And Carry On

I hate the Keep Calm memes. It isn’t just that I don’t like the choices, flippant or worse, of words used to finish that sentence–although I won’t soon forget eating dinner with my family at our local pub about a week after Sandy Hook and finding ourselves at a table next to a couple sporting matching tees that read “Keep Calm and Carry Guns.” It frustrates me that people can’t be bothered to google a little bit of history. If you aren’t aware of its origins, the now iconic Keep Calm and Carry On poster is what the British Ministry of Information was secretly holding in reserve to be used for morale-boosting after its people were conquered by the Nazis. You know, after Hitler had bummed everyone out by executing his plans to do things like publicly hang the royal family, and kill off British children with disabilities, and punish non-whiteness and non-Christianity and homosexuality with life sentences to be served at concentration camps. Thinking about the intent of that poster still has the ability to hurt my heart a little, knowing how frightening that time was, when it wasn’t clear that right would prevail, or that anyone would ever be safe again. I wish it commanded more respect.

I find myself thinking about the sentiment behind the original Keep Calm posters the morning after the shock of this presidential election. Let me stop you there, I’m aware that Donald Trump has not, to date, perpetuated a genocide, and I am not comparing him to Hitler. Among other reasons I don’t care for argument by analogy. But do I listen to my elders, who were there for the Second World War, when they tell me they’ve seen this before? You bet I do.

There is an elderly man who lives in my neighborhood, and with whom I sometimes chat at the bus stop. I don’t know his story, only that he appears to be in his 90s and speaks with a German accent. I imagine he has seen a lot. So it chilled me when, several months ago after violent conflict at a Trump rally in another state, my neighbor told me in tones of deep resignation, “That is the end of democracy.”

Being American doesn’t mean the same thing to me today that it meant yesterday. I am disappointed, and I am afraid. I am afraid for democracy, and for peace, and for myself, and for my countrymen, and for my country. I’m pretty sure Donald Trump and his supporters have no plans to hang the first family…but I’m not that sure. I don’t think the president elect cares one fig what happens to children with disabilities, queer Americans, immigrants, Muslims, or Jews. If he doesn’t actually want to kill the people he despises, well, he doesn’t care enough to defend our lives either.

And I’m angry at myself. I’m angry that I didn’t realize that I was living in the middle of a battleground state. I should have been the last to underestimate the racism of Wisconsin’s white people. They are my patients, and they tell me all about it. From the mom wearing confederate flag nail art in her child’s hospital room, to the man who confides in me why he won’t rent to Mexicans, to the granny that tells me she isn’t racist she just doesn’t care for black people because she can’t stand laziness. Mostly I am angry that I vanished up my own behind worrying about getting into a residency and I let that and the other stresses in my life distract me from the work that needed to be done. I owe amends.

Today, as we grieve, there is nothing else to do but carry on.  I think Jay Smooth puts it best when he says, “We come from a tradition of resistance. Just as surely as America’s history is the story of…hate, it is also the story of our resistance.”

Though it’s not sufficient, as a future pediatrician I’m responsible for carrying on with the training that will allow me some small power to protect children. Children with disabilities, children who survive abuse and neglect and violence, children living in poverty, children in danger of being separated from their families by deportation, children traumatized by discrimination of all kinds.

I’ll leave  you with a different British propaganda poster, one that was printed and circulated during the worst violence visited on the British people:

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That Time Prostitution was Decriminalized in Wisconsin

In his unpublished autobiography, David S. Rose recalled that one of his first orders of business on being elected mayor of Milwaukee in 1898 was to set up an official red light district. “I started to make an investigation,” he wrote, “And ascertain what would be the best and safest policy for society, for the rising youth, for the suppression of crime.” Mayor “All the Time Rosy” was a Democrat and a machine politician, more or less Wisconsin’s analog to Tammany Hall, and arch enemy of Progressive “Fighting Bob” LaFollette, who is more or less Wisconsin’s patron saint.  Rose instructed the chief of police to pursue a policy of containment: sex commerce inside the boundaries of the River Street district would be ignored, and outside it would be fiercely prosecuted. The city flourished, Rose remained popular for decades, and Milwaukee grew its reputation as an “open town.”

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Milwaukee Mayor David S. Rose (source: Milwaukee Historical Society)

Milwaukee was just one of many U.S. cities that decriminalized prostitution in the late 19th century, usually in the name of two things: preventing venereal disease, and protecting children. I say decriminalized rather than legalized, because it was not, in fact, ever legal to exchange sex for money. Rather enforcement became selective and strategic, to keep the sex trade regulated and geographically isolated, not necessarily in that order. Towns and cities all over Wisconsin tried some version of the decriminalization experiment until the rise of the Progressive movement turned the tide of public opinion against the regulation approach and toward a policy of abolition. Today we know about the “segregated vice” system mostly through the work of the Progressive reformers that dismantled it. In May of 1913, the Wisconsin State Senate passed bill, “to provide for the appointment of a committee to investigate and report on the subject of white slave traffic, and kindred subjects.” The committee would come to be known by the name of the State Senator who chaired it as the Teasdale Vice Committee. From 1913-1914 the Vice Committee deployed undercover private investigators throughout the state, to report on the true status of the segregated districts in Wisconsin.

