a sign of fear, McClane showed Strack, but rather evidence that each of those victims had been very near death. And each one of those cases had been prosecuted as a misdemeanor.14

Strack embarked on a mission to train those in the domestic violence field—from police to dispatchers to shelter workers to attorneys—on the signs of strangulation. Since the mid-1990s, she and Gwinn have traveled the country holding training sessions that cover anatomy, investigation, prosecution, and victim safety in strangulation cases; Gwinn estimates that they’ve trained over fifty thousand people. In 2011, Strack and Gwinn helped launch the Training Institute on Strangulation Prevention with a grant from the Office of Violence Against Women.15 Based in San Diego, the institute conducts four-day sessions there and nationally to “train the trainers” with the help of an advisory group that includes doctors, nurses, judges, survivors, police officers, and prosecutors. What I’ve found, anecdotally, in police departments across the country is far, far less training—just a couple of hours at most—and often none at all.

In 2013, Gwinn, Strack, and several other leading voices in the domestic violence community submitted briefs to the Supreme Court sentencing commission that outlined the particular danger of strangulation and suffocation. Subsequently, the Supreme Court added language to its sentencing commission report that specifically addressed strangulation and suffocation,16 recommending increased prison time for those found guilty. Today, forty-five states17 prosecute strangulation as a felony, and “every jurisdiction that has prosecuted strangulation as a felony with a multidisciplinary team has seen a drop in homicides,” according to Gwinn. Between 2012 and 2014, for example, Maricopa County in Arizona saw their domestic violence homicide rate drop by 30%.18 Gwinn and his colleague, Daniel Rincon, a Scottsdale detective sergeant and a national faculty member at the strangulation institute, claim this is a result, first, of the training undergone by their entire county-wide team—from dispatch to first responders to detectives to crime scene technicians—and, second, of the use of forensic nurses in examining strangulation victims. The county also purchased high-definition digital cameras that can highlight physical evidence, like broken blood vessels, fingerprints, and other markers. Prior to the training and forensic exams, only 14% of strangulation cases were prosecuted; that number is now closer to 62%.19 Though the program is too new to draw a direct causation, Maricopa County attorney Bill Montgomery did tell me, “When you look at the objective data, you could say where we have focused on domestic violence strangulation cases and improved our ability to investigate, charge and prosecute, we have also seen a significant corollary drop in domestic violence homicides.” At the time of this writing, in 2016, Kentucky, New Jersey, South Carolina, and North Dakota did not have legislation making strangulation a felony. Neither did Ohio or Washington, D.C.20

Still, for any kind of prosecution, both strangulation and brain injury need to be recognized and diagnosed. Sylvia Vella, who wrote her dissertation on strangulation, remembers a woman from her research who was in her late twenties and who’d had such severe bruising around her neck and ear that Vella sent the woman immediately to the emergency room, where they discovered a dissected carotid artery. The woman called Vella from the hospital and said she’d been put in a secure room under a pseudonym. “No one knows why she didn’t have a stroke,” Vella told me. “The physicians were like, I can’t believe she survived.”

While strangulation has been fairly well documented in medical literature, traumatic brain injury is only now being addressed in the larger domestic violence community. The vast majority of domestic violence victims who show signs of TBI never receive a formal diagnosis, in part because they rarely have visible injuries, and so emergency rooms don’t generally screen them for it.21 “We’re really good now in our [emergency rooms], if a kid comes in with an athletic injury or someone’s been in a car accident, about working people up for post-concussive syndrome,” said Campbell, who is the lead author on a study that examines the effect of brain injuries from domestic violence on the victims’ central nervous systems. Such symptoms include vision and hearing problems, seizures, ringing ears, memory loss, headaches, and blacking out. “But somehow we’re not as good with [domestic violence] victims,” she said. “We’re not saying, ‘Okay, did you lose consciousness for those bruises? Have you had prior strangulations and/or head injuries?’ So we need to do a better job of applying that protocol to abused women.”

