812: The Bear at the End of the Tunnel
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Prologue: Prologue
Ira Glass
His brother needed somebody last minute, because a guy bailed on him. Jeff also had somebody bail on him. He'd moved back home for the summer, for this girl he liked.
Jeff
And it became, like, really apparent right away that that wasn't going to work out.
Ira Glass
So he had some time on his hands. His brother was doing a research study on black bears. His brother was a wildlife biologist and offered him this job as a field tech.
Jeff
And a summer working with black bears was a dream, so--
Ira Glass
That wouldn't be a dream for everybody. Why was that a dream for you?
Jeff
Oh, I just think bears are the coolest animals. They're so cool. Black bears are, like, so cool, how fast they can climb a tree. Like, their ears-- I love their-- bears' ears. I just love everything about bears.
Ira Glass
So Jeff loves bears. His brother, Wes, studies bears. Jeff is the younger brother. Wes is the older brother. Wes's research was to track where bears were in Bryce Canyon National Park in Utah. Here he is.
Wes
There was a bear that had broken into a tent, swatted a woman while she was sleeping, really scared her. And so the idea was to collar some bears, track them, see where they're going, how they're spending their time.
Ira Glass
If they could figure that out, the park could relocate campsites away from those areas and post signs. So Wes and Jeff spent a summer putting collars with GPS devices onto a bunch of wild bears. And then in the winter, they had to go back and check on the bears, do a quick exam, make sure their collars weren't too tight once the bears fattened up for winter, swap out any old collars that needed new batteries.
And it turns out the easiest way to do that is to visit the bears when they're hibernating in their dens. In most bear dens, that job isn't actually too difficult or scary. The dens are small, like a cavity in some rock or under a tree, Wes says.
Wes
And they're generally shallow enough that I can just-- I have a pole that has a syringe on the end of it. I can just extend that pole and sedate the bear from outside of the den. I don't generally even have to go inside.
Ira Glass
Generally.
Jeff
But then, you get a couple dens where it's like you're the only thing between the bear and the exit. And that's when it gets kind of sketchy.
Ira Glass
And that's what happened in this case.
Jeff
Oh, this one was, like, on another level, though. This one was crazy.
Ira Glass
This one happened on a wintry day. The two of them headed out to see bear number 95 in their study. They saw a signal on the GPS, climbed maybe 1,000 feet up a steep hillside to get to him in the snow. It was hard and cold. And then they struggled to find any opening at all in the rock that could be a den, because it's just a blanket of snow everywhere. They searched for maybe half an hour.
Jeff
And then Wes is, like, standing on this, like, tiny little opening. And then I see these branches right by his feet. And a lot of times, bears will, like, bring branches into their den. So I'm like, Wes, like, I think you're standing on top of the den. (CHUCKLING) And he's just like, no way.
Ira Glass
They clear away the snow, and it's an opening the size of a manhole cover, going into the side of a sandstone cliff.
Jeff
And then we crouched down and looked. And, like-- I mean, you could only see, like, 20 feet in, and it's just black. So honestly, this den-- it would be terrifying to go in it if you, like, didn't know anything was in there. And you know that there's a bear in there, so that just intensifies it so much more. But it's like even if there wasn't a bear, I'd be like, this is scary.
Ira Glass
Wes and Jeff discuss whether they're going to go into this hole. Black bears aren't like grizzlies. They almost never attack people. But going into this very unusual den where the bear might feel trapped or threatened and have no way out except through them-- that's a choice.
Jeff does talk back to Wes way more than any normal field tech would, because he's his brother. But Wes is the boss, and he's like, we came this far, and we really do need to change that bear's collar.
Wes
And I start crawling in, looking for the back of the den, looking for the bear, and it's just not there. And this hole just plunges into darkness. My headlamp only goes so far. And I just keep going. And immediately, I realize, like, shit, this is a really, really long den. This is much longer than anything I've ever seen or even heard of.
Ira Glass
How long?
Wes
This thing extends 80 feet back, and at the end of it, it's just pitch black. You kind of-- you really do have to suppress a lot of primal stuff that's telling you this is a place where you are not supposed to be. This is not a place for humans.
Ira Glass
Wes is in front, big brother, scientist. Jeff's behind-- little brother, assistant. And they're army-crawling, because the tunnel is too low to stand up in. It's pretty cramped.
And you know that feeling where you're in your belly in a tunnel, inching towards a bear? No, of course not. You don't know that feeling. Who has done that?
But you have been in this situation of moving toward something scary or dreadful ahead. And now, you have gotten yourself in it. You can't turn back. You have to keep moving. You just have to deal. And that is what today's show is about. We have this story, and then we have another one in the second half of the show. And yes, it's This American Life from WBEZ Chicago, Ira Glass.
Act One: Everybody Knows, You're Not Supposed to Poke a Sleeping Bear
Ira Glass
Anyway, so they're edging towards this bear, right? The tunnel was gently sloping downward. And the smell-- you may be wondering about the smell. It's like wet earth, musty.
Wes
The bear brings in a nest of, like, pine tree boughs and other sticks and stuff. So it does kind of smell cedary and nice, too.
Ira Glass
Hmm.
Jeff
Like, it's musty, but it's honestly not as bad as what you would think. Because when a bear goes into hibernation-- Wes will give you a lot more scientific name on this, but they create, like, a butt plug of, like, poop, so that they won't poop the entire time they're in their den. So there's, like, no feces or urine in there. So it honestly isn't terrible.
Ira Glass
They may be 15, 20, 25 feet into the tunnel, and Wes's headlamp points at the far end.
Wes
And I just see these two green eyes at the very end of this tunnel, staring back at me. And the thing about these hibernating bears is they-- bears don't hibernate very deeply. So if a bear hears you approaching its den, it can come out of that hibernation, and generally, within 5 to 10 minutes, they can be mobile.
And so this bear was awake. And they have the tapetum lucidum, which is the thing you see in cats' eyes or deer eyes or whatever that reflects light back at you. And they reflect a really kind of green glow. And so it's just, again, the stuff of nightmares. Like, you're crawling down a deep, dark hole in the mountains, and there's two green eyes shining back at you.
Jeff
The light starts to catch these two eyeballs at the very end of the den that are just, like, gleaming back at us. So at that point, I'm, like, terrified. And I start kind of freaking out. I start saying, Wes, this is crazy, this is crazy. Like, I don't know about this.
