buckeyedoc's Open Salon Blog

The fight over a pregnant teenager

Thu, 11 Dec 2008 12:12:34 -0500

The fight over a pregnant teenager (or how the pro-lifers won me over, I suppose)

Let me start by saying that I am officially pro-choice. I vehemently do not want to see abortion become illegal. However, I don’t think I would ever have an abortion, and that is based on my own experience. I also would not counsel another woman one way or another about abortion.

It was the summer of 1993. I had just graduated from high school and would be heading off to Ohio University on academic scholarship in the fall. In a fit of fickleness, I initiated a sort of temporary break-up with my boyfriend of two years. He already attended Ohio University, so I suspected we would reunite at some point. In the meantime, I started a carefree dating relationship with an outgoing and popular “party guy” from the town near me.

Now, I wish I could say that my scholastic aptitude translated into common sense, but I convinced myself that I would not likely become pregnant after two unprotected episodes temporally close together, rationalizing that women are only fertile a day or two out of the month.

Intuition told me almost immediately that “something” was happening. Without knowing, I knew.

The day my period was expected, I went to a Meijer store and bought an early pregnancy test and a box of condoms (wishful thinking). I stopped in the store bathroom to take the test. The results were simultaneously shocking and wholly expected. I was 18 years old with a non-serious boyfriend, planning to head off to college in two months to become a doctor, and I was pregnant.

I immediately talked to my boyfriend, who was horrified. His first comment was, “You don’t expect me to marry you, do you?” followed by, “You should have an abortion.” I talked to my best friend. “You should have an abortion,” she said, followed by, “if you are really pregnant.” Neither of us had ever been to an OB/Gyn, so we did not know what to do in order to confirm the pregnancy without alerting my parents. We looked in the yellow pages and found an answer, Pregnancy Decision Health Center on the local university campus. While I didn’t know of Planned Parenthood at that time, I imagined PDHC was the same thing, a full-service reproductive issues center.

PDHC was located in a nondescript office building. I was introduced to a pleasant, dark-haired, middle-aged woman, who took me into a quiet office to talk. I think I was crying as I told her I thought I was pregnant. She administered a pregnancy test, which confirmed the previous findings. She calculated my due date. Then, she started talking to me about options. She spoke very kindly and seemed empathetic. Mind you, I did not know I was at an anti-abortion center. I told her I was thinking about having an abortion. She showed me a glossy chart with in utero photographs of embryos and fetuses at every stage of development and pointed out where mine would be. She talked to me about the abortion procedure in technical terms. I believe she showed me a few photos of aborted fetuses, although I seem to have blocked them out from my memory. She talked to me about adoption. I told her I was still thinking about abortion. She told me that they did not perform abortions. To her credit, she let me go with some literature and with the advice of giving my decision time and careful consideration. She never told me outright not to have an abortion.

I went home and tried to hide my despair from my parents. It worked for a couple of days. Finally, my dad asked me what was wrong, and I burst into tears and blurted out, “I’m pregnant!” In a fit of horrible timing, my older brother called at the same time to say that his girlfriend had just delivered their baby, who was going to be adopted privately. My dad called my mom at work and told her to come home immediately. My parents were devastated. They asked embarrassing questions. They were openly ashamed of me. They immediately started talking to me about abortion.

The next day, my mom took me to see her OB/Gyn. He did a quick ultrasound and showed me the evidence of early pregnancy. I asked him about abortion, and he told me that he didn’t perform them but that Planned Parenthood would do so. I later learned that he was a devout Christian who was anti-abortion.

I called Planned Parenthood myself and made an appointment for an abortion. The sooner, the better, I felt. I was shocked to learn from the woman on the phone that I was too early in pregnancy to have an abortion. I would have to wait three weeks to do so. These were the days before pharmaceutical abortion, so D&C was the required method. I scheduled the abortion. My parents were pleased. My boyfriend was pleased. I was becoming less and less pleased all of the time.

The nightmares started. In them, I was always on the operating table, getting a local anesthetic injection before the abortion. My decision was gnawing away at me. I couldn’t get away from the fact that it just felt wrong to me. While I didn’t appreciate the underhanded way in which PDHC had given me the anti-abortion spiel (and my parents were very angry about it), I couldn’t argue with some of the facts I had received there. My embryo/baby did actually look like the ones in the photo, and I would be terminating its potential life with the abortion. Could I live with this decision?

The answer was no. Abortion was not right for me. I had to tell my parents and my boyfriend. I had to find a way to make this pregnancy fit into my young life.

