Hektoen International

The doctor in literature: the abortion and the abortionist
Part 1

Volume 3, Issue 1 - January 2011

Solomon Posen, MD
Sydney, Australia

"I will not give to a woman a pessary to cause abortion. But I will keep pure and holy both my life and
my art."1
“It’s an awfully simple operation.”2

 

The Doctor and His Patient
By Jan Steen, Dutch (1626-1679)
Oil on canvas, 76 x 64 cm
Rijksmuseum, Amsterdam

The clinical scenario of a physician confronted by a desperate woman begging for a termination of her pregnancy is extremely common in the real world. The associated ethical dilemma is mentioned in the Hippocratic Oath,1 together with specific instructions concerning the doctor’s response.

This paper presents a portrayal of doctors in the context of unwanted pregnancies, as described in works of fiction, mainly dating from the last 100 years. While legal and technical considerations relating to abortions have changed considerably over this period, the portrayal of the abortionist (like that of the medical entrepreneur3) remains largely unfavorable.

Historical: literature of the eighteenth and nineteenth centuries

In eighteenth century literature abortions were not only openly discussed, but even treated facetiously and as a source of amusement. Smollett4 tells the story of a servant girl who has been “familiar” with Launcelot Crab, a surgeon of disgusting appearance and disposition. When the young lady tackles Crab with news of her pregnancy for which he may have been responsible,

[H]e was far from being overjoyed at this proof of his vigor … [He]… persuade[d] the girl that she was not with child but only afflicted with a disorder incident to young women, which he would easily remove. With this view (as he pretended) he prescribed for her such medicines as he thought would infallibly procure abortion.4

The scheme fails, not on account of anyone’s religious scruples, but because the young woman, encouraged by Roderick Random, uses her pregnancy to blackmail her master rather than accept his treatment.4

Samuel Richardson5 treats the subject less indulgently. Sally Martin, who begins her career as the mistress of the notorious Robert Lovelace, and subsequently becomes a London prostitute, has reached a stage where,

the effects of [her] … guilty commerce … became too apparent to be hid … She practiced to bring on an abortion which she effected though she was so far gone that it had like to have cost her life. Thus unchastity her first crime, murder her next.5

Abortions were still widely available during the early nineteenth century. Indeed, operators like "Madam Restell" openly advertised their "experience and knowledge in the treatment of female irregularity" in the popular press during the 1840's.6 "Self injecting syringe(s) ... with ... intrauterine tube(s)" were manufactured and marketed in the USA until anti-abortion legislation was introduced between 1870-1900.6

During the nineteenth and early twentieth centuries the subject became taboo, so that works dating from that time fail to mention even homely and useless "remedies" such as hot baths,7 jumping off the dining room table,7 large quantities of gin,7 and castor oil.8 Unplanned pregnancies (real or pretended9) amongst unmarried women were likely to lead to hasty marriages, not necessarily to the biological father.10, 11 Alternatively, a wealthy and powerful man might offer to set up a business for a potential suitor of a discarded, pregnant mistress, so as to make her more desirable as a "package deal."12 "Fallen" or adulterous women who became pregnant and did not commit suicide tended to go into premature labour13 delivering sickly infants who did “what was expected of them,”14 dying spontaneously in the neonatal period.13, 14, 15 A few babies were killed by their distraught mothers.16, 17 The surviving "children of shame" were handed over to strangers who treated them with varying degrees of brutality.18, 19 A few courageous women brought up their children single-handedly, sometimes at the cost of considerable social isolation.20 If termination of pregnancy ever entered the minds of these women as a possible option, such thoughts are not even alluded to in nineteenth century literature, let alone acted upon.

Unmentionable activities, cleaning up the mess

A bungled abortion is mentioned, somewhat obliquely, in Arthur Schnitzler's play Professor Bernhardi21 which was first produced in 1912. In the first scene, we hear about an 18 year old girl who is dying in a Vienna Hospital of what sounds like gram negative septicemia resulting from an "illegal operation." The patient herself never appears and the audience is left to guess what might have preceded her admission. The professor, who is in no way responsible for the girl's death, lands in jail through performing what he considers his duty. Similarly, Iris Storm in The Green Hat,22 comes to medical attention on account of “septic poisoning” which develops after what was probably an abortion23 though the nature of the procedure and Iris’ subsequent treatment are not revealed.

Eugene O’Neill, whose 1928 play Strange Interlude24 appears to condone abortions on eugenic grounds, does not once use the expressions “termination” or “abortion.” When Nina Evans tells Dr. Darrell the story of her pregnancy and its termination because of insanity in her husband’s family, she refers to the procedure as “an operation.” 25 The abortionist never appears.