Wes
And Jeff just started saying, we shouldn't be here, we shouldn't be here, we shouldn't be here. It was like a mantra that he was repeating.
Jeff
And, like, I keep saying that.
Wes
And it was starting to really freak me out. Like, I was trying to summon all this courage and draw on all my experience, and then I have him behind me telling me that we just should not be in there. And so I turned around.
Jeff
And then Wes just goes, Jeff, shut up. [CHUCKLES] So then my immediate response was like, you're so brave. [CHUCKLES]
Wes
And then, he just started repeating, you're the bravest person I've ever met, you're the bravest person I've ever met. And that helped, actually. That made me feel a lot better.
Ira Glass
It's funny how he needs to keep saying something to have some place to put his fear.
Wes
Yeah. Yeah. I think, for him, he needed to vocalize that, and for me, I was really going inward and just trying to focus on the bear. And I was looking for any cues that that bear was going to be aggressive. And at that point, you leave.
Ira Glass
What are you watching for?
Wes
They make a really distinctive [HUFFING] sound when they're really, really upset. And then, they also can-- they make this really interesting jaw-popping noise, too. It literally clacks its jaws. It pops its jaws.
It's kind of like a [CLICKING] sound. And then from there, it proceeds to swatting the ground with its paws. And then if it is still upset, it'll bluff-charge you. And a bluff charge is just where the bear comes at you, and then stops short.
Ira Glass
Are you terrified?
Wes
Oh, yeah. Oh, yeah, I was absolutely terrified. I have a video that I took when I got close to the bear. I took a quick video from my phone. And at the very end of it, you just hear me say, this is so scary.
[AUDIO PLAYBACK]
Wes
(OUT OF BREATH) OK. Oh, this is so fucking scary. This is so scary.
[END PLAYBACK]
Wes
Because it really was. It was terrifying.
[AUDIO PLAYBACK]
Wes
[PANTING] Oh my gosh.
[END PLAYBACK]
Wes
All of my body, a lot of my psyche was saying, you absolutely need to get out of this den. It's this feeling of being a soft, pink human being in a place where we don't belong.
Ira Glass
Of course, Wes, being in the tunnel with this bear-- he's a bear expert. And he's thought some about what this experience must have been like for the bear.
Wes
Where these black bears live, they're top dog. There's nothing bigger or more dangerous than them. And so they don't have stuff that crawls into their dens and gets closer and closer to them.
So it must be a very unique experience for them as well. Like, I'm obviously a bear. Like, what the hell is this thing doing in here?
Ira Glass
Wait, when the bear sees you, like, it knows it can kick your ass, right? Like, it can just look at you, and it doesn't even-- without even thinking or doing any math in its head or something, it just sees your size, and it just knows, well, you're not a threat. But then, is it scared?
Wes
Yeah, you know, I think the thing that we have to realize with wild animals is that for them, a fight means much more than can I win or will I lose. It's like, am I going to be injured in this? Because for any animal, bears included, if they sustain a big injury in any kind of scuffle or fight or whatever, that could be a death sentence for them. Because then they no longer have the ability to feed or escape or even move. And so they tend to be very risk-averse.
Ira Glass
So Wes and Jeff keep army-crawling forward with a syringe full of sedative on the end of a 7-foot pole. And finally, Wes gets close enough to jab it into the bear. Mission accomplished, right?
Jeff
But we jab it. The bear doesn't react at all.
Ira Glass
Doesn't flinch, and most important, does not fall asleep, partly because it'd gotten so big since they'd last seen it-- like, 350 pounds-- which would require way more sedative than West gave it. So the two of them head back out of the cave to prepare another dose of sedative, which they definitely are going to need. That job goes to Jeff, the little brother.
Jeff
And it was something I was fully capable of doing, but I think I was still just dialed up all the way to 11, with all my emotions, and my thoughts weren't clear. So I was doing a terrible job.
Ira Glass
Like your hands aren't totally steady?
Jeff
Yeah, I'm just making a mess. I'm, like, fumbling around. And eventually, the bear, like, makes its way all the way through the 80 feet of den and starts coming out.
Ira Glass
This is not the plan. It would be very bad for a tranq'd-out bear to leave its den at all. It could easily wander off and get lost in the snow in the middle of winter. And Wes and Jeff-- remember, they're bear guys. They do anything they can think of so the bears in this research don't get hurt by it, and experience the minimum amount of discomfort or stress.
They have another field tech with them who's been waiting outside the tunnel. And Wes orders that guy now, keep the bear in the den. And the guy starts swatting at the bear with a plastic shovel to keep it from emerging.
Wes
And it just does not care. It's not even registering that he's there and just keeps walking past him.
Ira Glass
Wow.
Wes
So yeah. So at that point, I ran. And the thing that I really didn't want to have happen was the drug take hold while this bear was trying to get away and have it tumble down the hillside or down a cliffside or something like that. I just wasn't willing to let that happen.
So I ran and actually grabbed the bear by its back legs and pulled them out from under it. And then I straddled the bear and pushed its head down into the snow. In the meantime, I had sent--
Ira Glass
Wait, wait, wait, wait. What are you-- what are you talking about? You're able to do that because the bear is kind of like-- is the bear walking like a sort of cartoon drunk bear kind of thing? Like, it's staggering along?
Wes
Yeah, that's honestly exactly how it was walking. That's a perfect representation.
[CHUCKLING]
Ira Glass
So he's on top of this bear, straddling it, holding its collar and head down in the snow. He's actually gotten a second dose of sedative into him by then, but the bear is still awake. And Wes then looks over at Jeff, who is so panicked that he has dropped the entire case of drugs. Jeff is supposed to be preparing a third dose.
Wes
And I just yell at Jeff. I say, Jeff, come grab this bear. I'll do the drugs.
Ira Glass
Kind of an unusual set of sentences to say to anybody.
They switch places. Jeff is now the one straddling the bear, hands on its collar. And the bear gets up and starts to move again.
Jeff
And it's almost like-- you know that movie, The Replacements, where Keanu Reeves is a quarterback? Or any of the football movies where the big hefty lineman catches the ball?
Ira Glass
Mm-hmm.
Jeff
And then they're just, like, slowly moving towards the end zone, and the whole defense jumps on him, and they're just kind of, like, falling off of him and trucking...
