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Wednesday, November 13, 2013

A Day in the Life: Clinic Days

It’s 6:30am and typically I’d still be sleeping. But today, I’m wide awake, lying in bed, stomach in knots, and praying to God that I’ll have the energy to make it through a 17 hour day. I know that today will easily end up being one of the most exhausting days of my life, but I’m ready for it. I’ve been waiting on this day for months, one could even say years. Later today, I’ll go to work for my typical 8 hour shift, but first, I’ll spend a few hours learning how an abortion clinic operates-from the inside.

If the idea of observing at an abortion clinic isn’t enough for my mind to process, I won’t be observing at just any abortion clinic. No, I’ll be observing at the clinic owned and operated by Dr. Leroy Carhart (and staff, respectively). Dr. Carhart has been a major player in this movement for years, as he is one of the only remaining abortion providers offering late term abortion services. Because of the late term options he provides, he’s also spent years being the target of violent pro-life extremists, even falling victim to arson at his ranch in 1991. The fire killed 17 of Dr. Carhart’s horses. Paintings of those horses now decorate the walls of his clinic.

For the last few months, I’ve held the title of "intake specialist" for the clinic. Simply put, this means that I obtain information, by phone, for women seeking Dr. Carhart’s services past 21 weeks gestation. In addition to this position, running this blog has also kept me involved in this movement (albeit, on the outskirts) for almost two years now. But for some reason, I feel that by exposing myself to the protestors who are bound to show on this particular morning, I’m involving myself on a whole new level. By meeting these women face to face and hearing their stories and observing procedures, I feel like I’m entering an entirely different arena. It’s a heavy feeling and I’m intensely aware that by the time I leave the clinic today, the views that I’ve spent the last three years defending could change. And still, I can’t bring myself to miss a moment of it.

After leaving home, I stop at the store and load up on energy drinks before heading to the clinic. Once I hit the interstate, my anxiety kicks in. I can’t stop the constant stream of thoughts from going through my mind: What should I expect? How crazy will the protestors be? Will this make me emotional? Am I going to completely humiliate myself and pass out? Will I leave just as strong in my beliefs as before? The questions are endlessly streaming and I can’t wait to find the answers.

It seems like it takes an hour to get to the clinic, but in reality, I’m there within 15 minutes. I arrive around 7:40am to what appears to be one protestor, an older man who seems to have placed signs in the grass with phrases such as "Abortion Hurts Women" and "Men Regret Abortion". If that isn’t annoying enough, he’s also holding a sign that reads, "Today is Kill Day!" in big, bold letters. Once I manage to get into the parking lot (while reading these signs), I realize that there are two women who are on the grass in front of the parking lot praying. I park my car and try to stall because I know the man has zeroed in on me. Within seconds, another car parks beside me and a man and women get out and enter the building together. I finally suck it up and get out of my car and instantly the man is yelling at me, "Don’t kill your baby! Let us help you! You’ll never forget this day…the day you murdered your baby!" In all honesty, I have no idea how to react, so I just mutter that I’m not pregnant and that I’m an employee. He doesn’t believe me, shakes his head and keeps yelling at me not to kill my baby. I walk away and head up the stairs that lead to the clinic entrance. The praying women are waiting for me. They’re very nice and I have no problem telling them that I’m not pregnant and that I work at the clinic. They instantly seem surprised that I’m talking to them and express interest in having a "real conversation" with me for my blog anytime I’m free. I awkwardly walk away and as the door closes behind me, I hear them tell me that they’ll be praying for me.

I’m finally inside the clinic and I feel like I can take a breath. I’m excited to see the girls, but I can’t help but notice the atmosphere in the clinic. There is one patient there, in addition to the couple from the parking lot. No one in the room seems to be any kind of noticeably emotional, though there does seem to be an awkward silence lurking in the room. GMA is playing on the t.v. in the waiting room and Lara Spencer’s perky voice is all that seems to cut through the uncomfortable silence. I laugh to myself at the thought of how excited I am to be here, while all the other girls in the office are discussing one’s recent overnight stay in the local haunted house. It’s about this time that I realize that in my nervous rush to leave the house, I forgot my notebook, so Lindsey (Dr. Carhart’s Director of Nursing) sets me up with a clipboard. I immediately start making notes and she laughs at me. I’m determined to not forget a single detail. Lindsey informs the other girls in the office that I’ll be following them around the clinic today and that I’d like to sit in on educations and procedures. After what felt like forever, the work begins.

By the time I sit through my first education, another patient has arrived. There is no single characteristic that any of these women visibly share. There is a young, married couple that seems down, a girl who is alone and seeking a medical abortion (the abortion pill), and another girl who must be somewhere around my age, who is accompanied by her best friend. They all appear to be from different walks of life. I’m asked if I’d like to sit in on the education for a F.I. (fetal indication) patient and I jump at the opportunity. It turns out that the young married couple (who I previously saw in the parking lot) is there because they just discovered that their baby has a chromosomal abnormality. The woman is devastated, the husband tries to remain stoic, and this is the first patient that I feel some connection with, even though we never speak to each other directly.

Finally, Dr. Carhart arrives and almost immediately jumps into action. I walk into the first patient room to find an older woman, calmly lying on the examining table. Her pregnancy was discovered so early that she did not qualify for a medical abortion. I stand discreetly in the back of the room by the door, so not to make the patient uncomfortable or be in the way. As the woman is being prepped, Dr. Carhart comes into the room and speaks with her, ensuring that she’s comfortable with her decision. All that’s going through my mind is, "This is it. This may change everything. I’m not sure I’m ready for this". By the time those thoughts play out in my mind, the procedure is over and the woman is getting dressed. I’m called over to examine the products of conception (POC) and to my surprise, I see nothing recognizable. Immediately, I wonder why people are willing to kill doctors over this.