While there is an emergency room screening tool, called HELPS, that aims to identify domestic violence victims with a potential TBI, its use is neither widespread nor standardized. Audrey Bergin, the director of a domestic violence advocacy group called the DOVE program out of Northwest Hospital in Maryland, says that while the HELPS tool isn’t used in their emergency room, their program has a nurse who reviews medical records for their domestic violence cases and looks for possible TBI events. Such clients would have been labeled “difficult” in the recent past, even by her staff members, she wrote in an e-mail.22 “The police may dismiss them as being drunk, the state’s attorney may think they have mental illness … Even the medical profession may dismiss them as being overdramatic. We have been able to intervene on their behalf to help other agencies understand that it is the TBI that is causing some of these behaviors and symptoms.”

The barriers to diagnosis and treatment are sometimes even more basic. Not every hospital is equipped with an MRI machine, and even those that are may not have personnel available twenty-four hours a day, seven days a week. Victims in more rural or low-income areas would almost certainly have to be transported to trauma centers, which is prohibitively expensive. Add to this the lack of training and awareness among first responders and emergency personnel, and many victims spend their lives grappling with the consequences of an unseen, undiagnosed, untreated, unsupported injury in which the narrative almost inevitably turns hostile—that they are crazy, or somehow they are to blame.23 Advocates talk of women who’ve lost jobs and custody of their children. They talk of women with little or no support medically, emotionally, or financially. Vella recalls one woman from her research whose “life was completely ruined” by brain injuries caused by strangulation. She’d lost her job, moved back in with her parents, and had to be escorted wherever she went. “She gets to the porch and can’t remember where she was going,” Vella says. She tells of another woman she studied who lost the ability to read and write, and child protective services took her children because they felt she couldn’t care for them. (Vella said this woman learned how to read again and has since regained custody of her children.)

It is not uncommon for victims of domestic violence to have poor recall of the incidents that landed their partners in trouble. They were in one part of the house and then suddenly another, and they can’t remember the sequence of events. Their explanation of what happened is cloudy, and law enforcement and courtrooms put the burden of proof on them. To the untrained, they sound like liars. Often, they also sound hysterical, which can be part of the symptomology. What researchers have learned from combat soldiers and football players and car accident victims is only now making its way into the domestic violence community: that the poor recall, the recanting, the changing details, along with other markers, like anxiety, hypervigilance, and headaches, can all be signs of TBI.

Campbell called these risk factors the Danger Assessment tool. She’d intended it to be used in emergency rooms by nurses, envisioning some version of her former self. In fact, the Danger Assessment would go far beyond emergency rooms to crisis centers, shelters, police departments, law offices, and courtrooms. It would be used from coast to coast in America, and then eventually in many countries around the world. It would change the course of how we view and treat domestic violence victims.

When Campbell’s research tells her that women often don’t know their own level of danger, what she means is that they may not know how to situate their danger in a larger context. They may not realize it is escalating. They may not know the specific predictors of intimate partner homicide. They may assume the children will be safe and even offer a kind of vague canopy of protection. As in, “He wouldn’t harm me so long as the children are around.”

Michelle’s family knows, now, that Rocky’s keeping her away from them was a sign of his coercive control. They didn’t know then. Another thing they didn’t know back then: access to a gun by an abuser is one of the three highest risk indicators for domestic violence homicide. Paul Monson had never thought to wonder if Rocky had access to a gun. Everyone in Montana has guns or at least can get guns pretty easily. A police officer in Billings once told me that in Montana, when you came of age, they practically threw guns at you. Sally knows now about the stalking, the addiction problems, the unreliable employment. Sally and Paul learned after it was too late. It’s an emotional brume of regret and guilt and how they can’t unlearn what they know now, but they wish they’d had a chance to learn it sooner.

But Michelle did know Rocky was dangerous, even if she didn’t know the full extent. She had inklings. Because she instinctively refused to press charges. She knew because the Sunday before she died, she was at Alyssa and Ivan’s house talking about it, about how mean Rocky had become. How scared she was. How determined she was to get out. It was this particular context, these sets of elements, that made the situation so immediately dangerous. “She was just through with it. You could tell,” Ivan said to me. Alyssa and Melanie confirmed this. The way she talked about it, all that last weekend of her life? She was done. And if Alyssa and Ivan and Melanie could tell, it stands to reason that Rocky must have, too, and it must have lit something inside him, scared the shit out of him. This time she meant it. She knew because she sent her kids to Sally’s house for safety. She knew because she filed a restraining order, dipped her toes into the system to see if it could help her.

