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Tilting at Windmills

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June 1, 2009
By: Hilzoy

Dr. George Tiller

My thoughts are with the family of Dr. George Tiller, who was killed today.

I'm not sure how many doctors still perform late-term abortions in this country -- one and two seem to be the most common estimates. This is, of course, due to the campaign of terrorism that has been waged against them. I cannot imagine the courage it takes to go on doing what you think is right in the face not only of consistent harassment and death threats, but of actual attempts on your life.

Why go on doing it? Here's one reason:

"Sometime early in the 8th month my wife, an RN who at the time was working in an infertility clinic asked the Dr. she was working for what he thought of her discomfort. He examined her and said that he couldn't be certain but thought that she might be having twins. We were thrilled and couldn't wait to get a new sonogram that hopefully would confirm his thoughts. Two days later our joy was turned to unspeakable sadness when the new sonogram showed conjoined twins. Conjoined twins alone is not what was so difficult but the way they were joined meant that at best only one child would survive the surgery to separate them and the survivor would more than likely live a brief and painful life filled with surgery and organ transplants. We were advised that our options were to deliver into the world a child who's life would be filled with horrible pain and suffering or fly out to Wichita Kansas and to terminate the pregnancy under the direction of Dr. George Tiller.

We made an informed decision to go to Kansas. One can only imagine the pain borne by a woman who happily carries a child for 8 months only to find out near the end of term that the children were not to be and that she had to make the decision to terminate the pregnancy and go against everything she had been taught to believe was right. This was what my wife had to do. Dr. Tiller is a true American hero. The nightmare of our decision and the aftermath was only made bearable by the warmth and compassion of Dr. Tiller and his remarkable staff. Dr. Tiller understood that this decision was the most difficult thing that a woman could ever decide and he took the time to educate us and guide us along with the other two couples who at the time were being forced to make the same decision after discovering that they too were carrying children impacted by horrible fetal anomalies. I could describe in great detail the procedures and the pain and suffering that everyone is subjected to in these situations. However, that is not the point of the post. We can all imagine that this is not something that we would wish on anyone. The point is that the pain and suffering were only mitigated by the compassion and competence of Dr. George Tiller and his staff. We are all diminished today for a host of reasons but most of all because a man of great compassion and courage has been lost to the world."

Here's another:

"A routine ultrasound on October 26--meant to be a time of great joy (my best friend came with us to the appointment--revealed terrible news: one of the twins had died, probably about a week before. We went from the ultrasound appointment to my obstetrician's office and were met with even more grim news. My weight had spiked up about 18 pounds, my blood pressure was soaring, and I had protein in my urine.

It turned out that I was in full-blown preeclampsia. I was admitted to the hospital immediately.

After that, everything happened very quickly. I was put on medication (magnesium sulfate) in an attempt to treat the preeclampsia and save the remaining twin until he reached outside-the-womb viability--a mere two weeks away (I was just over 22 weeks pregnant). But I got much worse overnight; my blood pressure couldn't be controlled, I had a massive headache and was vomiting uncontrollably. My kidneys shut down. I was moments away from seizures, coma, and death when the doctors came and told us the bad news: my remaining twin could not be saved. My pregnancy had to be terminated or both the baby and I would die.

You might, Mr. Obama and Mr. McCain, be able to imagine what it felt like to be my husband--to imagine being terrified of losing your children and your wife in one fell swoop. Ms. Clinton, you might be able to imagine lying in the hospital, so sick you barely feel any of what is happening, only knowing that the long-fought-for children you so desperately wanted are now both going to be dead.

Here's the part of the story where choice comes in. I could, of course, have gone through induced labor and delivered my tiny twins. But my blood pressure was hovering around 165/120 (often going higher), even with treatment. Can you imagine what labor would have done to my body with blood pressure that high? My doctor recommended, and I agreed, that I undergo the much less stressful intact dilation and extraction procedure--what the "pro-life" forces often like to call a "partial birth abortion." (...)

As I lay on the gurney, waiting for my procedure to start, I felt a gulf of grief and emptiness the like of which I have never known. I felt abandoned by God. I lay there, crying, alone, surrounded by doctors and nurses. You can't imagine the sadness.

I was lucky. Are you surprised that I would say that? I was lucky because the partial-birth abortion ban was not yet in effect in October of 2004. If it had been, I would have been forced to undergo labor and delivery, no matter the risks to my health, and I might right now be either dead or so brain damaged I would be unable to type this."

