Yesterday, there was a long human interest story in the Washington Post describing how staunchly pro-abort Johns Hopkins University School of Medicine med student Lesley Wojick determined to abandon her aspiration to become an abortionist to instead be an anesthesiologist.
Lesley’s reasoning was honest, although, despite what she did and saw, she’s still pro-abortion. ‘Don’t get that. But here’s how she decided, after helping commit a 2nd trimester abortion:

“It was definitely gruesome,” she said. “You could make out what a fetus could look like, tiny feet, lungs, but it didn’t look like a person.” She knew this abortion was an act that her friend Litty considered tantamount to murder. She herself expected to be very upset….
But this was different. She didn’t regard the fetus as a person yet. She said she was happy to help the woman: “I feel like I was giving [her] a new lease” on life….

Later that morning, though, while conducting a pelvic exam, Lesley noted that she wasn’t her usual slow, gentle self. That evening, discussing the second-term abortion with her mother, Lesley described a process that she found disturbingly brutal, especially the stretching of the vagina.

lesley 2.jpg

“It’s a lot more invasive than I thought,” she said. “A papaya doesn’t bleed and scream.” Women do.
Lesley didn’t want to have to steel herself emotionally to perform abortions, and she was coming to realize that that’s what she’d have to do….
As for obstetrics, the once-perfect mix of medical, surgical and preventive care for women, Lesley hadn’t loved very much about it. Even as she’d shadowed the abortion doctor, Lesley knew in her heart that this would not be the right place for her to make a difference. It was a big disappointment, she said. “I really thought I’d love it.”
The things she cared about — taking care of women, seeing them through the process — hadn’t happened. It was the nurse practitioner who cared for the patient. Vacuuming out a uterus and counting the parts of the fetus did not seem like a desirable way to spend her work days. It took a unique person to do that on a daily basis, she said.
Lesley still believed passionately in abortion rights…. Even so, she had to follow her heart. Somebody else – maybe Laura Merkel, the new chapter president of Medical Students for Choice – would become an abortion provider. But it wouldn’t be her.

I wrote earlier this year how Yale Daily News yanked an inappropriate article on papaya abortions.
But they’re back. Read about Lesley’s papaya abortion experience on page 2.
[Photos courtesy of The Washington Post; photo of instruments taken at Planned Parenthood of Metropolitan Washington]
Lesley’s description of the papaya abortion procedure…

It was Christina, the Students for Choice chapter president, who proposed holding a papaya workshop to expose more students to abortion. She’d heard about such a workshop at a national Students for Choice gathering. It was a hands-on opportunity for second-year medical students to learn how to perform an abortion, using a papaya as a stand-in for a woman’s uterus. Lesley thought it was a great idea.
The women enlisted doctors, residents and nurses from Maryland and Johns Hopkins to run the workshop and e-mailed an invitation to all second-year students. They promised dinner, a sure bet to lure medical students…. Soon the workshop, which could accommodate 20 students, had a waiting list – and the women organizing it had a small firestorm on their hands.
In her e-mail, Christina had hoped to attract participants by suggesting that they’d have fun learning the procedure: “You’ll get the opportunity to be shown how to use manual vacuum aspirators using papaya models (apparently papayas bear a striking resemblance to a uterus. Who knew?)”
But some of the students who received the invitation didn’t see it that way. “This is a serious matter,” one told Christina. Those offended by her tone demanded to be dropped from any future Medical Students for Choice e-mails. After consulting a dean, the women didn’t remove any names from their list, but they decided to word future missives more carefully.
On the day of the workshop, Christina wiped out the stock of papayas at a Whole Foods store. The man behind her at the checkout wanted to know what she was using them for.
A medical procedure, she told him.
Come on, tell me, he pushed. A suture?
Something like that, she said she responded. She was not about to get into an abortion discussion in the supermarket.
Bizarre as it might seem to perform an operation on a papaya, in medical school it isn’t unusual. Fruit or other food is regularly used to describe things in obstetrics. A uterus holding an 8-week-old fetus is the size of a naval orange. After 12 weeks, it is more like a grapefruit. The uterus itself is shaped like, well, a papaya….
“This is so cool,” said Lesley, who believed she was doing something important to address the shortage of abortion doctors. After years of defending abortion rights, she would finally learn how the procedure is done.
Ten women and 3 men showed up for the workshop, fewer than the organizers had expected….

