Intimate Wars (7 page)

I held her hand tightly in mine as I listened to her nervous staccato breath. I kept her talking to help ease the discomfort of the dilators. I locked her eyes on mine, breathed in rhythm with her, joined with her to the point of personal discomfort. In the end, I do not remember a word of what passed between us. It was strangely irrelevant. But I do remember her face. And I remember her hand, the hand that came to symbolize the intimate, personal connection of one woman
helping another, the gravity of forging a natural alliance with that woman and the thousands who followed her.

That understanding was to come to me later—much later. That day there was only that woman, her fear, need, pain, strength, vulnerability, and hand. Every day brought new connections, new discoveries. We held sessions on Tuesdays, Fridays, and Saturday mornings. I always arrived at the clinic early to start setting up the session before the patients arrived. While my classmates spent their Friday nights on dates or at the movies, mine were spent waiting until the last patient had left the recovery room before going home, sometimes as late as eleven at night, and rising again at six o'clock on Saturday mornings to get to the clinic in time for our weekend session.

I knew from my first week on the job that occupying the same space as the HIP doctors was going to be a challenge: they didn't want to share. Flushing Women's had staked out a territorial claim to the HIP group and I immediately had to defend it. The allergist who used the exam rooms during the day seemed to drag out his sessions as long as possible so that our patients had to wait until 7 p.m. for procedures that were supposed to begin at 5 or 6 p.m. Another physician stormed in during an abortion procedure and disdainfully threw the patient's clothes on the floor, ordering us to “get these damned abortion patients out of here.” These shocking attempts to make us feel unwelcome ushered me into the world of medical politics, where, I would learn, abortion providers were always shoved to the lowest rung of the ladder. I found ways to create small pockets of care and safety in an inhospitable environment.

After a few months, the New York City Department of Health, which had jurisdiction over all abortion providers in the city, sent in surveyors to review our facilities and practices. Our clinic was relatively small—we were only seeing
five or six patients per week at that point, and charging seventy-seven dollars per procedure—but with so many patients traveling from out of state to have abortions, New York took extra care to inspect every single facility. Flushing Women's was sterile and safe, but the inspectors took note of our meager six hundred square feet of negotiated space. I watched their faces tighten when they noticed the cots in the hallways.

Never having experienced anyone questioning his medical or operational judgment, Marty found their presence to be an intrusion and a violation of his privacy rights as a physician. He was arrogant. He hadn't yet realized that his doctor-as-god armor was penetrated the moment he took on abortion.

We could have listened to the critiques of the Department of Health respectfully and asked for time to work it out, but the inspection quickly deteriorated into a power struggle between Marty and the surveyors. A week after their visit, we received a long list of deficiencies. We were informed that our clinic would be closed down until they were corrected. Marty was furious. “Who the hell are these civil servants to tell me what to do?” he ranted. He felt that the report was unfair, and that keeping the clinic open might not be worth the hassle.

Not having a doctor's ego to defend, I wholly disagreed. Close Flushing Women's down? We'd just gotten started! Here was the first real challenge to the survival of this nascent project that I was beginning to call my own. I was already too invested to give up so quickly. The Department of Health's survey was simply a report card we had failed. I was a good student; I was determined to get an A.

I read the Department of Health's report until I had it memorized, then made an appointment with Dr. Jean Pakter, the head of the Department of Health, to discuss solutions. I wanted to understand exactly how I was expected to correct
the deficiencies. She was responsive to my earnest questions and obvious determination to fully meet the requirements.

During the four months that Flushing Women's was closed, Marty was again promoted to the position of medical director of a larger HIP group on Kissena Boulevard—one whose physical space, I pointed out to him, answered the environmental deficiencies in the Department of Health report. Marty would be too busy with his new responsibilities to devote much time to Flushing Women's, but I convinced him that under my direction the clinic could rent basement space at this new medical group and work on getting appropriate staffing, beds, and medical equipment to address our programmatic weaknesses. Most importantly, we could reopen.

After moving to Kissena Boulevard and working out a plan of correction, we were once again inspected by the Department of Health. This time, we passed.

 

I WAS STILL going to school and taking classes between clinic days. I had graduated from Queens College Phi Beta Kappa and entered a graduate program in social psychology at the City University of New York Graduate Center. In college I had been distanced from my peers by my age and personality; in graduate school I was distanced from the other students due to the fact that my time outside of school was spent operating an abortion clinic. It didn't bother me, though. I wasn't in school to make friends.

I encountered a hurdle early on in the program: I failed a statistics class. I went to the chair of the department requesting permission to retake it later in the curriculum, but he refused to give me any leeway. Not having any real option of another PhD program, and thinking that I was destined to fail, I decided to resign from the doctoral program. With
a great deal of sadness and anxiety I carried my resignation letter with me to give to the chair of the department. When I got off the elevator on the eighth floor, Dr. Stanley Milgram, the star professor of the PhD social psychology program, was there waiting in the director's office. Somehow he had gotten word that I was coming to see the director with my resignation, and even though he was not a professor of any of my classes, he decided to get involved. Sitting conspiratorially opposite me, he shared that he had also had difficulties with institutions, having been initially rejected from Harvard's doctoral program. Then he leaned forward and whispered, “I have a secret to tell you: I also failed statistics.” As I laughed in amazement at his revelation he went on to say, “All the really creative people have trouble with math.” After we spoke, I tore up my resignation and decided to go to summer school to finally master statistics.

I viewed Flushing Women's as an extremely interesting project, a world I was creating with Marty, but I did not see it as a life's work. It was not a profession, it was not a skill, it had no name or institutional reality, no well-worn steps of ambition. I'd always imagined a life of music, psychology, philosophy, disciplines with thousands of years of history and structure. And here I was in an untraveled medical landscape that had only just come into being.

