In Necessity and Sorrow: Life and Death in an Abortion Hospital by Magda Denes

(New York: Basic Books, 1977), 284

"I take it for granted that we are in the business of death here, and the tenor of each day will be heartache." (126)

"The D&C floor is civilized." (128)

"Even now I occasionally feel a little peculiar about it, because as a physician I'm trained to conserve life and here I am destroying life...But on a number of occasions with the needle, I have harpooned the fetus. I can feel the fetus move at the end of the needle just like you have a fish hooked on a line. This gives me an unpleasant, unhappy feeling because I know that the fetus is alive and responding to the needle stab. When you put in the needle, theoretically you go in the sac and take out fluid and put in salt water. But there are times when you hit the fetus and you can feel the fetus wiggling at the end of that needle and moving around which is an unpleasant thing. No one has ever mentioned this, but I've noticed it a number of times. You know that there is something alive in there that you're killing." (141, D&C floor physician)

"I do feel you'd be an abnormal person if you could really honestly say that abortion didn't bother you at all. It goes against all things which are natural. It's a termination of life, however you look at it." (147, physician)

"In the pivotal shadow of one decisions, made over and over again, that this life, this heartbeat, this unique combination of unpredictable possibilities for good or evil, for glory or for shame, will not be allowed to become." (239)

Notes


Contents


Introduction

  • "I wish to be taken for what I am. A proabortionist with a bad secular conscience." (xvi)
  • "For this is only in part a book about abortions. It is also a book about the intransigent tragedies embedded in being human...Above all, this is a document on the evasions, multifaceted, clever, and shameful, by which we all live and die." (xvii)

Chapter 1: The Hospital

  • "I am overwhelmed by the bureaucratic banality of suffering." (14)
  • ==quote on 18==
  • "I say to myself, I know I'm a Catholic but it is good that these babies aren't brought up in the world because it would be like me in the home. All they wanted was love. If these kids here were born a lot of them wouldn't have that." (22, telephone operator)
  • "I really didn't know what a fetus was going to look like. I never thought it would look—so real." (29, controller)
  • "So why bring somebody into the world who is going to be so miserable. What you don't know doesn't hurt you." (39)