Abraham Flexner, who is best remembered for importing the European system of medical education to the U.S. (and let me tell you it’s been slow going trying to get U.S. medical education to relinquish Flexner’s curriculum), was also an anti-vice reformer. He wrote in 1918, “Regulationist and abolitionist are absolutely agreed that prostitution exists and on a vast scale; that it is infinitely damaging; that something must be done about it. They disagree only as to what that something must be.” Those in favor of segregated vice districts and those opposed to it were equally vehement in their condemnation of commercial sex and their dire warnings that prostitution was a threat to decent citizens everywhere. They used the language of infectious disease to describe the sex trade, and they addressed it with policies that used the tactics of the burgeoning field of public health. “Regulationists” tried to quarantine prostitution, while “abolitionists” tried to eradicate it with both treatment (prosecution) and prevention (sex education). Continue reading

Wisconsin’s Strange History of State-Sponsored Sterilization

“It would be a rare phenomenon if the progeny of two mentally deficient parents were not likewise deficient. Yet in every state there are hundreds such in the pauper class free to bear children of whom a large percentage are certain to have criminal tendencies, murderous proclivities or vicious social traits. The public expense and private property loss they cause is beyond computation, and their presence at large is a menace that grows with the spreading branches of their family tree. What’s to be done?  ‘Well’, says Mr. John Average Public, ‘Why not try a safe and sane compulsory human sterilization law conservatively administered as in Wisconsin?’”

Frank C. Richmond, State Director of Psychiatric Field Services, 1934

The Law

People tend to be shocked when I tell them that the last state-sponsored sterilization in Wisconsin took place in 1963. It gives one a lot of cognitive dissonance imaging that some surgeon could have performed a coerced salpingectomy one afternoon and then popped over to the cinema to watch The Birds.  But so it was, and the law that permitted such operations actually stayed on the books until 1978. Although estimating the exact number has proven difficult, between 1,500 and 2,000 people were sterilized by the state under the Wisconsin Sterilization Act.

The passage of the act in 1913 was a victory long in the making for proponents of the practice of eugenics.  Wisconsin prided itself on using science to guide state policy, and eugenics was endorsed as science by representatives from the University and beyond. Writing a half-century later, Rudolph J. Vecoli documented in fascinating detail how “the congruity between  the eugenic doctrines and  certain aspects of the Progressive mentality,” including the Wisconsin Idea of connecting university and government, folded neatly into the creation of a law to restrict the freedom of its citizens to reproduce. Nonetheless in the early years of the 20th Century sterilization remained controversial and politically risky.  A law preventing the unfit from marrying had been passed in 1907, but it was unpopular and fated to be overturned in the courts the following year.  In the intervening years, two bills that would have codified state-sponsored sterilization had been defeated in the legislature. The 1913 bill succeeded in part because it was promoted as a conservative approach that would not take the extreme measures that had been seen in other states (then as now, a lot could be achieved in Wisconsin politics with by rallying around shared distaste for Illinois).

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Education poster from 1926 (source)

Wisconsin was the eleventh state to legalize compulsory sterilization, but it was not the last.  Thirty-two states passed sterilization laws in the 20th century, and five more generated a historical record of involuntary sterilizations without the blessing of the legislature. Wisconsin is an instructive case precisely because it kept the scope of its sterilizations narrow.  While other states defined the unfit broadly or loosely, and some used sterilization as a punishment for criminals and sex offenders (in Oregon men could be castrated for having sex with other men), Wisconsin separated the concept of sterilization from punishment.  The law outlined only three conditions that justified it: epilepsy, insanity, and “mental deficiency.”