Several novels published during the 1930's and early 1940’s 26-30 describe fictional doctors who have to tidy up after messy procedures performed by unidentified individuals or by the patient herself. Céline's Dr. Bardamu26 is summoned to see a young girl who has evidently been bleeding for some hours (there is a pool of blood on the floor). He advises immediate transfer to hospital, because even an adequate examination is impossible at home, but the girl's mother will not hear of a hospital admission. She prefers a "respectable" death at home to the inevitable publicity associated with hospitalization.26 Bardamu, corrupted by his poverty, meekly collects his fee of 20 francs, and departs.

Vicky Baum's Dr. Emanuel Hain27whose first patient was "a girl writh[ing] on a blood soaked mattress ... in a stuffy garret" seriously considers notifying the police and is only restrained by the "progressive ideas” recently acquired from a friend.27 Hain escapes unscathed from this episode but he pays dearly for his progressive ideas later on.

Dr. Alexander Addams, an intern, and Louise Boyer, a social worker, first meet at the sordid scene of a bungled abortion.28 The girl dies of septicemia and both Alexander and Louise are called to give evidence at the trial of the abortionist.28 The two become interested in each other and subsequently marry, but their sex-life is unsatisfactory and there are no children.29

Dr. Routh Graham,30 a newly graduated doctor trying to cope with a paratyphoid epidemic, comes across Rhiannon Price-Davies, a young woman suffering from the after-effects of a septic abortion. He even meets up with the abortionist, a ”mildewed midwife,” who comes to check on her victim in hospital. The whole affair makes him feel “disgusted because it was sordid and as far removed as possible from his idea of medicine.”30 (Rhiannon recovers and the police do not become involved).

“Virtuous” refusals

By the time when demands for abortions began to be mentioned in twentieth century fictional literature,24-38 anesthetic agents and sterile procedures were readily available. However, licensed doctors (real or fictional) generally continued to adopt the Hippocratic1 attitude.

The diary of Söderberg's Doctor Glas31 contains several accounts of pregnant women who implore this cynical doctor to rescue them:

A poor woman was here weeping and begging me to help her ... Married to a minor official, four thousand crowns a year ... with three children. In the first three years the babies came, one after another. Since then, for five years ... she has been spared. Has regained a little health, strength, youth ... And now, all of a sudden, here it is again ... She could hardly speak for tears … I replied, of course, with my usual lesson. Known by rote, I always recite it on such occasions: My duty as a doctor. Respect for life, even the frailest. I was serious, immovable. In the end she had to go away; ashamed, bewildered, helpless. I made a note of the case. The eighteenth in my practice. And I'm not a gynecologist. 27 [Glas strongly distrusts his stated motives in refusing to help this poor woman]. Respect for human life—what is it in my mouth but hypocrisy? Human life ... swarms around us on every hand. And as for the lives of faraway, unseen people, no one has ever cared a fig for them ... And duty! An admirable screen to creep behind, when we wish to avoid doing what ought to be done.31[The doctor justifies his inaction on practical grounds.] No one can risk his ... social position, respectability, future, everything, merely to help strangers he is indifferent to. Rely on their silence? That would be childish. Some woman friend gets into the same fix, a word is whispered as to where help is to be found and soon you're a marked man. No, best stick to duty.31

On another occasion a male acquaintance asks Dr. Glas "to help his girl-friend out of a fix. He talked about old memories and headmaster Snuffe ... I was unshakable. I recited my doctor’s oath to him. This impressed him to the extent of his offering me two hundred crowns cash and a bill to the same amount, together with his lifelong friendship. It was almost touching ... I threw him out." 32

Doctor Glas expresses some regret over not having helped the very first patient who asked him for a termination, a single girl "a big dark haired rather vulgar young beauty" who begged him to "save her." The doctor advises her to talk to mother. "She'll talk to Papa, and there'll be a wedding."31 There is indeed a hasty, somewhat undignified marriage to the "counter-jumper Don Juan."33 The non-aborted infant turns out severely retarded with "evil stupid eyes." "Couldn't I have helped her that time when in her hour of utmost need and despair she went down on her bended knees?"34

Doctor Glas’ pretended reverence for the "sanctity of human life" does not prevent him from murdering one of his patients, whose wife, also a patient of Dr. Glas, can no longer tolerate her husband's sexual endeavors.35,36

Another early hypocrite who virtuously refuses to terminate a pregnancy because of alleged moral scruples is described by Theodore Dreiser in An American Tragedy.37 Dr. Glenn who declines to help Roberta Alden because "his conscience will not permit [him to] destroy life" is quite happy to suspend his religious principles when "heavily sponsored" girls from good families require to be "extricated from the consequences of their folly."38,39

Hypocritical or not, doctors asked for a pregnancy termination in the pre-Roe v Wade days, generally refuse on moral or legal grounds with varying degrees of virtuous indignation:

The 'girl in trouble' was almost an institution in King's Row. Doctors were periodically visited by worried young men wanting to know if there was 'anything she could take, you know.' They never seemed to learn that there wasn't.40

Dr. Jim Wyatt, the romantic medical hero in Elizabeth Seifert's Bright Scalpel41 is asked by mother and father Downing to "get rid of the[ir] girl's baby." Jim who will have nothing to do with such wickedness, refuses as a matter of course. The Downings go elsewhere, only to be refused again, and the pregnancy continues its natural course.

