Life's Work

A Moral Argument for Choice

Dr. Willie Parker

• Publisher: 37 Ink
• Year: 2017
• ISBN:
  9781501151149
• Topic: Medicine
• Subtopic: Medicine Biographies

In this "vivid and companionable memoir of a remarkable life" ( The New Yorker ), an outspoken, Christian reproductive justice advocate and abortion provider reveals his personal and professional journeys in an effort to seize the moral high ground on the question of choice and reproductive justice. Dr. Willie Parker grew up in the Deep South, lived in a Christian household, and converted to an even more fundamentalist form of Christianity as a young man. But upon reading an interpretation of the Good Samaritan in a sermon by Dr. Martin Luther King, Jr., he realized that in order to be a true Christian, he must show compassion for all people at all times. In 2009, he stopped practicing obstetrics to focus entirely on providing safe abortions for women who need help the most—often women in poverty and women of color—in the hotbed of the pro-choice debate: the South. He thereafter traded in his private practice and his penthouse apartment in Hawaii for the life of an itinerant abortion provider, becoming one of the few doctors to provide such services in Mississippi and Alabama. In Life's Work, Dr. Willie Parker tells a deeply personal and thought-provoking narrative that illuminates the complex societal, political, religious, and personal realities of abortion in the United States from the unique perspective of someone who performs them and defends the right to do so every day. In revealing his daily battle against mandatory waiting periods and bogus rules, Dr. Parker makes a powerful Christian case for championing reproductive rights. "At a moment when reproductive health and rights are under attack…Dr. Parker's book is a beacon of hope and a call to action" (Cecile Richards, President of Planned Parenthood).

CHAPTER 1

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Conversion

In 2002, when I was forty-one years old, my life, by any measure, was good. I lived on the penthouse floor of a fourteen-story condo in Honolulu, Hawaii, that had floor-to-ceiling glass walls overlooking the Pacific Ocean. This meant that when I flopped onto my living room couch after a day of work and flipped through the channels on my television set, the backdrop twinkling beyond the television looked to me, having grown up in a small, tin-roofed house in Birmingham, Alabama, like something conjured in a dream—big, looping waves sparkled in the setting sun and then collapsed, frothing as their tongues and fingers reached the shore. As a kid, I had been mesmerized by the opening credits of Hawaii Five-0, and as a middle-aged man I still marveled daily at the fact that the view I possessed was entirely real. I had arrived in Honolulu the previous year, having accepted a faculty appointment at the University of Hawaii, and I spent my days working as a supervising physician at the Queen Emma Clinic, an outpatient clinic for indigent people, including many native Hawaiians, connected to the Queen’s Medical Center, a teaching hospital for the university. My university affiliation allowed me to see more affluent patients in a private practice, but my main job, which occupied most of my time, was to help run the women’s health division of Queen Emma and to oversee the work of several dozen medical residents, all in training to become ob-gyns, as I was.

The clinic was a ten-minute walk downhill from my house, across a highway and through a residential neighborhood, where front gardens blossomed with fragrant orchids, birds of paradise, and red and white blooming ginger. I frequently stopped at a convenience store on my walk to work, and picked up a Spam musubi to eat on the way: steamed rice topped with Spam and wrapped in seaweed; occasionally, as I strolled downhill, I would catch the scent of a rotting guava, fallen off a tree and now sweet and fermenting in the sun, or the pungent odor of the lilikoi fruit. Ripe nectarines grew abundantly on trees, practically begging me to pick them. The dramatic botanical and culinary diversity of Hawaii, so different from where I grew up, was echoed by an astonishing diversity in the ethnic, cultural, and racial admixtures of the people called Hawaiian. As an African American, I was the rarity. The Hawaiians have a word for black people, which is popolo, and for white people, haole; the majority of people inhabiting the islands are mixed, and the colors of brown I saw on an everyday basis made up a rainbow, indeed—the result of Japanese, Chinese, Filipino, white, and native Hawaiian people intermingling and procreating over generations.

