A Death in Wichita

by Stephen Singular

  They dated for three years before they were married in a church in 1986, yet neither was a member of any congregation. The couple spent their honeymoon at an elegant downtown Kansas City hotel and dined that first night at an expensive Italian restaurant.

  “Everything,” Lindsey recalls, “was so good back then, so simple.”

  Not entirely simple. She’d earned a college degree in elementary education, but soon became pregnant. A sonogram showed two umbilical cords, which might have suggested that she was carrying twins, and a protein test was needed to see if the fetus had a serious genetic defect. If the test came back positive, her physician suggested that she might want to consider an abortion. Scott didn’t go with her to these doctor appointments, but Lindsey wasn’t particularly worried about bringing the subject of abortion to his attention, since it had never been a controversial issue between them. They were, if anything, casually pro-choice. She had to wait two grueling weeks to learn about the test results, which in the end were negative.

  She gave birth to a healthy son, Nicholas, and became a stay-at-home mom. Money was tight, even though they were living with her family in a small home in Overland Park, an arrangement Scott despised. His plans to enter the life insurance business hadn’t developed and he’d been moving from job to job: Kansas City Power & Light, K-Mart, and the Darling Envelope Company. He had been very attentive to his wife during her pregnancy, sitting beside her throughout the twenty-six hours of labor, and he doted on his newborn son. For the next two years, Lindsey raised Nicholas and took care of her dying mother, while her spouse felt increasing pressure to generate more income. She found work as a telemarketer from their home, and was soon making more money than her husband. At times he seemed manic—hyperactive and not eating or sleeping at all, then crashing and nodding off on the couch. He had sleep apnea and might doze off in the middle of the afternoon. One day she came home to find him passed out in the living room, as their toddler was about to walk out the front door, toward the traffic outside their house. He wasn’t the same man he’d been when they’d gotten married—especially after his born-again Christian conversion.

  Lindsey watched him sit hour after hour before the TV and stare at Pat Robertson’s 700 Club or at a Texas televangelist named Robert Tilton, who sold believers a “miracle link” piece of cloth that would bring them miracles if they’d mail the cloth back to him to display on his altar. Lindsey felt dismay and anger when her husband sent an entire paycheck to Tilton, who was later exposed by Diane Sawyer as a fraud. At first, the only thing the couple fought about was finances. When things got tough, Scott’s father, John, slipped Lindsey some money behind his son’s back so she could buy necessary things for the family, and for Nicholas in particular. He was smitten by his grandson. One day in 1991, Scott learned of a seminar in the Kansas City area about how to avoid paying federal and state income taxes because (those running the seminar contended) the Sixteenth Amendment to the U.S. Constitution was never actually ratified. He went to the event and was told that collecting these taxes was illegal in America. He drove home and informed Lindsey that he’d found the solution to all their troubles: from now on, they wouldn’t be handing any more money over to the state or federal government.

  “Things,” says Lindsey, “were never the same.”

  When she tried to talk to her husband about this strategy and to steer him away from the anti-tax movement, he had a favorite word for her.

  “He always called me ignorant,” she says. “‘You’re ignorant about what the government is doing to us,’ he’d tell me, ‘and ignorant about the tax situation in America. You should read up on it. You should study the Constitution. I’ll give you some material to educate you. You should watch some videos about this and listen to certain radio programs. You should find out what’s really going on. Then you wouldn’t be so ignorant.’”

  All of this was hard for Lindsey to hear, she says, “Because I was the one with the college degree.”

  She didn’t like fighting, especially in front of others, and tried to keep the peace inside their small house. When she spoke with members of Scott’s family in Topeka about the direction his life was taking, they didn’t know what to say or do. He was just going through a phase that would soon end, they’d suggest; he’d always been high-strung and would straighten himself out. He needed to find a job and stick with it. These responses didn’t satisfy Lindsey, who wondered if the current troubles were related to Scott’s mental health diagnosis as a teenager. Was he schizophrenic? Should he be seeing a psychiatrist? Or be on medication? He’d hated those meds and made that very clear to her every time the subject came up. There wasn’t anything wrong with him, he said, Lindsey was just “ignorant” of what was happening to America. No matter what he did with his income, she fired back, she was going to keep paying federal and state taxes on her earnings.

  Scott wasn’t the only one she was concerned about. If her husband got into legal trouble, she’d have to raise their son alone. All of this conflict was already starting to have an impact on Nicholas. At school activities and Cub Scout meetings, Scott approached other parents and talked to them about taxes and religion. Lindsey was a Scout den mother and it was embarrassing to bring Nick to these public functions, where the boy watched his father harangue others about the evils of the American government. Why was his dad acting that way?

  Of all the people in Scott’s family, Lindsey had the strongest bond with his father, so she contacted him. John had observed his son drifting away from his responsibilities as a husband and a father, while drifting toward fringe politics and religion. What he needed was a wake-up call, so John suggested that Lindsey toss Scott out of the house, let him think about his behavior and appreciate what he had at home. That would turn him around. She took the advice.