Cronin's Dr. Andrew Manson42 becomes highly indignant when a married clergyman asks him, somewhat ambiguously, for advice on the subject. "You're a very up to date doctor by all accounts and purposes. You're in the way of knowin' everything that's new. And I'd be glad—mind you I'll pay you a nice little fee too ... You see the wife and I don't want any children for a while ... " Manson, whose wife is unable to have children, loses his temper and tells the patient to get out of his sight, calling him "a dirty little man of God."42

Dr. Andrew Thompson, of White Plains,43 who is ”beginning to establish a reputation throughout Westchester County,"44 also reacts with rage when consulted about the feasibility of a termination. In his case the objections are based on legal rather than moral grounds. The person seeking advice is Andrew’s brother Leroy, a Broadway director and producer, who believes he has impregnated a young actress and who has traveled to White Plains to ask Andrew to help him out:

'Certainly not!' said Andrew indignantly. 'Why, you must be crazy if you think I'm going to jeopardize my career and my family life and everything that goes with it just because you haven't learned to keep your pants buttoned.' 'I'm not asking you to do anything about it personally. All I'm asking is that you send me to the right place. What's so unusual about that?' 'I don't know any people like that, and if I did I wouldn't do anything about it. Supposing something went wrong and the girl died. Or somebody started talking and my name got dragged into it. I'd be ruined professionally and maybe even lay myself open to criminal prosecution. No thanks, I'm not having any of it. You got yourself into this and you can damned well get yourself out.'44

Dr. Chris Arden, the hero of Mary Rinehart’s The Doctor,45 who is consulted by an unmarried, pregnant woman, does not even consider abortion as an option. Instead, he presents an ultimatum to Jerry Ames, the father of the unborn child and one of the city’s eligible bachelors: Either Ames provides some financial support for his former girl friend, or his current fiancée will be notified.46 After an initial outburst of anger, Jerry tries diplomatic tactics. Why could Chris not terminate the pregnancy?

‘See here Arden. You’re a doctor. If you’re so interested in her why don’t you get her out of this mess?’ ‘She doesn’t want out,’ said Chris quietly. ‘And I’m not interested as you call it. I never saw her until tonight. I wouldn’t do it anyhow. Apart from the risk to her, it’s against the law.’ ‘Is it against the law if there’s enough in it?’ Jerry asked nastily. Chris kept his temper with difficulty. ‘I’ll let that go,’ he said. ‘She’s going to have this child and she isn’t asking a great deal. She doesn’t see it as blackmail, nor do I. After all, you’re the father.’46

Another description of a refusal on legal grounds is to be found in Doctor Rose,47 written in the 1980’s but set in the 1920’s. The patient in this instance is a twenty-year-old woman with an unemployed husband and two children under the age of eighteen months. She is now pregnant for a third time and inquires if Dr. Rose Stanton can do anything for her,48 “If you mean can I get rid of the baby, the answer is No. It’s against the law, even if I were agreeable. What you really need is advice on how not to have babies so close together. But now isn’t the time.“

In addition to “it’s against my principles” and “it’s against the law” there is the occasional “it’s against your best interests” that makes doctors refuse to terminate a pregnancy. Doris Lessing’s Dr. Stern49 is consulted by newly-married Martha Quest who wants contraceptive advice. From the moment Martha enters his office, Stern is convinced that contrary to what she says, what she really needs is a baby, and, of course, he wins the unequal struggle between doctor and patient. His standard "lecture designed for the instruction of brides," contains some half-hearted recommendations concerning birth control. When Martha displays "a greater degree of sophistication than he was used to" and mentions an alternative contraceptive device, Dr. Stern proceeds “to recommend the method she herself had suggested, and with as much warmth as if he had never recommended another." 49 The consultation ends amicably but once outside the office, Martha realizes that "Doctor Stern had said nothing at all." The doctor remarks to his nurse "that in three months' time [Martha] would be back in this room crying her eyes out and asking him to do an abortion—he knew the type."50

