Eighteen years as a practicing gynecologist taught Dr. Kimberly Madison that the best way to conduct a pelvic examination was to steer the conversation as far as possible from the pelvis.
That was a bit more difficult with a nervous 16-year-old who had her feet in the stirrups for the first time.
The usual small talk about husbands, kids, careers, and recipes—meant as a distraction while Dr. Madison gently intruded into an adult woman’s most private region—didn’t quite fit with someone Alex’s age. Neither did banter about boyfriends that Kim reserved for younger patients, considering that Joey, the young sperm donor, was sitting out in the waiting room.
So, the veteran woman’s doctor played it straight with an emphasis on sympathy mixed with humor.
“Rumor has it you had a little run-in with Typhoid Mary,” the doctor joked as her gloved hands gently examined Alex’s vulva for irritation, warts, discharge or other symptoms of infection.
“God, what a bitch!” Alex responded. “Frauds like her ought to be arrested.”
“Well, we’re doing our best with the state legislature,” the doctor assured, “but the religious right has lots of money.
As Dr. Madison spoke, she gently inserted a speculum, a hinged metal device that looked like a duck's bill, into Alex’s vagina. She held it open momentarily to inspect the condition of her patient's cervix. Almost immediately thereafter, she used a long cotton swab to wipe a few cells from the cervix. This would be Alex's first PAP test.
Before Alex could could think about it very much, the dual-tongue speculum had been expeditiously and painlessly withdrawn.
“Are you okay?” Kimberly asked as she probed Alex’s vagina with two fingers while she gently pressed down on her abdomen with the other hand.
“It doesn't hurt. I’m just still a little nervous,” Alex replied. “I never thought that when Joey and I did it . . . had sex on the spur of the moment . . . that it would lead so quickly to something as involved this.”
“I’m sorry, honey,” the doctor replied. “I was as surprised as anybody when I heard the FDA had suddenly recalled the morning-after pills. Emergency contraception is usually a lot easier than this. You don’t have to have a pelvic exam to take a pill.”
As she spoke, Dr. Madison deftly and methodically conducted a tactile check of the area surrounding her patient’s internal reproductive organs: the uterus, fallopian tubes, and ovaries.
“Before we can give you an IUD, we have to do a full gynecological exam,” she explained. “We’ve got to make sure you have no disease or abnormality of any of your female parts.”
“That’s okay,” Alex responded. “It's my fault. I brought this on myself by being so careless about contraception. I want to thank you for opening the clinic after hours, just for me.”
“You were lucky to walk into Tim Keegan’s pharmacy,” Kim said. “He’s done more for women’s rights in Seattle over the past couple of dozen years than just about anybody. I owe him, big time, so when he called I was glad to come down to the clinic and meet you.”
An observer would have been impressed by the fluidity with which Dr. Madison conducted her examination while engaging in non-stop conversation. The skilled gynecologist’s hands were always moving independently of her lips, striving to get the physically painless but psychologically stressful pelvic exam completed as quickly as possible for the patient’s sake.
All the while, Kimberly discussed how, when she was a young OBGYN, Tim Keegan had taken her under his wing in the first years of her practice, when she suffered repeated threats because she chose to provide abortion services.
“Okay, this is going to feel like a bowel movement,” Kim interjected, interrupting her own personal narrative.
As the doctor spoke, her fingers danced a carefully choreographed medical ballet, slipping out of one pair of latex gloves, into another, lubricating one finger, and then gently inserting it into Alex’s anus.
Before the teenager could react, the doctor had already checked the condition of her rectal muscles, felt for tumors, and then quickly withdrawn the gloved finger.
“Okay, you’ve passed your pelvic exam with flying colors,” Dr. Madison chirped in a happy voice. “Are you ready for your IUD? It won’t take very long.”
“I guess, so,” Alex sighed. She tried to relax.
* * *
As the flashing blue lights of a police cruiser illuminated the fenced-in parking lot of the White Eagle Clinic, the car's PA system blared the coded banter of the dispatcher’s calls on the regional law enforcement radio network. The volume was loud enough to be heard inside the clinic's waiting room, where Sergeant Phil Blackwell of the Seattle Police Department conferred with Drew and Joey. Fortunately, the insulation installed in the bowels of the clinic, to thwart the fanatical chanting of anti-abortion protesters outside, shielded Alex and Dr. Madison from hearing the distracting din as the examination progressed.
