The Vasectomy Doctor (18 page)

I believe Ann viewed this move to the large house as something of a mixed blessing. For me it was different of course. It was where I was born and where I grew up. But for Ann there were no such emotional attachments to alleviate the impracticality of the whole thing. She once referred to the house as a ‘glorified wind tunnel', which was probably quite accurate and certainly quite witty. But the house and the unsatisfactory land division that I negotiated with my sister was undoubtedly another nail in the coffin of an already shaky marriage.

A year after moving into Downings we applied to the Eastern Health Board to adopt a child. The screening process for potential adoptive parents was, as it remains today, long, gruelling and personally invasive. It was also incompetent because it failed to unearth the cracks that must have been already appearing in our marriage. In due course a three-year-old boy called Adam was identified as a probable candidate. Adam was of mixed parentage – his father Nigerian, his mother Irish. We took him in and loved him as one of our own. But when he reached maturity he flew the coop and today sadly we have almost no contact with him at all. But sometimes adoption can be like that. Sometimes, no matter how hard you try, adopted children are never quite yours and perhaps this is understandable at a certain level. Adopting is not always the same as natural parenting; at least it wasn't to be for Ann and I. That is not to say that the whole experience was not worthwhile and hugely rewarding in itself. A sad ending but perhaps adoptive parents should not always assume a long-term relationship.

* * *

Robert Brook built the village of Prosperous in 1780. Brook made his money by collecting rents in India – nice work if you can get it. He invested almost a million pounds of his own money in setting up a cotton industry and building the village of Prosperous for its workers. The houses were all to be of brick and slate and each to have enough land to graze a cow. Many of these houses survive today such that, in the old part of the village, you can still easily appreciate the broad Georgian streetscape with its two small squares.

The glory days for Prosperous were short lived. In spite of receiving two grants from Grattan's parliament amounting to almost two million pounds, this massive project never really got off the ground. Brook blamed drunkenness among the workers but the truth in fact may have lain closer to home. For a start the location was wrong and the concept too grandiose. Very little product was ever produced from the cotton mills and the whole venture folded within a few years. The successful battle of Prosperous in 1798 nearly finished the place off for good. Lewis, commenting in 1837, describes Prosperous as ‘little more than a pile of ruins situated in a low marshy spot, surrounded by bogs and without water of importance nor reasonable hope for its revival'. I am glad to say Lewis got it all wrong. Today Prosperous is a vibrant little community with new people moving in all the time. In 1980 I was chairman of the bicentenary committee when, thanks to the creativity of Nan Clark, we had a week of activities ending with the unveiling of a monument beside Healy's post-office. Here we placed a plaque on the wall commemorating Robert Brook.

Soon after these celebrations my father had to have a leg amputated due to gangrene that in turn was brought on by narrowing of
the artery supplying blood to his leg. A life-long habit of over twenty
cigarettes a day had eventually caught up with him in his seventy-ninth year. I went to visit him in the Richmond Hospital the day after the amputation and, while he may have lost a leg, he clearly had not lost his sense of humour. ‘I suppose they'd say that this operation was a great success,' he said to me with an impish grin on his face. He died the next day but I think that he had suffered enough and that it was time to go.

Being the doctor in the family certain tasks seemed to fall on me ‘naturally' and it was left to me to impart the bad news to my mother who was, by then, confined to a nursing home. When she saw the look on my face as I came into her room she instinctively knew and anticipated my sad message. This made my task a little easier and she took the news with great calm and poise. She died herself six months later. She too had had enough.

CHAPTER 9

Contraceptives were totally outlawed in Ireland under section 17 of the Criminal Law Amendment Act 1935. This act makes it quite clear that it is ‘unlawful to sell, or expose, offer, advertise or keep for sale or to import or attempt to import into Saorstat Éireann any contraceptive'. Since neither the birth control pill nor the intra-uterine contraceptive device (IUCD) had yet been invented the term ‘contraceptive' in section 17 is taken to mean condoms exclusively. How such a clearly sectarian statute could find its way into the legislature of a so-called republic is very difficult to understand. Other European countries that once had similar legislation had long since scrapped it. Fortunately for me vasectomy had not been invented in 1935. Otherwise I have little doubt but that it too would have been squeezed in under the terms of this act.