  Living on his own, Scott hooked up with an older woman in Independence, Missouri, just outside of Kansas City, who only furthered his view about taxes. Through her and other contacts, he began meeting people in other protest movements that were critical of the U.S. government.

  One day he came back home to Lindsey with a girlfriend who was as erratic and politically extreme as he was. To Lindsey’s chagrin, the two of them began kissing and fondling each other in front of her and her son. Scott showed Nicholas, age five, images of aborted fetuses, the evils of abortion now one of his strongest-held views.

  Lindsey watched in horror—before hustling them out of the house.

  “You just can’t do this to a five-year-old,” she says. “Scott and I had so many arguments at that time about abortion and other adult topics that you don’t bring up with a child.”

  Her choices were painful. She could keep trying to help her husband, but he’d shown no desire to help himself. If she filed for a divorce, the couple would likely end up with joint custody of Nicholas. Since meeting the girlfriend, Lindsey knew she couldn’t allow her son to be alone with his father, not to mention the extremists he had begun associating with. If Nicholas left the house with his father for a joint custody visit, he might not come back, she worried, or he could be harmed. She’d never forgotten the day her husband had fallen asleep on the sofa, with their young child headed out the front door into traffic. What if the couple ran off to another state and took Nick with them? Lindsey had already taught her son a secret password so that if somebody came to pick him up at school or a friend’s house and didn’t know that word, Nick must refuse to get into the car.

  After weighing her options, Lindsey asked her husband to return home; she recommitted herself to repairing the marriage for the sake of their son. Scott agreed, and he was soon back on the couch watching anti-government videos, imploring her to “get educated” and stop being so ignorant. In high school, he’d used recreational drugs for escape. Now religion and politics helped him cope.

  He wasn’t the only one having trouble adjusting to a changing America.

  III

  In the mid-1980s, Dr. Tiller hit bottom. As a churchgoing registered
Republican who belonged to the oldest country club in Wichita, he wasn’t raised to be a political activist. He was a man who liked corny jokes, mystery novels, floppy hats, Elvis Presley, Johnny Cash, James Bond, ice cream, and rooting for his beloved Jayhawks up in Lawrence. He loved swimming and playing with his four children. His decision to perform abortions wasn’t an ideological one, but it put him at odds with certain members of his community and with elements of his faith (although a significant majority of Americans, and of Kansans, about 75 percent, supported a woman’s right to choose).

  The problem wasn’t that he was doing something illegal; between 1973 and 1992, Kansas placed no restrictions on abortions or when they could be done. The problem was how deeply abortion disturbed some of his fellow citizens. The first church Tiller and his family attended in Wichita asked him to leave because of the feelings his presence had stirred within the congregation, so they’d moved on to Reformation Lutheran Church on the well-heeled northeast side of town.

  Tiller attempted to fit in to Wichita. He served as staff president at Wesley Medical Center (the two other major local hospitals, St. Francis and St. Joseph, were Catholic and refused to perform abortions). He was medical director of the Women’s Alcohol Treatment Services at the Sedgwick County Health Department. He lectured widely about abortion to medical groups, promoting new scientific breakthroughs and backing stem cell research, which the anti-abortionists opposed. But he eventually stopped trying to explain himself and his work to the local and national media, an unproductive drain on his time.

  Like Lindsey Roeder, he was faced with a challenging set of options. His medical practice and expertise in reproductive health were growing by the week. His commitment to helping women at the most vulnerable time of their lives gave him a great sense of purpose, and he was certain that his work saved lives. According to the World Health Organization, there are 19 million unsafe or illegal abortions a year, which kill 70,000 women. Unicef reports that unsafe abortions cause 4 percent of deaths among pregnant women in Africa, 6 percent in Asia, and 12 percent in Latin America and the Caribbean. At his clinic, Tiller was building a body of knowledge about severe pregnancy problems that was unparalleled in the United States, if not in the world. He’d evolved into an expert in diagnosing fetuses with spina bifida, hydrocephalus, fused legs, and deadly chromosomal abnormalities. The walls at Women’s Health Care Services were becoming lined with letters of gratitude from women across the country, thanking Tiller and his staff for being there for them during a crisis. His career was extremely fulfilling, in addition to being lucrative.

  But starting in 1975, protesters began showing up in front of his clinic, and they were no longer a group of meek nuns there on behalf of the Catholic Church. These demonstrators were more likely associated with evangelical Christianity and they carried grotesque signs showing aborted fetuses and denouncing Tiller as a murderer. Threats to himself, his family, and his employees had become routine.

  What could a doctor do in these circumstances?

  “There are pivotal patients in everyone’s practice,” he once said to the Feminist Majority Foundation, when showing the audience photos of some females he’d treated. “This girl on my left is nine and a half years old. She came from Southern California with her mother and her aunt for a termination of pregnancy. I told them…she was too far along, and I couldn’t help. There were some stories in the newspaper about Dr. Tiller is getting ready to kill babies for a nine-year-old…I was trying to explain to my daughters, who were ten and nine at the time, about why I had planned to do this procedure…I was about thirty seconds into explaining about this [when] Jennifer said, ‘Daddy, a ten-year-old girl, a nine-year-old girl shouldn’t be pregnant, and simply not by her father or her grandfather or her uncle.’

