CJR's Liz Cox Barrett flags an old Washington Post profile of a medical student's struggle to decide if she has the capacity to perform abortions. In one unsettling scene, Lesley, the student, practices the procedure on a papaya, "which bear[s] a striking resemblance to a uterus":
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.
Read the rest here.
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