It may be tempting to suspect that the Catholic hierarchy had a lean on the government to keep this legislation in the statute books. But in fact they did not need to overly interfere because they had a laity who were more than capable of doing the infiltrating for them. Deeply conservative groups like the Legion of Mary, the Catholic League of Decency, the Irish Family League and most particularly the all-male and secretive Knights of Columbanus were well represented on government benches and within the medical and legal professions. These were the self-appointed custodians of the common morality and the occupiers of the high moral ground.

Protestantism is a minority religion in the Republic of Ireland. Protestants do not share with Catholics a moral veto on contraception or birth control. So why did Irish Protestants not protest against this blatantly sectarian piece of legislation? I wish I knew.

I suppose one must try to understand the concerns of people at the time even if one did not always share them. Reading
the letter columns of our national newspapers around 1972 and 1973,
it seems many people expressed their opposition to contraceptives in terms of the perceived disastrous consequences of ‘introducing that kind of filth' into Ireland. To further justify these fears they would point to other countries, usually to the UK and say: ‘look at what happened over there'. The principles that one was being asked to take on board were: (a) that Irish sexual morality was superior to elsewhere in the world and (b) one of the reasons why that was so was because there were no contraceptives. The fact that there was not a shred of evidence to support either proposition did not seem to matter.

It was left to a Catholic mother of four, Mrs Mary McGee, then aged only twenty-seven, to take a High Court and later a Supreme Court action against the government in 1973. Mary's contraceptives had been seized in the post by customs. She had a history of toxaemia of pregnancy (a potentially fatal complication that tends to get
worse with each ensuing pregnancy) and was advised not to have any
more children. She claimed before the Supreme Court that by seizing her contraceptives the state was denying her her constitutional right to privacy including marital privacy. A very brave young woman, Mary McGee won her case and this precedent put an enormous dent in the efficacy of the 1935 act to keep contraceptives out of Holy Ireland.

Following this ruling the clause dealing with ‘import or attempt to import' was no longer sustainable. Anticipating this outcome Senator Mary Robinson attempted to introduce a Private Members bill to legislate for the new post-McGee situation but the government refused to even discuss it. It seemed that they were happier to have a deeply flawed prohibition on contraception than to actually face up to introducing laws that squared with the Irish Supreme Court ruling.

The exact same scenario repeated itself many years later when the Supreme Court ruled on a constitutional amendment to do with abortion. This ruling allows for abortion in Ireland where the mother's life is at serious risk but to date no matching legislation has been put in place and I very much doubt if it ever will be, at least not in my lifetime.

So there we were in the Irish Family Planning Association importing condoms to beat the band. The fractured Criminal Law Amendment Act 1935 still prohibited us from selling them so we gave them away for nothing instead and accepted a ‘donation'. Strangely this donation always covered our costs with a decent profit thrown in for good measure. In those days it was all to do with language. The contraceptive pill likewise in theory was prohibited by the 1935 act but we got around this by calling it a ‘cycle regulator' which was very handy.

And that's how things stood from 1973 until 1 November 1980 when the then minister for Health, Mr C. J. Haughey, introduced his inspired Health (Family Planning) Act 1979, the infamous ‘Irish solution to an Irish problem' that made us the laughing stock of Europe if not indeed the whole world. In a nutshell this ludicrous piece of legislation made condoms a matter for a doctor's prescription and they could then only be dispensed by a community pharmacist. Note that under this arrangement, a person seeking contraceptives could not just go in and buy them from a GP or a pharmacist. No, a responsible adult, seeking to exercise his constitutional right to limit his family size, had to make two separate trips to two separate professionals and pay professional fees at each stop.

