Andrea’s Crystal Ball
Author: Kristina Domanski, MD
Keywords: Abortion, abortion access, women’s health, gender bias,feminism
I first met Andrea in 1998. Long summers with no money and nothing to do meant going to the library. The library was free. It blocked out the noise and smell of London traffic. It blocked out the English rain. And it was in the library, as a teen venturing into the adult section with the uneasy feeling I was somehow trespassing, that I had my first encounter with Andrea Dworkin. Her words were like the coffee and cigarettes I’d begun to experiment with. Harsh. Bitter. Unmistakably adult. Unpleasant at first, they made my pupils dilate, my heart pound and my hands shake. Despite all this, I couldn’t put them down.
“Over 72 percent of the nursing home population is female. Women in nursing homes are generally widows or never married, white, poorer than most of their peers (70 percent having incomes under $3000 a year consisting mainly of Social Security benefits), and have several chronic diseases… they are taken from mainstream communities where they are useless and dumped in nursing homes. It is important to keep them away from those eager, young, middleclass white women who might be demoralized at what is in store for them once they cease to be useful. Kept in institutions until they die as a punishment for having lived so long, for having outlived their sex-appropriate work, old white women find themselves drugged (6.1 prescriptions for an average patient, more than half the patients given drugs like Thorazine and Mellaril); sick from neglect with bedsores, urinary, eye, and ear infections; left lying in their own filth.”
Right Wing Women is a political analysis that explores the themes of gender roles, abortion, racism and anti-Semitism. As a physician, the chapter on nursing home care is particularly disturbing, more so now than when I first read it as a teenager. Forty years after its initial publication, the same issues still exist. Andrea wrote of the abuse and mistreatment of elderly women on the State’s terms once they had fulfilled their ornamental and reproductive duty. She wrote in an era where abortion was accepted as a right, and actually discusses it in the same book as a tool men use to control women. She also made a sinister prediction and envisaged a time when the right to abortion and bodily autonomy would be taken away and yet more women would be deemed disposable by the State.
The U.S. Supreme Court’s decision in Dobbs v. Jackson Women's Health Organization brought about such a change. In a case well publicized by the media, Amanda Zurawski experienced preterm pre-labor rupture of membranes (PPROM) at 18 weeks gestation and was denied abortion care because fetal cardiac activity was still present. Three days later she was diagnosed with sepsis and was admitted to the ICU in critical condition. Jaci Statton was denied care for a molar pregnancy and advised by hospital staff to wait in the parking lot for her condition to worsen before they could legally treat her. In the 15 months since the Supreme Court’s decision, there has been a steady flow of cases like Statton’s and Zurawski’s, and the response has been the introduction of “medical emergency” exemption clauses that are poorly defined and put both patients and their physicians at risk. Evidence shows that abortion bans kill patients so why is the House of Medicine not pushing back harder against what is ultimately an extension of the femicide described by Dworkin in her 1983 work?
Ask any Emergency Physician “What’s the worst thing you’ve seen?” and you’ll get an anecdote about a foreign body. It’s what we default to, because the worst thing we see- the abuse of humans by other humans- leaves us with a level of moral injury that definitely doesn’t make for good dinner party conversation. There is an exodus of physicians from locations with abortion restrictions - 75% of Oklahoma’s OBGYNs are either leaving or considering leaving the state. The Dobbs decision has inserted the State firmly into the physician-patient relationship and created a political standard of care that binds physicians’ hands and prevents the provision of evidence-based care. There are no such laws denying men reproductive healthcare. The message is loud and clear: women are disposable, physicians must be complicit, and the list of “worst things we see” will soon be expanded to include the piles of bloodied female bodies that accumulate as a result of the Dobbs ruling. Moral injury, anyone?
Dworkin was heavily criticized throughout her life, and I fully expect the same treatment. The topic of abortion is a political minefield. However, I would rather speak and face the repercussions than remain silent as our nation sleepwalks into a regime where women are considered disposable second-class citizens. After all, the only thing necessary for the triumph of evil is for good people to do nothing.
About the Author: Kristina Domanski MD is an Emergency Physician based in Las Vegas and an Assistant Professor at Kirk Kerkorian School of Medicine at UNLV (Twitter: @carpe_venenum).
