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

  Sunday night. Judy B. is on my call list for 8:20. She has an appointment on Wednesday. I try to call, but the number I’ve been given is incorrect. Judy waits by the phone but never hears from me. Trivial error. Unintentional, but with huge consequences.

  On Monday she calls the clinic to reschedule the call, and I get the correct number. There is still time. When I call on Tuesday morning, a man answers the phone. “Judy had to go to the hospital with our three-year-old. I’m home with the other four kids. Can you call on her cell phone?” he asks.

  “Of course I can,” I say, but I try three times and only get her voice mail.

  The next morning Judy arrives for her appointment. We can’t do it because she has failed to comply with the law.

  “I HAVE to do this today. Please!” Judy says. “Today is my only day off for the next two weeks. I’ll get fired if I miss another day.”

  “I am so sorry,” I say. “The law is absolute. We really can’t do it.”

  Reluctantly she reschedules. We take care of the informed consent process right there. She leaves in tears.

  Several days later, Judy is finally able to have her abortion. She is angry and, as she predicted, has lost her job.

  Ultimately, much of the abortion war is waged in the court-room. From county courts to the Supreme Court, cases are in constant flux, susceptible to the political tenor of the moment, changes in judicial makeup, and social pressure exerted by politicians and advocacy groups.

  Roe v. Wade gets all the attention, but off the radar, innocuous-seeming legal wrangling can change the landscape for clinics and patients in dramatic, profound ways.

  In 1998 the courts found in favor of NOW and the National Women’s Health Organization, which operates eight clinics in the United States, citing the Racketeer Influenced and Corrupt Organizations (RICO) Act to prevent organized groups from crossing state lines to participate in activities that have the effect of hindering commerce. Operation Rescue and other groups routinely traveled across state lines, organized protests, and hindered the conduct of clinics.

  Operation Rescue faced heavy fines, and the decision had a chilling effect on their ability to continue harassing clinics. They were essentially shut down after the court decision and a period of relative peace ensued.

  In 2006 the U.S. Supreme Court revisited the case and overturned the decision. As a direct result, Operation Rescue reorganized under the banner Operation Save America and undertook a massive onslaught against the lone clinic left in Mississippi. Their express goal was shutting down the Jackson clinic.

  Operation Save America’s leader, Reverend “Flip” Benham, presided over a burning of the Quran during one gathering. When asked what the Quran had to do with abortions, Benham stated that they were “different manifestations covering the same fist, the fist of the devil.”

  Protesters verbally abused patients coming and going from the clinic and blatantly ignored the limitations placed on them by city ordinance. Benham said that the clinic, along with his other targets, which included Millsaps College, a high school, the Jackson police department, and the local newspaper, represented “the gates of hell.”

  In April 2007 the Supreme Court upheld the Partial-Birth Abortion Ban, reversing an earlier Supreme Court decision. It was the first time that the high court has mandated what a physician can or can’t do with a patient and opened the door for more severe restrictions on abortion rights. This decision makes it illegal for doctors to perform what may be the safest medical procedure for women having second-trimester abortions. Less than five percent of all abortions fall into this category. They are often performed to save the life of the mother, in response to severe fetal anomalies, or to end a pregnancy that has been shown to be incompatible with life.

  The legal and political furor focuses on the rights of embryonic tissue, not on the rights of women and young girls. All the attention is lavished on “the unborn.” The restrictions are cynically referred to as a “woman’s right to know,” when, in fact, they do everything to prevent women from exercising their legal options. If the right to know is sacrosanct, why is our foreign and domestic funding muzzled by gag laws that prevent physicians from even discussing legal health care measures available to women?

  In clinics, though, it is women we are dealing with, and girls. Where is the public outcry in defense of victims of domestic abuse, rape, and incest? Who is pursuing absent fathers who walk away from responsibility? Where are the protections of confidentiality for our patients?

  Every day people come through our doors coping with real-life dilemmas and traumas. I often wonder if it were men who got pregnant, men who faced these wrenching personal difficulties, whether abortion would even be on the political radar. Would men be expected to compromise their futures, give up the prospect of college, lose professional opportunities, sacrifice their ambitions . . . to fatherhood? I suspect not.

  In some cases, our patients face real danger. It is our job, our duty, to serve and help them. It is up to us to recognize their plight and to provide resources. No politicians or laws help us in that process. We have to rely instead on common sense, experience, and intuition. That duty requires the ability to ferret out the shape of a situation and intervene if necessary.

  “This one’s really young,” the nurse warns me one day in clinic. “Her father is here, and he’s awfully protective.”

  I look at her form. Fourteen, it says. But when I see her, she looks twelve. Twelve and terrified.

  “Come on back,” I beckon her down the hall. Her father follows her. A small man, unshaven, with nervous hands.

  “I just want what’s best for my girl,” he says, looking right at me over his daughter’s head.

  “Is your wife here?”

  He shakes his head. “We don’t want to bother her mama with this. She wouldn’t take it well.

  “My girl’s made a mistake, and we want to do what’s best.”

