The Blog I'm Not Writing

The real reason behind the total ban on abortion in Alabama and other backward misogynist shithole legislatures states, or so political strategists on both sides of the aisle tell us, is to set up a challenge in SCOTUS for Roe v. Wade. State legislators know their draconian laws will be struck down by state judges as unconstitutional; thus, the hoped-for trip to up the judicial ladder to SCOTUS chambers.

But so-called real reasons often leave real people and their real stories in the dustbin of history.   I will share some of those stories in this post: a series of vignettes, in no particular chronological order, from my time working in women’s reproductive health care. The stories I have from those years are legion; I’ll attempt both restraint and discretion in relating a just few of them.  [1]

The last one still blows my mind, all these years later. If I were to write it up as a short story I’m sure literary journals would reject it (“Contrived plot,” the editor’s notes might read), but trust me, I’m not a skilled enough writer to have made it up. Once again, reality trumps fiction.

TheBackground

 

From the early 1980s – 90’s I worked for a Planned Parenthood (“PP”) clinic in a SoCal county, a private OB-GYN practice in the Bay Area, and Planned Parenthood clinics in a Bay Area county.

PP clinics provided services determined by geographic need.  Example: because there were several other clinics in the county which performed abortions, the SoCal PP clinic provided a range of health care but referred patients seeking an abortion to those other clinics. Because there were few options in that same county for women needing colposcopy exams,  [2] that PP set up a colposcopy clinic, the patients mainly coming via referrals from the county public health system.

The Doctor (“Doc”) at the OB-GYN office where I worked (“The Practice”) shared the practice with a nurse practitioner (“NP”). Their patients ranged from Silicon Valley execs to welfare recipients (but skewed toward the higher end of the economic spectrum). Doc infrequently performed first trimester abortions (~ four per year), at an offsite day surgery center (he was aware that many more of his patients had abortions, but went elsewhere for the procedure). He told me he didn’t like performing them (“It’s a sad situation, all around”), but what he didn’t like even more was the idea of abandoning his patients when they needed help.

The Bay Area county PP had four clinics in the county, three of which offered abortions services, one to three mornings per week. I worked initially at the main site’s STD screening clinic,  [3]  then at their abortion (AB) clinics.

 

 

The Stories

We (The Practice’s Doc, NP, and I) developed a personal relationship  [4]  and had many interesting conversations on issues re women’s health care. Doc and NP were both staunchly pro-choice, Doc in particular due to his knowledge of what things were like before Roe v. Wade.  He told me stories about The Bad Old Days, about how (surprise!) the rich could always get safe care, no matter what. Back in the late 50s – 60s when abortion was illegal, a Japanese airline had a clandestine (but procurable, if you knew the right people) package deal: the fare included flights to and from Tokyo from West Coast airports, overnight lodging in a Tokyo hotel, and the fee for an abortion performed by a Japanese doctor. Sympathetic American doctors whose desperate patients had no safe local alternatives would refer their patients to someone, who would refer them to someone else, who would refer them to….   [5]

One of The Practice’s OB patients, after a routine exam, asked Doc if he ever performed abortions. Although it was none of her %&!$ business (and moiself wanted him to tell her so) he answered honestly, while tactfully letting her know that he would not be steered down the anti-abortion harangue road she was heading for.  After she’d left, Doc signaled to me to follow him to the office’s back room, where old/inactive patient files were kept.

As Doc searched through the files he told me about a former patient of his who’d sought an abortion, back when the procedure was illegal except for “medical reasons.” This woman had to go before a (male, of course) judge to get approval to have an abortion. Her physicians had to testify as to her mental and physical well-being, and they had lots of material: she had chronic health problems; was depressed to the point of suicide; her husband had left her and their three children…. She’d wanted to get her tubes tied after birthing her second child but could not find a doctor to do so – as per the standards of the time, hospitals would not book a sterilization surgery for a woman unless she met this weird algorithm (criteria included her age, the number of children she had, and other factors I can’t recall).  She also needed her husband’s permission for the surgery, which he’d refused.   [6]

The woman won her petition. At this point in the story Doc had found the patient’s chart, and showed me the transcript from her day in court. He snorted with disgust as he recalled how a grown-ass adult woman had to grovel and reveal highly personal information to male strangers who held power over her life.  Doc re-filed the chart, the ever-present twinkle in his eyes absent as he said, “Don’t ever let it go back to that.”

