I flushed, and stared down at the kitchen floor, which I had helped Dad install—covering the old painted plywood floor with real oak—in junior high. The oak was still golden, though scuffed from years of boots and heels, scratched by the toenails of two generations of dogs.
“I didn’t mean . . . ,” I began. I couldn’t finish.
“It’s okay,” Dad said.
CHAPTER 2
IT WAS ABORTION THAT CONVINCED ME THAT MY DAD WAS right, and I should go into medicine. Not any abortion I had, but working in an abortion clinic. This is not a story I tell often.
The February after my last year of college, I got a job as a patient advocate at a clinic. When I arrived there for the first time, I thought, It will look like I’m getting an abortion. Then I shrugged and went in. I was twenty-two and had just gotten the news that I’d been accepted into the master of fine arts program in creative writing at Columbia. I needed money for the move to New York City, so I’d applied for a job as a patient advocate.
At my interview, the clinic leader pointed out that the clinic strives to be respectful of every patient.
“Of course,” I said.
“I mean,” she said, “we really try to be kind.”
“Got it,” I said.
“Really,” she said again. “To their faces and when they’re not around. We don’t say mean things about our patients.” I peered at her, in her cat-eye glasses, and wondered what I was missing.
They hired me for a six-month stint, likely because I speak Spanish. The afternoon I was hired, one of the other gals working there drove me down to Goodwill to pick out some secondhand scrubs. So I was official: a clinical person for the very first time.
Inside, the clinic looked like any other: a large waiting room, white hallways, an office with telephones. The only differences were that there were lamp-lit counseling spaces and each room was named after a famous woman. Indira Gandhi was the bathroom, until an Indian American patient pointed out that decorating a bathroom with a picture of Lakshmi, who is a god, could be insulting.
The clinic runs on antihierarchical principles. It is woman owned and woman run, and every person who works there trains in every position that interests her. Every other Saturday there were meetings for the entire staff, where we could bring up and discuss relevant issues. The only people who didn’t come to these meetings were the doctors, because they didn’t live in Austin. The doctors were scattered all over the state, and would fly in to Austin one or two days a week to provide abortions. Providing abortions in the same town where you live, I learned, can be dangerous. Also, many providers are family practitioners who don’t want their primary care practices threatened by protestors.
I started out in the front office, which is the best place to learn how the clinic works. We in the front office were the first point of contact for women who needed an abortion. I answered the telephone. “So, I think I’m pregnant,” the conversations would begin. Or just, “I’m pregnant.” I took all the Spanish-speaking phone calls, because the senior gal in the office didn’t speak Spanish. (I had learned to speak Spanish because the Port Aransas Rotary Club sent me off to be an exchange student in Spain my senior year of high school.) Sometimes, the women on the other end of the phone would whisper, or their voices would echo as if they were calling from behind a locked bathroom door. I learned to echo their feelings—It can be a really scary thing—and to gauge the term of the pregnancy from their last period. Most were in the first month of pregnancy. When they were ready to make an appointment, I would tell them what to expect.
First off, to comply with a Texas law requiring a mandatory twenty-four-hour waiting period for women to get an abortion, our patients had to call a day before their appointment to listen to a recorded message about abortion. Not all the information in this message was true. The state had mandated that the message use the term “unborn child” rather than “fetus,” and that women be told that abortion increases their risk of getting breast cancer. (It doesn’t.) On the morning of the appointment, women would come in to start the complicated process of getting this simple procedure. First, they would get blood tests. That was followed by an ultrasound to verify the length of the pregnancy, and then (state-mandated) counseling by one of the clinic staff.
Women who were less than nine weeks pregnant could get a medical abortion, where they take medications that cause the fetus to detach from the uterus and the uterus to cramp—essentially inducing a miscarriage. The medical abortion could be done at home, after the women saw a doctor in the clinic. If the pregnancy was farther along or they felt safer doing it in the clinic, then we’d set them up for a surgical abortion, where the fetus is removed with suction. Rarely, pregnancies were advanced beyond sixteen weeks. In those cases, we would have to do a two-day procedure where dilators are placed into the cervix, and then left overnight before the abortion was done the next day.
