Crazy Stable

Bernard Nathanson, MD, the abortionist and co-founder of NARAL turned pro-life advocate, has died at age 84.

I profiled him for The American Spectator back in 1985, when his video The Silent Scream was the talk of the abortion wars. He was a fascinating interview subject: prickly, a bit arrogant, and utterly unsentimental in his claim to have realized that he had presided, in his own words, over "60,000 deaths." He described himself to me as an atheist, but a decade later was received into the Catholic Church by Cardinal John O'Connor. 

Nathanson never told me what he thought of the profile, although years later his wife (the third of four, I believe) said he thought it was the best thing he'd read about himself. This surprised me, since I didn't go easy on him. The article is not available free on line, but presuming that the rights have reverted to me, I'm posting it here in PDF and below in its entirity. My favorite quote? The one where he describes how doctors can bring  themselves to perform abortions:

"I don't deny that I knew what a fetus looked like. But under political inspiration, you invoke an enormous mechanism of denial—a machine 500 feet high and made of lead. It's just a job, and you don't want to know about it. But when you start working with these ultrasounds, your mechanism of denial starts to fissure and crack. First thing you know, you're face to face with what you're doing. That's what happened to me between 1973 and 1977.”

Rest in peace, doctor.

Image: Associated Press

 

BERNARD NATHANSON'S

HIGH TECH HERESIES

Playing at an Ethical Culture Society near you, in ultrasound.

The American Spectator, October, 1985

 

Until recently, the two armed camps in the abortion debate had, for me at least, one thing in common: Both had upon numerous occasions insulted my intelligence. The pro-abortion crowd, with their doubletalk about the “contents of the uterus,” all seemed to suffer bouts of ethical epilepsy; I had yet to meet one who could define for me the exact moment or physiological change that turned “reproductive choice” into infanticide. (Their definitions of viability were even flimsier; most would have excluded toddlers and anesthetized surgical patients from the ranks of the living.) And the pro-lifers I'd encountered were grass-roots enthusiasts who appeared content to wallow in sentiment. As medical advances like fetal surgery and in-vitro fertilization brought us deeper into ludicrous paradoxes (like saving preemies young enough to be aborted, and fighting for the legal rights of zygotes), they went on handing out their blurry broadsheets and marching around clinics. Then came Bernard Nathanson, M.D.

I first learned about Nathanson in an unlikely place: New York, the glossy weekly for would-be Yuppies. Their profile article had obviously begun as a routine hatchet job on the Right-to-Life movement's most prized convert—a man who decided, after helping to found the National Abortion Rights Action League (NARAL) in the sixties, and supervising the biggest abortion mill in the country, that he had, in his own words, “presided over 60,000 deaths.” Yet the article wound up as a near-tribute to the renegade obstetrician who has almost single-handedly thrown the left into a defensive frenzy with his videotaped ultrasound scan of an actual abortion, The Silent Scream.

The man intrigued me. Even if he was a blatant media hound, as has been charged, there was some bizarre courage involved in ostracizing yourself so completely from all the best New York parties. I also wanted to see the film, if only because the feminist establishment has howled it down as the most dangerous piece of propaganda since Triumph of the Will.

I saw the film twice—once at a pro-life rally and once in a nest of pro-choicers. Then I sat and talked to the man who's being glorified and vilified for the rather simple act of showing what an abortion looks like. The experience convinced me of one thing: The wretched debate is entering a new phase that will utterly flummox the media with its complexity, which is to say they will largely ignore it. And it will make the old picket lines and shouting matches, the coat hangers versus the crucified baby dolls, look like child's play.

 

It is a raw night in late April, and I am sitting in a pew of St. John the Baptist Church in Yonkers, New York. The Silent Scream is on tonight's agenda of the parish pro-life committee, along with a live appearance by its narrator, Bernard Nathanson. He's late. The crowd waiting patiently is about three-quarters female and middle-aged, with a smattering of Nice Young Couples in jeans and nylon windbreakers. The folk group regales us with an atrocious pro-life song of their own composing; still no Dr. Nathanson. Finally, we go ahead without him, after being informed that the Blessed Sacrament has been reposed in the chapel. Good thing, I guess; what follows is strong stuff.

Strong, and flawed. The clips I've seen of Scream showed a fuzzy bobbling form that could have been a fetus—or just about anything else. Here, on a large screen, the images gain startlingly in clarity and impact. And the narration nails the congregants to their pews.

