This Common Secret: My Journey as an Abortion Doctor (16 page)

“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 intense 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, already 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!”

In the hallway we confront the suspicious glare of the aunt and uncle. “We’re closing up now,” I announce. “You can sit here a little longer if you want, but the building closes soon.” They say nothing as we troop past.

Tired and preoccupied as I am, I can’t afford to give in to it. I read every stranger’s face in the corridors of the building, study the cars in the lot. We drive a new route home.

“More bad letters in today’s mail?” Tom asks.

“One. But I didn’t have time to dwell on it. I hardly read it—just put it in the file.”

We idle in the driveway and make arrangements for the next morning. Then I’m done.

But I’m never really done. When I go to a movie later that evening, I see one former patient in the ticket line, another in the lobby. We make eye contact. One of them says “hi” in a whisper. I let them lead these interactions. Sometimes they give me an update on their lives; sometimes they ignore me; most often there is that moment of strong eye contact, a brief nod, our confidential bond, then on with our lives.

Very late at night the phone rings—1:30 blinks at me from the clock as I grope for the phone. “Dr. Wicklund? There is a woman on the line. She says it’s an emergency.” It is never over, I think, waiting to be put through, waiting to find out what kind of an emergency it might be. Then I realize that the day did end and that this is another, new day.

I
fired up Betty at five AM on a Thursday, aiming for the starting blocks at the Cambridge High School pool a thousand miles away. I had twenty hours. I figured that if everything went smoothly, Betty could manage a fifty-mile-an-hour average, which would put me there on Friday afternoon with about an hour to spare. Betty and I wheeled into the parking lot with more like ten minutes of cushion.

Sonja was delighted. Her hug just about erased the road fatigue, and before I was ready, I was suited up and aligned with the rest of the sacrificial parents waiting for the start pistol. That the parents lost was a foregone conclusion. That I was there for Sonja was the triumph. Randy sat poolside, cheering for both of us.

Within days I was back on the same highway, driving into the sunset. I often drive without music or news on. I let the land flow past, the miles accumulate in my wake, and my thoughts roam. This is when I do some of my best thinking, sorting things out, and occasionally, stumble across a revelation. The warmth of my visit with Sonja and Randy faded in the distance. North Dakota spread ahead for hundreds of miles. My thoughts centered more and more on the many obstacles that get in the way of my direct interaction with patients, layers and layers of obstacles.