  The girl stands quietly, head down.

  “It will be an hour or so before your daughter’s finished,” I tell him. “You can wait up front.”

  “I can comfort her,” he pleads. “I want to be with my girl.”

  “She’ll be fine. Please.”

  He backs away, looks hard at his daughter, who won’t look back.

  I take her thin arm with my hand and lead her into the procedure room.

  “Let’s talk for a minute,” I say.

  She sits straight-backed, hands clasped in her lap. She looks cold.

  I ask her general questions about her home, her family, how the drive was, what she likes about school. Her answers are small whispers.

  I go on to tell her about the abortion, what we will be doing.

  “Are you sure you want to do this?” I ask, finally coming to the point.

  “I have to,” she talks to the floor.

  “Why?”

  No response.

  “Do you want to be pregnant?”

  She shakes her head.

  “Do you want an abortion?”

  Another shake.

  Alarm bells had started going off when I saw her interaction with her father. It was time to figure some things out.

  “Do you have a boyfriend?”

  Silence.

  “Did a boyfriend get you pregnant?”

  Nothing. I can see her shivering.

  I move closer. I want to hold her, make her warm and unafraid, but I know that’s the wrong move. “Listen,” I say, gently. “Sometimes things happen that aren’t easy to talk about. I need to know how you got pregnant. Did somebody do something bad to you?”

  She sits mute.

  “Who made you pregnant?” I insist, moving as close to the scared girl as I dare. “Who?”

  Long silence, but she finally lifts her head, looks at me. Her eyes are troubled. No fourteen-year-old eyes should look that way.

  “It was my daddy,” she whispers.

  For a minute I don’t speak. I can’t speak. The rage exploding inside me
is molten. I want that man’s neck in my hands. “I just want what’s best for my girl,” he had said. The same man who violated her, who tortured her life in service to his perversity. I start shaking, trying to control my anger.

  “The man in the waiting room who you came with? Is that who you call ‘Daddy’? Is he the one who did this to you?”

  “Yes,” she says. “It’s him.”

  “No one else? No one else has touched you down there? Nobody has done this to you but your daddy? The man you came here with?”

  “No one.”

  “Does your mama know?”

  She tightens up, looks down again. One question too many.

  “Listen. I won’t do an abortion today. We have time to consider that. We won’t touch you or deal with your pregnancy. Our first job is to make sure you are safe.”

  Her head jerks up, fear flaring in her eyes. “He’ll hurt me if I don’t. I have to! He said if I didn’t he’d beat me up again. He will! He’s done it before.”

  “You are a minor,” I say. “We have to get you away from him for a while, someplace safe. You are very early in the pregnancy. We can talk again soon, but we have to make you safe.”

  Her eyes plead with mine. They ask for honesty. They search for an adult to trust.

  I reach out, touch her, carefully, very gently. “We’ll get you through this. I’m going to have a nurse come sit with you while I make some phone calls. We won’t let him hurt you.”

  Nearly an hour had passed before I felt comfortable leaving the young girl with a nurse and could return to the main office.

  “I want to see my girl!” the father demands, as soon as he sees me. His face is red; his hands are clenched in fists.

  I keep a lid on my own temper, quell the temptation to scream at him, and instead, impose a cool, professional demeanor.

  “It’s taking a little longer than we thought,” I tell him. “She’s young, and we want to be careful. It takes time to prepare such a young patient,” I lie. “Try to understand. She’s perfectly fine, and we’re doing everything to make sure she’s safe.”

  “I want to see her!” he paces back to his seat.

  I close the door and hurry to the administrator’s office. “We have a reportable incident,” I blurt out. “We have to hurry. The girl is a minor, an incest victim. She’s identified her father. He’s in the waiting room now, but he’s really nervous and demanding. He may suspect something. I’ve told him we’ve been delayed.”

  She has the phone in her hand before I finish. We notify both the police and the Child Protection Agency, stress that it’s essential for them to synchronize. The girl will be escorted out the back door by a caseworker at the same time the police take the father out the front.

  All this takes more time. It’s been almost two hours since the girl checked in.

  “Where’s my girl?” the father demands when I return. “I want to see her!”

  I have to physically block him from coming through the door. “Please. Be reasonable,” I say. “I’m sorry it’s taken so long. We’ll be through soon, but it only prolongs things if I have to keep coming out here. It won’t be long now.”

  “I know something is wrong,” he accuses. “What’s going on?”

  He finally storms back to his chair, muttering to himself.

  Back with the girl, I fill her in. “People from a place called the Child Protection Agency are coming to pick you up. They are set up to take care of young people who have troubles at home. They’ll keep you safe while you figure things out.”

  “He’ll never let them take me,” she says.

  “The police are coming to ask him some questions. They won’t let him hurt you.”

  The events daze her. By turns she looks relieved, anxious, scared, thankful. The door opens, and the administrator calls me out.

  “Everything’s set,” she says. “The police are coming in.”

  I get to the waiting room just as they open the door. The father is looking at me, about to speak, when an officer takes his arm.