Nathanson, dapper and owlish, delivers it with laser-cool intensity. “When I was a medical student in 1949,” he intones, “we had no such science as fetology. We were taught that the unborn child was something in the uterus—but it was really an article of faith as to whether or not it was a human being. But the whole story has changed since the 1970s.”

He goes on to list the window-to-the-womb technologies “so discerning that the tiny valves of the heart can be studied as they snap open and shut. Those technologies have convinced us that beyond question the unborn child is simply another member of the human community, indistinguishable in every way from any of us.”

If this audience was not already convinced, it soon would be. “Now for the first time, we have the technology to see abortion from the victim's vantage point. Through ultrasound, we are going to watch a child being torn apart, dismembered, disarticulated, crushed, and destroyed by the unfeeling steel instruments of the abortionist.”

Aside from the soft clacking of the projector, you could hear a holy card drop. He presses on with a clinical description of dilation and curettage, holding tenaculum and dilators aloft disdainfully for the camera. We proceed to watch an abortion, and it's a stomach-turner.

At first, the ultrasound image is hard to sort out. But as minutes elapse, the pulsing contours become easier to identify, and it's sort of elating. (Whispered cries of “There it is!” punctuate the dark.) “We can see the child moving rather serenely in the uterus,” Nathanson says. Enter the suction tip, a stark white rod at bottom screen. “As it moves toward the child, the child will rear away from it and undergo much more violent, agitated movements.” Sure enough, the fetal image contracts like a poked sea creature, clambering up the far side of the womb. The little convulsion is eerily purposeful—and unquestionably a response to an outside stimulus.

The suction tip flashes across the grainy screen. Freeze frame: “Once again, we see the child's mouth wide open in a silent scream…It senses aggression in its sanctuary.” I squint hard: This so-called scream provoked the biggest outcry of charlatanism, and in this image as porous as coral, I admit I'm at a loss to discern it. This hyperbolic sticking point is maddeningly superfluous; what follows shakes us up far more than any alleged micro-scream.

“The heart has speeded up; the child is being pulled in a downward direction, and the body is now being torn systematically from the head.” Sickened groans; the instrument shadow yanks and tugs. Finally the free-floating head, a pathetic wandering golf ball on a gray sand trap, is extracted by forceps. “Now all we see remaining,” says the voice-over, “are the shards, the pieces of tissue, that document that there was once a living, defenseless, tiny human being here.”

As the lights go up, these parishioners seem ready to run out and give their life savings to the cause. Myself, I find there's one picture I can't get out of my mind; not the babies in bottles, not even the unnerving grappling on the ultrasound, but a brief shot of that woman lying in stirrups, her body jiggling as the suction machine chugs between her legs as insistently as a Roto-Rooter. It is an image of utterly pure and sanitized violence; nothing, not even the hacking of a saw through diseased bone, could seem so antithetical to the concept of healing, to the ancient dictate of primum non nocere. The scene looked like a Black Mass of medicine, savagely parodying the prostrate sacrifice of childbirth. It looked like—rape.

Nathanson's arrival at St. John's gets a standing ovation and much earnest fawning. He is impeccably clad in cream jacket and chocolate tie; he is also astoundingly articulate and a shameless showman. He tells us that abortion is not just a Catholic issue or he wouldn't be here, because he is an atheist; later, he deftly fends off a daft little old lady who harangues him for neglecting to mention that “abortion is an attack on the life of almighty God.” After receiving their zillionth red-rose lapel pins, he and his lovely wife head home to their Chelsea townhouse.

 

The next time I see Scream, the scene has changed to the gentrified brownstone neighborhood of Park Slope, Brooklyn. The ladies of the Brooklyn Pro-Choice Network have gathered in the basement of the Ethical Culture Society (where else?) to view the loathed film and screen a Planned Parenthood rebuttal. Nathanson boasts correctly that he's moved the fight onto his turf; it's a bristling bunch.

These central-casting feminists are a predictable lot. The required facial expression is one of sardonic boredom, usually assumed while droning about how “exciting” something is. Little makeup to be seen, but many work-boots and scrubby antique clothes.

We start out on an objective note. “The alleged science shown in this film is laughable; feel free to laugh,” sneers our young moderator. As the film progresses, a tide of nervous, derisive giggling ripples through the room. The word “fetology” is a hoot, for reasons unclear. All the weak spots I noticed subliminally in the first showing—the somewhat sappy music, the soft-focus shots of sad post-abortion women who look like feminine-freshness commercial actresses, an absurd allegation of a link between the Mob and the abortion industry—are greeted with contemptuous snorts.

