This Common Secret: My Journey as an Abortion Doctor

by Susan Wicklund

  The mother had a few questions after I finished, and then we sat together in silence.

  “I come from a family that never showed emotion,” the father broke the quiet. “If you had a problem, you dealt with it. You didn’t go burdening others with your trivial difficulties.”

  His wife had turned to him, but he was staring off through the window.

  “Now I see that my family is the same way.” His hand came to his face, ran quickly through his hair. “I feel so ashamed that my little girl couldn’t tell us that this, this criminal, hateful, violent thing had happened to her.

  “She tried to take care of it all alone, thinking it would be a burden to us, that somehow this crime was her fault and that it would be better,” he pounded his hand softly on his thigh, “that it would be better if we didn’t know.”

  His voice broke. His wife put her hand on his. I moved closer. “I love her so much,” he was openly crying now. All of us were. “I love her so much, and I am so terribly ashamed that she wouldn’t come to us for help, that she kept this to herself.”

  He turned to his wife, and they embraced. She comforted him, cried with him. I wondered if he had ever sobbed in her arms before, if he had cried in his adult life.

  “If we hadn’t discovered her pregnancy, she might have buried it from us always,” he said through tears.

  When he had collected himself a bit, I left to check on their daughter.

  “How are you doing?” I asked her.

  “Better,” she admitted. “I finally understand that the only thing I did wrong that night was to walk home alone. It isn’t my fault I was raped. It isn’t my fault I am pregnant.”

  “No, it certainly isn’t,” I said. “But you aren’t alone. Many women feel the way you did. That they are somehow responsible for being the victim of a sex crime.”

  “I just wish my father could understand,” she said.

  “I think he does,” I reassured her.

  She shook her head.

  “He’s in the other room right now, crying in your mother’s arms.” She looked at me in disbelief. “He told me how much he loves you, how terrible he feels about all this.”

  “No,” she said. “I know he loves me, but he’d never say it. He’s never said that!”

  “I think maybe he should come in here. I think you two need to talk.”

  I left the room and returned with her parents, leading her father in first. She saw his tear-streaked face, hesitated just a moment, and then went to him. They held each other as if they hadn’t hugged since she was an infant. This man who never showed emotion, who had never told his sixteen-year-old child that he loved her—he held her now as if he would never stop, crying anew, kissing her hair, saying again and again how much he loved her, how sorry he was, and what a gift she was in his life.

  All three of them came back out together, laughing their relief, looking at each other with different eyes and obviously aware of some hurdle they had just cleared as a family.

  After that session, the abortion procedure was truly anticlimactic. The mother stayed with her daughter throughout, held her hand much of the time. All of them sat together in the recovery room, listening attentively to our after-care instructions.

  By the time they left, they were changed people; the barriers had evaporated. I believed that no terrible secret would ever divide them again.

  I walked them to the stairs to say good-bye. The young woman and her mother started down, but the father turned to me again, started to hold out his hand, then pulled me into an embrace.

  “Thank you,” he whispered, his voice fierce with emotion. “Thank you for keeping my daughter safe.”

  My experience with that family reaffirmed my belief in the importance of talking things through, allowing a story to unfold and paying attention to intuitive cues that so often lead to breakthroughs. The powerful experience these people shared had nothing to do with parental notification laws or twenty-four-hour waiting periods. It was the result of their commitment to each other, the opportunity to fully express their feelings, and the force of events to catalyze a revelation.

  Some days women come to the clinic saying they want an abortion, but nothing they say or do convinces us that the decision is whole-hearted or genuine. Everything about them screams no, regardless of what their voices say.

  Some of them are being threatened by partners or parents. Some just can’t see any other way out of a bad situation. In either case, we have to be cautious. I would rather have someone be very angry at me, even to the point of taking legal action against me, for not doing an abortion, than for doing an abortion she later regrets. It isn’t uncommon to get a letter or picture in the mail, as much as a year later, thanking us for our refusal.

  Most women, by the time they arrive at a clinic, are very clear in their decision. They have been tormented by the dilemmas they face for days or weeks, sometimes months. They need the counseling sessions to simply clarify and solidify their convictions.

  Even then, it can be a murky process. It is one thing for a woman to decide on a course of action, but sometimes quite another to truly own that decision. Some patients are very adept at pulling me in, as if they want me to recommend an abortion so they can feel more removed from that responsibility.

  “I’ve been smoking and drinking alcohol while I’ve been pregnant,” they might confide in me. “Don’t you think it’s best to have an abortion rather than risk a birth defect?”

  “Sure, it’s a risk,” I’ll throw back at them, “but there’s no way to predict the outcome. What if you hadn’t been smoking or drinking? Would you want to go through with your pregnancy?”

  Almost always, when they are honest, they’ll admit that it wouldn’t make a difference. They simply want me to validate their decision, and perhaps assume some of their burden.

  Once in a while the simple question I ask each patient just before starting the procedure will bring out startling information I hadn’t anticipated.