Wisconsin’s law represents one of the least extreme cases of government regulation of fertility, and as such it is among the most instructive. In his book Breeding Contempt: The History of Coerced Sterilization in the United States, Mark Largent notes that in historical debates surrounding sterilization, “Even the most aggressive opponents of coerced sterilization often set aside some particularly problematic group for the procedures,” and the same might be said to be true today. People with cognitive disabilities are often made to occupy that role of the particularly problematic group for whom an exception might be made to the concepts of autonomy and the right to reproduce, opening a back door to legitimization of coerced sterilization.  Of the three medical conditions made explicit in the law, mental deficiency provided the rationale for surgery in the overwhelming majority of cases, perhaps because it was the most acceptable.  As it was put by one prominent supporter of the law, University of Wisconsin professor of sociology E.A. Ross, “The wedge should have a very thin end indeed. Sterilization should at first be applied only to extreme cases…As the public become accustomed to it, and it is seen to be salutary and humane, it will be possible gradually to extend its scope until it fills its legitimate sphere of application.” Continue reading

Talking about Abortion with my Mother

This is the third time I have posted this week on the topic of abortion, inspired by the proposed ban in Wisconsin on terminations after 20 weeks’ gestation. The following is a transcript of part of a conversation between myself and my mother, Mary Gordon, that took place yesterday afternoon on my couch in Madison. At my suggestion, we sat down to discuss my mother’s personal experiences with abortion, before and after Roe v. Wade, and recorded it for the purpose of sharing on this blog. I have edited it for clarity, meaning that I deleted some instances of um/uh/like and whatnot, as well as a few seconds when our words were inaudible, and a minute or two when my mom’s dog started to whine and required attention. A few hours after we talked, the 20-week abortion ban passed in the Wisconsin State Senate on a party line vote.

Anna: So, thanks for doing this.

Mary: Oh, you’re very welcome.

Anna: I wanted to do this because I’ve been writing on my blog recently about the public health and scientific aspects of abortion, and how I kind of got interested in it partly cause of my public health training and my epidemiologic training. But really if I go back further it’s not like that’s what persuaded me of any of the positions that I hold now, really. Most of us kind of don’t come to them through this like pure, reasoned, theoretical process, it’s because of stories of people that we know, and that’s particularly true I think for people that want to keep abortion legal. And, for me, a lot of my thinking about this has been shaped from talking to older women, talking to women who were alive before Roe. For women of my generation I think there’s a lot we don’t get about it, and it’s easy to miss what it was really like if you don’t talk to older people. So that’s kind of my thinking.

I guess I wanted to ask you to start with what—you’ve been involved in reproductive rights movements a lot, you’re a writer, you’re very vocally and publicly involved, and you’ve had a voice for a long time. What makes you willing to talk about your own abortions now, in ways that you haven’t wanted to in the past?

Mary: Well I think that it was probably your challenging me as to why I wasn’t talking about it publicly—

Anna: I challenged you about that?

Mary: Yeah.

Anna: I don’t remember doing that.

Mary: And I think that one reason why I’ve been unwilling to talk about my own abortions—which is not shame—but I thought that if I said I had an abortion, it would suggest that I was pro-choice in order to justify the position I had personally taken, and I was afraid that that would weaken my argumentation.

Anna: That you’d lose credibility.

Mary: Exactly. And so that’s really why I have been unwilling to do it. And now that I’m older and I think actually my voice isn’t as important, and that younger women are going to have to take the cause up or it’s going to die. Oddly that’s sort of liberating, and I think now’s the time. It’s not that I was silent because of shame, it was because I was afraid of it weakening my credibility. Cause, of the things I’m ashamed of in my life, you know, including not being nice to Joseph Kelly in eighth grade, I have not had one second of regret or guilt about having had an abortion. And I can feel guilty about almost anything.

Anna: Yeah that’s really true, you’re really good at that. That’s really interesting to me, cause I remember when you told me that you had had an abortion when I was about eight or nine, cause I’d seen [something about abortion] on TV and didn’t really know what it meant—I remember that you were really worried that I was going to have some kind of crisis about the idea that you could have had an abortion when you were pregnant with me. Which had like, never crossed my mind. That always stayed in my mind as though somewhere along the line you’d been indoctrinated with the idea that this part of your history was bad for your children.

Mary: Well it’s one of the things that the anti-choice people say, that if your children knew you had an abortion they’d always think that you could have aborted them. So I guess I was afraid.

Anna: I mean I guess I knew you could have, but I also knew you never wanted to. I’ve never doubted my wantedness.

Mary: My point is that even I was susceptible to the poisonous narrative that the anti-choice people are really good at. And you would say I should have known better, but you know “It will hurt your children” is a real hot button.

Anna: Yep. You know a lot of women of my generation, and actually I myself, are taking a tack of moving past the language of pro-choice and anti-choice.

Mary: So what’s the alternative?

Anna: I think the idea of there being a binary, that doesn’t describe most people’s position on the ethics of abortion or the best way to go about enacting whatever they would like to see–

Mary: So are you saying it’s pro-abortion and anti-abortion?

Anna: No, I’m saying that to be in favor of continued legalization, wanting to keep it decriminalized, is a big umbrella that can include a lot of people who have a lot of different positions on whether they think abortion is desirable, undesirable, morally neutral, ethically fraught, always a tragedy—you know, that people have as many different relationships to the concept of abortion as they do—

Mary: So then what language would you use to replace pro-choice and anti-choice?

