Chapter Sixteen
An hour later I was considering whose car I might wash in order to calm my nerves and start to pass what would no doubt be a long week ahead when my phone rang.
It was Dr. Blankman.
“I’ve had some further thoughts about your case,” he said.
“I’m afraid we didn’t get off entirely on the right foot,” he said.
“There were so many people in the room last week,” he said, “that I wondered if a visit on your own might be useful. Can you come in this afternoon?”
“It’s Saturday,” I said. “It’s Halloween.”
“I have special hours,” said Dr. Blankman, “for special patients in special circumstances.”
Maybe his directive to come alone should have set off alarm bells, but he was right: There had been too many people at the appointment where we’d met.
Making my own way to his office was slower than if I’d called someone for a ride, but my children did not come in ones.
And it was lonelier than if Moth had come with me, but I was guessing he’d gone to ground after yesterday’s meeting with Dr. Kim.
I got it. It was a lot to take in. It made sense he’d had enough tagging along to medical appointments for the time being.
But it was unlike him not to say so. At least, I thought it was.
Truthfully, we hadn’t known each other very long.
Maybe I didn’t know him that well after all.
I felt fifteen again on the walk to Dr. Blankman’s, not stamina- or cartilage-wise, unfortunately, but I remembered in my tired bones that feeling of ruminating over a boy, the stone in my stomach, the round and round of it.
Was he mad at me, or was I mad at him? Was I indignant or repentant?
And what if I’d lost him? What would I do without him?
What would I compromise to get him back?
But I was also wiser than I’d been at fifteen and knew the answers were both complicated and pointless.
I wasn’t affronted he might need some space; I was sympathetic, commiserative even.
I knew it didn’t matter who was mad at whom.
I was sorry, even though none of it was my fault, and suspected he was too.
I was upset he hadn’t come down for dinner last night, not because I was cross about being stood up, but because I missed him.
And besides, I was too old for this shit. Anger wasn’t good for our hearts. Skipped meals weren’t good for our digestion. Time apart was a game for young people who had enough of it to waste.
So I arrived at Dr. Blankman’s unsettled and distracted. Instead of vigilant and trepidatious.
A nurse brought me into an exam room. Weight, height, blood pressure, pulse and pulse ox, temperature, questionnaires.
Had my meds changed, had my insurance changed, had my address changed.
Since yesterday? I thought. Take your clothes off please—you can keep your socks—and wait, paper gown to paper table cover.
Try to angle yourself away from the air-conditioning. The doctor will be in shortly.
By the time Dr. Blankman arrived, I was already shivering.
“Thank you for coming, Pepper,” he said, as doctors often do, as if you’ve dropped by for a social call.
“You’re welcome,” I said anyway.
“I had some thoughts after you left last week that I didn’t have an opportunity to communicate, so I thought we should touch base.”
Some options, I thought. Some information at the least. Some reassurance.
“Last we spoke, you seemed to be keen on an abortion. I’m concerned we gave you the impression that that option is not available to you because of the laws in this state, and that is not the case.”
My heart soared. “You did,” I affirmed, relieved. It’s not that New York wouldn’t have been nice, but I was so tired. Staying home would be better. We could go to New York some other, calmer time.
“Whereas in fact,” he continued, “you cannot have an abortion because I am not at all certain you would survive one.”
My soaring heart crashed like Icarus.
“I don’t want to frighten you, but I do want you to understand the risks because I worry you’re contemplating doing something scary and irresponsible.”
“Scary?” I squirmed in my paper gown.
“Such as traveling elsewhere in search of a dangerous and unpredictable procedure.”
“Dangerous?” Was I just going to repeat everything the man said?
“Don’t feel bad. A lot of patients are confused about this.
People think we banned abortion in Texas because of politics or family values or because we’re somehow against women’s rights.
I have three daughters. I’ve had three wives.
I love women. I’ve made caring for them my life’s work.
Texas and states like ours that banned these procedures did so because we value women.
Abortions aren’t nearly as safe as anti-life protesters want you to believe.
Abortion presents a heightened risk of three conditions in particular that are often fatal—infection, hemorrhage, and embolism—and this is in young, healthy women.
The truth is we don’t know how risky an abortion is for you because no one’s ever performed one on a patient even close to your age.
And in case you’re thinking that medical is safer than surgical, you should know that patients who take abortion pills find themselves at increased risk for sepsis, uncontrolled bleeding, depression, suicide, infertility—”
“If only,” I interrupted. I wasn’t trying to be funny, but risks to my fertility were hardly the point.
“I’m afraid I don’t find this to be a laughing matter,” he snapped. “Did you know that any kind of abortion significantly increases a patient’s risk of certain kinds of cancer?”