Working in the front office, I was also trained on how to respond to a bomb threat. You alert someone to call the police, and try to get details about the bomb. A bomb threat never came while I was there.
“We’re not Planned Parenthood,” my boss explained, “so we don’t get as many protestors.”
I also learned how to answer women’s questions.
Will it hurt? Yes, there is cramping-type pain, like you get with menstrual cramps, but more intense. We’ll give you medication to control the pain.
Can I bring my sister? Yes.
What does the baby look like now?
I learned to answer that final question when I moved from the front office to the pathology lab. In the pathology lab, I had two jobs. First, I would clean and sterilize surgical instruments. But also, I would check the bottles that came back from the procedure room, to make sure that each contained the expected parts—amniotic sac, umbilical cord, fetus. I would pour the bottles over a strainer, rinse the blood away, and look. If anything was missing, the procedure might have to be repeated.
The pathology lab is where things grew more complicated for me. At the front office I had learned to describe how abortion works in appropriate, neutral terms. But in the pathology lab, I learned what the fetuses looked like.
The very early ones were soft and delicate. You could see the amniotic sac, which looked like a jellyfish, and the thin twisty umbilical cord that had connected it to the woman’s bloodstream. There was no body. Many of the ones I saw were like this.
In later pregnancies, the fetuses were farther along, and they looked like little fish-people, with curved spines and tiny arms and legs. Some, more developed, just looked like the tiniest possible babies, but thin and red-skinned and bloody. My mind went cool and silent when I saw them, and I turned to my work with calm remove.
Everyone who worked at the clinic had abortion dreams, and mine began when I worked in the pathology lab. In the dream I would be driving, and the road was blocked by bloody bottles of tissue suctioned from inside a woman’s body. Or I would be in the grocery store, and the fruit would be covered in slippery amniotic sacs. Another woman dreamed of performing an abortion on herself; yet another dreamed of a full-size baby emerging from a vagina and turning its head to stare at her. And so if we did our daily work as calm and warm professionals, the moral ambiguity emerged in dreams.
Despite the dreams, neither the pathology lab nor the front office changed my life. That came from counseling.
The state of Texas had mandated that every woman receive counseling before an abortion, and although the law was surely an attempt to add cost to care—bolstered by the patronizing notion that women couldn’t make this decision on their own—we tried to use it for good. Counseling was the last step before the procedure. Alone with the patient in a private room, I would make sure all questions were answered and screen for women who were being coerced into having the abortion. But my real job was to support these women, and to listen to their stories.
Sometimes the women did not need to talk much. They just wanted their basic questio
ns answered, and to get on with it. These were often women like me—white, college educated, blessed by a circle of supportive friends. But I also saw women who were living on the margins, and my Spanish-speaking women were more likely to come into the clinic with stories they had no other place to tell.
I know now that neither education nor friendship nor whiteness can spare us from the worst of the suffering that women go through. But at that time, it seemed to happen in this way. These stories, the stories that changed my life, were told in Spanish.
THE FIRST WAS NAYELI, whom I saw shortly after I had completed my counselor training and begun counseling patients on my own. She was sitting in the waiting room on a busy Saturday, clutching her bag—surrounded by other women, but alone. I called her back to the counseling room.
“Are you here by yourself?” I asked, opening the door to the lamp-lit counseling room.
“Yes, I couldn’t tell anyone,” she said.
“I’m so sorry, that must be hard.” We sat down in the chairs, so close our knees could have touched. I quickly checked her chart to make sure she wasn’t set up for IV pain control—no. She’d be able to drive herself home.
“Well, I have three kids, you know. And my sister is in Mexico. She would not understand. And my husband. No.”
“No?” I asked.
