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This story is from the Anamnesis episode called Taboo and starts at 23:42 on the podcast. It's from , a doctor in New York City and author of High Risk: Stories of Pregnancy, Birth, and the Unexpected.
Following is a transcript of her remarks:
Like any good doctor in the year 2020, I am in a bunch of Facebook groups for physicians. In one of them, somebody posted a thread. She was upset about the recent New England Journal of Medicine editorial critical of the Trump administration's reaction to the pandemic.
She felt that a vote for President Trump was justified because he was pro-life and she was proudly a one-issue voter.
She reminded me of this story. This story is not a metaphor. It's a true story and it really happened.
She Really Doesn't Look Good
One day, somewhere around 10 years ago, I was in my OB/GYN clinic finishing up the day, tired, done, ready to go home. One of the nurses came to get me. "There's a patient out front. She just got sent home from urgent care, but she doesn't look great."
"Well," I said, "she just got discharged by urgent care. I bet she's fine. Can't we give her an appointment later this week? Maybe tomorrow?"
"Dr. Karkowsky, she really doesn't look good. Dr. K, please?"
I sighed. "OK, OK. Put her in Room 11 and I'll see her." I sighed again, texting my husband that I'd be late for dinner, and went to Room 11.
In Room 11 there's a 20-something-year-old woman bent over, clutching her abdomen, in obvious pain. She tells me it's been terrible and she just figured out that she was pregnant today, and everything hurts. "I went to urgent care to ask for an abortion," she said, "but they don't do that. They sent me away."
She waves her hand towards papers on the desk. I start reading. There's a short note from a doctor. "Patient presented requesting abortion, complaining of abdominal pain, green vaginal discharge. Blood pressure 173/100. Patient informed that we do not perform abortion services, discharge to home."
I turn over the paper. That's it. No mention of a possible ectopic pregnancy. No mention, actually, of the gestational age. No mention of her dangerously high blood pressure. No workup, assessment, or even a solitary medical thought about this woman.
Emergency Delivery
I ask the patient to lie down on our exam table, and as soon as she straightens out, it's pretty clear that she has a third-trimester belly. I quickly put our ultrasound on. "Yes, that appears to be 35 weeks? 36?" It's hard to see because there's no amniotic fluid around the baby. Fetal heartbeat? "Yes, 130's normal."
I chat soothingly while I put this all together. Blood pressure 173/100, abdominal pain, greenish discharge, which on review seems to have been her water breaking.
I call quickly to get an ambulance to take her to labor and delivery, while we try to get some basic stabilization done. I call the hospital. "I'm sending you someone around 35 weeks estimated, no prenatal care, preeclampsia with severe features, ruptured membranes with meconium. Likely early labor. She needs to be stabilized and she will need to deliver."
I find out that, later, at the hospital, the fetal heart monitor shows deep decelerations of a baby in distress. The patient agrees to cesarean and undergoes it once her blood pressure is no longer dangerous. She's in the OR within one hour of arriving at the hospital.
He Almost Killed His Patient Who Asked for an Abortion
A few days later, I call the medical director of that urgent care center. "Your provider discharged this patient with no attempt to verify gestational age. He did not address her stroke-level blood pressure. He in no way assessed, treated, or considered this patient."
"Yes, yes. Well, that doctor is very pro-life, you see, really doesn't like abortion. So when she came in, you know, asking for an abortion, he just ..."
"He just what? Didn't evaluate her? Didn't do his job? Didn't treat her like a human? Almost killed this patient because she asked for a pregnancy termination, and oh, incidentally almost killed the pregnancy he cares so much about?"
"Yeah, I'll talk to him."
So that's a story about someone who is so pro-life that they almost killed a pregnant woman and her baby. Stories are important. They're so important that I wrote a whole book about them called, High Risk: Stories of Pregnancy, Birth, and the Unexpected, and there, like this story, are true stories of things I saw, things I saw my patients live through, experiences that would be unbelievable if we didn't see them happen.
This story is about how a terrible doctor used the label pro-life as a wall to hide behind, as an excuse to not encounter a human being and at least assess, if not alleviate, their suffering. It is a story of malpractice. The point here is that people use the term pro-life to confuse the scene and then do pro-death things.
Other stories from the Taboo episode include "I Was Pregnant and Swallowed a Handfuls of Pills" and "You're Never Prepared for the Screams."
Want to share your story? Read the Anamnesis Storyteller Tip Sheet and when you're ready, apply here!