Kristin Ito

UNPLANNED

KRISTIN ITO

Cosmonauts Avenue, July 2020

A petite, tan girl, maybe 16 or 17, sits beyond the Plexiglas window, waiting to see if she’s pregnant. Behind the desk, I’m shadowing Mariana, who’s worked at this clinic for a few years. I just started last week.

The teenage girl in the waiting room is pretty: big eyes, full lips, cinnamon brown hair with blonde highlights. She looks trendy and put-together, an oversized bag in her lap, her sandal-clad foot tapping lightly on the ground.

Back in the lab—a kitchen-like corridor just big enough for two people to pass through—Mariana and I take a pipet of the girl’s urine and drip-drop it onto a rectangular plastic slab. It’s flat like a domino and houses a paper strip, a smaller version of the dipstick test we’ve all used at home. The second pink line comes in faint at first, then darkens.

“Mmm hmm,” Mariana says. “She’s probably taken a test at home already.” With that, she pulls her gloves off into the trash can and nods at me to come with her.

“Jazmín?” she calls into the waiting room.

The girl follows us into a windowless room the size of a closet. It’s warm and stuffy but the walls are cold. We sit down.

“Your test is positive,” Mariana says. “Based on when you told us your last period was, you’re about five and a half weeks along.”

Tears are streaming down the girl’s face, and she dabs at them with her slender fingers. Mariana hands her some tissues from a box I hadn’t noticed before and softens her voice as she goes over the options. I want to wrap my arms around the girl and let her cry into my velvety scrubs. But instead I just listen as Mariana comforts her with well-practiced words, with reassurance that this happens, that she has choices, that she is safe, that everything will be all right.

When the girl leaves, I notice that Mariana looks shaken. Running a hand through her curly black hair, she smiles at me distractedly. I think Mariana’s in her early twenties, maybe 25. I wonder if she has a younger sister, or if she’s thinking about herself at that age. I wonder if some just get to you more than others.

A few weeks before, I’d hurdled down the 5, my car stuffed to the brim with my belongings. I’d left Seattle, the guy I was seeing, my tiny studio apartment on Capitol Hill. I’d run through my savings and had been unemployed for six months. It had been a wild, dizzying summer. I’d applied for writing jobs, and when that failed, I dropped my resume off at restaurants and bars. My server friends made it look so glamorous. I hung out with them since I also had nowhere to be in the mornings. We stayed out until 3 or 4 a.m., got up and went out for reubens in the early afternoon. I was on cloud nine, drunk a lot of the time, and both in my element and out of control. When I still didn’t have a job by the end of the summer, I left.

My parents welcomed me back, as they always have, into the southern California ranch-style house where I grew up. At night I read in my childhood bedroom by lamplight, surrounded by frayed stuffed animals who’ve seen me come and go.

I am 27, and lost. All I want is some sort of path, so I come back to something that interested me since I was a teenager and had my first appointment with my mother’s female gynecologist: women’s health. I take a month-long nurse assistant training course, enroll in anatomy at community college. I find a position open at a Planned Parenthood a few cities away. In the early mornings, I leave my parents’ house in the quiet darkness and inch my way through the concrete desert, while the sun begins to burn orange behind me.

I’m trained on all the birth control methods. I memorize the effectiveness percentages, the most common side effects. I learn to take vitals and discover which exam rooms have the digital blood pressure monitors, and which ones will require me to use a stethoscope, the ear pieces so hard they hurt as I listen for the muffled beat.

We have laminated sheets the patients fill out with dry erase pens. I go over all of the answers and enter the information into the computer, black ink coming off powdery on my fingers. Number of sexual partners. Vaginal, anal, oral. Five days, heavy flow the first two days, bad cramps for three. The pill, always at the same time every day. Headaches and weight gain.

I show them the ring, bend the “O” into a skinny 8 and back to show how flexible it is. I have a soft, peach-toned model of what’s supposed to be the skin on the inside of your upper arm. “You can barely feel the implant,” I say. “It’s the size and shape of a matchstick.” Most end up opting for the pill, though, and I put everything back in the drawer.

I look out into the dim waiting room. The ceiling hangs low and the walls are lined with chairs, the type made of synthetic leather that sticks to your thighs. On these hot summer days, all the seats are filled within minutes after we open and remain filled until the end of the day. I never see men in the waiting room, which confuses me since aren’t they the whole reason we’re all even here? Once in a while, a man does come in to get treatment for genital warts. And in the afternoons, sometimes, teenage boys will stumble up to the front desk and mutter “condoms” under their breath. We spend our downtime packing them in brown paper lunch bags, counting them out ten at a time. They crinkle like candy wrappers, and we pass them across the counter like contraband.

I see Mariana once in a while in the break room, coming in or leaving. Somehow our shifts never align, but I often think about that day with her and the pretty pregnant girl. I want to ask Mariana what happened to her, as if she would know, as if somehow she’d managed to bypass patient confidentiality rules. Sometimes I daydream about the girl. She seemed like the type who’d have an older boyfriend, maybe an emo type who wears eyeliner and a vegan leather motorcycle jacket. I wonder how she told him, and if she’d cried again. If he’d wiped away her tears. If he’d made her keep it.

One of the trainers, Carolina, is showing us how to draw blood. We all need to learn, since almost every patient who comes in gets STD testing. So here we are with Carolina, going over the steps, our materials set out on the table: the needle, the plastic hub, the vacuum-pressured tube, the alcohol wipe, the cotton ball, the adhesive tape. The blue rubber tourniquet we’re not to leave on for more than a minute.