“No,” she said. “He does not, he would not understand this. If he knew, he would suffer.” I imagined her arriving home from her abortion, breezing in the door with a forced smile, beginning dinner.
“Do you want to tell me about it?” I said.
She spoke quickly, words tumbling out to form the story that she had not been able to tell to anyone else. “I did not want to get pregnant, you understand. But he, he won’t use the condom. He will not do it. I cannot make him do it.”
“Okay,” I said. “Okay. If you want to try the pill or something, we can start you on that at your follow-up appointment.”
“Yes,” she said.
“So. How did you find out you were pregnant?”
“Well, I have three kids, so it was obvious,” she said, spreading her hands in the air before her belly. She was only a few weeks along. “But now, but now. What will happen to me?” and she began crying.
“You’re going to be okay,” I said.
“No, I am not,” she said. “It’s—you don’t understand. I’m Catholic.”
“A lot of Catholic women come here,” I said.
“I know. Oh, I know. And I have been praying and praying, but there is no other way. I have to do it. My husband, he is a good man and he works so hard. But there is no money, barely any money, not enough. So I can barely feed my kids. My husband goes to bed hungry, you know, so that I can eat. And some days my children, they go to bed hungry. And they are so small, you know, they don’t understand about money. But they understand about hunger. It breaks my heart.”
“It breaks your heart,” I said, simply repeating quietly what she said to give her more space to talk.
“It breaks my heart, and if there were a fourth one, no. I cannot do it. I have those three, and I have to feed them, and it is already more than I can do.”
“I understand,” I said.
“You do, okay, but him!” and she pointed up, to the ceiling of the clinic, beyond which stretched the branches of the live oaks and the open sky. “God. God does not understand.”
“God understands your heart in every moment,” I said, grasping for some intuition of Catholicism that I did not really possess. “He knows you’re acting out of love for your children.”
And then the air seemed to grow perfectly still, because she stopped crying and looked straight at me and said quietly and firmly, “Yes. For them, I will go to hell.”
THE SECOND STORY that changed my life was Gloria’s. She was already in the counseling room when I went to meet her, because she had needed assistance to get there. She smiled from the chair where she was sitting, with her bandaged leg propped on a stool in front of her and her crutches leaning on the wall.
“I’m Rachel,” I said, “your counselor.”
“Hello,” she said as I sat near her, and took my hand in both of hers. Kindness radiated into me from her. “Thank you.”
“Oh, thank you,” I said. And I began my spiel. “I’m here to explain the procedure, and to answer any questions you have, and also just to listen.”
She nodded, and I went briefly through what would happen in the procedure room, finishing with “And then you’ll rest up in the recovery room for as long as you need, and have a snack, and you can go when you’re ready.”
“Back to the shelter,” she said. I nodded.
“And will I have a chance to say good-bye to my baby?” she asked.
“We could say good-bye together now, if you want,” I said.
“I mean, could I see him? Could I see the baby afterwards?”
I thought of the slippery fetuses in the pathology room, and wondered what this kind woman would feel looking down at hers. She was eight weeks along, just far enough that there would be a little form along with the amniotic sac.
“If you want to,” I said. “Of course you can.”
“Everyone has been so kind to me,” she said.
“Oh,” I said. “Good.”
“I mean,” she said, laughing. “Except my husband.”
I was so surprised by her laughter that I laughed, too.
“Can I show you?” she asked.
I paused. “Yes,” I said, slowly. “If you want to.”
“I want you to see,” she said, “why I’m doing this.” She leaned forward and pulled down the bandages over her thigh, and I saw the edge of the wound. Thick black stitches tracked down from the top of her thigh. “It goes from here,” she said, “to here.” And she traced the length of her thigh almost to the kneecap. “He wanted to kill me. I passed out from the blood loss, but the neighbors had heard me screaming and they called the police.”
“My god,” I said.
“I know he was trying to kill me,” she said. “He slammed my head on the ground.”