As expected, the response I got was shame, shame, shame, with a heaping serving of, “Get an abortion. You are ruining your life!” My grandparents told me that abortion was no different than using a condom; it was just another method of preventing a birth. My mom took me to see a psychologist for personality testing to see if I was prone to being a martyr. My parents both thought I was trying to replace my brother’s baby (given away for adoption) by having a baby myself. There was no truth to any of these theories. I had made a mistake in getting pregnant, and I felt I would be making a colossal second mistake by having an abortion.

I wanted to keep the baby. I contacted my local university, Ohio State, where I had been offered a full scholarship and had never officially declined admission. They told me the offer still stood, a National Merit Scholarship covering tuition, room and board and more. I would be able to use the room and board money to live outside of the dorms, if necessary. I would take one quarter off after the birth and then arrange for child care when I started again. I would need to get help with child care expenses from my boyfriend, who had a full-time job. I would make this work, damn it. I would do it. I would not become a cautionary tale. This baby and I would take on the world. I had an inkling of excitement hidden in the despair.

The relationship with my boyfriend fizzled out. The last straw was probably when I encountered young guys from his hometown at the restaurant where I was a waitress. They were chatting me up and had no idea I was pregnant. I asked if they knew “X” (my boyfriend, although I didn’t tell them he was), and one guy said, “Oh, I heard he got this girl pregnant and she had to drop out of college and he doesn’t want anything to do with her!” Despite his pleas that he never said anything like that, I am certain he did. His reaction to the pregnancy was the reason I could never take him back, even years later when he called me to reconcile.

Two days before the start of my college career at OSU, I went shopping for books with a friend. When I got home, the bleeding started. My parents took me to the emergency room, where blood work showed low progesterone levels. I was sent home with an ironic diagnosis of “threatened abortion” and referred for an ultrasound the following day. The ultrasound confirmed a miscarriage. I was 11 weeks along, and the embryo measured two weeks earlier, indicating it had stopped developing at that time. “Here is the heart, and this is where we would normally see beating,” the technician said. She printed off ultrasound photos and gave them to me. I couldn’t bear to look at them, so I asked my mom to keep them.

I was scheduled for a D&C on the morning of the first day of classes. As soon as I could be released from the hospital, I went to those classes. I didn’t miss one.

About 6 months later, I had another boyfriend. I told him about what I had been through the previous year, and he was disgusted. He said, “Where I come from, only whores got pregnant as teenagers.” I decided not to tell people about it anymore. I stuffed it inside. It came out once in a while, like when I wrote a poem in poetry class that referenced the bleeding and shame. My professor asked me to stay after class and told me that if I needed to talk to someone, he was there.

I still think about it at times, like when I fill out medical forms and have to list the number of pregnancies and births, and they don’t match. It’s right there under the surface. I’m sure many women have that feeling.

I don’t know if there is a reason things like this happen or if it is all by chance. It is extremely coincidental that the pregnancy happened right before I went off to college, causing me to change colleges, and then ended in miscarriage at the exact time classes began. I ended up staying at Ohio State for 14 years finishing multiple degrees. I met my husband there. Some good came out of the bad.

The experience has absolutely affected my perspective on abortion. While it is incredibly wrong for anti-abortion activists to use disgusting tactics to try to sway pregnant women away from abortion, I believe it is nearly as bad for pro-choicers to pressure the women in their lives to have abortions. How can someone make that decision for you? Abortion has a huge psychological impact. Only a person facing that decision is equipped to weigh the consequences of taking either route.

There is still a little awkwardness between my parents and me, although it lessens year by year. I always suspected they were relieved about this miscarriage, and that bothered me. I wished for a reaction like the father in the movie” Juno”, which was kind of muted disappointment followed by unification of the family behind the decision. I am not one to blame parents for everything. I am a parent myself now, and I realize that we are all just winging it and doing the best we can with what we have. A couple of years ago, my mom apologized to me for trying to pressure me into having an abortion. I appreciate that.

The Giving Cow

Sat, 6 Dec 2008 08:12:38 -0500

“Miss Piggy” was a cow who saved the lives of hundreds of (perhaps more than a thousand) other animals. How exactly does a cow save a life? Let me start at the beginning…

In 1994, I was a college undergraduate student hoping to become a veterinarian. Admission to veterinary school is difficult, since there are less than thirty in the United States. Being a suburban girl, I was looking to enhance my application with some hands-on large animal experience. I procured a grunt position at The Ohio State University Veterinary Teaching Hospital in “the barn,” which was the original food animal and equine wing of the hospital. My job was to clean out stalls, scrub hallways, distribute feed, move animals to new stalls, and to help spruce up the hospital before the ground-breaking ceremony for the new, high-tech and beautiful equine center.