Ira Glass
And he's still going towards the goal line? Yeah,
Jeff
...is going in a straight line with all these people hanging on him? It's kind of like that. We were just hanging on this black bear, and it's just, like, slowly going in a straight line.
Ira Glass
Jeff's holding it by the collar, getting dragged along-- slowing it down a little bit, but that's all he can do, in this thing with this bear where none of the normal rules apply, totally off the map.
Jeff
I was like, this is what I have to do, but I can't believe I'm doing it. It was, like, surreal. Like, I just-- it's like I was in a dream.
It starts making its way to more of a downward slope, too, so now, it's really hard for me to stop it. And I'm just kind of, like, on the back of it. And it walks straight into a pine tree, and literally, like, couldn't figure out what was going on and just tried to keep walking forward into a tree.
Ira Glass
Wes remembers it more like a juniper bush, but in any case, it does the job. The bear stops, finally passes out on the ground. They do their business, change the collar, examine the bear.
And then, so the bear doesn't get lost and confused in the snow when it wakes up, they grab its limbs and drag it 15 yards or so back up the slope to the opening of the tunnel, which is exactly as completely exhausting as you would imagine. It takes maybe half an hour.
The temperature is dropping. Wes is worried that the bear might get cold, so he leaves a blanket on top of him before they go.
Looking back, what Wes and Jeff both talk about is the terror that they felt in that tunnel. Wes says it was a whole new level of fear he didn't know existed, like the kind of primal fear that, long ago, humans must have had all the time facing off with animals that wanted to kill them and eat them.
Wes
And it's something that we've forgotten, but I think it's something that still sits deep inside of us, that when you do have these experiences with large animals, that it bubbles to the surface. And in a way, it was really intoxicating. I'll tell you, that night, I didn't sleep a wink, because my adrenaline was just coursing through my body. It just made me feel-- honestly, made me feel very alive. And even when I think back on that, I can still remember the feelings I had that night as I went back to my cabin and everything, just how bright the stars seemed and how crisp the air felt. And it really just reminded me how good it is to be alive.
Ira Glass
And the bear? The bear was fine. The drugs they gave it, it probably doesn't remember the details of what happened, Wes said. And over a year later, Wes went back to that tunnel when the bear wasn't in it and found the blanket inside. The bear must have liked it a little. It smelled like bear, fur all over it. Wes took it back, kept it as a souvenir. He says it still smells faintly like bear.
After the break, we have another story of people thrown into a dangerous and utterly foreseeable situation, and how they handle it, in this episode that we're calling "The Bear at the End of the Tunnel." Wes and Jeff, by the way, have a podcast where they tell stories of animal attacks. It's called Tooth and Claw.
If you enjoyed this story that you just heard, you should know that by their standards, this story was not so special. The ones on their show-- way more eventful. More in a minute from Chicago Public Radio when our program continues.
Act 2: The Devil Is in the Details. And There Are So Many Details.
Ira Glass
It's This American life from Ira Glass. Today's program, again-- "The Bear at the End of the Tunnel," stories of people who find themselves trapped in some dangerous situation, and now they just have to deal. We have arrived at Act Two of our show. Act Two-- "The Devil's in the Details. And There Are so Many Details."
So a few months ago, we brought you this story from one of our producers, Miki Meek, about an OB/GYN in rural Idaho who was deciding whether or not to leave the state after Roe versus Wade was overturned and abortion was outlawed there.
Amelia Huntsberger
I don't want to leave here. I mean, I don't want to leave, but I don't know if I can stay.
Ira Glass
This OB/GYN, Amelia Huntsberger, was facing in Idaho a set of abortion laws that kicked in after Roe was overturned that are some of the most restrictive in the country. And can I just say, I think when most of us think of these laws, we think of their effect on abortion clinics and abortion care providers. That wasn't this story.
Amelia was a general OB/GYN at a hospital-- in other words, doing pap smears, birth control, delivering babies. And her hospital did not terminate pregnancies unless there was a medical complication-- which, by the way, is like most hospitals in the United States.
But when Roe was overturned and these new laws in Idaho took effect, they defined abortion in the broadest possible terms. It was effectively a complete ban. Even pregnancies that weren't going to be viable could not be terminated.
And any doctor who performed an abortion, breaking those rules, faced severe consequences. They could lose their medical license, they could go to prison for two to five years, and they could get sued. Family members could sue. If a rape resulted in a pregnancy and the victim decided to get an abortion, the rapist's family could sue the doctor for performing the abortion.
And the problem for Amelia, this OB/GYN, is that she ran into all kinds of situations where, in the course of administering normal health care for her patients, she could run afoul of the law. For instance, if a patient showed up at her hospital miscarrying and bleeding uncontrollably, in the past, Amelia could terminate the pregnancy to stop the bleeding. But now, she could be charged with a felony if she did that, if she did anything to terminate a pregnancy, if it still had a, quote, "fetal heartbeat." That's a phrase in the law, though in the early stages, it's not a heartbeat. It's just electrical activity and some tissue that could eventually become a heart.
So now, when Amelia faced pregnancies with serious complications, situations where the longer she waited to act, the more danger the patient was in, she could no longer just think about what was best for the patient who was in front of her.
Amelia Huntsberger
You know, when you do surgery like that, where somebody is having ongoing active bleeding, that's already high stress. And that sort of high stress-- like, I trained for that. I know what to do with that. I can handle that.
Then you add in this other weird layer of, like, is her brother going to not understand that this was a not-viable pregnancy and that her life was at risk? And what about her mom? What about her partner? What about her sister?
Do these people understand how serious this condition is? Or do they only understand that I removed a pregnancy that had a heartbeat? I don't know. How am I supposed to know?
Ira Glass
So she worried about getting sued. She worried about getting prosecuted. This came up all the time.
At the end of our story back in March, Amelia was still hanging on in Idaho, still deciding. Since then, so much has happened. Just a few weeks after we aired that story, Amelia decided she was going to move away because of Idaho's abortion laws. She was one of the first OB/GYNs in the state to announce she was going.
About a week after that, something that she feared might happen someday happened a lot quicker than she had imagined. The hospital where she practiced-- Bonner General Health-- announced that it was shutting down its entire labor and delivery department. The hospital cited the new laws as one reason. They said recruiting new doctors would be, quote, "extremely difficult." Finances was the other reason. Since then, all three of the other OB/GYNs who shared a practice with Amelia have left the state.