Chapter 2: Saline Floor: Staff

  • "Abortions in my mind happen to grown-ups who are unwillingly pregnant but doh't look it. These are little girls far gone with child." (49)
  • "Dora says, "As time goes on you will feel worse. I am a little? surprised that you feel this bad so soon." I look at her quickly to see if she is making fun of me, but she appears completely serious. Suzy, who has a slow drawl and whose voice is a melodious instrument with a crack in it (I like very much to listen to her when I am not in a hurry, as I am not, now), says, "I am having difficulty with my feelings about late abortions also. More and more, I don't even know anymore if I believe in it. There is just so much pain." She has worked here for two years." (51)
  • "There is no way then to assert, except by pretense, that what is being salinated in its mother's womb is not alive or not human. There is no way to say that this is not a type of murder. And yet, there is no way to say that it would not be just as surely murder, more cold and vengeful, to force little Flo to give birth to her bastard. This is no floor for self-assurance. No floor to feel good about anything." (57)
  • "Two doors down from the nurses' station there is a little room with several large garbage cans, each neatly marked for different types of garbage, and a medium-sized table on top of which stand paper buckets—the type in which one buys fried chicken from take-home stores. The buckets are covered with their paper lids. Attached to each lid there is a white cardboard label bearing-printed in ink—the mother's name, the doctor's name, the time of delivery, the sex of the item, the time of gestation. Inside each bucket, I have been told, there is a fetus and its placenta stored in formaldehyde. At the end of the day the buckets are transferred to the laboratory where the contents are examined for abnormalities. That done, they are collected in a large plastic bag, and a special messenger takes them to a sister hospital in possession of an incinerator. There they are burned." (58-59)
  • "I look inside the bucket in front of me. There is a small naked person in there floating in a bloody liquid—plainly the tragic victim of a drowning accident. But then perhaps this was no accident, because the body is purple with bruises and the face has the agonized tautness of one forced to die too soon. Death overtakes me in a rush of madness... I take the lid off all the buckets. All of them. I reach up to the shelf above this bucket graveyard tabletop and take down a pair of forceps. With them I pull aside in each bucket the placenta, which looks like a cancerous mushroom shrouding the fetus. With the forceps I lift the fetuses, one by one. I lift them by an arm or a leg, leaving, as I return them again, an additional bruise on their purple, wrinkled, acid-soaked flesh. I have evidently gone mad. I carry on the examination, whose sole purpose by now is to increase the unbearable anguish in my heart. Finally, I lift a very large fetus whose position is such that, rather than its face, I first see its swollen testicles and abnormally large stiff penis. I look at the label. Mother's name: Catherine Atkins; doctor's name: Saul Marcus; sex of item: male; time of gestation: twenty-four weeks. I remember Catherine. She is seventeen, a very pretty blond girl. Not very bright. This is Master Atkins—to be burned tomorrow—who died like a hero to save his mother's life. Might he have become someday the only one to truly love her? The only one to mourn her death?" (60-61)
  • "Someone not long ago in a lecture defined the classic physician as a man who has attained Christ-like posture...I dare say any thinking sensitive individual can't not realize that he is ending life or potential life, you know. I certainly don't enjoy that. I have no conscious conflict over killing a fetus. There's certainly nothing enjoyable in the act, except providing a necessary something to a person to make their life or burden happier, or easier, or whatever." (62-64, physician)
  • "You have to become a bit schizophrenic. In one room you encourage the patient that the slight irregularity of the fetal heart is not important, everything is going well, she is going to have a nice baby, and then you shut the door and go into the next room and assure another patient on whom you just did a saline abortion, that it's fine if the heart is already irregular, she has nothing to worry about, she is not going to have a live baby. I mean you definitely have to make a 180 degree turn, but somehow it evolved in my own mind gradually, and I have no trouble now making the switch" (67, physician)
  • "It was a gradual change, because at the beginning we were doing abortions on fetuses that were not quite as large. And the kicking and the fetal heartbeat did not manifest itself quite as obviously as it does now, in the larger cases. So I can imagine, if I had started doing twenty-four-weekers right off the bat, I would have had much greater conflict in my own mind whether this is tantamount to murder. But since we started gradually, with fifteen-, sixteen-weekers, where the overwhelming interest of the mother was so obvious, the fetus just never got consideration. It just did not enter the picture. Then, as one gained experience, the whole range of cases that we had to take care of started to become larger. All of a sudden one noticed that at the time of the saline infusion there was a lot of activity in the uterus. That's not fluid currents. That's obviously the fetus being distressed by swallowing the concentrated salt solution and kicking violently and that's, to all intents and purposes, the death trauma. You can either face the method or you can turn the other way and claim it's uterine contractions. That, however, would be essentially re-pressing, since as a doctor you obviously understand that it is not. Now, whether you admit this to the patient, that's a different matter...The patient's distress by unwanted pregnancy is to me the primary consideration and I am willing to put that ahead of the possible considerations for the fetus. We'll just have to face it, that somebody has to do it. And, unfortunately, we are the executioners in this instance. "In my view it would be unfair to say 'Well, I enjoy taking out fibroids but I just abhor doing abortions.' That's not fair. Whether this is a rationalization on my part or not, I'm not sure. But I think I have no conflict in my own mind of representing the patient's interests all the way...I am not prepared to defend euthanasia outright, because it has too many pitfalls." (68-69, physician)
  • "What happened when I was first working here was that I just thought about the baby and that was very upsetting. I'm very proabortion. I think that if women want it, and need it, they should definitely have the opportunity to get it. So I had to try to make myself keep thinking of that and the fact that these people need it. And when you hear their stories and get involved in them as people, it's much easier to take...What happened when I was first™ working here was that I just thought about the baby and that was very upsetting. I'm very proabortion. I think that if women want it, and need it, they should definitely have the opportunity to get it. So I had to try to make myself keep thinking of that and the fact that these people need it. And when you hear their stories and get involved in them as people, it's much easier to take." (75-76, social worker)
  • "There's so much pain in the mothers." (80, social worker)
  • "And yet, quantity has a way of radically altering the essence of quality. When, under one roof, the number of dead fetuses mounts into the thousands, the simple fact of death gradually overshadows the significance of individual histories. It seems that none who work here can witness the extinction of a segment of the future generation without guilt and fear. The word "murder" surfaces again and again, and it sticks on the tongue like a searing coal of fire that one knows will do further damage whether it is swallowed or spat. A struggle evolves between reason and conscience, between pragmatic morality and one's own commitment to all human seed. With the struggle there also evolves a shamefaced solution: "I do not decide for these women, I just do my job"; "I give them what they want"; "I only help out." As if disclaiming responsibility could make one free of it." (89-90)

