Why Bernard Nathanson Inspires Me

“Is there a doctor who you look to as a role model? Someone in whose footsteps you could see yourself following?” I remember my friend asking me this question on a hot, dry night in southern Africa, where we were studying abroad together. I probed the depths of my mind and could come up with precious few names to provide as an answer—indeed the thought had rarely even crossed my mind. I had recently read a semi-autobiographical book by Dr. James Orbinski, who worked for Medcins Sans Frontiers, in some of the most horrific conflicts of the late 20th century. Reading the gripping tales of his life as a doctor in the most difficult settings, I remember the specific feeling that “this is medicine, this is what I want to do!” I offered Dr. Orbinski as my role model. It was an honest answer, but still had the convenience of proximity rather than deep thought or prayer. Yet there was another doctor, creeping in the back of my mind that I considered, but withheld. He was not a role model, it didn’t seem at the time, yet his curious life had gripped me from the first time I heard of its telling. That doctor was Bernard Nathanson.

Perhaps outside of the circles of people who reside at either pole of the abortion debate, that name may not sound too familiar, and perhaps to my generation it has been forgotten altogether. However, for those who know it, it is sure to garner intense emotion. Dr. Nathanson was a man of immeasurable talents both as a physician as well as an academic. As a budding young physician, Dr. Nathanson found a passion in the field of obstetrics and gynecology, yet he found a movement in the fateful issue of abortion. At the forefront of the 1960s progressive movement, Dr. Nathanson helped found the National Abortion Rights Action League (NARAL), and he was the director of the largest abortion clinic in the United States—overseeing thousands of abortions and as he bluntly puts it, “performing thousands myself.” As he approached the twilight of his career, Dr. Nathanson had been successful in every way, at least as judged by the world of his peers. He was a learned doctor who treated his patients with care and compassion and even helped advance the cause of “justice” for so many women. But at the same time that accolades and achievements were making his name prominent, new technologies were beginning to revolutionize the way medicine was done in America. There was one technology in particular which provided great advancements in diagnostic medicine—but also in the soul of this perhaps not-so-humble doctor. Dr. Nathanson describes this effect:

It was ultrasound, which for the first time threw open a window into the womb…for the first time I began to think about what we really had been doing. For the first time, we could really see the human fetus, measure it, observe it, watch it, and indeed bond with it and love it. I began to do that…I found myself bonding with the unborn.

Dr. Nathanson, true to the careful scientist he was, did not convert all at once. He began to have doubts about his career, about his achievements. He continued to do abortions for “medically justified reasons,” but he also began to question the wisdom of the direction medicine was taking with regard to its treatment of human life. In 1974—still performing abortions himself—he wrote an article in the New England Journal of Medicine, stating that he had presided over sixty thousand deaths. He declared that the fetus, while a special kind of human life, was human life nonetheless, and “denial of this reality is the crassest kind of moral evasiveness.” In Dr. Nathanson’s slow change of heart, the gripping need for moral clarity began to break through his deep commitment to abortion. “In the mid-seventies, I would be up on one floor, putting the hypertonic saline into a woman twenty-three weeks pregnant, and on another floor down, I would have someone in labor at twenty three weeks, and I would be trying to salvage this baby. The nurses were caught in the same bind, the same moral whipsaw. What were we doing here, were we saving babies or were we killing them?” Dr. Nathanson recorded the fruits of this moral struggle in his book Aborting America. In this book he began to formulate his argument for protecting human life in the womb. However, he also listed many reasons for which abortion ought to be morally justified. But the dam of Dr. Nathanson’s past could not hold back the moral floodgates that the “window into the womb” had opened into his own heart. “I did two or three abortions in 1978, and then in 1979 I did my last one. I had come to the conclusion that there was no reason for an abortion at any time; this person in the womb is a living human being, and we could not continue to wage war against the most defenseless of human beings.”