  “What’s going on?” he explodes. “What is this?”

  “You’re coming in for questioning.” The officer handcuffs him as they speak.

  “My daughter’s here. You can’t do this.”

  He shoots me a haunting, burning look. He’ll be back, I think. He’ll be back, looking for me. I watch just long enough to be convinced they will indeed take him away, then turn and go quickly to the back of the clinic. The girl is just about out the door with the social worker, but I stop them briefly.

  “Please come back and talk to me when you feel safe,” I say.

  She nods distractedly. She looks tiny and vulnerable. A child starting a new life.

  I tell the caseworker I’m available any time. I write down my phone numbers. The car drives off.

  I have a moment of doubt. I didn’t have to probe for the truth. I could have performed the procedure and let her return to her life. It was only through my persistence, and my legal obligation to act on information, that this happened.

  In the end, though, it is these cases that make me feel I’m performing the best medicine. It would have been easier not to be thorough, to ignore the red flags. But that extra twenty minutes spent digging for the truth, or explaining something a patient doesn’t understand, or answering the hard questions can make a difference for the rest of a woman’s life. The moment I simply become a technician performing procedures is the moment I have to quit.

  Shortly before the trial of Michael Griffin

  for the 1993 murder of Dr. David Gunn,

  former Rev. Paul Hill and 33 others

  signed what has become known as the

  “defensive action statement.” . . .

  We, the undersigned, declare the justice of

  taking all godly action necessary to defend

  innocent human life including the use of force.

  We proclaim that whatever force is legitimate

  to defend the life of a born child is legitimate

  to defend the life of an unborn child. We assert

  that if Michael Griffin did in fact kill David

  Gunn, his use of lethal force was justifiable

  provided it was carried out for the purpose of

  defending the lives of unborn children.

  Therefore, he ought to be acquitted of the

  charges against him.

  Frederick Clarkson, “Justifiable Homicide:

  The Signers,” Intelligence Report 91

  (Summer 1998)

  chapter eleven

  Irony, if not blatant hypocrisy, is everywhere in the realm of abortion clinics and women’s reproductive health. Sexuality is a universal drive, no matter what your ethics are, and a pregnancy is irrefutable. It forces people to confront weaknesses, to face the inconsistencies of their beliefs, conflicts of lifestyle, the disconnect between a public persona and private reality. Or it provokes the powerful temptation to deny and rationalize, to escape that confrontation, whatever it takes.

  Sometimes the brazenness of the hypocrisy takes my breath away. In clinics and in protests, we see it every day.

  Kathleen was forty-two years old and a model of perfection. Hair, nails, clothes done up as if she were prepped for a high-profile job interview. When I came into the room and asked my standard question, “Are you absolutely sure you want this abortion?” she squared her jaw and glared at me.

  “Of course I don’t want to have an abortion. I HAVE to have an abortion.” She held an oversized purse on her lap, kept fumbling with the latch.

  “Why? Is someone forcing you?”

  “No one is forcing me. I just CANNOT have a baby now. I know it’s murder and should not even be legal, but I HAVE to have an abortion.”

  “So,” I spat back, “if you think this is murder, do you think I am a murderer?”

  “Of course you are.”

  “Do you think I should go to jail for doing abortions?”

  “Yes, I do.�
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  I couldn’t believe I was hearing this. I felt sick with outrage and disbelief. Maybe I had misunderstood. I asked her again.

  “So, you think this should be illegal and that I should go to prison for murder, but you also want me to do an abortion for you?”

  “Yes,” she said, without blinking an eye.

  Everything inside me turned upside down. I had never encountered anything like this.

  “I need to step out of the room a minute,” I said. I got off my stool and headed for the door.

  “You can’t leave,” she barked. “I want an abortion. It is my right, and you have to do it.”

  “I have rights, too,” I replied, and I slipped through the door. Flashes of the final scene in the movie If These Walls Could Talk ran through my head. In the movie, a couple comes to an abortion clinic, supposedly for an abortion. The woman’s partner accuses the doctor of being a murderer, then pulls out a gun from a hand bag and kills her. It is a scene burned into my memory.

  I paused and took a deep breath before going to talk to the clinic administrator. After I relayed the conversation, I asked that someone else tell the patient that we would not be providing the abortion. There was no way I could do it.

  The counselor who had visited with Kathleen earlier went into the room. Within twenty seconds the conflict was loud enough for everyone on the floor to hear.

  “I will NOT leave! It is my RIGHT to have an abortion and I am staying until it is DONE!”

  Brief silence.

  “NO! I will NOT get dressed until I have the ABORTION!”

  We heard a loud thump, the patient slamming her fist onto a desk. The clinic administrator called the front desk guard to escort her out. If that didn’t work, we’d have to call the police.

  “I am going to sue that doctor and this stupid clinic!” the woman yelled. I imagined everyone in the waiting room cringing. I literally hid in the staff lounge until she was gone.

  At the end of the day all the staff gathered in the empty recovery room.