Hello Diary,

Today I witnessed my first abortion, at Trivandrum Medical College Hospital. Let me tell you about it.

Our patient, the first patient during my time at the Department of Obstetrics and Gynecology, is a young girl, mentally disabled and currently five weeks pregnant after being sexually abused by an unknown man. She says she doesn't know when we ask how old she is, but she doesn't look older than 18 or 19 to me. And she seems happy, smilling and rolling her head from side to side when the nurses put her on the gynecologist's table.
I hope the happiness is at least somewhat conscious and sincere, but it's hard to know what to think. Does she even know what's happening to her, I wonder. She is stripped, and her feet secured in the stirrups. There's a big scar running the length of her thigh. Still, she seems happy enough while gynecologists and nurses come and go, inspect her vulva and wash it with antiseptics. After this, we're ready to start.

First the cervix has to be dilated, so a short, spongy stick is inserted. The girl squirms a little as it starts absorbing liquid and grows, widening the cervix and the portio. Spatula-looking instruments are put in place to hold the vagina open, and the doctor brings out the suction pipe - it looks sort of like the instrument a dentist uses to keep your saliva from flooding, only straight, and longer. It goes in deep, back out, in again, up and down. There are blood clots dripping down into the suction jar, and the girl's not smiling anymore. She moans in agony now, squirming back and forth.
It goes on for minutes: in, out, up, circle; and more clumps of blood dripping out of her vagina and landing in a bucket on the floor. I stand there like a statue, thinking about things like what her name might be and what the scar on her thigh comes from. My gaze pendulates between her vagina and her face, and there's nothing in her eyes but fear and agony now. Her moaning turns into wails of pain. She is calling to her mother I think, if my Malayalam is up to speed. Clenching my fists, I sway and become aware that things aren't ok. I stare at her vagina, and I can all but feel my blood pressure dropping.

After a lot of suction, a spatula is inserted to scrape the walls of the uterus and make sure the embryo (or the pregnancy as it's called in the business - medicine is full of euphemisms) is gone.
The girl is screaming now.. my god, how she is screaming, and tossing back and forth on the table. I need to sit down.. I have to sit down. I look up and catch a glance of Erik, and he's like a wax figure, pale as death. I must look about the same, I think, and then my field of vision breaks up into shimmers of light, and I sit down, heavily, and try to breathe. In through the nose, out through the mouth, all that. I see even more blood on the floor, and feel certain that I'm going to throw up. Erik runs by me, headed for the doorway. There's so much screaming. The room is full of it.

You see, somehow I always thought abortions were sort of like surgeries. You're rolled away, put to sleep, and a few hours later you wake up and the whole thing is over. But it isn't like that. Not for this girl.
And I am feeling so weak - so worthless. I want to hold her hand, help her through the pain, tell her not to worry; but I don't. I just sit there, trying not to throw up. I am worthless.
I have seen people die. I've seen them die up close, falling down and not getting up again, but I've never seen anything like this.

After what feels like a long time, I muster the energy to stand up, seeing clearly again. The procedure is almost over now. There's a lot of blood, and the girl looks exhausted. I loathe myself. I've been here for two weeks and now I snap like an amateur in the face of suffering. Two weeks seeing more misery than most non-travelling westerners absorb over a decade, and here I am like a kid in a foreign land. Never again.
We are leaving the room now, and she is still moaning a little. One more person I couldn't help, who I'll never see again. How long does she have before someone else takes advantage of her, and how many times will she have to go through this again, I wonder. I am thinking of mankind, and it makes me sweat. Evil lives in India, too.

Dear Diary.

Not everyone can carry the weight of the world.