I know it’s not the solution, but a big part of me, since starting medical school, wants to take people who pretend that illegalizing abortions prevented them on a tour of a hospital ward somewhere they’re still illegal.

The smell of rotting flesh on a living person is something you never forget.

I don’t hold with a lot of things, but you’d never catch me advocating that we illegalize some other kind of surgery on consenting adults. People do it anyway, and they do it wrong. And they show up with bacterial soup where flesh used to be, and they can easily die of it. Especially now, with resistance to antibiotics such an issue that our hospitals have a chart of what diseases are most resistant to what antibiotics just in our area. I may think liposuction is a surgically unnecessary unacceptable risk, but no one deserves to die from a botched liposuction by an illegal provider, or a botched silicon injection.

Legalize all surgeries by competent and well-trained providers. Illegalize all others. Make care accessible to everyone. Make informed consent the cornerstone. God, the days I spent shadowing in an abortion clinic, I went from being apologetic about abortions to thinking “This? You can’t even see the villi yet.” Let alone the embryo. In the first eight weeks or so, you cannot recognize anything even vaguely human-like, even crouched over the uterine contents squinting at them in a water-filled glass bowl over a light source, which you do every time to make sure that there aren’t any unexpected findings. There are certain conditions that are rare, but for a provider in a major urban area with few clinics, like the one I shadowed, who might do hundreds in a year, the odds are she’ll encounter them at least occasionally and someone with, for instance, a hydatiform mole, which is something like “what if the blastocyst turned into aggressively invasive cancer instead of an embryo,” needs urgent medical attention.

In general, I think high schools need to devote more time to human physiology. Everyone should know how their blood and guts work, at least at a basic level. When I took a specific class on medical terminology in high school, part a prep course for people interested in nursing, I was shocked to discover how little I knew and how little my classmates knew–things that any medical professional would consider absolutely basic, we had no idea. We filled in the gaps with intuition that was wrong. And for many people, that’s never remedied.

We’d be having completely different national conversations if everyone knew how bodies work. That’s just a fact. You’ll never meet a competent doctor who wouldn’t make birth control freely available to literally everyone if they had the chance. They’ve seen the consequences. Not just botched abortions, back in the day, but I saw a kid whose mother was on meth during the pregnancy. The mother cleaned up afterwards, but the kid has excruciating constant migraines. At six, that’s a hell of a burden, and the mother’s guilt was palpable and unrelenting. It may not have even been related, but what if that poor addicted woman had had actual control of her reproduction? I doubt she would have chosen to be pregnant then. An IUD, a Norplant, would have meant she could have waited until she cleaned up and felt ready for the responsibility, even without the presence of mind and resources to use a condom. Addicts deserve medical care, too. They deserve choice.

Everyone deserves choice. Even reckless people, even drug addicts, even people who don’t have a sympathetic story. And the people running the national conversation on abortion want to ignore that in favor of talking about “innocent” people, whether that’s the sympathetic woman (nobody talks about trans men or nb people) getting an abortion or the embryo or fetus being aborted. It makes me so angry, to be so irresponsible with how we talk about bodies, health, minds, choices. Dignity.