It was 1972, and I was a nursing student in the final months of my training, eagerly awaiting graduation and the beginning of my real life as a nurse. I don’t recall the time of year exactly, but it must have been early spring, just warm enough to come to work without a cardigan. I know this because I remember thinking how oppressive it was in that closet, the one where my patient awaited me; I remember thinking that it was a good thing I didn’t bring a sweater.
The closet that housed my patient was simply that—a linen closet with a stainless steel rack that held piles of sheets and jonny coats, pillow cases and Chux. This rack had been shoved to the side to make room for the single isolette that stood just inside the closet door. A small crib with a thin mattress and an extra bumper, it held a newborn infant, a boy, who slept on and on. There was no card attached to the front of the isolette proclaiming his date of birth, his weight, or his name. I called him Baby Boy, although they told me I shouldn’t get attached to him. I sang and hummed to him, although they told me he couldn’t hear.
When he wasn’t being tended by me or one of the other nursing students who, during the day, were assigned his care, Baby Boy’s closet door was closed and the light was turned off, leaving him alone in the quiet dark. When I protested, I was told that he couldn’t see and so the light being left on or off made no difference. When I asked about his mother, the nurse in charge hushed me. It’s a tragedy, was all she would say. It took us students some time and quite a bit of snooping to discover that his mother’s room was just down the hall on the other side of the maternity ward. We learned that her baby boy had been whisked away at birth, before she awoke from anesthesia. We learned that the doctors had told her, at her husband’s urging, that the baby was stillborn. She’d never seen her boy, never held him; and she didn’t know that he was only a short walk away, left in a closet until, as the charge nurse said, “Nature took its course.” Sometimes we students ambled past the mother’s room, peeking in to see her face. We talked about how we might go in and let her know that her baby wasn’t dead at all; we said, what if she had a chance to hold him?
Looking back, I assume that we were assigned Baby Boy’s care because he was considered a lost cause—even bumbling nursing students couldn’t cause him any more harm. And he required minimal care: diapering and turning. No vital signs were to be taken. Water was to be offered but no sucking response was anticipated. The medical staff expected the baby to die within hours. But two, three, four days later, he lived on.
When I first saw him, I was only mildly taken aback. Well warned by the charge nurse, I expected the baby to be some sort of monster, born “without a brain” as she said, “with nothing left but a face and a body.” Instead, I saw an infant with a strangely compressed forehead, eyes tightly closed, and perfectly chiseled lips and chin. Although his face was prominent, he did in fact have what seemed to be a near-normal sized skull, only steeply sloped and covered with fine blond hair. He looked, from some angles, like an elderly wizened man. If I turned him just a bit, he looked like a peacefully sleeping infant. Did he respond to my holding and rocking? I thought he did. Did his lips and cheeks respond to the nipple, to the bottle of water I offered? I believed they did. When I asked the charge nurse if I could please try some formula, that I thought he might take it, she said she would ask the doctor but she doubted he’d be unwilling to prolong the inevitable. On the second day, Baby Boy began to cry, a high pitched, hungry, agonizing whine. Okay, the nurse said, try some formula. But although his lips smacked and his cheeks tried to suck, most of the formula dribbled out of his mouth.
When the keening persisted, some of the nurses worried that his mother might hear and, responding to some primal recognition, try to investigate—why were such haunting sounds coming from behind the closed linen closet door? They moved her further down the hall, and the next day the doctors sent her home. I wondered how long it took her to stop crying over a baby she’d never seen. I wondered how her husband lived with the knowledge that he’d left their newborn boy in the hospital where it was taking what the doctors called “way too long to die.”
No, the doctors told me. No intravenous. And a feeding tube was out of the question.
