This Common Secret: My Journey as an Abortion Doctor Read online

  We finally start talking about home care, birth control, and general recovery issues. Patients generally stay for at least thirty minutes so we can be sure they are stable. She wants to leave after just ten minutes, hoping to be gone before her uncle and aunt get there, if they really are coming. But I make her stay the full thirty minutes. Taking short cuts with her health is not an option. In the meantime I leave her with the nurse and excuse myself to go see another patient.

  Finally, we are escorting her out of the clinic with her girlfriend, after having checked the corridor and elevator for signs of her relatives. I wrap my arms around her briefly as she passes through the door. The waiting room is tense. Then I let her go. The two of them hurry out of sight.

  All of the staff is lined up at the window overlooking the parking lot. I hear one of them muttering urgently, “C’mon, girl, get out of here!” Finally we see them, moving quickly, getting into the van they arrived in. All of us are half-dancing with tension at the window. Finally they turn out of the parking lot, down a side street—the blinker flashes—gone.

  “Yes.” I breathe. And we all turn back, grinning our relief. There are so many women who leave the office to return to their uncertain receptions, their uncertain futures. If only we could fast-forward for a glimpse to better prepare ourselves.

  We are behind schedule now, and the weight of the pistol drags on my consciousness. We aren’t through this yet, I remind myself. And as I ready myself for the next patient, I hear a man’s voice at the reception desk, an ugly voice.

  “Where’s that doctor?”

  No time to think, just react. I suppress the momentary urge to hide, forcing myself out front.

  “Where’s that doctor?” he repeats, and I can see him leaning aggressively over the counter. A heavy man, tiny sharp eyes, thick gnarled hands out in front of him.

  “I’m right here,” I announce. “What can I do for you?”

  “YOU?” he is thrown off. He expected a man. Now I see a woman behind him, a tall, skinny figure with gray hair. She is craning for a look at me.

  “Yes. What can we do for you?”

  “We know Grace is here. You can’t kill that baby. We’re here to take her home.”

  The other people in the waiting room are all ears and eyes, the tension palpable. One gathers her coat in her lap. They glance at each other.

  “We have no one by that name here. There is no one by that name in the appointment book at this time. You have no business disrupting this office!”

  “Office!” he sneers. “This—this slaughterhouse? You’re a killer! You call yourself a doctor?”

  “That’s enough!” the strength in my voice comes from somewhere I can’t fathom, overriding the fear, pushing aside the ugliness emanating from this man. Then I catch a glimpse of a young man standing just inside the door. He is shifting nervously, looking everywhere but at me. The boyfriend, I think. “That’s enough! There is no one here for you, and you have no business with my office. You’ll have to leave.”

  “We know she is coming!” he tries to look around me to the back rooms. “You’re not killing that little baby!”

  “You’ll have to leave. Now!” I come around to herd them out, thinking about the pistol as I approach, watching the man and woman. “There are chairs by the elevator. If you must waste your time, I can’t stop you from sitting out there.”

  They are backing up. The woman’s eyes are burning with anger. The boyfriend is already out, more than willing to leave. “You’ll have some answering to do!” I hear the uncle say to him in the corridor. On their way to the chairs in the hallway the man turns to me again, shaking his fist. “And you’ll answer, too, you doctor!” he spits the words. “You’ll answer!”

  I shut the door on them, lean against it briefly, and try hard to make my smile reassuring for the waiting-room audience.

  “Sue,” the receptionist interrupts. “Sonja’s on the phone.”

  I step into my office, pause, take a big breath. “Hi Begonia!” I use my Happy Mom voice. We chat briefly before Sonja springs the real reason for her call.

  “Mom, a week from Friday is the parent/student swim meet. You know, parents against the swim team.” Silence.

  “Mom,” she brings me back. “Randy doesn’t swim. Can you come home?”

  I take another breath, try to get everything back in perspective. “I’ll do my best, sweetie.”

  Then the call is cut short when one of the counselors knocks on the door.

  “Can you come help for a minute? This one needs some comforting,” she whispers. I sigh, say good-bye to Sonja, gather myself, try to push the people in the hallway out of my mind. But I’m still flushed from the confrontation.

  When I enter with the counselor, I recognize the patient. I saw her arrive earlier. She edged in through the door as if she were afraid it would slam and lock behind her. College age, jumpy, from a rural area, I expect. She confirmed her appointment without approaching the counter, sat right next to the door, never took her coat off. I see that even in the counseling room she is balanced on the edge of her chair, flinches when I close the door.

  “Hi,” I say. “I’m the doctor.” She nods, gulps, looks away.

  “Is everything alright?” She nods too emphatically.

  “Have you been somewhere else for a pregnancy test?”

  She looks surprised, makes eye contact for the first time.

  “Was it the clinic that advertises abortion information in the paper?”

  “How did you know?”

  “You act the way most people do after they’ve been there,” I tell her. “We aren’t the same kind of place. And I doubt we’re anything like what they told you there.” I have her attention now.

  “I thought I’d be able to get an abortion there,” she admits. “They looked like nurses and doctors with their white coats. They told me they were giving me a pregnancy test and put me in a room for two hours. There was a television playing an awful video in there. I couldn’t leave.”