Dr. Stern’s predictions prove correct. Some weeks later Martha reappears suspecting that she might be pregnant. The doctor "explored the more intimate parts of Martha's body with rubber-gloved fingers and at the same time made conversation about the international situation. Finally he informed Martha [incorrectly] that he did not think she was pregnant, she might set her mind at rest … He then made the mistake of complimenting her on her build which was of the best kind for easy child bearing. Martha was stiff-lipped and resentful and did not respond. He quickly changed his tune saying that she needn't think about such things yet." 51

After another two months' amenorrhea, a full bottle of gin, a boiling hot bath and ineffectual leaps off the table,7 Dr. Stern informs Martha during a further visit that she is over four months pregnant:

He saw her reproachful look and said that doctors were not infallible ... She looked at [his] grave responsible face and hated him bitterly from the bottom of her heart. She asked him bluntly if he would do an abortion. He replied immediately that he could not. There was a long and difficult silence. Dr. Stern ... reached out for a small statuette which stood on his desk. It was in bronze of a mermaid-like figure diving off a rock. He fingered it lightly and said ‘Do you realize that your baby is as big as this already?’ It was about five inches high. ... ‘Eyes, ears, arms, legs—all there.' Martha was so bitter that she could not move or speak a word. All she was for him ... was a 'healthy young woman.’7

[As a parting shot, Dr. Stern tells her] with a real human kindness that she was able to appreciate only later, that she should think twice before rushing off to see one of the wise women: her baby was too big to play tricks with now. If she absolutely insisted on an abortion she should go to Johannesburg where as everyone knew, there was a hospital which was a positive factory for this sort of thing. The word 'factory' made her wince and she saw at once ... that it was deliberately chosen. 7 [Dr. Stern ultimately takes care of Martha during the birth of a healthy girl.]

Margaret Drabble, who is more sympathetic to physicians than most female authors, describes a consultation between a pregnant writer (Lydia Reynolds) and a psychiatrist. Lydia hopes to enlist the doctor’s help in legitimizing an abortion52 but he refuses, not on moral, legal or pecuniary grounds, but because he genuinely believes that an abortion would do more harm than good.53

Off I went to convince this ... fat old man ... that if I had this baby I was going to be a mental and physical wreck. ... He asked me all my life story and I told him the whole lot which was great fun—ferocious mother, dad bumped himself off because she bullied him, four roomed house, squalor, sent to work at sixteen. ... By the end of my recital I felt so sorry for myself, I nearly burst into tears … When I finished he said he was very sorry but in my case ... he couldn't possibly recommend termination of the pregnancy. He said I was too sensitive and impressionable and conscientious, and that in cases like mine, termination was far more likely to lead to a breakdown than going to full term.53 [Lydia has a spontaneous miscarriage "without any effort at all."]

Medical fathers aborting their own fetuses are described,54-57 but the phenomenon is rare. Whether this is due to a reluctance of any but the most depraved physicians to destroy their own offspring is unclear. Dr. Jesse Vogel58 evidently feels too paternal towards Reva Denk’s fetus to contemplate an abortion. Jesse is infatuated with Reva, a former patient, an artist and an artists' model, but his feelings are not reciprocated. She has no time for Jesse who does not understand art in general and her own paintings in particular,59 and she resists his advances.60 A few years later, when Jesse has developed into an eminent neurosurgeon, she turns up again, ostensibly to renew their acquaintance but in reality to enlist his help in obtaining an abortion.61 Jesse, who has been fantasizing about Reva bearing his children, is disgusted when he finds out what she is after, and tells her to go to hell. However, some weeks later he follows her to an artists’ colony in Northern Wisconsin62 offering to leave his wife and daughter to marry her and to be a father to the unborn child. Nothing comes of this proposal and the reader never discovers how Reva's pregnancy ends.

Repulsive abortionists

Up in Pennsylvania I met a little man
Not Rumpelstiltskin at all, at all...
He took the fullness that love began.63

As soon as abortionists reappear in fictional literature they are portrayed as physically and intellectually repulsive individuals, who possess few redeeming features other than their willingness to carry out the “forbidden” procedure (for an exorbitant fee). These characters display lecherous tendencies,64-67 they are ignorant of the most elementary principles of hygiene,67and several are drunkards.67-68 The type persists for most of the twentieth century..