Chapter 3: Saline Floor: Patients and Parents

My own heart let me more have pity on

  • "When you have an abortion you are just destroying a part of yourself, that's the way I feel anyhow." (94)
  • "My life comes first. I've got. my plans before this happened." (101)
  • "I don't feel like I'm really killing anything because it's not breathing yet. I would rather get rid of it, then make it suffer it's whole life." (110)
  • "Oh yes, these people lie, they kid themselves, testify falsely, confess in bad faith, shirk responsibility, only pretend to honor, bracket the past, and invent their lives. And who among us does differently? Especially in times of crisis. Especially in times of irreversible choice." (122)
  • "I take it for granted that we are in the business of death here, and the tenor of each day will be heartache." (126)

Chapter 4: D&C Floor: Staff

  • "The D&C floor is civilized." (128)
  • "Even now I occasionally feel a little peculiar about it, because as a physician I'm trained to conserve life and here I am destroying life...But on a number of occasions with the needle, I have harpooned the fetus. I can feel the fetus move at the end of the needle just like you have a fish hooked on a line. This gives me an unpleasant, unhappy feeling because I know that the fetus is alive and responding to the needle stab. When you put in the needle, theoretically you go in the sac and take out fluid and put in salt water. But there are times when you hit the fetus and you can feel the fetus wiggling at the end of that needle and moving around which is an unpleasant thing. No one has ever mentioned this, but I've noticed it a number of times. You know that there is something alive in there that you're killing." (140-141, physician)
  • "Most doctors who do abortions also do them for the money's sake. It's a big motive." (144, physician)
  • "I don't like abortions over five months basically, twenty weeks as a rule. This is, of course, a compromise—a cop out. Because it doesn't make any difference. What's the difference between twenty-two and twenty-six weeks. One is as much a fetus as the other one. It's not rational, it's just an arbitrary point to allow some sort of moral outlet, guilt outlet. I've tried not to make it a moral issue, but a social issue without moral overtones as much as possible. But I think from a straight moral point of view I probably would object to abortion. Because I love kids. From that point of view every fetus is a potential child, and morally I just really don't think that should be done. Socially there's a great need for abortion, purely because there's a large group of women, who for various reasons will get pregnant and they don't want a child. I feel that they should have a right to allow themselves a choice, to have another chance, so to speak." (146, physician)
  • "I do feel you'd be an abnormal person if you could really honestly say that abortion didn't bother you at all. It goes against all things which are natural. It's a termination of life, however you look at it." (147, physician)
  • "But when it's a big fetus, you will hear them asking a lot of questions: 'Is it a boy or is it a girl?' 'Will it be baptized?' We've had many requests for that too. We do it, it doesn't mean a thing. But if it rests somebody's peace of mind, you baptize a fetus. I mean for the psychological effect. It's not recognized by the church, how can you murder a fetus and then baptize it? I feel if it makes the woman happy, why not? If it satisfies her psychological hang-up, whatever it is." (152, nurse)
  • "The numbers game is the opiate of the D & C floor. Everyone plays, although the particular number varies from person to person. Dr. Harris places the magic figure at twenty. Another doctor at ten. The favorite of the unit is fifteen. New York State bids for twenty-four. The numbers represent weeks of gestation above which the act of abortion is said to qualitatively alter, and to be transformed into—let us not mince words-murder. There is no logic to these numerals. They are arbitrary choices in the struggle against guilt; they are bones thrown to the savage dogs of conscience. Some of the figures make medical and procedural sense. None are valid as arbiters of the moral issue. They evolve from and affect subjective reality based on degrees of self-deception...The numbers game in the abortion field is an absurdity. Extrauterine viability of the fetus as a deciding factor in doing abortions is a position of ignorance or of extreme bad faith. Abortion fetuses, after all, come to be outside the uterus by force and not by mishap. To argue, therefore, in favor of abortion exclusively on the basis of viability is logically akin to maintaining that to drown a nonswimmer in a bathtub is all right, because he would have drowned anyway had he fallen into the ocean." (158-159)

Chapter 5: D&C Floor: Patients, Parents, and Boyfriends

  • "There can be no better argument in favor of legalized abortions than the story Mr.s A tells." (166, Mrs. A being a patient who previously had a dangerous illegal abortion performed by a Cuban physician at his apartment)