Energized by the company of others and always seeking out novel experiences, I am an extrovert by temperament. My boyhood had been defined by sports: I was a fairly good left fielder, and though not as gifted as some of my peers, I was proficient enough to be recruited my senior year of high school by a community college for its baseball team. Now I had season tickets to the university’s football team, the Rainbow Warriors; the famous woman’s volleyball team, the Rainbow Wahine; and when the Lakers came to Honolulu for their regular two-week preseason retreat, I frequently went to watch them play. The medical residents at the Queen Emma Clinic were a young, tight crew, more than happy to stick together and enjoy one another’s company far past the grueling training hours required of them. When we clocked out at the end of a twelve- or twenty-four-hour shift, whole groups of us would retire to any bar with a sign in its window offering $2 DRINK. There, we would order pitchers of beer and gigantic platters of pupu, the Hawaiian version of soul food: pork chops, chicken wings, edamame, poke, kimchi fried rice, calamari, lomi lomi salmon—like home but with a Polynesian twist. I joke sometimes that the only people who like to set pigs on fire more than black people are Hawaiian people, and when I think of Hawaii now, one of my strongest memories is the smell of barbecue, sweet and burned, infusing the air. This was paradise, for real. I had no reason to ever want it to end.

Professionally, I was fulfilled as well. The man who had wooed me to Hawaii was an old mentor of mine, an eminent reproductive endocrinologist named Dr. Bruce Kessel, who had been an attending doctor when I was doing my residency in ob-gyn at the University of Cincinnati. During a phase of my life when I felt eternally exhausted and vulnerable, working long shifts and living in constant fear of making a fatal mistake, Bruce distinguished himself from his peers with his kindness. We reconnected several years later in Boston, when he was working at the Beth Israel hospital and I, having moved to Cambridge to get a degree in public health from Harvard, knew no one. In Hawaii, we were a good fit. Together with Dr. Mark Hiraoka, a local Japanese-Hawaiian surfer boy turned ob-gyn, we made a sort of dream team of supervising attendings: the residents at Queen Emma were eager to work with us.

Bruce and I came from different worlds. He was the son of a prominent doctor, whereas I was fatherless and had experienced firsthand the inadequacies of the health care available to indigent people. Starting from these opposite orientations, both of us believed that the health-care system should not punish poor people, either in terms of quality of or access to care, simply because they were poor, and we both believed strongly in a holistic approach: a woman should be able to come to the Queen Emma Clinic and, in one place, get all her health needs met—to be treated for the flu and deliver her baby and get an older child vaccinated seamlessly.

On an average day, the ob-gyns at Queen Emma saw between twenty and forty patients. We did it all. We did routine gynecological care: pelvic and breast exams, Pap smears; we treated urinary tract infections, incontinence, yeast infections; we screened for STDs. We did prenatal care, monitoring pregnancy-induced diabetes and preeclampsia; and we delivered babies, doing C-sections and handling miscarriages as needed. There were all the other usual medical departments in the Queen Emma Clinic as well, so if a woman presented to us with hypertension, we might refer her to the internal medicine unit; if the internists saw a woman with abnormal vaginal bleeding, they would refer her to us. We prescribed birth control pills, inserted IUDs, and offered a fair amount of routine sex education.

As part of this menu of services, the clinic also did abortions. Bruce Kessel had been trained in abortion care as a matter of course when he was a medical resident in the early eighties. The way Bruce told it, the years after Roe were an exuberant time, and physicians who cared, as he did, about public health and family planning rejoiced over the freedoms and possibilities that legal abortion promised women. I was in college during those years, devoting myself to my growing passion for service by going door-to-door in my dorm, informing my college classmates about the gospel of Jesus, so it’s hard for me to imagine a time when abortion rights were so enthusiastically embraced by individual practitioners—a sea change from today, when so many of my colleagues in ob-gyn are reticent to stand up for abortion, let alone to perform them themselves. But doctors of Kessel’s generation, especially those who believed in family planning as a path out of poverty, sought out abortion expertise and were proud to have done so.

