by Olaf Kroneman
1967 was a bad year to be a hospital intern.
My first rotation was unlucky. I was assigned to surgery during Detroit’s 1967 riot. The suffering, panic, and blood overflowed. Forty-three people died. Most of them came through our emergency room, and those that made it went to surgery. Those that didn’t make it went to surgery, then the morgue. I saw it all including Temple, Pollard, and Cooper, murdered at the Algiers Motel, and four-year-old Tanya. It was a shock for which I was unprepared. Entering the emergency room caused my stomach to churn knowing that a human catastrophe would await, but in what form it would arrive would be a surprise.
By August, things moderated. But not completely. A sign read: For your own safety do not wear your doctor’s white coat or white nurse’s hat when leaving the hospital at night. There was sporadic sniper fire.
I entered the emergency room at seven one morning. It was quiet. The only sound was of the large, oscillating fans humming and blowing the heated air with the lingering human stench of the night. It was very hot without airconditioning. Dog Days of August was not an adequate description: inferno was more like it.
“Place cleared out fast,” I said, speaking to the senior surgical resident, Dr. Luke Ballinger.
“Don’t get your hopes up,” Dr. Ballinger said. “We are the controllers of entropy and entropy increases with time and stupidity and anger.”
A black hearse pulled up to the emergency room entrance, a portable emergency flasher attached to the roof.
“The Addams Family just pulled up,” Dr. Ballinger said.
“A hearse?” I asked.
“Yeah,” Ballinger said. “Half of our patients come by hearse and half by ambulance. The hearse drivers get first dibs on the dead. The early bird gets the worm.” I did not like Ballinger.
The door opened with an explosive vacuum sound. It sounded like the air was being sucked out of the corridor. Three men, dressed in black suits, pushed the stretcher fast.
“What’s this?” the charge nurse asked.
“This one’s critical, dying,” the mortician/ambulance driver said. “Bleeding from below.”
A young girl lay on the stretcher. She was ashen— motionless — frozen; honey-blonde hair, long with flowers woven in, hippie love beads around her neck, and a T-shirt with a pink peace sign. She was placed in a cubicle and curtains were pulled around her. A nurse cut off the girl’s clothing and threw blood-stained jeans into a bucket. The charge nurse placed a hand over her mouth. “Oh my God. Another one.”
Blood oozed off the sides of the stretcher. Dr. Ballinger assessed the situation and talked in a loud but calm, measured voice.
“No blood pressure?”
“No.”
He shone a light in her eyes. “Pupils fixed and dilated. Start IVs, put EKG leads on, go through the motions, and work on her ‘til her parents get here. Get my intern.”
I approached the stretcher. The girl had a large ID bracelet on her wrist that read, “Breeze.”
“Shine the light in her eyes.”
I pried the girl’s eyes open with my thumb and forefinger. Her pupils were black, the size of nickels, haloed with a deep, full-of-life-and-promise powder blue. I shone the light. Nothing. The pupils remained static, like a doll’s. The reflex of life was gone.
“Remember those eyes,” Ballinger said. “That’s death, big boy. That’ll be you someday, when you’re all used up. Sooner than you can imagine, especially if you flunk out and get drafted and get sent to Vietnam. Life is short. The art is long. The jungle is hot and dangerous.”
“So is Detroit,” a nurse said.
“What happened? Why is she bleeding?” I asked. She looked young and healthy. She should start breathing and her eyes should pop open any second, I knew it. I wished it.
“Botched abortion, back alley.”
“Or a miscarriage,” a nurse said.
“A miscarriage doesn’t bleed out this fast. Something was nicked. Have the parents arrived yet?” Ballinger asked.
“They’re on their way.”
“Let’s try to get a pulse back, I want her to be alive when her parents get here. It makes it easier.”
“Easier for what?” I asked.
“Easier for me to tell Mommy and Daddy we’re doing everything possible and technically their child is still alive. I don’t like to tell them their child’s dead. It’s too damn hard. Have the nurses tell them, they’re better at it.”
My dislike of Ballinger increased, but he continued to work on the young woman methodically and efficiently.
Her pupils remained nickel-sized and black. The powder blue around her pupils faded to gray. The light had no effect. There was the sound of brass rings scraping against metal, the drapes pulled back.
“What are you doing to my daughter?” A woman grabbed Ballinger’s arm.
“It’s her mother,” a nurse said.
