This Common Secret: My Journey as an Abortion Doctor (22 page)

She never looked up at him, kept her head bowed. “Oh, I’m alright,” she mumbled.

“It must be hard to see people your age who are healthy,” I said, after he left.

“I’m so angry that this happened!” she blurted out. “My friends are out playing golf, spending time with their families, going places. Look at me. It’s not fair!” She hunched over, her muscles tight, her hands clenched into fists.

I did look at her. The sight made me grieve. This is what had replaced the retirement my parents had looked forward to, this purgatory full of pain and dependence.

Days marched past, weeks, years. Mom’s condition steadily worsened, but Julie and I were very attentive. Every change was monitored, medications adjusted, quirks checked out. She outlived her prognosis. We hired a compassionate, cheerful local woman to help out several days a week. Dad was cantankerous with her and resented having a stranger in the house. Fact was, we desperately needed the help. The smallest chores had become ordeals.

Flower Grandma was still alive, suffering from Alzheimer’s disease, living in her third nursing home. She and I had never again discussed her childhood friend. I don’t know if, in her later years, she even remembered the trauma. We tried to explain Mom’s situation to her. She seemed to understand. It had been months since they’d seen each other.

On a sunny spring day I picked up Flower Grandma and drove her to my parents’ home. The farms were green with new crops. Flocks of Canada geese flew over the fields.

“Oh!” she exclaimed. “Big birds.”

When we passed farm silos, she’d count them off. “One, two, three silos,” she said. “One, two, three, four, five silos.” Her obsessive behavior was symptomatic of Alzheimer’s. On one level her habit was cute and endearing. On another, a chilling sign of a mind trying desperately to hang on to some thread of control.

At the house I helped Flower Grandma from the car. She shuffled her way in through the doorway she had entered hundreds of times over the decades. Some spark of recognition lit her face. We moved farther into the house, to the old dining room. Mom lay there on her hospital bed. In that moment I saw her truly for what she’d become, a shrunken, diminished husk of herself.

“NO!” Flower Grandma shouted at the sight of her daughter. “Not . . . not . . . oh no!”

I pulled her into the kitchen and made coffee—my ingrained response to stress. We sat together at the table in silence, cradling the warm mugs. Crying. Eventually she was able to walk back into the room, holding her coffee cup, and sit with Mom.

On the trip back to the nursing home, Flower Grandma counted silos, looking out across the land so familiar and yet so foreign. She died that spring, just after Easter. Bucking tradition, her six granddaughters were her pallbearers.

I went back to work part-time for a clinic owned by a large corporation in St. Paul. The two-hour commute became my island of calm and solitude. I could listen to books on tape, play music, let my thoughts wander uninterrupted, simply be alone without demands or distractions. I loved being with patients again and got completely pulled in by their circumstances.

At this job, however, I was no longer the boss, and I had little opportunity to have an impact on policies or protocols. Decisions about patient care, staffing, and individual concerns were dictated by a hierarchy that I often couldn’t understand and that seemed unapproachable. I was continually getting into trouble for rocking the boat, for questioning the wisdom of rules, and for putting patient requests above rigid guidelines.

“Hi, I’m Dr. Wicklund. How are you doing, Kelly?”

“Why can’t my mom be here with me?” she asked.

She was sixteen but looked twelve. She clutched a stuffed animal and slumped in her chair. Her eyes were pleading, young, afraid. What she needed, more than any other thing, was the comfort that her mother, and only her mother, could provide.

I clenched up. It was so clear that a mother should be allowed to join her daughter through this process if that was what they both wanted. Yet it was counter to clinic policy. I had gone through appropriate channels and requested that, in some cases, rules be bent in response to unique circumstances. I had been consistently rebuffed. Only staff could be with a patient during an abortion: end of discussion.

Kelly’s mom and the seventeen-year-old boyfriend sat off by themselves in the waiting room. When I went to visit with them, the mother immediately put her hand on my arm and begged to be with Kelly. Her eyes were mirrors of her daughter’s.

“Please, Dr. Wicklund, let me come in with her. She is so young. So scared. I can help her through this.”

“It’s against regulations,” I sighed. “But listen, I’m a mother, too. I understand your desire.” What I was really thinking of was my parents and my compelling need to be included in the decisions and procedures that affected their lives. More than that, the need to be watching them, holding their hands, reading their body language—that language only someone close would understand.

“Listen,” I said, with sudden resolve. “In just a minute I’ll get up and walk into the surgical area. I want you to get up and follow me. Look like you know exactly what you’re doing and where you’re going. Just follow me.”

I waited until I saw the clinic manager go into her office and close the door; then I stood and walked through the waiting room into the surgical area. Kelly’s mom was right on my heels when we entered the room where my assistant was waiting. She immediately went to her daughter and hugged her.

“Your mom can be with you,” I told Kelly, “but please don’t mention this to any of the patients you see in the recovery room. When the abortion is over, your mom will stay in this room until we can slip her back to the waiting area.”

The procedure went smoothly. Kelly needed lots of TLC. Her mother was a tremendous help. She pressed her face against her daughter’s, quietly sang her a song, kissed her tear-streaked face.