Across the street at the Crisis Pregnancy Center, Mary Magdalene O’Shea rallied a number of Coalitions for Life supporters, some with picket signs. It was all a show staged for the representatives of the news media who showed up to cover the latest skirmish in Seattle's reproductive rights struggle. Two television trucks parked in the Center’s lot extended their hydraulic stabilizing jacks to support deployed, dish-like satellite transmission antennas that beamed the proceedings live into TV station news rooms. It must have been a slow news night in the Puget Sound area.
Sergeant Blackwell, a veteran of 15 years on the force, was no stranger to the culture wars that enveloped the pro-choice and pro-life camps in his native Seattle. Nominally a political conservative who might have otherwise enlisted in the anti-abortion forces, Phil had come to resent the Coalition’s abusive and deceptive tactics.
Himself a parishioner at Our Lady of Perpetual Adoration Church, he had come to regard Mary O’Shea as one of the agitators who made life difficult for law enforcement. While his religious beliefs deplored abortion, like so many contemporary practicing Catholics he was able to separate his civic consciousness. As the father of two teenage daughters, he wanted nobody outside the family telling them how they could exercise their reproductive rights.
If God wants to punish people who have abortions, let Him take it up with them, Phil thought privately. And as far as contraception is concerned, it was just plain nuts to discourage it. Absence of birth control produced more abortions.
“There’s no way that the Pregnancy Center is going to press charges against your daughter,” Sergeant Blackwell assured Drew. “They know they’re on thin ice with the state legislature, which is investigating their tactics. Our own police department’s fraud division also has a file open on the Coalition for Life.
"They're using Mary O'Shea's run-in with Alex as a publicity stunt," the officer advised.
“But you’ve got to counsel your daughter that she can’t be grabbing a scissors out of some trouble maker’s hand and throwing it around,” he admonished.
As Drew nodded, thankful that there would be no further legal complications, he kicked himself silently for letting Alex go on her own to seek her emergency contraception. If he had accompanied her, he’d have smelled a rat at the Crisis Pregnancy Center.
It wasn’t easy being a father, Drew sighed silently. And he had five more to rear after Alex. He thanked the police officer for his understanding and received assurances that patrolmen would be on hand to escort the family safely off of the clinic grounds after Alex’s procedure.
Across the street at the developing dog and poly show being staged by the Coalition for Life, two neatly groomed gentlemen in dark suits stood apart from the crowd. One was the Coalition’s executive director, a Forth Degree Knight of Columbus whose status as a board chairman of one of Seattle’s largest banks allowed him to oversee the Coalition’s financial affairs. The second overdressed gentleman was a senior partner in one of the Puget Sound area’s largest corporate law firms, a conservative partnership that that provided pro bono legal representation for the Coalition.
Both shook their heads as they conferred in hushed tones. One of these days, they agreed, they’d have to do something about Mary O’Shea’s fanaticism. Perhaps they could get rid of her once the Supreme Court's emerging conservative majority finally overturned Roe v. Wade and made banning abortion a state-by-state prerogative.
For now, she was doing a bang-up job raising hell, raising funds, and raising public awareness. In the quarter hour since the Crisis Pregnancy Center had set up a phone bank, which occurred only 45 minutes after Alex's flying scissors broke the ultrasound machine's monitor, it has already received enough pledges to replace the broken parts. Local television stations had already carried the story of Alex’s scissors throwing and broadcast pictures of the shattered glass. By tomorrow, if donations continued on pace, the Crisis Pregnancy Center’s annual budget would be met.
Outside the White Eagle Clinic, Sergeant Blackwell noticed a disturbing trend. A dozen sign-carrying protesters had crossed the street and positioned themselves outside the wrought-iron fence that surrounded the Clinic. They stood on each side of the gated driveway where Drew, Alex, and Joey would emerge after Alex's procedure. Not good, the veteran policeman thought.
Not good at all.
To be continued . . .