Yeni is a medical assistant and receptionist at the Clínica Médica para la Mujer de Hoy, an abortion clinic in Chula Vista. She's taking care of a customer, a very thin young Mexican, 28 years old, and of disheveled appearance. He's come to get information. He smiles nervously all the while. Yeni deals with him coldly. In Spanish, she greets him, "Hi, good afternoon."
Customer: "Is this where you do abortions?"
Customer: "How much does it come out to? She's got about two-and-a half months."
Yeni: "If it hasn't been over three months, the cost is $300. The doctor's not coming in today. He won't be available until Saturday of next week, but what you don't want to happen is for it to go over three months."
Customer: "It's a little over two months."
Yeni: "You can come in a week from this coming Saturday. Come in with the patient and it'll be $300. Do you know her blood type?"
Yeni: "No? Well then, if it turns out her blood type is negative, there will be an additional $75 charge. Okay, I'm going to give you a number for you to call in case you want to make the appointment later on since we don't have a doctor right now. But if you want to make the appointment next week, this is the number for the clinic."
Customer: "I can make the appointment by phone?"
Yeni: "Uh-huh. You can make the appointment by phone, but for a week from this Saturday. This coming Saturday you won't be able to do it because we've got a lot of patients."
Customer: "Is it safe?"
Yeni: "It's very safe. It takes five minutes for the termination."
Customer: "Five minutes?"
Yeni: "Five Minutes."
Customer: "Is there any treatment, afterward?"
Yeni: "Yes, she needs to come back in two weeks for a checkup to make sure she's doing okay. We will prescribe medication for pain, and an antibiotic. It's very safe, but she needs to follow the treatment and come back in two weeks, okay?"
Customer: "Yes. Thank you."
Yeni: "Have a nice day."
This young man was her last customer for the day. It's almost dark outside, and the clinic is about to close. Yeni is staying to tidy the reception area. She agrees to an interview next week away from the clinic. What follows is her testimony from that interview.
"I started working at the clinic in 2002. I had just graduated as a medical assistant. I had applied at a lot of places, but I didn't get a job because I didn't have any experience. Then someone told me that Sonia, an acquaintance of mine, needed someone. When I talked to her, she made it clear that it had to do with a clinic where they do abortions, but that they do other things, too. My goal was to gain at least six months' to a year's experience in the medical field. Sonia told me to go to the clinic to try to help out the doctor, and that if I couldn't take it, it was no problem, they would have me do something else. I didn't like the idea, even though having an abortion isn't something I'm unfamiliar with. I myself had an abortion a year before. Sonia had the same thing happen to her, though it wasn't as voluntary as mine. Her parents took her to get the abortion.
"I agreed to try it out," Yeni continued. "The first time I helped the doctor, I almost fainted. I couldn't see, and I couldn't hear. I was overwhelmed by the blood and the girl's screams. They took me out of there and I told Sonia that I couldn't do it, but they advised me to try it once more. By the second abortion I found that I could deal with it. The weeks went by, and even though the job is ugly, I was learning a lot about medicine.
"I made up my mind to withstand the work at the clinic until I got a little experience I could apply somewhere else. Then came the abortions of babies who were five or six months, and it became impossible for me to continue. After three months, I resigned. But the pressure to pay my bills, all my debts, and my situation as a single mother, forced me to go back to work at the clinic.
"To this day, I have left and returned three times," she said, but added, "I myself can't believe that I'm here for the money. That's what is so absurd. I make $8.50 an hour here. But because I wanted a career as a medical assistant, I stayed."
Yeni checked a small notepad where she has made a few notes for the interview. In this little notebook she has written important points she wants to mention, "So," as she put it, "that it can be of use to someone."
She then continued her account. "At first I thought most of the patients would be young, single mothers, but it's not that way. The great majority are married women; say around 29 years-old, the typical woman who doesn't want another child. The ones who are separated, or don't have a man in their life, also come to us. We hardly get really young ones. I think that younger girls appreciate becoming a mother more than the ones who are on their second or third pregnancy.
"We get patients on Tuesdays, Wednesdays, Fridays, and Saturdays. On average, five or six women come in each day. However, since the doctor hasn't been able to come in until tomorrow, which is Saturday, we'll be getting 16 patients," she said.
Yeni then explained what her work entails.
"Basically, what I do is to assist the doctor in the terminations [abortions]. After the patient fills out the forms and waits for her turn, I lead her into the private room where the procedure is carried out. I tell the patient to take her clothes off from the waist down. I tell her where she needs to sit and ask her to wait for the doctor.
"As soon as the doctor arrives, he has her lie down for the ultrasound to see how many months she is pregnant. If the baby is less than three months, the abortion can be done the same day.