Axel Munthe's abortionist69 is "a coarse and cynical … fellow ... The last time he had called me in had been to assist at the agony of a young girl dying of peritonitis under very suspicious circumstances, so much so that it was with hesitation that I consented to put my name next to his on the death certificate."69

Céline's Dr. Sabayot, a confirmed alcoholic,68 is appointed municipal medical officer as a reward for performing abortions on the girl-friends of local politicians. There are no disasters—his hands have not as yet developed their chronic tremor.68

Theroux' Lucy67 who has been refused help by a fashionable Park Avenue doctor, finishes up under the "care" of a dirty, smelly and unshaven alcoholic.67 Lucy has to meet this person in a bar, he drives her to an isolated, dilapidated house and he rapes her prior to inserting a metal tool which he had brought in a paper bag.67

Van der Meersch, who exaggerates, and whose medical details are often inaccurate, begins his Bodies and Souls55 with an abortion. Santhanas, a senior medical student has tried to terminate the pregnancy of his current girlfriend, to whom he refers contemptuously as "a bit of skirt." The bungled procedure is carried out by candlelight without any pretense at asepsis, the girl lying "on an old piece of oil-cloth ... which was drenched with blood." Fortunately, Santhanas has the sense to summon a more competent friend who completes the procedure, checks the uterus for perforations and takes the girl home to her "highly respectable lower middle class parents" giving her a lecture in the taxi.55 Santhanas comes across as an incompetent, dissipated and despicable character who is referred to as a swine by his colleagues. 70 He manages to graduate but he is subsequently expelled from the University Hospital for falsifying a laboratory result. Moreover, he is discovered to be living on the immoral earnings of his mistress.70

Konsalik's Dr. Alf Bornholm56 although medically highly qualified, is another vicious character. He aborts one of his discarded girlfriends, kills her in the process and manages to attach the blame to his current lover, Erika Werner.71 He is ultimately exposed and disgraced.

When Weldon’s Helen Lally,66 makes plans to have her pregnancy terminated, she consults Dr. Runcorn66 another revolting character. Runcorn is described as:

an evil man … a small plump fiftyish doctor with pebble glasses through which he stared at Helen's most private parts while his stubby fingers moved lingeringly (so it seemed to Helen) over her defenseless breasts and body ... 'We don't want to leave the little intruder in there any longer than we have to' said Dr. Runcorn in his wheezy nasal voice. 'At ten tomorrow we'll set about getting you back to normal! A shame for a girl as pretty as you to waste a single day of her youth ... Next time you go to a party ... remember me and don't get up to mischief. You've been a very naughty girl.' "66 (There is no abortion and “the little intruder” develops into “Little Nell”).

A particularly repulsive abortionist appears in Susan Schaeffer’s The Madness of a Seduced Woman,72 Dr. Grimsby was a "short plump man" who:

stank of sweat and smoke …. His skin hung loosely from his skull, his lips were thin and bitten and the top of his head gleamed yellow under his oily hair.73

 

Grimsby, who performs abortions in patients' homes, is received by Agnes Dempster and her sensible friend Polly. His first two questions are "Who's the patient?" and "Who's got the money?"73 " 'It's here,' Polly said holding out an envelope, 'you can have it when you've finished.' 'Now, or I don't do it at all,' he said." Dr. Grimsby then makes Agnes work the curette on herself so as to protect himself from subsequent prosecution:

'Just a minute!' Polly hissed; 'we're not giving you all that money to do this ourselves' ... He threw the envelope down on the bed next to me. 'It's yours,' he said. ‘I'll just pack up.' 'No,' I said, you have to do it.' ' Little lady,' he said nastily, 'I don't have to do anything I don't want to do.' 73

After a few further threats and counter-threats Agnes agrees to handle the instrument herself, despite her intense pain. At the end of the procedure Dr. Grimsby announces: " 'She'll be all right in the morning.' 'And if she's not,' said Polly's voice ... then we don't call you, do we?' 'Don't call me,' he said, 'I never saw you before.' 'Get out of here,' Polly said, 'or I'll shout the house down.' 'You're all the same,' the doctor said, 'you can't wait to get me here and then you can't wait to get rid of me.' "73

Graham Greene in A Gun for Sale 74 describes yet another physically repulsive abortionist: Dr. Alfred Yogel’s "hair was jet black. He looked as if it had been dyed and there was not much of it. It was plastered in thin strands across the scalp. When he turned he showed a plump, hard bonhomous face, a thick sensual mouth ... He smelled faintly of brandy." Yogel is consulted by James Raven, the hare-lipped criminal, who wants his appearance changed immediately, and who evidently can not understand that Yogel would be quite incapable of performing the appropriate plastic surgery.75

The doctor's receptionist is as disgusting as her employer. She has "a mean lined face and untidy gray hair. Her uniform needed washing: It was spotted with grease marks and what might have been blood or iodine. ... She was toughened by a long career of illegalities, by not a few deaths." The shabby waiting room is illuminated by a single bare light globe and contains as the only pieces of furniture "a chair (and) a round oak table splashed with dark paint.” The set-up is entirely in keeping with an abortionist’s sordid establishment in the days before abortions were decriminalized... Raven, the hired killer, feels betrayed when he discovers that Yogel is planning to hand him over to the police. "These people were of his own kind; they didn't belong inside the legal borders."75