Cancer nearly killed me. To prevent it from doing so, I took drugs that led to pregnancy, which could also kill me, but stopping it could cause cancer. It was less a circle than a whirlpool, a vortex.
“It would be unethical for me, as your doctor, not to highlight these risks just because what you’re contemplating would necessarily be outside my medical jurisdiction. I feel that I would also be remiss not to mention serious legal implications.”
I started. “Legal?”
“If you were to seek an abortion out of state while under Dr. Kim’s care here in Texas, you could get her in a lot of trouble. She could lose her license. She could face significant fines and even jail time.”
That didn’t sound right to me. “But … she would have nothing to do with it.”
“Doesn’t matter.” Dr. Blankman turned up his hands. “She’s your doctor of record. She has not, I trust, as I have, advised you of the risks here?”
I shook my head mutely. He put his hands in his pockets and gave a little shrug, meant to suggest that she wasn’t as good a doctor as he was, or perhaps that she didn’t care enough about me to bother with warnings.
He knew more than I did about many things, but not this one.
Dr. Kim was just as good a doctor as he was, unless you included bedside manner, in which case she was quite a bit better.
And when she thought I needed warning, she didn’t hesitate.
He must have seen I wasn’t buying it because then he switched tack. “Dr. Kim knows so much about your life and your family. Have you, in turn, gotten to know hers?”
Shame sparked somewhere beneath my sternum. Was it selfish that I knew so little about her when she’d taken such good care of me? Or was it keeping myself to myself, as Moth would say? I hugged my arms around my chest and tried to stop shivering but could not meet his eyes.
“She has a ten-year-old and an eight-year-old. Daughters.” Dr. Blankman struggled to make his expression grim but actually looked triumphant.
“What about their so-called female empowerment? Speaking of which, Dr. Kim is the breadwinner of her family. What happens to them if she loses her license … or goes to jail?”
What would happen? That would be terrible. “I … didn’t think of that.”
“No, you didn’t,” he agreed. “And what about your own daughter?”
Another spark of shame. “What about her?” It didn’t matter which daughter he meant because I wouldn’t let anything happen to either one.
“Alice Mills is also a beacon of female empowerment, isn’t she.
” Not a question. “She’s managed motherhood and an impressive career all on her own.
From what I understand, she’s also quite ambitious.
What do you think happens to her aspirations, to say nothing of her reputation in this city, if she’s caught illegally smuggling a patient out of state for an abortion? ”
I recalled Alice’s voice on my tinny laptop speaker saying “plausible deniability,” “highly classified,” “completely buried in shit.”
“And not just Alice. Think of your other daughter’s standing in the community. Think of your son. He has a cornerstone career at a highly connected corporation in a public-facing industry.”
He did?
“Your whole family needs you now more than ever. Your children. Your grandchildren. If something happened, what would they do without you? Or maybe you come through the procedure unharmed—it’s certainly possible—but then they find themselves beset by scandal, pariahs in their community. What then?”
The sparks caught and started smoldering. “But … how would the community find out?”
“I have a duty of care. To you. But also to the child you’re carrying. If I thought you were going to undertake measures outside the law that might endanger yourself or your unborn child, I would take steps to prevent that. I would have to.”
“What steps?” I wasn’t asking so much as stalling. This is a trick you learn when you’re older, that confusion and overwhelm will often clear if you can wait them out.
“Who knows?” Dr. Blankman answered. “I suppose I would have to figure that out when and if it became a problem. I might call the Texas Medical Board. I might call the state bar. I might call the press.”
My center was ablaze now, flames licking up toward my collarbone, spreading downward to my navel. “The press?”
“Yes, the press. I imagine they’d be very interested in an elderly scofflaw on the run from the authorities.”
“Impossible.” I made myself smile. “It’s been years since I’ve been able to run anywhere.”
But he didn’t laugh. “What else would you call secretly crossing state lines in order to obtain something from which you are legally barred?”
He wasn’t asking really, but I answered anyway. “Not their business?”
That was when he laughed. “Newspapers aren’t doctors. They don’t care about privacy or confidentiality. In fact I imagine that the press, unlike the state, wouldn’t even require you to break the law before they developed some urgent questions about any number of aspects of this case.”
I was confused how we’d gotten from a doctor’s appointment to journalistic integrity, but I didn’t argue. Probably he was right, at least on this point and who knew on how many others.
There was a knock on the door, and the same nurse from earlier stuck her head in to tell Dr. Blankman his next patient was ready for him.
“Think about what I said,” he told me.
I wished I wouldn’t, but I bet I would.
It did not occur to me until I was on my way home that there’d been no exam. I could have kept my clothes on.