The third procedure that I observe is not an actual abortion procedure, but the administration of Digoxin to the fetus and placement of laminaria for cervical dilation. It’s the young married couple. I walk into the room and notice that instead of the patient being distraught, her husband is. She is calm and it’s his turn to cry. He holds it together quite well, holding her hand and speaking with the doctor. Dr. Carhart is incredibly sympathetic to their situation and speaks to them like this is a personal situation for him, as well. It is obvious that they appreciate his compassion during such a difficult time. These types of situations are what originally opened my mind to the pro-choice movement and it’s hard for me to process how this couple must be feeling. After speaking with the husband, Dr. Carhart takes his seat and is given the instruments needed for the procedure. Once the ultrasound screen lights up, the husband buries his head into the examining table and his wife strokes his forehead. The room falls completely silent and as soon as the first part of the procedure is over, the husband falls apart. It’s clear that his heart is broken. I’m still standing awkwardly in the corner, not wanting to make anyone uncomfortable or be in the way, but I notice that he’s looking for something to wipe his face and he’s too distraught to notice the box of tissues that had been sat on the head of the examining table for him. I quietly step over and hand him the box. He’s grateful and thanks me. In the time it takes me to take three steps back to the corner, I’m sure my heart is about to burst through my chest. In handing him that simple box of tissues, I feel like I’m officially involved. Part of me feels ridiculous; part of me feels grateful to be a part of it, even in some small way. I know I won’t be there to see how this couple handles their procedure the following day, and I make a note to ask Lindsey to keep me informed of how they’re doing. And suddenly, it’s real to me. I don’t know these people…I don’t know their story, but it feels personal. This really is a needed service. I like to say that I knew that before, but for some reason, now it’s really hitting home for me.

I see one more F.I. procedure before the day is over. It’s for a couple that I didn’t see earlier, but again, the husband is by his wife's side and it makes me appreciate Dr. Carhart’s way of doing things. The couple is laid back. They discuss their other children with us, the wife jokes and tries to make light of the situation, but keeps bursting into tears. The husband remains calm and strong for his wife. Once Dr. Carhart comes into the room, he asks how she’s doing and she dissolves into tears and says, "This fucking sucks!" Dr. Carhart agrees with her and tries to put her at ease. He handles the situation beautifully and it’s amazing to watch his bedside manner. He ensures that this is the route the couple wishes to take. Throughout this procedure, the patient tries to lighten the mood by making jokes and I admire her for working so hard to hold it together. We all end up jumping in to help lighten things up. In a matter of minutes, this procedure is completed and Dr. Carhart leaves the room to help his next patient.

Finally, I’m standing in for my last procedure of the day. This woman, probably close to my age, is farther along than the rest of the surgical abortion patients and I’m curious as to why she’s waited so long. It doesn’t take long to figure out that it was a financial issue. As she talks with the staff, she’s clearly concerned about any extra costs that she may have to pay. I’m instantly irritated because I know that this service should be more readily available and affordable for women who need it. For women living paycheck to paycheck, an unexpected pregnancy and termination (if she chooses that route) could unravel everything that she’s worked so hard to gain and it appears that that may be the case for this patient. As Dr. Carhart finishes his paperwork after the procedure, I scribble a few extra notes down and start to get my papers together.

Back in the office, I’m gathering my jacket and papers when it starts to set in that the last few hours have changed the way I feel about this movement. The protestors, the patients, Dr. Carhart…all of it has left me with a feeling of overwhelming pride in this movement. For the doctors and nurses and staff members who are willing to risk their own well-being in an effort to provide a safe, dignified place for these women to go in their time of need. Even for the women who are brave enough to recognize that they made need to utilize their right to choose. As I start to leave the building, I remember that protestors will be waiting and suddenly there’s a sickening churn in the pit of my stomach and I feel nothing but disgust for these close minded zealots. How could anyone meet one of these women and dare to judge them? How could they assume that they know what is best for these women and (possibly) their families? What makes them think that they have a say when it comes to a woman exercising her freedom of choice? This time when I walk outside, there’s a different woman by the door and again, I have no problem speaking with her. I’m a little more confident this time around so when she starts preaching, I politely (yet, somewhat sarcastically) tell her that I disagree with her. I state that I CHOSE to have my children and I wouldn’t dare try to take that choice away from another woman. I walk away, and am again told that they’ll be praying for me.

By the time I get in my car and start to leave the clinic, there are about 5 protestors hanging by the entrance. I have to stop for oncoming traffic and while I'm stuck there and they're trying to hand me pamphlets, I crack my window and start blaring Ani DiFranco's "Lost Woman Song". It is ironically appropriate for the moment and I can't help but smile to myself. Yes, the first part of my day is over and instead of feeling exhausted, I'm feeling energized and more confident in my beliefs than ever. There is no way to justify taking a woman's right to choose away from her. Ani DiFranco had it right when she said, "They keep pounding their fists on reality, hoping it will break. But I don't think a one of us leads a life free of mistakes". 


Abortion isn't going anywhere. And outlawing it will only result in more lives lost. The real question of morality lies in whether or not we (as a society) are willing to let women needlessly die?

I can officially say that I know this movement from the inside...which leads me to this: I support the freedom of choice and the physicians and clinic staff that make the choice possible. Where do you stand?