"The doctor sits in front of the patient. The patient is lying there conscious â€” as if she were about to give birth. I hand the doctor the local anesthesia and I hand him the instruments as needed. I am seeing everything.
"Our doctor is quite old. He's 84 and uses an antiquated method." (The doctor to whom Yeni is referring is Dr. Phillip Rand. On Sept. 29, the California Medical Board suspended his license to practice medicine, noting that Rand is "incapable of practicing medicine safely.")
"First he puts the mirror in place. Then he measures the depth of the uterus. Next he opens the neck of the uterus with a dilator to make it easier. Then he introduces a small rod with an abrasive ring at the end. The ring isn't sharp, but the scraping hurts a lot of women and they cry or scream.
"When the baby is less than three months, the baby disintegrates completely. When the doctor feels that the baby has been dislodged completely, he introduces something similar to a straw. The exterior opening of the straw connects to a vacuum. Then he vacuums up everything that has broken apart. All that he vacuums goes into a jar. You see blood, and bits and pieces of tissue that look like chopped meat. It all comes out in pieces.
"This is the procedure for eight weeks or less, " she said. "When they're about 12 weeks, then the doctor takes the baby out with forceps. He takes the baby out in pieces. He checks each part and he places each one in a tray down below. When he finishes the procedure, I have to drain everything. We drain it to separate body parts from blood. We place all the parts in a jar that goes to the laboratory.
"It's impressive how well-defined they are. You can't believe what you are seeing. You see perfect little hands, tinier than those of a Barbie doll. You can see intestines, tiny ribs, their little faces, and their tiny squashed heads. You can distinguish among the parts if the baby was a boy or girl.
"It makes me so sad to see the jars. It's very hard for me to do all this. To see all that falls on the floor, or for example, to remove a tiny foot from the instruments. A girl who worked here told me that she came home with a tiny foot stuck to her uniform, close to her shoulder. She, of course, hadn't noticed until her husband told her."
Yeni continued getting off her chest what happens inside the clinic: "When the patient is less than three months pregnant, we have to prepare her so that she can come back the next day when she is dilated. The really large terminations are impressive. I have seen three fetuses come out whole. In one instance, you could see the little hand coming out of the uterus. The little hand was moving. But the most impressive thing was the baby that came out breathing. That time, the doctor got sick.
"The girl lived in Tijuana. They put dilators in her for two days. The baby was five and a half months. She didn't have a car and came walking to the clinic. Then it seemed like she was going through labor. When the doctor started to work on her, the baby came out without any help. The child came out breathing and died right there. After a minute, he changed color. He turned purple. The assistants felt very bad. They didn't want to put him in the receptacle. The doctor had to do it. All of us were very affected by it.
"Later, I saw the doctor in his office. His gaze was lost and fixed on the wall. Afterward, he was on the phone with someone telling them what had happened."
Yeni pauses. She wants to continue talking, but it's as if she has a lump in her throat. The interview took a bitter and sad turn.
"Since a few days ago," she said, "a substitute doctor has been coming in. He's younger and has a different technique. He doesn't scrape the uterus, he just uses the vacuum. Last Sunday, he couldn't take it any more because we did some rather large terminations â€” around four months. He used a technique I hadn't seen. He divided the ultrasound screen in two parts and used an apparatus during the entire procedure. Usually, what you see with the ultrasound is the child sucking his finger, or playing, but on this occasion when the doctor began vacuuming, you could see the baby was moving as if he hurt because it was pulling him or tearing something off. It was horrible, horrible.
"During the procedure, I feel as if they were doing it to me. I want it to finish quickly. I don't want to see it, and yet I have to see it. It's as if it were a penance for the abortion I had myself. With every patient I relive the same thing, and I feel the same thing. It's as if they're doing it to me again. It's as if it were so that I never forget, that I never forget what happened. And it hurts. Every day I wake up thinking, 'I have to go work there again.'
"When I started working at the clinic, Sonia and I made up our minds to help people. We were going to try to persuade them not to get an abortion. We often tried to secretly do a good deed. We'd ask the girls, 'Are you sure?' We would tell them to think it over carefully. Sometimes we would tell them it was going to hurt them terribly. We scared them. A few here and there would regret it and not go through with it. We even helped a few of them, who arrived under pressure from their mother or their husband, to escape out the back door.
"But this attitude of helping out was off and on for short periods of time. This is because you see how, when a patient has made up her mind, there's not much you can do. That has discouraged us. What's more, I would tell the ones who got an abortion, 'Be careful; make sure you don't have to go through this again. Look at me; I did it and it has really affected me.' According to me, I was providing them with therapy. That has passed in me. I don't feel sorry for them, as I did at first. Now they make me angry.
