Intimate Wars

by Merle Hoffman

  The nurses and counselors posed a different kind of challenge to my authority. There was no room for me to have my own office, so I set up an executive director’s desk amid the nurses’ station and recovery cots. I knew I wouldn’t be able to run the clinic efficiently unless my staff took me seriously, and since I had no physical area I could use to enforce professional boundaries, I had to firmly demonstrate that even though I was young and inexperienced, I was in charge. But some of them made it clear that they resented my position in the medical hierarchy, their lack of respect palpable with every interaction. They weren’t going to accept my authority so easily.

  I’d wanted power, and now I had it, but I had no idea how to wield it effectively. I found that the very notion of women having power was difficult for many of my female staff to digest. Many had adopted the popular belief that power in and of itself was oppressive and destructive, regardless of who had it. Others thought women in positions of authority should use their power differently from men. When I conducted interviews for new employees, I asked each candidate how she felt about the concept of power. Extraordinarily, each and every one of the applicants, even those for supervisory positions, said almost the same thing: “I don’t want to have power over others, I want to empower others.” I would run up against this particular female hesitation about power for years to come.

  A few of my staff, wanting to employ the egalitarian concepts of the times, told me they felt that the clinic’s atmosphere was too traditionally medical, and that the white coats might be off-putting to patients. We were all equal, so why did medical personnel have to differentiate themselves by their dress? I decided to conduct a pilot study on the issue to put their ideas to the test. I made up a questionnaire that I gave to patients asking about their attitudes on medical uniforms. The results were significantly skewed toward a preference for professional dress in white coats. Patients needed to feel safe, and the traditional white coats helped them to do so. In a world where most women were afraid that having an abortion could kill them, many had never been to a gynecologist, and there were no sexual education classes to teach people how their bodies worked, power—the power that came with knowledge, expertise, and experience—was something to embrace, not reject.

  Still, my employees expected me to embody all the alternative superior qualities that women with power would ideally have: sensitivity, openness, and leniency. Wanting to be liked, I decided to try to meet their expectations. Perhaps that would earn me their respect.

  I took them to dinner, listened when they confided in me about their personal relationships, helped them to analyze their dreams, and offered sympathy when they spoke of their stress levels. If people needed extra time, they got it. If someone was late, I often overlooked it. Every decision was individually negotiated. Never feeling quite satisfied, my employees began expecting more and more from me on a personal level. I felt guilty when I could not grant a specific request, and this general empathizing led to my feeling more and more responsible for their happiness.

  Worse, this method of apologetic supervision put a damper on my ability to make across-the-board management decisions. When I had to give unpopular directives, I was met with passive-aggressive attempts to undermine my position of power. I would walk through the hallways and hear whispers in my wake. One day at lunch, I found a dirty speculum in my soup. I’d gotten caught up in the tension between wanting to be liked and needing to be respected, and the situation was beginning to snowball out of my control.

  The HIP group with whom Flushing Women’s shared space was unionized by 1199, an extremely powerful institution whose representatives sat on the board of HIP. Mingling with the HIP employees, my staff decided they wanted to unionize, too. My office manager, a middle-aged woman who had particular difficulty with my authority, contacted 1199 as a self-appointed leader of eight people, and I soon received official notification that Flushing Women’s was in the process of being unionized. Within days of the announcement, a union meeting was held at the clinic in the room where both the patients’ beds and my desk were located.

  With that, my attitude toward my employees changed. I experienced their alliance with the union leaders as a direct invasion of hostile forces. Who were these people interfering with my staff? Why was I now being censored in my interactions? How dare they interfere with the way I ran my clinic? I felt a diminution in my power, and it frustrated and enraged me. Since I was not allowed to attend the meeting, I stood outside of the room like a kid at her parents’ bedroom door and listened to the rhetoric. The leader used fiery, fighting words:

  “If she does not want to give you these benefits, then we will close this place down! If you don’t like what she is doing, we will take care of it!”

  It sounded like a street rally against an oppressive ruler. Regardless of my emotional reaction, it soon became clear that there was only one thing I could do to survive this challenge: submit to the process.

  The union was voted in, and I was now in a position to negotiate an employment contract with union representatives. I came face to face with the philosophy of unionization and the way it was practiced at 1199. They used a boilerplate contract developed to suit a large insurance company with thousands of employees instead of one designed for a small business like ours. When Ed Bragg, the representative from 1199, advised me to terminate someone so that he could drive the salaries of others higher, I realized that the union’s philosophies did not necessarily translate into better conditions for the workers. Merit? There was no real way to address it, because all raises were built into the contract language. But this was what my staff wanted, and we all had to bear the consequences.

  The workplace atmosphere became stilted and tense. These people were no longer my coworkers, but my adversaries. We had to function as a team together to deliver an extremely sensitive service to patients, yet we had no camaraderie. And because I was aware that I could be charged with union busting if I so much as discussed the unionization issues with my staff, I was relegated to dealing with them through the intermediary of a union delegate.

