Artigo Revisado por pares

A Remembrance of Dr. George Tiller

2009; Wiley; Volume: 18; Issue: 5 Linguagem: Inglês

10.1007/s10897-009-9257-5

ISSN

1573-3599

Autores

Elizabeth Gettig,

Tópico(s)

Legal Systems and Judicial Processes

Resumo

On May 31, 2009 I posted the following on the NSGC listserv: I just cannot believe it. I have known Dr. George Tiller since about 1988 when I referred my first of many patients to him. The patient had some concerns about her experience and I called Dr. Tiller upon the patient's return to PA. He said, “come out here and see what we do, let us know how better to assist families with genetic issues.” And I went. I saw the care, the concern, the attention to detail, the staff who was so dedicated it was hard to believe and we sat and rewrote all the patient literature. After the 1992 Casey law in Pennsylvania limiting abortion services went into effect, Dr. Tiller was the closest service provider for our patients. Our relationship grew over the years and he became a supporter and friend to the NSGC (National Society of Genetic Counselors). For years he paid to publish our newsletter, Perspectives. He was always at NSGC conferences and I remember the flowers he gave Bea Leopold, our Executive Director, upon her separation from NSGC. He was a class act. His work complicated his life and on the two visits I made to Dr. Tiller's clinic I witnessed his dedication to women and the provision of services to families at very complicated moments in their lives. I asked why he still provided services, why he put up with all the turmoil—his security was provided by off duty law enforcement, he used to travel with a German Shepard at his side, he was followed everywhere, he was under the thumb of aggressive legal review. His legal fees ran $10,000 a month for decades. Yet he remained an advocate for choice and supported legislative efforts to protect a woman's right to choice not just in Kansas but nationally. As late as March of this year he was acquitted on charges that he violated Kansas's abortion laws. This was his second Grand Jury. It just never stopped…. but he would grin and say he was providing a service. That's what he did…. provided a service and he said he was privileged to do so. Privileged? With all he had to endure…. yes, he would say…. privileged! I had a hard time on the two visits with being followed, having blood spattered notes left for me at my hotel and even had an attempt at being “rescued” by an antiabortion group who was disappointed to learn I was overweight and not pregnant. I found the pressure uncomfortable and could not imagine living day to day in Wichita with this kind to pressure. You know it is not paranoia when people actually ARE watching. But George took it in stride. When he was shot in 1993 I called the clinic the next morning and was told, “Doctor is in surgery.” I was in shock until the staff said he was in HIS surgery providing services to families. I was amazed. He was not going to stop and he did not. Most of us don't have to live with this level of scrutiny on a daily basis but George and his loving and supportive wife and children knew this was their lot in life and they took on the challenge with grace and dignity. The impact on families will be great. Already 90% of US counties provide no abortion services. Only about three programs offer late term abortions and now Dr. Tiller is gone—so just two exist now. I am at a loss for words…a loss, a profound loss for the families we serve. I write this tribute before the funeral for this fellow NSGC member. A doctor has been killed for doing his job. My own emotions and those reported to me by other NSGC members range from profound sadness to rage. Members seem to want to do something; some advocating a more visible support of prochoice positions, others wanting to privately grieve, and others wanting to express their anger in some constructive fashion. I have no answers for anyone but I know I can no longer ask the NSGC to “quietly” support abortion rights—I plead with my professional organization to stand up and be counted in this complex and long standing national debate. In Dr. Tiller's words, “I am a willing participant in this conflict. I choose to be here because I feel that it is the moral, it is the ethical thing to do.” As counselors we too should agree. Many NSGC members have individually supported choice actively and visibly—marching in Washington, testifying before legislative groups, volunteering at clinics, becoming members of prochoice organizations. For the past few years there has been debate about NSGC lobbying for our profession in Washington but the question remains, what are we lobbying for? We now have a position to promote and we should not fear being associated with the abortion controversy. Abortion services are part of our job, too. In order to serve the families we counsel me must support all options related to reproductive choices. George had it right again when he said, “Prenatal testing without prenatal choices is medical fraud.” For years genetic counselors have wished to distance our organization from the abortion issue. Our profession was branded with the abortion connection early in our own professional development. It made us uncomfortable but if we do not advocate for our patients, options will cease to be available. We have not particularly wanted to have the issue of choice define our role. We much preferred the role of health advocate or health educator but I think the time has come to embrace our reproductive choice position more literally. If we do not, options will disappear and may not resurface. It is our families we must consider. Dr. Tiller was one of only three late second or third trimester abortion providers in all of the United States. Now there are two and the anti-choice blogs list names and addresses of these providers as they did Dr. Tiller's and now we know that outcome. George Tiller known on these blogs as Tiller the Killer, Dr. Killer (from Bill O'Reilly), and Public Enemy No. 1 have preached intolerance for too long. My current retort to anti-choice protesters is—if you don't support abortions, don't have one. The right to choose is constitutionally protected….it is the law of the land. Peacefully protesting abortion is also lawful and constitutionally protected. But abortions are lawful and constitutionally protected, too. As I think about Dr. Tiller I cannot help but remember his dedication to women. “Trust Women” appeared on cups and mugs he distributed at NSGC conferences. He defined himself as a service provider and he had to go to great lengths to protect his patients, staff and family. His death has abortion opponents concerned this act of violence will lead to the demonizing of the prolife movement. And it should. You cannot use intimidation