Abortion In the Mountains

I am met in the parking lot by a grey haired woman in a blue vest that reads “escort” in big letters, and by a security guard packing heat.  In the adjacent parking lot is the “fetus van,” a local anti-abortion effort involving a truck emblazoned with a picture of a 7 week embryo magnified thousands of times.  While we wait for security to clear me, the clinic escort tells me how in the 70’s when she started doing this work “we literally had to step over the bodies of protesters lying down in the parking lot trying to block women from entering the clinic.  It’s gotten a lot better.”  Then the security guard gets the all clear and brings me inside.

One patient has a history of bleeding during her previous abortion, and upon talking to her, we find she hemorrhaged badly during the birth of her child.  She sits there anxiously. She looks older than her age.  She tells us she is afraid she might die if she continues this pregnancy. In Baltimore we might have sent her to the hospital-affiliated abortion clinic for higher risk patients but here in the mountains we are the end of the line.  The nearest hospital is catholic.  The nearest abortion clinic is hours away, and the time it would take to get another appointment, if she could get one, and get to it, would put her further along in her pregnancy, and with each week of pregnancy her uterus grows, and with it, it’s ability to hemorrhage more blood.  So the doctor talks through with her her history and her risk factors, and scrutinizes the ultrasound to confirm the dating.  In the end she decides the safest thing is to do it today.  The nurse readies two medications to clamp down her uterus in case she bleeds. But the procedure goes fine, with almost no bleeding, and we place the IUD the patient wanted, and then we’re done.

The first day I worked at the abortion clinic in Baltimore, the attending physician asked me I planned to do procedures or just observe.  I’ll do it, I said, feeling squeamish.  Abortion is an icky word in America.  We avoid it, slipping in the euphemisms of “choice” and “life.” Babies are the happy, life-affirming endings to our stories.  Abortion is a little painful and a little bloody.  But there have been times, and may again be times in my life where I know if I got pregnant I would get an abortion, so I it seemed unethical to deny to others what would be my own choice.

Shortly after finishing that gynecology rotation, I went camping on the beach with my parents.  My mother asked what I’d be up to at work, and I told her, including the abortions. It felt strange to say the word “abortion” to my mother.  My mother responded with a story about my great-grandmother’s sister. It was actually a story from my father’s side of the family. I knew she had died young and her children were sent to an orphanage, except for one daughter who was raised with my grandmother.

She had married young, then had four children in as many years, and it was all she and her husband could do to support them.  When she found herself pregnant again, she went and got a back street abortion, and then she died of sepsis.  The family begged her to disclose the name of the surgeon, and on her deathbed she refused.

I thought of the nurse at the abortion clinic watching us like a hawk for sterile technique, the iodine and chlorhexidine scrubs of the cervix, the autoclaved instruments, the antibiotics.  I thought of the one patient who had hemorrhaged, and “forgotten” to tell us that she had bled badly during the C-section delivery of her last child.  We gave her multiple medications, reached up with our gloved hands to remove clots from her uterus, massaged her belly hard enough that she yelled but finally the bleeding slowed.

I also thought of the woman whose baby I had just delivered who had hemorrhaged almost two liters of blood postpartum.  This is bloody business no matter how you slice it, and I am new enough in this business that the wait between when you give a medication and when it actually takes effect is agonizing.

Back to the abortion clinic in the mountains, the next few patients have more straightforward stories.  They are not thrilled to be here, and are relieved to leave no longer pregnant.  The next patient is also here for medical reasons.  She had a recent C-section, with a risk of uterine rupture if she continues the pregnancy.  Her last babies were longed for, finally conceived with IVF, and now this pregnancy happened on its own, and the timing is a sad sort of funny, and all wrong.  She too, leaves no longer pregnant, and with birth control.  It’s birth control for everyone today.  Post-abortion birth control may be the service most irreplaceable if Planned Parenthood is barred from billing insurance for routine health care.  (I anticipate that leading to more abortions.)

The last patient is a young immigrant here with her older American husband.  He tried to speak for her at intake, a red flag for staff, who get an interpreter on the phone and re-ask all the questions when she is in the exam room.  She answers without hesitation.  Yes, she wants this abortion. No, no one is forcing her.  I like to tell each patient each step before I do it. No one should have surprise fingers or instruments in her vagina.  The nurse is trying to pass the cell phone fast enough for interpretation, and finally settles for announcing each step herself to keep translation fast enough.  When I leave, her husband is smoking and pacing outside, more anxious than the patient herself. The stories get complicated here.

Abortions are actually down at this clinic, which means they are down for this whole far-flung rural, mountainous region it serves.  Delivery rates are down at most of the major hospitals as well.  The senior doctor’s best guess is it’s the IUDs.  And I think about how this little clinic nestled among the warehouses, in this town that is itself nestled among these glorious mountains, feels like a refuge in this ever crazier world.

