MY FIRST abortions, as an intern and resident, caused me no emotional distress. I felt that I was helping a patient solve a serious problem. The fetus was no more than unwanted tissue. Although doing second-trimester abortions sometimes disturbed me, my qualms were easily overcome by ideas of women's rights and free choice. Among most people I respected, the practice of abortion might as well have been part of the Bill of Rights.
My discontent began after many hundreds of abortions.
I decided to do no more second-trimester abortions when I started my private practice. Extracting a fetus, piece by piece, was bad for my sleep. But as a gynecologic consultant at a university health center, I saw many early abortion referrals, since unwanted pregnancy is, by far, the most common surgical problem in young women. I felt great sympathy for these women, often abandoned by boyfriends or afraid to tell them about their pregnancy. I took good care of these patients. Their gratitude gave me much satisfaction.
But, insidiously, the satisfaction diminished. Depression clouded my office day when I had an abortion scheduled. My pulse raced after giving the local anesthetic. Although I still felt sorry for the unmarried 20-year-old college junior, I felt increasing anger toward the married couples who requested abortions because a law-firm partnership was imminent, or a house remodeling was incomplete, or even because summer travel tickets were paid for.
Anxiety attacks, complete with nausea, palpitations and dizziness, began to strike me in some social situations. In public, I felt I was on trial, or perhaps should have been. I no longer was proud to be a physician. Arriving home from work to the gleeful embrace of my kids, I felt undeserving that God had blessed me with their smiling faces. The morning shaving ritual became an ordeal, as I stared at the sad face in the mirror and wondered how all those awards and diplomas had produced an angel of death.
Why did I change?
Early in my practice, a married couple came to me and requested an abortion. Because the patient's cervix was rigid, I was unable to dilate it to perform the procedure. I asked her to return in a week, when the cervix would be softer.
The couple returned and told me that they had changed their minds and wanted to "keep the baby." I delivered the baby seven months later.
Years later, I played with little Jeffrey in the pool at the tennis club where his parents and I were members. He was happy and beautiful. I was horrified to think that only a technical obstacle had prevented me from terminating Jeffrey's potential life.
The connection between a 6-week-old human embryo and a laughing child stopped being an abstraction for me. While hugging my sons each morning, I started to think of the vacuum aspirator that I would use two hours later. This was an emotional tension I could not tolerate.
Nor could I live with the conflict between Jewish law and my medical practice. Judaism has became the lens through which I see the world. The Mitzvot -- God's commandments -- guided my behavior. But as a religious Jew, my desire to fulfill Torah was absurd as long as I performed elective abortions -- a clear transgression.
My ritual observances seemed hollow and hypocritical. I yearned to sing prayers passionately. I could not draw closer to God. The contradiction was too great. My spiritual aspirations were shattering. My intellectual integrity was disintegrating. I had to stop doing abortions.
Perhaps you might expect to hear me speaking at the next anti-abortion rally. You will not. There are some abortions I would do even now -- pregnancies that threaten the mother's life, pregnancies resulting from rape or incest, pregnancies involving extreme birth defects.
Second, I am unable to impose my personal beliefs on a woman who feels her pregnancy will ruin her life. My conscience would not tolerate the terrible complications that illegal abortions would inevitably produce.
Finally, I do not believe that all immoral actions must be illegal. Perhaps in my ideal society of chastity until marriage, of poverty eradicated, of universal respect for human life, abortion would be illegal. Alas, the Messiah (whether it be for a first or second time) has not arrived.
Since I stopped doing abortions, my life has blossomed. I love my practice. Years of struggle and guilt have ended. A certain calm and inner peace have returned. I feel closer to God. Our third child, Hanna, was born, bringing my wife and me immeasurable joy. She is named after my two grandmothers, one who survived Auschwitz and the other who was murdered there.
Yom Kippur is here again. Last week I went to a sofer to check my tefillin. I had to buy new ones. My old tefillin were not kosher.
George Flesh practices obstetrics and gynecology in Los Angeles.