Traditional stalls were set up so that the front facing the hospital hallway had metal bars with a built-in stanchion and a wide gate for accessing the animal. The rear side faced the feed aisle and was made of concrete with a high sliding panel for dropping in the hay and grain along with a thin wooden “escape door” from the stall into the feed aisle. As I walked through an empty, dusty, narrow feed aisle early one Saturday morning, I sensed someone’s eyes on me. To my surprise, I turned and saw a huge bovine head with eyes staring inquisitively at me through the escape door from her stall. I had met Miss Piggy.

Miss Piggy was young in those days, probably 3 years old. She was a large Holstein cow, or technically a heifer, since she was never bred. Her purpose was loftier. You see, Miss Piggy was a transfaunation cow.

Cattle are ruminants, meaning that most of the abdomen is filled by a large multi-chambered stomach. The rumen is the largest chamber and functions as a fermentation vat. It can hold nearly 20 gallons of matted hay and fluid. The micro-organisms in the rumen are essential to the life of the animal, as they perform much of the digestion process that breaks down the cellulose in hay and other feedstuffs. When the microflora are killed off or severely altered by antibiotic treatment or sudden intake of high-carbohydrate feed (called “grain overload” or “rumen acidosis”), ruminants become dangerously ill and often die from an influx of fluid into the rumen, severe ulceration of the lining, absorption of acids into the bloodstream and shock. In order to save the animal, rumen contents can be harvested from a donor animal and gavaged through a tube into the ill animal, restoring the normal microflora.

Miss Piggy was the donor cow. She had a permanent rumen fistula in place, which is a soft rubber gasket through the skin of the flank into the rumen and covered by a plug when not in use. While it looks disturbing to some observers, it is actually painless to the animal aside from the initial surgical placement, which is done under spinal anesthesia. When harvest of rumen contents is necessary, the plug is removed and a gloved hand/arm (or tube) is passed through the fistula to draw out a small volume of greenish partially digested material. Thus, whenever a cow, sheep or goat (or rarely a camelid, although their forestomach anatomy is different) needed transfaunation, Miss Piggy provided the donation.

Don’t get the impression that Miss Piggy’s life was spent confined to a stanchion with someone reaching into her fistula, though. That was her very part-time job, but it wasn’t the way she spent most of her time. Miss Piggy was the hospital mascot, or pet, if you wish. She was the star of the whole place. Before the new equine wing of the hospital was built, and while she was still young, Miss Piggy used to go outside into the grassy area behind the hospital. A hospital staff member or student would put a rope lead around her neck and literally run through the grass with her. I have never seen anything like it, watching a cumbersome 1000 lb. cow frolicking and bucking around with joy. When she was inside, she would take leisurely walks through the hallways of the barn. Whatever stall she was in would have the stanchion left open so that she could pass her head through it and crane her neck to see what was going on in the hall. No one passed her stall without giving her head a scratch. Everyone who toured the hospital met her. Children loved her.

Being a crafty bovine, she even figured out how to grab the escape door knob and turn it, opening the door to look out into the feed aisle as she did on the morning I met her. That caused her trouble on one occasion when someone left a full bag of sweet grain in the feed aisle very close to her door. She quickly gobbled up almost the entire bag, ironically sending herself toward rumen acidosis. Not to fear! Her rumen fistula was opened and the grain was removed by hand before it could do severe damage to her.

Two years ago as I was finishing my veterinary pathology residency, a biopsy from Miss Piggy’s rumen fistula site came through the surgical pathology service. Squamous cell carcinoma, a slow-growing and invasive tumor that can be associated with chronic irritation. The presence of the rubber gasket for more than a decade eventually led to tumor formation in Miss Piggy’s skin. Still, she remained comfortable and happy for more than a year, with occasional debulking of the tumor, but it eventually became invasive enough to justify her euthanasia. She passed away peacefully at the age of at least 15 years old (and some say 17). It was a somber day in the OSU Veterinary Hospital as word of her death spread.

A food animal veterinarian who had worked with Miss Piggy since her youth raised money for a tree to be planted in her honor outside the hospital, and word has it that a lock of her hair was buried underneath. There is a new transfaunation cow residing at the hospital, but it still feels a little empty not seeing Miss Piggy’s head poking out curiously into the hallway next to her stall-side medical record clipboard, which was always empty except for the worn-out identification card reading simply “Miss Piggy.” I have moved on from the university, but I think of her whenever I reflect on the time I spent there.