Anna: I think that the idea would be to move to a place where you don’t describe your position with an identity anymore, you just describe the nuances. Like, you know, Planned Parenthood had the campaign about In Her Shoes, you never really know what decision another woman’s making until you’ve been in her shoes. And just emphasizing that there are more stories out there than you could possibly imagine, and you can’t think of all the contingencies that could lead to someone choosing an abortion. I get the feeling that’s not very satisfying to you.

Mary: No, cause one of the things that the right is better at than we are is buzzwords, and they work. So I’m concerned on that level that In Her Shoes doesn’t really get the message across that you are trying to keep abortion safe and legal. I can understand the reluctance to use the word choice—

Anna: Yeah cause for a lot of women, you know, what actually constitutes choice. It’s not much of a choice.

Mary: Right, but we better work on coming up with something.

Anna: Fair enough. So, can I ask you—one of the things I wanted to talk about today is, I mentioned that from a pretty early age I knew you had had an abortion. I didn’t know until I was an adult that you had had an abortion when it was illegal. So I was hoping you could talk a little about what that experience was like for you. So to start with, how did you become pregnant the first time?

Mary: Well, as you know I’m incredibly fertile.

Anna: Women in our family are so fertile.

Mary: And I had actually had sex twice (intercourse, penetrative sex), but the last time I had had intercourse was maybe six or seven months before I missed a period. So I got pregnant with somebody who had an orgasm on my thigh.

Anna: That’s like one of those stories that I always thought they were making up in sex ed class, that like could never really happen.

Mary: But it did, cause I literally didn’t have sex for six or seven months. And so I didn’t think I could possibly be pregnant.

Anna: Yeah, I don’t blame you.

Mary: But, you know, I did know that I had missed a period, my periods were very regular. I then when to a gynecologist, who said to me “Well you’re pregnant, and if you give me $2,000”—and this was in 1969, and I didn’t have twenty dollars—

Anna: And how old were you?

Mary: I was nineteen, and I was in college, on a scholarship. [He said], “If you give me $2,000, I will arrange for a psychiatrist to say that it would be emotionally dangerous for you to continue this pregnancy.” And I just said, you know, that’s not possible and he said goodbye and good luck. And then, I was a student at Barnard, and at Columbia actually, the Protestant chaplain was helping women get in touch with a network of abortions that were supposed to be relatively safe.

Anna: Was it like the Jane network in Chicago?

Mary: I don’t think so.

Anna: That is to say it wasn’t run by other young women?

Mary: No it was pretty secret, and I actually don’t know who ran it. Just that if you wanted that number, either of you could go Earl Hall. And I got the number. I told the guy who had made me pregnant that he had made me pregnant, and he didn’t believe me. I can’t really blame him, but he didn’t. And it cost $200 and I didn’t have it. A friend of his who did believe me came up with $100, and I had to borrow $10 from everybody else I knew.

Anna: Who gave you the $10?

Mary: All my friends.

Anna: And they were willing?

Mary: Yeah. And everybody was very sympathetic. I had a boyfriend at the time who was gay. But we were very close.

Anna: You knew he was gay?

Mary: Yeah.

Anna: But he was your boyfriend?

Mary: At that time you believed that if you loved somebody enough you could turn them, and he was in therapy and his shrink told him that if we loved each other enough he would get over this terrible disease. In any case, he agreed to go with me. We had to go to a street corner in the Bronx, somewhere in the Bronx, I don’t remember. He wasn’t allowed to come with me. I got in a car with someone I’d never seen before in my life. I had to wear a blindfold. I was brought somewhere, I have no idea where, to an apartment building. We went down to the basement, there were six or seven women sitting there, just in the living room of an apartment, and women would go in this door and then they’d come out looking very white. And we kind of all bonded, cause we were in this desperate situation, we all knew why we were there.

Anna: Who were they?

Mary: I don’t know. They were a big range of ages. I think everybody was white now that I think of it, and pretty middle class. And I had to wait there basically the whole day, it was really pretty terrifying. And we also knew that the cops could come in at any minute, and not only would you not get an abortion but you’d have to go to jail. So it was really terrifying. And finally my turn came, and there was a man, a Latino man, very kind. He said he was a doctor—I don’t know. He gave me a shot of Demerol, and it hurt like hell. He did a D&C.

Anna: So the Demerol was the only pain relief you had?

Mary: Yep. And it really, really hurt. And he kept saying, “I can’t stop, I can’t stop, I have to keep going.” And then it was over. The driver came and put the blindfold back on. My boyfriend had waited in a café or luncheonette for me all day. He took me home in a cab. I went to sleep. I made an appointment to see the gynecologist who wouldn’t help me.

Anna: For follow-up care?

