I have a story for you, prompted by someone on one of my medical groups upset about that NEJM editorial, and defending her vote for Trump because he's "pro-life". She reminded me of this story.

It's not a metaphor; it's a true story. It really happened. 1/x

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One day, somewhere around 10 years ago, I was in an OBGYN clinic, finishing up the day. One of the nurses came to get me. "There's a patient out front. She just got sent home from urgent care, but she doesn't look great." 2/x

"Well, if she just got discharged by urgent care, I bet she's fine. Can we give her an appointment later this week? Tomorrow?"
"Dr. K, she really doesn't look good. Dr. K? Please."
"Ok, ok. Put her in Room 11 I'll see her."
I sigh, and go to room 11. 3/x

There is a 20something year-old woman there, bent over, clutching her abdomen. She tells me she's in terrible, terrible pain, and she just got figured out she was pregnant, today. "I went to urgent care to ask for an abortion. But they don't do that. They sent me away." 4/x

She waves her hand towards papers on the desk. I start reading: "Patient presented requesting abortion. Complaining of abdominal pain, green vaginal discharge. Blood pressure 173/100. Patient informed that we do not perform abortion services. Discharge to home." 5/x

No mention of ectopic pregnancy. No mention of gestational age. No mention of her dangerously high blood pressures. No workup, assessment, or even a solitary medical thought about this woman. 6/x

I ask the patient to lie down on our exam table, and it's pretty clear that she has a 3rd trimester belly. I quickly put the ultrasound on. Yes, that appears to be...35 weeks? 36 weeks? Hard to see because there's no amniotic fluid around the baby. Fetal heartbeat 130s. 7/x

I chat soothingly while I put this all together. Blood pressure 173/100; abdominal pain; greenish discharge which, on review seems to be her water breaking.
I call quickly to get an ambulance to take her to L&D, while we try to get some basic stabilization done. 8/x

I call the hospital: I'm sending you someone estimated 35 weeks, pre-eclampsia with severe features, ruptured membranes with meconium. She needs to be stabilized, and she will need to deliver. 9/x

I find out later that at the hospital, the fetal heart monitor shows deep decelerations of a baby in distress. The patient agrees to cesarean, and undergoes it once her blood pressure is no longer dangerous; she is in the OR within an hour of arriving at the hospital. 10/x

A few days later, I call the medical director of that urgent care center.

"Your provider discharged this patient with no attempt to verify gestational age. He did not address her stroke-level blood pressures. He in no way assessed, treated, or considered this patient." 11/x

"Yes. Well. That doctor...that provider is very pro-life, you see. Really doesn't like abortion. So when she came in asking for an abortion, he just...." 12/x

"He just what? Didn't evaluate her? Didn't do his job? Didn't treat her like a human? Almost killed this patient because she asked for pregnancy termination, and oh, incidentally, the pregnancy he cares so much about??"

"Yeah."
13/x

So that's a story about someone who is so "pro-life" that they almost killed a pregnant woman and her baby.

This is a true story. It's not a metaphor.

But also: it is absolutely a metaphor. 14/x

It is a metaphor for how you, and I, and this entire country is being treated by our current administration. 15/15

@TheRaDR writes about this a lot, using holier language; I'll try to go find the relevant piece to link to later (I presume she is busy watching the debate)