“I am so sorry.”
“I love this baby, and I will not let it be born to him. This baby’s life, and my life, would be tied to him forever.”
“I understand,” I said, my voice moving thinly through the air.
Later, I walked with her into the room where what remained of the body of her baby, the baby she loved, was waiting in a smooth glass bowl.
When I turned to leave her alone for a moment, I heard her begin to pray.
THE THIRD STORY that changed my life that year was Xochitl’s. Xochitl was born in a Nahuatl village in Mexico, and when she was four years old her parents sold her.
“They sold you?” I asked, thinking surely I had misunderstood.
“Yes,” she repeated. “They couldn’t feed me, so they sold me. I went to work in a big ranch house, and I stayed there until I was sixteen and I ran away.”
“Whoa,” I said.
“Yes. I worked so hard.” She took my hand in hers. “Feel my hands. I will never have soft, pretty hands like yours. I have been working as hard as I could since I was four years old.” Her hands were small, and the skin was rough. When I touched them I could sense the truth of everything that I had heard. She was sitting face-to-face with me in the clinic and touching my hand. She lives here, I thought. I might’ve passed her in the grocery store, and I would never know.
“And the pregnancy?” I asked.
“Well, I am twenty-two now. And I do want to have babies,” she said slowly. Then she leaned toward me, and brightened. “But listen to this,” she said. “When I got pregnant, I realized that my boyfriend is a bastard! He steals my money, and he won’t let me call my friends. I don’t want to have his baby!”
“So this is a good choice for you,” I said.
“Yes,” she said firmly. “I have been through so much. But I have a job now. I make my own money. I have a place to live. I don’t have to do what
he tells me to do.”
“So you’re leaving him?” I asked.
“I already left him. That was the first real decision I ever made for myself, and this is the second,” she said. “The abortion.”
“You seem like a really strong person,” I said.
“Maybe so,” she said. “Somehow when I got pregnant, I realized that I was in a trap. But here is the miracle: I can get out.”
THAT WORK IN THE CLINIC was the beginning of my life becoming unspeakable. So many of my stories are hard to tell. One does not go to a party and tell stories that end in “But the baby died three days later, with sepsis,” or “And then we removed the old man’s leg.” One does not go to a party and speak of blood slipping down the drain at an abortion clinic. No story I could tell seemed like it would do justice to the women I had met, anyway, and so I began to keep a kind of silence that has become part of my professional life. I kept my old life up for a while, bicycling around my city, dancing, but it began to feel less and less real. I could not draw a thread between the life I lived outside of the clinic and the stories I heard there.
I left that job at the end of the summer and, as I had planned before I got the job at the clinic, I moved to New York. If my life in Austin had felt unreal, New York was hyperreal, and I was outside of it the whole time. I would go to writing workshops in the MFA program I had enrolled in at Columbia, and care, passionately but briefly, about the stories we were telling. When a friend got pregnant I thought, Mothering is a sacred thing. Did you know that I met a mother who gave up her immortal soul in order to feed her children? But I didn’t say it. I said congratulations, as you do. Women I knew fell in love with men, and I thought, He seems like a wonderful man. But sometimes they try to kill you, my mind tracing the stitches up and down Gloria’s thigh. She would be walking again now; she would have a scar.
The public debate about abortion rights hummed on and sometimes flared, and always seemed to have little to do with either the fetuses—those slippery little almost-lives, those bodies I myself could not look at for long—or the women. It seemed mostly about male politicians and abstract morality. Certainly no political discussion could hold half of Xochitl’s strength, Gloria’s kindness, or Nayeli’s determination. As I drifted through my unreal life and a pretty fall turned into a biting, big-city winter, my mind continued wandering back to the clinic. The counseling room had felt sacred to me: there, women shared stories that could be told in no other place. I remembered the touch of Xochitl’s rough hands, and how instantly I had recognized her story as true. That space, the clinic room, was real.
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