What Amelia dreaded most in moving away was, what was going to happen to her patients? How would all this affect everyone in Idaho trying to have a baby? We thought about that for today's show, because what would happen to them?
This was, in a sense, the bear in the tunnel-- the difficulties and possible danger that all those patients face because of the new laws. And what has unfolded since has been pretty dramatic. Our producer, Miki Meek, went back to talk to patients and to the lawmakers who put them into the situation that they're in in the state. Here's Miki.
Miki Meek
I talked to half a dozen pregnant women who'd been planning to deliver at Bonner General and suddenly found themselves contorting their lives around logistical problems they had never imagined facing for something as everyday as trying to have a baby in the state of Idaho. Brooke Macumber is 25 years old and was days away from giving birth when I reached her. Amelia had been her doctor, and Brooke's plan had been to do her prenatal appointments at Bonner General and deliver there, too.
But now, the closest Idaho hospital with a labor and delivery department was almost two hours away, in a small city called Coeur d'Alene. She had to take her three little kids with her in the car on a four-hour round trip for every prenatal appointment-- blood pressure, fetal heartbeat. Four hours for a 15-minute check-in.
Brooke Macumber
The days that we would have to go out to Coeur d'Alene, it was, like, from 9:30 to 6 o'clock at night. I would have my sister-- she lives in Spokane, so she's about 35 minutes from Coeur d'Alene. But she would hang out with the kids so I could go to my appointment. And then we would have to go out for lunch or do a picnic, and then go to a park. Because I'm like, they can't just sit in the car for four hours back to back.
Miki Meek
The distance of the hospital also worried her. She was freaked out about not getting to the hospital in time and giving birth on the side of the road. Her labors have always been pretty fast. Would she have time to make it to the hospital?
When Brooke got three weeks away from her due date, she couldn't take being on high alert all the time. So she moved in with her mom, who lived two hours away, close to Brooke's new hospital. Brooke took the kids with her.
Her husband couldn't join them because of work, and her mom was working every day. So Brooke was caring for three little kids, basically on her own at eight months pregnant. It was hard to leave her husband. But splitting up their family temporarily was the only solution they could come up with.
Brooke Macumber
Me and my husband have never really been apart before, and so being in a bed alone has been strange. And then our two boys-- they've had some trouble sleeping, so they'll wake up in the middle of the night. So then both the boys will crawl into bed with me, and then I wind up, like, on the couch, because I'm like, I need to try to at least get one more hour of rest.
Miki Meek
Bonner General had been the only labor and delivery unit in its region of northern Idaho. When it shut down, it became a statistic in a whole separate longstanding crisis-- the closure of labor and delivery services in rural hospitals all over the country. Nearly half of rural community hospitals no longer offer obstetrics care.
The chaos created by Bonner General's closure for the women I spoke with involved the most basic important stuff-- childcare, money. Some women told me they would lose a day's worth of pay every time they had to drive to an appointment. They talked about having to budget hundreds or even thousands of extra dollars for travel or housing in a place closer to a labor and delivery department, or switching to a midwife not covered by insurance. Or if they went to another state to get care, insurance might not cover that either.
I talked to one woman who told me she bought helicopter insurance for a medical evacuation flight, in case she started hemorrhaging or had some other kind of emergency complication. Turns out it's cheaper than you'd think-- $75. And she wasn't the only one. Helicopter insurance for normal pregnancies.
This woman's name is Jessie Grossman. She's 32 years old, and this was her first kid. And in Idaho, she worried the abortion laws tied doctors hands in too many cases.
Jessie Grossman
So I decided-- what I put in my birth plan was that if we do have to transfer to the hospital, I want to be taken to Washington. Like, I can be less worried about dying, basically.
But you know, then of course, I'm just spiraling about, well, what if the worst-case scenario happens? And what if I have sepsis? Is the helicopter going to be able to get us to Spokane in time? And just this, like, "am I going to die," "is my baby going to die," like, fear. And there's no guarantees.
Miki Meek
For anyone-- pregnant person, doctor, anyone-- who might want to look at the maternal mortality statistics in Idaho since the new laws passed, the state used to have a committee that tracked maternal deaths and their causes. But it doesn't anymore. The legislature decided not to renew it in its last session. Idaho is now the only state in the country without a committee like this.
So that's the situation for these women who just needed general OB/GYN care during their pregnancies. But then there are the high-risk patients, which includes, by the way, anyone who's expecting twins, anyone with high blood pressure or diabetes, anyone over 35, and anyone whose pregnancies include rare complications. These people are in a much more dire situation in Idaho now, because they may need what's called a maternal fetal medicine doctor. These are highly skilled OB/GYNs, specialists at keeping both the fetus and the patient alive and healthy through these pregnancies. And these doctors have been leaving the state.
Kayla Smith had a maternal fetal medicine doctor. Her first pregnancy had complications, but things were going smoothly with this one. It was a boy. She and her husband had picked out a name-- Brooks. And then, when she was 19 weeks, she went in for her anatomy scan.
Kayla Smith
And I just remember the sonograph. Like, I know they can't say anything, but she just kept going over his heart, like, quite a bit. And so of course I'm, like, talking myself down, like, it's fine. It's just different this time. Like, each person has a different way of doing things.
And then, it was just really quiet. And then she left. And so Dr. Cooper walked into the room.
Miki Meek
Dr. Kylie Cooper, her maternal fetal medicine specialist.
Kayla Smith
I just remember she had a diagram, and she-- I just remember her being like, I have never seen a heart defect this severe before. Like, they couldn't really see the baby's aorta at all. Like, his-- [SIGHS] I guess-- aortic arch wasn't really formed.
Miki Meek
The only thing Kayla wanted to know was, could Brooks survive past birth? She and her husband had already decided they could care for a child with special needs, so Dr. Cooper referred her to a pediatric cardiologist. But he told her, no. Brooks's chances of survival were very unlikely.
He called some of the best pediatric hospitals in the country, and none of them could offer her a surgical option to fix his heart. She remembers sitting in an ultrasound room with her doctor.
Kayla Smith
She's like, if you decide to continue this pregnancy, like, I'm here for you, and we will figure out what that means and where we need to go from here. She's like, but if you do decide that you did not want to continue this pregnancy, she's like, I'm just really sorry. (CRYING) There's nothing I personally can do for you.