As a young physician, Bruce moonlighted at Planned Parenthood, which was then as it is today, the largest single provider of reproductive health services, including abortion and prenatal care, in the United States. As the senior attending and the recognized expert in fertility and menopause, he did abortions himself and trained any resident interested in learning how to do them. None of this, I might add, drew anyone’s particular attention. Hawaii is, and was at the time, an extremely liberal state. Even today, Hawaii has passed none of the bans and restrictions that other state legislatures have imposed on abortion since the early 2000s—no waiting periods, no parental consent, no counseling rules—and for the vast majority of Hawaiian women living almost anywhere on the islands, abortion is easily available. As far as we were concerned, abortion was a nonissue. The clinic did them when women said they needed them, at a rate of about a hundred a year.

• • •

I, personally, didn’t raise my hand to be trained in abortion care and didn’t plan on doing them at all. When I was fifteen years old, I had become a born-again Christian, the result of studying the Bible under the tutelage of a charismatic and driven young Pentecostal minister in Birmingham named Mike Moore. On a sunny day in 1978, I asked for and received the indwelling of Jesus and a certainty of his love for me—a belief I hold strongly, and gratefully, to this day. This experience changed me. It gave me a sense of joy, of possibility, of a future, which I had never been able to contemplate before. But as it grew, my role as an evangelizing Christian among my friends and neighbors also placed me in a larger fundamentalist world defined by a whole lot of rules and obligations, and characterized, sometimes, by what I came to understand later as a kind of shallow conformity about what Christian people “should” and “should not” do. I lived in a world of moral certitudes: Sex outside of marriage was sinful. Unwanted pregnancy was sinful. Women were almost always the ones who had to bear the public shame of that sinfulness. So many of these rules were taken for granted in the churches of my youth, embedded in their rhetoric and principles, that though the bald facts of my own life told a feminist tale—I myself was the child of a single mother; the starting third baseman on our community baseball team was a girl—I accepted the double standard. It did occur to me to wonder about the justice of it all. These teenage girls don’t get pregnant by themselves, I would think. But as a young person, my Christian identity was far more important to me than interrogating the inconsistencies of my faith. So even as a middle-aged man, having spent more than a decade in training as an ob-gyn, and a subsequent decade caring for women, I retained that powerful Christian identity, constricted as it was by convention and custom. Abortion fell into the category of “should nots.” Consequently, as a young doctor, I made a fragile promise to myself. To uphold my professional commitment to caring for women, I would refer patients seeking abortion to doctors who would provide them. But for me, I continued to insist that providing abortion was wrong. I would not do them.

Looking back it’s hard to believe, but until the spring of 2002, when I was living in bliss in Hawaii, the circumstances of my life had insulated me from having to really wrestle, in a deep and nuanced way, with the question of abortion. When I was a child, abortion wasn’t a topic of any conversation, polite or otherwise. When I was a young teenager, encountering Jesus for the first time, the political terms “pro-life” and “pro-choice” did not exist, nor did the milieu that forced people to pick a side. And though through Mike Moore, who was first my baseball coach and then my pastor and friend, I became enraptured with the idea of God’s radical, egalitarian love, I was not yet in possession of the intellectual tools to unpack or query the fundamental sexism embedded in the ancient Scripture, or to discover for myself a more nuanced, or feminist, vision of justice. Now I see the Bible as it was written: the inspired word of God, but also a historical document preserving the ancient hegemony of men; starting with Eve, women are always thrown under the bus when it suits the men in power to do so. But the way I understood Christianity as a young person was literalistic, strictly black and white. The churches I was raised in were patriarchal. The father was the head of the family, just as Jesus was the head of the church. I tried, as Mike taught me, to emulate Jesus by upholding a biblical standard of sexual purity—and I did. I did not have sex until I was twenty-one, and so, unlike the other teenagers in my neighborhood, I never had to face the actual fear of an accidental pregnancy, nor the heart-thrumming anxiety of what that pregnancy might mean—not just to the future of the woman or girl in question, but to me, as an equal participant in the conception. My life was all about serving God. Having chosen heaven, I didn’t want to risk the chance that I might go to hell.

