LITMIR.BIZ

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sliding apart.

      I watch the shadows that creep up unnoticed and suddenly darken her face as she screws up her features and pushes a tear out each side to slide down her cheeks. I have learned to anticipate the quiver of chin, the rapid intake of breath, and the surprising sobs that rise soon after the machine starts to drum. I know this is when the cramp deepens, and the tears are partly the tears that follow pain—the sharp, childish crying when one bumps one’s head on a cabinet door. But a well of woe seems to open beneath many women when they hear that thumping sound. The anticipation of the moment has finally come to fruit; the moment has arrived when the loss is no longer an imagined one. It has come true.

      I am struck by the sameness and I am struck every day by the variety here—how this commonplace dilemma can so display the differences of women. A twenty-one-year-old woman, unemployed, uneducated, without family, in the fifth month of her fifth pregnancy. A forty-two-year-old mother of teenagers, shocked by her condition, refusing to tell her husband. A twenty-three-year-old mother of two having her seventh abortion, and many women in their thirties having their first. Some are stoic, some hysterical, a few giggle uncontrollably, many cry.

      I talk to a sixteen-year-old uneducated girl who was raped. She has gonorrhea. She describes blinding headaches, attacks of breathlessness, nausea. “Sometimes I feel like two different people,” she tells me with a calm smile, “and I talk to myself.”

      I pull out my plastic models. She listens patiently for a time, and then holds her hands wide in front of her stomach.

      “When’s the baby going to go up into my stomach?” she asks.

      I blink. “What do you mean?”

      “Well,” she says, still smiling, “when women get so big, isn’t the baby in your stomach? Doesn’t it hatch out of an egg there?”

      My first question in an interview is always the same. As I walk down the hall with the woman, as we get settled in chairs and I glance through her files, I am trying to gauge her, to get a sense of the words, and the tone, I should use. With some I joke, with others I chat, sometimes I fall into a brisk, businesslike patter. But I ask every woman, “Are you sure you want to have an abortion?” Most nod with grim knowing smiles. “Oh, yes,” they sigh. Some seek forgiveness, offer excuses. Occasionally a woman will flinch and say, “Please don’t use that word.”

      Later I describe the procedure to come, using care with my language. I don’t say “pain” any more than I would say “baby.” So many are afraid to ask how much it will hurt. “My sister told me—” I hear. “A friend of mine said—” and the dire expectations unravel. I prick the index finger of a woman for a drop of blood to test, and as the tiny lancet approaches the skin she averts her eyes, holding her trembling hand out to me and jumping at my touch.

      It is when I am holding a plastic uterus in one hand, a suction tube in the other, moving them together in imitation of the scrubbing to come, that women ask the most secret question. I am speaking in a matter-of-fact voice about “the tissue” and “the contents” when the woman suddenly catches my eye and asks, “How big is the baby now?” These words suggest a quiet need for a definition of the boundaries being drawn. It isn’t so odd, after all, that she feels relief when I describe the growing bud’s bulbous shape, its miniature nature. Again I gauge, and sometimes lie a little, weaseling around its infantile features until its clinging power slackens.

      But when I look in the basin, among the curdlike blood clots, I see an elfin thorax, attenuated, its pencilline ribs all in parallel rows with tiny knobs of spine rounding upwards. A translucent arm and hand swim beside.

      A sleepy-eyed girl, just fourteen, watched me with a slight and goofy smile all through her abortion. “Does it have little feet and little fingers and all?” she’d asked earlier. When the suction was over she sat up woozily at the end of the table and murmured, “Can I see it?” I shook my head firmly. “It’s not allowed,” I told her sternly, because I knew she didn’t really want to see what was left. She accepted this statement of authority, and a shadow of confused relief crossed her plain, pale face.

      PRIVATELY, EVEN GRUDGINGLY, my colleagues might admit the power of abortion to provoke emotion. But they seem to prefer the broad view and disdain the telescope. Abortion is a matter of choice, privacy, control. Its uncertainty lies in specific cases: retarded women and girls too young to give consent for surgery, women who are ill or hostile or psychotic. Such common dilemmas are met with both compassion and impatience: they slow things down. We are too busy to chew over ethics. One person might discuss certain concerns, behind closed doors, or describe a particularly disturbing dream. But generally there is to be no ambivalence.

      Every day I take calls from women who are annoyed that we cannot see them, cannot do their abortion today, this morning, now. They argue the price, demand that we stay after hours to accommodate their job or class schedule. Abortion is so routine that one expects it to be like a manicure: quick, cheap, and painless.

      Still, I’ve cultivated a certain disregard. It isn’t negligence, but I don’t always pay attention. I couldn’t be here if I tried to judge each case on its merits; after all, we do over a hundred abortions a week. At some point each individual in this line of work draws a boundary and adheres to it. For one physician the boundary is a particular week of gestation; for another, it is a certain number of repeated abortions. But these boundaries can be fluid too: one physician overruled his own limit to abort a mature but severely malformed fetus. For me, the limit is allowing my clients to carry their own burden, shoulder the responsibility themselves. I shoulder the burden of trying not to judge them.

      This city has several “crisis pregnancy centers” advertised in the Yellow Pages. They are small offices staffed by volunteers, and they offer free pregnancy testing, glossy photos of dead fetuses, and movies. I had a client recently whose mother is active in the anti-abortion movement. The young woman went to the local crisis center and was told that the doctor would make her touch her dismembered baby, that the pain would be the most horrible she could imagine, and that she might, after an abortion, never be able to have children. All lies. They called her at home and at work, over and over and over, but she had been wise enough to give a false name. She came to us a fugitive. We who do abortions are marked by some as impure. It’s dirty work.

      When a deliveryman comes to the sliding glass window by the reception desk and tilts a box toward me, I hesitate. I read the packing slip, assess the shape and weight of the box in light of its supposed contents. We request familiar faces. The doors are carefully locked; I have learned to half glance around at bags and boxes, looking for a telltale sign. I register with security when I arrive, and I am careful not to bang a door. We are all a little on edge here.

      CONCERN ABOUT SIZE and shape seem to be natural, and so is the relief that follows. We make the powerful assumption that the fetus is different from us, and even when we admit the similarities, it is too simplistic to be seduced by form alone. But the form is enormously potent—humanoid, powerless, palm-sized, and pure, it evokes an almost fierce tenderness when viewed simply as what it appears to be. But appearance, and even potential, aren’t enough. The fetus, in becoming itself, can ruin others; its utter dependence has a sinister side. When I am struck in the moment by the contents in the basin, I am careful to remember the context, to note the tearful teenager and the woman sighing with something more than relief. One kind of question, though, I find considerably trickier.

      “Can you tell what it is?” I am asked, and this means gender. This question is asked by couples, not women alone. Always couples who would abort a girl and keep a boy. I have been asked about twins, and even if I could tell what race the father was.

      An eighteen-year-old woman with three daughters brought her husband to the interview. He glared first at me, then at his wife, as he sank lower and lower in the chair, picking his teeth with a toothpick. He interrupted a conversation with his wife to ask if I could tell whether the baby would be a boy or a girl. I told him I could not.

      “Good,” he replied in a slow and strangely malevolent voice, “’cause if it was a boy I’d wring her neck.”

      In a literal sense, abortion exists because we are able to ask such

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