On March 3, a member of our community, Fredlynn Hoapili, was murdered.

At the arraignment of her husband of 35 years and alleged killer, the coroner testified that she had been stabbed 18 times, mostly in the chest. When faced with such disturbing news, some of us might try to convince ourselves that this tragedy was a “freak” occurrence — something that does not normally happen here.

As one of your emergency physicians, I feel obligated to inform you that domestic violence is a tragedy everyday somewhere on Kaua‘i, not just on the ones that make the news. If we wait until someone dies to do something about it, then we have waited too long. But better late than never.

Bringing justice to Fredlynn Hoapili and to those who grieve her will require more than the conviction of her killer. It will take a concerted effort on all of our parts to raise our awareness and lower our tolerance of domestic violence as a problem in our community. We owe it to Fredlynn and to others like her to bring something good out of her injustice by learning from it to prevent similar misfortunes from happening to others.

Domestic violence is not just a criminal matter. It is also a disease, both for abusers and for victims. Many abusers have learned violence as a response to conflict while being victims of abuse themselves in earlier life. Having been abused is not an excuse to harm others, but if we are to break the cycle of domestic violence it helps to understand how it starts.

Victims of domestic violence are silent, more often than not, because their abuse has battered more than their bodies. It also batters their confidence and self-esteem such that they learn helplessness. Domestic violence can take many forms. Verbal and psychological abuse can be as harmful as physical and sexual abuse. Abuse doesn’t only happen to women. It happens to men too, and men are even less likely to report it out of shame and fear of embarrassment.

Victims of abuse inevitably suffer some combination of depression and anxiety. Many will attempt to treat their emotional problems by unhealthy methods that actually worsen them and make the victim more vulnerable to abuse without knowing it. Predictably, the co-occurrence of alcohol, tobacco and substance abuse; eating disorders; promiscuous unsafe sex patterns; and other self-destructive, high risk-taking behaviors is disproportionately high in victims of abuse; all of which cloud judgment and exacerbate “learned helplessness” and lack of self-esteem that prevent victims from getting help.

The first step toward healing is recognition of the problem. Never underestimate the power of denial in this step. Victims are often so overwhelmed by feelings of hopelessness, worthlessness, guilt, shame, and/or denial that they fail to recognize the warning signs that the abuse inevitably will get worse. Abuse is often followed by repentance and apology from the abuser and then a “honeymoon” period in which things seem to get better — until the next explosion.

Likewise; friends, family members and coworkers often deny the existence or severity of abuse out of a natural desire not to believe that such things are happening. We all could do better at not ignoring and not tolerating the warning signs of domestic violence in our community, and that’s the second step.

Don’t tolerate domestic violence and don’t accept it into the proud and honorable culture of Kaua‘i by ignoring the problem that exists. If it’s obvious, do something.

Not doing anything sends the wrong message, both to abusers and to victims, that domestic violence is somehow acceptable. It’s not, and we need that message to be loud and clear to our community.

When do you intervene? Intervene when you know or have good reason to believe that harm is occurring. Don’t take the law into your own hands. Call the police. Don’t assume that someone else will. Let the police do their job and help them by making them aware of abuse when it is happening so they can catch abusers in the act. Police not only are trained to handle domestic violence, they are trained to document it properly; which can be very challenging, but is critically important to making restraining orders and convictions stick.

If the victim is a child, call the Child Abuse Hotline (808-832-5300). If you suspect elder abuse, call the Adult Abuse Hotline (808-832-5115). Teen dating abuse also has a hotline (866-331-9474). The national domestic violence hotline is (800-799-7233). Check out the police domestic violence hotline Web site at www.hawaiipolice.com/policeHotlines/domestic_abuse.html.

Third, if you know a victim of domestic violence, act to empower them in a way that avoids traumatizing them further. Empowering them means being supportive and understanding that the victim may be doing the best he or she can in a difficult situation rather than berating and blaming them for still being in it, which only worsens things.

Many victims are hesitant to leave their abusers because they have nowhere else to go and/or are afraid their departure will provoke more violence. It’s twisted logic, but anyone who watches the news knows that victims are statistically most likely to be killed during and around the time they try to leave their abusers.

The psychology of abuse, victimization and re-empowerment is complicated. Some victims may even intentionally stay in abusive situations and provoke violence towards themselves in an attempt to direct it away from others (children, siblings) they are trying to protect while the abuser “blows off steam.”

Victims of domestic violence, like victims of rape, have had all sense of control taken away from them. Telling them they’re stupid and have only themselves to blame if they don’t leave their abuser only worsens their sense of loss of control. Victims need to be re-empowered, which requires teaching them how to rescue themselves from their own “learned helplessness.” That process can be long and difficult. It is unique to each individual and can’t be done for, or be forced upon, them. However, it is every bit worth the effort and is certainly better than losing a life or living in pain and fear.

Kaua‘i has an excellent supportive resource in our community that understands what it is like to be in abusive situations. They know how to get started on a safe escape and the steps toward recovery. That resource is the Kaua‘i YWCA. They can provide counseling and recommend services and resources for victims and abusers. If you know a victim of abuse or an abuser who is willing to get counseling, encourage them to contact the YWCA (24-hour hotlines: domestic violence 808-245-6362, sexual assault 808-245-4144, www.ywcakauai.org) to find out what options are available or even just talk and listen.

We must act and educate against these self-perpetuating cycles of learned violence and learned helplessness for the silent victims amongst us they affect  because, ultimately, they affect us all.

• Dr. Chris Elliott works in the Emergency Department at Wilcox Memorial Hospital.