Mary: For follow-up care. He was willing to see me, and not turn me in, which was—

Anna: More than you could get anywhere else.

Mary: And I was fine. Apparently he did a good job, there was no infection. You know, and that was it. But it was pretty terrifying.

Anna: And who supported you through all this?

Mary: All my friends. My one friend [name redacted, they are still extremely close] spent the night with me, and everybody was incredibly supportive and kind. I was terrified that my mother would ever find out because, that would be—

Anna: Right, yeah, with Nana that would be—

Both: The end of the world.

Mary: And she never found out. And I think that just the trauma of it made me very shaky, just what I had gone through made me very shaky for a couple of months.

Anna: Just in general?

Mary: Yeah. At the same time, my gay boyfriend was kind of shoving it in my face that he liked guys.

Anna: The one who had taken you to the appointment even though he wasn’t the one who got you pregnant?

Mary: Right. And that was a trauma. And then it was—there was just a lot of political turmoil in the air. I kind of think I put my energy into anti-war stuff because it was distracting—I mean I cared about it, it was a good thing to do. I was writing poetry, it was my first writing class, I was very very nurtured by my teachers at Barnard, particularly by Jan Thaddeus [Mom’s mentor] who nurtured me.

Anna: Did she know what you’d gone through?

Mary: I wrote about it. We didn’t talk about it, but it was kind of clear from the poetry, which she thought was good. And, I would say—it happened in January, and certainly by the summer I was kind of back to myself. And then I really determined that I was going to get involved in whatever we’re calling it—pro-choice, pro-abortion—and I really think I have been since—that was 1969.

Anna: So you weren’t involved in it before?

Mary: No, I was not.

Anna: Do you feel like that’s what made you get involved?

Mary: Yes. But I brought all my friends with me, none of whom had abortions.

Anna: Did you know other women who had been through it?

Mary: Not at the time. No. Later, I did. But not in my cohort.

Anna: Did you ever consider any alternative to an abortion?

Mary: No, no. It would have been—to have had a child—I thought that giving –If I believed—and I know you don’t think I have a scientific brain, but at least—

Anna: It’s not your brain!

Mary: If I really believed—and I was 10 weeks pregnant–if I really believed that a ten-week-old fetus was a child, I would not have an abortion, I really wouldn’t. And I had enough scientific intelligence to really study and read what the size was, what the development of the brain was, what the ability to feel pain was, and I really didn’t think that it was anything but a kind of advanced birth control. I felt I would never have been able to give a child up for adoption, because that would be a child, and I thought that having brought that life into the world I was really responsible for it. And also the pain of having carried a child to term—I would never have been able to live with giving it away. And if I had had a child it would have been the end of any kind of full life that I could have had. I would have had to go home and live with my mother and not finish college, work as some kind of secretary, and it would have been a life that would have been so radically diminished that I could only see a life of depression and misery ahead of me. The shame would have been, in my community, enormous, but more than that nobody would have helped me go back to school [Mom’s family had always opposed her going to college]. It would have been—now that I look back on it I can say well, maybe when the child grew up I could have gone back to school—

Anna: How many people actually make that happen, though? You have to be a pretty extraordinary person.

Mary: I was on a path that was very important to me and having a child would have meant the end of a fulfilled life.

Anna: And being in school–knowing as much of your biography as I do–being in school wasn’t just about being in school. It was a whole life away from the life you grew up in. It was most of the people who cared about you in the world.

Mary: Yes. And again, if I had believed that the fetus was a baby I would have just sucked it up. I’m very glad that I didn’t. But I think, of the things that I doubt about myself, I don’t think that I’m a morally callous person and I like to believe that I can look at the hard truths. And I’ve never wavered in that position, that early abortion is an absolutely ethically neutral if not an ethically positive choice.

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None of the people pictured here are my mom.

Anna: For the record it’s not that I don’t think you have a scientific brain; I don’t think you have a scientific heart. It’s not the same thing. So then what I wanted to ask you is that you then had another abortion some years later, after Roe.

Mary: Yes.

Anna: One thing that someone told me when I was working with Medical Students for Choice which I found very helpful is that for a lot of people who’ve come up in an identity opposing abortion, very different from the one I grew up in, people don’t really make much of a distinction between legal and illegal abortion. It sort of seems like the same thing. So when I would share pictures from WHO of women who’d had illegal abortions that were botched and their intestines fell out of their vaginas or something like that—the friend who was telling me this was like, “That’s never going to persuade somebody, cause they’re just going to look at that and say yeah, abortion is terrible, we’ve got to do whatever we can to stop abortion.”

Mary: I do remember when I was working on pro-choice things in the early seventies, I was in graduate school, three of us that lived together shared a car, and I did have pictures of women with their intestines coming out of their vaginas which I left in the trunk. And one time this delivery boy opened up the trunk and went “AAAAAH!”

