Late-term: The legacy of George Tiller

[dropcap]“W[/dropcap]hen I walk out the door of my office, I expect to get assassinated.”

So says Dr. Warren Hern in a new documentary, “After Tiller,” that screens in Denver Wednesday.

Since Dr. George Tiller was shot and killed in Kansas by an anti-abortion activist in 2009, there are four physicians left in the country openly performing late-term abortions.

One of them is Hern, whose Boulder Abortion Clinic is a constant target of protesters.

“I don’t know which one is carrying a gun,” he says.

Directed and produced by Martha Shane and Lana Wilson, the film is about Hern and the trio of other physicians performing abortions for patients close to or solidly into the third trimester of their pregnancies.

related hernThe film highlights the extreme difficulty women face deciding whether to abort at that point, either because of fetal abnormalities or an inability to care for a baby. It conveys the heavy weight for doctors, who choose which patients to accept and which to turn away. It details their determination to continue delivering a service that desperate women travel hundreds, even thousands, of miles to undergo. And it chronicles how the work of the doctors, and especially the bitter opposition to it and harassment they endure because of it, affects their personal lives.

“Boo hoo,” comes the response of anti-abortion activists who decry the documentary for dignifying late-term abortions.

“What I can’t figure out is why the news media is tripping all over themselves glorifying the slaughtering and dismemberment of late-term babies,” said Troy Newman, president of the Wichita-based Operation Rescue, the Christian group leading the movement against late-term abortions nationally. “They’re trying to make these people out to be saints for doing the most despicable atrocity that we’ve seen since the Holocaust.”

Tiller, who was 67 and ushering at a church service in Wichita when he was shot through the eye, performed abortions since Roe. v. Wade made them legal in 1973, and he pioneered a technique to end late-term pregnancies. His Wichita clinic was bombed in 1985. He was shot in both arms in 1993. And, days before his 2009 murder by activist Scott Roeder, he told colleagues that he planned to retire to spend more time with his family.

“After Dr. Tiller was assassinated, there was absolutely no question in the three doctors who worked for him, in any of our minds, that we were going to keep on doing this work,” said Dr. Susan Robinson, a Tiller protégée practicing in Albuquerque.

Hern recalls as “miraculous” his experience first delivering babies in medical school. Then, as a Peace Corps physician in Brazil, he treated one ward of women recovering from childbirth and two wards of women recovering from illegal abortions. Forty percent to 50 percent of the women who had abortions died. While doing pediatric work, hen commonly treated children who were battered by parents who didn’t want them. However enchanted he was by delivering babies, he felt called to help women who wanted to end their pregnancies safely. He did his first late-term abortion in 1982. For years, he and Tiller were the only doctors willing to induce labor and delivery of a euthanized fetus.

The film shows Hern working with a patient who had been raped. He listens to and hugs her in a way that makes clear the mix of gravity and empathy he brings to work that, as indicated in the film, he charges some patients $10,000 for a four day outpatient procedure.

“My job is to help you get through this safely so you can go on and live your life and maybe have other pregnancies that are healthy,” he says, to the patient who found out she was pregnant at 5 months and 2 weeks.

The film also reveals personal aspects of the man known mainly in Colorado for his steadfast commitment to his polarizing work.

You watch Hern, who’s over 70, visiting his elderly mom, Edna. Since 1973, she has been fully aware of the death threats against her son, the toll those threats took on his marriage in the 1980s, the five bullets shot through his window in 1988 and the extreme isolation he has felt living with a target on his back. Even she gets threatening phone calls at her home, shrugging them off as the price of having a son who won’t back down from his principles — even if she wishes he would retire and “enjoy the rest of his life.”

“The work I’ve done has been very, very fulfilling for me. But the anti-abortion attacks have had a terrible effect on my personal life,” says Hern, whom you watch buying a ski pass, riding up a chairlift alone and skiing solo down an empty Colorado ski slope. “Many, many times, I felt so alone.”

Operation Rescue’s Newman, in response, calls Hern a “narcissistic egomaniac who’s completely wrapped up in the narrative of his own mind.”

Citing polls showing an overwhelming national intolerance for third-trimester abortions, Newman said, “Hern and all these guys are outcasts within their own communities. Outside of their little sycophant, ghoulish fan clubs, nobody talks to these people, they don’t have any friends, they’re not welcome in their communities, their neighbors don’t like them. Nobody wants them there.”