  I sit in front of her and give her all my attention, encouraging her to keep talking.

  “When they told me my test was positive, they started saying there was a good chance I’d bleed to death from an abortion. That I ought to consider keeping the baby. That I’d regret this the rest of my life.”

  “And,” I say as I hold her attention, “they told you you’d probably never have children after having an abortion, right?”

  “How did you know?”

  “And they told you there was a good chance you’d die, right? And that I am not a real doctor? That if you came here you could get AIDS from other patients?” She is open-mouthed, nodding.

  “First of all, you are completely free to leave any time you want. We will answer any questions you have. This isn’t something we do to you. You can decide to have this done. If you want to talk about adoption, about social services available for mothers without money, about prenatal care, about any of that stuff, that’s fine. We have lots of information available on all the options, including accurate information about abortion.”

  She is visibly relaxed, although she still looks guardedly back and forth between us, like we might be tricking her yet.

  “They told me you have knives and scissors here. That you cut up babies and throw them in the garbage!”

  “There are no knives, no scissors, no scalpels. If patients want to see the embryonic tissue, we give them that option. Most women are actually quite relieved when they see it. And we take great care disposing of it in a respectful, appropriate, legal manner.

  “The very last thing we want is for you to make a bad decision. You got some wrong information. Let me just tell you this. There is a greater chance you’ll die in a car wreck on your way to the office than there is of a serious complication with an abortion.” She is listening intently now, looking at me closely.

  “We use gentle dilation and suction.” I show her some tubing, dilators, and a speculum. “There is no cutting, no inte
nse pain. Those gruesome pictures they showed you have nothing to do with the reality of what we do here.

  “The most important thing is that you make the right decision. And if you want to find out about my credentials, you should call the medical board. I’ll give you the number.”

  “That’s okay,” she says. “I believe you.”

  “Good. Now we’ve got that behind us. Why don’t you start the counseling over again? Can we do that?” I get up to go.

  The amazing thing, I think as I close the door, is that they still come. After hearing all that terrible propaganda and lies and being shown the inaccurate pictures by the places calling themselves some version of a pregnancy counseling center, they still come. They are desperate to end an unwanted pregnancy.

  Back in my office I collect myself for a minute. I’m the one who needs a little settling before I go on. And it’s barely lunchtime. I realize how hungry I am and pick up the phone to order some sandwiches for the staff. As I order, I stroll to the window. Half a dozen protesters parade slowly along, holding their signs, watching people come and go. All of them are regulars; four out of the six are men.

  Since a recent court injunction they have been forced to stay on the sidewalk below and are banned from coming inside the building or accosting patients in the parking lot. “Sidewalk counseling” they call their harassment. “If you saw a murder in progress, wouldn’t you try to stop it?” one of them asked the judge at the hearing. Absently I check the lot for strangers, anything out of place.

  I see the morning patient’s aunt appear around the corner of the building. She is doing her own checking, no doubt looking for her niece’s car. She looks perplexed, angry, impatient. She stops and watches the protesters for a second. I wonder if she’ll go over to them, but she continues on through the lot, then comes back inside.

  There are two more procedures before I get a chance to eat the soggy sandwich that has been waiting on my desk. I see a phone message from the British television people who have been after me for an interview about violence against abortion providers in America. I remember to call the lawyer from the Center for Reproductive Law and Policy who is working on getting the FDA to approve a version of the morning-after pill. So much to do.

  Another message under a file folder. This one from a local man who has offered his mountain cabin for a staff retreat if we ever need a break. How about right now? I think to myself, ruefully. Right now would be great! I smile, visions of ski trails, a wood stove pulsing heat, silent stars in a black sky. Enticing as the scene is, the gesture of support is better still. But here and now we are behind schedule, and the young, frightened patient is ready. I glance over her chart before I go in.

  “How are you doing now?” I ask her, as I pull up the stool to talk before we begin.

  “Better,” she says, and she looks better, even a little sheepish.

  Within ten minutes we have completed the abortion without incident, and I head up to the front desk. The receptionist looks exhausted as she lifts her head and gestures toward the waiting room. The young boyfriend is sitting there, head down, looking at his hands.

  “He came in a few minutes ago. He looked so sad when he asked if he could sit in here. He said he couldn’t stand it out there with them. I couldn’t say no.”

  I nod. An overwhelming urge to go to him wells up in me. I want to go sit by him, whisper that she’s been here, that she’s fine, that everything is okay. He’ll know soon enough, but that anguish on his face is almost unbearable, when I could remove it so easily.

  A tap on my shoulder. “I think we have a fake one,” the counselor says. “Maybe we should team up on her a little.” I give the waiting room one more glance, hoping to catch the young man’s eye, hoping I can say what I want to say with a look, but he doesn’t raise his head.

  “Her urine sample wasn’t even warm,” the counselor tells me. “Of course it was positive, but she doesn’t seem right. She keeps asking questions about the clinic hours, what days you are here, stuff like that.” We start to go in, but the counselor stops me again. “I think she’s got a tape recorder going.”

