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Here they go again, lining up behind Todd Akin, who delusionally believes he wouldn't abort a fertilized egg to save his own life. I'll bet Paul Ryan, when he called Akin during the "legitimate rape" frenzy last month, said something like "look, Todd, we have to pretend to disown you, but just hang in there, and it'll all blow over." He refused to comment on the content of their conversation, you may recall.

No doubt Ryan and his "personhood" ally Akin believe they themselves would never, ever contemplate getting an abortion if they were female. I wouldn't be surprised if Mitt Romney believes the same. But how many No Exceptions believers personally choose to bear a rapist's child after personally being raped? Or personally refuse an abortion that will rescue them from an otherwise personally fatal condition? My guess, as a former provider of a wide range of OB-GYN services including abortion, is fewer than ten percent.

Romney and Ryan have demonstrated, ad nauseam, that they lack the capacity for realistically imagining themselves in a situation they haven't experienced. For example, Mitt on unaffordable education: "Borrow money if you have to from your parents." I can't say I went to Stanford with Mitt, because he headed to France after his freshman year and never re-enrolled, but I was there a year behind him, thanks to an all-expense grant package. (Luckily for me my father, who wouldn't have sent me to an "elite Communist brainwashing outfit like Stanford" if he'd had the resources, was a self-employed lab technician netting only $8,000 a year.) Everyone on campus knew, or knew someone who knew, offspring of governors, senators, cabinet members, and famous plutocrats in our midst. Myself, I'd shared a mattress from seventh grade until I left for college, and shared a bedroom with four younger sisters throughout the first two years of high school. Acutely aware of being one of the poorest, if not the poorest, in Stanford's Class of 1970, I soon learned an eye-opening lesson: Most sons and daughters of wealthy families mistake their lifestyle for the norm. They all know richer people.


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This observation was reinforced for me once in a Stanford classroom, when our lecturer asked how many of us came from average-income families and ninety percent raised their hands. His next question was, "How many of your fathers make more than $30,000 a year?" (Mothers weren't part of the equation back then.) There was hesitation, but eventually three quarters of the class identified themselves in this category. "You're in the top five percent," he informed them. "You're not average, you're better off than ninety-five percent of people in this country." Some accepted this fact and began thinking of themselves differently. Others openly rejected such a challenge to their preconceptions. And these were students interested enough in different circumstances to enroll in a sociology course.

Don't get me wrong. This isn't about the camel and the Needle's Eye, it's about understanding others, a prerequisite for empathy. (Come to think of it, maybe this is what Jesus meant when he said the rich have a hard time getting into heaven.) Growing up rich like Romney and Ryan makes it all the harder to see outside your bubble, because you sure as hell aren't cleaning poor people's bathrooms or touring garage sales in search of a bedspread or bookshelf or cast-off coat. My closest friend from Stanford, besides my middle-class husband, happens to be a multimillionaire's daughter married to a billionaire's son. In 1966 she told me her family was "just average." But she, unlike Mitt and Paul and the donors Mitt was pandering to with his false 47% remark, has a capacity for empathy that matches her purse, paired with an open-minded curiosity about the world. She never would have embarked on a road trip with her dog crated on top of her car, or jeeringly assaulted a fellow preppie for being different, or fallen in love with the dog-eat-dog narcissism of Ayn Rand, or destroyed the pension funds of hard-working employees to fatten her own portfolio. My friend is proof that you can be richer than Mitt yet sensitive to the perspective of other people.

Empathy has become a Democratic trope this year for good reason. After all the suffering wrought by deluded neocons and their fictional bouquets awaiting us in Iraq, it bears repeating that the ability to imagine oneself in another's place when one has never been there, without burying reality beneath one's own fantasies and projections, is a crucial trait in any leader of a free country. (Ironically it can be put to vicious use by a sociopath, though genuine empathy is impossible without it.) Rarely if ever do the uncompromising idealogues who control today's Republican Party display this ability. Nobody illustrates their mentality better than one of my former patients.

Being a doctor or nurse is like being inside that Boca Raton mansion with Mitt's $50,000-a-plate donors: you get to see and hear the real person, up close. Of course the sacred principle of doctor-patient confidentiality means we can't put a cell phone on the counter in our exam room and give the results to Jimmy Carter's grandson. So a lot of hypocrisy goes unexposed, including the not-uncommon hypocrisy of "right-to-lifers" choosing abortion for themselves or their adolescent daughters. (In fairness, some women in this group do change their views after making the personal choice they previously sought to prohibit. But others do not, and naturally they conceal their choice, unlike some converts who regret undergoing abortion in the past. Publicly the least represented group, for obvious reasons, is women who regret bearing a child they're doing their loving best to raise. If you doubt they exist, check out the work of anthropologist Sarah Hrdy.)

My patient Ellen W. (not her real name) was an anti-abortion activist employed by an agency of the Roman Catholic Church. A single woman in her thirties with no children, she ignored the official Church position on "artificial" contraception, like most sexually active Catholics. In fact when I met her, she'd been on low-dose birth control pills for ten years.

Ellen had always assumed that women with unwanted pregnancies were careless and irresponsible, like Mitt preposterously assumes about 47% of Americans. She admitted this in my office. Too lazy to take precautions (never mind that even tubal ligation and vasectomy can fail), those women should be forced to bear the consequences of their sluttiness, in her view. So when Ellen conceived while taking an antibiotic supplied by a dentist who didn't tell her it might reduce the effectiveness of her oral contraceptive, she came face to face with an undistorted fact: you can be careful and responsible and still get pregnant against your will. Perhaps she also opened her mind to a raw truth she felt no need to bring up with me, less than five weeks from conception: killing an embryo of any species, ours included, can't begin to approach the cruelty of killing a seeing, smelling, hearing, breathing, cognizant, terrified, innocent animal or human, which we've done every time we've deployed our military overseas or eaten a slice of bacon, without war or meat becoming litmus tests for appointment to the Supreme Court.

I thought Bill Clinton nailed it last week with Jon Stewart, when he said "the problem with any ideology is that it gives the answer before you look at the evidence. So you have to mold the evidence to get the answer you've already decided you've got to have." Because Ellen's unintended pregnancy didn't cause her to ask how many other women in this situation hadn't acted carelessly or irresponsibly (the majority). It didn't make her question whether her own decision to obtain an abortion might have something in common with others' decisions. No, Ellen wanted to believe her situation was unique: It was unfair that she got pregnant on the pill. It would be disastrous if her employer found out she was having unmarried sex. People were counting on her at work. She had to get this over with. Part of me wanted to refuse her out of spite, but it would have been unethical and illegal to discriminate, and early abortion (for the past several decades, in a licensed medical setting) is safer than carrying a pregnancy to term with modern prenatal and obstetric care.

Ellen couldn't compassionately consider the consequences of unwanted pregnancy for a woman in circumstances different from hers; she couldn't even see herself in the women she went back out to demonstrate against, after her abortion. This is what we have in Mitt Romney and Paul Ryan and their ilk, call it what you will. Watching them lie and obfuscate and flip-flop while displaying zero compassion for people outside their circle of privilege, I can all too easily imagine either of them, if he had a uterus, aborting a pregnancy (confidentially, of course) and justifying this as a regretful necessity to which he alone was entitled.

Extended (Optional)

Originally posted to pianogramma on Fri Sep 28, 2012 at 06:59 PM PDT.

Also republished by Abortion and Community Spotlight.

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