Can I help you?
I've never thought twice about answering my phone. Now, I'm not so sure.
Last week, I was mucking horse stalls, and my phone rang with an unknown number. Expecting a call from our vet’s office, I answered.
“Hey, Dr. Wentworth,” replied a man’s voice in a slow, Southern drawl, “I don’t know if you remember me, but you treated me for cancer a few years ago. I wasn’t sure you would answer but since you’re on the line…”
My former patient went on to describe a recent surgery he had for skin cancer. His dermatologist recommended that he receive radiation treatments due to adverse features on his final pathology report. The patient had consulted a radiation oncologist in a nearby city who agreed with his surgeon and proposed a standard regimen of daily treatment for six weeks. The 30-minute drive to that hospital meant his daughter would insist on taking him.
“She can’t take off work every day, Doc, and I would rather drive myself. Is there any way I can get the same treatment with you? You’re only 10 minutes from my house, and I trust you.”
Although I no longer worked at the cancer center near his home, I assured him that there were competent physicians who did. I agreed to get him an appointment. We hung up and I called a colleague who agreed to fit him in her schedule that week. I returned to my barn chores.
In less than fifteen minutes, I secured quality care and independence for my former patient. And as a daughter with aging in-laws who live nearby, I felt good about removing a potentially tricky work situation from my patient’s daughter’s to-do-list. This patient was a beloved local physician, and I was happy to provide the professional courtesy of navigating his care.
A great privilege bestowed upon physicians is being the go-to person for friends, family and colleagues in high stress moments. As an oncologist, I am called in the most critical of these situations.
“It’s Stage III breast cancer. Is that bad?”
“What’s a Moh’s surgeon?”
“Her father is in the ICU and they’re trying to decide what to do. It doesn’t sound good. Can she call you?”
My friends and family appreciate my knowledge and, perhaps more importantly, my ready availability. No AI chatbot or interminable phone tree that ends in a cryptic “Thanks for calling. We’ll get back to you soon” message. A doctor in their contacts means they have an inside track to someone who can offer help and hope in a desperate time.
A few weeks ago, actress Sally Field revealed that she had an abortion when she was just 17. Her harrowing story involved a doctor who was a family friend driving Field and her mother to Mexico. Her recollection of the doctor’s new Cadillac, his wife’s presence in the car and the envelope of money he handed her while motioning to a nearby building were chilling.
Alone and scared, she received an unhygienic, painful abortion followed by molestation at the hands of the abortion “provider.” Once it was over, she said she was told to “run, run, run” out the door and back to the adults waiting in the car.
While listening to Field recount this horrific experience, I could only focus on the doctor. Field describes herself as naïve at the time, not appreciating the personal and professional risk that physician assumed while transporting her across an international border to have an illegal procedure performed by an unlicensed, unscrupulous, and unnamed person.
Fellow Gen-Xer’s remember a similar scene in Dirty Dancing.
Set in 1963, a decade before Roe vs. Wade, a teenage protagonist, aptly named ‘Baby’, steals money from her father to fund a dancer’s illegal abortion. Afterward, the dancer (named Penny) develops a life-threatening infection. (In the mid-1960’s, deaths related to complications from abortions comprised almost a fifth of pregnancy related fatalities.)
After the co-worker who drove Penny admits that the abortion provider “had a dirty knife and a folding table,” Baby runs to wake her father, a physician. When he enters Penny’s cabin, leather bag in tow, he doesn’t even pause once he realizes what is happening. He has seen this situation before.
Almost without thinking, he orders everyone to clear out and immediately draws up medicine from a glass vial. The doctor saves Penny’s life but expresses his disgust to his daughter: “Is this what my money paid for?” he asks her menacingly.
Women grab the spotlight of these important stories. Field as she recalls the trauma which preceded her entrance onto the world’s stage as Gidget, America’s sweetheart. And Baby as the naive and nerdy teenager who ends up in bed with a hunky male dancer who teaches her all the right moves.
In the background, however, are doctors who are asked by friends to provide care outside the bounds of their practices, their licenses, and the law.