  I had a patient once who seemed as calm and ordinary as they come. She could have been Sonja’s grade school teacher or the woman behind the counter at the grocery store. We went through her history, and she received counseling, had her lab tests, and completed all the paperwork. None of us picked up on any tension or unspoken agenda. She was sitting on the exam table, and we were about to start, when I asked the questions I always ask.

  “Are you absolutely sure you want this abortion? Is there anyone pushing you or telling you to be here? Is this really your decision?”

  “If I couldn’t have this abortion, I’d kill myself,” she said, voice flat and matter-of-fact.

  “What?” I asked, stunned, but completely believing her.

  “The man I’ve been living with for the last two years is abusive. I have two children. We’re trying to get him out of our lives, but he refuses to leave and even threatened me with a gun two days ago. I filed for a restraining order yesterday.”

  She paused, gathered herself, then went on.

  “My girl and I are very close. She’s fourteen now. We talk a lot, and she understands so much for her age. Too much. When I found out I was pregnant, I wanted to tell her, to see what she thought about it.

  “We were sitting together on the couch. She was half facing me, but as soon as she understood what I was telling her, she pushed herself off like she couldn’t get away fast enough. She started backing away from me. Backing across the room, her face all twisted up and her frantic voice shouting at me.

  ‘Mother,’ she said. ‘Mother, you can’t have his baby! NO! NO! We’ll never get rid of him then! It would look like him! It would talk like him! Walk like him! Be like him! Mother, it would act like he does. It would hurt me the way he hurts me! NO! NO!’”

  By the time the woman finished she was shaking. Tears streaked her face. “Do you understand me? Do you see why I could never have this man’s baby?”

  As I did her abortion, all I could think about was this woman’s life, her two
children, and that abusive man. It was hard to focus on the technical work of the procedure. Thoughts kept sweeping into my head. What would she have done if safe, legal abortion hadn’t been an option? What would her life and her daughter’s life have been like?

  Something else was working on me. She had gone through all the required and routine steps at the clinic. Only when I asked her these last questions had all of this come out. Why? And was it important that she verbalize all this for me anyway? Did I need to be privy to this information?

  Both the patient and I were rather quiet through the short time it took to end the pregnancy. Each of us was deep in our own, private thoughts. When she was dressed and headed for recovery, I stopped her and asked her to stay a minute longer. I apologized to her, thinking I had perhaps pushed her too far, gotten too personal with my inquiry.

  “No, oh no.” She shook her head. “I am so glad I got that out of my system. When I was telling you about my daughter’s reaction to all of this, I realized how much I felt the same. Saying it all out loud completely took away all doubt I might have had. No, I am so glad you asked the question you did. Thank you.”

  When I leave the clinic after a day of work, there are patients who stay in my thoughts. Often it is the ambivalent woman we send away. I hope we have given her the tools she needs to come to a clear decision. I hope that she understands we all have choices. We at the clinic have a right, even an obligation, to refuse an abortion if we don’t believe a patient really wants it.

  My thoughts might be with a fourteen-year-old who couldn’t even comprehend how she got pregnant but, thanks to our educators, now understands the mystery. I think about how we affect family dynamics, like the sixteen-year-old rape victim. It is a tremendous satisfaction to know that she and her father will communicate in a healthier way, and that we helped make that difference by opening the doors to honest dialogue.

  All of this, of course—the way I think about patients and their outcomes, the way I approach a patient when I first meet her, my voice, my questions, my empathy—comes from my own experiences. It is shaped by the way my abortion unfolded in 1976, by the difficult decisions I have had to make, and by what I have learned from patients and staff and life. I hold these things in me every day. They come with me into every counseling session. They are who I am.

  Missoula

  Feb. 17, 1993

  Dear Susan Wicklund,

  As promised in my Feb. 16 letter,

  you’re now hearing from me again.

  We will shut you down, you murdering butcher.

  How dare you kill unborn Americans! What gives

  you the right! How would you like to be torn limb

  from limb in your mother’s womb, your head

  crushed, and then thrown on a garbage dump?

  Or, how would you like to be slowly tortured to

  death by suffocating and burning by saline?

  You murderess. We will end your vile practice,

  you cold-blooded murderess!!

  How many babies have you murdered in your

  “illustrious” career? 100? 500? 1,000?

  Proud of it, are you, you reptile?

  Stop the killing. Stop murdering

  innocent children. Until next time.

  Mike Ross

  chapter eight

  The woman behind the counter looked at me as if I were her definition of a really bad day. She was confused and exasperated. This was a simple transaction she could accomplish with her eyes closed.

  “Look,” I repeated. “I need to have the utility bills sent to the Mountain Country Women’s Clinic, not the apartment, and I can’t have my name on it.”

  “Okay,” she said, sighing. “You are the person living at this address, correct?”

  “Yes, we’ve established that. But I can’t have the bill sent there. I can’t have my name associated with that address. I can’t even have my name on the account.”

