Cross-posted at EllenKolb.com. This post contains an affiliate link.
Gosnell by Ann McElhinney and Phelim McAleer is not easy to read. The style is smooth and fluent, but the topic’s a tough one: Kermit Gosnell, former abortion doctor, now serving life in prison. He killed children who survived attempts to abort them. He was found responsible for the death of a woman who came to him for an abortion and died under what passed for his “care.”
He committed terrible crimes. He is in prison now. Reporters covered the trial as it happened, once they were shamed into it by people like journalist Kirsten Powers. Three years after Gosnell’s conviction, there is now a book that sets down not only what happened, but tells more about the people who were involved. As McElhinney and McAleer tell their stories, the book becomes less about a court case and more about human beings, capable of good choices and bad ones.
I listened to McIlhinney and McAleer talk about their book at CPAC, a political conference in Washington. An odd venue, but perhaps that was the place to reach readers who might not otherwise hear of the book. McAleer was a quiet man, leaving most of the talking to his co-author (who is also his wife).
McIlhenney was not at all quiet. She was passionate and angry as she talked about Gosnell. She was indignant. She called Gosnell “America’s biggest serial killer,” and she meant it. She made no bones about it: she had no objectivity left regarding her subject.
Familiar as I was with the Gosnell case, and as impressed as I was by McElhinney’s passion, I wondered what could be new in the book. As I read, I quickly realized that the close attention to the individuals involved in the case, starting with the investigators, set Gosnell apart from anything else I’ve read on the subject.
The authors’ perspective is unique as well, as McElhinney explains in the preface: “I never trusted or liked pro-life activists. Even at college I thought them too earnest and too religious.”
Fast forward to April 2013 and Kermit Gosnell’s trial in Philadelphia, when everything changed….[T]he images shown in the courtroom were not from activists, they were from police detectives and medical examiners and workers at the 3801 Lancaster Ave. clinic….What they said and the pictures they showed changed me. I am not the same person I was.
After three and half years, the makers of 3801 Lancaster (see link below) are ready to release the follow-up documentary, 3801 Lancaster: American Tragedy. The address in the title refers to the facility where abortionist Kermit Gosnell killed children who survived attempted abortions. He was also found guilty of manslaughter in the death of patient Karnamaya Mongar. Gosnell is in prison for his crimes.
Those crimes are at risk of being forgotten or mischaracterized. Director David Altrogge of 3801 Lancaster doesn’t want that to happen. The new film is available for pre-order on iTunes.
Here’s the trailer:
And here is the original 3801 Lancaster, 21 minutes long. Disturbing material, but must-see viewing for anyone concerned about public health in general and women’s health in particular.
As the Supreme Court hears a case involving a Texas law mandating that abortion facilities be given the same regulatory treatment as ambulatory care facilities, the Gosnell grand jury report from 2011 reminds us what happens when pro-abortion ideology trumps women’s health. I hope the Justices find this report somewhere amid the many briefs that have been filed in the Texas case.
Gosnell was in Pennsylvania, but the recommendations of the grand jury are of interest to anyone who cares about public health in any state. From page 248 of the grand jury report, under “Recommendations”: “The Pennsylvania Department of Health should license abortion clinics as ambulatory surgical facilities.”
“The regulation of Pennsylvania’s ambulatory surgical facilities – which run over 30 pages – provide a comprehensive set of rules and procedures to assure overall quality of care at such facilities. The effect of the Department of Health’s reluctance to treat abortion clinics as ASFs was to accord patients of those facilities far less protection than patients seeking, for example, liposuction or a colonoscopy….Gosnell’s facility fell far below the basic, minimum standards of care that any patient having a surgical procedure should expect to receive. There is no justification for denying abortion patients the protections available to every other patient of an ambulatory surgical facility, and no reason to exempt abortion clinics from meeting these standards.”
Does the Texas law at issue today create stronger regulations on abortion providers than on, say, liposuction providers? Based on their questions today, some Justices apparently think so, and they don’t like it. I wonder how many of them would object if they believed the law simply required parity with ASFs.
Today at the Supreme Court of the United States, our nation’s solicitor general argued against the Texas law, calling it an “undue burden.”
The Pennsylvania Family Institute and Council anticipated that argument. Their words: “Ask the women who went to Kermit Gosnell if lower standards for abortion clinics is a good thing.”
Never forget that abortionist Kermit Gosnell’s crimes were made public by accident. Had federal agents not raided Gosnell’s facility on February 18, 2010 during a drug investigation, he’d probably still be snipping the spines of babies who survived his attempts to abort them and women would still be dying at his so-called “clinic.”
A detective for the local district attorney was looking into reports of foul deeds at Gosnell’s place, but nothing came of that until the drug raid.