I first cared for Baby Boy on a Wednesday. Thursday he cried, and Friday he seemed to settle into a resigned stupor. His mouth worked in the pantomime of nursing. His fists curled and uncurled. His eyelids—did I imagine this?—opened and his eyes wandered about, searching. I never asked what happened to him on the off-shifts, on evenings or nights. Did the aides have time to rock him, to sing to him? When I returned to the maternity floor on Monday, the linen closet held only linen. Baby Boy had died, unattended, sometime during the afternoon on Saturday, in the fifth day of his age. He died before the time of grief counseling and support. He died before the time when his parents would hold him; when a nurse would wrap him in receiving blankets and photograph him; when another nurse would clip a lock of his hair and tie it in a blue ribbon. He died before we understood how necessary it is for parents, siblings and grandparents to gather together to welcome such a child, and then to accompany him gently to his death.
I don’t know what happened to Baby Boy’s body. At the time, I never thought to ask. At the time, I never thought that such disregard for life, such secrecy, such denial of the reality of grief, was all that unusual. It wasn’t until years later that I wondered, as I do now, where all those babies went, all those who were not whole, not perfect. Were there other closets in other hospitals where infants, abandoned as hopeless, were tended by other nursing students who sang to babies who could not hear, and loved babies who would not survive? Today, when genetic testing is so common early in pregnancy, these babies are too often “weeded out,” denied not only sustenance and love but also life itself—even if that life would be brief and seemingly insignificant. But I wonder, how many lives did Baby Boy touch from within the small space of his life, during the few days he spent in the dark, never held by his parents, never loved except by some awkward students? But here I am, all these years later, writing about him. If he only touched one life, one soul, wasn’t that enough? And even if, during his brief life, he never touched anyone, still, he had a soul—and wasn’t that enough?
Tuesday, May 26, 2009
Monday, May 18, 2009
My Double Life
Until a few years ago, I led a double life. Not easy, that going back and forth between acting like the woman everyone thought I was and yet wanting to be openly the woman I had become. The conversation that tipped me off to the reality of my double life went like this:
“So,” my nurse practitioner friend said. “Can you believe that they’re still trying to push abstinence education in the schools? Kids don’t need abstinence; they need birth control and easy access to abortion.” She looked at me, sure of my agreement. “Well?” she asked.
I hesitated. Should I tell her that I actually did support teaching teens about abstinence and that I was, in fact, not in favor of “easy access” to abortion? If I said what I really thought, would she look at me and, in an eye blink, see me not as her colleague and friend but as an enemy—someone she might label a right-wing, pro-life kook? I didn’t want to get into an argument. And I certainly didn’t want to be labeled a kook.
For most of my adult life, I’d viewed abortion as a woman’s right. As a nurse practitioner, I’d worn a button on my lab coat that said “Pro-choice!” When I wasn’t working I wrote about my work, and my published poems and books reflected my “feminist” stance. But during my eighteen years in women’s health, my views on what is truly pro-woman had changed; alas, my courage had not kept pace with my beliefs.
For years I’d remained silent regarding my feelings about abortion for a variety of reasons: unwillingness to judge others; desire to fit in with the caregiving community; fear of job repercussions; and fear of challenging the view of our takes-abortion-for-granted society. Yet at the same time I wondered how many other caregivers had experienced a change of heart about abortion. Were there others who, like me, were leading double lives; others who were against abortion in their minds and hearts but who, like me, remained silent?
My own change of heart was fostered by patients who chose abortions, by my direct participation in their abortions, and by the advances made in perinatal medicine during my years in women’s health. Many of the women who came to the clinic asking for abortions told me they felt they were choosing something, as one woman said, “terribly wrong.” Often, they mourned the loss of their pregnancies even before the abortions had been accomplished; some asked if they would ever forgive themselves. Many were propelled into choosing abortion by the inability to find an alternative solution. And we clinicians in the clinic did little to help them. After all, we’d been taught to tell women that twelve-week pregnancies were nothing more than a “bunch of cells”; we were taught to turn the ultrasound monitor away so that a woman couldn’t see her unborn baby. “If she sees it,” one doctor told me, “she might change her mind.”
I saw women who, after their abortions, were not relieved, but grieving. Some were downright angry. Many felt their pre-termination counseling had been rushed; some felt they hadn’t been given enough information about other options. More than one woman returned dismayed that no one had explained to her exactly "what we would be aborting." Until going online and searching out photos of fetal development, these women had no idea of what a five to twelve-week fetus “was like.” These women—and many more—felt that we, the doctors and the nurses, had not been honest with them and had not fully revealed what abortion entails.