And this:

"I also know a woman who had two "partial-birth abortions," or D&Xs (dilation and extraction) as they are more accurately called. My friend Tiffany is a carrier of a terrible genetic abnormality. In addition to other defects, her babies developed with no faces, with no way to eat or breathe. They were doomed. The only way to extract them without hurting her chances of ever having another baby was through a D&X."

And this essay that I will never forget, about a woman whose child died in her womb, and who couldn't find anyone to do a dilation and evacuation, the safest procedure for someone in her condition, because it was too controversial:

"I could feel my baby's dead body inside of mine. This baby had thrilled me with kicks and flutters, those first soft tickles of life bringing a smile to my face and my hand to my rounding belly. Now this baby floated, limp and heavy, from one side to the other, as I rolled in my bed.

And within a day, I started to bleed. My body, with or without a doctor's help, was starting to expel the fetus. Technically, I was threatening a spontaneous abortion, the least safe of the available options.

I did what any pregnant patient would do. I called my doctor. And she advised me to wait. (...)

On my fourth morning, with the bleeding and cramping increasing, I couldn't wait any more. I called my doctor and was told that since I wasn't hemorrhaging, I should not come in. Her partner, on call, pedantically explained that women can safely lose a lot of blood, even during a routine period.

I began calling labor and delivery units at the top five medical centers in my area. I told them I had been 19 weeks along. The baby is dead. I'm bleeding, I said. I'm scheduled for a D&E in a few days. If I come in right now, what could you do for me, I asked.

Don't come in, they told me again and again. "Go to your emergency room if you are hemorrhaging to avoid bleeding to death. No one here can do a D&E today, and unless you're really in active labor you're safer to wait.""

Why didn't her own Ob/Gyn do the procedure?

"I can't do these myself," said my doctor. "I trained at a Catholic hospital."

George Tiller endured decades of terrorism to help women like these, women in unspeakably awful situations whom very few people were willing to help, given the price domestic terrorists had decided that anyone who helped them would have to pay. Now he has given his life.

Hilzoy 12:41 AM Permalink | Trackbacks | Comments (32)

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Comments

I see a lot of the "N-1 lives saved" argument today... i.e. "if a doctor would kill N babies if he weren't shot, then N-1 lives are saved if you shoot him- God should love this!"

Assuming first of all some sort of parity between fetuses and gynecologists trying to practice their love with women, and second, that civil institutions cannot be relied on to provide justice. These people have no faith in civil institutions when they see the outcomes as conflicting with their religion. And there's a Manichean attitude- that since I "know" what the just outcome would be, I can act as judge, jury, and executioner and enforce it- saving N-1 lives, and becoming a hero.

Posted by: MillionthMonkey on June 1, 2009 at 1:15 AM | PERMALINK

So sad, and so necessary to reveal. Thank you for the background stories, it could not have been easy to compose this post.

Dr. Tiller is now my heroic symbol, the human face of pro-choice necessity. He's a martyr for the rule of law, and we can now define domestic terrorism for what it really is.

Posted by: BuzzMon on June 1, 2009 at 1:18 AM | PERMALINK

Dr. Tiller was well known in the genetics community as one of only a handful of physicians in North America would had the will and experience to carry out abortions for women who found out late in their pregnancies that they were carrying a fetus who was affected with a fatal genetic condition. Geneticists and genetic counselors across the United States and Canada referred patients to him. He will be sorely missed.

Posted by: Platypus on June 1, 2009 at 1:24 AM | PERMALINK

And another meme I've noticed today- the idea that the guy must have been running an operation for women in late pregnancy who decided they didn't look good in bathing suits- a sort of no-questions-asked elective surgery outlet. People seem to assume this with nary a forethought. So posts like this are good.

Posted by: MillionthMonkey on June 1, 2009 at 1:25 AM | PERMALINK

i have looked at some pictures of doctor tiller on the internet today, noticing what a marvelously typical looking man he is, and that he is almost a stereotypical looking old fashioned country doctor, those wireless glasses with that look of kindness, compassion and intelligence.

except he is gone now. murdered by the misogyny that he fought with every fiber of his being. he was quite a wonderful man. someday, someday, this sick society will know that he was a wonderful courageous man,

and by that measure, we'll know that our society is somewhat healed.

Posted by: neill on June 1, 2009 at 1:28 AM | PERMALINK

I wish someone would force Bill O'Reilly to read these stories and/or listen to the women who had to make those horrible choices.