At my clinic, as in many of the smaller, independent clinics I’d worked in, we made decisions like this on an individual basis. In some cases it is extremely helpful to have a partner or husband or parent with the patient. Many times it would not be the best thing. In St. Paul, we were discouraged from assessing cases on an individual basis and reprimanded for bending the rules.

At the end of the day I was called to the manager’s office. My infraction had come to her attention. She wasn’t interested in the extenuating circumstances, the fact that a patient’s experience had been eased by having her mother with her. That wasn’t the point. The point was that I had disobeyed policy.

I felt like a school kid in the principal’s office. I took my reprimand, but I didn’t apologize. Nor did I promise never to bend the rules. My priorities were clear. I kept remembering my own mother’s tears when she learned about my abortion and wanted so badly to be with me. My experience would have been so different had she been there. There are times when corporate guidelines and efficiency are secondary to the needs of a family going through transition. For me, ignoring individual circumstances was unacceptable.

Resuming work at a clinic was a relief, but my true refuge was in Montana. Whenever I could carve out some time to take a break, I would drive nonstop to my cabin retreat. Each time I had to overcome the burden of guilt for leaving Julie behind to take the load.

Once there, I might stay in pajamas for days. Hours at a time I sat on the deck and stared out at the mountains, holding an unopened novel on my lap. Time flowed past me. Dry winds stroked my face. The open space made me breathe deep, drink in the view, wallow in the long silences.

I began to meet my neighbors on the ranches and in houses scattered across the landscape. Some of them would become my best friends. They got to know me, listened to my stories, shared their own. Every time I came back, I settled in more comfortably and quickly. More and more, it was becoming home.

Sadly, we weren’t able to care for Mom at home to the end. She needed blood transfusions every two weeks. Transportation to the hospital had become intolerable. Putting her in an extended care facility adjacent to the hospital was our only recourse. The small hospital was very supportive of our family efforts. We were included in medical discussions and decisions. Staff welcomed our help.

Much of the time we simply sat at her bedside, waiting for whatever might come up, just being in her company. Toward the end, she lapsed into long periods of semi-consciousness, more than sleep. As I sat through the hours, I started drawing plans for remodeling my Montana cabin.

Mom never reconciled herself to her fate. Her bitterness, so uncharacteristic, made me ache for her. We were always on call. More than once I had to turn around on a Montana-bound trip to tend to the latest crisis. She had been terminally ill for more than five years. I had put my life on hold for half a decade already. And Dad’s Alzheimer’s symptoms were becoming undeniable.

He would forget where he was, why he’d come someplace, who he was talking to. At least he could still play a cunning game of cribbage, but we learned not to challenge him when he bent the rules here and there. He developed an alarming habit of taking off in his car and driving aimlessly around on the rural roads. We’d get calls from people who’d seen Dad’s car twenty miles away. As Mom’s life wound down, we started Dad on a new regimen of medications specifically targeting his Alzheimer’s symptoms.

January 2003. Mom had been in a light coma for three days. She hadn’t eaten but had roused enough to sip some liquids. These spells had been going on for the last month. Her lucid periods were rare and fleeting. Most of the time she was incoherent, confused, weak. Her pain was so intense that she required large doses of morphine. Her bones were so fractured we could no longer turn her. Her kidneys were shutting down.

On a Monday morning, her lab day, I got a call from the doctor.

“The only reason we would do labs is to see if she is low enough on hemoglobin to qualify for Medicaid to pay for a transfusion on Wednesday,” he said.

“If we don’t give her blood, she’ll die,” I whispered.

“Sue, your mom is dying right now.”

In the end, we decided to forgo the labs and provide comfort measures only. Let her go. The words kept running in the background. It’s time. Let her go.

Then, on Tuesday morning, Mom opened her eyes, looked around, wanted something to eat. She asked what day it was.

“It’s Tuesday, Mom.” I knew what the next question would be, and I dreaded it.

“Am I getting my three units of blood on Wednesday?”

“Mom,” I said, “you’ve been completely out of it for four days. We didn’t do your labs.”

Silence. She knew exactly what I was saying.

“Are you just letting me die?” she accused. “I want the labs, and I want the blood, and that’s that.”

I called the doctor, who came right over. Despite his explanation she insisted on the transfusion. Mom demanded to sit up in a wheelchair. She hadn’t been out of bed in weeks. She placed herself with her back to me while she spoke to the doctor. I felt like an abject failure.

We did as she asked, but her lucidity lasted only a few hours. She lapsed again into a restless coma.

Sonja was with her when she died, early one January morning. Most of the family had gathered around her the night before, telling stories, being together. Some of us hadn’t seen each other in years. Mom lay motionless, but her vital signs reacted to the sounds of our voices. I knew that on some level she was aware of us, responding to us.

At dawn, just before death, she roused, became very restless. Everyone but Sonja and one of her cousins had gone home. Mom was trying to say something. Sonja leaned close. She wanted desperately to make it out. Mom was very frustrated, repeatedly struggled to form words. She died with Sonja still bent over her, still trying to hear.

Four days later I was with Dad at the house, getting him ready for the funeral.