The Women’s March on Washington

I’m glad the march was so big that Baltimore’s MARC station was so overflowing at 720 on a Saturday, the line for the train 6 people deep and wrapping around the building and out to St. Paul St., that I gave up and drove to DC, and then contemplating the traffic jam in the direction of the metro, parked on a side street, and took the S4 bus downtown.  I watched the bus fill up, at first it was the usual faces of DC buses, locals on errands, tired immigrants coming home from godawful shifts, and then filling rapidly with passendegs holding clear bags of snacks, and wearing protest signs and knit hats, the bus driver reminding us to move on back until everyone is behind the yellow line, and patiently helping newcomers pay their fares, and then skipping stops as we approached downtown as we were too full for more passengers.

I’m glad the march was so big I couldn’t even see or hear the jumbotrons, let alone the stage.  I’m glad we more than filled the planned parade route to the point where they had to improvise a new route.  It was so big we crashed the cell networks for hours. I’m glad that while were were packed in bodies pressed against bodies, as far as the eye could see, when someone called out that someone who was feeling ill or in a wheelchair was coming through, the crowd parted and formed a path.

I’m glad the crowd chanted chanted “my body my choice” and then men in the crowd responded “her body her choice.”

I’m glad the crowd chanted “black lives matter” over and over and over.

I’m glad I saw a “water is life NoDAPL” sign and wish we had picked up that chant, at least in the small section of the march I could see or hear.

I enjoyed the signs with pictures of uterus with an ovary giving the finger with one of its follicles. God knows we need a smile. I also appreciated the reminders from other signs that being a woman is not defined by ovaries, and from signs reminding cis-women to stand in solidarity with our trans sisters.

Overall I found the language that borrowed from trump about “small hands” and “pussies” momentarily amusing, and then unsatisfying.  Any conversation that is based on his terminology will by definition be shriveled and stunted.

I’m glad I can still read enough Arabic to sound out from the NARAL stickers that the Arabic word for feminist is more or less “nisawiyeh,” which makes sense. And I felt a flash of pride and nostalgia to see “פמיניסטית” in hebrew on those stickers.  This is what intersecting identities feels like.

I saw brewing and building strength a movement based on compassion and supporting one another rather than the trumpism where the rich steal from the poor and the powerful devour the powerless.  I saw it in the gentle ways that no one pushed and people made room for eachother. I saw it in the diversity of signs and chants.  I saw it in the old people marching with canes and signs demanding a better world for their grandchildren. I saw it in the hand lettered sign of a seven year old proudly declaring herself the “black daughter of immigrants.” I heard it from the Maya Angelou and Audre Lorde quotes that appeared again and again on signs like background music.  Trump is the last gasp of the old world and those of us who have been in some ways complacent are rising up and tearing down what he represents.

After 4 hours of rallying at 2 more of marching I ended with a full heart and a migraine from thirst and hunger and exhaustion.

Worth it.

Swimming with the fishes, yoga with Egyptians

“Tishmori al-atzmekh”.  Take care of yourself, pleaded the grizzled border agent at the Taba crossing, who I had never met before, calling my by the diminutive version of the name he read off my passport, the same nickname my father called me when I was little.  I was speaking on behalf of our group of four American students, which as a sort-of Hebrew speaker, sometimes smooths the process, particularly when the friends I’m travelling with are not white.  And being a sort-of Hebrew speaker who looks passably-Jewish puts me, for the moment at least, on the “inside” of Israeli society, despite the American passport I just presented, and the guard is worried about me in a way that he is not worried about my friends, maybe I remind him more of his own children, or maybe he thinks I am more or a target.

We turn off the Hebrew as soon as we cross, saying “marhaba” and “awfan” instead of “shalom” and “slikha”.  The owners of the camp on the beach where we are staying pick us up from the crossing, so they know that we came from Israel, but we play down the connection, present ourselves as tourists rather than students who have been there for multiple years.

At the camp, we relax, we snorkel, we curl up on the cushions reading our medical school books, and then, drawn back to the otherworldly universe that is the edge of the coral reef, we snorkel again.

Our second morning, a young man in green pants and perfect English with an undefinable accent, is walking around inviting people to a yoga class that he will be giving at 9:30.  One of my friends and I decide to go, and a few other women show up as well.  His name, he tells us is Ali, and he just got back from a month-long yoga retreat in Rishikesh, India.

It’s a good class, he has a good perspective on yoga, he seems to have internalized that it’s not a competitive sport, and his corrections are subtle and helpful.  It was a beautiful place to be doing yoga, on the sand, with the sea in front of us and the mountains rising up behind us, but the heat began to overwhelm people and we cut slightly short at the end.

Afterwards, my friend and I are speaking with him.  He says he is from here- from Egypt.  I mention that I haven’t been to Cairo but I want to go.  Ali is surprised- how did we get here if not from  Cairo?  We tell him that we crossed from Israel at Taba.  He asks us what Israel is like.  “There’s a lot of  . . . security,” says my friend.  I don’t want to blow our cover, even though I feel safe, but I also feel protective of Israel, defensive maybe.  “It has a lot of sub-cultures,” I say.  “You can go from a more traditional Bedouin community, to a very religious Jewish community, to a secular, modern one, and sometimes it’s all a bit mixed together.”

