A Spark of Light(92)
Louie knew exactly what it meant to disrupt a life process. At five weeks, he’d see nothing but a tiny sac. At six weeks, a fetal pole with cardiac activity—but no limb buds, no thorax, no calvarium. By nine weeks, there were differentiated body parts: tiny arms, tiny hands, the black spot of an emerging eye. At the fifteen-week mark, like today’s procedure, the calvarium had to be crushed to fit through a 15-millimeter cannula. As a provider, you could not unfeel that moment. And yet. Was it a person? No. It was a piece of life, but so was a sperm, an egg. If life began at conception, what about all those eggs and sperm that didn’t become babies? What about the fertilized eggs that didn’t implant? Or the ones that did, ectopically? What about the zygote that failed to thrive when implanted and was sloughed off with the uterine lining? Was that a death?
Up till twenty-two weeks of pregnancy a fetus wouldn’t survive without a host, even on a respirator. Between twenty-two and twenty-five weeks, a fetus might live briefly, with severe brain and organ damage. The American Congress of Obstetricians and Gynecologists did not recommend resuscitating babies born at twenty-three weeks. At twenty-four weeks, it was up to the parents and doctors to decide together. At twenty-five weeks, the American Medical Association suggested resuscitation, but also said that the ability to survive was not a sure thing. There were plenty of babies diagnosed late in the second trimester with anomalies that were incompatible with life. If those babies were born past twenty-nine weeks, they would feel pain when they died. In those cases, was abortion murder, or mercy? If you decided this was an exceptional case, what about if the mother was a heroin addict? What if her husband beat her so bad she broke bones several times a year? Was it ethical for that woman to carry a baby to term?
He got it, he really did. In that boggy mess of blood and tissue were recognizable parts. They were familiar enough to be upsetting. The bottom line was this: a zygote, an embryo, a fetus, a baby—they were all human. But at what point did that human deserve legal protection?
“We’re in the homestretch now.” Louie turned on the suction and swept the cannula along the uterus. “You never heard that story?”
She shook her head.
“And you call yourself a Yazooite!” Louie joked. “What do people from Yazoo call themselves?”
“Cursed,” Joy said.
He laughed. “I knew I liked you.” Louie felt for the familiar grittiness of the uterine wall that let him know he was done.
Whether or not you believed a fetus was a human being, there was no question in anyone’s mind that a grown woman was one. Even if you placed moral value on that fetus, you couldn’t give it rights unless they were stripped away from the woman carrying it. Perhaps the question wasn’t When does a fetus become a person? but When does a woman stop being one?
Louie glanced down at the tissue in the tray between his patient’s legs. The contents of the tray were swirled and amorphous, like a galaxy without stars. It was part of his job as a physician—if all the products of conception couldn’t be accounted for, then there would be infection later. It was also philosophically important to him as an abortion provider to recognize the procedure for what it was, instead of using euphemisms. He finished his silent count of limbs and landmarks. He could feel Joy’s womb starting to shrink back down.
He stood so that he could look his patient in the eye, so she would know he had seen her—not just as a patient, but as the woman she was and would be when she walked out that door. “You,” he told Joy, “are no longer pregnant.”
The woman closed her eyes. “Thank you,” she murmured.
Louie gently patted her knee. “Miz Joy,” he said simply, “you don’t have to be grateful for something that’s your right.”
—
HOW WAS IT, JOY WONDERED, that she was ending a pregnancy and talking about ghosts? Maybe it wasn’t all that far off the mark. She knew there were all sorts of things that could come back to haunt you.
She felt cramping, and she winced. She could still hear the whir of the machine that did the suction. It seemed like an oversight; surely they could have given her headphones, like the kind they had on planes that canceled out all the noise? Or piped in heavy metal music, so that you wouldn’t have to lie here and listen to the sound of your pregnancy ending?
Maybe that was the point—they didn’t want to make it easy. They wanted you doing this with your eyes (and your legs) wide open.
Joy stared at the ceiling at a Where’s Waldo? poster, where there were a thousand penguins wearing red and white scarves and one lone guy in a striped hat. Why would you try to find Waldo? Let the poor guy stay lost.
The suction was a choke, a throttle, a throat clearing. Little vacuum, Joy thought. Cleaning up her mess.
Nine a.m.
HUGH WAS PAINTING WITH WATER. THAT’S WHAT HE CALLED POLICE work that was not only painfully boring but ultimately a complete waste of time. Today, it was processing a 2010 Toyota RAV4 that had been taken for a joyride after its owner, a college kid, left the keys in the ignition. It had been found off the side of the road, dented and reeking of pot. Christ, you didn’t have to be a detective to figure out what had happened here; or to realize that the amount of time that Hugh spent processing the car and the scene—a dusty ditch off the side of the highway—was going to exceed the value of the check the insurance company would eventually send the owner for repairs. Who wanted to spend his fortieth birthday getting the fingerprints off a stolen vehicle? He sighed as he attempted to dust the interior. It never worked, because of the texture of the dashboard, but if he didn’t do it, he’d be told he had overlooked evidence. He’d already photographed the vehicle 360 degrees and also taken pictures of the tracks in the grass made by the tires. He had noted how far back the seat was reclined, what station the radio was tuned to, what detritus lived in the console. Later today, he would have the dubious honor of contacting the car’s owner and giving him this list—gum, Kind bar, water bottle, key chain, baseball cap, receipts from a Piggly Wiggly, junk mail—and then ask the guy what else was missing. Hugh would bet his house that the owner wouldn’t be able to answer. There wasn’t a person on earth who could accurately catalog the contents of their console and glove compartment.