Anna: Oh dear. What did you say?

Mary: I don’t know what I said, I think I just put the groceries in really fast.

Anna: So I wanted to ask you if you’d talk about the experience with your second abortion and how it was different.

Mary: Yes. I had a diaphragm failure with my second abortion. I had a diaphragm in and it did not work. One of the things that I remember is I was able to go to Planned Parenthood in Syracuse, and this wonderful older nurse said to me, “I’ve come back from retirement to help people have abortions legally, because I saw the horror of illegal abortion and I’m so happy to be able to help women to have safe abortions without pain, and I’ve come back to work just to be a part of that.” And there was no terror, I didn’t think the cops were going to come and get me, I didn’t think that someone who could have been a plumber could have been doing the abortion.

Anna: How old were you?

Mary: I was twenty-three.

Anna: And you were in graduate school.

Mary: Yeah.

Anna: Were you in a stable relationship then?

Mary: No. And the person who made me pregnant I thought was about to get into a long-term relationship with me, and then the minute he left me he wrote to tell me that he was actually involved with somebody else.

Anna: The entire time?

Mary: Yep, as well as having given me gonorrhea.

Anna: Ugh, men suck.

Mary: So whereas I was really really traumatized for several months after the first illegal abortion cause I had been so terrified, it was really not traumatic at all.

Anna: What was it rather than being traumatic?

Mary: It was always a little bit sad. You think, gee, I wish this didn’t happen, and I wonder what this would be like—I don’t think anybody goes into –well maybe some people do, I can’t—I certainly didn’t go into it lightly. It was sad, I had to grieve it. I never regretted it.

Anna: How did you make your decision?

Mary: Again I would have – I was in graduate school, I was not in a stable relationship, I was starting a career, and you know I could not have raised—I could not have had the life I wanted to and raised a child. So the differences were really really significant. I felt safe, I felt cared for. Actually this wonderful nurse made me feel like I was doing a good thing. And it was just as easy as it could possibly be, as opposed to being utterly traumatic. Oh also the first abortion was a D&C, and this was an aspiration.

Anna: Do you mean they just used a curette the first time?

Mary: Yeah.

Anna: Gotcha.

Mary: Which is a lot more painful. The second abortion seemed to be a matter of seconds.

Anna: Were you conscious for it?

Mary: Mm-hmm.

Anna: There’s sort of not medical consensus these days about how much pain relief to provide, is the reason I asked, I was sort of curious how they were doing it back then.

Mary: Well, it didn’t hurt.

Anna: So how do you kind of feel about the experiences that you’ve had and how that’s shaped your feelings about abortion?

Mary: I like to think that I would have had the moral imagination to be pro-choice without these experiences, but certainly knowing that I really could have died—I really could have died. And you know, I did know girls in high school, it was Catholic high school, and they were pregnant and they went away and you never saw them again. And you never knew what happened to them. And in speaking to older women, I remember having had a lunch in Cape Cod, four wonderful women, I was in my thirties I think they were in their seventies, and every single one of them had had at least one abortion.

Anna: That’s something that has surprised me as well, is, it’s analogous to what I discovered when I had a miscarriage, and it turned out that a lot of people I knew had had miscarriages and I never heard about it. I found that once you start talking about abortion, particularly—well maybe with any group of women, but particularly with older women, I’m surprised how many never talk about it.

Mary: And speaking of miscarriage, I am a woman who has had abortions, a late miscarriage, and two healthy vaginal deliveries. And I’m telling you, I know what the experience—I had a miscarriage at twenty weeks. It still didn’t seem like a baby to me.

Anna: That’s interesting cause Dad, you know, Dad found that experience so devastating, and to him watching you have the miscarriage, and seeing—for you guys it was really losing a baby—and he didn’t quite use these words but he said that what came out of you really looked like a baby to him.

Mary: But I knew—that was something that I really grieved for a very long time, it really changed my life, the loss of that fetus, baby, whatever it was. But I didn’t name it. It was interesting. I didn’t have the impulse to name it, I didn’t have the impulse to bury it, I didn’t have the impulse to do a ritual around it. I mean I was sad because of the potential, but it would have seemed utterly ghoulish to bury it or name it. I knew it wasn’t a child. And that was interesting to me. Cause I certainly grieved it. But it was not a child. And Daddy felt the same way, even though he saw whatever I didn’t have to see.

Anna: So, you mentioned older women. What kinds of stories have women a generation older than you told you?

Mary: Stories of terror. A bunch of these women had gotten pregnant during the depression, and it was just not possible. I remember being in pro-choice groups with women whose mothers were very lower class and the women were doing it to each other in kitchens, and in really dangerous circumstances.

