At The Children's Center, waiting to help
"I love my job," she says. "You have to. Because it can be very hard."
The center, which is the only child abuse medical assessment center in Clackamas County, opened its doors in 2004 after seven years of planning. They provide head-to-toe medical exams as well as counseling and family support.
"There is something about working with children, especially being in a position to help children in need that is so rewarding," says Smith, who previously had worked in other fields including neurosurgery and general surgery.
"I had to wait until I was in the right place in my life to be able to handle this kind of work."
Smith says she waited until her own children had grown up a little.
"I knew that there would be a chance that every time I saw a child who had been abused, I would see my own child," she says. "And that would be unbearable. As it is, there are times where I am talking to a child and see my own.
"It can just be heartbreaking."
Smith estimates that she sees between seven and 12 kids a week.
"Often they arrive after being referred by law enforcement or DHS," she says. "And it's our job to get them to open up about what happened. My first question is almost always something light like about how is school going or what's some of their favorite things to do."
She looks for ways to make them feel comfortable.
"They're afraid," she says. "Sometimes they have been abused by a parent and no child wants to say anything bad about their parents. Talking about abuse can be very hurtful on so many levels."
In the initial evaluation, it's often just the child and Smith - though there is a microphone on the ceiling so that law enforcement and DHS can listen in.
"I'll talk about almost anything at first other than abuse," she says. "I'll ask about their birthday, about their friends. And then after a bit, I will ask the tough question - 'Do you know why you're here?'"
Smith says the children often say they're not sure.
"I explain to the kids that sometimes adults see things in kids that gets them worried and when they are worried they come to people like me for help."
Smith says it's around this time that the child usually opens up.
"I work very hard to get them to realize I am someone that they can talk to," she says. "I am someone who wants to help them."
After she has performed an evaluation, the child is often then interviewed by a counselor and someone from either law enforcement or DHS. Or both.
"There are a lot of sad stories that come through the doors," she says.
The center says that in the 12 months ending this past July, they conducted assessments of 447 children. Of those children, 350 had been referred because of sexual abuse, 200 for physical abuse, 186 for neglect and 55 for emotional abuse.
The number is greater than 447 because many children were brought in because of more than one reason.
"After each child is done with their visit, we bring them to what we call the bear closet," she says, quickly pointing out that it has pretty much every kind of stuffed animal imaginable. And blankets - many handmade. "We have a lot of very generous donors.
"And because of that every child leaves with a friend and a blanket."
While that helps take off some of the edge of what she does, Smith says it's very hard not to be overwhelmed by the sadness involved.
"We all look after each other, check on each other, make sure we're not drowning," she says. "That is so important. We see so many children who have been abused or been exposed to something horrible like a friend dying. We just have to keep looking after each other."
Smith says the looking out for each other extends to home. Her husband is a detective on the child abuse team of the Clackamas County Sheriff's Office.
"We won't discuss details of our cases but it means so much to have each other, to be with someone who understands," she says.
What frustrates Smith is the feeling that as many children as she helps, they are many more out there who are not getting help.
"We know these kids are only a fraction of the kids that we need to help," she says. "There are people out there that we know exist but they don't necessarily know that we exist, that we are here to help them.
"That is the hardest part, trying to figure out how to make sure everyone who needs help, who knows a child who needs help, knows that we are here."