I felt from the beginning that this piece of legislation was grossly iniquitous, unworkable and a violation of human rights. As a doctor I felt a deep sense of disgust that my chosen profession had agreed to co-operate with this kind of hypocrisy. Also the political cowardliness and the craven way that the proposed legislation seemed to pander to a particular view of morality was, I found, deeply depressing. I strongly felt that if this were the best that Mr Haughey could come up with he would have been better off leaving the thing alone.

A doctor's prescription, or so I was always led to believe, was for serious medicines like antibiotics, addictive sedatives and analgesics like opiates and morphine and things that, in the public interest,
need to be controlled. But condoms are not medicines or drugs, they
are made from inert latex so what are they doing on a doctor's prescription? It was clear from the very beginning that this proposed new legislation was being foisted onto us in an awkward attempt to ‘medicalise' our national neurosis about things sexual and to let the government off the hook. But we accepted it.

But it was even worse than that. The responsible adult seeking a package of condoms so as to prevent his wife from becoming preg
nant could only get a prescription for them from the doctor for ‘bona
fide family planning purposes or for adequate medical reasons'. So here now was a brand new role for doctors to play. We were now being asked to make a judgement about our patient's morality when heretofore all that used to concern us was our patient's health. One implication of Mr Haughey's Health (Family Planning) Act was that if doctors suspected that their patients were going to use condoms for some purpose other than ‘bona fide family planning' then that doctor was duty bound to refuse that patient a prescription. Doctors had to exercise great care in making this moral judgement about their patients because any laxity in this regard could result in the doctor facing a fine of £500 or six months imprisonment.

So why did the Irish medical profession accept this legislation which distorted the doctor–patient relationship and sought to exploit people who were just looking for condoms? Our collective opinion on this proposed new law was never sought. Mr Haughey discussed the proposal with the Irish Medical Association of the day and they agreed to accept it on our behalf. It was all to do with money. The Health (Family Planning) Act 1979 would bring increased business for general practitioners and therefore how could they object to it so why bother even asking them? But I believe that had this proposed legislation been put to a proper ballot of all doctors in Ireland, following proper debate, the vast majority of them would have rejected it.

As if to underline this notion that money would assuage us all I had a chance encounter with Mr Haughey after the press reception to launch his new Family Planning bill. Ann and I were at a reception given by the
Irish Medical Times
when in walked the minister. A small man, he walked with great economy of effort. He came into the room as if he was being pulled along on wheels for he took short but rapid steps, his arms held motionless by his side. Ann and I went right up to him and told him what we thought of his new bill. To this Mr Haughey replied that if I did not like it, then, as the bill stipulated, there was no obligation on me to participate, I could just opt out. This response was delivered with a backwards wave of his right hand as if he was trying to get rid of a housefly that had landed on the sugar bowl. It was a dismissive answer from an arrogant little man and it showed how the minister failed to grasp or perhaps did not want to grasp the serious flaws in his new legislation.

After this rather terse exchange Mr Haughey then addressed the assembled doctors. His opening words were: ‘I will make money for you doctors yet'. It was difficult to decide which was the more painful, the tastelessness and insensitivity of a minister for Health who would make such a remark or the vulgarity and crassness of the assembled doctors who thought that this was funny. It hardly matters. I left that gathering feeling like a complete outsider, ashamed to be a doctor and very alone, sick to the pit of my stomach at the whole lot of them. It was then that I vowed to do whatever I could to bring this piece of legislation down and to expose it for the hypocrisy that it surely was.

The new laws surrounding the sale and distribution of condoms threw the Irish Family Planning Association into something of a backspin. As its newly-elected chairman I had to tread an impartial path. The sale of condoms, or should I say the giving away of condoms for nothing and the accepting of a ‘donation', had been the organisation's main source of income and now all that was seriously threatened. There were two schools of thought as to what we should do. One was that we should simply ignore the law, carry on and see what would happen. This would have been my favoured approach because I saw the IFPA as a trail-blazing and pioneering organisation and had absolutely no respect for this new legislation. The association may have been pioneering at one time but by now, over a decade since its foundation, many of the people working in it were becoming institutionalised in their thinking and were fearful that if we broke the law we could be closed down and then they would all lose their jobs.