The Heart's Truth: Essays on the Art of Nursing

The Heart's Truth

76 The Heart’s Truth A young woman, who I will call Susan, had been coming to our hospital clinic for years complaining of a deep pelvic ache that interfered with her intimate relations with her husband. She’d had cultures for infection, Paps, ultrasounds— even an exploratory laparoscopy that discovered no adhesions, no cysts, nothing to explain this troublesome pain. This particular day, she sat slouched on the exam table. Her short hair was blond and shining, but everything else about her was dark. When I sat down before her, she fixed her gaze on me. “Sorry I was late,” she offered. “Was it difficult for you to get here?” I asked. “No. I just wasn’t sure why I should bother to come.” “The secretary said that you’re still having pelvic pain,” I prompted. “Yes, but everything always comes back negative. My husband thinks this is all in my mind.” I hesitated a moment. “Do you believe it’s all in your mind? What do you think causes your pain?” My simple question—had no one asked it before?—released a torrent. Susan began to cry, lifting the sheet and pressing it to her eyes. I thought I could surely guess the reason for her sudden outburst. Maybe she’d been raped or abused, and my question somehow allowed her to acknowledge the pain of those memories. Maybe she was being abused now. I had, ready and waiting, my list of possibilities . But Susan’s story surprised me. It also changed the way I practice nursing. Susan told me that she’d gotten pregnant at sixteen. She told her boyfriend and he told his mother who paid for Susan’s abortion. She kept this abortion a secret from her parents and friends. Engaged in her early twenties, she became pregnant again. Even though she wanted to keep this pregnancy, her fiancé didn’t think the time was right. Susan had an abortion at his urging. After this termination, Susan became “angry and grouchy.” She and her fiancé broke up, the heart’s truth 77 and for several years, Susan said, every time she’d see a child about the age her child would have been, she’d weep, hiding her tears, once again, from friends and family. She even calculated when she would have delivered the pregnancy and then, every year, spent that day grieving. Five years ago, she’d married a “wonderful” man. Even though she wanted to tell him about her two abortions, the time never seemed right. “After a year or so,” Susan said, “he started to talk about our getting pregnant. That’s when I started getting this pain. I don’t think it’s in my head. I think it’s in my heart. How can I be a mother, after what I did? What if I become pregnant and something goes wrong?” I had no easy answer for Susan. I’ve seen women who choose abortion and have no obvious remorse. I have also seen women who, postabortion, are hounded by grief. Women have told me that they were angry at the incomplete or hasty counseling they received. Some have told me that caregivers tended to minimize the procedure. Other women have told me that they thought their abortion was “in the past,” yet suddenly they were experiencing remorse anew, as if it happened only yesterday. Susan mentioned two specific fears: she felt that she didn’t deserve to be a mother even when she was choosing to have a baby, and she worried that any wanted pregnancy might now be jinxed. Her abortions were secrets that weighed on her like stones. Afraid until now to tell anyone these secrets, Susan didn’t need more tests— she desperately needed healing. But how could I best help Susan, or any patient, whose lives had been dramatically affected by the choices they’d made? Susan told me that what she wanted most was to feel forgiven. She wanted to talk to her husband, telling him her story and trusting in his love and support. But that day, she talked to me, crying until she had no more tears to shed. Several weeks after our visit, Susan called to tell me that she and her husband were incounseling.She’ddoneanInternetsearchandfoundresourcesthere.Slowly,she was beginning to feel that the weight and the pain of her secret were lifting. How did Susan change the way I practice nursing? I am, more than ever, sensitive to women...