“Get her out of here,” Ballinger said. He did not look at her. He did not shout; he talked in a firm, authoritative voice. “I am trying to save your daughter’s life, now let go of my arm.”
“Please, please, oh God, please,” the mother shouted. Three nurses held the woman and guided her out of the cubicle. Ballinger returned to his work. The mother was treated as an annoyance and not in the equation. Cold-blooded control of chaos, that was Ballinger.
But I had to admire his work. Ballinger asked, “Where is the blood?” He looked at the monitor.
“I have four units of O-negative blood,” a nurse said.
“Pressure is now up to one hundred systolic,” the resident said.
“How much dopamine?”
“Ten mikes.”
“Okay,” Ballinger said. The ER cubicle looked like a crash site. IVs were open, some running into the patient and some onto the floor. Needle casings littered the floor and EKG paper draped around like crepe paper. A strong, metallic smell of blood fogged the room.
It went from calm to chaos to panic to catastrophe. Ballinger seemed to thrive in this setting. To me, it was foreign, frightening. I doubted that I would ever be comfortable here.
Ballinger said, “She’s breathing nicely, we have a blood pressure, her rhythm is okay… alright, let’s go.”
Two muscular orderlies gently placed the girl on a stretcher and headed for the operating room. Ballinger said, “You, intern, come with me. We need to talk to the family.”
Ballinger’s white bucks were now stained a fierce orange-brown. He should change them before meeting the parents or at least hit them with a chalk bag. The family shouldn’t have to see their daughter’s blood covering his shoes.
We entered the waiting room. The mother and father were sitting on plastic chairs. They stood when they saw us.
“How’s my baby?” Her voice a hysterical, guttural scream. “Where is Breeze? What have you done to her?”
“My name is Dr. Ballinger.”
“Your daughter’s on her way to the operating room. We must operate immediately.”
“Operate?” her father asked.
“She had an abortion that went bad.”
“No.” Her mother screamed, put her face in her hands, stamped her feet. Nurses, social workers, police, and detectives filed in. Ballinger and I left.
“Detectives, police?” I asked.
“Abortions are treated as manslaughter. That’s why it’s so expensive. The people that do them need to make a lot of money to make it worth it. The women who really need them can’t afford it. They do it themselves.”
“Manslaughter? Why isn’t it murder?”
“Don’t know, but criminal law for centuries didn’t call it murder unless you aborted after mom could feel the baby kick, quickening. To me, it’s a close call, but I fall back on the wisdom of our ancestors. If the mother dies it is murder, second degree. Complications are most likely to occur after the first trimester. That’s why the criminals don’t abort after about fifteen weeks. They won’t risk a murder rap. It’s not about ethics, just risk and rewards.”
“You know a lot about abortions,” I said.
“Comes with the territory.”
“What territory?”
“The territory of taking care of people being people and living their lives the best they can, and I’m just trying to help them, keep them safe and alive. My skills obligate me.”
“They should be legal,” I said, “and safe.”
“No shit.”
I followed Dr. Ballinger to the surgical locker room to change into scrubs. The emergency room was the frying pan; the operating room was the fire. Things went from bad to worse. I recalled surgical lectures on how to scrub properly, slowly, and methodically, one finger at a time.
“Hey, intern, hurry up,” Ballinger said.
“This is how I was taught in medical school.”
“You’re not in med school anymore. You are no longer a useless observer. They’re firing real bullets at you now.”
I entered the cold operating room. Surgical instruments were being placed in regimented order on a tray. A crisp, metallic noise echoed. I put my hands into the latex gloves held by a nurse and rolled into the cocoon of a warm surgical gown. Breeze’s head and eyes were behind a mint green drape; her chest moved up and down in concert with the whooshing sound of the ventilator. The heart monitor made a pinging sound. Apple green heartbeat spikes marched across the tracing and appeared normal, except for the rate of one hundred and twenty beats per minute. Her rapid heart rate matched mine.
An IV was attached to her arm. Somebody had removed her ID bracelet. The name Breeze should mean life and youth, possibility, and joy—not this.
The scrub nurse poured brown disinfectant over the girl’s petite abdomen, then spread a clear adhesive sheet over the area.
Ballinger held a scalpel over the abdomen and in a surgical ritual said, “I want to make the opening incision.”
“Proceed,” the anesthesiologist said.
“Now, intern,” Ballinger said. “When I make the incision and open the abdomen, blood is going to gush out. It will be like a dam breaking.”