  When we both enter the room, the patient fidgets nervously, gives us a forced smile.

  “Hi. I’m Dr. Wicklund,” I say, and I extend my hand. She takes it gingerly, quickly.

  “Tell me about yourself,” I prompt her.

  “Well,” she says, brightly. “I’m twenty years old. I already have three children, and I’ve been on welfare for a while. Now I’m pregnant. Do you think I should have an abortion?”

  “What I think isn’t very important.” I smile back. “It’s what you think that matters. Have you thought about your options? Have you considered adoption?”

  “Oh, I don’t know about that,” she says, looking back and forth between us. “I think I should have an abortion, don’t you?” There is no emotion coming from her, not even the forced control some patients impose on themselves. She talks as if she’s playing a game. Likely, she is.

  “If you have to ask us what we think, you aren’t clear enough about it.” I pull an informed consent sheet from a nearby drawer and hand it to her. “Please read through this. It will give you some information about the risks and alternatives and the procedure.” She barely glances at it. “We’ll give you some pamphlets about adoption and the social service agencies to contact. You need to gather more information and not ask someone else to make this decision for you. The counselor will show you out.”

  She looks momentarily flustered, as if she is scrambling mentally for some way to stay, then gives in and starts putting on her coat. She leaves the informed consent sheet behind and refuses the additional information we try to give her.

  “Could have been worse,” I shrug, “but it’s still a waste of time.”

  At least she wasn’t one of the disruptive ones. Some of them park themselves in the waiting room and start ranting. “I don’t know,” they fret. “I don’t know if I want to kill my baby. Do you want to kill your baby?” They turn to the patient next to them, wringing their hands. “I don’t know if I want to kill mine.”

  If you don’t get control of those in a hurry, they can have the whole clinic in an uproar.

  The next patient needs a routine yearly exam, and I need the basic, unemotional interaction to center myself again. We chat about her work, the prospects for a good ski year, general banalities. She is perfectly sound, absolutely healthy, and I find myself grateful to this woman for her mundane normality.

  The people are still sitting in the hall, their presence brooding outside like dead air before a storm. They assume either that we have their niece hidden in a back closet or that she is yet to come. At least they’ve been quiet since the first outburst.

  What would we have done if they had trapped her here? Police escort, probably. And what will she face at home now? The uncle’s angry face is fresh in my mind.

  Two more abortion patients cycle through the lengthy process. They tell their stories, talk everything through with a counselor. Each of them undresses, entrusts herself to my hands, listens intently to my droning voice all the way through the procedure. Most wear a look of relief and gratitude as they leave. There is much that has become standard and routine over the years. Things I have done thousands of times. Yet each patient is unique. Each has her own set of fears, her own hopes and dreams and emotions. Every woman has personal reasons behind her choice that are hers alone. Nothing is routine about any of this for them. And for the life of me, I couldn’t describe the common reasons for abortions, couldn’t sketch the typical patient.

  The work day won’t let go easily. The final patient is one of the cases I dread. She is unsure of her last normal menstrual period, and as soon as I begin the ultrasound I know she is into the second trimester of the pregnancy. The measurements put her pregnancy at seventeen weeks, well past my usual cutoff date.

  “Why don’t you sit up?” I say, gently. “Let’s talk a minute.”

  She is concerned, alr
eady on the verge of tears. “What’s wrong?”

  “It appears that you are further along in the pregnancy than you may have thought. We have a lot to talk about, and you have more to think about.”

  She is starting to cry, and I move in to hold her for a brief second.

  “Why don’t you get dressed? We can’t talk properly when you’re half naked. I’ll step out, and we’ll go to my office.”

  “This means you won’t do it?” she says when we are seated. “You can’t do it? What am I going to do now?” She is crying in earnest. I go and hold her again, say nothing.

  “I spent all my money on the bus to get here. How can I get another day off? Where will the money come from? I thought it would be over today, that I wouldn’t be pregnant after today.”

  “I know. I know,” I soothe her. “You had no idea.”

  She looks at me, imploring. She is young, alone, devastated. She has traveled almost three hundred miles by herself, has gathered all her resources for this.

  “I can’t do an abortion for you. I’m really sorry. I have made a personal decision not to do abortions after fourteen weeks.

  “There are places that will help you if you still decide to have an abortion,” I tell her. “We’ll give you the numbers. If you want us to help you contact them, we can call from our office today. Even if you just want to talk things over, call the 800 number any time. I’m really sorry.”

  It is half an hour before she is in shape to leave. We refund her money; one of the staff gives her a ride to the bus station. Our patient day is over, but I can’t turn it off like that, not with the memory of the morning patient. Not thinking about this last young girl on her seven-hour bus ride home. Home to what? Will someone be there to hold her?

  The staff is tidying up, locking doors, making sure the day’s paperwork is complete. I heave an end-of-the-day sigh and pitch in to help. The young man in the waiting room leaves again, quietly, still downcast.

  Tom arrives to escort us all out.

  “Oh wait,” I interrupt. “We need to look at the schedule for the end of next week. I think Betty and I will be making the drive back to the Midwest for a few days. Turns out I have to compete in a swim meet!”