Miki Meek
And you understood at that point, like, this is because of the laws.
Kayla Smith
Yeah. Yeah. I mean, her hands were tied. I knew, I knew she was protecting herself. But also, like, I would never ask her to be in that position. Yeah, we just all kind of looked at each other like, what the hell do we do now?
Miki Meek
Most patients like Kayla, whose pregnancies have what are called lethal and life-limiting fetal anomalies, choose termination, because continuing their pregnancies will result in miscarriage, stillbirth, or death shortly after delivery. But Kayla's doctor could not offer her a termination. Just a week or so before this, terminating a pregnancy like Brooks's would not have been considered an illegal abortion in Idaho. But now, under Idaho's new laws, it was.
So Kayla started asking her doctor about, what if she did continue her pregnancy and delivered Brooks's? What would it be like for him? Would he feel any pain during the birth? Would he suffer from air hunger, feel breathlessness as he gasped for air? But of course, her doctor couldn't guarantee that he wouldn't feel anything, even with palliative care and morphine.
Kayla Smith
So then it just also felt like there was only one option, and it wasn't one that we wanted to make. But I don't want my son to suffer. I don't-- I'm not going to put myself through that and also risk my own life. Because Dr. Cooper kept reiterating to me, she's like, you have a 40% chance of getting preeclampsia again.
Miki Meek
Preeclampsia is one of the leading causes of maternal mortality. It usually involves a surge in blood pressure that can seriously harm or kill a pregnant patient. It's unpredictable and hard to know when it'll happen and how severe it will be, which brings us to the main thing doctors find so frustrating about Idaho's new abortion laws.
There's language in the law that says they can't terminate a pregnancy unless it's, quote, "to prevent the death of the pregnant woman." Dr. Cooper said she doesn't know what that means. Does it mean she'd have to wait for Kayla to be near death's door from preeclampsia before she could intervene?
Her whole training-- all doctors' training-- is to stop problems before death ever becomes imminent. The only other situation where Dr. Cooper could terminate a pregnancy is if the fetal heartbeat stopped, if the fetus was dead. Kayla described her options in Idaho as a, quote, "shit buffet."
Kayla Smith
So do I risk going to term, knowing that I'm not even going to have a son to take home, and risk my life, and not be there for my daughter? I mean, I want to make it very clear that I was, at that point, 20 weeks pregnant. Like, I could feel him move. He was very active.
(EMOTIONALLY) And what that does to someone's mental health-- it's just devastating. Because I felt-- I just felt trapped.
There are some really dark thoughts that I never thought I would have thought. Things like, you know, is there a chance that his heart will stop? Because I know here, where I'm currently at in Idaho, that would be a reason for them to help me.
Miki Meek
I heard this from other pregnant women in Idaho with lethal fetal anomalies. They found themselves wishing for the heartbeats to stop.
Hearing that Brooks could suffer if he made it to term, Kayla decided to leave the state in order to end her pregnancy. She got an appointment at a hospital in Seattle, because she was so far along-- 21 weeks, second trimester. And because it wasn't clear if her insurance was going to cover it, she had to pay almost $15,000 up front. She and her husband took out a loan, and then drove seven and a half hours with their two-year-old daughter.
Kayla had a choice of how to end her pregnancy-- with a surgical procedure or by inducing labor early. Kayla knew she wanted to induce. She delivered Brooks after 12 hours of labor. He was stillborn. She says there was this weird eerie silence in the delivery room, and then everyone left so she and her husband could hold Brooks.
Kayla Smith
There were things that came up after that were kind of-- like, someone just-- people saying, congratulations, like just walking in the room and--
Miki Meek
Oh my god. Because they didn't know.
Kayla Smith
Right. [SIGHS] Right.
Miki Meek
Brooks was cremated. Two weeks later, Kayla made the seven and a half hour drive back to Seattle to pick up his ashes.
Kayla Smith
My parents would have, without a doubt, driven up to Seattle to get him if I needed them to, and brought him to us when they were able to come over here. But I just remember talking with my husband and being like, it doesn't make me feel good. Like, I feel like I just need to go. And he was like, then you just need to go.
And so I drove-- I drove over to Seattle with my daughter. It was one of those things that I was like, I just need to be in charge of this, so I know what's happening.
Miki Meek
Kayla was the first case like this that her doctor, Dr. Cooper, handled after Idaho's abortion laws changed, her first case where she couldn't do anything to help. Then there were more patients like Kayla she couldn't help. And in April of this year, she was the first maternal fetal medicine doctor to leave Idaho because of its abortion laws.
There was already a shortage of these specialists in Idaho before the laws went into effect-- only nine in the entire state. Now, there are just five, and one of those will retire before the end of the year.
That fear that every pregnant woman I talked to in Idaho had, that they'd be left totally on their own in a medical emergency, it happened to Becca, the last patient Dr. Cooper had to tell, I'm sorry, I can't help you, before she moved out of Idaho.
Becca is 31. She lives in the Boise area and used to oversee a fitness club. She went to college on a pole-vaulting scholarship.
When she was about 16 weeks pregnant, she learned that her fetus had a genetic anomaly. Multiple organs were developing abnormally, including its heart and kidneys. If she continued the pregnancy, she'd likely miscarry and was at risk for preeclampsia or severe hemorrhaging.
Becca
You know when you see in movies, and people get, like, a fatal diagnosis, and they just kind of go numb, and all you hear is a blabbering doctor in the background? And I don't actually remember a whole lot of that conversation. I just remember sitting there and trying not to bawl my eyes out.
Because we'd wanted this one. We wanted to grow our family. We tried for almost a whole year for this one. And we told people. We were like, yeah, we're pregnant. It's going to be exciting, you know. And we think it's going to be a little girl or something, you know.
Miki Meek
She decided to make the same choice Kayla made-- leave the state. Becca drove to Portland, Oregon, to terminate her pregnancy at a clinic. But that's not what she and her husband told their family and friends.
Becca
We were not comfortable being outright and telling them exactly why we were going to Portland. So we told family and friends that we were going for genetic testing.
Miki Meek
Yeah.
Becca
Just because it is so controversial right now in our state, and we didn't want to risk losing good relationships if it came down to it.