  “That’s not possible,” she said, her voice flat and final.

  “It has to be possible,” I said, just as adamant.

  We stared at each other.

  My turn to sigh. “This is my situation,” I said, leaning toward her across the counter. “I’m the doctor who owns that clinic. We offer women’s reproductive health care. We also perform abortions. There are people stalking me, threatening me. I don’t like it one bit, but I have to be thinking about that all the time. I can’t just set up an account like most people. They will track me down, find where I live. Then, who knows?”

  “Oh,” she said.

  Her expression softened. She went very silent. “Give me a minute,” she said. “Let me think about how to do this.”

  The move to Bozeman was exciting, even exhilarating, but it was fraught with complications and danger. I had to take precautions worthy of a witness protection placement in order to stay off the radar of anti-abortion zealots.

  At that time, there were no anti-stalking laws in Montana. I could be followed and approached with impunity. By the time any law enforcement could legally become engaged, it would be too late. I kept my Minnesota driver’s license to avoid having my local address on record. I had an unlisted phone number. My checking account was tied to the clinic address.

  Everything was complicated by that reality. By now I was used to feeling like prey, used to watching my back, but in Bozeman I was truly alone. No family. No friends. Totally exposed.

  Mine was a life of constant airport runs, different beds, different colleagues, different offices, different vehicles and streets. I was always on guard, listening for the wrong voice, watching for the eyes that meant trouble, checking the rearview mirror, never knowing who would be on the other end of a telephone call.

  Sometimes it felt completely unreal, silly, overblown. The shenanigans I had to go through were ridiculous. But I had no choice.

  I wouldn’t allow the janitorial service to clean the offices. My staff and I handled that chore. When I spent the night, I never turned any lights on in rooms facing the street, never even went in those rooms. I bought a tiny television and kept it in the box, hidden under a table. Some nights I’d pull it out, make popcorn in the microwave, and let the mindless TV shows keep me company.

  Always, Michael Ross hovered in the background, a forbidding predator. The day the clinic opened I started receiving his threatening letters. They came two or three at a time. He would scrawl out descriptions of how he was going to kill me—tear off my arms and legs, squish my head and watch the brains come out like Jell-O, set me on fire and listen to me scream. Day after day they sat in the pile of mail, his distinctive, handwritten scrawl a beacon of hatred.

  He actually signed the letters, but the law enforcement people I contacted wouldn’t investigate. Written threats were not a punishable offense, they told me. My office manager collected them, opened and read them, filed them. She developed a sense for when to keep the letters from me, days when she picked up my frazzled, stressed-out vibes. In the first month, sixty-three of his letters came in the mail.

  The clinic could not be targeted directly by protesters, but they would be on the street and sidewalk in front of the building, carrying their signs, watching for me, trying to identify likely patients. People who arrived for dentist appointments, visits to their accountant, or to give blood at the American Red Cross and even customers at the pharmacy would have to deal with the ugly signs and rhetoric.

  By and large, most of the other tenants in the building were at least not hostile. An investment broker and another physician in the building went out of their way to visit and offer assistance. Of course, another tenant posted a Right to Life poster on their office window. Although I didn’t venture out to socialize, I was very grateful to those who offered friendship.

  By the same token, people unknown to me came and went all the time. They could be in my hallway, in the restroom on our floor, coming and going in the elevator right by the door to the clinic. I never knew who might be there to harass my patien
ts or target me.

  Within several weeks of opening I was invited to a private slide show. Some local people were sharing their canoe adventure in northern Canada. The man who invited me had given me a book by another Bozeman couple who had spent more than a year in the wilds of Canada, paddling across the continent and spending the winter in a remote log cabin. I was completely engrossed by the idea of these extended wilderness expeditions. Right then, nothing sounded better than to escape to some place wild and pure, some place far removed from protesters, death threats, airport corridors, clinics, and the media.

  Yes, I was in Montana, surrounded by clear air and mountain views. The fact was, however, that I was so occupied with the clinic, my work, and my vulnerability that my world stayed small. For all the opportunity I had to embrace Montana, I might as well have been in New York City.

  That winter evening, with a snowstorm blowing outside, surrounded by friendly people, I sat alone, watching the images of water and boats and campsites in the middle of vast country. It was all I could do not to break into tears. I thought of the book I had been reading, the experiences these people shared. I was deeply envious of their ability to craft a life full of adventure.

  During a break in the slides, I was introduced to a couple. It didn’t take me long to realize that they were the people in the book. I connected with them immediately. Marypat was eight months pregnant with their second child. Their first son had been conceived on one of their extended northern canoe expeditions. We talked about her experience using a midwife for her first delivery and her plans to continue that practice.

  I was thrilled to be around someone with a planned and desired pregnancy. Marypat had such positive energy. She and Al, her husband, were completely dedicated to incorporating adventure into their family life. Before the evening was over, we made plans to have supper together soon.