“And people are a bit aggressive,” says my friend.  “It’s true,” I said.  “They get in your business, though sometimes they mean well.  Like, an old man yelled at me a few days ago for not wearing a sweater, even though it wasn’t cold.”

Ali laughs.  “My grandfather would do something like that.”

I asked him what Egypt was like these days.  He told us that they had gotten a new monarchy in place of the old one, but now that the people had woken up, they would not stop fighting until there was a democracy.  He told us that he had gone to India to find himself, or to first lose himself, and then find himself.  He reminded me then of just about every Israeli I had ever met.

My friends and I went snorkeling one last time, and then headed in to shower and pack and travel back to Israel.  At the crossing, my friend expresses the hope that she doesn’t get the extra-special-for-non-white-people-interrogation that she got on her way back from Jordan.  We are behind a very large group of tourists, but eventually we get to the passport check, where I speak on behalf of our group again and there are no problems.

Then we are putting our bags through the scanner, and my checkpoint karma catches up with me, because my backpack is pulled off the belt, and I am asked to wait.  My friends go on ahead, anticipating that I will catch up at the border control station where I will pass through more easily than them.  I ask the guard why my backpack was pulled aside, and he tells me it’s not suspicious.  “Then what are you looking for,” I ask?  He says he is just looking.  And he looks through the wet towel and bathing suit balled up on top, and then through the overabundance of medical textbooks that I brought, leafing through them and shaking them out.  He then runs my bag through the scanner again, and clears me to repack in and go on.

In the meantime I had been talking with a Filipina tourist who’s own overabundance of souvenirs was being examined by the guard.  I told her that one of the friends I was traveling with had just come back from a medical student rotation in the Philippines.  She asked me if he had liked it, and I told her that he had said that his host family was very welcoming and had fattened him up.  She laughed, and I wished her a good trip in Israel.   I don’t say that I hope strangers don’t try to hire her to clean their floors or change their grandparents’ diapers, as happened to a few of my Asian friends here.

At the very last passport check, I was behind a Palestinian-Israeli family.  The border guard took the passports from the father, removed the tickets, and sent them on their way.  When it was my turn, he looked at me and asked me if anything had happened to me.  I was a bit sweaty and disheveled, but only from travelling.  I didn’t think I looked as if anything had happened, and he obviously wasn’t asking everyone that, he was just picking up the thread of Israeli border guards worrying about me.  “I’m fine,” I told him, and headed out to where my friends were waiting for me in the sun.

Election Night

The day the news broke
we awoke in sick confusion
to the crash.
The American dream overturned,
ran off the moral arc’s rails,
and knocked our dreams askew
from their foundations.
Who are we to stand?
Jerusalem fell, and Athens
is pillaged for museums.

The day the news broke
An ancient beast stirred,
and sniffed the air.
My atheist brother read
aloud the book of Job
and no one answered
from the whirlwind
which raged inside us.
A gray rain fell
and the wind blew.

The day the news broke
I planted winter peas
in the dark crumbled earth
behind the home I don’t own,
under the usual Baltimore light
of police helicopters
and the waxing
half-moon.

The day the news broke
a cold rain fell
on new seeds.
They stirred, swollen,
pregnant with nitrogen and possibilities.
They stretched out roots
into a darkening world.

bats

i jot down notes
in the language of the heart
to recite back to myself
when i’ve forgotten how to hear
its steady whisperings.
i leave in the dark
fly through clattering tunnels,
walk through concrete forests.
I repeat poetry behind strip malls
and return home in the dark.
i’m a bat, chirping to hear
where i am, chirping,
to hear who i am.

I wrote this last year, but I’m starting to feel this way again.  its long dark days at the hospital again, solid weeks without sunshine again.  better camaraderie than last year, but still navigating life and death and sickness and pain without time to reflect, time to feel, time to be present.  thank god for friends who restore the soul on the weekend.

An incomplete list of people who should not be surprised . . . .

-Supporters of Palestine, when all the French Jews make aliya and, convinced that all Arabs want to kill them, and join the ranks of the angry and paranoid.

-Israelis, when the Bedouin in Israel stop going into the army, and demand en masse that their villages become part of the future state of Palestine.

-Israelis, when Hamas has a surge in popularity now or very shortly.

-Palestinians, when people in Sderot cheer and drink beer while watching bombs fall on Gaza.

-Israelis, when Palestinians give out candy to celebrate a successful attack on Israelis.

-Moderate Israelis, when they realize how much irreparable harm is being done to their own country by the daily mobs of fascist Jews beating up Arabs and leftist Jews.

-The current Israeli government, when no one takes seriously their claim that they care about Palestinian civilian lives at all.

-Anyone, when the results of this carnage prove startlingly ephemeral, except for a bit more grief and hatred in the air.

What’d I miss?