Miki Meek
Becca's story is different from Kayla's, because she wasn't able to get the full procedure. The night before her appointment for a surgical termination, she started miscarrying. It was around midnight. She was at a hotel with her husband and two-year-old daughter, who were sleeping.
Becca
And I was just laying in bed, and I started counting and counting. And contractions were happening every 30 seconds. And so the only thing that I kept thinking to myself was like, oh, no, this is-- it's happening.
And so the only thing I could think of was to lay on my side, to breathe through it and relax, and just think to myself, like, I have to keep this thing in. I've got less than eight hours. I've got to keep it in, got to keep it in.
Miki Meek
The clinic didn't open until the morning. So Becca woke her husband, who phoned the clinic's on-call doctor. Becca says the doctor told them she'd be fine. She was just cramping.
Her contractions continued to get more intense, surging, and then backing off. Her husband kept going out to the hotel hallway to call the doctor again. They thought about getting an ambulance but knew their insurance wouldn't cover it.
Becca says she forced herself to not make a sound-- no crying or groaning. Her daughter was sleeping in a Pack 'n Play near her, and she didn't want to wake her up and scare her. Then what happens next gets graphic.
Becca
And then, right around 4 o'clock is when it-- all of a sudden, like, it was just a consistent, intense, just curdling, like, you-want-to-scream-and-grit-your-teeth contraction. And it lasted what seemed like forever. And then, the pressure was completely gone.
And then, all of a sudden, I started leaking amniotic fluid everywhere. So I ran to the toilet, and all of a sudden, my body, once again, had one another-- one of those contractions, and just squeezing like you're going to squeeze all your organs out of you. And out came the baby. And I looked down at the toilet bowl, and there it was. And I just kind of sat there and just stared at it.
Miki Meek
Becca got into the hotel shower, and again says she didn't make a sound, even when her husband was trying to get her uterus to contract so she'd stop bleeding, which meant kneading his fist into her lower abdomen, the way the doctor instructed him over the phone. She says it was incredibly painful.
Becca
And so laying in the shower and-- is just streams of blood going into the drain. And the whole time, you're just like, why is this happening? This should not be happening.
Miki Meek
If Becca had been able to get a termination in Idaho, it probably wouldn't have. Her doctor, Kylie Cooper, could have done the procedure as soon as she decided. Becca would have been in and out in a day, not in a hotel room far from home.
In the morning, when the clinic opened up, a couple of employees showed up to collect the fetus. Becca then hobbled over to the clinic for an exam. It was next to her hotel, and she had to walk past a line of anti-abortion protesters. Her husband had to stay behind to watch their daughter.
When she came back, they drove home to Idaho, seven hours. They sat silently almost the whole way.
Before talking to Kayla and Becca, one part of the post-Roe experience I'd never heard about was that people who had to travel out of state to terminate safely had all these complications figuring out what to do with the remains, because of rules about traveling across state lines with human remains. Becca had wanted to donate the body for medical research to give her pregnancy loss more meaning. But for logistical reasons at the clinic, she didn't get that option. Becca and her husband decided to cremate, but they had no idea when the clinic would send the remains.
Becca
A couple of weeks later, we're home, and a postal worker comes up to our door and was like, hey, I'm here. You need to sign for a package. And I was like, oh, OK. There's this white box that says, "remains," labeled on every single side of the box.
Miki Meek
For some reason, the box was addressed to baby and not the parents.
Becca
And the postal worker doesn't actually realize it until I was signing for it, and she saw the name on the top, and her face just fell. And she was like, OK, bye, and immediately just left. And I was just like-- [SIGHS]. So I just grabbed the box and shut the door and just sat down.
Miki Meek
As a terrible coda to a terrible experience, back home, Becca worried that people who'd helped them go out of state might get in trouble if she talked about it. It wasn't clear who a prosecutor might go after. So in the earliest, hardest days, she had a secret instead of just a loss.
Becca
I didn't feel like I could openly talk about it. And so a lot of the grieving process, at least for me, is being able to talk about it, write about it, like, you know, even just sympathize or empathize with other people who've gone through similar situations. People-- they just don't-- it made it a muted and quiet, very lonely grieving process.
Miki Meek
Becca and Kayla met recently. They're part of a group of people, with other patients and doctors, who are trying to sue the state, hoping to expand the exceptions in the abortion laws to include lethal fetal anomalies like the ones they had in their pregnancies. And most important, they want the law to allow doctors to provide abortions to preserve a person's health, not just to prevent their death, which is the language in the law right now.
Their case was filed by the Center for Reproductive Rights, who filed similar legal actions in other states with restrictive laws. They represented the abortion clinic in the Supreme Court case that overturned Roe.
I contacted the two Idaho lawmakers in the House and Senate who sponsored the law that criminalizes abortion. I wanted to find out how they think it's working. Were they hearing about the kinds of experiences I was? Did they know about the doctors leaving the state? Do they think they need to make any changes?
One of the law's sponsors declined an interview, and the other didn't respond to multiple requests. So I reached out to Republican lawmakers who voted for the law back in 2020, before Roe fell.
Senator Jim Guthrie represents a district in southern Idaho and identifies as pro-life. I was surprised he walked into the interview with a notebook with stats about the number of doctors who had left the state and started citing them. So far, it's at least 19 doctors. That worried him.
Jim Guthrie
I'm pro-life, but I think there's got to be some consideration for the docs as they practice, that they're not going to find themselves in court. The second is the health of the mom. Because when you talk about pro-life, the life of a mother is-- if you're trying to protect that, that's pro-life, too, to me.
Miki Meek
When you first voted for the abortion laws, did you think that Roe would actually fall, or did it feel more like a symbolic act at that time?
Jim Guthrie
That's a good question. And I think, to answer that honestly, probably didn't think it would happen. Because it had gone on for, what, 50 years? Something like that?
Miki Meek
He's the chair of a committee in the Senate that abortion bills go through before they go to the rest of the legislature for a vote. He says the language in the abortion ban was always more aggressive than his own personal beliefs.
Miki Meek
At that time when you voted for them, were you looking that closely at the language of the laws?
Jim Guthrie
You know, maybe there was some things overlooked, as far as what the consequences would be, because they weren't truly consequences yet. In your subconscious, you're thinking, it's not going to be overturned, so this is one way you can make a statement. You kind of get into that deal where if you're pro-life, even though the bill has some things that are problematic, you know, you're going to come down on the side of erring on the side of protecting the unborn.