 

*   *   *

The R- PP clinic site (Bay Area) performed abortions on Friday mornings. The R-PP had two recurrent anti-abortion protesters who hung out on the sidewalk by the clinic parking lot. They were an odd pair: an older woman with an imperious air, always impeccably dressed in a woolen suit, designer handbag matching her designer pumps, her chin-length white hair sprayed into a Doris Bay-type bob, and a tall, lanky young man with wild eyes and a shock of Conan O’Brien-ish, unruly red hair. I called them Snow White and Big Red.

Dateline: A Friday am; the clinic had just opened, patients were in the waiting room filling out forms. One of the four clinic aides motioned for me and the other aides to follow her down the hallway. Looking out the clinic’s rear window, we saw “Consuela” outside, approaching Big Red.

Consuela, a native Mexican married to an American, was R-PP’s AB clinic manager. She was committed to providing reproductive care for Latinas, even as she admitted struggling with her work, due to her harsh Catholic upbringing. Consuela was kind and sweet-tempered, admired by PP’s staff and beloved by PP’s Latina patients, about whom she would tolerantly (but never patronizingly) educate us “white girl” clinic aides. She told us about the vagaries of the male-dominated culture Latina women had to endure, and the stories of her patients who’d had a horrifyingly experience common to impoverished Latinas entering the US were truly heartbreaking. The template: a woman’s husband summoned her to join him in the US after he’d found a job. He’d wired money to pay a coyote  [7] to escort her across the border, and during the journey the coyote raped her. Coyotes often assaulted women and girls with impunity and threatened their lives, knowing they’d be too frightened to tell the authorities or their husbands (sadly, Consuela said, even loving husbands were steeped in their culture’s machismo code, which cast a wife’s rape as a stain upon her husband’s honor…or as a cover for an affair).

Consuela would be in a certain mood I learned to identify – anger muted by melancholy – after working with a woman impregnated by coyote-rape. I often saw her, as her patient was leaving the clinic, slip the patient some money (“For bus fare,” Consuela would whisper in Spanish).   [8]

Back to the sidewalk: Sweet, warm Consuela was also very, very shy. Thus, we (her fellow clinicians, staring out the window) were amazed to see her approach Big Red, speak to him for a few minutes, return to the clinic…and holy crap, Big Red is leaving the parking lot! When the clinic was finished (~ 1 pm) Consuela told me what she’d said to him (paraphrased here):

I know you are here because you think you are doing good, but there is something you need to know. Three weeks ago, there was a no-show at our clinic – that older Latina woman you thought you had talked out of having an abortion. Actually, she left when you confronted her because she was afraid of you; she speaks only a little English, and didn’t understand everything you had to say, only that you were a stranger, who knew nothing about her, trying to intimidate her into not having an abortion.  She returned last week and had the procedure.

She may be poor and illiterate, but she is not stupid. When a woman makes such an important decision she considers all her options, and when she makes up her mind she is going to do whatever it takes.  All you did was make her wait another two weeks; she had to be sick and stressed and distraught for another two weeks. That may not have been your intention, but that is what happened. You caused even more grief for her.

For several weeks after Consuela spoke to Big Red, Snow White was the lone protester outside the R-PP clinic.

*   *   *

I’m glad those days (when abortion was illegal) are passed. But I fear the younger generations have no memories of what happened and take their rights for granted, and those of us who lived in those times are dying out, and our stories will die with us.
(paraphrased, from a conversation with Samuel Greenberg, M.D., PP-M physician)

Dr. Greenberg was an older gentleman, retired from his longtime OB-GYN practice, who worked several days a week at the PP main site (“PP-M”). “Dr. G” was the doctor I most often worked with at PP, and I came to admire his expertise, experience, humor, and compassion.

We talked often; Dr. G was concerned that when he and his peers died there’d be no one left to tell about The Bad Old Days, and that people might forget….  Sound familiar? Like many Jews of his age, he’d lost loved ones to the WWII concentration camps. His family’s experiences as Jews in non-Jewish cultures was one of the reasons, he said, he felt so strongly about his work at PP  –– he knew first-hand what can happen when people have their rights abridged by those of differing beliefs.

