‘Just as bad as denying penicillin to a sick man’

As a medical student in 1968, Michael Crichton adopted a pseudonym to write a thriller about a young woman seeking an abortion, at a time when abortion was mostly illegal in the US. The book still packs a humane punch today.

Jennie Bristow

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Michael Crichton, who died on 4 November at the age of 66, will always be best remembered for bringing dinosaurs to life in Jurassic Park. But his work dealt with real-life dramas, too – like illegal abortion in America, before the landmark 1973 judgement Roe v Wade.

Crichton wrote A Case of Need in 1968, under the pseudonym Jeffery Hudson. In the novel, a well-connected young woman dies following an abortion, and the hunt is on for the abortionist who killed her. Crichton’s protagonist, John Berry, is pulled into the drama when his closest friend is arrested. Art Lee is an obstetrician who carries out abortions; Berry, a pathologist, helps him to cover up his activities. The question is not whether Lee conducts abortions, but whether he conducted this particular, fatal abortion.

A Case of Need manages to combine a zany, implausible plot with a moral fable that somehow resists pat moral conclusions. With the geekish addition of scientific footnotes and appendices, it is vintage Crichton – despite the fact, as Crichton later wrote, that this is ‘the work of a young man, not yet 25 years old, writing with enthusiasm and considerable haste’. And not to mention the other fact that, as with the other medical thrillers he wrote at the time, the primary aim of this endeavour was to finance his way through medical school: ‘My method was to accumulate debts until my next vacation. Then I would sit down, push my textbooks aside, and write furiously for 18 hours a day.’

When A Case of Need won a literary award, Crichton’s main fear was that his lecturers would discover the man behind the ‘Jeffrey Hudson’ pseudonym, and never take him seriously as a doctor.

Yet despite his youth and lack of literary pretension, Crichton in 1968 handles certain aspects of the abortion debate with a maturity lacking in many of those who approach the issue today.

Art Lee tells us why he decided to conduct abortions, despite the knowledge that he was committing a criminal offence. A woman asked him for an abortion; when he refused, ‘she said she knew of a man in the North End who would do it for two hundred dollars. He had been a medical orderly in the Marines, or something.’ The prospect bothered Art all night:

‘I had a vision of her going to a smelly back room somewhere and meeting a leering little guy who would letch her and maybe even manage to kill her. I thought about my own wife and our year-old baby, and how happy it could all be. I thought about the amateur abortions I’d seen as an intern, when the girls came in bleeding and foaming at three in the morning. And let’s face it, I thought about the seats I’d had in college. Once with Betty, we sat around for six weeks waiting for her period. I knew perfectly well that anybody can get pregnant by accident. It’s not hard, and it shouldn’t be a crime…

‘By morning I had decided that the law was unfair. I had decided that a doctor could play God in a lot of crappy ways, but this was a good way. I had seen a patient in trouble and I had refused to help her when it was within my power. That was what bothered me – I had denied her treatment. It was just as bad as denying penicillin to a sick man, just as cruel and just as foolish.’

John Berry never wavers in support of his friend, though his own attitude to abortion is ambiguous. ‘I suppose I should question his motives’, he muses at one point. ‘But I don’t usually, because I feel that a man’s reasons for doing something are less important than the ultimate value of what he does. It is a historical truth that a man may do the wrong thing for the right reasons. In that case he loses. Or he may do the right thing for the wrong reasons. In that case, he is a hero.’

But what about Crichton himself? In a new introduction to A Case of Need, written in 1993, Crichton wrote:

‘One issue ignored by medicine in my student days was the problem of abortion, which was then for the most part illegal in the United States. A million American women flew out of the country every year to have an elective abortion. Those who could not afford the plane fare often showed up, septic and bleeding, in hospital emergency rooms. There were abortionists in every city, back-room mills, and whispered addresses passed to frightened women in need – a tawdry, dangerous industry which the medical profession pretended did not exist.’

All of which created a situation where illegal abortions were ‘about 25 times as deadly as they had to be’ – a situation that, as Crichton protested to one of his colleagues, was ‘medically dangerous and unfair’.

But Crichton was not only motivated by the humane pragmatics of legal versus illegal abortion. In one of the seven appendices to this short thriller, he briefly lays out six main arguments for abortion, and their counter-arguments. He concludes:

‘There are other arguments, but they are mostly evasive and petty. There are economic arguments concerning the cost of turning hospitals into abortion mills; there are vague and wild-eyed arguments of unleashed libertinism, similar to the arguments heard before the introduction of birth-control pills. There are also reflex liberal arguments that anything freer is by definition good and meritocratic arguments that the outpouring of children from the lower classes should be stemmed. There is no point considering these viewpoints. They are advanced, for the most part, by thoughtless and irritable little men.’

Jennie Bristow is editor of Abortion Review, where this article first appeared.

A Case of Need, by Michael Crichton, is published by Arrow Books. (Buy this book from Amazon(UK).)

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