and terrorism to prove a point. You cannot condemn those providing legal services. And there are consequences to teaching intolerance. As for the common ground between pro-choice and anti-choice groups suggested by the Obama Administration, Dr. Tiller's death shows there is not common ground to be found. “Debate” is not what has been going on. Systematic, sustained harassment of clinic professionals and demonization of doctors has been the modus operandi of the extreme anti-abortion groups. Four thousand individuals were arrested during a single summer at Dr. Tiller's clinic. A week before his murder he reported tampering of surveillance equipment at his clinic to the FBI. It is now up to us to contact our elected officials and insist that abortion services be included in any proposed universal health care. Enough is enough, we must not remain silent. George Tiller was a candid, opinionated individual. From my own Southern heritage I would say he was a “character.” He easily self-disclosed the tragedy of a single engine airplane crash which simultaneously took the lives of his mother, father, sister and brother-in-law and which left him a clinic to run and a nephew to raise. He adopted the nephew and took up his father's practice where he unexpectedly discovered his father had been a secret illegal abortion provider. His father had refused to perform an abortion for a patient who later sought an illegal procedure and died. The fact his father had never disclosed this aspect of the practice led Dr. Tiller to explore the importance of providing all reproductive options to women and in 1975 he started offering legal terminations to women. He also was a recovering alcoholic, sober for over 40 years. How he functioned under the pressures of his practice is hard to comprehend. One positive is that a respectful, loyal, and incredible family and staff surrounded him. I made two visits to Dr. Tiller's clinic. I want to share a few items with you. Dr. Tiller was comprehensive. The care plan began when you landed in Wichita and covered all time intervals until you departed. Contrary to blog reports, Dr. Tiller never to my knowledge performed a partial birth abortion and I will add with 30 years experience in genetic counseling I have never heard of ANY provider performing this procedure. The debate on partial birth abortions has consumed hundreds of hours of legislative time but the only positive may be this issue distracted the anti-choice movement to eliminate a procedure which was hardly ever performed. I am glad it wasted time, energy, and money. Dr. Tiller had a good sense of humor. I guess he had to. My first night in Kansas he took me to Towanda, KS and dared me to eat the “Prairie Oysters.” I did NOT know what that was but asked if it was fried. Being from the South, I knew I could eat anything fried. He laughed and dared me to eat one so I said I would take two. For the uninformed, as I had been, Prairie Oysters are bull testicles. I probably could eat a fried shoe with my heritage so the “oysters” were actually fine and George and his staff were amused and laughing about this night years later. I liked Dr. Tiller and I respected him. I was grateful to him for the care he provided to the women whom I referred to him. He had a gentleness to his demeanor though he must have been a stubborn person to put with all the harassment over the decades. I never witnessed fear from him. He was committed to his profession. Dr. Tiller rewarded loyalty. On one visit a staff member was celebrating 20 years of service with the clinic and Dr. Tiller was buying her a new car….any car of her choice. The only gift I ever got from an employer was a frozen turkey. Dr. Tiller was a bit “old school” and few people called him by his first name. He allowed me that privilege but I could tell her preferred just Doctor (no last name). I sat in on his clinic during my visits. I wanted to see things from the patients’ perspective and Dr. Tiller never objected. He confirmed each diagnosis with ultrasound, when possible, or had laboratory reports for the pregnancies with chromosomal abnormalities. He met with each couple individually and made available group counseling throughout their 3 or 4 day stay at the clinic. He never told anyone to have an abortion. He saw couples once they had made their decisions. One couple we saw from the east coast arrived in a state of great concern as their doctor had told them to get to Dr. Tiller immediately since their fetus had been exposed to a high level of radiation. The mother had had some tests during the pregnancy. The couple was in frenzy as they had driven all night to reach Kansas. Dr. Tiller inquired to the number and type of x-rays and he had me take a family history. Essentially the mother had had one upper and lower GI series. We excused ourselves and jointly agreed this couple had been misinformed. We went back in and explained that the amount of radiation from these x-rays most likely presented little risk to the baby. Obviously now confused, the couple had lots of questions. We called their doctor and got a hospital-based radiation physiologist to calculate the fetus’ radiation exposure which amounted to less than one rad. The couple returned home and continued their pregnancy. How many others Dr. Tiller correctly diagnosed as having viable pregnancies, we will never know. I admit I was fearful on my visits to Wichita. I had uniformed law enforcement officers meet me at the airport and they escorted me throughout my visits. I did have blood-spattered notes left for me at hotels and I felt paranoid. Maybe I would not look over my shoulder as I did if I lived like this for years. Maybe I would adjust, but I doubt it. I was offered a bulletproof vest but declined. Dr. Tiller wore one and had one on when he as shot in 1993 but the wound was to his arms not his torso. I don't know if there was a vest last Sunday but it would not have mattered as the gunman shot Dr. Tiller in the head, in a church, in front of his wife. My emotions are still churning and I miss that rye smile Dr. Tiller had. In my last conversation with him in Kansas City he told me he was going to stake me on my next trip to Las Vegas. He knew I liked to play poker and I guess we shared risk-taking behaviors. He thought I was a good investment and the feeling was mutual. Most of all, I miss him not being available to the families we serve. “Courage is not the absence of fear, but the mastery of it” according to Ralph Waldo Emerson. Dr. Tiller had courage and he, his family and his staff had mastered their fear. In remembering Dr. Tiller I know that he was brave, patient, and a skilled physician. He will be missed and the families we serve have lost a provider dedicated to their care.

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