Trust Women

Yesterday was Blog for Choice day. Thanks to MICU call, I'm a day late. I know that some of the things I'll say will disturb some people who read; some of you are friends and family who I love. If you don't want to know some of my rawer thoughts on the topic, don't read (when has that warning ever stopped anyone?).

This year, the theme is "Trust Women," the George Tiller slogan. Remember when George Tiller was murdered in his church? I sure do. I was a wreck . I was a new doctor, a few weeks away from starting ob/gyn residency, a training program where I planned on performing abortions. This was after doing a Family Planning elective in Pittsburgh with some of the people who get called upon to testify in supreme court cases. Mitch Creinin, Matt Reeves, some of my early mentors in this field.

At Pitt, I saw women come from Baltimore, Philadelphia, Cleveland to get care, and we weren't considered a late term center. We were just a place that the woman with the anencephalic fetus (no brain = 100% mortality) could get a 20 week termination, or the woman with heart failure who was slowly dying from her pregnancy could get a 22 week abortion. We went to the state limit of 23 weeks and 6 days. Was the 23 and 6 week abortion I saw disturbing as hell? Absolutely. But was it necessary? I have to believe so. Because that woman wouldn't have chosen it if it was not necessary. She chose to value her life. I have to trust that. I never actually performed the procedures as I was still a medical student, but I would do the prep on some: speculum, lidocaine injection, dilator placement. I was involved, an active participant in this emotionally and politically wrought procedure.

So when George Tiller was shot, it was personal. I immediately thought of the next George Tiller. The next murder in the name of a false justice. There are the obvious names that were immediately introduced in the media: Carhart and Hern immediately came to mind. But I thought of other people, people I knew: Mitch, Matt, Bea, Lisa. And then, Karen. Because now, as a resident, I too have become an abortion provider. And so I have the fear, the fear of being gunned down or watching my professional colleagues be gunned down for providing reproductive rights.

Recently, a new George Tiller quote was discovered:

"It is not for you, if it is not an inner calling, it just isn't. It doesn't work that way. It's not the technical component, it's not the intellectual stimulation, abortion services are a heart issue. It's a heart issue, and if you have a willing heart to help women in catastrophic situations, you can be an abortion provider. You can qualify and have a satisfactory life. There are probably more physicians who get shot working in an emergency room than are abortion clinics. There are all sorts of dangers - postal workers, firemen, police officers. Everything has a risk to it."

I try to remember that. I try to remember that this is important. I trust my patients, and I trust myself. If I'm going to be brave enough to do this, I have to trust in my passion, my heart, for this field. There are 1787 abortion providers in this country, according to Guttmacher data. If not me, who? Trust women.