So here’s to you, Miss Piggy. If there is a Heaven for cows (and if there is a Heaven, I strongly support the presence of cows there), I hope you are there stomping through the grass with sunlight streaming across your back again.

Barack Obama has ruined Christmas (and Thanksgiving!)

Tue, 18 Nov 2008 10:11:17 -0500

This letter to the editor of The Columbus Dispatch caught my eye during breakfast:

Election has ruined spirit of Christmas

"For the first time in 55 years, I won’t be celebrating Thanksgiving and Christmas. Why? Because President-elect Barack Obama said we need a change.

No turkey dinner, no Christmas cards, no checks to the grandkids and no decorating. My heart is not in it since I am so disappointed that so many people looked right past the odd people that Obama associated with and his views on abortion. We will have to wait and see how his many promises are carried out.

And to the people who want handouts and for the government to take care of them, I say do as I did 31 years ago when I lost my union job: I had to go take another one that paid me $4 less per hour. Plus, we had just bought a new house and the payments were almost double what we had been paying. Working is how you succeed, even if it is at JCPenney or McDonald’s.

MARGIE COLLINSWORTH
Columbus"

_______________________________________________

Really? The election has ruined the holidays? I would laugh at this if it were satire, but this grandmother is serious.

I can't understand someone who would let election results ruin their life. Trust me, I was bummed in 2000 and especially in 2004, but the holidays are a time to enjoy being with friends and family. If this woman is not going to enjoy them, it is her own fault and not Barack Obama's doing.

Whether one agrees with Barack Obama's positions or not, the sky isn't falling. In fact, I would argue that the political party in national power has a modest (at best) effect on day-to-day life and should have zero effect on enjoying the beautiful things in life.

One of my grandmothers strongly supported John McCain. We are going to visit her next month with the kids, and I can guarantee the election won't be an issue. Heck, we are even going to look at the holiday decorations outside the White House, even though I'm no fan of the president who currently resides there.

Life is too short for such nonsense.

The one I saved

Thu, 13 Nov 2008 12:11:26 -0500

It was nearly midnight on a Saturday night during my fourth year of veterinary school when she was presented to me. As part of my emergency medicine rotation, I was working in the after-hours clinic of the university veterinary teaching hospital along with three other classmates, a technician and an intern supervising us. In walked a couple who had driven to our hospital from their home more than an hour away. They had been referred by their regular veterinarian due to the late hour. They were country folks. Nice folks. They fell into the category of pet-owners-who-can-afford-healthy-pets-but-not-sick-ones, the large middle region of the client spectrum between pet-owners-who-do-nothing-to-care-for-their-pets and pet-owners-who-have-lots-of-disposable-income-or-credit-to-pay-for-extreme-measures-of-care-for-their-pets.

The dog was a tiny middle-aged female poodle-ish type, and her problem was obvious. Protruding from the “business end” of her body was a puppy’s head, hopelessly stuck during delivery at the level of the shoulders, with a bloated purple face, clearly lifeless. The mama-to-be looked to be in agony. She was panting, crying, straining and looking terrified. The owners did not know what type of dog had impregnated their pet, but he was clearly much larger than a miniature poodle mix.

Caesarian section was almost immediately ruled out by the owners. They could not afford it, as it took all of their spare cash just to pay for the emergency visit itself. Additionally, we were not convinced the puppy could be extracted surgically from its location without breaking the dog’s pelvis, increasing the cost and complexity of surgical intervention. We took a quick X-ray to confirm the normal conformation of her pelvis, the size and formation of this puppy and to look for others still living in the womb. There were two more, one large and one small (Note: X-rays are commonly used for puppy assessment late in pregnancy in dogs, as it can be hard to find all of them using ultrasound).

We committed to trying manually to pull the puppy out.

“Shouldn’t we give her a sedative?” I asked the intern, who I will call Gary to protect his identity (he was an abysmal veterinarian, at least at that point in his career).

“No,” said Gary, “We want her to help push while we pull.”

“But Gary, she is already straining as hard as she can, and it is making the opening that much smaller,” I pleaded.

“No,” he said again, “We will lubricate the puppy with K-Y jelly and pull.”

He proceeded to infuse K-Y jelly around the puppy and tried to delicately maneuver the puppy while the female dog strained and straining. Nothing. Totally stuck.