Dr. Nathanson’s conversion, fortunately, did not end there. He had been raised a secular Jew, and had no belief in God—a faithful scientist. But as he entered the pro-life movement, he was moved by the spirituality of those nonviolent resisters who kept vigils at rallies and outside abortion clinics. At first, he remained at the periphery of their religiosity, tolerating them as allies in the cause to end abortion, but always keeping them at arm’s length. However, rally after rally and year after year, their prayers and their spirit invaded him, and Dr. Nathanson soon found himself overcome by the idea that God might exist. This was no small movement for him, for with belief in God came belief in responsibility for his past, for his sins. “The thought violated every certainty I had cherished; it instantly converted my past into a vile bog of sin and evil; it indicted me and convicted me of high crimes.” Dr. Nathanson soon dove into the literature of conversion stories, and was particularly enamored by Jews who had converted to Catholicism. He found in the mystery of the Cross the only hope for his life, and the only remedy for his neurosis: “Someone had died for my sins and my evil” (emphasis added). Yet accepting this responsibility was the most difficult step of his life. Leaving his career and his old life paled in comparison. “For I have such heavy moral baggage to drag into the next world that failing to believe would condemn me to an eternity perhaps more terrifying than anything Dante envisioned in his celebration of the redemptive fall and rise of Easter. I am afraid.”

There seems to be very little in Dr. Nathanson’s life that I, a cradle Catholic—yet sinner nonetheless—could emulate. Yet, when I survey the field of doctors after which I think I could fashion myself, I still find his story at the forefront of my mind. It is not his deeds or his career or even his wit (I couldn’t emulate that if I tried). Dr. Nathanson’s story does not stand out for his achievements, it stands out for his humility. He was a rigorous scientist, who would quite literally follow the truth wherever it led him, even if that meant face to face with thousands of victims of his own hand. This virtue in the field of medicine cannot be understated. In medical school, we are asked to absorb exorbitant amounts of information and are given very little time to reflect on the scientific value of that information. Even less time is given to reflection on the moral ambiguities of the practice of medicine, and almost none is given to the spiritual qualities that are required to navigate such ambiguities. We are asked to accept ‘standards of care’ and to follow the rules. In many ways, this environment is necessary to provide high quality, egalitarian care to patients across a spectrum of providers, clinics, hospitals, and socioeconomic conditions. However, it also fosters an environment wherein moral questioning is given little room, even less moral objection.

Nearly fifty years after ultrasound opened that “window into the womb,” Nathanson’s story remains an exception rather than the rule for doctors and medicine in general. In my experience, medical students and the doctors they become basically reflect the opinions of the general population. A significant minority vociferously opposes or advocates for abortion and the rest take varying positions of tolerability. We, the scientists, who study the process of life and disease, are unable to break with the lay public. Indeed, abortion, rather than becoming more rare and less acceptable, has found a comfortable niche in the medical community: morally questionable enough for those who oppose it to stay away, but not relenting an inch as an “acceptable medical option.” Recent headlines have placed on center-stage the degree to which our society has dehumanized the life that resides in the womb. Yet, as I watched Dr. Nucatola describe the trade of fetal parts and the special care doctors must take to kill in such a way as to preserve these, I could not say I was surprised. Dehumanization is part of the job in medicine. It provides a shield against the vacillating realities that occur when science meets the human experience of disease. Yet, we as a society have accepted dehumanization at every level; from the migrant farm worker to their wayfaring children to young black lives to the aged suffering, dehumanization has become commonplace rather than an exception. On a systemic level, abortion has taken dehumanization to its furthest extreme, and Dr. Nathanson’s great hope for the pro-life movement, that “window” that was opened up, has not convinced medical society or human society as a whole of this humanity. Still, where ultrasound has failed, perhaps his very life should give us hope.

Dr. Nathanson was among the most influential forces in moving abortion from the shadows of America to an acceptable practice. And yet, Dr. Nathanson’s life provides an example of what can happen when a scientist combines his immense talents with the theological virtue of humility. Within a rigid establishment, he dared to challenge the powers that be. And facing his own inner demons, he candidly showed the world how hope in redemption can save the most fallen of lives.

Thomas McHale is a medical student at the University of Nebraska Medical Center in Omaha, Nebraska. He has studied in Botswana, lived as a volunteer in the St. Anthony’s Shelter for Renewal in the Bronx, and worked with Catholic Workers at St. Joseph’s House in Manhattan. He hopes to continue accompaniment with the poor and working for social justice during his medical career.