Miki Meek
Like the other lawmakers I talked to, he says he believed the intent of the laws, when he voted for them, was to shut down abortions happening in clinics in the state, not to help shut down a rural labor and delivery unit or force patients to travel out of state because of severe fetal abnormalities. Those were consequences he didn't foresee.
Miki Meek
Now, seeing how things have played out, do you regret voting for those laws, or would you have done something different if you could go back in time?
Jim Guthrie
In the context of being pro-life and recognizing the importance of the unborn, I feel like that vote at that time, with what was in place as far as trying to push back against an embedded law, I think that was an appropriate vote at the time, even though once the Roe versus Wade was overturned is when the reality, I think, sunk in for all of us.
Miki Meek
I talked to three Republican legislators, and they were all in the same situation, trying to grapple with the consequences of what had just been theoretical policy when they first voted for them, but now was real law, affecting real situations in people's lives. Where Republican lawmakers used to be pretty much on the same side, now they have different ideas about how to apply pro-life to Idaho's new laws.
The next lawmaker I talked to was Representative Brent Crane. For nearly 20 years, he's represented a district outside of Boise and makes his living running a fire alarm and security business. He believes in life at conception and says he's proudly sponsored or co-sponsored more than a dozen pieces of anti-abortion legislation.
He and Senator Guthrie are on the same page, as far as seeing the need to broaden exceptions in the abortion laws. But they also have to work alongside lawmakers who think there shouldn't be any exceptions-- for instance, for rape and incest victims. Representative Crane describes them as still stuck in what he calls a pre-Roe mindset, where everything is still black and white. He says he used to view abortion that way, too, until Roe finally fell.
Brent Crane
I remember sitting by the fireplace with my wife. That's usually where we sit and download in the evening or early morning. And I said, I've got to get my head around this issue, because we are not prepared to deal with this as a state.
Miki Meek
What did you mean by that?
Brent Crane
A post-Roe environment is totally different. In pre-Roe, all legislation was crafted to try to set questions up before the court. Well, now, you're in a post-Roe environment where you have to govern. And that means you have to have legislation that is going to work.
And for a pro-life lawmaker-- most pro-life lawmakers will take a very conservative and very rigid stance on the issue of life. Like, no, I'm not-- I'm not going to give any ground at all for any more exemptions. That's it. Whatever. For me, personally, I think that there are some instances where the families need to make those decisions.
Miki Meek
Again, this is a place where lawmakers who used to all be on the same side of abortion are now in conflict. And there was a draft of a bill in the last legislative session that got to the main problem with the current law, the way OB/GYNs see it. The bill would have allowed abortions for some serious health complications before they became life-threatening-- in other words, letting doctors make decisions based on the health of the pregnant person, not just their potential death.
Representative Crane chairs the House committee that abortion legislation goes through. And he scheduled a hearing for the bill that he had to cancel at the last minute because he didn't have the votes to get it out of committee. For some of his members, considering the health of the pregnant person opened a can of worms.
Brent Crane
Behind closed doors, that was part of the debate. And then, if we're opening health of the mother, where does that stop? Is it mental health? Is it just tied to physical health? Is it financial health? What is-- how are you defining health of the mother?
Miki Meek
Representative Julianne Young is a Republican from southeastern Idaho. She's vice chair of that committee, and opposed that new language about health complications.
Julianne Young
What I don't want to do is put language in that's so vague that it has the effect of opening the door to abortion in situations where you could protect both lives. And so if we're talking about high blood pressure, if we're talking about conditions that are common to pregnancy, then we don't want that lumped into anything that could be a life-threatening condition for the mother. Because the reality is that as women, we put our lives on the line by choosing to have children. There are always risks with every pregnancy, and you can never eliminate every risk.
Miki Meek
What is your-- yeah, what's your medical knowledge of pregnancy?
Julianne Young
Oh, well, I'm not going to claim to be an OB/GYN, but I've learned a lot-- (LAUGHING) over the years. And you know, I guess I speak to the issue not as a medical professional but as a mother. That's really where my expertise is.
Miki Meek
She has 10 children. She switches off bringing her youngest two to the Capitol with her, and they sit in on committee meetings and hearings. Also, random fact-- turns out my uncle was her orthodontist when she was a kid.
Representative Young is wary of letting doctors consider the health of the pregnant person, of giving doctors in Idaho hospitals the kind of control they had before Roe fell. For Representative Young, the sweep of the new laws is not some overreach. It is the point.
Julianne Young
The concern, I think, with the health exception is that we have some in the medical community who have practiced in an environment for a lot of years where the life of the child was not valued equally.
Miki Meek
Are you talking about in Idaho hospitals specifically or--
Julianne Young
Around the country. Because that was the way it was. It was a fetus. It was a clump of cells. And there wasn't the protection in the courts for the life of the child.
Miki Meek
Unlike Senator Guthrie, who is worried about doctors leaving Idaho, Representative Young thinks that some Idaho OB/GYNs are exaggerating their fears about prosecution under the law. She says others are scaring themselves by overthinking the phrase, "to prevent death." She points to language in the law that says they can use their, quote, "good-faith medical judgment."
Representative Crane, who talked about the pre-Roe and post-Roe mindsets of Republicans, also agrees with her on this. On this topic, he doesn't see as much gray.
Brent Crane
If you're not performing elective abortions, you have nothing to worry about. Just like if you're not going over the speed limit, you don't have to worry about a cop pulling you over for speeding.
Miki Meek
"Elective abortions" is a phrase anti-abortion lawmakers and activists use. But it's not a medical distinction. In medicine, any termination of a pregnancy for any reason is an abortion, whether it's to prevent death, or to help rape and incest victims, or just not wanting to be pregnant. They're all just called "abortions." Disconnects like this in terminology are another frustration doctors in Idaho have about the new laws.
Miki Meek
OB/GYNs who have left and ones that are trying to figure out if they can stay but aren't sure if they can stay-- they're like, the law is still vague to me.
Brent Crane
What's the vague-- what's the vagueness in the law?
Miki Meek
The vagueness for them-- there's an exception for life of the pregnant patient. But what does that need to be? How is that defined? Is that 15% close to death? 50%? 45%?
And also, there are these things that come up. This person has preeclampsia. It is going to develop. I can't say when. They're like, I just-- I can't operate in that area, because there isn't that health language.