The doctor who performs Mary Whitney’s abortion,76 is incompetent as well as rapacious.77

Two days later [Mary] said she'd ... heard of a doctor who could help her; he was the doctor that the whores went to when they needed it; and I did not know what she meant, having never heard of such doctors. And she asked if I would lend her my savings ... The doctor lived in a large enough house in a good neighborhood. We went in by the servants' entrance and the doctor himself met us. The first thing he did was to count the money. He was a big man in a black coat and looked at us very severely; and he told me to wait in the scullery and then said if I told anything about it he would deny ever having seen me. Then he took off his frock coat and hung it on a hook and began rolling up his shirtsleeves as if for a fight. [There is much screaming during the procedure and Mary dies the next day.]77

Dr. Matthew O’Connor78 whose “interest in gynecology” has compelled him to move his “practice” from San Francisco to Paris,79 though well educated and articulate, with an original turn of mind, now lives in filthy conditions, and supplements his “gynecological” income80 with hand-outs from friends and acquaintances.81 Like the rest of the characters in Nightwood, O’Connor is a grotesque freak. He has turned into an alcoholic,82 and a thief who steals not only money but also cosmetics, which he proceeds to apply to himself. 83,84

John Barth's The End of the Road85 contains a detailed account of Jacob Horner's search for an abortionist, which leads him and his lover to an untrained man and to disaster. The story is set in "Wicomico", a small college town in Maryland in the year 1953. The patient is Rennie Morgan who has become pregnant after an adulterous relationship with Horner, though there is some doubt about the paternity of the fetus. Rennie, who threatens to kill herself unless her pregnancy is terminated, consults her regular doctor who tells her "she should be ashamed."86 Horner then telephones every doctor in Wicomico, (in alphabetical order), calling himself Dempsey and quoting the names of several fictional out of town psychiatrists who have allegedly diagnosed desperate mental troubles in his wife. Predictably, the Wicomico physicians are unhelpful; three of them refuse to discuss anything at all over the telephone,87

Doctor #7, to my inexpressible relief seemed not quite so unreceptive to my story. ... He sounded like a younger man ... 'Now Mr. Dempsey,' he said when I'd finished my piece, 'you realize that any doctor who agrees to help your wife is assuming considerable responsibility. ... I sympathize with your problem ... and the law does provide that where there's a clear danger to the patient's life, certain measures can be taken at the physician's discretion. You admit that Mrs. Dempsey is in good physical condition so the question is whether her psychological condition is as serious as you believe it is. That would be a difficult thing to prove if anyone wanted to make an issue out of it and I may as well tell you that certain of my older colleagues in Wicomico would jump at the chance to make an issue out of a thing like this. Frankly I'm not the martyr type.' [Doctor #7's loquacity gives Horner some hope.]87 Any professional man who would criticize his colleagues to a perfect stranger on the telephone was, I guessed, a man with whom arrangements could be made.

However, Doctor #7 is not quite as gullible as he first appears. Unimpressed with Horner's impersonation of a Philadelphia psychiatrist, the doctor demands a signed affidavit before he will act. He is also somewhat conspiratorial. "Despite the fact that this won't be illegal, we'd just as well keep it quiet." In the end the procedure is performed by an unnamed itinerant black crank who calls himself a doctor but whose medical expertise and qualifications are highly suspect.88 This man relieves Horner of his remaining funds and performs a brutal curettage. He fails to ascertain that Rennie had eaten a large meal just before presenting to his "establishment" and Rennie dies from inhalation of vomitus during an ether anesthetic.

Skeet MacGowan, a glib drug-store clerk in Faulkner’s As I Lay Dying89 has no medical training whatsoever, and would be quite incapable of performing an abortion. However, he has learnt enough of the jargon to impersonate a doctor, and to behave in a way he considers appropriate to an abortionist. Skeet evidently finds his encounter with Dewey Dell Bundren highly entertaining. She is seventeen, simple, distraught, and almost totally inarticulate.90

‘Now, madam,’ I says, ‘what is your trouble?’ ‘It’s the female trouble,’ she says, watching me. ‘I got the money,’ she says. ‘Ah,’ I says, ‘Have you got female troubles or do you want female troubles? … You got something in your belly you wish you didn’t have?’ She looks at me. ‘You wish you had a little more or a little less, huh?’90

When Dewey Dell finally indicates that she is pregnant and insists that she needs urgent help, the “doctor” persuades her that she requires a further “operation” consisting of the insertion of his own organ. ”It won’t hurt you. You’ve had the same operation before. Ever hear about the hair of the dog?“ Skeet, who is opportunistic rather than vicious, at least lets Dewey Dell keep her ten dollars.90