Anna: Peggy [my husband’s late grandmother] told me this story about how girls when they got pregnant would try to get a job at a bowling alley, because something about having to put up the pins, and with all these balls flying around was supposed to cause a miscarriage.

At this point the recording cut out, but we didn’t realize it till several minutes later. So the last few minutes of our conversation was lost, and we found we couldn’t recreate it after the fact. The last question I asked Mom was what she wished women of my generation and younger would understand. I posed that question to her a second time, and this is what she said:

Mary: What I hope that they understand, although it’s not something that they’ve experienced, is that when abortion is illegal or hard to come by, women die. Women have always had abortions because they’ve always needed to have abortions, for very good reasons. And a lot of them have died. And so you’re never going to stop abortion, you’re just going to stop women’s safety. And if you are concerned about abortion as a moral issue, which indeed you should be, I think it’s important to think that whatever is the nature or ontology of the fetus is pretty unknown, or certainly debatable. What’s not debatable is that if abortion is made illegal or unsafe, women will die. And to stop women from dying is certainly an unequivocal moral good. And I want that to be remembered.


Image source: https://inyourfacefeminism.wordpress.com/art-third-wave-feminist/

The Incredible Story of Gertrude B. Elion, Mindbogglingly Awesome Lady Scientist, Inventor of a Cagillion Lifesaving Drugs, and Mensch

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Image via Brittanica.com

Sometimes when I want to think of happy things, I think of the fact that Gertrude B. Elion existed. I am talking about a legendary figure here, so you might not think the world needs a new blog post about her. She got this award you might have heard about called a Nobel Prize (one of only 12 women out of 201 laureates in the category of Physiology or Medicine). She merited her own chapter in The Greatest Generation, and her own segment in Me & Isaac Newton. She even, apparently, has her own posthumous blog? Her biography crops up in lots of places, because when someone wants to talk about the 20th Century’s great female scientists, the A-list is not that long. But when I polled a convenience sample of my friends who were available on gchat at the time, it was clear that none of them had heard of Gertrude B. Elion–neither the scientists, nor the feminists, nor the feminist scientists. So I thought, hey, folks might really like to know her story. It’s pretty amazing.

The contribution for which Elion won the Nobel, along with her mentor and collaborator George H. Hitchings and Sir James W. Black, was a revolutionary method. They pioneered the concept of drug design. In the early part of the 20th century, most drugs were more or less made by starting with a chemical and then putting it inside lab animals to find out if it did anything useful. Drug design, in contrast, starts with understanding a biochemical pathway, and then formulating a substance whose molecular properties change that pathway. As you can imagine, that was a game changer.

Sometimes a team of scientists with a game-changing method can invent a really useful drug. So the first thing you might hear about the team of Elion and Hitchings is that they invented the first treatment for leukemia, specifically leukemia in children. Let me say that again–before the drug 6-Mercaptopurine (Purinethol), all pediatric leukemias were 100% fatal. “Today, as a consequence of the combined efforts of Elion and Hitchings in developing 6-MP,” says this big-deal biochemist, “Most children with acute leukemia can anticipate a remission when the drug is used in combination with two or three other agents…and some patients can even be cured.” The drug was also quite novel at the time in its mechanism of action. It works by interfering with the production of certain types of nucleotide. You may be familiar with nucleotides as the building blocks of DNA, but at the time that Elion and Hitchings made this drug, that was unknown. The drug is still used to treat both leukemia and autoimmune diseases.

I mean, wow, right? That is an achievement that would be enough for any lifetime, letting a person feel secure that she had saved lives and done good in the world. But I’m just getting started, because Elion also helped to invent…

  • The first antiviral drug. Acyclovir is a really important drug in its own right, front line treatment for Herpes to this day. If you are not already aware of what a huge deal it is to be able to treat herpes and to lower the risk of spreading it, let me tell you about a woman I once met who was worried about losing her job because her untreated genital herpes made it too painful for her to sit down. But this is bigger than just Acyclovir. This drug proved that it was possible to kill viruses using drugs, and it paved the way for every existing antiviral medication. Remember how HIV/AIDS used to be inevitably fatal, usually within about two years? And now people with HIV in the US are not only able to live for decades, but have only about a 50% chance of ever dying of AIDS? That’s because of antiretroviral medications, and those exist because of Acyclovir.
  • The immunosuppressive drug that allowed the first organ transplants between non-relatives. So that was pretty important. Azathioprine is also still used for that, as well as to treat autoimmune disease.
  • The anti-gout drug Allopurinol. If you don’t know what a big deal gout is, let me show you the 1799 picture by James Gillray of a devil-monster eating your foot that is legally required to be included in every lecture slideshow about gout:
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    Yeah, gout really hurts. Image via Wikimedia Commons

  • The anti-malarial drug Pyrimethamine, still used. You probably know how important malaria treatment is.
  • Trimethoprim (aka TPM), a component of the front-line antibiotic treatment for urinary tract infections. And if you don’t know what a big deal urinary tract infections are, I invite you to bite me like an 18th Century gout imp.
  • Literally about 40 other drugs. These are only the incredibly famous ones. “Trudy has really revolutionized virtually every aspect of medicine that an oncologist would practice in,” said pediatric oncologist Henry Friedman in this video, “Better drugs, better ways to give other drugs more safely. She’s just changed the entire field. There’s no comparison.”