I’m not afraid of needles or blood, but I’ve never done anything like this before. I look around for fake rubber arms or dummies, but then I realize: we’re going to practice on each other. Carolina pairs us up, and I’m with Carmen, a sweet girl who wears headbands and hasn’t lost her baby cheeks.

My hands prickle with sweat inside my gloves. I attach the needle to the hub. I rub the soft crease of Carmen’s forearm with the alcohol wipe, circling longer and more slowly than I need to. I say the steps in my head as I do them, and think I can do this as I press the needle down and into Carmen’s vein.

Nothing. No blood.

Where is the blood?

Carmen giggles. She doesn’t move a muscle.

“Just pull out a little bit,” Carolina says, coming up behind me.

She puts a firm hand on my shoulder. Though I can’t feel them, my hands must have understood because suddenly, blood is flowing into the tube. I can feel my whole body relax and Carmen’s, too. I snap the cover over the needle and drop it into the Sharps container. Carmen smiles at me.

“Your first one,” she says. I write it down on my sheet, and Carolina signs it. I’m determined to fill it with more successful draws.

Later that night in my bed, I think about how forgiving a vein is. How I went completely through Carmen’s, but it didn’t whither or dry up, how it still gave to me. How her lifeblood was there just beneath the surface. How strange it felt to break through skin like that. How fragile we are, how full.

My grandmother is Catholic, and I remember going to mass with her a couple of times as a child, on weekends my parents were out of town. As we stood to get in line to receive communion, she showed me how to hold my arms across my chest to let the priest know that I was not Catholic, that I could not receive the body and blood of Jesus. I didn’t care about the wafer or grape juice, though, and only wanted to get back to playing games or gardening with my grandma. Now, she’s ninety and has started to repeat herself, asking the same questions over and over.

Many of the women who work at the clinic are Catholic, too. One day while we’re working the front desk, Carolina tells me she had a child when she was 16. She shows me a wallet full of pictures of her daughter who’s almost a teenager. She’s the smartest girl in eighth grade and Carolina is so thankful for her baby, so happy she kept her. She couldn’t imagine her life without her.

I think about how the people who protest outside our building most days don’t know about Carolina, don’t know that a pro-life mother works here. I think about what they’d say if I told them, if anything I can say or do would stop them from screaming with angry eyes.

I come home from work one day, and my grandma is at the kitchen table, flipping through a magazine. One good thing about moving back home is that I’ll get to spend more time with my grandma: she lives with my parents for weeks at a time, now that my grandpa has passed away. I go to my room to change out of my scrubs and return to the kitchen.

“Hi, Grandma,” I say, grabbing a banana from the counter. She looks up, her round, cherubic face lighting up with a smile.

“You’re home,” she says.

I sit down at the table next to her and take bites while rifling through sections of the Los Angeles Times.

“What do you do at work?” my grandma asks, looking up from her magazine, her brow furrowed.

“I work at a health clinic,” I say. “I’m an assistant.”

“Oh,” she says, with no expression of recognition. But after a beat, warmth spreads over her face like hot steam from a teacup. “You must be very good with the patients.”

I smile at her and pray that she’ll remember this conversation tomorrow, even though I know that’s not how it works.

“Mariana!” I say, as I walk into the front office.

“Hey, girl,” she says. I’m excited to be working with her, and also relieved. Mariana speaks Spanish, and will take the patients who don’t speak English. Plus, she’s fast. The front desk gets frenetic, and often it seems like two people aren’t enough.

I log into the computer and quickly look over the schedule. Fully booked, as usual.

“Ready?” I say, getting up to open the front door of the clinic.

“Hell, yeah,” Mariana says.

She takes the first person in line, I take the next. Most of the patients this morning are new, which means a steady flow of running Medicaid cards, entering contact information, scanning forms, printing labels. We have to think three steps ahead, so we don’t fall behind.

I don’t stop to breathe until late morning when there’s a stretch of calm. Mariana leans back in her chair and pulls her purse out from under the desk.

“Last night we had another fight,” she says. “My boyfriend and I.”

I don’t know what to say. Mariana takes out a wand of nude gloss and applies it slowly on her lips.

“He doesn’t have a job right now,” she says.

“I’m sure he’s trying,” I say, but I immediately regret it. Why am I defending someone I don’t know?

“Not as hard as he tries at Halo,” Mariana says. I laugh, but see that she’s serious. I think about her boyfriend playing video games all day with the shades down. I wonder if she cleans up after him, picking up socks and empty soda cans off the floor.

“Hey, maybe we can go to The Hat and get pastrami sandwiches for lunch,” I say, as I take the next patient in line.

I never actually see an abortion. I’m not trained to assist with them, but Mariana is, and sometimes I help her fold blankets and arrange the juice boxes and crackers they’ll use the next day in the recovery room.

What I do see is hundreds of people with uteruses trying to find a contraceptive method that works with their bodies. People in need of birth control so that they can function each month without debilitating menstrual cramps. People getting tested and treated for sexually transmitted diseases. People getting cancer screenings. People getting healthcare.

I no longer work in scrubs or draw blood, and I’ve moved far away from the clinic. My grandma is gone, her sweetness a memory that floats around me like the incense at her memorial service.

But now, it is anything but sweet. It is all rage—the pandemic numbers swelling, the defensiveness of racists rising, hot and shrill. The wealth gap widening like COVID hot spots, disparities in access to healthcare becoming deadly clear. It’s hard to focus or remember what happened last week, much less something that happened last year: 25 states passed new abortion bans. And we’re still under an administration that wants to defund Planned Parenthood.

I do not know if Mariana and Carolina and Carmen still work in that crowded clinic. But I do know that what we so desperately need right now lives in the hearts of people like them.