My stomach tightened, and my mouth went dry. Here it comes, I thought. Ballinger made a long, semicircle incision, exposing a thin line of yellow fat. Blood poured out of the wound.
Ballinger took a sudden step back from the operating table.
“There’s too much blood; I can’t see anything. Intern, open the wound. Get the tonsil suckers, as many as you can,” Ballinger said. “It’s an artery. The blood is filling up faster than I can suck it out. I didn’t expect that. Surprise.”
The surgical drains filled with bright red blood and collected in two canisters at the sides of the operating table. Ballinger probed the red cavity of her insides, using his gloved fingers to sort through the snake-like small intestines, looking for the trouble.
“Okay, I see the bleeder,” Ballinger said. “Clamp.”
Ballinger grabbed the clamp from the scrub nurse, but the blood made it slippery. It escaped from his grasp, hit the floor, and the interlocking parts fell apart. A pulsating artery sprayed blood on us and the bright, hot, surgical lights suspended above.
“Damn,” Ballinger said. “I’ve lost the artery. It was luck finding it the first time.”
Blood continued to spray the operative field. The artery was enveloped in red and was lost.
“We’re going to lose her,” Ballinger said. “I had one chance.”
I knew where the artery lay. I saw it nestle down in the pool of blood encased in clots and tissues. I put my hand into the wound. I felt the jet of blood coming from the artery and pinched it between my thumb and index finger. The bleeding stopped.
“You’ve got it. How did you find it? Now someone hand me another clamp.”
Ballinger placed a clamp on the bleeder.
“Now get those big mitts out of her abdomen,” Ballinger said. “More blood please.”
“I’ve given her eight units already,” the anesthesiologist said.
“She’ll need twenty,” Ballinger said.
Ballinger used hemostats and silk sutures to tie off several arteries. Once the bleeding was controlled, he removed the small uterus and placed it into a metal bowl. The organ sat in a metal dish. Ballinger took a probe and pushed it through the tiny hole where the abortionist punctured the uterus and hit the artery.
Ballinger noticed me staring at the now-useless organ and said, “The lucky ones end up sterile, the unlucky ones end up dead.”
I thought I might get sick.
“Being human is tough. Heartbreaking, unforgiving. They don’t teach that in medical school.”
“It isn’t fair.”
“I can make it better. But I need help, from you.”
Dr. Ballinger told me he was part of a group of doctors and policemen and women that had floating abortion clinics. Clinics that kept desperate women out of the hands of the criminals. He asked me to help. I didn’t know what to do. I’d never done anything illegal.
I was obsessed with what I should do. I needed a place to think and, as was my habit, I went to the Detroit Institute of Arts.
The art was permanent and perfect and eternal, it wouldn’t grow old and sick, or bleed to death. Except for the steadfast mummies. They were very dead.
Everything else was alive with emotion. The portraits and paintings, like literature, were time machines, connecting you to different ages, and I realized we were not that much different. It was the display of a timeless humanity that connected me to the Renaissance, the Middle Ages, Diego Rivera, and Frida Kahlo. My favorite room contained the impressionists, a reminder, especially now, that life could be beautiful, but you had to be selective of what, and how, you saw it. It definitely was in the eyes of the beholder.
Vincent Van Gogh stared at me. Vincent’s left eye hung low on his anguished face such that you couldn’t escape his hurtful stare; it was alive and followed you around the room. That was genius. Van Gogh painted the beautiful and tried to escape the ugly. I’d been exposed to a lot of ugly.
In the cathedral-like room, the frescoes of Diego Rivera surrounded me and made me feel small; unimportant. My footsteps echoed. The Detroit Industry mural depicted the aggressive, blast-furnace-powerful, manufacturing character of the city. The north and south walls showed Black men, brown men, and white men laboring in choreographed muscular unison to produce automobiles, airplanes, tractors, ships, and bombs. Rivera believed that men and women of all races could work in harmony, homogenized for good or bad.
On the higher levels of the mural, agriculture was displayed, the good earth. The scene of a child being vaccinated by religious and divine figures made me wonder if science had displaced religion, or were they complementary and able to be integrated? All the backbreaking work and sacrifice of the laborers, the scientists, the engineers, must have a purpose other than industry, steel, and strength. What did it all mean?