There were also women who did not express any grief following their abortions. And yet many of these women sensed that there was something about abortion that wasn’t natural. I saw women who, after several abortions, decided to keep the next unintended pregnancy although their financial and social situations had not changed. They simply felt they “couldn’t do this again.” One woman decided against abortion when an ultrasound confirmed she was pregnant with twins. Her exact words were "I couldn’t kill two of them." I saw women who were torn between their maternal instincts and their life circumstances. We caregivers said, “You have to do what is right for you at this time in your life.” Even as I spoke those words, I sensed how wrong, how against God and nature, that advice was.
I wondered why we tried so hard to preserve a woman’s choice to abort but invested so little energy in helping women who might choose, against difficult odds, to keep a pregnancy. I wondered why we didn’t give women complete information about the termination procedure, the stage of fetal development of their pregnancies, and the local pregnancy centers that could help them to keep their pregnancies. I wondered why we didn’t listen to those women who were plunged into sadness, guilt, grief and remorse after their abortions.
During my years in women’s health, I also discovered that it’s much easier to be pro-choice when one is not actually participating in abortions. For many of my pro-choice years, I’d never seen an abortion and had little idea what was involved in abortion; my "being pro-choice" was merely giving easy lip service to the feminist (and society's) mantra. But working in women’s health, eventually I did participate in abortion; I did learn what abortions were all about. I participated by inserting laminaria, the cervical dilators often placed the day before a woman’s abortion, thus beginning the then-unstoppable progression to pregnancy termination. One day, when I’d inserted one laminaria after another, it struck me that while some women might have had several abortions, I’d participated in so many more. How many babies, I asked myself, had I helped to abort?
My conversion to being pro-life was also supported by the astounding advances made in fetal medicine over my years in women's health. The gestational age of viability crept down from twenty-eight or twenty-nine weeks to twenty-four weeks or less. We identified women whose fetuses had operable defects and sent these women to perinatal centers where specialists operated on the babies, still in the womb. With these advances, I began truly to understand the miracle of pregnancy. Scientifically, I knew that life begins at conception; emotionally, I understood that fertility is a gift and that the ability to bear children is not to be taken lightly. I’d already realized that we were not serving women by withholding the true details of abortion from them. Soon, whenever I had to insert a laminaria, my hands began trembling. What was I doing? How could I participate in a procedure that was, more and more clearly, against God, against natural law, against reason, and against my own belief?
My final “conversion” came in a flash when I knew, at a gut level, that I would not—that I could not—any longer sanction the taking of human life, not even when that human life was at the earliest stages of development, and not even when a mother insisted on her "right" to abort her unborn child. My conversion occurred on a sunny Friday afternoon when I walked into the doctor’s conference room and found, lying on the table, a pathology lab report clipped to a patient’s chart. There before me, in black and white, was the lab report of that patient's abortion. The pathologist had, after carefully reassembling the fetal parts pulled apart in the abortion process (a gruesome necessity in order to make sure that the doctor had “gotten it all”), listed the “products of conception,” the visible remains of that twelve-week fetus: the skull, the intestines, the fetal arms and hands (five fingers on each), a hip and leg, the other leg, the right fetal foot measuring one centimeter. Reading that lab report, knowing that we humans have somehow sanctified and approved the choice to murder our unborn, something changed within me at the deepest level.
Then, only a few months later, I came across these words written by Mother Theresa:
"The so-called right to abortion has pitted mothers against their children and women against men. It has sown violence and discord at the heart of the most intimate human relationships. It has aggravated the derogation of the father's role in an increasingly fatherless society. It has portrayed the greatest of gifts—a child—as a competitor, an intrusion, and an inconvenience."
When I looked about me, both in the clinic and in our society, the truth of her words was undeniable. In the end, becoming pro-life was not simply a matter of science, not simply a matter of grieving women or perinatal advances—it was a matter of faith.