Posted by: EddieInCA on June 1, 2009 at 1:28 AM | PERMALINK

Just want to remind everyone that Sotomayor sided with anti-abortion protesters and against the cops who arrested them in Amnesty America v. Town of West Hartford.

You may now go back to pretending that Obama's SCOTUS pick represents progress.

Posted by: Disputo on June 1, 2009 at 3:47 AM | PERMALINK

Killing Tiller is terrorism? Defending the EXPLICIT constitutional right to the freedom of speech over the IMPLIED constitutional right to abortion means that Sotomayor isnt progress? Providing women with dubious late term abortions = fighting misogyny?

Some people need to get a grip. extremes to the right AND to the left are just as bad.

Posted by: stan on June 1, 2009 at 4:58 AM | PERMALINK

Killing Dr. Tiller is absolutely terrorism. The intent is to intimidate other doctors from performing the same procedures. If you read Hilzoy's accompanying article, you will see that Operation Rescue engaged in a long-standing siege against people who worked for Dr. Tiller. If any of them had to suffer what they put Dr. Tiller and his people through, they would have been screaming and moaning to the police about harassment.

And yes, we have our strident angry voices on the left. The difference is, WE don't kill people for our convictions, so I will take a hardcore lefty over a rightwinger any day of the week.

Posted by: asiangrrlMN on June 1, 2009 at 5:21 AM | PERMALINK

stan,

Yes, of course killing Dr. Tiller is terrorism. The point is to instill terror in doctors and health workers performing abortions and in their patients.

Posted by: Daryl McCullough on June 1, 2009 at 6:08 AM | PERMALINK

stan, amongst all the other incorrect assumptions in your statements, the anti-abortion protesters in AAvToWH are not arguing that their first amendment rights were denied.

Posted by: Disputo on June 1, 2009 at 7:03 AM | PERMALINK

I am totally sick and tired of those people who surely need to spend much more time "correcting" their own behaviors and lives in stead of trying to tell the rest of the world how to live. And, as usual, in the name of religion they seek out those THEY kill! There is a word for them and retribution waiting for them in their AFTERLIVES...America...all about HATE!!!

Posted by: Dancer on June 1, 2009 at 7:40 AM | PERMALINK

Hilzoy, it matters not one bit these mothers lives were saved. It's about limiting a woman's freedom to choose anything without approval from some male. I'd hope to live long enough to see the day this wouldn't be an issue, but I doubt I'll get there.

Posted by: MissMudd on June 1, 2009 at 7:54 AM | PERMALINK

One thing you never hear about is the babies that were later born to women who had to have problem pregnancies terminated. These happy, healthy children would have been denied life if thier mothers had been forced to give birth in situations that could have killed them or wrecked their own lives. I'd like to hear more of those kinds of stories.

(When I feel particularly snarky with Catholic abortion prohibitionists, I like to point out that the Church's mandate of priestly celebacy has denied life to countless millions of potential children.)

Posted by: Virginia on June 1, 2009 at 8:30 AM | PERMALINK

First, Thank You Hilzoy for this article. I could have been one of those in your article. I was also along in my pregnancy (in my 29th week) when the mounting of fetal abnormalities began to outweigh the things that were right. The doctors suggested speaking to Dr. Tiller and exploring the options. My son was to have a painful, lack of brain function and surgery filled existence, should he have survived the labor and delivery. An extremely difficult decision, the only comfort at that time was the kindness and compassion of Dr. Tiller and his staff. They should be applauded for the work they do, no shot down by zealots who could never understand what a woman goes through and the burdens that she bears. I feel very sad today, both for the women and families that will be stripped of Dr. Tiller's services and his family which stood by him and his decision to continue to provide this much needed service. I will light a candle for him in church today.

Posted by: Anonymous on June 1, 2009 at 8:39 AM | PERMALINK

Just asking - have they determined the motive for Tiller's killer?

Posted by: Anon2 on June 1, 2009 at 8:42 AM | PERMALINK

I'd like to know what happened to the Hippocratic Oath for all those medical staff and the Ob/Gyn in the last story of the woman denied a D&E? Damn their self-righteous hides, what if she had died of a massive hemorrhage standing there asking for treatment?

Posted by: Kevin on June 1, 2009 at 9:27 AM | PERMALINK

Providing women with dubious late term abortions = fighting misogyny?

So which of the abortions above was "dubious," the conjoined twins with no chance of survival, the woman with pre-eclampsia that was killing both her and the fetuses, or the woman with the dead fetus that no one would agree to remove from her before its rot killed her?