References

  1. Hippocrates (5th century B.C.) The Oath. In: The Works of Hippocrates, (translated by Jones WHS) Loeb's Classical Library, Harvard University Press, Cambridge, 1962, vol. 1. pp. 299-301.
  2. Hemingway E (1927) Hills Like White Elephants. In: The Complete Short Stories of Ernest Hemingway. Scribner Paperback Edition, Simon and Schuster, New York, 1998, pp. 211-4.
  3. Posen S (2005) The Doctor in Literature: Satisfaction or Resentment? Radcliffe Publishing, Oxford, 298 pp.
  4. Smollett T (1748) The Adventures of Roderick Random. Dent, London, 1964, pp. 33-7.
  5. Richardson S (1747-1748) The History of Clarissa Harlowe. In: Stephen L (ed.) The Works of Samuel Richardson. Henry Sotheran, London, 1883, Vol. 8, p. 512.
  6. Mohr JC (1978) Abortion in America. Oxford University Press, New York, 1979, pp. 51-67.
  7. Lessing D (1954) A Proper Marriage. In: Lessing, D Children of Violence. Hart-Davis, MacGibbon, London, 1977, vol. 2, p. 416-9.
  8. Davies R (1985) What's Bred in the Bone. Penguin, Harmondsworth, 1988, p. 36.
  9. Hardy T (1895) Jude the Obscure. Macmillan, London, 1971, pp. 64-77.
  10. Maugham WS (1919) The Moon and Sixpence, Penguin, Harmondsworth, 1953, pp. 141-2.
  11. Young FB (1928) My Brother Jonathan, Heinemann, London, p. 553.
  12. Ibsen H (1884) The Wild Duck. In: Ibsen H Three Plays (translated by Ellis-Fermor U). Penguin, Harmondsworth, 1957, pp. 233-4
  13. Hardy T (1891) Tess of the D'Urbervilles. Macmillan, London, 1975, p. 123.
  14. Barbery M (2006) The Elegance of the Hedgehog (translated by Anderson A). Europa Editions, New York, 2008, p. 288.
  15. Cronin AJ (1931) Hatter’s Castle. Gollancz, London, 1967, p. 383.
  16. Shakespeare W (1606) Macbeth. In: The Folger Library General Reader’s Shakespeare, Wright LB and LaMar VA (eds.), Washington Square Press, New York,1969, Act IV, Scene 1, p. 58.
  17. Eliot G (1859), Adam Bede. Penguin, Harmondsworth, 1986, Chapter 43, pp. 476-82.
  18. Maupassant G. de (1884) A Parricide. In: The Entire Original Maupassant Stories. (translated by McMaster, AMC, Henderson AE, Quesada LCG and others). NuVision Publications, Sioux Falls, SD, 2007, 730 pp., pp. 166-9.
  19. Munthe A (1929) The Story of San Michele. John Murray, London, 1950, p. 203.
  20. Hawthorne N (1850) The Scarlet Letter. Ohio State University Press, Columbus, OH, 1971, pp. 89-99.
  21. Schnitzler A (1912) Professor Bernhardi (translated by Landstone H). Faber and Gwyer, London, 1927, pp. 10-16.
  22. Arlen M (1924). The Green Hat. George H Doran, New York, pp.180-6.
  23. Posen S (2006) The Doctor in Literature: Volume 2. Private Life. Radcliffe Publishing, Oxford, p. 170.
  24. O'Neill E (1928) Strange Interlude. In: The Plays of Eugene O’Neill. Random House, New York, 1955, Vol. 1, 633 pp.
  25. Ibid., p. 83.
  26. Céline LF (1932) Journey to the End of the Night, (Translated by Manheim R). New Directions, New York, 1983, pp. 223-7.
  27. Baum V (1939) Nanking Road, (translated by Creighton B), G. Bles, London, p. 37.
  28. Fineman I (1938) Doctor Addams. Random House, New York, pp. 62-4.
  29. Ibid., pp. 95-8.
  30. Arey JS (1943) There Was No Yesterday. Eyre and Spottiswoode, London, pp.171-6
  31. Söderberg H (1905) Doctor Glas (translated by Austin PB), Chatto and Windus, London, 1963, pp. 17-19.
  32. Ibid., pp. 145-6
  33. Ibid., p. 56.
  34. Ibid., p. 74.
  35. Ibid. p. 122
  36. Posen S (2006) The Doctor in Literature: Volume 2. Private Life. Radcliffe Publishing, Oxford, p. 114-5.
  37. Dreiser T (1925) An American Tragedy. Signet Classics, New York, 1964, 831 pp.
  38. Ibid., pp. 397-407.
  39. Posen S, op. cit., pp. 124-5
  40. Bellaman H. and Bellaman K (1948) Parris Mitchell of Kings Row. Simon and Schuster, New York, p. 81.
