Of Women, Health, and Death

Years ago, sometime around 1995, I sat with a colleague who, over the years, had become a dear friend as well as a co-worker.

A man who was raised a Catholic, joined the US Air Force, became a Air Commando in Viet Nam, joined the San Antonio Police Department, and finally became a nurse and then a Nurse Anesthetist.  We sat one afternoon in the Burn Center operating room, having finished one case and waiting for the second one to be prepped to start, talking of women and women’s “rights”.

Paraphrasing that conversation I remember so well:

“Joe”, he said with a smile that was both infectious and self deprecating, “I’m a man, a conservative, an ex-cop, ex-military, and I was raised in the [Catholic] Church.  Nothing, though makes me angrier or sadder than the talk about banning abortions.  Not that I like them, but…..”.  This colleague of mine looked away, his face changed, and then he continued.

“…I remember being just out of school. I was in the operating room one night and was called to the emergency room to see a woman needing an emergency abdominal operation.  This woman was young, a teacher by training, she told me”

It turned out that this young woman had become pregnant, had a back-alley abortion – these were the days before Roe versus Wade made abortions safe – that had been botched.  Her uterus was perforated, she was bleeding and she was severely infected.

“Joe”, my colleague continued, “just as I put the [face] mask on her [to begin her anesthetic induction, so that the surgery could be done] she looked up at me.”

‘Don’t let me die. I am so afraid’.

“She said that to me; I told her I would take care of her.  And she died on the OR table.”

“This is why I get so angry. Some of us would rather see women punished – die – than admit sex happens, pregnancy happens, and sometimes abortions happen.  They just should not be back- alley.”

That discussion happened in the Burn Center operating room almost 20 years ago.  I remember it as if were from an hour ago.

Today, we are witness to an attack on women that is almost unbelievable.  The major contenders for President in the Republican Party have – each of them – questioned whether women should have access to hormonal therapy for birth control. Guised in pseudo-moral argument – one must not, they say, make the church (or pharmacist, or nurse, or doctor or….) do anything they find morally objectionable – these men and their female-gendered supporters would force us to return to a place that does not exist; that, perhaps, never existed.  A world of black and white, where gray – the color of most days of our lives – is banished.  Where difficult moral decisions are handled with a shrug of the shoulder and a world-view that admits no doubt.

And this verbal violence, aimed at 50% of our population, passes today in our United States for considered, even thoughtful, opinion.  Violence toward our mothers, wives, daughters, sisters. Violence made worse by the well-paid buffoons of the Right such as Mr. Rush Limbaugh, recently quoted and proudly re-quoted having called a young Georgetown law student a “whore and a slut” for having the audacity to suggest birth control should be part of a health care package.  Indeed, Mr. Limbaugh went on to ask that this law student put film of her having sex on the web, so that he and – one assumes – people like him could watch her.  This was the price he demanded for a health insurance product that included hormonal birth control.

It is not reasonable to ask if this man – Mr. Limbaugh – has no shame.  The question should be: What, Mr. Limbaugh, do the women in your life – mother, sister, lover – think of comments such as these ?  What do these women say to you Mr. Limbaugh, for spewing such violent vulgarity ?  One wonders if there are women in the life of this very sad man.

But let us proceed further.  Would these men’s rule-making eliminate hormonal contraceptive use for uterine hyperplasia, post-menopausal symptoms, uterine fibroids, endometriosis ?  How about the use of hormonal contraceptives in young autistic women who suffer from severe dysmenorrhea ?

There are other reasons to use these agents, but one wonders how far these men are willing to go, how much suffering they are willing to allow in the name of the “moral” world they wish to create.

It is interesting, actually, to take note of who is made to suffer so that these men – they are all men – can create the world they so desire.  The weak, always the weak.  These men, and their female hangers-on, are bullies, pious bullies.

Tragically, sometimes things happen that we would were otherwise. Sometimes, difficult choices are made by men and women, together, with no need for the likes of Rick Santorum, Rush Limbaugh, Mitt Romney or Newt Gingrich to weigh in.  Personal, difficult, and intimate decisions, tragic decision at times, but decisions that adults make.

That day almost 20 years ago. The look on my partner’s face.  The limp and pale body on the operating room table.  The loss of that woman’s life, all of her promise, all of her sorrows and joys, a life dedicated to teaching, was a tragedy.  Clint Eastwood’s character was right: when you kill someone, you take everything they have and everything they ever would have.

It would be a moral tragedy if the men who wish to be our leaders are allowed to theocratize our United States, make it into  a country in which women are consigned to die, potentially, for the “sin” of having sex.

And it  would be beyond tragic if all of this happened in the context of a health care reform law – Mr. Obama’s Affordable Care Act – that, from its’ inception, saw no benefit in a single-payor option.  An option that, because it would have been national,  federally-funded, and would not have required employers to pick or eliminate coverage options, would have prevented this attack on women’s health. But, to his discredit, Mr. Obama saw no benefit in pushing for this option.

So here we are, in 2012, fighting over the bodies of women.  Amazing.  One no longer knows whether to laugh or cry.

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About AJ Layon

AJ Layon was, for 28 years, at the University of Florida College of Medicine, in the Division of Critical Care Medicine, in Gainesville, FL. For the past approximately 10 years, until September 2011, he was Professor and Chief of Critical Care Medicine at UF; In September of 2011 he became System Director of Critical Care Medicine in PA. While his interests are primarily related to health care, health care reform, and ethical issues, as a citizen of our United States and our world, he will occasionally opine on issues of our "time and destiny". You are welcome to respond to him at ajlayon@gmail.com.
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