Let us know which of those three you think was medically unnecessary.

Posted by: Mnemosyne on June 1, 2009 at 10:47 AM | PERMALINK

"One thing you never hear about is the babies that were later born to women who had to have problem pregnancies terminated. These happy, healthy children would have been denied life if thier mothers had been forced to give birth in situations that could have killed them or wrecked their own lives. I'd like to hear more of those kinds of stories."

This is a prime example of the way conservatives think. Maybe you haven't heard "more of those kinds of stories" because they don't exist, lady.

Posted by: MillionthMonkey on June 1, 2009 at 11:23 AM | PERMALINK

Whoops I read that way too fast! My eyes are glazed over this morning- my apologies. I've just read way too many posts in the past 24 hours that say what I think I thought you said. So many boneheads are coming out of the woodwork.

Posted by: MillionthMonkey on June 1, 2009 at 11:26 AM | PERMALINK

While I condemn the murder of Dr. Tiller, I must say I'm quite surprised at these stories.

The woman who carries a genetic abnormality who has had two late term abortions: Why is she continuing to get pregnant? Why in the world would she risk that, and why would she want to pass down that genetic abnormality?

The woman with the dead fetus: Obviously, that would not have been considered a late term abortion. The fetus was dead, and I have known people who experienced this. They had no problems whatsoever with having a hospital remove the dead fetus. I don't believe this story is true.

The woman with pre-eclampsia: At 22 weeks, she could have had a Caesarian and they could have tried to save her surviving fetus.

I don't think stories like these are going to be successful in convincing anyone.

Posted by: Thal on June 1, 2009 at 12:23 PM | PERMALINK

Thal, you are sadly mistaken. I don't know where you or your friends live, but I live in California and have seen many many women face fetal demise and have extreme difficulty finding a hospital that can help them remove the fetus safely. Many hospitals refuse to do anything they see as abortion, and many others simply do not have trained doctors. The medical procedure is the same regardless of why a woman needs an abortion, so when doctors do not learn what they consider to be a 'political' procedure, they put the lives of all women at risk for exactly this reason.
And a woman with full blown pre/eclampsia might not survive a C-section, which is major major surgery. Not to mention that a 22 week old fetus has a minuscule chance of survival even with the best technology, and almost no chance of surviving without serious longlasting disabilities.
I think it is unbelievably callous of you to dismiss these stories so easily. I'm glad you and all your friends have had such easy lives but you are certainly very lucky to have avoided any difficult choices.

Posted by: JPD on June 1, 2009 at 1:14 PM | PERMALINK

The woman with the dead fetus: Obviously, that would not have been considered a late term abortion.

I don't think you understand what an abortion is. A natural miscarriage is, medically, a "spontaneous abortion," which means that the body itself ended the pregnancy.

If the fetus is dead but the body does not spontaneously abort it, a doctor must go in an abort the pregnancy to remove the dead fetus. In fact, if the fetus has died, it's much preferable to abort the pregnancy since, as the patient herself stated, a spontaneous abortion is much more dangerous and can lead to uncontrolled bleeding and death.

The woman with pre-eclampsia: At 22 weeks, she could have had a Caesarian and they could have tried to save her surviving fetus.

From the actual story above, which you clearly failed to read:

After that, everything happened very quickly. I was put on medication (magnesium sulfate) in an attempt to treat the preeclampsia and save the remaining twin until he reached outside-the-womb viability--a mere two weeks away (I was just over 22 weeks pregnant). But I got much worse overnight; my blood pressure couldn't be controlled, I had a massive headache and was vomiting uncontrollably. My kidneys shut down. I was moments away from seizures, coma, and death when the doctors came and told us the bad news: my remaining twin could not be saved. My pregnancy had to be terminated or both the baby and I would die.

I'm surprised that you think you can read a brief story on the internet and claim that you know better than the actual doctors treating the actual patient in real life and that of course they could have done major abdominal surgery on a patient with uncontrollable high blood pressure and kidney failure without killing her.

You really should educate yourself about these things before you start making medical pronouncements and expose your embarrassing ignorance.

Posted by: Mnemosyne on June 1, 2009 at 1:19 PM | PERMALINK

Thal - what you are doing with your questions is a classic rhetorical flip. You are blaming on the women for getting pregnant in the first place, or questioning their need for an abortion -- to distract from the issue that is directly before us.

I don't give a damn about your armchair prognosis of whether these women faced medical emergencies that required late term abortions.