A 2016 debate in the New Hampshire House included brief references to the imprisoned Pennsylvania abortionist. One state representative warned that children born alive after attempted abortion need stronger legal protection, lest they die at the hands of someone like Gosnell. Another representative dismissed the warning in a that-doesn’t-happen-here tone. “He [Gosnell] is in jail.”
He’s only in jail because drug investigators stumbled across his filthy facility. Without that drug investigation, Gosnell’s savagery would have remained cloaked. In 2010, Pennsylvania had laws regulating abortion, and didn’t enforce them. Pennsylvania had an abortion-friendly political environment. That left Gosnell unaccountable, with a free hand to use his best medical judgment. His best judgment left women and children dead.
As an aside, consider that New Hampshire has no abortion laws to enforce, aside from parental notification and a partial-birth abortion ban. The Granite State also has an abortion-friendly political environment.
On February 18, 2010, the Federal Bureau of Investigation and detectives from the Philadelphia District Attorney’s Office executed search warrants at the Women’s Medical Society, a clinic operated by Dr. Kermit Barron Gosnell at 3801-05 Lancaster Avenue in Philadelphia. The federal Drug Enforcement Administration (DEA), the Philadelphia Police Department, and the District Attorney’s Dangerous Drug-Offender Unit had been investigating Gosnell and his clinic for months, based on reports of illegal prescription drug activity.
During the drug-trafficking investigation, District Attorney’s Detective James Wood learned from one of the clinic employees that a woman had died in November 2009, following an abortion procedure. Detective Wood discovered other disturbing details about Gosnell’s medical practice. The premises were dirty and unsanitary. Gosnell routinely relied on unlicensed and untrained staff to treat patients, conduct medical tests, and administer medications without supervision. Even more alarmingly, Gosnell instructed unlicensed workers to sedate patients with dangerous drugs in his absence.
Based on this information, Detective Wood believed that further investigation of the woman’s death the previous November was warranted. The detective searched for a police report on the incident, but finding none, he went to the Philadelphia Medical Examiner’s Office to try to identify the woman and to find out more about her death. Detective Wood learned that the dead woman was Karnamaya Mongar, and that her toxicology report revealed an extremely high level of Demerol, a drug Gosnell used at the clinic to anesthetize patients.
In light of this suspicious death and the other significant health and medical concerns, DEA Agent Stephen Dougherty invited personnel from the Pennsylvania Department of State (which regulates doctors and the practice of medicine) and the Pennsylvania Department of Health (which regulates health care facilities) to accompany law enforcement officers on the February 18 raid. No one from these agencies had visited the clinic in more than 15 years, even after the Department of Health had been informed of Mrs. Mongar’s death months earlier.
The search team waited outside until Gosnell finally arrived at the clinic, at about 8:30 p.m. When the team members entered the clinic, they were appalled, describing it to the Grand Jury as “filthy,” “deplorable,” “disgusting,” “very unsanitary, very outdated, horrendous,” and “by far, the worst” that these experienced investigators had ever encountered.
There was blood on the floor. A stench of urine filled the air. A flea-infested cat was wandering through the facility, and there were cat feces on the stairs. Semi-conscious women scheduled for abortions were moaning in the waiting room or the recovery room, where they sat on dirty recliners covered with blood-stained blankets.
All the women had been sedated by unlicensed staff – long before Gosnell arrived at the clinic – and staff members could not accurately state what medications or dosages they had administered to the waiting patients. Many of the medications in inventory were past their expiration dates.
Investigators found the clinic grossly unsuitable as a surgical facility. The two surgical procedure rooms were filthy and unsanitary – Agent Dougherty described them as resembling “a bad gas station restroom.” Instruments were not sterile. Equipment was rusty and outdated. Oxygen equipment was covered with dust, and had not been inspected. The same corroded suction tubing used for abortions was the only tubing available for oral airways if assistance for breathing was needed. There was no functioning resuscitation or even monitoring equipment, except for a single blood pressure cuff in the recovery room.
Ambulances were summoned to pick up the waiting patients, but (just as on the night Mrs. Mongar died three months earlier), no one, not even Gosnell, knew where the keys were to open the emergency exit. Emergency personnel had to use bolt cutters to remove the lock. They discovered they could not maneuver stretchers through the building’s narrow hallways to reach the patients (just as emergency personnel had been obstructed from reaching Mrs. Mongar).
The search team discovered fetal remains haphazardly stored throughout the clinic – in bags, milk jugs, orange juice cartons, and even in cat-food containers. Some fetal remains were in a refrigerator, others were frozen. Gosnell admitted to Detective Wood that at least 10 to 20 percent of the fetuses were probably older than 24 weeks in gestation – even though Pennsylvania law prohibits abortions after 24 weeks. In some instances, surgical incisions had been made at the base of the fetal skulls.