"In most of the cases we handle there is no really pressing need. We used to ask them what their situation was, but I don't ask them any more because they're the same dumb responses. I'm angry that they come to get an abortion so unashamed, joking, and laughing. One that was in the reception area told me, clowning around, 'Kick me, why don't you, so it comes out.'
"When I did it [had an abortion], I was totally in shock. I can't justify it, but here I see almost all of them come in as if they were getting a facial. They're very selfish. One 38-year-old woman told me, 'It's either the baby, or it's my daughter's quinceaÃ±era (A traditional Mexican debutant party for 15-year-old girls). It's not my daughter's fault that I got pregnant.' Some of them have gotten mad at us because they're seven months pregnant, and we can no longer do it. We have had women who come in as patients and later bring their daughter. We have patients who come back here in three months. There's one patient who has had eight abortions. Even the doctor said the tenth one will be free. Another one came because she was going to get married and wanted the abortion before the honeymoon.
"One woman was afraid and said, 'Oh my God, please don't let it hurt, don't let it hurt.' Sonia answered, 'Ma'am, you leave God out of these things.'
"Others ask, 'How did it come out?', like they want to see it. I don't answer them. I only say to myself 'Don't worry, the baby came out in pieces. What do you want to see? The baby in pieces?' After the abortion, they'll ask, 'Can I go to a party? Can I drink alcohol?'
"I can't help being angry â€” at the patient, at the doctor, and at myself. It's useless to be here. We aren't doing anything good. I'm very mad at myself. I feel wasted away. I feel as if I'm not the same person."
At another time in her life, Yeni was part of a youth group at a Tijuana parish. Imbedded in her mind are many happy moments, innocent and full of hope. One recent event has made her think long and hard about the meaning of her life.
"Three days after it opened, we went to see Mel Gibson's The Passion of the Christ. Believe me, it was very hard. When we saw how they beat Jesus and the instruments they used, we compared it to the instruments the doctor used. I saw everything we did in the clinic in that movie â€” so much blood spilled. I couldn't stop crying in the theater. I also saw the devil portrayed as a fetus. I wanted to die. The following day, I told Sonia that we had to stop working at the clinic. She also saw the movie and we remembered that in the picture they said 'He who lives by the sword, dies by the sword.' We were very afraid because just a few months before, the manager of the clinic was killed by her husband. We felt something was going to happen to us because of what we were doing", she said.
"Before my abortion, and before working here, I wasn't afraid of death. Whenever I thought of the day God would come for me, even while knowing I have sinned, with all of my sins, I wasn't afraid. Now, I live with that fear. I feel that I don't want to die because I wonder how I would face God if I should see him. I don't have peace.
"Last week, I visited my brother and wanted to hug my nephew. The child was crying almost hysterically. My sister-in-law said the child was scared because he felt I have the devil inside because I kill babies for a living. I was really angry at my sister-in-law, but I felt it was true to some extent."
Yeni wants to leave her present situation and has started to take the first steps.
"A few days ago, I went to see a guy from the church group that I used to go to. He told me that he was happy that I worked for God and that I was doing well. I felt as if I were choking! I told him I worked at something that I had to leave before I can get closer to God again. He told me to talk to a priest, but I'm afraid. I can't see how I can in all conscience walk into a church. I know the trouble that I'm in. I know the situation I'm in, and what it is I need to do.
"I applied for a job where they take care of the elderly in San Diego. I told the woman who interviewed me about the type of work I do at the clinic, and I pleaded with her to help me get out of here. I told her my hope was with this new job. She was very kind, and she said she would do all she can. No matter what happens, if I don't get the job, I'm going to look for a job in whatever I can. It doesn't matter if it's not as a medical assistant. I'm fed up with the situation here.
"Sonia also had an interview somewhere else. It is for a totally different job. She told me that when she was walking back from her interview, she was telling God, 'My dear God, please, you don't want me to return to the clinic. Give me this job. Please give it to me.' She also told me, 'You'll see; they're going to give us those jobs.'
"We're both sick of our jobs, but for one reason or another, we're still here. I agreed to talk to La Cruz because I think it's necessary that people know the horrors that we have experienced here. Both of us feel a great need to do something good to start compensating God for everything we have done in this job."
Yeni said she wanted to make one important comment before concluding the interview:
"I want to add that some religious groups deliver pamphlets to women before they enter the clinic. I've seen that they look at those pamphlets that show the formation of a baby week after week. Some reconsider and leave the clinic. They are few, but sometimes it happens."
Yeni and Sonia left their job at the clinic a week after this interview, which was conducted on September 27, 2004. The woman who was their supervisor is considering resigning, as well. She has told this to the coordinator of one of the two prayer groups that get together in front of the clinic. They continue to pray for the clinic to be closed permanently.
Read this article on the San Diego News Notes website (new window will open). Reprinted with permission.