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David: When did you start working with Dr. Tiller and how did it come about?
Dr. Robinson: I started doing abortions in 1995 after the Salvi shootings in Brookline, Massachusetts. By 2000 I had dropped OB and general GYN and was doing only abortion care. I remember reading and hearing about the mythic Dr. Tiller and the troubles he was having with Operation Rescue in Wichita, and wishing that I could do something to help him.
Then at a professional meeting in 2003 or 2004, at the opening reception, there he was. So I went up to him and said "I just want you to know, you're my hero" and he said "Come and visit us in Wichita." As soon as I got home I started an application for my Kansas license. And I did go and visit, but he wasn't really looking for help at that time so there was no offer of a job.
In mid-2005, I got a call from him saying that he was looking for a third doctor to help him. I lived in Northern California so that meant driving to San Francisco (3 hours) and then flying to Wichita, staying for the week and coming home. No problem. I was happy to say that I had a Kansas medical license and could start as soon as he wanted.
Dr. Sella: I started working with Dr. Tiller in June 2002. We met for the first time at a professional postgraduate seminar in September 2001. I went to his booth where he was showing a video of a third trimester abortion. In person, he told me one of his truisms: "The woman's body is smarter than the doctor. Time, patience and the baby will come." When I said, "That's midwifery!" his interest was piqued, and within five minutes, he had offered me a job.
Before beginning my residency in Ob/Gyn, I had worked with home birth midwives. Midwifery's focus on respecting the woman and the natural process of birth inspired me. Dr. Tiller's similar approach to abortion care resonated deeply.
He was starting to think of retirement, and he was looking for someone to train and to eventually take over the practice. Through our rather painful ensuing negotiations, he came to realize that I was not going to move to Wichita with my family, nor would I take over the practice. Instead, we worked out a compromise where I would commute from California. He would train me to carry on his legacy. In the beginning, I trained with Dr. Tiller every other week. Eventually, I worked there every third week.
David: What was your favorite part of working with him?
Dr. Robinson: He was a brilliant and very patient teacher. He had an extraordinary sense of when to leave the room long enough for me to be pushing my limits, and then to amble back into the room asking how everything was going. He watched and supervised and made certain that I was doing things the way he wanted. This included time in the operating room but also discussing issues with patients and facilitating patient group discussions. This was no 'see one, do one, teach one.' He knew what he wanted from me, and he taught me till he got it.
He was very polite and formal with his staff and he ran a very tight ship. He did management by walking around and often said "You have to Inspect what you Expect." He also often said that if you have authority, you have to exercise it, sometimes in an arbitrary or capricious way, otherwise someone would come along and take it away from you.
In conversation he would listen absolutely, never interrupting, never even nodding or making encouraging "uh huh" noises the way women are used to doing. And when he was talking, if I said "uh huh" or "yes" he would stop talking as though I had interrupted him. He really listened and he really heard and took in what the other person was saying. He really thought about it.
Then he would make up his mind, say "this is how it's going to be" and there was NO further discussion. Even with a fetal indication patient who had come from hours away -- if he felt that she was unsure about having an abortion, he would say that -- say that he wouldn't do it and that she should go home and think it over. I remember once he did that with a patient from the UK. I was sitting in on the interview and I was shocked since I had heard no uncertainty in her voice, but all she said was "Thank you so much; you're right."
Dr. Sella: I had been looking for a mentor for abortion care for years, and so training and then working with him was like a dream come true. I loved his meticulous attention to detail, both the technical aspects of the work and the emotional aspects. I loved his astute psychological insight into our patients and how he was able to establish connections with them. I loved sitting with him in his office and listening as he talked to patients, and I loved talking with him. He was an excellent teacher who became a wonderful colleague and friend.
David: He was a proud member of Abortion Care Network. Do you have a sense of what it meant to him to provide abortions at an independent clinic?
Dr. Robinson: I don't think he could ever have functioned in anything but an independent clinic setting. He had very strong opinions about how things should be done, he was the boss, and he built an organization where he could do things the way he wanted and the way he thought they should be done.
Dr. Sella: He was an abortion provider, but he was also a small business owner. He liked the control that offered him, allowing him to create the environment that he thought was best for patients and staff. He had a vision of how abortion care should be provided and was able to implement that.
What I remember most about his clinic was the warmth and dedication of the staff. The care we gave patients was so personal, and it was Dr. Tiller who set the tone for that. We spent as much time as needed with our patients. There was a chaplain on staff who would minister to the spiritual needs of the patients and their families. We held support groups for the third trimester patients and families. This kind of care would not have been possible within the framework of a large, non-independent institution.