The east wall showed a human fetus enveloped in the placenta, encased in the womb. The fetus was the largest figure represented and was the focus of the mural. The reason for all human endeavors was for the protection and proliferation of the human race. I’d been in this room many times, but now I finally got it because events had changed me. I was being asked to help in the termination of a pregnancy. The fetus was safe in the womb fed by the large arteries of the placenta. A steel plowshare was depicted menacingly close to the sleeping, hibernating infant. Was the plowshare the instrument of an abortionist?
A woman sat on the floor in front of the east wall sketching the mural in charcoal. I looked at her work. The detail was exquisite.
“You are very talented,” I said.
She did not look at me.
“Anybody can copy,” she said. “This is an assignment.”
She refused to notice me.
“Assignment?”
“I’m an art student. I have to draw this. I hate it.”
“Diego Rivera? This is magnificent.”
“It was a mean insult to his more talented wife, Frida Kahlo.”
“But the work shows that all human activity is to support life. Protect that which lies in the womb.”
“Rivera’s work is rough, brutish, powerful, but lacks emotion. There is no love, honor, compassion. It might as well be a series of large photographs.”
“Rivera was obsessed with creation.”
She looked at me, finally. “What are you doing here?”
“I’m a doctor. I come here to think.”
She shook her head. “Rivera painted a fully developed infant entering the birth canal. It was at the time that his wife Frida Kahlo had another miscarriage and almost died. She wanted to give birth so badly. He drew that to mock her for what she’d lost and could never have. He was very cruel to her. He was a pig, a beast. Come with me. I’ll show you.”
We walked to an adjacent room that held the works of Frida Kahlo. The works were small, but emotion exploded off the canvases. The difference was striking, and I had dismissed it in my years at the museum.
“Diego the elephant kept Frida the dove in a cage. Someday she will be more famous, more appreciated. While he painted the beautifully formed, healthy infant, Frida painted this self- portrait.”
The painting was Frida Kahlo in a hospital bed. She was hemorrhaging from a miscarriage. Blood poured off the side of the stretcher. Images of the lost infant hovered over her. On the side of the bed was painted Henry Ford Hospital. It was a tribute to the hospital that saved her life. I thought of Breeze who could have changed places with Ms. Kahlo. Their suffering identical.
I would help Dr. Ballinger.
It has been over fifty years. Dr. Ballinger and I and several other doctors performed abortions on women in the first trimester. We never got caught. The police and detectives knew what we were doing, but we all worked to keep the women safe and out of the hands of the criminals, the first-trimester butchers. We saved many lives.
In the first trimester, we removed formless cells, safely. I removed the microscopic to save a developed life. Nobody would extract a fully developed fetus. But to remove cells to save a life? A young woman in trouble? There was a difference in the terminations, I can’t explain it, there just was. Once Roe v. Wade was law, we ceased operation.
The young art student was correct; with time, Frida Kahlo became appreciated and eclipsed Diego Rivera. I still am amazed by the frescos, but the emotion comes from Ms. Kahlo.
Frida Kahlo reached out to me from the grave in 1967. Now that Roe was overturned. I may be called to help again. Nobody should die from a first-trimester abortion. Got to keep it out of the hands of the criminals.
I am seventy-five, enjoyed helping humanity, and would like to exit doing the same thing. I am distraught that the lessons of the 1960s have been forgotten. Police brutality, racism, unwanted foreign wars, and the harm that can come to women have resurfaced. If called on I would once again remove cells. It was a difference that I could live with.
I won’t disappoint Frida Kahlo.
I may meet her one day.
Solitaire with the Spirits
by Rachel Berkowitz
Olaf Kroneman graduated from the Michigan State University College of Human Medicine with an MD. He interned at the Mayo Clinic in Rochester, Minnesota, then attended the University of Virginia to complete a residency in internal medicine. Upon completion of his residency, he participated in a fellowship in nephrology.
Rachel Berkowitz (b. 1993) lives and works in Los Angeles, CA. Born in Columbus, Ohio, and raised in London, Rachel Berkowitz graduated with a BA in Fine Arts from the UCLA School of Art and Architecture in 2016. Rachel is currently working on paintings for a solo exhibition February 2023 , called “Biophilic Harmonies”. The work brings attention to the innate human desire to be close to natural elements within everyday life.Rachel has self-published three complete Fine Art photography books. One of her most popular series titled “Fairfax Royalty” was displayed at a booth for Gallery 1202 in The LA Art Show, 2020.
Ignatian Literary Magazine 