Yet even after Milgram's encouragement to persevere, the theories and critical texts with which I was engaged at school were failing to hold my interest. I completed the course work for my doctorate in psychology, but I lost momentum before writing my dissertation.

I applied to a few law schools and was accepted by Ford-ham and Adelphi. Law would be straightforward, lucrative, and impressive. I went to my uncle Louie, a lawyer, for advice. He laughed in my face, telling me that a woman could never
amount to anything in the law and how he would love to have his son, also an attorney, “wipe the floor with me” in a courtroom. Of course I knew he was wrong—if I wanted to, I could be an excellent attorney—but the conversation left me disgusted. I tried to picture myself as a lawyer, but the truth was, the advocates and attorneys I met in my reading were usually tools of the state attempting to bring down my heroines. They were always on the wrong side.

As part of my psychology studies I had done an internship at the Creedmoor State Mental Institution. I'd seen a little boy banging his head against the wall, another playing with feces. A staff member pointed to a child and told me she had never spoken a word. All I could do was observe them, my power confined to the limited interactions I could have with the children as a student.

I contrasted that to my role at Flushing Women's, where I would stay with each patient through her abortion, taking the rings off my hands and putting them in my lab coat pocket to avoid the pressure of their desperate, clutching fingers. I would see the patients again when they came back for their follow-up exams. I knew most of them by name.

A fifteen-year-old patient I had recently counseled had been terrified of telling her mother she was pregnant. I'd spent almost two hours with the mother trying to help her connect to her daughter, to break through her anger, until finally she began to cry in front of me, saying, “I had her when I was fourteen. I just don't want her to go through what I went through.”

When it came time to pay the tuition for my first semester of law school, I realized I could not leave the clinic, not for law. Not, I knew, for anything. Flushing Women's had become a living organism, almost a part of me. Leaving now would be tantamount to abandonment.

AFTER THAT, I stepped into my self-appointed role as executive director of Flushing Women's without looking back. I signed up for night classes to learn business, management, and finance skills. I learned about gynecology and abortion, set nursing schedules, met with city and state representatives, and argued with the doctors at the HIP group who harassed me with their anti-abortion sentiments.

I was in charge of a staff that included a full-time front desk receptionist, two counselors, two doctors who worked on a case-by-case basis, and three part-time registered nurses and licensed practical nurses. To many of the employees, I was the symbol of a radically changed world. I was young, I was a woman, and I had no medical training. The idea of a person like me running a clinic turned their concept of the medical world on its head
.

By the age of twenty-six I was hiring and firing physicians. Much to their chagrin I “auditioned” my doctors, staying in the operating room while they performed abortions so I could assess their interactional skills with the patients. The doctors cared about their patients' well-being, but they resented my position of power. They were comfortable with women as nurses, handmaids in the surgical suite, but the very idea of a young woman telling doctors how to handle patients, influencing their financial lives and time, was anathema. They could not get used to being under my jurisdiction, and when there were conflicts they would appeal to Marty. As a fellow member of that elite male club, he was able to smooth their ruffled feathers. He never allowed them to undermine me, though. He made sure they knew that my administrative directions were to be followed.

The nurses and counselors posed a different kind of challenge to my authority. There was no room for me to have my own office, so I set up an executive director's desk amid the
nurses' station and recovery cots. I knew I wouldn't be able to run the clinic efficiently unless my staff took me seriously, and since I had no physical area I could use to enforce professional boundaries, I had to firmly demonstrate that even though I was young and inexperienced, I was in charge. But some of them made it clear that they resented my position in the medical hierarchy, their lack of respect palpable with every interaction. They weren't going to accept my authority so easily.

I'd wanted power, and now I had it, but I had no idea how to wield it effectively. I found that the very notion of women having power was difficult for many of my female staff to digest. Many had adopted the popular belief that power in and of itself was oppressive and destructive, regardless of who had it. Others thought women in positions of authority should use their power differently from men. When I conducted interviews for new employees, I asked each candidate how she felt about the concept of power. Extraordinarily, each and every one of the applicants, even those for supervisory positions, said almost the same thing: “I don't want to have power over others, I want to empower others.” I would run up against this particular female hesitation about power for years to come.

A few of my staff, wanting to employ the egalitarian concepts of the times, told me they felt that the clinic's atmosphere was too traditionally medical, and that the white coats might be off-putting to patients. We were all equal, so why did medical personnel have to differentiate themselves by their dress? I decided to conduct a pilot study on the issue to put their ideas to the test. I made up a questionnaire that I gave to patients asking about their attitudes on medical uniforms. The results were significantly skewed toward a preference for professional dress in white coats. Patients needed
to feel safe, and the traditional white coats helped them to do so. In a world where most women were afraid that having an abortion could kill them, many had never been to a gynecologist, and there were no sexual education classes to teach people how their bodies worked, power—the power that came with knowledge, expertise, and experience—was something to embrace, not reject.

Still, my employees expected me to embody all the alternative superior qualities that women with power would ideally have: sensitivity, openness, and leniency. Wanting to be liked, I decided to try to meet their expectations. Perhaps that would earn me their respect.

I took them to dinner, listened when they confided in me about their personal relationships, helped them to analyze their dreams, and offered sympathy when they spoke of their stress levels. If people needed extra time, they got it. If someone was late, I often overlooked it. Every decision was individually negotiated. Never feeling quite satisfied, my employees began expecting more and more from me on a personal level. I felt guilty when I could not grant a specific request, and this general empathizing led to my feeling more and more responsible for their happiness.