Posted by: Bokonon on June 1, 2009 at 1:28 PM | PERMALINK

When I entered my 13th week of pregnancy, my baby died and I had no problem finding a doctor in Dayton, OH to do a D and C. The procedure involved dilating the cervix and inserting a tool into the womb to remove the child's remains. I began to cramp and bleed, and when I went to my doctor he could not find a heartbeat. To be certain he sent me for an ultrasound which confirmed that my child had no heartbeat. He sent me to the hospital where the procedure was completed. He assured me that such procedures were common.
I had a friend whose baby son died in utro at 7 months. She was admitted to the hospital and given pitocin to stimulate labor. She and her husband spend almost an hour in the delivery room holding their dead child and mourning his passing. He was buried in a family plot and they have pictures of him in their photo album.

Posted by: Carolyn Johansen on June 1, 2009 at 2:25 PM | PERMALINK

No matter what the crazy, vicious, murdering pro-lifers and their friends online say about Dr. Tiller...

he was a hero to thousands of women and families whose lives he personally touched. For whom he was there in their hour of need. He was the only one brave enough to stand up for them. And he did so with a compassionate, kind manner that is legendary among his patients.

Zecher tsadik l'bracha. the memory of the righteous is only for a blessing. thousands have blessed the name of Dr. Tiller. Thousands bless his memory.

Dr. Tiller showed what the pro-choice movement is all about - compassionate care for women in need. Likewise, the pro-life terrorist and his friends here show what the "pro-life" movement is all about.

Posted by: Hannah on June 1, 2009 at 2:27 PM | PERMALINK

Carolyn,

leave Ohio and you, and your friend, may not be so lucky.

Posted by: thinkpeople on June 1, 2009 at 9:56 PM | PERMALINK

These cases do happen, no one is arguing that, but very few compared to normal, healthy pregnancies and healthy babies. No one is against a D&E's,when the fetus has died or when the mom's life is in no doubt in danger. It's not true that a woman can't easily get one from any ob/Gyn., I've had friends who's babies died in their wombs at 6 monhts along,even at 8 mos. and they said had no problems getting treatment at just about any clinic. The outrage against Dr. Tiller's practice is that the majority by far, is the late-term abortions of healthy babies by healthy moms, for non-medical reasons. Now that is a TOTALLY different side of Dr. Tiller practice and I have the right to call it murder if I want to, I live in the USA. It was horrible how he was shot and killed, I do no at all condone such an act.

Posted by: Olivia on June 2, 2009 at 9:16 AM | PERMALINK

"The outrage against Dr. Tiller's practice is that the majority by far, is the late-term abortions of healthy babies by healthy moms, for non-medical reasons."

Olivia, do you have any statistics to back up this claim?

Posted by: Shan on June 2, 2009 at 10:19 AM | PERMALINK

Olivia said:
"These cases do happen, no one is arguing that, but very few compared to normal, healthy pregnancies and healthy babies." AND "The outrage against Dr. Tiller's practice is that the majority by far, is the late-term abortions of healthy babies by healthy moms, for non-medical reasons."
- and you have seen the records so you know the kind of cases Tiller treated?

So do the protestors outside his clinic screaming and waving picture of dead babies automatically know when a woman is coming there for one of the reasons you deem as "valid"? No, they scream at everyone. Can you imagine being a woman in one of the situations listed above, and before you can get treatment you have to drive through a crowd of people banging on your car windows, screaming "don't kill your baby!" and throwing pictures of aborted fetuses in front of you? After all of the turmoil they've already been through?

The self-righteous protestors are the ones who should be ashamed of themselves.

Nobody LIKES abortion. But Tiller performed a necessary service that few were unwilling to do.

By the way, Olivia, your statement that "any" clinic can do a D&E is blatantly false. Most don't have the training, the equipment, or the knowledge. It's an extremely dangerous, lengthy, and complex procedure that takes certain expertise. Tiller was the foremost expert in performing these safely.

Posted by: Mel on June 2, 2009 at 12:43 PM | PERMALINK

Of all the stories following the brutal murder of Dr. Tiller, one of these bothers me the most. "I can't do the procedure (I can't save your life) because I trained in a Catholic Hospital." What the Hell??????????? Who are these people???????????

Posted by: Fred Harrington on June 3, 2009 at 5:15 PM | PERMALINK

Prove it OLIVIA. I keep hearing people like you say these things..Prove it so the rest of us can be enlightened as you are.

Posted by: marcie harris on June 3, 2009 at 9:26 PM | PERMALINK




 

 

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