The investigators found a row of jars containing just the severed feet of fetuses. In the basement, they discovered medical waste piled high. The intact 19-week fetus delivered by Mrs. Mongar three months earlier was in a freezer. In all, the remains of 45 fetuses were recovered at the clinic that evening and turned over to the Philadelphia medical examiner, who confirmed that at least two of them, and probably three, had been viable.
It’s not dead yet: House Bill 629, a proposal to authorize New Hampshire officials to collect abortion statistics, was reviewed at a legislative work session on September 8. It was introduced last January, but it never made it to the House floor after the Health, Human Services and Elderly Affairs committee voted to retain the bill until 2016. A subcommittee led by Rep. Bill Nelson (R-Brookfield) is looking at the bill this summer and fall. “I’d like to see if we can move this forward,” said Nelson.
If “forward” ever comes, it will be no earlier than January 2016, when the House and Senate re-convene. If the bill is ever passed, and if Governor Hassan decides in an election year not to veto it, it would probably take a year to put into effect. Figure mid-2017 as the earliest possible time New Hampshire might collect abortion statistics, and a year and a half after that to get results from the first year’s data collection – and that’s if all goes well with HB 629 next year.
Passing a stats bill remains uphill work. There are apparently legislators who are quite content for New Hampshire to remain one of only three states not reporting any abortion information to the federal Centers for Disease Control. Other legislators will support a stats bill as long as it amounts to a guide to where in the state to promote more contraception. Any resemblance to a marketing plan for Planned Parenthood would no doubt be entirely coincidental.
Rep. Thomas Sherman (D-Rye), a physician, told his colleagues, “A lot of what I do is driven by statistics, but the first rule of statistics is [to know] how are they going to be used. If the goal is to reduce abortions by identifying how many are occurring and if there’s an area where there’s an untoward number, fine.”
The bill’s co-sponsors take a broader view. Rep. Kurt Wuelper (R-Strafford) told the subcommittee, “We have no idea what’s going on in our state [regarding abortion]. We have only anecdotal information. That’s why this bill is here. It’s straightforward and will lead to good public policy.”
A fellow legislator with a history of opposing abortion regulation was skeptical. “How do you expect this knowledge to be used?” asked Rep. Helen DeLoge (D-Concord). “Abortion isn’t a communicable disease. Only me, myself and I is affected.”
Affected, indeed. Who’s doing abortions, and whose procedures are leaving women injured? How old are the mothers? How far along in pregnancy are abortions being done in our state, and how does gestational age affect the risks an abortion poses for the woman? Are abortions being performed for reasons of rape or incest, and if so, are the assailants being prosecuted for assaulting women?
Subcommittee members are looking at what data other states are collecting. There’s no nationwide standard.
One thing was clear at the work session: the subcommittee will not bring forward any bill that calls for public identification of abortion providers. There was even discussion of preventing public health officials from knowing the names of providers – a problematic proposal, as we shall see. A woman seeking abortion would thus have no way of knowing if her provider had a history of botching abortions. The subcommittee consensus was that collecting names, even if the publicly-available data were to be aggregated to protect patient and provider identities, would lead to violence against providers.
I can’t help but think that that’s a consensus to warm Kermit Gosnell’s heart. Women who were unaware of what was going on in his “clinic” kept him in business. The Keystone State abortionist, now imprisoned for murder and manslaughter, would have gotten away with killing Karnamaya Mongar and killing children who survived attempted abortion if he hadn’t been accidentally discovered by pill-mill investigators.
Patricia Tilley of the New Hampshire Department of Health and Human Services was on hand to answer technical questions from the subcommittee: When the subject of identifying providers came up, she sounded a cautious note. Rep. Sherman made a pitch for tracking abortions by region rather than by provider or even facility. Tilley replied that such an approach would affect the validity of abortion data. “We wouldn’t know who’s reporting [statistics] and who’s not reporting. You would take away the ability for us or anyone to do QA [quality assurance] on provider data.”
That gives subcommittee members something to mull over before their next meeting.
There are other statistics in the proposed bill with which the subcommittee had no trouble: maternal age, fetal/gestational age, date of abortion, method of abortion, maternal residence by county or other geographic subdivision. Public identification of women seeking abortions would be off-limits, and statistical reports would be generated using aggregate data. The DHHS officials expressed concern about a penalty clause in the bill that could conceivably threaten DHHS workers who make innocent mistakes in data collection or processing; that clause may very well bite the dust by the time the subcommittee makes its final recommendation. All of this would make for a good start on a stats bill.
Good starts have been made before, though. And still we wait.