This derogatory soundtrack ceases, in fact, at only two points. As we watch the fetus squirm at the instrument’s touch, a stout granola-fed baby in a Snugli sets up a howl. It is hustled away, but its shrieks still filter through the narration, and there is much shuffling and throat-clearing. Later, the snickering starts again as Nathanson says, “The abortionist and the anesthesiologist have a secret language between them, which shields them from the grisly reality of what is going on.” Then the snickers die: “They refer to the head of the child, which is now being sought, as ‘number one.’ And the anesthesiologist will inquire of the

abortionist, ‘Is number one out yet? Are we finished? ’”

Next, we see Planned Parenthood's film, a bland collection of “experts” who offer unsubstantiated complaints about a number of technicalities. None tries to deny the stuff about the fetus being ripped apart. Our live rebuttal speaker is a local ob/gyn named Vicki Alexander. Dr. Vicki, who nobly assures us that she just loves to deliver babies, proceeds to tear that old film to bits. “Notice how he uses large terms to set himself up as an expert,” she says. “And his voice goes up and down.” Ah, yes, we nod; most deceptive. “And by the way, we don't use those forceps at a 12-week abortion. You don't have to ‘crush the head.’ The head is very malleable, and it just sorta slides right out.”

 

Bernard Nathanson and I sit across a mahogany desk from each other in his unpretentiously posh office on the Upper East Side. The patients and the nurse have gone home for the day; the suave and outrageous pundit, suffering jetlag from a European tour with the video in tow, rubs watery eyes and puts his feet up on his desk. Here is what looks like a very tired Jewish doctor inching past middle age.

He is initially cagey; the “megapress” is his Moby Dick. I warm him up a little with the story about the head sliding right out. “Yes, I'm told that NARAL and NOW are mounting a campaign to bring out all their women who've had abortions,” he chuckles, “which of course is morally and medically irrelevant. How can we present our victims? They're all dead. Have you seen the rebuttal film? Six talking heads.”

Now he's rolling, stabbing a pencil irritably at a prescription pad. “You'd think the rebuttal film would use the same technology I did—‘Nathanson's totally wrong; here's our film.’ Of course, all the movies made of it are repulsive. If they think they're going to see the fetus slide down the suction tube smiling and waving as it goes into the bloody sponge, they'll have a monumental surprise.”

I mention the clamor over Reagan's comment about the unborn feeling excruciating pain during abortion, a charge whose veracity has bogged down in endless arguments about the development of the cerebral cortex at eight weeks, twelve weeks, whatever. Doesn't it weaken your case, I ask, to imply an emotional response in an embryo?

Nathanson shoots a don't-play-reporter-with-me look. “No. I only said, this is a set of primitive responses to pain. There is no intellectualization here. If the fetus somehow survived the ordeal, it wouldn't sit down and write a book about it years later. But this is a living creature being stimulated. If you stroke a ten-week-old fetus around the lips, it will try to suck. If you poke it with a sharp object, it will try to get away.

“You know, my wife suggested that we show an abortion being performed on a dog—except that we'd have the animal-rights activists bombing the stage.” (In a curious parallel, Nat Hentoff—another pro-life heretic from that curia of liberalism, the VillageVoice—has begged his cohorts on the left to “think of the fetus as a baby seal.”)

Quiet and querulous, Nathanson hardly looks the part of a pariah. But he is now a detested exile from much of the medical establishment. Was breaking ranks difficult?

“Well, you know, I broke ranks in 1969—much more radically than I have now, by the way. When I first helped organize NARAL, I was attacking things which were absolutely sacrosanct. People tried to take away my hospital privileges, called me before a board of professional conduct. But I felt these things needed saying—and in the state of the art at that time, I was absolutely right.” Elsewhere, Nathanson has described his discreet referrals to doctors in Puerto Rico for his affluent patients, his encounters with weeping septicemia victims in the E.R.; he told an AMA interviewer that one of these ashen survivors was his college girlfriend, to whom he lent $500 for an abortion in Montreal.

“But as science developed,” he continues, “I was totally wrong. So, having been that vociferous on one side, I felt the least I could do as a public obligation was to be equally vociferous on the other. It wasn't enough to say, ‘I was wrong,’ and crawl into a hole.”

Yes, I say, but you performed abortions; you were aware of what a fetus looked like at every stage of development.

“No I wasn't. I had no idea what we were working with then.”

