A tale of two abortion doctors

Lesley Wojcik, a young Johns Hopkins medical student, was worried that there are fewer abortionists in America, so she got busy trying to show fellow med students how to perform abortions. That's where the papaya teach-in came in. Here's an excerpt from a Washington Post story:

It was Christina, the Students for Choice chapter president, who proposed holding a papaya workshop to expose more students to abortion. She'd heard about such a workshop at a national Students for Choice gathering. It was a hands-on opportunity for second-year medical students to learn how to perform an abortion, using a papaya as a stand-in for a woman's uterus. Lesley thought it was a great idea.

The women enlisted doctors, residents and nurses from Maryland and Johns Hopkins to run the workshop and e-mailed an invitation to all second-year students. They promised dinner, a sure bet to lure medical students. This time, if the dean knew about their plans, he didn't object. Soon the workshop, which could accommodate 20 students, had a waiting list -- and the women organizing it had a small firestorm on their hands.

In her e-mail, Christina had hoped to attract participants by suggesting that they'd have fun learning the procedure: "You'll get the opportunity to be shown how to use manual vacuum aspirators using papaya models (apparently papayas bear a striking resemblance to a uterus. Who knew?)" But some of the students who received the invitation didn't see it that way. "This is a serious matter," one told Christina. Those offended by her tone demanded to be dropped from any future Medical Students for Choice e-mails. After consulting a dean, the women didn't remove any names from their list, but they decided to word future missives more carefully.

On the day of the workshop, Christina wiped out the stock of papayas at a Whole Foods store. The man behind her at the checkout wanted to know what she was using them for.

A medical procedure, she told him.

Come on, tell me, he pushed. A suture?

Something like that, she said she responded. She was not about to get into an abortion discussion in the supermarket.

Bizarre as it might seem to perform an operation on a papaya, in medical school it isn't unusual. Fruit or other food is regularly used to describe things in obstetrics. A uterus holding an 8-week-old fetus is the size of a naval orange. After 12 weeks, it is more like a grapefruit. The uterus itself is shaped like, well, a papaya.

Lesley's eyes were drooping as she, Christina and Regina set out tortillas and taco fixings in a second-floor classroom and assembled papayas and abortion instruments at stations in a lab next door. Like the others, Lesley was recovering from a big test earlier in the week, but she also had overextended herself on the treadmill. Still, in a long-sleeve, black scoop-neck top, jeans, shiny black rain boots and a tan sweater vest tied lightly at her waist, she was a picture of elegance. Her chin-length blond-streaked hair was tied into a tiny pony tail, accenting her angular features.

"This is so cool," said Lesley, who believed she was doing something important to address the shortage of abortion doctors. After years of defending abortion rights, she would finally learn how the procedure is done.

Ten women and three men showed up for the workshop, fewer than the organizers had expected. After heaping their plates with food and chatting about the recent test, the students cleared the lab tables for the teaching doctor to lay out her equipment and pass around photocopies of her lecture slides. Her tray contained a pair of scissors with a sharp tooth on each end, for grasping body parts during surgery, called a tenaculum.

The doctor gave a short lecture on first-trimester abortions. Then she showed the students how to grip the papaya with the scissors to hold the angle of the "cervix" straight on. With one hand, the doctor demonstrated how to administer a local pain killer, at 3 o'clock and 9 o'clock positions. She picked up different sizes of dilators used to widen the cervix and advised against pushing them in too hard, because in a soft-skinned papaya, the dilators might come out the other side. In a woman, more pressure would be needed to slide the dilator past the cervix and into the cavity of the uterus.

The doctor next picked up the suction instrument, a manually operated vacuum suction syringe. It was attached to a cannula, or thin tube, that she inserted into the papaya. She rotated it around the fruit's cavity, pulling and pushing the syringe, suctioning the papaya's contents.

"This is the most important thing and the hardest to learn," the doctor said as she pulled out lots of seeds and juice, what in a real abortion she called the "products of conception," or POC. "You put the POC into a bowl, repeat if necessary, and examine them under a microscope to make sure you got everything," she advised.

There was silence as she passed around photos of a dish with a light under it from a real abortion. It contained something that looked like a cotton ball, a yolk sac, and some blood and tissue. It was hard to make out any parts of a fetus under 3 months old, which, she said, is when more than 90 percent of all abortions are performed.

"How do you know you are done?" a student asked.

When you do it often enough, the doctor replied, you'll notice a gritty feel as you are scraping the uterus. If not, there is another tool, a rod with a spoon, one side sharp as a knife, to scrape again.

Now it was the students' turn to try the procedure in the lab next door. Imagining herself working on a real woman, Lesley looked tentative as she pushed up her sleeves and reached for the razor-sharp tenaculum.

"This just seems so awful," she exclaimed as she tried to grab the papaya with it. "Do [patients] feel this?"

Her look turned to fright when the nurse practitioner at her station answered that they do.

Why not apply the local anesthetic before gripping the cervix with the sharp instrument? Lesley asked. The answer: A doctor needs something to hold the cervix steady to administer the drug.

Lesley offered Christina the suction instrument to try first, and Christina took it without hesitation. "You can feel once you get into the hollow part," Christina told Lesley.

When Lesley's turn came, she ignored the directions and numbed the papaya before using the scissors. Then she gripped the papaya with the scissors, dilated it with the instrument in her other hand, and suctioned it with the vacuum, twice bringing up lots of seeds and pulp. Finally she tried the curet, the spoon with one sharp side, and pulled out still more pulp.

"So," she asked the nurse, "did we not suction correctly, or is this a papaya issue?"

"It's the papaya," the nurse replied.

Meanwhile, on the same planet but in a different world, a Serbian doctor at the other end of his career comes to a different conclusion:

The Spanish daily "La Razon" has published an article on the pro-life conversion of a former "champion of abortion." Stojan Adasevic, who performed 48,000 abortions, sometimes up to 35 per day, is now the most important pro-life leader in Serbia, after 26 years as the most renowned abortion doctor in the country.

"The medical textbooks of the Communist regime said abortion was simply the removal of a blob of tissue," the newspaper reported. "Ultrasounds allowing the fetus to be seen did not arrive until the 80s, but they did not change his opinion. Nevertheless, he began to have nightmares."

In describing his conversion, Adasevic "dreamed about a beautiful field full of children and young people who were playing and laughing, from 4 to 24 years of age, but who ran away from him in fear. A man dressed in a black and white habit stared at him in silence. The dream was repeated each night and he would wake up in a cold sweat. One night he asked the man in black and white who he was. 'My name is Thomas Aquinas,' the man in his dream responded. Adasevic, educated in communist schools, had never heard of the Dominican genius saint. He didn't recognize the name"

"Why don't you ask me who these children are?" St. Thomas asked Adasevic in his dream.

"They are the ones you killed with your abortions,' St. Thomas told him.

"Adasevic awoke in amazement and decided not to perform any more abortions," the article stated.

"That same day a cousin came to the hospital with his four months-pregnant girlfriend, who wanted to get her ninth abortion--something quite frequent in the countries of the Soviet bloc. The doctor agreed. Instead of removing the fetus piece by piece, he decided to chop it up and remove it as a mass. However, the baby's heart came out still beating. Adasevic realized then that he had killed a human being,"

After this experience, Adasevic "told the hospital he would no longer perform abortions. Never before had a doctor in Communist Yugoslavia refused to do so. They cut his salary in half, fired his daughter from her job, and did not allow his son to enter the university."

After years of pressure and on the verge of giving up, he had another dream about St. Thomas.