Chapter 6: Surgery

  • "Forceps please." Mr. Smith slaps into his hand what look like oversized ice-cube tongs. Holtzman pushes it into the vagina and tugs. He pulls out something, which he slaps on the instrument table. "There," he says. "A leg. You can always tell fetal size best by the extremities. Fifteen weeks is right in this case." I turn to Mr. Smith. "What did he say?" "He pulled a leg off," Mr. Smith says. "Right here." He points to the instrument table, where there is a perfectly formed, slightly bent leg, about three inches long. It consists of a ripped thigh, a knee, a lower leg, a foot, and five toes. I start to shake very badly, but otherwise I feel nothing. Total shock is passionless. "I have the rib cage now," Holtzman says, as he slams down another piece of the fetus. "That's one thing you don't want to leave behind because it acts like a ball valve and infects everything." Raising his voice and looking at the nurse, who stands next to Dr. Berkowitz, he says, "The table is a little bit too high. I am struggling." The nurse jumps to crank it lower. "That's better," Holtzman says. "There, I've got the head out now. Also a piece of the placenta." I look at the instrument table where next to the leg, and next to a mess he calls the rib cage but that I cannot recognize, there lies a head. It is the smallest human head I have ever seen, but it is unmistakably part of a person. My vision and my hearing though disengaged, continue, I note, to function with exceptional clarity. The rest of me seems mercifully gone. (222)
  • "I practice medicine not to make a living and yet I like to make money at it. We made a lot of money in abortions. I don't really know why I did it. I sort of fell into it." (225, physician)
  • "Basically every gynecologist doesn't like women, otherwise he couldn't work with them. He enjoys the position of mastery over them. The fact that he is the god, king, they do what he tells them, which is what he would always want women to do, because every man wants his women to be subservient to him. The patients are subservient to us, and when they rebel it's very simple: 'Go to somebody else. Don't come back to me, if you're not going to take my advice.' What better relationship can a man have with a woman? Besides if you fuck thirty women a day with your fingers, and in a way you do, this is a form of sexual violation. If you really want to be technical, it does interfere in many respects...." (227-228, physician)
  • "Not that I think they should be punished by pregnancy out of wedlock, it isn't that. It's just the idea that what they think are simple solutions are not as simple as they think. They can die, they can become sterile, and they can have many other complications. That unfortunately is the biggest evil of abortions. You'd have to educate women and young girls to a more sensible way of life, more sensible behavior, better contraception. I don't think complete sexual freedom is logical and sensible. I think it's destructive. They may not think so when they are engaged in it. They're not intelligent enough to realize it. They'll just develop all sorts of problems later on in life, not knowing why..." (232, physician)
  • "Abortions, well, abortions, it is difficult to be consistent in relation to them. They are lucrative. They are necessary. They make for a bad conscience." (234)
  • "In the pivotal shadow of one decisions, made over and over again, that this life, this heartbeat, this unique combination of unpredictable possibilities for good or evil, for glory or for shame, will not be allowed to become." (239)

Epilogue

  • "The truth, I think, is that the hospital falls apart under the weight of its purpose. It disintegrates through a cumulative sense of horror. Death is no easy companion." (242-243)
  • "Her words lacerate my heart and highlight the irreconcilable paradox of this place, where what is done must be done, and yet what is done surely injures a higher order." (243)
  • "Abortion is an abomination unless it is experienced as a human event of great sorrow and terrible necessity. Abortion is not a legal issue or a social convenience. It is a decision of dreadful daring, through which personal worlds are validated. It is a frontier of individual rights to private destinies, be that redemption or inconsolable remorse. No one undergoes this ordeal for the sake of societal gain. No one is here to reduce population growth. A given fetus lives or dies as the mother's needs dictate. And so it should be. But not without awareness. Not without a lingering attitude of restitution that would make of the mother's spared life something better. Lend it a nobler course, a higher fate, a commitment to the enhancement of the quality of life. That is the heart of this struggle. The quality of life pitted That is the heart of this struggle. The quality of life pitted against life. Whichever we choose, we lose. And that, too, is Part of being human. That too is the dilemma of abortions." (245)
  • "Toward the last days of the hospital's existence several of us sit in the cafeteria around a luncheon table, eating overdone, tasteless stew. "What do you think this is made of?" someone asks. "Venison," I say. "Pigeon," says Betsy. "Don't be silly," says one of the counselors. "There is a hell of a lot cheaper meat to be found around here." All of us laugh, guffaw, splut-ter, and slap each other on the arms. It is the funniest thing we have heard in years. Berta nearly chokes on her mouthful from uncontrollable mirth. "I think I'll throw up," Edie says, and she looks as if she meant it. "Get a hold of yourselves, ladies," Rachel says. "This is unseemly." She is right, of course, but all of us laugh again. "I think it's a Greek dish," says Teresa, laughing so hard that tears begin to roll down her face and we can barely understand her. "It's fetustu." There is no containing any of us now. "There is mince meat pie for dessert," someone shouts. "And that isn't tomato juice you're drinking," adds somebody else. Most of us are doubled over. The air fills with our shrieks, and gasps, and gurgles. My sides begin to ache." (246)

Topic: Abortion

Source

New Words

  • emesis: The act of vomiting. (129)

Created: 2023-11-19-Sun
Updated: 2024-05-27-Mon