When Dr. G was a young doctor in the 1950s, doing his OB-GYN residency rotations in two different urban Catholic hospitals, he saw and treated many women who showed up in a the hospitals’ ERs, gravely ill and/or dying from botched illegal or self-induced abortions. Yet he never *once* saw the attending physicians list complications from illegal abortion as the cause of death for a patient who had indeed died from that.  On one such occasion, when Dr. G had the unhappy task of writing the “cause of death” on the patient’s chart, he challenged the doctor in charge who’d instructed Dr. G to write that the patient died of sepsis from an incomplete miscarriage. But, that’s a lie! Dr. G protested. – How can we, as doctors, lie about such a thing – people need to know, and the public health statistics will never reflect the reality…

Dr. G’s boss grabbed Dr. G by the elbow and steered him to the ER waiting room, pointing toward a sofa where the dead patient’s bereft husband and children sat.  He then led Dr. G to an empty hallway and spoke to him, privately and sternly, about the hospital’s non-official policy re reporting abortion-related deaths:  This is a Catholic hospital, with a mostly Catholic clientele. The truth will only bring further anguish, and shame, to a grieving family; also, since abortion is illegal, the police will have to be notified, and the hospital does not want its staff to get dragged into criminal investigations….

I will never forget the patience and kindness Dr. G showed toward all of the women we saw in the clinic, but in particular, to one recovering heroin addict.  Like most addicts, she was hypersensitive to pain, and howled as if she’d been stabbed when I did a simple finger prick blood test to check her iron level. She’d asked for additional analgesics for her procedure, which less than 5% of patients requested and which the doctor had to approve and then administer intravenously. Due to her years of junkiedom, Dr. G couldn’t find a usable vein to inject the medication.  I waited with an impatience I tried not to show, thinking thoughts for which I was later ashamed (What a whining wimp – suck it up lady, this is all from your own doing… you’ll be out of here in 10 minutes, and nobody else begs for drugs….), while Dr. G searched and searched, and searched again, and finally found a usable spot between her toes. After her surgery Dr. G spent additional time with her, holding her hand and encouraging her not to get down on herself or let this be another setback on her road to healing and sobriety.

*   *   *

In the PP clinics I saw a variety of women, from a wealthy Señora from Guadalajara whose IUD “slipped” while she and he husband were vacationing in the US, to a mother of four, in her late 40s and going through a bitter divorce (who’d had been told by a doctor that she’d gone through early menopause and couldn’t get pregnant), to the proverbial teenage girls who seem as if they can get pregnant just by standing downwind from a boy.

As per the coyote story,  rape/incest victims were the saddest cases to see. Those included a preteen holding onto her mother with one hand and her stuffed animal with her other hand (accompanied by a police escort, to retrieve “evidence’ of the assault, evidence they hoped to use to prosecute the family member who’d raped the girl); a woman forcibly impregnated by her estranged, abusive husband (she was told  [9] by a police officer that she couldn’t press rape charges because she was still married to her rapist), girls abused by their brothers/cousins/stepfathers/mom’s “new friend”/youth pastors….

And then there were those who’d been assaulted by non-related acquaintances – scenarios given a term I despise for its downplaying of the trauma it inflicts:  Date rape.

During a patient’s intake procedure we reviewed her medical history, and one of the questions we asked was, What kind of contraception were you using when you became pregnant? That question was not posed to known rape victims, and was a particularly cutting one to hear for sexual assault victims who’d not yet told anyone what had happened to them.  One patient, her tough chick attitude failing to mask her nervousness, threw her hands up in the air and laughed bitterly when I asked that question. Nothing; I was using nothing!  Can you believe that the guy my friend set me up with, the guy who choked me until I passed out, didn’t have the decency to put on a condom before he raped me?!   [10] 

*   *   *

 

She was not my patient; I’d finished my first intake and was on my way to place my patient’s chart in the surgical queue. She stood in the hallway outside the clinic’s bathroom, holding her urine sample cup, fidgeting in a way I’d come to recognize as a woman trying to convince herself to pee when she didn’t have to go. She was dressed like a 1950s secretary, with a pleated plaid skirt and a faded, rose red cardigan sweater. She looked sweetly anachronistic, nervous, and shy.

“Let me guess,” I pointed toward the empty cup she held.  “It seems like you have to go every five minutes, then when you need to go, you can’t?”

Exactly!  She flashed me a puppy-eyed look of gratitude. Kelly, my, uh, intake lady, left me here; she needed to talk with a nurse or something.  It might take awhile before I can… she looked askance at the empty cup in her hand. I shouldn’t have gone at my mom’s, before we came here.

I offered to get her a glass of water, and as I walked her back to her intake room she told me how out of place she felt.  I can tell I’m the oldest girl here. It’s so embarrassing. She lowered her voice. I’m twenty-seven.

“I’m thirty-one,” I said. “I win!”

She blushed, and told me she hadn’t meant the age of the staff, but rather “the girls” she’s seen in the waiting room, whom she assumed were, like her, there for an abortion, but unlike her, were probably not virgins… I mean, were virgins, until….