  “One of the things that my father taught me was that to be credible in medicine, you must require for your patients the same care that you would require for your family. I made a decision that if my nine-and ten-year-old daughters at that time were in that situation, I would do the procedure. I did it for this girl. It turned out marvelously. There were no problems, no complications. And I made that decision at that time that I was going to help as many people as I possibly could…If a woman was or a girl was able to get pregnant, we should be able to do a termination of pregnancy.”

  If he couldn’t walk away from his work or from the expanding number of women who came to his clinic, he needed to adapt to the contempt of those around him. Some days, adapting was easier than others.

  In 1984, he was pulled over for driving under the influence of alcohol and he also had substance abuse issues. The Kansas State Board of Healing Arts, a medical regulation body, told him to seek treatment and he did. One of his best friends was Don Arnold, who’d come to Wichita from Saskatchewan and started the first substance abuse treatment program in rural Kansas. Arnold helped him get clean and Tiller later served on the Kansas Medical Society’s impaired physicians committee and supported Alcoholics Anonymous.

  His abuse problems, he claimed, had nothing to do with being under constant assault by abortion foes, but many doubted that. The pressures were everywhere: he was in life-and-death situations with his patients all day at work, and life-and-death situations when he left the office and rode home in his car (security professionals advised him always to drive in the far right-hand lane, because that lessened the number of angles he could be attacked from). His only escape was relaxing with his wife, Jeanne, and with his four children and friends. They helped him kick the addictive habits, but Tiller’s challenges were just beginning.

  He wasn’t the only doctor in America facing this kind of pressure. Those who performed abortions, especially complicated late-term abortions, made up a small and select group of physicians. One was Warren Hern, a couple of years older than Tiller and also born in Kansas, but his family had soon moved to the Denver suburbs. After graduating from the University of Colorado School of Medicine in 1965, Hern did an internship in the Panama Canal Zone, served as a doctor in Brazil for the Peace Corps, and worked in the Family Planning Division of the Office of Economic Opportunity in Washington, D.C., as part of the nation’s “War on Poverty.” With each job, his political consciousness and commitment to human rights, including women’s rights, had deepened. Neither Tiller nor Hern had ever imagined becoming an abortion specialist, but Roe v. Wade changed everything.

  Hern did his first abortion in the early 1970s and later wrote that the patient was “a 17-year-old high school student who told me…before the operation that she wanted to be a doctor and an anesthesiologist. I was terrified, and so was she. She cried after the operation for sadness and relief. Her tears and the immensity of the moment brought my tears. I had helped her change her life. I was relieved that this young woman was safe to go on with her dreams. I felt I had found a new definition of the idea of medicine as an act of compassion and love for one’s fellow human beings.”

  Dr. Hern, unlike Tiller, was a born political and medical activist. He spoke widely and wrote at length about his work as an abortion provider, one of several ways in which the two men were opposites. Hern became a pioneer in the abortion technique known as D & E (dilation and evacuation). In the 1970s, a pregnant woman’s cervix was manually dilated the day before an abortion, which created the risk of tearing or perforating her uterus. Once dilation was complete, the fetus and placenta were removed from the uterine wall and suctioned out by a vacuum. Dr. Hern and others began using laminaria sticks—sterilized stalks of seaweed—instead of manual dilation. After the sticks were inserted, they absorbed water, slowly expanded, and opened the cervix in a more gradual way.

  “A protocol I have adapted from the Japanese experience…” Dr. Hern wrote in 1994 in a chapter of the book Gynecology and Obstetrics, “uses serial multiple laminaria treatments over 2 days. Under this protocol, one or more laminaria are placed in the cervix on day 1. They are removed and replaced by a larger number on day 2, and the uterus is evacuated with forceps on day 3
under paracervical block amnesia.”

  Dr. Hern was as concerned with a woman’s mental state during an abortion as he was with the details of the medical procedure. For this reason, he opposed women being given a general anesthetic for the operation and losing consciousness.

  “The use of general anesthesia,” he wrote, “eliminates physician-patient interaction during the abortion and insulates the physician from the patient’s emotional experience. This loss is a serious problem for physicians, and may make it extremely difficult for them to relate to the emotional problems encountered by abortion patients. It does nothing to enhance the physician’s empathy for the patient’s dilemma or the physician’s understanding of the importance of the experience to the patient.”

  In time, three doctors from across America were rotated into Tiller’s clinic from week to week to assist at WHCS, sleeping on a pullout sofa in a waiting room and using a shower in the basement. On Wednesday through Friday, WHCS performed first-trimester abortions, usually about fifty a week, and most were without complications. Women seeking late abortions, after the twenty-second week of pregnancy, arrived in Wichita on Sunday nights. Some were called “maternal-indication patients,” whose own physical health was at risk if their pregnancies were brought to term. Others, called “fetal-indication patients,” had babies that could not survive outside the womb without facing extreme medical complications and ongoing treatment. A third segment, by far the most controversial one, were women who suffered from depression and believed that giving birth would be too psychologically damaging—to both mother and child.