  41. Seifert E (1941) Bright Scalpel. Aeonian Press, New York, 1973, p. 10.
  42. Cronin AJ (1937) The Citadel. Gollancz, London, pp. 213-6.
  43. Rice E (1949) The Show Must Go On. Gollancz, London, 1950, 458 pp.
  44. Ibid., pp. 411-3.
  45. Rinehart MR (1935) The Doctor. Farrar and Rinehart, New York, 506 pp.
  46. Ibid., p. 224.
  47. Rhodes E (1984) Doctor Rose. Century Publishing, London, 256 pp.
  48. Ibid., pp. 56-8.
  49. Lessing D, op. cit., p. 314.
  50. Ibid., p. 317.
  51. Ibid., p. 394.
  52. Drabble M (1965) The Millstone. Weidenfeld and Nicolson, London, 199 pp.
  53. Ibid., pp. 73-4.
  54. Faulkner W (1939) The Wild Palms. Random House, New York, 339 pp.
  55. Van der Meersch M (1943) Bodies and Souls, (translated by Wilkins E). William Kimber, London, 1953, pp. 11-13.
  56. Konsalik, HG (1962) Doctor Erica Werner (translated by Bell A). Aidan Ellis, Henley on Thames, 1979, 202 pp.
  57. Ruddick J (2001) Death at the Priory.Atlantic, London, 209 pp.
  58. Oates JC (1971) Wonderland. Vanguard Press, New York, 512 pp.
  59. Posen S, op. cit. p.145
  60. Ibid., pp. 349-51
  61. Ibid., pp. 366-81
  62. Ibid., pp. 390-403.
  63. Sexton A (1962) The Abortion. In: Sexton A The Complete Poems. Houghton Mifflin, Boston, 1981, p. 61.
  64. Crichton M (Hudson J, pseudonym) (1968). A Case of Need. Signet, New York, 1969, 416 pp.
  65. Ibid., pp. 28-30.
  66. Weldon F (1987) The Hearts and Lives of Men. Fontana Collins, Glasgow, 1988, pp. 67-77.
  67. Theroux P (1989) My Secret History. Penguin, London, 1990, pp. 164-86.
  68. Céline LF (1936) Death on the Installment Plan, (translated by Manheim R). New Directions, New York, 1966, p. 32.
  69. Munthe A, op. cit., p. 170.
  70. Van der Meersch M, op. cit., pp.117-9.
  71. Konsalik HG, op. cit. pp. 80-95
  72. Schaeffer SF (1983) The Madness of a Seduced Woman. Pan Books, London, 1985, 656 pp.
  73. Ibid., pp. 324-6.
  74. Greene G (1936) A Gun for Sale (also titled This Gun for Hire). Heinemann, London, 1973, 227 pp.
  75. Ibid., pp. 29-33.
  76. Atwood M (1996) Alias Grace. Bloomsbury, London, 469 pp
  77. Ibid., pp. 174-6.
  78. Barnes D (1936) Nightwood. Faber and Faber, London, 1985, 239 pp.
  79. Ibid., p. 29.
  80. Ibid., p. 164.
  81. Ibid., p. 54.
  82. Ibid., p. 232.
  83. Ibid., p. 57-8.
  84. Posen S, op. cit., p. 221.
  85. Barth J (1958) The End of the Road. Doubleday, Garden City, New York, 1967, 188 pp.
  86. Ibid., p. 97.
  87. Ibid., pp.150-3
  88. Ibid., p. 172.
  89. Faulkner W (1930) As I Lay Dying, Vintage Books, New York, 1985, 267 pp.
  90. Ibid., pp. 243-7.

SOLOMON POSEN, MD an emeritus professor of medicine at the University of Sydney, majored in English before obtaining his medical degrees (MB BS, MD) at the University of Adelaide, Australia. He is a Fellow of the Royal Australasian College of Physicians, a Fellow of the Royal College of Physicians, London, and a past president of the Endocrine Society of Australia. He lives in Sydney, Australia.

Dr. Posen taught General Medicine and Endocrinology at Sydney University for almost 30 years and served on the Editorial Boards of several medical journals. He is the author of some 130 scientific papers (mainly in the field of calcium metabolism) and a co-author of a book on Alkaline Phosphatase. He is the author of a projected four-volume work titled The Doctor in Literature. The first volume, Satisfaction or Resentment was published by Radcliffe in 2005. The second volume, Private Life, appeared in 2006. This excerpt is from the third volume, Career Choices, yet to be published. Dr. Posen can be contacted at solposen@mail.usyd.edu.au.

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