  I developed a new strategy: I worked by the book. There were no more decisions to make concerning staff’s sick days and personal days and emotional troubles; almost every potential situation was spelled out by contract. No longer could someone appeal to my sensitivity or “feminism,” a word employees used as a tool against me when they didn’t agree with my final decisions. Staff began to feel that I was too autocratic, that I should be more collaborative. But the union contract had spelled out every part of the manager/ employee relationship, and there was little for me to do but follow these directives. Gradually, the employees found that dealing with the union and the details of the contract was impeding their ability to work with me on a personal level in our intimate setting, and that our former situation had been far more advantageous. After about a year, quietly and without my knowledge, the union was voted out.

  After that experience I took on a new management style that suited me, one that combined some of my feminist attitudes with the lessons I had learned from the unionization of my employees. I thought of it as a collective autocracy. I listened to everyone’s opinions with respect and interest and promoted a good deal of feedback, but I stopped treating my staff as my surrogate family. I kept myself separate. The decision-making role was ultimately mine, because the results of those decisions fell—and still fall—most heavily on my shoulders.

  I HAD ANOTHER IDENTITY besides executive director: I was the mistress of a married man, a role I had never intended to play, though I did relish it. Marty and I had successfully created the world he wanted to have together, a world that his family never entered. At Flushing Women’s his wife and son receded to hazy impressions in my mind, and it was easy to push aside the fact that his evenings and weekends were spent attending to a home life to which I had no access. My own evenings and weekends were saturated with the anticipation of seeing him at the clinic, which in itself was an enormous pleasure. Ou
r meetings outside the clinic were hidden, riddled with obstacles that heightened the intensity of each stolen moment. I would pray for red lights to lengthen our time together when he drove me home from the office.

  At times I felt I was in the Bette Davis film Now, Voyager: “Don’t let’s ask for the moon! We have the stars!” I was satisfied with the stars—content, even pleased, with our situation for the time being, even if I could not have all of him.

  My mother slowly began to suspect that something was going on between Marty and me—all those late evenings and lunches on Saturdays—but she never asked me about it directly. One day I finally spoke frankly about my affair. The first thing that she said was, “You know, he will never leave his wife for you.”

  I answered with earnest disdain, “Oh mother, I don’t want him to!”

  Being a married woman had never entered into my fantasies; the passion and transgression of being a mistress seemed so much more alluring. After all, I was the one for whom he was risking his marriage. I was the one he wanted, the one he loved. Obstacles were the fuel to our fire, and his marriage was the constant and immobile obstacle, his wife a psychological paper cutout for me. I was too much in love, too self-involved to have empathy for someone I considered to be powerful, someone denying me happiness. It would be many years before I would come to understand the pain I had a share in causing her.

  Like any new lovers, Marty and I did rather reckless things in the grip of our passion. Once, we took a few compromising Polaroid photos of me in the office. The cast-offs were stupidly left in a garbage pail and picked up by another employee, an older married woman who worked the morning sessions and had her own designs on Marty. I received a telephone call telling me that she had the pictures and would send them to his wife; she only wanted to ensure that she would get a raise and have job security.

  Marty knew the Brooklyn district attorney, Eugene Gold. He contacted him for help and was advised that I should tape all my conversations with the woman as potential evidence.

  As I sat in my studio apartment for hours transcribing these unpleasant discussions, I felt sick with fear that this woman would be able to use her situational power to destroy my authority over the clinic and to separate me from Marty. The issue of shame and scandal was different then. Having a child out of wedlock or an affair with a married man could affect the rest of one’s life—it was not an audition for a reality show.

  One day I walked into the small waiting room we used for our patients and found her sitting there with a manila envelope on her lap. She had come to intimidate me, and to let me know that time was running out before she would do something with those photos. Our eyes met, and I felt terrified. I thought my entire life would be over. Our relationship would be unmasked, Marty would have to leave me, and I had no idea what his wife would do to us.

  Playing for time, I told her I would have to get back to her. I was waiting for the New York district attorney to review my transcripts and advise me on our legal course of action. After the evidence was reviewed, it was determined that although the employee was in fact blackmailing me, the tapes could not be used in any legal fashion.

  Marty fired her and warned her not to dare approach us again or she would be criminally liable. She left us alone.

  Shaken but immensely relieved that the episode had finally ended, I resolved never to give an employee or coworker the chance to take me down like that again. I would have to learn to watch my back.

  This was my first direct involvement with the law and its exquisite nuances. Dealing with lawsuits would come to be almost a second career for me; at times it felt like I was practicing law without a license—and thanks to Marty’s connection with Eugene Gold, it was also the first time I got to see the inner workings behind the presentation of political power, the personal strings that could be pulled to achieve a certain outcome.