Resigned, Gary went to talk to the owners in the waiting room. They began to cry. They loved the dog but couldn’t afford to do anything more for her. Euthanasia was discussed and chosen. The owners paid their bill and headed out to their car. A fellow student retrieved a syringe of euthanasia solution from the Pyxis machine, an automated pharmacy. I stayed at the examination table with the dog, now virtually collapsed from fatigue and no longer pushing. In a sudden move, I put on some gloves, grabbed behind the protruding puppy’s head and gave it a firm pull. It budged slightly.

“I really think I can get this out,” I whispered excitedly to a fellow student.

I pulled again, firmly and evenly. Crack went the puppy’s neck and shoulder, and he was out. The mama dog literally sighed and went to sleep. The fact that she had given up probably saved her life.

“Stop the owners!!!” I cried.

The intern ran out to the parking lot to retrieve the bewildered couple, who returned inside to see their dog still alive and now well. We came up with a plan to send them to their regular veterinarian the next morning, where they said they would be able to pay for a C-section at a lower cost and would also have their dog spayed. We administered a drug to slow labor and warned them that one of the remaining puppies was also large and could get stuck, so they needed to watch their dog overnight. We warned them that the other puppies could die from the delay in treatment.

After they left, I wrapped up and carried the dead puppy through the night to the walk-in cooler next door. I stepped into the quietly humming cooler and around the giant bull with white foam coming from his nostrils lying on his back in full rigor mortis. I set the puppy on the shelf next to the white cardboard coffins containing the other pets that could not be saved, and for that night, it was enough to me that there had been one animal in this world I could, and did, save.

Epilogue:

Remarkably, the mama dog delivered the other two puppies at home that night all by herself. The puppies were born alive. Her owners had her spayed, and she went on to live for years.

Over time, the weight of the animals I couldn’t save, and especially the animals that no one could afford to save, did wear on me. I left clinical veterinary practice to specialize in veterinary pathology and earn a Ph.D. degree in molecular biology. I was always more of an academic, so being positioned behind the microscope fits my personality. Ironically, I chose a specialty where I commonly deal with dead animals (or pieces of live ones). However, I’m situated beyond the point where the life-or-death decision was made.

Ohio turning blue was HUGE as expected.

Wed, 5 Nov 2008 12:11:57 -0500

Ohio is an interesting place. Much of the area is rural to small town, but vastly more of the population resides in larger towns and cities. The northern part of the state trends liberal, especially in the northeast corner, and the southern part of the state is very conservative and not unlike Kentucky. Columbus is in the center and is a fairly liberal city but with some markedly conservative suburbs, and especially exurbs. There are counties in western Ohio north of Dayton where almost zero non-white people reside and urban counties with 20-40% non-white population. It's kind of a microcosm of the country as a whole.

The big question for Election Day was whether the urban (and, to a lesser extent, suburban) voters would show up in large enough numbers to compensate for the rural voters.

While vote tallying is only 97% complete, it looks like we saw a slightly lower turnout this year than in 2004. While Bush beat Kerry with 2.8 million to 2.7 million votes, Obama is beating McCain with 2.6 million to 2.4 million votes. Population growth is pretty flat in Ohio but not decreasing, so I would have to assume that while a bunch of new voters showed up at the polls, a number of other voters stayed home. I've got to wonder who they were. Perhaps the marriage amendment (against gay marriage) in 2004 brought out conservative voters who rarely vote and didn't show up this time?

Looking at the county-by-county map, many results were predictable and a few were not. As expected, Franklin county (Columbus), Montgomery county (Dayton), Cuyahoga county (Cleveland) and almost the entire NE corner of the state (Akron, Canton, Youngstown), and Athens county (Ohio University) went blue. Interestingly, Hamilton county (Cincinnati) also went blue. Cincinnati is a very conservative city, and although it has a non-white population in the 40% range, the county went for Bush in 2004. Overall, Obama won 21 counties vs. the 16 won by Kerry in 2004. His biggest gains were along Lake Erie and in Cincinnati.

Exit polls showed Obama overwhelmingly won the vote of people living in cities and towns of >50,000 people (70%-28%) and narrowly won the suburban vote (51-48%) but lost the rural vote (43-54%).

Critical demographics for Obama included winning 54% of the women's vote, 63% of the 18-29 vote (McCain only won the 65+ vote category), 97% of the black vote, and 57% of the vote from families with total income < $ 100,000 per year.

On the Bradley effect, 54% of voters said that race was not a factor at all in their decision, and the voters who considered it an important factor broke for ... Obama.

On the PUMA effect, 81% of Democrats who supported Hillary Clinton in the primary election voted for Obama.