After heaping their plates with food and chatting about the recent test, the students cleared the lab tables for the teaching doctor to lay out her equipment and pass around photocopies of her lecture slides. Her tray contained a pair of scissors with a sharp tooth on each end, for grasping body parts during surgery, called a tenaculum.
The doctor gave a short lecture on first-trimester abortions. Then she showed the students how to grip the papaya with the scissors to hold the angle of the “cervix” straight on. With one hand, the doctor demonstrated how to administer a local pain killer, at 3 o’clock and 9 o’clock positions. She picked up different sizes of dilators used to widen the cervix and advised against pushing them in too hard, because in a soft-skinned papaya, the dilators might come out the other side. In a woman, more pressure would be needed to slide the dilator past the cervix and into the cavity of the uterus.
The doctor next picked up the suction instrument, a manually operated vacuum suction syringe. It was attached to a cannula, or thin tube, that she inserted into the papaya. She rotated it around the fruit’s cavity, pulling and pushing the syringe, suctioning the papaya’s contents.
“This is the most important thing and the hardest to learn,” the doctor said as she pulled out lots of seeds and juice, what in a real abortion she called the “products of conception,” or POC. “You put the POC into a bowl, repeat if necessary, and examine them under a microscope to make sure you got everything,” she advised.
There was silence as she passed around photos of a dish with a light under it from a real abortion. It contained something that looked like a cotton ball, a yolk sac, and some blood and tissue. It was hard to make out any parts of a fetus under 3 months old, which, she said, is when more than 90 percent of all abortions are performed.
“How do you know you are done?” a student asked.
When you do it often enough, the doctor replied, you’ll notice a gritty feel as you are scraping the uterus. If not, there is another tool, a rod with a spoon, one side sharp as a knife, to scrape again.
Now it was the students’ turn to try the procedure in the lab next door. Imagining herself working on a real woman, Lesley looked tentative as she pushed up her sleeves and reached for the razor-sharp tenaculum.
“This just seems so awful,” she exclaimed as she tried to grab the papaya with it. “Do [patients] feel this?”
Her look turned to fright when the nurse practitioner at her station answered that they do.
Why not apply the local anesthetic before gripping the cervix with the sharp instrument? Lesley asked. The answer: A doctor needs something to hold the cervix steady to administer the drug.
Lesley offered Christina the suction instrument to try first, and Christina took it without hesitation. “You can feel once you get into the hollow part,” Christina told Lesley.
When Lesley’s turn came, she ignored the directions and numbed the papaya before using the scissors. Then she gripped the papaya with the scissors, dilated it with the instrument in her other hand, and suctioned it with the vacuum, twice bringing up lots of seeds and pulp. Finally she tried the curet, the spoon with one sharp side, and pulled out still more pulp.
“So,” she asked the nurse, “did we not suction correctly, or is this a papaya issue?”
“It’s the papaya,” the nurse replied.
The whole thing was over in less than three minutes, but Lesley had plenty of questions.
“Do you feel you have to distance yourself emotionally from your patients?” she asked the nurse practitioner.
“No,” she answered.
“Are patients sad? Upset?”
“Many times they are sad,” the nurse said, but also relieved. “They have made up their minds.” Some cry afterward, she added. “I tell them it’s normal to grieve. It’s a loss.”
“Do they ask you, ‘How can you work here?’ ”
“I tell them, ‘I meet wonderful ladies like you,’ ” the nurse said.
Lesley bit her lip and tried the procedure again, and this time she asked technical questions, all the while thinking of what she might say to the patient, how she would explain what she was doing.
On her second try, she perforated the papaya, but she knew the fruit was far softer than a woman’s uterus would be. She put down the instruments. “Now I know how to do one, I guess, if I needed to,” Lesley said.
But she seemed to be harboring reservations about the procedure. She thought using the tenaculum was barbaric: “I don’t know, insensitive. You’d think there’d be something else besides digging into the cervix with a toothlike instrument.”…

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