What she didn’t know was how to piece all these clues together, over the years and in the weeks and months before her murder. Clues that would have helped her cobble together a picture that would have told her how much danger she was truly in. She couldn’t see the escalation, though instinctively she knew she had to act as a united front with him.

Instead what Michelle saw was what so many other women before her had seen: that an abuser appears more powerful than the system.

And how, exactly, did Michelle receive this message? Because Rocky broke in to Sally’s house, hit Melanie full-on, pulled Sally by the neck from where she was covering Kristy and Kyle with her own body, trying to keep them safe, and then he kidnapped Kristy. The decoding of these actions is critical. Rocky broke in to the house, assaulted two women, tore his child away. One after another, the actions sent a signal to Michelle that the safety measures she was trying to put in place—leaving her kids with her mom, facing him alone, finally vowing to leave for good—were weaker than whatever it was that he wanted. The police acted as if the victims—Sally and Melanie—were overdramatizing the entire event. Some guy taking his own kid. It’s his kid after all. The gendered messages are crucial: men are strong; women are weak. Men have the power; women are powerless. Men are rational; women are hysterical. Whether you are a violent abuser or a law-abiding officer, the men on both sides of the Monson equation sent a message to the women.

When Rocky bailed himself out it was an even more crucial message to Michelle. This time, it’s Not only am I stronger than you, but the system prioritizes my freedom over your safety. Rocky manipulated whoever he could to secure his freedom—in this case, Gordon and Sarah—and thus he maintained his control over Michelle. Except now it wasn’t just control; it was control and rage.

And in these small, separate moments, Rocky showed her something even more urgent: that if she tried to contain him, tried to use the system to beat him, he’d win, and in case she didn’t get those two messages, he made sure she understood that he’d escalate, that he’d take what she valued most in the world: her children.

And so Michelle did the thing so many victims through the years have done. The thing they might not even realize is a last-ditch effort to keep them all safe in the face of a man who’d always been dangerous, but was now dangerous and angry and scared. A man who was now a bear. Michelle sided with him. She went back into the system and tried to show her loyalty by dropping the restraining order, by refuting her own affidavit. She tried to get herself back in his good graces, buy herself some time so that she could figure out a safe way to leave. Another way to think of it is that Michelle Monson Mosure was most assuredly not staying. She was a victim trying to figure out how to become a survivor—not that she’d have thought of herself in this way.

So often, by the time a situation is this critical, it is already too late unless those in a system—police officers, advocates, judiciaries—are aware of the context of these kinds of actions and have appropriate measures to address them. Things like evidence-based prosecution (rather than witness-based, so that victims don’t have to testify in court, which I’ll address more in a following chapter), or police officers trained to understand the emotional and psychological dynamics, or judges who can gauge lethality and offer containment strategies that offenders can’t easily manipulate. I filled out a Danger Assessment on Michelle once. She scored somewhere between a sixteen and an eighteen. (There are two questions that can never be known in her case.) This score put her in the highest risk category for domestic violence homicide.

It is a failure to understand these critical moments in context that makes the “Why didn’t she leave?” question so maddening.

Look at Michelle Monson Mosure. Look at any intimate partner homicide anywhere in any given year and it will be the same: she tried every which way she could. She tried and tried, but the equation, or rather, the question, isn’t a matter of leaving or staying. It’s a matter of living or dying.

They stay because they choose to live.

And they die anyway.

Michelle Mosure stayed for her kids and for herself. She stayed for pride and she stayed for love and she stayed for fear and she stayed for cultural and social forces far beyond her control. And her staying, to anyone trained enough to see the context, looked a lot less like staying and a lot more like someone tiptoeing her way toward freedom.