I stopped before entering the intake room, where her mother sat.  Sweet Twenty-Seven-Year-Old-Former-Virgin looked at me imploringly. Can you come in and talk with me?

I said I’d love to, and asked if it would be okay to talk in front of her mother.  She assured me it was.  I sat down with the two of them, and STSYOFV began to spill her guts. 

STSYOFV had flown out from Kentucky, where she’d gone to college and where she lived now. Her mother was helping out, paying for the abortion –  STSYOFV didn’t want to have it done where she lived, in case any of her friends and especially her church friends found out…well, I  really don’t have any friends besides church friends…

As STSYOFV told it, her  life revolved around an evangelical church where she was a member of the choir. STSYOFV ‘s mother discretely shook her head and gave me a look.

STSYOFV said she loved choral music; her church choir met for practice several times a week…and what they would think of me, if they knew where I was now.  I know what I’m doing is wrong in their sight, but my they’d disown me if I was pregnant out of wedlock and I know all my options and everyone here is so nice about reminding me but I wish they’d stop asking I don’t need adoption or pregnancy referrals I know what I’m doing and I can’t bear being pregnant it would destroy me and how could I be was so stupid and ignorant and naïve to stay a virgin until 27 and then get pregnant the first and only time…I feel felt guilty but I’m going to do it anyways, I tried a few home remedies, even thought if I threw myself down the stairs…

My eyes widened at the remark, and STSYOFV’s mother gasped. STSYOFV assured us both that she’d chickened out; I made her laugh when I told her that a miscarriage caused by falling down the stairs only happens in the movies.

 

My eyes flitted back and forth, from STSYOFV to her mother, who mostly remained silent while her daughter talked.  The mother’s unwavering love for STSYOFV was evident to me, as was her disapproval of the church her daughter had gotten involved with.

STSYOFV said she hadn’t even intended to have sex… I hope god will forgive me but I am going to do this, or if he can’t forgive me, at least I hope he won’t hate me.   If they only knew…they all think I’m a nice person….

“Then that’s one thing they’re right about – you are a nice person.” I placed my hand over STSYOFV’s. She grasped my hand with both of hers, her eyes moist with gratitude. Although a (closeted, at that time) non-believer, I attended a liberal Christian church, and knew what STSYOFV needed to hear. I assured her that her god, that no one, could ever hate her.

STSYOFV smiled at me through her tears. I wish you would be doing my intake, and be with me during the procedure. Kelly is nice, but she’s so young.

Actually, Kelly is 26, I thought to myself.  I also thought about how STSYOFV, with her gentle, desperate naivete and high voice, seems like a 12 year-old in a 27 year-old’s body.

I told STSYOFV I had another patient to help, but promised I’d check on her after her procedure. She hugged me, and said she’d like that.

STSYOFV was the last patient to see the doctor, and when she was out of the recovery room she, her mother and I had a heartfelt conversation before they left the clinic. I assured STSYOFV re how much she had going for her – she was young, strong- spirited and good-hearted, with a wonderful mother who loved and supported her…

She is the best. STSYOFV gazed lovingly at her mother. And she says she won’t let me pay her back, for lending me money for the plane tickets and everything.

“Speaking of which…” I hesitated. “What about the guy who got you pregnant? Why isn’t he helping you with this, or at least paying?”

Oh, no, that would ruin him. STSYOFV shook her head, sadly yet vehemently.  While her mother’s mama bear eyes blazed with rage on behalf of her daughter, STSYOFV told me that the man who’d seduced her was her choir director. He was older, married and with children, and active in the church’s pro-life demonstrations. When she went to him with news of her pregnancy he warned her to not to tell anyone, and told her to “take care of it,” and so STSYOFV had swallowed her pride and telephoned her mother….

*   *   *

Department Of This One Takes The Cake
Aka If I Hadn’t Seen It With My Own Eyes….

I lost track of how many times an AB clinic patient laughed and said, “Until it happened to me, I was against abortion. That” – the patient would indicate the clinic’s entrance, referring to the protesters outside – “might have been me a couple of months ago.” I’d smile, say, “We hear that a lot,” and do my best not to reveal that I didn’t find her admission – that she’d have supported taking away other women’s autonomy until “it” happened to her –  to be amusing.

