Thread by @ChaviKar, I have a story for you, prompted by someone on one of [...]

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& #39;s "pro-life". She reminded me of this story.

It& #39;s not a metaphor; it& #39;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& #39;s a patient out front. She just got sent home from urgent care, but she doesn& #39;t look great." 2/x

"Well, if she just got discharged by urgent care, I bet she& #39;s fine. Can we give her an appointment later this week? Tomorrow?"
"Dr. K, she really doesn& #39;t look good. Dr. K? Please."
"Ok, ok. Put her in Room 11 I& #39;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& #39;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& #39;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& #39;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& #39;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& #39;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& #39;t like abortion. So when she came in asking for an abortion, he just...." 12/x

"He just what? Didn& #39;t evaluate her? Didn& #39;t do his job? Didn& #39;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& #39;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& #39;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& #39;ll try to go find the relevant piece to link to later (I presume she is busy watching the debate)

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