Outside the clinic were the protestors with their bullhorns, ranting and raving. Outside, were all the companies who refused to do business with the clinic. Outside, was the community that had publicly abandoned Dr. Tiller. Inside, was warmth, tolerance and understanding. The clinic was an oasis of compassion in a desert of intolerance.
David: How did his assassination affect you?
Dr. Robinson: I really had two lives: my life with Dave, my husband, in California and my life in Wichita with Dr. Tiller and the clinic staff. They felt like a second family. They were my important social connections aside from Dave. When he was assassinated and Jeannie decided to close the clinic I felt as if my family had all been killed. The people with whom I was used to being social all disappeared in a puff of smoke. I have never experienced anything like it although I have been there for the deaths of both my parents. Dr. Tiller was the glue that held together half my life and his murder shattered that.
Dr. Sella: My father died three months before I met Dr. Tiller, and then Dr. Tiller assumed a father/ benevolent patriarch role for me. I felt a deep connection to him, and his violent death was shattering to me.
David: You were both featured in "After Tiller" as part of a handful of providers in the country providing late abortions. What does this mean to you, to be carrying on Dr. Tiller's legacy?
Dr. Robinson: When we started looking for a place to continue doing third trimester abortions, we were determined that Dr. Tiller's assassination should not close down the service even if it succeeded in closing down his Wichita clinic. We knew that the patients who needed this care were still out there and we wanted to keep it available. We looked for a place until we found our current practice in Albuquerque.
Dr. Tiller would have disapproved of our being in "After Tiller." He refused all interviews, saying that "it is about the patient, not about me." In fact, having learned this attitude at his knee, so to speak, we said no to the directors for a long time. We changed our minds because they were persistent and very likeable, because we wanted to help give a good face to later abortion (counteracting Kermit Gosnell), and because we became progressively more aware that being silent about providing abortion care is really cooperating in its stigmatization. So we broke completely with that aspect of his legacy by participating in the movie.
Dr. Sella: It's a tremendous honor to carry on Dr. Tiller's work. I can only hope that we do him justice. At the same time, I think it's important to recognize that our work is not stagnant. Thanks to the opportunity that the Boyds (owners of the Albuquerque practice) presented us, we've been able to further develop the practice. Like Dr. Tiller, our practice continues to be acutely sensitive and responsive to women's emotional, as well as, physical needs. A comprehensive counseling program for patients that plays a huge role in our care and midwifery continues to influence our practice. I think that our practice has become a synthesis of Dr. Tiller, the Boyds and us.
David: He was killed before the new wave of anti-abortion legislation starting with the Tea Party takeovers of state legislatures in 2010 and beyond. How do you think he would have reacted to what's going on now with abortion in this country?
Dr. Robinson: He would have been horrified and disgusted at the wave of anti-abortion legislation that we have seen in recent years. He must have had a lot of influence or lobbying power to hold off the Kansas government as long as he did; I wasn't privy to how he managed it. He was a good businessman but he regarded his abortion care practice as a "ministry to women" (his words).
Dr. Sella: Things were looking grim even at the time of his death. Arch-conservative, anti-abortion Sam Brownback was elected governor of Kansas shortly afterwards and signed a ban on abortions after 20 weeks.
Dr. Tiller had worked tirelessly over the years to ensure that women had access to abortion and Julie Burkhart continues to champion his legislative leadership legacy in Kansas.
David: How can we encourage new, young abortion providers to not only be providers, but to have a practice that includes late abortion care, like Dr. Tiller and both of you?
Dr. Robinson: I think there are plenty of young doctors who want to provide abortion care but are unable because of restrictions by their employers (as Lori Freedman's book shows). I think that abortion providers should (continue to) speak out proudly and loudly about their work, doctors and patients should put pressure on medical practices and hospitals to allow abortion care, and that the public should be made aware of the danger that the Catholic ownership of hospitals poses to women's health.
Dr. Sella: Realistically, we don't need many providers offering third trimester care, since third trimester abortions are a minute proportion of abortions that occur in the United States. We do need providers to offer first and second trimester abortions in underserved areas in the United States, which, aside from some metropolitan areas, means the whole country. It is important that those providers have an understanding of third trimester abortions and be able to refer to clinics that do offer them.
I am encouraged by the number of young doctors that would like to provide abortions. They are constrained however by numerous factors including, restrictive abortion laws in their states, medical groups which forbid its doctors to provide abortions as well as Catholic hospitals which forbid them as well.
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