Oh, come on, I press. In a second-trimester saline or prostaglandin abortion, doesn't one in effect deliver a stillborn fetus?

Nathanson looks haughty. “One is not there. Clearly you're not familiar with what we used to do, and what they still do. The saline or whatever is injected, and then you leave. And you do not come back. The nurse delivered all those babies; she'd just wrap them up in a towel and send them to the pathology lab.

“Look,” he says impatiently, “I don't deny that I knew what a fetus looked like. But under political inspiration, you invoke an enormous mechanism of denial—a machine 500 feet high and made of lead. It's just a job, and you don't want to know about it. But when you start working with these ultrasounds, your mechanism of denial starts to fissure and crack. First thing you know, you're face to face with what you're doing. That's what happened to me between 1973 and 1977.”

 

Indeed, it was in 1974 that Nathanson sent his infamous letter to the New England Journal of Medicine, the one about 60,000 deaths. At that point, however, he didn't advocate recriminalizing abortion; he advanced only to the currently fashionable soft-left position of “grieving a loss.” Was there a certain incident that pushed him over the edge?

“If you mean, was there a single point at which my apostasy became an epiphany, no. I didn't have any dazzling vision on the road to Damascus. I just became more and more uncomfortable with it.”

The TV-movie scriptwriter in me tries again: How does he live with the thought of those 60,000 lives? Nathanson seems to find the question a little silly. “I don't walk around with an insufferable burden of guilt. The denial mechanism was much more effective in those days, because you couldn't see this child in there, moving, breathing, doing all the things every other baby does.”

His hospital colleagues, he says, “are very, very upset with me. They deal with me largely the way the upper classes dealt with FDR—they considered him a traitor to his class. In the New York article, a former colleague of mine, who didn't question my sincerity, said, ‘How can he be associating with those people? ’ People are astonished that I could be involved with what the liberal press and the liberal medical establishment consider our reactionary elements—the Catholic Church, the fundamentalist Protestants, the Orthodox rabbis, and the rest.”

It is indeed true that Nathanson, a Joyce scholar and quintessential Manhattanite, has shown great willingness to rub elbows with busloads of  grassrooters—a margin of whom are even loonier than that little old lady in Yonkers. With admiration, I mention his refusal to hold his nose in the air, and he chews me out for elitism.

“That's America. It's not here on Park and 79th Street, it's out there in the middle. I've crisscrossed the country on this issue, and what we see here is so skewed by the press, it's appalling—and I detest that attitude.

“I’ll admit that at first I found myself being a little—disdainful, shall we say? But you've got to look into their hearts. These are good people, they really are. And the pro-life movement's been regrettably stereotyped.” He hands me the letterhead of the American Association of Pro-Life Obstetricians and Gynecologists; it is studded with lofty credentials.

Few of these thoughtful docs make the evening news, however. I try to explain my frustration at the movement's crummy graphics and down-home spokesmen, who are arrayed (in New York, at least) against the best that Planned Parenthood can buy from Madison Avenue. Technology has thrown an ammo dump in the movement's lap, yet their image is defined by Bible-Belters and clinic-bombers. Why, I ask, don't they at least find a decent PR agency?

To my relief, he agrees. “Really, I've been saying this till I'm blue in the face. For Christ's sake, quit being amateurs about it. Of course, they are pretty smart; the National Right-to-Life Committee is right down there in Washington with their lobbyists, and they've knocked off a lot of pro abortion legislators. That's what they've set their sights on. The last election was a virtual referendum on abortion, and it was a landslide victory. Maybe they're more realistic than we are; maybe public relations is bullshit.”

We talk about politics. His desideratum, a constitutional amendment, will not happen, he says; the best we can hope for is a reversal of Roe v.Wade. “Then the matter will be returned to the states, and the people will decide what they want. Unfortunately, what we'll probably end up with is about forty-five states that legislate against abortion, and three or four states that will become abortion sanctuaries.”

Finally, we get back to the point where my fascination with this issue began—the medical laboratory, and the primal metaphysics of the test tube. “You know, you've asked how the abortion issue will be solved politically, but not how it will be solved technologically. In the next five years, we will have the technology to move the pregnancy from the uterus at twelve or fourteen weeks and put it into another uterus, intact, or into a life support system where it will mature. There will be no cause for killing then.”

Five years?

He shrugs, relishing the role of provocateur. “It's being done in veterinary medicine now. This will of course defuse the whole abortion issue. We'll be able to speed up pregnancy; instead of nine months, how about three weeks? Visionary, yes—but so was ultrasound thirty-five years ago.