  THESE POWER STRUGGLES and political lessons were important for my coming-of-age as a leader. Without them I would not have been able to build and maintain a successful organization. But simultaneously, almost in spite of myself, I was undergoing a sort of awakening I’d never imagined possible. My entrance into a field that I was also creating was giving me more than a chance to exercise my ambitions. As the volume of patients steadily grew, my political strife with my employees was tempered by a growing awareness that the power and meaning of Flushing Women’s extended far beyond my own life and dreams.

  Legal abortion had split the world open to the realities of women’s lives, laid bare in my counseling rooms. My patients had anxiety levels that matched their relief and dread. They were here, they had made the choice, but there was an accompanying fear of punishment and death. “Can I really do this thing and go on with my life?” they would ask. “I won’t be punished—I won’t be butchered—I won’t die?”

  It was that face-to-face connection that so drew me in. After a childhood spent largely alone, my heart was expanding to embrace others. I saw that the politics, the power struggles, the hiring and firing, the hours of work that went into the clinic, were all in the service of these women, my patients. Power, my power, could be channeled to facilitate this good. I was meant to do this. And my life collided and fused with the massive force of the history behind these issues.

  There were poor women of every race, many of whom had numerous children. There were patients as young as eleven years old and as old as forty-five, patients who so much wanted to keep the pregnancy but could not, Russian immigrant women with a history of multiple abortions, college students, and middle-class married women who never told their husbands. They all needed my help.

  The general ignorance regarding women’s bodies, health, and sexuality was astounding. Many patients had never had a gynecological exam. Our Bodies, Ourselves—the influential women’s health book published by the pioneering feminists at the Boston Women’s Health Collective—had not yet been published. The working- and middle-class women I worked with often believed old wives’ tales about how one could become pregnant. “Can I get pregnant again after this abortion?” they would ask. “Will I still have sexual feelings?” I kept a plastic model of a uterus on my desk, and I would use real medical instruments to show them how an abortion was done. I wanted women to know what was happening, to gain control over their reproduction. As the months and years flew by, my eyes were opened to how deeply difficult a task this was for my gender.

  One morning the Medical Control Board of HIP, led by Dr. Alan Guttmacher (known as the father of Planned Parenthood), made an official visit to Flushing Women’s. His mission was to review our protocols and report back to the board on whether HIP should continue to refer patients to our clinic. Marty and I had decided to have the clinic licensed, and the Medical Control Board wanted this stamp of approval. Becoming a licensed facility meant that we were regulated and inspected by both the City and State of New York, and there were pages and pages of requirements ranging from exactly how many square feet a hallway could be to how many nurses had to be in the recovery rooms.

  Dr. Guttmacher was as impressive as his résumé, and I was nervous about how the day would go. But as we conversed, he said something that so shocked me I forgot my performance anxiety. After observing a couple of abortions he asked me whether or not we inserted IUDs immediately after the abortion. Thinking his question strange, I told him we did not. It was necessary to wait a couple of weeks to monitor the bleeding from the abortion itself, and to give the woman an opportunity to think about the kind of birth control she wanted to use. Immediately inserting a device that could have its own side effects and that would potentially exacerbate the side effects of the abortion was not good care, so I preferred to wait until the follow-up visit. To this, Guttmacher replied, “You already have them on the table. Why not just insert them? I would do that with all my patients.”

  During counseling sessions, I got the patients’ side of the story. They told me of doctors who purposely enacted procedural delays so by the time they got to the clinic, t
hey were beyond twelve weeks pregnant and could not have an abortion. There were women whose doctors told them it was unnecessary to refit their diaphragms after their last childbirth. I heard of doctors who refused to allow sterilization procedures on any woman unless she was at least twenty-seven years old with two children, doctors who refused to insert the IUD when patients asked for them, doctors who didn’t tell their patients that a backup method of birth control is necessary during the first two weeks a woman is on the Pill. Women came to me with pills that were too strong or too weak, diaphragms not properly sized because they were told it was unnecessary, IUDs that had been inserted incorrectly. They came with shame, anxiety, and tangles of questions someone should have answered for them long ago. “Should I go off the Pill and use foam?” they would ask. Or, “I didn’t have an orgasm, how can I be pregnant?” The trail of pregnancies caused by doctors’ misinformation, ignorance, or carelessness was endless. I began to call this phenomenon iatrogenic pregnancy.

  I knew that many doctors had a deep commitment to women and their reproductive health. They had seen firsthand the results of illegal abortion. Most knew that whether abortion was legal or not, women would move heaven and earth to have one if needed, and often lose their lives in the process. Some had a political commitment to the issue and felt that abortion should be an integral part of women’s health care. Others saw it as a good way to earn extra money. The stigma that has come to haunt abortion providers had not yet fully materialized, so there was little deadly social drawback to offering abortions as part of their practice. Whatever their reason for getting involved, most doctors who did this work saw abortion services as an integral part of women’s reproductive lives.