Abortion first entered my vision only abstractly, as a news event, with the rise of the Moral Majority, the very vocal and political Christian constituency whose anti-abortion rhetoric helped elect Ronald Reagan in 1980. I had just left Birmingham for college when slogans such as “Life begins at conception” began to be bandied about. And my first effort at grappling with abortion was intellectual, too—as removed from the real lives of real women as I was at the time. In my first year at Berea College, in 1981, I wrote a paper about abortion for a required freshman course called Issues & Values; my professor, who had formerly been a Catholic priest, suggested the topic to me. In those days, I traveled almost exclusively in fundamentalist Christian circles. No one I knew talked about having abortions, and I had no clue where one of my classmates might get an abortion in central Kentucky, had she decided she needed one. Committed personally to sexual abstinence, I was totally oblivious to the real-life circumstances that might lead a woman to that decision. And so I did not question the rigid Christianity I had learned at home, which was perpetuated by my Christian friends and mentors at school. I held fast to my understanding of the moral rights and wrongs concerning the sacredness of sex and marriage, and the potency of God’s will. In my paper, I called abortion a “life-ending process.” As a believer in the healing power of prayer, I hoped women in this undesirable situation might enter into their decision making “prayerfully.” God, I hoped, would find a way. About fetuses and their viability, I had no opinion at all. As a child in Birmingham, my friends and I used to watch cows and dogs mate. We knew where babies came from, but we never moralized about the process.

I learned a black-and-white faith, but I am not a black-and-white person. Even in college, my love for science began to chip away at some of the absolutist claims of my faith. In medical school at the University of Iowa, I even began to see how abortion might be regarded as necessary health care for women. Partly, my own personal world had expanded. In the years since my Issues & Values paper, I had become sexually active, and for the first time in my life had to cope with the emotionally fraught aftermath of a broken condom. My girlfriend at the time, an ambitious woman with her sights set on a very competitive residency, made me promise, tearfully, that if she became pregnant I would support her decision to terminate the pregnancy and not ask her to bring a fetus to term. She had worked hard her whole life and wanted to become an orthopedic surgeon more than anything. Moved by her anxiety that I might fail to be a loving support to her, and by my own strong desire to defy the stereotype of the sexually irresponsible black man (even though nothing in my personal history indicated that I might conform to it), I easily agreed—an agreement that cost me nothing because she did not become pregnant. Then, in my third year of medical school, as part of my coursework, I decided to observe abortions on my ob-gyn rotation for the simple reason that I was curious. I had no part in performing them, but for the first time, I took the patients’ medical histories and was in the room with the doctor where the procedures occurred, and I remember understanding, profoundly, that these women were like me. They were mostly college students—eighteen, nineteen, or twenty years old. I was twenty-five. In the moment, they were choosing to pursue their educations over parenthood. Their decisions resonated with me: they made sense. The moral absolutes that I had learned in church began further to erode.

It is a testament to the strength of my Christian faith that it took me so long to revise my stance on abortion, for the seeds of my personal revolution were in me from childhood. But even after medical school, when I saw that I related to and empathized with the women who sought out abortion care, and even in Hawaii, where attitudes around abortion were relatively relaxed, I still refused to do them myself. Part of this was circumstance. At the University of Cincinnati, where I did my residency, abortion care was not offered as part of the program, and the university hospital did not openly perform abortions at all. The first abortion clinic bombings post-Roe had occurred in Cincinnati in 1978, and I believe that, situated as the hospital was in a conservative, Republican city, its administrators had decided not to take up the fight. So even though I was being trained to provide health care for women, I saw only one abortion performed during the whole time I was there: my attending physician, Dr. Paula Hillard, who has since become a friend, discreetly did a fourteen-week procedure in the operating room and invited me to observe. That observation was the extent of my experience with the procedure. As a young doctor, it was easy for me to say I wouldn’t do abortions, because the fact was, I couldn’t do them. I didn’t know how.