Third-trimester abortions are legal, though with restrictions, in nine states, including Colorado. Those procedures account for less than 1 percent of all abortions in the country.

In Colorado, disability activists have taken a nuanced stand on late-term abortions, which are often carried out to prevent the birth of disabled kids.

“Abortions based on prenatal diagnoses have concerned us because families are often given gloom-and-doom information that their lives will be imperiled, they won’t be able to work, their other kids will suffer, et cetera. Certainly that’s the case for some people, but not for others,” said Carrie Ann Lucas, executive director of the Center for Rights of Parents with Disabilities, who has lived with an array of disabilities for 23 years and has adopted four disabled kids.

“Our experience is that living with a disability is a positive thing. From a social rather than medical model, it looks very, very different. We’re not focusing on impairments, we’re focusing on the diversity that it brings.”

As hardened as the four remaining doctors have become by constant threats, some speak candidly about the crises of conscience that comes with their jobs.

“I think the reason I’ve struggled is that I think of them as babies. I don’t’ think of that as a fetus. You can’t say that’s just tissue. That’s not tissue. It’s a baby,” said Dr. Shelly Sella, Robinson’s partner in the Albuquerque clinic.

“I think about what I do all the time. And I recognize what I do. At times I struggle and at times I don’t,” Robinson added. “But I always come back to the woman and what she’s going through. And, often, what life will this baby have?”

Robinson learned to perform late-term abortions after two doctors were shot in Florida.

“ I thought ‘Oh my God, you know? Everybody’s going to get scared out of doing it and then who’s going to do it?’” she said. “There’s two reactions to being bullied. One is to sort of go, pull your head in and try to get away from the bully. The other is say ‘Oh yeah?’ That’s how I feel. ‘Oh yeah?’”

Robinson describes herself as “a sort of court of last resort” for her patients. She admits feeling uncomfortable in the role of having to weigh one woman’s story against another. Ultimately, she said, “What I believe is that women are able to struggle with complex ethical issues and arrive at the right decisions for themselves and their families. They are the world’s expert on their own lives.”

“If somebody comes and says I want an abortion, whether she is articulate about it – let alone whether she has a good story to tell – isn’t the point. The point is that she has made this decision,” she added.

Given the veils of secrecy legally required around medical care, the filmmakers manage to capture a surprisingly intimate conversation between Sella and a patient, whose face is not shown and name is not identified. She and her husband want to know how to explain their decision to family and friends. Sella gives them words to answer.

“The baby was sick. We went for testing. The baby didn’t make it. It’s hard for me to talk about it right now,” she coached them in their response. “There’s nothing else for you to say. What’s important is that you had a loss and right now it’s hard for you to talk about it.”

Dr. LeRoy Carhart, the fourth doctor featured in the movie, is shown with his wife moving from state to state, clinic space to clinic space, after having been kicked out by state laws, city ordinance changes or landlords refusing to rent to his practice. His beleaguerment comes through on his face as he constantly glances in his rear view mirror to monitor whether he’s being followed.

“We’ve  been at war since Roe. v. Wade was passed. Except there’s only been one side that’s been fighting this war. We’ve been sitting back and letting them take over the government, take over the school boards and the little local governments and work their way to the state and federal level.”

Carhart comes off as the least sympathetic of the four doctors. His affect is flat, joyless, even as he says, “I think George would be proud that we are carrying out his work.”

As the film progresses, Hern’s often steeled tone softens as he discusses the changes in his life since he remarried and is raising a son with is new wife. During a family car ride, the boy asks his dad what he wanted to become when he grew up.

“Well, I wanted to be a race car driver, I wanted to be a photographer and photojournalist and a writer and I wanted to have a family. I wanted to be an epidemiologist,” he answered.

“Being an abortion doctor is something I have to do, something I need to do. I want to do it,” Hern added later. “You know, this is not a subject which is easy. And you know, people can disagree.”

In the end, the filmmakers tell viewers that “Dr. Hern is now taking more time off to spend time with his family…

“but he has no plans to retire.”

“After Tiller” screens at the Sie Film Center at 2510 East Colfax in Denver on Wednesday. Reception begins at 5:30. The documentary begins at 7:00. For more information, contact