PP-M had a semi-regular group of protesters who demonstrated outside the clinic’s front entrance. (I never saw them; I parked in the employee lot at the back of the clinic and entered and left through the back door.) Other PP-M employees became quite familiar with the protesters, who were part of some Catholic group led by a perky blond in her mid-thirties. The Vice President (“Veep”) of PP-M went out of her way to befriend the protesters. Veep was an ex-Catholic, and would go outside and chat with the protesters during her coffee breaks, sometimes joining them in reciting The Rosary. On sweltering summer days Veep carried cups of water out to the protesters – one day she even brought them lemonade – and on more than one cold winter morning I heard a fellow clinic aide good-naturedly grouse about how She ( meaning, Veep) is out there, serving them hot cocoa, can you believe it?

Dateline: one memorable Monday, ~ 8 am, at the PP-M AB clinic. As I reached for the first chart in the intake pile, “Cindy,” the clinic’s assistant manager, whisked the chart out of my hand. “I don’t believe this,” Cindy hissed. She motioned for me to follow her to the reception office, where she and the receptionist stared through the  bullet-and-sound-proof plate glass window to the waiting room, and traded incredulous remarks back and forth:

I don’t believe it – can you believe it? That can’t be her…no, it is her…this is got to be a joke…a plant…a set up…no – look at the chart, it is!….

I asked, What’s up? Cindy told me that Perky Blonde Anti-Abortion Protest Leader was in the waiting area, with her 15 year old daughter, whom she’d brought in for an abortion.

“I am doing this intake,” Cindy announced. As her WTF ?!?!  expression morphed into that of Compassionate Health Care Worker, she opened the door to the waiting area and called PBAAPL and her daughter back to an intake room.

It was a busy morning; I didn’t get to talk with Cindy until after the clinic was over, when all four of us clinic aides gathered around Cindy to ask, What the heck….?  Cindy told us that she’d started the intake as usual – she led PBAAPLW and her daughter back to a private intake room, then asked the daughter to give a urine specimen. While the daughter was in the bathroom, Cindy introduced herself to PBAAPL, and the following conversation (paraphrased) ensued:

Cindy: I need to tell you something. I recognize you, from the protesters outside. If this makes you or your daughter uncomfortable, you can request another…

PBAAPL:  Oh no; thank you. You’ll be fine.

Cindy: Okay. Uh…now I’m speaking for me, personally, not on behalf of Planned Parenthood.  I can’t help but wonder, what are you doing here?

PBAAPL:  Well, my daughter got in trouble, you know?  And you people here are all so nice, I knew you’d take good care of her.

Imagine, if you will, the sound of four jaws simultaneously dropping to the clinic’s tile floor.

PBAAPL skipped the protests for the next two weeks (there were a few demonstrators who showed up, and only for one day, during PBAAPL’s absence). After she brought her daughter in for the girl’s post surgery exam, PBAAPL returned to leading the protests, trying to deny other women’s daughters the “good care” she’d sought for her own.

*   *   *

Department of Epicurean Excursion   [11]

 The excursion returns next week, having been temporarily grounded this week, due to the appetite-quashing political upheavals which prompted this post.

*   *   *

 

Thanks for stopping by.  Au Vendredi!

*   *   *

 

[1]  We didn’t have HIPAA laws then; still, I’ve altered all names and a few geographical details for privacy’s sake.

[2] A colposcopy is a procedure to closely examine a woman’s cervix for signs of disease, using a special instrument (colposcope). The procedure is most often done due to the woman having an abnormal pap smear, and may be followed by a cervical biopsy.

[3] I worked primarily at two PP clinics  in the county, and twice at a third PP clinic.

[4] Which continued after I left the practice and which exists to this day.

[5] I later heard about this same service from another doctor who was Doc’s age.

[6] Yep, that’s right – he knocked her up a third time, and then abandoned her and their children.

[7] A coyote is a man who makes a living smuggling migrants across the US-Mexico border.

[8] Consuela and her husband ( who was still in college) were far from wealthy, and had two children of their own to support. It probably violated some kind of clinic policy to give money, even your own, voluntarily, to patients; I always saw her look around furtively when she did so.

[9] Erroneously, I believe, although I don’t know the status of the marital rape laws in California at that time.

[10] I stopped the intake immediately and got the patient to speak with someone from PP’s counseling/education department. She was over 18; we couldn’t force her to go to the police, and she refused our advice to do so (she said she’d known someone that had the same thing happen and “was raped again by the cops” (i.e. they didn’t believe her ). After her procedure we set her up with referrals for individual counseling and a rape crisis center…I have no idea if she ever followed through with those contacts.

[11] A recurring feature of this blog, since week 2 of April 2019, wherein moiself decided that moiself would go through my cookbooks alphabetically and, one day a week, cook (at least) one recipe from one book.