I’m not saying these doctors did anything wrong. I just want to be clear that they put their careers, families and potentially their freedom on the line to help. But by answering the call of a desperate person, they put their own lives in jeopardy.
Sadly, we don’t have to go back to the 1960’s to find examples of physicians doing the same.
In June 2022, obstetrician-gynecologist Dr. Caitlin Bernard answered a call from a friend - a physician who specialized in child abuse and who practiced in a neighboring state. A 10-year-old girl was the victim of sexual assault and needed an abortion.
The child lived in Ohio which, following the Dobbs decision, banned abortion after six weeks of gestation. When the child abuse specialist saw the girl, she was six weeks and three days pregnant.
The physician asked Dr. Bernard to care for the patient and she agreed. Dr. Bernard performed an abortion which, at the time, was still legal in Indiana. The child would still bear the scars of sexual assault but would not have to deliver her rapist’s baby.
Unlike Sally Field and Penny, this girl had a safe abortion by a trained physician in a sterile, supportive environment.
Weeks later, when the Dobbs decision was announced, Dr. Bernard spoke to the Indianapolis Star about the implications of the new law. She mentioned this case in generalities as an example of the necessary healthcare that would no longer be available.
After her comments appeared, Dr. Bernard found herself targeted by an internal investigation at her hospital, reprimanded by the Indiana Medical Board and forced to pay a $3,000 fine. The attorney general of Indiana brought a case against Dr. Bernard and her hospital.
Although ostensibly not about her medical care, Dr. Bernard was punished for advocating for her patients and educating the public on the real-world implications of Dobbs.
The message from peers and elected officials was clear: We will not have your back.
Either don’t perform abortions or at least don’t talk about performing abortions. Keep these problems in the back alleys, not on the front page.
The CDC estimates that the maternal fatality rate from abortion in the pre-Roe era was five times higher than it is now. Thanks in part to the widespread use of contraception, physician training, and abortion being brought, as Betty Ford told 60 Minutes in 1975, “out of the backwoods and put it in the hospital where it belongs.”
As I watched Sally Field discuss her abortion on Instagram, I thought about Dr. Bernard and the hundreds of calls she likely received over the course of her career. From friends, colleagues, and family members about abortions but other health conditions as well. I wondered if, after this public shaming, she still answered these calls.
I thought about Sally Field’s doctor. About how many phone calls he answered. How many trips he took to back alleys in Mexico. How many teenage girls bled in the back of his Cadillac. How hard he prayed that he would not be caught and that they would not die because of his actions.
Of how he carried the guilt when one eventually did.
I thought about his landline ringing in the middle of dinner. Of the tearful mothers and angry fathers asking for his help. Of him counting crisp bills and placing them in white envelopes. Of handing them to teenagers and pointing them to the entrance of a dark building where the outcome was uncertain.
I thought about Baby’s father’s frustration. Of physicians who didn’t answer the phone. Of those who said “I’m sorry. I can’t help you” while watching their own children playing in the back yard. Of those doctors who were angry when they were forced to help by well-meaning female relatives.
As a physician with a cell phone permanently attached to my hip, I don’t know how to find care for my patients outside the medical system. I’m not familiar with back alleys and backwoods.
I also don’t know where my oath to “first do no harm” will land when this call in a future, which appears to be rapidly approaching, comes.
In front of me, I see my friends, patients and relatives. But just beyond I see medical boards, a ruined career, my family living without me, and prison bars.
Will I drive the daughters of my friends to a strange city, hand them envelopes of cash and point to a dark building?
Will I jump out of bed in the middle of the night to treat sepsis in a stranger?
Will I live with myself if I don’t?
The question I grapple with now is whether I will even pick up the phone.
This essay makes me think achingly. As a retiree addictions specialist I sometimes dread picking up the phone; there have been calls over the years where as soon as I saw the number I knew the outcome. But like you, I didn’t get into this muddy field just for the good outcomes. I still ache reading your essay for the second time.
Powerful and real. Thank you for being you.