“Of course, that's going to bring up a whole group of other questions. If we have fetal transplants and life support systems, whom does the baby belong to if it's put on one? The state? The prospective adoptive parents.? The woman we took it from? Nobody? It raises another interesting question—would we use this technology if it were available?”

 

It seems that the key message to be learned from Nathanson—or, perhaps more accurately, from the furor over Nathanson--is that personhood is closing in on the fetus from both ends of an unbroken continuum. And none of us, on either side of the issue, is quite ready for what that will mean.

First, let's move human identity backwards from birth. It's happening; a reasonable definition of “salvageability” has crept from twenty-eight weeks' gestation to twenty-four weeks' just since that quaintly obsolescent pronouncement, Roe v. Wade. It will keep moving back, although not as fast as Nathanson says. Ponder some consequences:

• In-utero surgery is now being performed on fetuses with hydrocephaly and urinary-tract problems. These fetuses are second, discrete patients whose hospital bed is a uterus. On another floor of the same hospital, they could be aborted on demand; parents and doctors essentially declare them person or non-person on an ad-hoc basis, depending on how badly the birth is desired.

• According to a Centers for Disease Control official quoted in the Philadelphia Inquirer, some 400 to 500 late abortions a year produce the most dreaded complication of all—live birth. (The real number is probably much higher, since hospitals cover up these incidents in a frenzy of embarrassment and fear of litigation.) That “statistically insignificant fraction” of our million-plus abortions a year equals more than one a day. As a rule, the “live-born fetuses” (is it okay to call them babies now?) are left to expire quietly; a few are placed on fancy life-support systems until they die in a few hours or days.

• But as our life-support systems get fancier, and we can save these usually brain-damaged mites even sooner, who pays for and takes custody of them? The mother, who entered the facility to destroy the fetus? The taxpayers? Private insurers? Right-to-Life groups? On the brink of viability, baby-saving is an avocation pricier than collecting vintage Jaguars and considerably less glamorous.

 

Now let's consider personhood at the very dawn of pregnancy. Our wizardry here is accelerating even faster than in the neonatal phase. In-vitro fertilization—IVF, in jargon—has brought one boon to the pro-lifers: It has focused our attention on that DNA-packed droplet as the tangible first appearance of a couple's long-sought baby. The achievement of fertilization, the sweating-out of implantation in the uterine wall—all render ludicrous the pro-legalizer's medieval fogginess about what's “in there.” It may not yet be cute and anthropomorphic, but the desperate couples in the IVF clinics will tell you: That's our kid in there.

But IVF has brought its own tangled woes. To wit:

•  To achieve a pregnancy, you need overkill—literally. As many concepti as possible must be harvested and implanted to improve the odds, sometimes even enough to freeze for later tries. One embryo is lucky to make it; the other siblings-to-be are lost. The implications make you wonky if you stick to the credo that life begins at conception; the argument for life starting at implantation looks better and better. Somehow, it strains even a pro-life moral framework to contemplate crippling this astonishing technology—which has ended heartbreak for hundreds and will do so for thousands—to prevent the “murder” of hours-old cell clusters.

• IVF has saddled us with another, more urgent dilemma: To perfect this technique, like any other, scientists need to tinker. On what? Not, right now, on living embryos; the Reagan Administration has nixed it, and IVF biggies are chafing and feeling like Galileo. The less radical among them have suggested an experimentation cutoff of fourteen days after conception—with the medical community, of course, monitoring its own adherence to its own chaste standards.

On paper, this looks like a reasonable compromise, until we recall just how elastic those standards tend to become. Fetuses, nothing; think of hare-brained Golden-Fleece-Award “studies” with mangled kittens and chimps festooned with electrodes, all to prove that pain hurts or smoking is bad for you. Without implying an overnight leap to a Mengele scenario, let's remember that scientific curiosity is a potent drug, and that history's lesson is that it winds up justifying too damn much.

 

Nathanson and I kick these exhausting topics, and others, around for a while longer. It is late; Nathanson roots around for a copy of one of his seldom-reviewed books to give me, and courteously shows me to the door and the limo-filled Park Avenue night. As I leave, I notice a quotation framed on the wall from his beloved Joyce:

“Welcome O Life! I go to encounter for the millionth time the reality of experience and to forge in the smithy of my soul the uncreated conscience of my race.”

These words have always struck me as both bombastic and irresistible; in this setting, they also seem peculiarly appropriate.