dear readers,i sat down to share with you a story of a one patient's explanation for her abortion decision. but then this story came my way. my story will wait. today this physician's tale is more moving.
My Moral Choice
Thu May 31, 2007 at 02:21:09 PM PDT
Since I was about 8 years old I knew I wanted to be a doctor. I have always loved science and loved people – there was no better way for me to put the two together in my mind. All the way through the second year of medical school, I envisioned myself as a cardiothoracic surgeon, or perhaps a trauma specialist. But these plans faded after I did my gynecology rotation in my third year.
I fell in love with gynecologic oncology. The cancer patients really needed their doctors. I could see myself helping women and their families through difficult treatments and emotionally trying times. It felt so rewarding to be a part of the team that was helping to fight cancer.
As a matter of fact, that is exactly how I started my residency: with a plan to go on to do an oncology fellowship. But careers, just like life, make their own plans.
- docswede's diary :: ::
This is a story about the first time I realized that I was not going to be a gynecologic oncologist. I will never forget this patient; she changed my life. ‘Fran’ was a 30 year old, single mother of an 18 month old son. Her partner was unfaithful and she had not seen him in over a month. Fran had a large, cancerous tumor in her neck. She was 10 weeks pregnant when it was diagnosed and she needed chemotherapy, radiation and possibly surgery immediately. Even with aggressive treatment, the chances were better than 50/50 that Fran would be dead within a year. She came to our clinic for an abortion, which I performed.
I got a surge of emotion after I did the procedure. I cried when I got home that night. I wasn’t crying about doing the abortion, I was crying for her.
She had no one to accompany her to the procedure. She had only one friend who was willing to watch her baby, but was adamant about her prompt return to pick the child up. The only contacts she had with her family were phone calls from her sister, and they were infrequent. All I could think was, ‘Who is going to take her to her chemo appointments? Who will watch her baby while she recovers from surgery? Who will take her baby when she dies?’. I felt helpless. There was nothing more that I could do to help her.
While I could not take care of Fran’s baby, or hold her hair back while she was vomiting from chemotherapy and radiation, I could prevent her from having to bring another child into this world when the time was clearly not right. I helped her prevent a child from being born to a mother who would be dead before it was a year old. It was such a sad situation, but I felt like I had been an important part of her care.
After the procedure, she thanked me and with tears in her eyes said, ‘You don’t know how much you’ve helped me today’. The gratitude she expressed took me by surprise. This was one of my earliest personal experiences with performing an abortion and I never expected patients undergoing this procedure to be grateful. At best I thought they would be polite and quiet, at worst I thought they would be angry at me or incredulous that I could possibly even do the procedure. I have since learned that this is not the case at all.
I realized shortly thereafter that I didn’t ‘only’ perform her abortion. I provided her with a service that most doctors do not even offer. I was able to help her in a time of unique need. I was not fighting her cancer, but I was helping her to live out the end of her life the way she wanted to. From that point on, I knew where my calling in medicine was: to be a provider of abortion care.
There are very few of us willing to do these procedures. Most obstetrician-gynecologists do not offer them to their patients. With the history of anti-choice extremism we have witnessed in this country, it is easy to understand why a physician would decide not to offer abortion services in their office. They may be afraid of being protested or worse. What I do not understand is how someone could call refusing to provide abortion care, or at least provide a referral, a ‘moral choice’.
What is moral about telling a woman with a terminal illness that she has to continue her pregnancy? What is moral about telling a woman who can not afford to support the children in her home to have another one? What is moral about bringing a child into this world that will not receive the love, support and attention it needs because its mother has to work two jobs just to pay the rent and their father is long gone? Frankly, I do not see it.
Abortion is a moral choice. It is about a human being’s right to determine their own destiny and the destiny of the family surrounding them here on Earth. It is never an easy choice, but it is always moral.
My career has led me to dedicate my life to making sure women can make that choice. I decided that I could help more people this way than I ever could by treating cancer. Providers of abortion care are relatively few, but we can change that. I hope that other young doctors will be similarly inspired by the depth of the impact providing this procedure can have upon their patients. I hope that they see abortion as part of comprehensive gynecologic care. After all, we do over a million of them a year and 1 in 3 women will have one at some point in her lifetime. If we do not do them, then where will our patients go? It is physicians’ moral obligation to be sure that they can come to us for compassionate, safe abortion care. It is one of the times when they need us the most.