I could very easily skip over the story of working for the Johnson Country Health Department as a Family Planning Counselor. But it is a part of my story. The lessons learned from the job were not only eye opening but a great lesson in compassion for people that were less fortunate than I, people I either ignored growing up or that I didn't know existed. In all honesty I jumped at the chance to do it knowing it would look good on a medical school application but I gained far more than that.
The job consisted of doing pregnancy testing, screening for sexually transmitted diseases, birth control methods and abortion counseling. Roe vs.Wade had passed in 1973 on the issue of laws that criminalized or restricted access to abortions. In 1979 the view of sexual morality had changed drastically from what I grew up with in the era of "nice" girls were not supposed to be sexually active until they were married. I knew nothing about sexually transmitted diseases but there were memories of girls getting pregnant in high school and of course, the hint of what an abortion was from the story I wrote titled Family Secrets, 6/13/18.
A county health department offered services to the segment of the population that does not have a doctor, does not have insurance and can not afford a visit to a doctors office. They also have clients who may not want to go to a family doctor for reasons of privacy. Beyond female services they also offered Well Baby Clinics, vaccinations and other services for the entire family. Services were conducted on your ability to pay or free if you could not afford any medical care. Nurses were in charge for most of the services with doctors scheduled in at regular intervals as they were when I was a volunteer prior to the time I took the part time job.
The term Family Planning I found out was not exactly what the job entailed. There were few discussions with anyone as to how many or when a client should have children which to me was the proper use for the term family planning. It was a steady stream of pregnancy testing and breaking the not so good news to women - correction - children that they were indeed pregnant. There were not many times when I gave out the news that someone was pregnant that they could not wait to spread the news to family and friends. Most of the time there were no husbands or even boyfriends they wanted to rush out and tell. There were a lot of tears. These were the nightmare stories that still haunt me.
One day a thirteen year old girl arrived in my office with her mother. The girl did not even look thirteen, skinny, not very clean and very scared. Her mother who I have always referred to a "toothless wonder"
wanted a pregnancy test for her daughter. Upon the news that the child was indeed pregnant the girl could not even comprehend what that meant. The mother boasted to me that she had her first child when she was fifteen and could see nothing wrong with her daughter being pregnant. The "toothless wonder" had multiple children by multiple men and thought a pregnant thirteen year old girl was fine to have a child and would not hear anything about terminating the pregnancy. She even declined signing the girl up for the prenatal clinic. I gave the girl my card with my home phone number on it in case she needed someone to talk to but she had said nothing during the entire clinic visit so I knew I would never hear from her.
Sadly to say there were many just like her. Some came in without their mothers with that same scared look in their eyes. There was only one clinic that performed abortions for the health department and it was in Topeka. They charged three hundred dollars which was more money than most of these girls could imagine plus there was usually no way for them to get to the clinic. The really sad part of the whole scenario is that most of the girls who came through my office came from homes that were not the best for love and attention. Some dude would come along, pay attention to her, throw out the word "love" and the girl would do anything to keep that attention. The dude would then disappear leaving the girl devastated and more often than not, pregnant.
There were grown and supposedly adult women who already had more children than they could care for that used abortion as a means of birth control. What do you do about them? It was difficult to hide the anger I felt but at the same time it was not my job to preach to the masses. The best I could do was to give them a referral for an abortion along with a suggestion they used another method for birth control. It was better to think that perhaps an abortion was better than bringing another child into what seemed to be a vicious cycle.
By far the saddest case I remember was a seventeen year old couple that came in together. They were seniors in high school from fairly affluent families that had been dating along time. Both had plans to go to college on academic scholarships. They came to the health department for a pregnancy test so the family doctor would not know.
By the time I had to tell the girl she was pregnant we were all in tears.
Both were Catholic and abortion was not something they could do but at the same time how do they tell the parents? This scenario has probably played out millions of times in history and no one can answer this question except the couple themselves. I don't know what happened to them but the three options they had was to have the baby, have an abortion or commit suicide. Each alternative was not good in it's own way.
My boss, Frances, and I had lots of talks about the fact I would come out of my office at times in tears. She always told me that there was nothing wrong with that as I may have been the first person who ever cried over the plight these girls were in. She wished she could cry for them but through the years she had just become a little hardened with story after story. Francis understood that after three months at the health department I could no longer take the agony and the frustration of not being able to change the morality of the world. I just could not take the constant sadness of the thoughts and nightmares that haunted me everyday.
I hear all the pro and con arguments today on the subject of abortion and I understand them. I myself could have never had an abortion but as a doctor I could have performed one in a New York minute. I see on the news or read in the paper everyday the heartbreaking stories of children being abused, starved to death or killed by a family member and I think of all the clients who passed through my office. Who was there to defend or to raise all these children who were not welcomed into the world in the first place? The sad part was that this was not a new problem but one that has been occurring since the beginning of time. Perhaps one day there will be answer.
I learned a lot in those three months and as hard as the lesson was I have always been glad that it made me realize that everyone was not as lucky as I. There have been many times that in reflecting back on that experience made me think of my mother's favorite saying which was "There but for the grace of God there go I". I also realized that if you haven't been in the trenches you simply have no idea of what it is like.
Sorry that this story is not one that made you laugh or one filled with my usual crazy antics. We will get back to those next week. This story is one I had to tell as it had a profound effect on my view of the world and gave me a greater sense of compassion for others.
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