I am deeply and personally aware of the very real difficulties of single parenthood, abuse and poverty. I’ve been there. As a nurse, I’m intimately aware of the tragedy of rape. But I know that abortion is not the answer to these societal blights. Still, our society—one that has been lulled into accepting, among other atrocities, the torture and humiliation of prisoners of war—has a very long way to journey until we establish a culture that helps women find alternatives to abortion.
Through casual conversation and earnest dialogue, I've learned that many nurses and doctors feel the same way that I do about abortion. Within hospital halls, it's acceptable, even honorable, to be pro-choice; how difficult, radical and unpopular it is to hold an opposing view! As I did, many caregivers are leading double lives, keeping their true thoughts about the tragedy of abortion a secret, afraid to speak the truth at their work places or in the public sphere. In their hearts, minds and souls they are desiring the culture of life. And yet, in their work, they are aiding the culture of death. As I once did, they are leading double lives. Maybe you are too. Maybe you too can change your life.
“So,” my nurse practitioner friend said. “Can you believe that they’re still trying to push abstinence education in the schools? Kids don’t need abstinence; they need birth control and easy access to abortion.” She looked at me, sure of my agreement. “Well?” she asked.
I hesitated. Should I tell her that I actually did support teaching teens about abstinence and that I was, in fact, not in favor of “easy access” to abortion? If I said what I really thought, would she look at me and, in an eye blink, see me not as her colleague and friend but as an enemy—someone she might label a right-wing, pro-life kook? I didn’t want to get into an argument. And I certainly didn’t want to be labeled a kook.
For most of my adult life, I’d viewed abortion as a woman’s right. As a nurse practitioner, I’d worn a button on my lab coat that said “Pro-choice!” When I wasn’t working I wrote about my work, and my published poems and books reflected my “feminist” stance. But during my eighteen years in women’s health, my views on what is truly pro-woman had changed; alas, my courage had not kept pace with my beliefs.
For years I’d remained silent regarding my feelings about abortion for a variety of reasons: unwillingness to judge others; desire to fit in with the caregiving community; fear of job repercussions; and fear of challenging the view of our takes-abortion-for-granted society. Yet at the same time I wondered how many other caregivers had experienced a change of heart about abortion. Were there others who, like me, were leading double lives; others who were against abortion in their minds and hearts but who, like me, remained silent?
My own change of heart was fostered by patients who chose abortions, by my direct participation in their abortions, and by the advances made in perinatal medicine during my years in women’s health. Many of the women who came to the clinic asking for abortions told me they felt they were choosing something, as one woman said, “terribly wrong.” Often, they mourned the loss of their pregnancies even before the abortions had been accomplished; some asked if they would ever forgive themselves. Many were propelled into choosing abortion by the inability to find an alternative solution. And we clinicians in the clinic did little to help them. After all, we’d been taught to tell women that twelve-week pregnancies were nothing more than a “bunch of cells”; we were taught to turn the ultrasound monitor away so that a woman couldn’t see her unborn baby. “If she sees it,” one doctor told me, “she might change her mind.”
I saw women who, after their abortions, were not relieved, but grieving. Some were downright angry. Many felt their pre-termination counseling had been rushed; some felt they hadn’t been given enough information about other options. More than one woman returned dismayed that no one had explained to her exactly "what we would be aborting." Until going online and searching out photos of fetal development, these women had no idea of what a five to twelve-week fetus “was like.” These women—and many more—felt that we, the doctors and the nurses, had not been honest with them and had not fully revealed what abortion entails.
There were also women who did not express any grief following their abortions. And yet many of these women sensed that there was something about abortion that wasn’t natural. I saw women who, after several abortions, decided to keep the next unintended pregnancy although their financial and social situations had not changed. They simply felt they “couldn’t do this again.” One woman decided against abortion when an ultrasound confirmed she was pregnant with twins. Her exact words were "I couldn’t kill two of them." I saw women who were torn between their maternal instincts and their life circumstances. We caregivers said, “You have to do what is right for you at this time in your life.” Even as I spoke those words, I sensed how wrong, how against God and nature, that advice was.