Brent Crane
So I mean, honestly, do you think that if a doctor says, hey, look, I'm going to have to take your child, goes to the dad, I'm going to either have to-- if I don't take the child, the mom's going to die, what do you want me to do? Take the child. He does that.
And you get a wildly aggressive prosecutor that says, I'm going to take you to court for violating the trigger law in the state of Idaho. You think a reasonable court of people that are made up of just honest citizens like you and I are going to say, yeah, we're going to throw you in jail for that? We're going to prosecute you for that?
They're not going to. How long has the law been in effect, right? It's been in effect a little over a year. Have any doctors been prosecuted? Have any cases come forward? No.
Miki Meek
I mean, I think what the doctors are saying is they're like, I know lawmakers are telling us that, but there is no guarantee that a prosecutor isn't going to come after me. There is no guarantee that a family member isn't going to sue me. And I don't want to have to go to court.
And I've also got kids, and I've got a livelihood. You know, we have an AG that's really aggressive. So they're like, the lawmakers' assurance of "no one's going to come after you," "you're not going to lose in court," isn't assurance for me.
Brent Crane
I understand. I mean, I spent more than almost 90 days listening to these exact same arguments. And so I mean, look, life of the mother is life of the mother. It's not this highly technical, highly nuanced argument that I think some of these folks are scared about.
I don't know. I mean, you're a reporter. I'm an alarm guy. For me, it's pretty simple. Life of the mother-- hey, the mother's life? Yeah, OK, then I have the ability to operate in this space.
Miki Meek
I mean, I think that's where OB/GYNs get mad. We have legislators who are not doctors.
Brent Crane
That's true. But on the flip side, you have doctors that are trying to tell legislators how to do their job. And we have constituents that are asking us, hey, this is what we want you to enact, and that's where the tension exists.
Miki Meek
I ran by him and Representative Young some of the specific experiences I'd heard from pregnant women and OB/GYNs-- the actual people who've been stuck shouldering the emotional and logistical burdens of the new abortion laws-- and how disconnected they said they felt from this new era in Idaho that's supposed to be pro-life and pro-family. Here's how Representative Young sees this moment.
Julianne Young
So what I hear you describing a lot seems like adjusting to a new situation. And undoubtedly, there's a little pain with every change. So we just don't live in a world where everything works out perfectly all the time. And so that-- just because there's some inconvenience associated with making the policy change to protect life doesn't mean that it's not the right thing to do. Because there's always two sides to the story, and there are a lot of babies who are going to live in this state that might not have lived.
And that's valuable. That's worth protecting. That's worth paying a price for, even, if it means that there has to be some growing pains associated with that.
Miki Meek
OB/GYNs in the state have been telling me that access to good maternal health care in Idaho has deteriorated so rapidly over the last year that the state is now in crisis. Does that feel accurate to you, is "crisis" the word that you would use?
Julianne Young
Yeah, you know, I guess I haven't seen that yet. But what I keep coming back to as a legislator, if you're a physician that doesn't want to adhere to a standard of protecting both the life of the mother and the life of the child, then that may be frustrating for you. I think there's going to be some sorting out, maybe, as the standard of practice adjusts to what the statute is.
Miki Meek
Do you-- I mean, I guess the concern is like, if people-- an adjustment is-- yeah, like--
Julianne Young
I guess what I'm saying, Miki, is I don't think that we have to desert this value of protecting life in order to have a thriving OB community. We should be able to make these two things work together. And it might take a minute to have the conversation and figure it out, but I do believe that it's possible.
Miki Meek
In the year after Idaho's new laws went into effect, Representative Young and other lawmakers did end up making a few changes to the law. Some of the most notable-- abortions are now legal for certain kinds of pregnancies that are never going to be viable, like ectopic pregnancies. And abortions are now legal for rape and incest victims, if those victims do it in the first 13 weeks and file a police report. Since most sexual assault victims never report, this is still a steep barrier.
But the thing OB/GYNs wanted most-- new wording that would allow them to consider the health of their pregnant patients-- legislators didn't give them that. The lawmakers say they're still working on it. But after that legislative session ended, that's when most of the OB/GYNs who left the state or decided to retire early got out.
We're living in this moment where there's a political and ideological sorting happening in many parts of the country. There are people who are picking up and specifically moving to red or blue states to escape the laws their state legislatures have passed. It just seems easier than trying to change the politics of the place where you live.
But the big question for the patients I talked to in Idaho is, how many OB/GYNs will still be left standing to care for them after the "sorting-out" period Representative Young brought up is finally done? In a recent survey, 50% of OB/GYNs in the state said they were definitely leaving or still considering leaving-- 50%.
Ira Glass
Miki Meek is one of the producers of our show. Two of the women in her story with high-risk pregnancies, Becca and Kayla, are pregnant again, both with girls. Kayla recently moved out of state because of the abortion laws.
Credits
Ira Glass
Well, today's program was produced by Aviva DeKornfeld and Nancy Updike. The people who put together our show today include Jane Ackermann, James Bennett II, Susan Burton, Jendayi Bonds, Sean Cole, Michael Comite, Bethel Habte, Stowe Nelson, and Katherine Rae Mondo, Nadia Reiman, Alix Spiegel, Lilly Sullivan, Frances Swanson, Christopher Swetala, Matt Tierney, Julie Whitaker, and Diane Wu. Our managing editor is Sarah Abdurrahman. Our senior editor is David Kestenbaum. Our executive editor is Emanuele Berry.
Special thanks today to Emily Corrigan, Stacy Seyb, Katie Bradish, Lauren Sanders, Leandra Wright, Jaclyn Kettler, Paige Belfry, Jen Jackson Quintano, Becky Uranga, Liz Woodruff, and Ali Block from the podcast The Nocturnists. Our website-- thisamericanlife.org, where you can stream our archive of over 800 episodes for absolutely free-- thisamericanlife.org.
This American Life is delivered to public radio stations by PRX, the Public Radio Exchange. Thanks as always to our program's co-founder, Mr. Torey Malatia-- I don't know how he snuck into the Republican caucus this week, as it's been fighting over who the new House speaker should be. He said he totally figured out how to tell when any Republican was going to vote against Jim Jordan.
Wes
They make a really distinctive-- [HUFFING] sound when they're really, really upset.
Ira Glass
I'm Ira Glass. Back next week with more stories of This American Life.