An image search for Gertrude B. Elion tends to turn up pictures like the one above of her in her later years as a celebrated biochemist, when she looked like your Bubbe. But the picture I can’t get out of my mind is this one:

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Image via Jewish Women’s Archive

That is the future Nobel laureate with her fiancé, Leonard Canter. And don’t they look hot? And so completely in love? Before they could be married, Leonard died suddenly from bacterial endocarditis. By all accounts he was the love of Trudy’s life. She never married. And in one of those ironies of history, not having a husband or family allowed her to have a scientific career that was barred to most wives and nearly all mothers of her generation (if you don’t believe me, go look up The All-Too-Familiar Story of Elizabeth Bugie Gregory, Lady Scientist who Didn’t get Credit for her Contributions to Inventing the First Antibiotic to Combat Tuberculosis). In fact, Elion only got her foot in the door because World War II left a serious shortage of qualified male chemists.

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Image via Sandwalk

The door in question was not the door to Academia, by the way–despite transcripts made of gold, she at first couldn’t get into a PhD program, then later decided it wasn’t worth it. She did all her major drug work at a pharmaceutical company, where Hitchings was working when he hired her. And while we’re talking of Hitchings, let me take a moment in praise of the male mentors of female scientists. I don’t really know much about Hitchings, but in a time when it would have been socially counterintuitive, he was able to perceive the potential in this young person, who lacked both credentials and testicles (and was Jewish–did I mention that?). If he had wanted to steal the credit for her accomplishments as young Elizabeth Bugie’s mentor did, he could have, but instead he helped Elion grow into a star.  I feel, in a way, as romantic about their collaboration as I do about that picture of Trudy and Leonard.

Thinking about Gertrude B. Elion makes me happy, even though it humbles me so profoundly, and makes me want to light my CV on fire. One of the reasons is that she seems to have been such a nice person. It’s something of a cliché that the first women to pioneer any masculine sphere are forced to act “like men”–a term that generally connotes acting “like sociopaths.” But everyone mentions what a good colleague and mentor Elion was, and how kind. Though she never had her own children, she had four nieces and nephews who adored her. And she had a true sense of the social justice aspects of science. As she said in this video for her Lifetime Achievement Award from MIT, “The same thing that inspired me over the years inspires me now. I want to get sick people well. I want to get children involved in science. I want them to have the same kind of excitement and fun that I’ve had, and do something useful with their lives.”

Gertrude B. Elion (1918-1999)

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Image via Academy of Achievement

Lying with graphs is an old game.

Y’all may know that I dabble in the History of Medicine (specifically it’s my PhD minor). Well, today I’d like to either introduce you to or remind you of Benjamin Rush’s Moral and Physical Thermometer chart. If you need a refresher on Rush himself, he signed the Declaration of Independence, but more importantly for our purposes he was like THE preeminent physician of his day–in Philadelphia for sure, and probably the whole of the United States. The thermometer is a figure that accompanied his 1790 monograph, “An Inquiry Into the Effects of Ardent Spirits Upon the Human Body and Mind with an Account of the Means of Preventing and of the Remedies for Curing Them.” The 18th Century was not known for its snappy titles.

I’m posting the thermometer to remind you that just because a person has a chart doesn’t mean he knows what he’s doing. Not only did physicians in general during this period have sod all idea of how to cure disease (“Acne, you say? Try more leeches.”), but the whole concept of empiricism was still kind of cutting edge. I don’t doubt that Rush believed he had objectively and dispassionately observed a continuum of alcoholic spirits, and shown that the more plebeian your booze, the more pernicious its effect on your health. Maybe now is also the time to mention that after meeting a black man with vitiligo, Dr. Rush decided that blackness was a curable form of leprosy–it’s ſcience!

So yeah, you and I know that Rush was talking out of his founding fatherly butt. I know from personal experience that wine causes “puking” just as effectively as gin. But doesn’t that chart make it all look so…measurable? So quantitative? And so precise? Thermometers are objective–surely these measures of social ruin have been as carefully calibrated as a mercury thermoscope. Doesn’t it just make you want to shout, “When will big Egg Rum stop denying that its product causes peevishness?”