Later, when I worked as an ob-gyn in general practice in a community health center in medically underserved Merced, California, circumstances again conspired to protect me from the conflicts that were rising in my own conscience. There were no abortion providers within fifty miles of the Golden Valley Health Center women’s clinic, so every patient seeking an abortion had to be referred away. For almost the entire time that I was a practicing ob-gyn there, I had the luxury of holding on to my unexamined Christian morals, uncontested by circumstance. I could tell myself that I was doing good work, helping poor women deliver healthy babies, and providing birth control to teenagers and working against domestic violence. But on the question of abortion, I could continue to absolve myself of having to take responsibility for my own inaction, pointing to the authorities or circumstances or laws that barred me from doing battle with myself. I was not pro-life. I believed in a woman’s right to choose. But I was complicit with anti-abortion forces in that I did not place myself on the front lines.

• • •

In March of that year in Hawaii, however, the line I had drawn was getting harder and harder to defend. The board of the Queen Emma Clinic had recently hired a new chief administrator, a man I will call here Dr. Sweet. He was a lovely person, Hawaii born and bred, with a gentle, nonconfrontational demeanor, and I knew that he was a Bible-believing Christian, as I was. He began his tenure like a lamb, deferential, but his intention soon became startlingly clear. Within months of his arrival, Dr. Sweet let it be known that the Queen Emma Clinic would no longer be providing abortion services to its patients. His rationale was, in my opinion—then and now—misbegotten.

It was the beginning of the George W. Bush era, and anti-abortion sentiment was at a peak. Dr. Sweet told us that if we continued to offer abortion services to patients, our Title X money—federal funds that support the family planning needs of poor people, excluding abortion—would be at risk. This was not true. Family planning clinics receiving Title X grants have merely to have rigorous accounting practices to show a separate funding stream for their abortion services. (Planned Parenthood clinics still receive Title X money; they just can’t use it to support their abortion practice.) But Dr. Sweet had been raised in fundamentalist Christian churches, as I was, and he was now the target of zealous political activism by anti-abortion forces who were telling him, from the pulpit, and on Christian television and radio, that “abortion is murder.” Sweet was no fanatic, but a gentle, traditionally minded man disinclined to question the religious authorities in his life, a person who hoped more than anything to discharge his professional duties within the context of his Christian faith. The prominent spokespeople for his faith were telling him that abortion was evil, and, in my opinion, he chose to believe them. I understood his dilemma—no one understood it better than I—but I vehemently disagreed with his action. In fact, I was surprised at how fast indignation boiled up within me. This was a public hospital serving an indigent population. I believed, based on long years in the field of public health, that the services we offered should be based on the needs of our patients and not subjected to the religious beliefs of the doctor.

Dr. Sweet’s edict coincided with a time of a dramatic change in the way anti-abortion activists were waging their war against abortion rights. The 1990s had been characterized by violence and hatred: threats, bombings, assassinations of clinic workers, and massive demonstrations aimed at the Supreme Court and, more broadly, at the hearts and minds of the public. As a medical resident I had been dimly aware of this war—the Planned Parenthood clinic in Cincinnati had been firebombed in December 1985, five years before I arrived there, and the abortion doctor David Gunn was assassinated in Florida in my final training year—but until Dr. Sweet’s intervention, I thought of the battle as raging “out there.” Partly because ob-gyns are trained to concentrate on obstetrics, I was paying attention to delivering babies. And partly, I did not feel pressed to wrestle with...