Michael Crichton: A Case of Need

“I don’t understand,” I said. “You mean Sanderson is in this with you?”

“Yes,” Art said. “He has been for several years.” Sanderson was a very wise, very kind, and very proper man.

“You see,” Art said, “that whole chart is a lie. The girl was twenty, all right. And she had German measles. And she had menstrual irregularity, too, but the reason was she was pregnant. She had been knocked up on a football weekend by a guy she said she loved and was going to marry, but she wanted to finish college first, and a baby would get in the way. Furthermore, she managed to get measles during the first trimester. She wasn’t a terribly bright girl, but she was bright enough to know what it meant when you got measles. She was very worried when she came to see me. She hemmed and hawed for a while, and then blurted it all out and asked for an abortion.

“I was pretty horrified. I was fresh from my residency, and I still had a little starry idealism in me. She was in a terrible fix; she was a wreck and acted as if the world had collapsed around her. I guess in a way it had. All she could see was her problem as a college dropout, the unwed mother of a possibly deformed child. She was a nice enough girl, and I felt sorry for her, but I said no. I sympathized with her, feeling rotten inside, but I explained that my hands were tied.

“So then she asked me if it was a dangerous operation, to have an abortion. At first I thought she was planning to try it on herself, so I said it was. Then she said she knew of a man in the North End who would do it for two hundred dollars. He had been a medical orderly in the Marines, or something. And she said that if I wouldn’t do it for her, she’d go to this man. And she walked out of my office.”

He sighed and shook his head as he drove.

“I went home that night feeling like hell. I hated her: I hated her for intruding on my new practice, for intruding on my neatly planned life. I hated her for the pressure she was putting on me. I couldn’t sleep; I kept thinking all night. I had a vision of her going to a smelly back room somewhere and meeting a leering little guy who would letch her and maybe even manage to kill her. I thought about my own wife and our year-old baby, and how happy it could all be. I thought about the amateur abortions I’d seen as an intern, when the girls came in bleeding and foaming at three in the morning. And let’s face it, I thought about the sweats I’d had in college. Once with Betty, we sat around for six weeks waiting for her period. I knew perfectly well that anybody can get pregnant by accident. It’s not hard, and it shouldn’t be a crime.”

I smoked a cigarette and said nothing. “So I got up in the middle of the night and fought it out with six cups of coffee, staring at the kitchen wall. By morning I had decided that the law was unfair. I had decided that a doctor could play God in a lot of crappy ways, but this was a good way. I had seen a patient in trouble and I had refused to help her when it was within my power. That was what bothered me—I had denied her treatment. It was just as bad as denying penicillin to a sick man, just as cruel and just as foolish. The next morning, I went to see Sanderson. I knew he had liberal ideas about a lot of things. I explained the whole situation and told him I wanted to do a D & C. He said he would arrange to do the path examination himself, and he did. That was how it all started.”

“And you’ve been doing abortions ever since?”

“Yes,” Art said. “When I’ve felt that they were warranted.”

After that, we went to a bar in the North End, a simple place, filled with Italian and German laborers. Art was in a talkative, almost confessional mood.

“I often wonder,” he said, “about what medicine would be like if the predominant religious feeling in this country were Christian Scientist. For most of history, of course, it wouldn’t have mattered; medicine was pretty primitive and ineffective. But supposing Christian Science was strong in the age of penicillin and antibiotics. Suppose there were pressure groups militating against the administration of these drugs. Suppose there were sick people in such a society who knew perfectly well that they didn’t have to die from their illness, that a simple drug existed which would cure them. Wouldn’t there be a roaring black market in these drugs? Wouldn’t people die from home administration of overdoses, from impure, smuggled drugs? Wouldn’t everything be an unholy mess?”

“I see your analogy,” I said, “but I don’t buy it.”

“Listen,” he said. “Morality must keep up with technology, because if a person is faced with the choice of being moral and dead or immoral and alive, they’ll choose life every time. People today know that abortions are safe and easy. They know it isn’t a long, tedious, dangerous operation. They know it’s simple and they want the personal happiness it can give them. They demand it. And one way or another they get it. If they’re rich, they go to Japan or Puerto Rico; if they’re poor, they go to the Marine orderly. But one way or another, they get that abortion.”

“Art,” I said. “It’s illegal.”

He smiled. “I never thought you had so much respect for the law.”

That was a reference to my career. After college, I entered law school and stuck it out for a year and a half. Then I decided I hated it and quit to try medicine. In between, I did some army time.

“But this is different,” I said. “If they catch you, they’ll toss you in the clink and take away your license. You know that.”

“I’m doing what I have to do.”

“Don’t be an ass.”

“I believe,” he said, “that what I’m doing is right.” Looking at his face, I saw he meant it. And as time went on, I personally encountered several cases where an abortion was the obvious, humane answer. Art handled them. I joined Dr. Sanderson in covering up in the path department. We fixed things so that the tissue committee never knew. That was necessary because the tissue committee of the Lincoln was composed of all the chiefs of service, as well as a rotating group of six doctors. The average age of the men on the tissue committee was sixty-one, and, at any given time, at least a third were Catholic.

Of course it was not a well-kept secret. Many of the younger doctors knew what Art was doing, and most agreed with him, because he exercised careful judgment in deciding his cases. Most would have performed abortions too, if they had dared.

A few didn’t agree with Art and would have been tempted to turn him in if they’d had the guts. Anal retentives like Whipple and Gluck, men whose religion precluded compassion and common sense.

For a long time, I worried about the Whipples and the Glucks. Later on I ignored them, turning away from their nasty knowing glances and pinched, disapproving faces. Perhaps that was a mistake.

Because now Art was down, and if his head rolled, so would Sanderson’s. And so would mine.

THERE WAS NO PLACE TO PARK near the police station. Finally I came to a lot four blocks away and walked quickly back to find out why Arthur Lee was in jail.

WHEN I WAS IN THE ARMY a few years back, I served as an MP in Tokyo, and the experience taught me a lot. MP’s were the most unpopular people in the city in those days, during the last phases of the occupation. In our white helmets and uniforms, we represented the final reminders of a tiresome military authority to the Japanese. To the Americans on the Ginza, drunk with sake or whiskey if they could afford it, we represented all that was frustrating or constricting about rigid military life. We were therefore a challenge to anyone who saw us, and more than one of my friends ran into trouble. One was blinded by a knife in the eye. Another was killed. Of course, we were armed. I remember when we were first issued our guns, a hard-nosed captain said to us: “You have your weapons, now take my advice: never use the gun. You shoot a rowdy drunk, even in self-defense, and you’ll find out later his uncle is a congressman or a general. Keep the gun in sight, but keep it in your holster. Period.”