I wondered why we tried so hard to preserve a woman’s choice to abort but invested so little energy in helping women who might choose, against difficult odds, to keep a pregnancy. I wondered why we didn’t give women complete information about the termination procedure, the stage of fetal development of their pregnancies, and the local pregnancy centers that could help them to keep their pregnancies. I wondered why we didn’t listen to those women who were plunged into sadness, guilt, grief and remorse after their abortions.
During my years in women’s health, I also discovered that it’s much easier to be pro-choice when one is not actually participating in abortions. For many of my pro-choice years, I’d never seen an abortion and had little idea what was involved in abortion; my "being pro-choice" was merely giving easy lip service to the feminist (and society's) mantra. But working in women’s health, eventually I did participate in abortion; I did learn what abortions were all about. I participated by inserting laminaria, the cervical dilators often placed the day before a woman’s abortion, thus beginning the then-unstoppable progression to pregnancy termination. One day, when I’d inserted one laminaria after another, it struck me that while some women might have had several abortions, I’d participated in so many more. How many babies, I asked myself, had I helped to abort?
My conversion to being pro-life was also supported by the astounding advances made in fetal medicine over my years in women's health. The gestational age of viability crept down from twenty-eight or twenty-nine weeks to twenty-four weeks or less. We identified women whose fetuses had operable defects and sent these women to perinatal centers where specialists operated on the babies, still in the womb. With these advances, I began truly to understand the miracle of pregnancy. Scientifically, I knew that life begins at conception; emotionally, I understood that fertility is a gift and that the ability to bear children is not to be taken lightly. I’d already realized that we were not serving women by withholding the true details of abortion from them. Soon, whenever I had to insert a laminaria, my hands began trembling. What was I doing? How could I participate in a procedure that was, more and more clearly, against God, against natural law, against reason, and against my own belief?
My final “conversion” came in a flash when I knew, at a gut level, that I would not—that I could not—any longer sanction the taking of human life, not even when that human life was at the earliest stages of development, and not even when a mother insisted on her "right" to abort her unborn child. My conversion occurred on a sunny Friday afternoon when I walked into the doctor’s conference room and found, lying on the table, a pathology lab report clipped to a patient’s chart. There before me, in black and white, was the lab report of that patient's abortion. The pathologist had, after carefully reassembling the fetal parts pulled apart in the abortion process (a gruesome necessity in order to make sure that the doctor had “gotten it all”), listed the “products of conception,” the visible remains of that twelve-week fetus: the skull, the intestines, the fetal arms and hands (five fingers on each), a hip and leg, the other leg, the right fetal foot measuring one centimeter. Reading that lab report, knowing that we humans have somehow sanctified and approved the choice to murder our unborn, something changed within me at the deepest level.
Then, only a few months later, I came across these words written by Mother Theresa:
"The so-called right to abortion has pitted mothers against their children and women against men. It has sown violence and discord at the heart of the most intimate human relationships. It has aggravated the derogation of the father's role in an increasingly fatherless society. It has portrayed the greatest of gifts—a child—as a competitor, an intrusion, and an inconvenience."
When I looked about me, both in the clinic and in our society, the truth of her words was undeniable. In the end, becoming pro-life was not simply a matter of science, not simply a matter of grieving women or perinatal advances—it was a matter of faith.
I am deeply and personally aware of the very real difficulties of single parenthood, abuse and poverty. I’ve been there. As a nurse, I’m intimately aware of the tragedy of rape. But I know that abortion is not the answer to these societal blights. Still, our society—one that has been lulled into accepting, among other atrocities, the torture and humiliation of prisoners of war—has a very long way to journey until we establish a culture that helps women find alternatives to abortion.
Through casual conversation and earnest dialogue, I've learned that many nurses and doctors feel the same way that I do about abortion. Within hospital halls, it's acceptable, even honorable, to be pro-choice; how difficult, radical and unpopular it is to hold an opposing view! As I did, many caregivers are leading double lives, keeping their true thoughts about the tragedy of abortion a secret, afraid to speak the truth at their work places or in the public sphere. In their hearts, minds and souls they are desiring the culture of life. And yet, in their work, they are aiding the culture of death. As I once did, they are leading double lives. Maybe you are too. Maybe you too can change your life.
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